HomeMy WebLinkAboutRes-2016-096BOARD OF COUNTY COMMISSIONERS
COUNTY OF KITTITAS
STATE OF WASHINGTON
RESOLUTJOJlf
NO. 2016-0 q {fJ
RESOLUTION TO ADOPT THE KITTITAS COUNTY PUBLIC HEALTH
DEPARTMENT'S EMERGENCY OPERATIONS PLAN
WHEREAS, Kittitas County, through the Kittitas County Public Health Department (KCPHD),
is charged with the preservation, promotion, and improvement of health in the
County; and
WHEREAS, the preservation, promotion, and improvement of health includes emergency
response and preparedness; and
WHEREAS, KCPHD has developed a comprehensive Emergency Operation Plan (EOP) that
provides guidelines for coordinated preparedness and response to emergency
incidents that may have public health implications in Kittitas County, which is
attached hereto and incorporated herein by reference.
NOW THEREFORE, BE IT RESOLVED that the Board of County Commissioners of Kittitas
County, Washington, adopts the Kittitas County Health Department's Emergency Operations
Plan that is attached hereto, and incorporated herein by reference .
DATED this ~ day of ----.1.ro~~~~'="lI.liti;""'" ..::......._~, 20 16~ at Ellensburg, Washington. o
BOARD OF COUNTY COMMISSIONERS
KITTITAS COUNTY, WASHINGTON
~{)f;[(ifL ,
Obi ' . Chairman
Jewe V ice-Chairman
La ~ Commissioner
~A1~~I<J
. .eJ Julie Kjor vii< Clerk of the Board
o Mandy Buchholz, Clerk of the Board
Kittitas County Public Health Department
Emergency Operation Plan
(Updated: 6/2016)
1
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT
The Kittitas County Public Health Department on this day hereby adopts this Kittitas County
Public Health Department Emergency Operations Plan for emergency preparedness by majority
vote of the Board of Health.
Paul Jewell, Chair
Board of Health
Laura Osiadacz
Board of Health
Dr. John Asriel
Board of Health
Date -------
Rich Elliott, Vice Chair
Board of Health
Obie O'Brien
Board of Health
It is the responsibility of the Kittitas County Public Health Department to prepare and maintain
procedures and guidelines in order to provide KCPHD emergency preparedness stajJtraining,
exercises, and an updated emergency operation plan.
2
Kittitas County
~ ... ., Department
To Protect and Promote the Health and the Environment of the People of Kittitas County
June 2015
The Kittitas County Public Health Department Emergency Operation Plan is a practical guide
that helps you prepare for an emergency and defines your role and responsibilities as a
department employee in the event of an emergency or disaster. The 2015 updated plan
supersedes all previous emergency operation or emergency response plans.
As a Kittitas County Public Health Department employee, you are a vital and important member
of the department's Emergency Response Team. Without you, the careful plans and preparations
we have made to provide assistance to our residents may not succeed.
This plan is designed to guide you in how to respond to emergencies and disasters as a first
responder under the public health agency. As an employee, you are required to know the goals,
roles, and responsibilities assigned to the public health department in the event of a disaster.
Even though we may not be able to prevent a disaster such as a catastrophic earthquake, we can
be prepared. When disaster strikes, the speed and efficiency with which the department responds
and the skill with which we perform our assigned duties will lessen the impact on the people of
Kittitas County.
Your help and cooperation is greatly appreciated!
Dr. Mark Larson
Health Officer
3
Record of Changes Change linked to AAR?
Incident Name?
Text formatting changes, updated
officials information
1-7.19.2011 Sarah Bedsaul
Plan restructuring to follow . Comprehensive Preparedness
2 . 1.22.14 Kasey Knutson Guide 101 recommendations
3. 6.30.2015 Kasey Knutson Annual Updates
Zach Vavricka Addition of Point of Distribution
forms, CD and EH annex, mass
fatality annex.
4 . 9.10.15 Kasey Knutson Procedures defining how KCPHD
will request assistance during
disasters from the local
Emergency Operations Center
(EOC), neighboring LHJ s, and
DOH.
5. 10-5.2016 Kasey Knutson Added column to show revisions
Zach Vavricka made that are linked to an AAR
6. 10-5.2016 Kasey Knutson Included decision making protocol
Zach Vavricka language for health officer to make
policy level decisions during
emergency.
4
Record of Distribution
10.2.14 Mary Small Chelan Douglas Health
1. District.
10.2.14 Theresa Adkinson Grant County Health District
2.
3. 10.2.14 Jon Ness Grant County Health District
4 . 10.2.14 Douglas Hale Okanogan County Health
District
5. 10.2.14 Alma Castillo Chelan Douglas Health
District
6 . 10.2.14 Dan Banks Washington State Emergency
Management
7 . 10.2.14 Darren Higashiyama Kittitas County Sheriff s
Office
8. 10.2.14 Rachel McKinlay Washington State Department
of Health
5
Record of Exercises and Incidents
1.
2 . -3.
4.
5 .
6.
7.
8.
9.
10..
11.
12.
13.
14.
15 .
6
TABLE OF CONTENTS
I. Purpose
II. Scope
III. Situation Overview
A. Hazard Analysis Summary
B. Capability Assessment
C. Limitations
D. Memorandum ofUnderstandinglMutual Aid Agreements
IV. Planning Assumptions
V. Concept of Operations
VI. Organization and Assignment of Responsibilities
VII. Direction, Control, and Coordination
VIII. Information Collection, Analysis, and Dissemination
IX. Communications
X. Administration, Finance, and Logistics
XI. Plan Development and Maintenance
XII. Authorities and References
XIII. Functional Annexes
A. Laboratory Procedures
General Packing and Transportation Procedures
B. Isolation and Quarantine
C. Medical Countermeasures/Material Mgmt.
Medical Countermeasures Points of Distribution (POD)
POD Calculator
POD Agency Partnerships
Patient Registration Form
Local Mass Clinic Facility Worksheet
Antiviral Withdrawal Form
D. Pandemic Flu Response
E. Emergency Communication Plan
Press Release Template
Fax Machine Speed Dial Numbers
Emergency Contact List
•
9
9
9
9
9
9-10
10
10-11
11-12
12-13
14-15
15-16
16
16
16
17-32
33-86
33-37
38-45
46-59
53-54
54
55
56
57
58-59
60-67
68-82
71-72
73-75
76
7
Regional Satellite Phone List
Common Media Questions
Recording Hotline Greeting
Emergency Notification Tree
F. Sheiter/Mass Care
Shelter-Tool form
G. Continuity of Operations
Reporting to Work in a Disaster/Emergency
Emergency Succession Plan
H. Environmental Health
I. Communicable Disease
J. Mass Casualty
K. Investigation Protocol
77
78-79
80-81
82
83-85
85
86-92
88
89-92
93-95
96-98
99-101
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I. PURPOSE:
The purpose of the Kittitas County Public Health Department's (KCPHD) Emergency Operation
Plan (EOP) is to provide guidelines for coordinated preparedness and response to emergency
incidents that may have public health implications in Kittitas County.
II. SCOPE:
The plan is specific to KCPHD employees. KCPHD emergency response works in conjunction
with the Kittitas County Comprehensive Emergency Management Plan (CEMP) in coordination
with the Kittitas County Emergency Management Department as well as under the Regional lead
of Public Health Emergency Preparedness and Response Region 7, including Chelan, Douglas,
Grant , Okanogan, and Kittitas County.
III. SITUATION OVERVIEW:
A. Population estimates by the Office of Financial management as of April 1, 2015 put Kittitas
County at 42,670. According to the US Census, approximately 7,400 residents are persons under
the age of eighteen. In addition, Central Washington University (CWU) has 10,750 enrolled
students. For People with Access and Functional Needs (PAFN), KCPHD has identified some
general numbers, which will be annually updated and expanded:
Population SUb5i1t Pcn;cnt:lga of Population· Numbilr of Peoplil
Disability Status
He.rin. diffiwlty
Villon difficulty
Co,nitive difficulty
ANulMory difficulty
Independent IIvlnc difficulty
Non-En •• rsh ..... ldn, ho'-Hho'.
Householdswithout. II hiel.
*U.S. Census 1014 estimates
HNumberof Ho u s eholds, not Indlllldvafs
4.6"
3.4%
3.6%
3.6it;
3.8%
3.9%
1.5"
6%
6 .7'J{,
1.956
1.446
1,530
1,5 30
1.616
1,658
255"
l,05S"
1,118
B. According to the Hazard Identification and Vulnerability Assessment (HIVA) 2012,
completed by the Kittitas County Emergency Management, focus areas of potential emergency
incidences range from civil disturbance to wild land fire .
C. KCPHD does not have adequate staff to respond to a community wide epidemic. KCPHD
expects to receive assistance from local emergency management located within the Kittitas
County Sheriffs Office (KCSO), in addition to partners within Region 7. In the event of a
pandemic or large incident, local response will be quickly overwhelmed and require mutual aid,
state, and possibly federal assistance. If an incident results in the need for equipment or
9
personnel, requests are made to the Kittitas County Emergency Operation Center (EOC)
(Emergency Contact List in Annex E/ Attachment C)
Limitations for requests for personnel or equipment include the following:
1. Damage to facilities and infrastructure
2. Transportation services
3. Staff availability
4. Damage to or disruption of communication systems
5. Fiscal constraints
6. Possible civil umest
7. Other County/Local Agency Limitations
8. Other hazards may exist that are not addressed by this plan
D . The use of Memorandums of Understanding (MOU) and Mutual Aid Agreements (MAA) can
mitigate some of the incident limitations. However, each situation or incident will dictate the
extent that agreements will be implemented.
IV. PLANNING ASSUMPTIONS:
A. There is a surveillance system in place for the prompt detection, identification, and reporting
of epidemic disease or a bioterrorism incident.
B. Individuals/institutions required to report disease are doing so within the time frame required
by law.
C. Potential outbreaks/epidemics of disease are being investigated promptly and as required by
statute.
D . KCPHD, Emergency Management, healthcare, law enforcement, emergency medical
response, and other agencies will work cooperatively to reduce the impact of epidemic
diseaselbioterrorism in the community.
E. KCPHD staff is adequately trained to respond to epidemic disease.
F. Responders will be properly trained and issued the appropriate personal protective equipment,
and are aware of the threat of a secondary incident. Within Kittitas County, responders will most
likely be exposed to risks including physical injury, exposure to vaccine preventable diseases
such as pertussis, chronic health problems if exposed to hazardous materials, as well as mental
health issues resulting from disasters.
G. Governmental agencies and officials will respond as outlined in the appropriate Revised Code
of Washington (RCW) and Washington Administrative Code (WAC) (EOP page 7).
H. In situations not specifically addressed in this plan, KCPHD and other emergency
management officials will improvise and carry out their responsibilities to the best of their
10
abilities using the Kittitas County Comprehensive Emergency Management Plan/Emergency
Operations Plan.
I. Memoranda Agreements and Mutual Aid Agreements will be in place and honored between
the organizations named in this plan and between neighboring governmental agencies.
J. As KCPHD may not have sufficient staff to respond adequately to an emergency situation,
local agencies such as Kittitas Valley Fire and Rescue (KVFR) may partner with KCPHD to
provide both staff support and logistical support.
V. CONCEPT OF OPERATIONS:
A. The Pre-Incident Phase
The pre-incident phase of an incident may be activated in the following ways:
1. National Terrorism Advisory System (NTAS)
a. Elevated -no specific information about timing or location of credible threat.
b. Imminent -if the threat is impending or very soon.
2. Kittitas County Sheriff's Department/Emergency Management
3. KITTCOM -Kittitas County 911
4. Kittitas County Public Works
5. Complaint from the general public
B. Response Phase
Notification of a potential incident or epidemic disease could happen in several ways:
1. Notification from regional, state, or national level authorities.
2. Notification by healthcare provider.
3. Notification by general public.
4. Notification by a law enforcement agency.
5. Detection by KCPHD staff.
6. KCPHD staff will notify Washington State Department of Health (DOH) in a timely
manner of events or disease findings indicative of an emergency incident or an epidemic.
7. Increased surveillance may be necessary to confirm existence of an incident.
8. If indicated, KCPHD may activate its Emergency Coordination Center (ECC) to
coordinate activities. The Incident Commander will be responsible for coordinating a
response within the department in an emergency. The Incident Commander will
determine the appropriate activation level, staffing, and roles. Incident Commander will
utilize the Federal Emergency Management Agency's (FEMA) Incident typing to
determine activation of the EOP or activation of the ECC. Response will act according to
the following incident types:
a. Typ~ 5 -No incident Command System (ICS) staff activated.
b. Type 4 -Command/general staff activated, only as needed.
c. Type 3 -Some or all Command/general staff activated. Written Incident
Action Plan (IA) may be required.
d. Type 2 -Regional resources required. Many Command/general staff positions
filled. lAP required for each operational period.
11
e. Type 1 -National resources required. All positions activated. Written lAP
required for each operational period.
9. If agencies other than KCPHD are needed to participate in disease control, the Health
Officer/Commander may request activation of the county Emergency Operation Center.
1 1"\ T\ .L. _.L ~ 1..1 • 1 t· b 1 , ..... T It. r"1 f"\ A r ... A A 1"\" A ""T"l 1 {"" 1 u. raLlem lSOtauOn ana quaran me may e usea per w 1-\.'-., L"fO-l UU-U"fU --rroceaures lOr
Isolation or Quarantine." (Annex B).
11. Procedures for requesting laboratory support for establishment of diagnoses and to
help determine the scope of the potential bioterrorism incident/epidemic disease are
found in Functional Annex A.
12. Healthcare support and mass casualty management: The Incident Commander will
coordinate with Kittitas Valley Healthcare (KVH) and Emergency Medical Service
providers to determine the ability of the local community to respond to the disease. If
community resources are about to be or are already overwhelmed, the Incident
Commander may request assistance through the Emergency Management Division.
Request for assistance is completed through the Emergency Management office via the
Kittitas County Sheriffs Office. (Emergency Contact List in Annex E/Attachment C)
c . Recovery Phase
1. Environ.rnental Restoration. Steps for environmental restoration may be determined at
the time of the incident by the Incident Commander and the Command Staff, based on the
Centers for Disease Control and Prevention (CDC) protocols for the organism or agent
involved. The County Health Officer will give final approval for all protocols performed.
2. Re-entry Authorization. Re-entry authorization will be determined at the time of the
incident by the County Health Officer. Determination will be based on CDC protocols
for the organism or agent involved. The County Health Officer will give final approval
for all protocols performed.
VI. ORGANIZATION AND ASSIGNMENT OF RESPONSIBILITIES:
All emergency response activities will follow the National Incident Management System (NIMS)
guidelines.
Health Officer: The Health Officer assumes a leading role during an incident involving
bioterrorism, infectious disease, or other medical emergency. The Health Officer in consultation
with the Public Health Administrator and Board of Health will decide policy, maintain contact
with other agencies, and develop public health priorities. In all other emergency incidences, the
Health Officer provides information and support to the Incident Commander as needed.
Other KCPHD Staff: Other KCPHD staff or trained volunteers, including Medical Reserve
Corps (MRC) volunteers, will assume the appropriate NIMS roles
Kittitas Valiey Healtb car e: KVH will activate its Emergency Operations Center (EOC) and will
be responsible for the coordination of the overall operations of the hospital in any disaster
12
situation. KVH will have primary responsibility for staffing the hospital and will assist with any
auxiliary areas created to manage the medical needs of the public during an emergency (i.e.,
mass casualties, quarantine and isolation, etc.). KVH will support an alternate care facility, if
possible, through provision of medical expertise and resources.
KITICOM (911): In a bioterrorist incident or other public health emergency in Kittitas County,
the primary emergency service agencies, including public health, shall be notified of the situation
byKITTCOM.
Kittitas County Emergency Medical Services System (EMS): Kittitas County Emergency
Medical Services (EMS) System will facilitate the county's transportation and pre hospital
medical needs. The system consists of 11 licensed EMS agencies (primarily local fire
departments) and 5 affiliated-level services. Coordination between licensed EMS agencies to
meet the local EMS needs will be facilitated through KITTCOM and based on the Regional
County Patient Care Operating Procedures and the Kittitas County Mass Casualty Incident Plan
(MCI Run Cards). These documents are part of the South Central Region Trauma Plan,
available through Kittitas County EMS.
Emerg ncy Management: If a bioterrorism incident is suspected, KCPHD will make prompt
notification to the Kittitas County Sheriff as the Director of Emergency management for Kittitas
County. The Sheriff or his designee will direct the county EOC with the Health Officer assisting
with direction, control, and management of the emergency as appropriate. Emergency
Management will attempt to acquire the resources and supplies needed to respond to an incident
when local resources are exceeded.
Local, County. and State Law Entbrcement: Local and county law enforcement, Search and
Rescue (SAR), and Fire District #1 will assist KVH and KCPHD with site security, perimeter
control, and facility access. In an evacuation of the hospital, local, county, and state law
enforcement agencies may be called upon to assist in the coordination of the evacuation. Should
the need for an alternate care facility (quarantine or mass vaccination, etc.) or mass dispensing
operations arise in Kittitas County, local, county, and state law enforcement may be requested to
assist with site security, perimeter control, facility access, isolation and quarantine orders, and
for the maintaining of order.
Washington tate DepaJtment of Health (DOR): DOH will coordinate statewide emergency
planning and preparedness efforts and statewide surveillance activities. Samples collected by
KCPHD will be tested by the public health laboratory network operated by DOH. DOH will
coordinate with CDC and disseminate appropriate data and situation updates to KCPHD. DOH
will coordinate development and implementation of disease containment strategies across
multiple counties and regions within the state. DOH will supplement and support local effort to
educate and inform the public about public health emergencies and preventative measures.
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VII. DIRECTION, CONTROL, AND COORDINATION:
A. Kittitas County Public Health Department
1. During a bioterrorism, chemical, or radiological incident; communicable disease
outbreak or public health emergency; KCPHD will respond based on the complexity of
the incident.
2. KCPHD may activate the Emergency Coordination Center (ECC). (The ECC is
located in room 115, with KCPHD Panaboard). However, there may be situations
where KCPHD ECC is not activated. Ifthe KCPHD ECC is not activated, the Kittitas
County EOC will be used for operations.
3. All communications with the general public will be distributed through the Public
Information Officer (PIO) to the County EOC.
4. Shifts during operation of Kittitas County Public Health Department ECC will
normally be 12 hours during activation.
5. Security for the ECC will be provided by the Ellensburg Police Department, Kittitas
County Sheriff's Office, or Search and Rescue (SAR) if needed.
6. KCPHD will provide support to, and take guidance from, the Kittitas County EOC in
public health emergencies. All public health activities will be coordinated with the
Kittitas County EOC ifKCPHD's ECC is functioning.
B. Kittitas County Public Health Department Representation In On Scene Incident Command
System
1. On-scene Incident Command representation will depend on which agency will have
the lead in the incident.
2. If the incident is an actual bioterrorism incident, communicable disease outbreak, or
public health emergency where a crime has been committed, law enforcement will be the
lead agency. In this case, KCPHD will be represented on the Command Staff by the
County Health Officer/Public Health Administrator, or a designee, who will be
involved in various aspects of the response.
C. Coordination with Region 7 Public Health Agencies
KCPHD will immediately notify Chelan-Douglas Health District, headquarters for Region7
Public Health Agencies, when a bioterrorism incident is suspected or confirmed in Kittitas
County. The Administrator of KCPHD will coordinate with Chelan-Douglas in determining
when support personnel from the regional partners may be needed in Kittitas County.
D. Coordination with Region 7 Hospital Network
KVH will notify its Region 7 partners when a bioterrorism incident is suspected or confirmed in
Kittitas County.
E. Coordination with Kittitas County Emergency Medical Services
14
Kittitas County falls under the South Central Region (SCR) Trauma Plan for regional planning
and coordination. The request for resources from outside the county will be made through
KITTCOM.
F. Coordination with Kittitas County EOC
Requests for assets to support a local emergency are made through the Kittitas County EOC. If
the County EOC has not been activated, requests should be made directly to the Kittitas County
Emergency Management Department via the Kittitas County Sheriff s Office. Requests can be
made via phone, email, or in person. If the request cannot be handled locally, or through mutual
aid, they are then sent to the Washington State Emergency Operations Center at the Washington
State Emergency Management Division, Camp Murray, Washington.
If the request is specific to Emergency Support Function (ESF) 8, Public Health and medical,
that desk will then address the issue as appropriate, working with the requisition agency to best
meet that need . Washington State Department of Health serves as the lead for ESF 8 along with
other state agencies in a supporting role.
The Kittitas County Emergency Management Department (KCSO) must be aware of any
potential requests for assistance in order to determine the need for a declaration of emergency
within the county.
G. Health Officer
The Health Officer or designee may assume the role of Incident Commander during an epidemic
disease or bioterrorism incident. The Health Officer, Public Health Administrator, and Board of
Health will consult to decide policy pertaining to health and medical decisions during
emergencies. The Health Officer in consultation with the Board of County Commissioners will
make decisions if there is a financial implication to public health policy decisions during an
emergency. The Health Officer may also maintain contact with other agencies, develop public
health priorities, lead incident response, and delegate tasks.
VIII. INFORMATION COLLECTION, ANALYSIS, AND DISSEMINATION:
Critical information that will be collected includes client or patient identification, location of
client or patient, the identified potential or confirmed disease or health risk, date of onset, any
related symptoms associated with the potential or identified disease, as well as individuals who
may also have been potentially exposed. Sources of information may include local law
enforcement, local healthcare providers, laboratories, KITTCOM, a complaint from the general
public, national, state, or regional partner.
Collected information will be used only for the investigation and response of any identified
disease threats or health risks. Information will be shared in accordance with the Health
Insurance Portability and Accountability Act (HIP AA) regulations. Only emergency responders
15
who are required to comply with HIP AA regulations will receive confidential medical
information relating to the investigation or response.
IX. COMMUNICATIONS:
KCPHD has access to 2417 support services and resources outside of the department, which
require communication in a timely manner. Communication may be through various means
including by fax, telephone landline, satellite phone, and in person requests. Communications
procedures are outlined in the Communications Annex, Annex E. Call down lists for 2417
support services
X. ADMINISTRATION, FINANCE, AND LOGISTICS:
Memorandum of Understandings as well as local resources will be utilized first in response to
emergencies. KCPHD and Kittitas County polices for financial accounting and auditing will be
adhered to in regards to financial records, reporting, and tracking resources. All financial
records will be kept in accordance with archiving requirements. Special purchasing policies
under Kittitas County will require a Board of County Commissioners' declaration of emergency
in order to utilize.
Xl. PLAN DEVELOPMENT AND MAINTENANCE:
A. Training regarding this plan will be performed regularly as staff time and personnel permit.
B. This plan will be exercised, evaluated, and updated at least once annually hased on after
action reports completed after KCPHD and/or county wide drills and exercises. Evaluations will
include improvements as a result from exercise analysis completed and challenges identified.
Updates will be based on recommended changes.
C. Recommended changes to this plan should be submitted to the Local Emergency Response
Specialist at KCPHD, located at 507 N Nanum Street Suite 102 in Ellensburg, Washington,
98926. The phone number is 509-962-7515. Post exercise and or/incident debriefing will be
utilized to review effectiveness and need for revision of this plan. The report will recommend
changes, which will be incorporated immediately.
D. At a minimum, this plan will be reviewed by the Kittitas County Emergency Management
Council after annual review and the Local Emergency Response Specialist is responsible for the
annual review of the Emergency Operation Plan. Updated plans must be sent to the Region 7
Emergency Response Coordinator and to the Kittitas County Emergency Management via
Kittitas County Sheriffs Office (KCSO).
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.'
XII. AUTHORITIES AND REFERENCES:
P' nmary S tate S t t G ta u es overnmg P hI' H I h u IC ea t
KCPHD Program Specific Revised Code of Washington (RCW) and Washington Administration Code
(WAC)
VITAL RECORDS
Revised Code of Washington Administration Code (WAC)/ Washington Title Purpose
(RCW) Kittitas County Code (KCC)
Vital records means records
of birth, death, fetal death,
Local marriage, dissolution,
RCW 70.58.020 246-490-010 Registrars -annulment, and legal
deputies separation, maintained under
the supervision of the state
registrar of vital statistics.
COMMUNITY HEALTH
Revised Code of Washington Administration Code (WAC)/ Washington Title Purpose
(RCW) Kittitas County Code (KCC)
43.20 State Board To protect the health and of Health
43.20.050 -Communicable well-being of the public
powers and 246-100 communicable and certain other diseases and Certain by controlling
other Diseases communicable and certain duties of state other diseases. board of health
Local Health Enforce laws and control
RCW 70.05.070 246-100-036 Officer-powers spread of disease within
and duties jurisdiction.
Local Health Officer may
43.20.050 246-100-040 Isolation and Issue an emergency
Quarantine detention of a person or
group of persons.
Requires that all
49.17 employees with
Washington 296-823 Blood borne occupational exposure
Industrial Safety Occupational Exposure to Blood borne Pathogens participate in a training
Pathogens program that is provided and Health Act at no cost to them and
I conducted during
17
compensated working
hours.
Identify responsibilities of
Standards of the professional registered
18.79 246-840-700 Nursing nurse and the licensed
practical nurse in health Nursing Care 246-840 Practical and Registered Nursing Conduct or care settings and as practice provided in the Nursing
Practice Act. .-
Reports-
Duty and
authority to
make-Duty
of receiving
agency -Duty
to notify-
Case planning When a healthcare
and professional has
consultation -reasonable cause to
26.44 Abuse of Penalty for believe that a child has
Children unauthorized suffered abuse or neglect,
26.44.030 exchange of he or she shall report such
information -incident, or cause a report
Filing to be made, to the proper
dependency law enforcement agency
petitions -or to the department.
Investigations .
-Interviews
of children -
Records-
Risk
assessment
process. -..... -_. ----
Practical Licensing process and
246-840 Registered requirements of registered
Nursing nurses.
RCW70.28 246-170 Tuberculosis TB Prevention, Treatment,
(TB) and Control
Control of Guidelines specific to
RCW 43.20.050 WAC 246-110-020 Communicable controlling outbreak
disease within a school and/or
daycare.
18
ENVIRONMENTAL HEALTH
Revised Code of Washington Administration Code (WAC)/ Washington Title Purpose
(RCW) Kittitas County Code (KCC)
Food Service
The purpose of chapter
246-215 WAC is to
establish state board of
43.20.050 (d and health standards for food
f)
70.05.070 246-215 WAC Food Service service under RCW
43.20.050 to promote and
protect the health, etc.
Chapter 246-215 includes
11 sections specific to
food service.
The purpose of chapter
246-217 WAC is to
establish state board of
health standards for the
issuance of food worker
cards (food worker
43.20.050 permits) under chapter
RCW 69.06 Food 69.06 RCW and RCW
and beverage 246-217 WAC Food Worker 43.20.050.
establishment Cards Chapter 246-217 includes
workers' permit 8 sections specific to food
worker cards.
RCW 69.06 includes 9
sections regarding service
workers' permits
including validity,
diseased persons, and
limited duty permit.
The Board of County
Commissioners hereby
Chapter 8.04: adopts by reference the
KCC Title 8: Health, Welfare, and Sanitation Food Handling Washington State Board
WAC 246-215 Rules and of Health Rules and
Regulations Regulations for Food
Service Standards
(Chapter 246-2] 5 WAC)
effective May 2, 2005, and
19
KCC Title 8: Health, Welfare, and Sanitation
On Site Sewage
Chapter 8.08:
as hereafter amended.
8.04.020 Penalty section
regarding violation of 246-
215 WAC.
Health Penllits Establishes standards for
-Food permitting food
Handling establishments.
Establishments
~----------~-------------------------
40.20.050
43.70.310
43.20
Public Law 93-
523, the Federal
Safe Drinking
Water Act of
1974, and Public
Law 99-339, the
Safe Drinking
Water Act
Amendments of I
1986, and certain
246-272A WAC On-Site Sewage Systems
WAC coordinates with RCW 18.210 and WAC
196-33 for design and RCW 36.70 and 58.17 for
land use.
The purpose of the chapter
O S·t S is to protect the health by n-1 e ewage .. .. d I· mllllmlzlllg an regu atlllg
onsite sewage systems. 246-270 through 246-274 Sewer System WACS I
------~----------~------------------~
KCC Title 13: Water and Sewers
KCC Title 13: Water and Sewers
Protect public health by
minimizing potential for
Cha ter 13.04: public and ground water
O S~t S exposure to sewage from n-Ie ewage . D' lon-sIte sewage systems.
S lSPtOSa Chapter 13.04 contains 31
ys ems ..c. •• sectIOns lrom permlttlllg
Chapter 13.08:
Private Sewage
Disposal
Systems in
Plats
to health hazards and
health emergencies.
Chapter 13.08 contains 9
sections pertaining to plats
connecting to septic tanks
from applications to plat
size requirements.
Drinking Water and Regulation of Wells
246-290 WAC
---------
Public Water
Supplies
[ -
Protect the health of
consumers using public
drinking water supplies by
establishing requirements
for persons operating
small public water
systems.
(1) The purpose of this
chapter is to define basic
regulatory requirements
and to protect the health ofl
20
.'
provisions of consumers using public
Public Law 104-drinking water supplies .
182, the Safe
Drinking Water (2) The rules of this
Act Amendments chapter are specifically
of 1996. designed to ensure :
(a) Adequate design,
construction, sampling,
management,
maintenance, and
operation practices; and
(b) Provision of safe
and high quality drinking
water in a reliable manner
and in a quantity suitable
for intended use.
(3) Purveyors shall be
responsible for complying
with the regulatory
requirements of this
chapter.
Protect the health of
consumers using public
drinking water supplies by
establishing requirements
for persons operating
public water systems.
(1) The purpose of these
rules is to define basic
regulatory requirements to
43.20.050 protect the health of
70.05.070 246-291 WAC Group B Public consumers using Group B
70 .116 Water Systems public drinking water
70.119 supplies. These rules are
specifically designed to
ensure the provision of
high quality drinking
water in a reliable manner
and in a quantity suitable
for intended use.
(2) The rules set forth
are adopted under chapter
21
43.20 RCW and owners of
Group B public water
systems shall be
responsible for ensuring
compliance with these
rules. Other statutes
relating to this chapter are:
(a) RCW 43.20B.020 ,
Fees for services --
Department of health and
department of social and
health services;
(b) Chapter 43.70
RCW, Department of
health;
(c) Chapter 70.05
RCW, Local health
departments, boards,
officers --Regulations;
(d) Chapter 70.116
RCW, Public Water
System Coordination Act
of 1977; and
(e) Chapter 70.l19A
RCW, Public water
systems --Penalties and
compliance.
(3) Prior to expanding a
Group B public water
system to a Group A
public water system, the
entire system shall be
brought into compliance
with chapter 246-290
WAC
-t--70.116 Water System This chapter is
Public Water 246-293 WAC Coordination promulgated pursuant to
System Act I
the authority granted in
Coordination Act the Public Water System -
22
of 1977 Coordination Act of 1977,
chapter 70.116 RCW, for
the purpose of
implementing a program
relating to public water
system coordination
within the state of
Washington, for
evaluation and
determination of critical
water supply service areas,
and assistance for orderly
and efficient public water
system planning.
Washington
Revised Code of Administration
Washington Code (WAC)/ Title Purpose
(RCW) Kittitas County
Code (KCC)
Authority to act when well, spring, stream,
river or lake used for drinking water source
is being polluted.
Authority to act when landlord is furnishing
impure water.
Every person who shall deposit or suffer to
be deposited in any spring, well, stream,
river or lake, the water of which is or may
be used for drinking purposes, or on any
property owned, leased or otherwise
70.54.010 Polluting Water Supply controlled by any municipal corporation,
corporation or person as a watershed or
drainage basin for a public or private water
system, any matter or thing whatever,
dangerous or deleterious to health, or any
matter or thing which mayor could pollute
the waters of such spring, well, stream,
river, lake or water system, shall be guilty
of a gross misdemeanor.
-
18.104 Water Well Construction The regulation and licensing of well
23
-contractors and operators and for the
regulation of well design and construction.
The legislature declares that the drilling,
making or constructing of wells within the
state is a business and activity of vital
interest to the public. In order to protect the
public health, welfare, and safety of the
people it is necessary that provision be
made for the regulation and licensing of
well contractors and operators and for the
regulation of well design and construction.
Chapter 13 .20
KCC Title 13: WELL CONSTRUCTION, Allows the developer of a plat to bond for
Water and RECONSTRUCTION AND completion of the water system
Sewers DECOMMISSIONING infrastructure.
REQUIREMENTS
Well Setbacks:
Prior to approving any development, the
health officer shall require establishment of
a 100 foot radius water supply protection
zone to fit within the lot lines OR
Establishes a wellhead protection zone
around each existing or proposed well site.
(1) /!;L person proposing a subdivision v/here
the use of OSS is planned shall obtain a
recommendation for approval from the
local health officer as required by RCW
58.17.150.
OSS Regulations-
246-272A-0320 Developments, subdivisions, (2) The local health officer shall require
WAC and minimum land area the following prior to approving any
requirements development:
(a) Site evaluations as required under
WAC 246-21?A-0220, excluding
subsections (3)(a)(i) and (4)(d);
(b) Where a subdivision with individual
wells is proposed:
(i) Configuration of each lot to allow a
one hundred-foot radius water supply
protection zone to fit within the lot lines; or
24
(ii) Establishment of a one hundred-foot
protection zone around each existing and
proposed well site;
( c) Where preliminary approval of a
subdivision is requested, provision of at
least one soi1log per proposed lot, unless
the local health officer determines existing
soils information allows fewer soil logs;
Well Setbacks:
KCC Chapter Well head protection areas Wellhead protection areas. All non-
17A.08.025 community wells must be placed a
minimum of fifty feet from property lines.
Well Head Protection Zones:
1) The department may require monitoring
and controls in addition to those specified
in this section if the department determines
a potential risk exists to the water quality of
a source.
(2) SCA.
(a) The purveyor shall maintain an SCA
around all sources for the purpose of
protecting them from existing and potential
sourccs of contamination.
246-290-135 (b) For wells and springs, the minimum
WAC & 246-291 Source Water Protection SCA shall have a radius of one hundred feet
WAC (thirty meters) and two hundred feet (sixty
meters) respectively, unless engineering
justification demonstrates that a smaller
area can provide an adequate level of
source water protection. The justification
shall address geological and hydrological
data, well construction details, mitigation
measures, and other relevant factors
necessary to assure adequate sanitary
control.
(c) The department may require a larger
SCA than specified in (b) of this
subsection, or additional mitigation
measures if land use, geological, or
hydrological data support the decision. It
25
shall be the purveyor's responsibility to
obtain the protection needed.
(d) The purveyor shall prohibit the
construction, storage, disposal, or
application of any source of contamination
within the SCA without the permission of
the purveyor.
(e) The SCA shall be owned by the
purveyor in fee simple, or the purveyor
shall have the right to exercise complete
sanitary control of the land through other
legal provisions.
(f) A purveyor, owning all or part of the
SCA in fee simple or having possession and
control, shall send to the department copies
of legal documentation, such as a duly
recorded declaration of covenant, restricting
the use of the land. This legal
documentation shall state:
(i) Constructing, storing, disposing, or
applying any source of contamination is
prohibited without the pennission of the
purveyor; and
(ii) If any change in ownership of the
system or SCA is considered, all affected
parties shall be informed of these
requirements.
(g) Where portions of the control area
are in the possession and control of another,
the purveyor shall obtain a duly recorded
restrictive covenant which shall run with
the land, restricting the use of the land in
accordance with this chapter and provide
the department with copies of the
appropriate documentation. -
Minimal Daily Production of Well j
246-290-221 Water Demand Criteria Water:
WAC (l) Except as provided in this section,
expanding systems s~all ~se water demand
26
design for average day demand (ADD), and
peak periods of demand such as maximum
day demand (MDD), and peak hourly
demand (PHD) that are based upon actual
metered water use records. The data
collected shall be sufficient to account for
seasonal or other cyclic changes in water
demand, and shall correlate to the
maximum number of full-time or part-time
equivalent residential units in service at any
time.
(2) For seasonally used, transitory non-
community, or recreational developments
the design for ADD, MDD, and PHD shall
be based upon metered water uses
whenever such data is available. The data
must account for the daily population using
the water over the time that records are
collected, and must reflect the uses
associated with maximum occupancy for
the development. The design demands for
these developments apply only to part-time
uses, and may not be applied to structures
or dwellings that can be permanently
occupied.
(3) In the absence of metered use or
other comparable information, the
following sources of design information
maybe used:
(a) Comparable metered water use data
from analogous water systems. Analogous
systems are those with similar
characteristics, such as demographics,
housing sizes, income levels, lot sizes,
climate, water pricing structure, water use
efficiency practices, use restrictions, and
soils and landscaping; or
(b) Design criteria or guidelines in the
most recent edition of the department
manual for design of Group A public water
systems.
27
(4) The design for water systems based
upon metered water use records shall have
an MDD no lower than three hundred fifty
gallons per day per equivalent residential
unit (ERU), except for the design of any
expansion to an existing water system that
has a minimum of two years of meter
records that clearly demonstrate that a
lower design value for MDD may be used
without significant risk of pressure loss.
The meter records must correlate the
demand data to the actual level of
occupancy for the periods covered by the
records.
(5) The minimum water demand and I
duration required for fire flow and/or fire
suppression storage shall be det~rmined by
the local fire control authority or chapter
246-293 WAC for systems within the
boundaries of a designated critical water
supply service area (CWSSA). Public water
systems that are not required to comply
with minimum fire flow standards shall
coordinate with the local fire control
authorities to ensure that any hydrants on
the system, if they can possibly be used in
the course of fire suppression activities, do
not create adverse pressure problems within
the water system as a result of fire control
actions. --
Water Availability & OSS: Land Development and Building Permit Approval
Land Development Preliminary and Final Approval
Allows withdrawal of public ground waters
for stock watering purposes, or the watering
of a lawn or a noncommercial garden not
90.44 Regulation of public ground exceeding ~ acre in area or for single or
waters (exempt wells) group domestic uses in an amount not
exceeding 5000 gallons a day. Authority
granting Department of Ecology to require
water metering as well.
Plats, Subdivisions, L ocal h~fu d epartment or other agency I
58.17.150 Dedications must provide recommendations for
approval or disapproval as to the adequacy
28
of the proposed means of sewage disposal
and water supply (before final plat
approval).
Short plats& short subdivisions The legislative body shall provide that a
short plat and short subdivision may be 58.17.060 -summary approval -approved only if written fmdings th at are regulations -Requirements appropriate as provided in RCW 58.17 .110 -
Washington
Revised Code of Administration
Washington Code (WAC)/ Title Purpose
(RCW) Kittitas County
Code (KCC)
Approval or disapproval of A proposed subdivision and dedication
subdivision and dedication-shall not be approved unless the county
58.17.110 Factors to be considered-legislative body makes written findings
Conditions for approval -that (a) appropriate provisions are made for
Finding -Release from the public health, safety, and general
damages welfare and for potable water supplies.
ass Regulations-
246-272A-0320 Developments, subdivisions, ass regulations for developments,
WAC and minimum land area subdivisions and minimum land areas .
requirements
The county health officer shall certify to the
KCC Chapter Road, sewer, water and fire planning commission prior to the hearing
their recommendations as to the adequacy 16.12.150 system recommendations of the proposed sewage disposal and
potable water supply systems.
Moratorium on use of ground water in
WAC 173-539A upper Kittitas County. Requires water
budget neutrality for land subdivisions .
1. Public Water Supplies -must be
constructed, letter from purveyor
2. Group B Public Water Supply -Well
KC Resolution CDS administrative policy site inspection provided, Group B
2004-36 related to potable water supply Workbook submitted and approved,
for subdivisions well tag ID assigned approval from W A
DOH.
3. Individual wells -well log or
hydrogeological report required. -
AGO 1997 No. WATER-WATER RIGHTS Provides interpretation of use of exempt 6, October 10, -WELLS -Status in water I 1997 rights system of exempt ground water for subdivisions of land.
-
29
ground water withdrawals
Building Permit Approval
Each building pennit applicant of a
building needing potable water shall
Building pennit application -provide evidence of an adequate water
19.27.097 Evidence of an adequate water supply for the intended use of the building
supply -Applicability -in the fonn of a water right pennit from
Exemption Ecology, letter from an approved water
purveyor, another fonn sufficient to verify
the existence of an adequate water supply.
Each building pennit applicant shall
provide evidence of an adequate water
365-196-825 supply consistent with RCW 19.27.097 for
(GMA) Potable Water a building needing potable water. If
Ecology has adopted rules on this subject,
or any part of it, local regulations should be
consistent with those rules.
Washington
Revised Code of Administration
Washington Code (WAC)/ Title Purpose
(RCW) Kittitas County
Code (KCC)
GMA -DOH-BOH-The local building department must satisfy
Buildings -Counties -State itself that the potable water source is
AGO 1992 No. Building Code -Water-reliable, of sufficient quality and quantity.
17-July 28, 1992 Requirement of Adequate This requires demonstration that water
Water Supply before a actually will be made available to the
Building Pennit is Issued building for a reasonable period of time.
Moratorium on use of ground water in
upper Kittitas County. Requires water
WAC 173-539A budget neutrality for building pennits and
requires metering for new residential
connections and/or new use of exempt
I 1-••••
groundwater.
Decision made by the Attorney General
AGO 2002 No. related to a case between Washington State
70279-928-Campbell & Gwinn Department of Ecology and local
March, 2002 government about contiguous plats and use
of exempt wells.
~ --
Other Environmental Health Programs: Schools, Camps and Parks, Water Recreation Facilities, Smoking
in Public Places
~
43.20.050 =r 246-366 WAC I Primary -;-nd Secondar;J Maintain minimum environmental health
,-
30
Schools and safety standards for school facilities
until legislative action.
43.20.050 246-376 WAC Camps Requirements for environmental conditions
mcamps.
70.90.120 246-260 WAC Water Recreation Facilities Protect the health, safety, and welfare of
43.20.050 users of water recreation facilities.
To protect the health and welfare of all
70.l60 Smoking in Public Places citizens, including workers in their places
of employment, by prohibiting smoking in
public places and workplaces. -
KCC Title 8: Chapter 8.24: Smoking in Health, Welfare
and Sanitation Public Places
Solid Waste
-r-
Chapter 173-351 2. Criteria for municipal solid Establish minimum statewide standards for
70.05, 70.95 all municipal solid waste landfill (MSWLF) WAC waste landfills units
-
Establishes and designates sitting, design,
70.05, 70.95 Chapter 173-303 3. Dangerous Waste operation, tracking, and handling
WAC Regulations responsibilities for hazardous waste
management.
70.05, 70.95 -
43.21A.080 Provides guidance and funding to local
91.11.090 173-312 WAC Coordinated Prevention Grant health for monitoring and enforcing solid
70.95 waste violations.
Chapter 246-205 Decontamination of Illegal Requires local health agency to post
64.44 Drug Manufacturing and warnings and supervise clean-up of WAC Storage Sites contaminated properties
Washington
Revised Code of Administration
Washington Code (WAC)/ Title Purpose
(RCW) Kittitas County
Code (KCC)
General Sanitation and Environmental Health Issues
Establishes rules for public or common
Chapter 246-203 General Sanitation nuisances that are set up, maintained or
continued so as to be injurious to the health WAC or an obstruction to the use of property
including disposal of dead animals.
'-----
59.18 Residential Landlord Tenant Requires local health jurisdiction to respond
31
Act to complaints --
70.94 Washington Clean Air Act Preserve, protect, and enhance the air
quality for current and future generations
ENFORCEMENT
KCC Title 18: Chapter 18. Establishes enforcement actions for
violations.
32
XIII. FUNCTIONAL ANNEXES:
I. INTRODUCTION
Kittitas County Public Health Department
Laboratory Procedures Plan
AnnexA
Table of Contents
II. PLANNING ASSUMPTIONS
III. RESPONSIBILITIES
IV. CONCEPT OF OPERATIONS
V. ATTACHMENT
Attachment A General Packing and Transportation Procedures
I. INTRODUCTION:
33
33
34
34
35
35-37
The use of laboratory services refers to sending biological specimens, water samples, or
wastewater samples to local, state, and/or private laboratories in order to identify disease agents
and environmental health hazards. 2417 Access to laboratory services will assist KCPHD in the
surveillance of diseases or environmental health hazards affecting Kittitas County during
outbreaks and emergency incidents.
II. PLANNING ASSUMPTIONS:
KCPHD has very limited capacity to collect specimens and has no testing capacity, internally.
This plan applies to incidents requiring services that exceed the capacity of KCPHD as well as
local health care providers and KVH. Local laboratory services will be overwhelmed in the case
of an outbreak. The Washington State Department of Health Public Health Laboratories in
Shoreline (accredited by the College of American Pathologists), Washington will be the main
laboratory contact. During a statewide disaster, KCPHD may utilize out of state laboratory
services. If a scene has been designated hazardous and a HAZMAT team is responding, KCPHD
will not collect samples and will defer to the appropriate agency.
33
III. RESPONSIBIL TIES:
A. KCPHD will be responsible for the following activities:
1. Initiating the use of laboratory services.
2. Choosing the appropriate laboratory site to utilize for testing.
3. Coordinating with the laboratory regarding supplies, shipping, and results.
4.KCPHD staff may collect the samples or coordinate with the public or agencies in the
collection of samples.
5.KCPHD staff who collect samples will follow the appropriate collection method as
listed by Washington State Department of Health or the Environmental Protection
Agency, or other appropriate agency.
6. Receive testing samples including, but not limited to, samples involving stool, blood,
sputum, nasal swabs, water, or wastewater.
7. Communicate with the appropriate laboratory regarding supplies, shipping, and testing
results.
8. Act as courier for shipping and handling of specimens.
9. Ensuring staff are trained in Packaging and Shipping Division 6.2 materials and
trained staff is available to send emergency biologics 2417.
IV. CONCEPT OF OPERATIONS:
A. KCPHD will coordinate with local labs such as KVH or other clinics within Kittitas County
for laboratory collection of samples and specimens.
B. The local Health Officer, Community Health Supervisor, Environmental Health Supervisor,
and/or Public Health Administrator will authorize the use of laboratory services for KCPHD
submitted specimens or samples.
C. The above staff will initiate request for testing and the appropriate laboratory site.
D. In suspected bioterrorism situations, a law enforcement agency may transport the specimen
directly to the laboratory site.
E. Staff will utilize emergency contact number list for laboratory 2417 coverage, which is located
in the Emergency Communication Plan annex. Should contact be unavailable via phone or
email, staff will utilize alternate means of communication including SAT Phone or partner
agencies for assistance such as Kittitas County Sheriff s Office or ARES/RACES HAM radio
operators.
34
Attachment A: General Packing and Transportation Procedures
1. The points of contact for shipping of laboratory samples for KCPHD are:
Primary: Community Health Supervisor
Alternate: Public Health Nurse
2. Questions on shipping of environmental and clinical samples should be directed to the
Washington State Public Health Laboratory at (206) 418-5400 during business hours or (206)
418-5500, a 24-hour number.
3. The following are the general procedures for packaging and transportation of suspected
bioterrorism and other infectious laboratory samples to the Washington State Department of
Public Health Laboratory (WSPHL).
a. All suspected specimens that meet the criteria for submission must be coordinated
with KCPHD first and then the Public Health Laboratory by calling (206) 418-
5400 during business hours or (206) 418-5500 a 24-hour emergency phone
number. No specimens will be accepted unless the Public Health Laboratory
has been contacted prior to arrival of the specimen.
b. In suspected bioterrorism situations, local law enforcement, HAZMAT,
Wash ington S tate Patrol, or an FBI r~presentative will t r:ansport the pecimell
directly to the P u blic Health Lab o ratory at 1610 150th Street NE, Shoreline W A
98155 (north of downtown Seattle). However, public health employees may also
transport specimens as indicated.
Driving directions to the Washington State Department of Health Public Laboratories:
1-5 Northbound
Take NE 145th St. exit (Exit #175). After exiting, move to the far right lane. Turn right at the
traffic light onto NE 145th St. (eastbound). Proceed in the left lane on 145th St. to the next traffic
light at 15th Ave. NE. Turn left onto 15th Ave. NE, travel four blocks on 15th Ave. NE
(northbound) to NE 150th St. Turn right onto NE 150th. You will see the state laboratories on
the left at the intersection of 17th Ave. NE and NE 150th St.
1-5 Southbound
Take NE 145th St. exit (Exit #175). After exiting, stay in the left lane of the off ramp. Turn left
at the traffic light onto NE 145th St. (eastbound). Proceed in the left lane on 145th St. to the next
traffic light at 15th Ave. NE. Turn left onto 15th Ave. NE and travel four blocks until you reach
NE 150th St. Turn right onto NE 150th St. You will see the state laboratories on the left at the
intersection of 17th Ave. NE and NE 150th St. In cases where the specimen is shipped by
commercial carrier, State and Federal shipping regulations pertaining to infectious substances
must be followed.
A. Packaging specimens for testing at the Washington State Department of Health
Public Health Laboratories
1. Infectious substances must be packaged and labeled according to certain specifications as
outlined by the Washington State DOH Public Health Laboratories "packing and
shipping of infectious substances." Material must be packaged "to withstand leakage of
contents, shocks, pressure changes and other conditions incident to ordinary handling in
35
transportation." The figure below shows how to triple package (primary receptacle,
watertight secondary packaging, and durable outer packaging) according to the
regulations.
a. Primary Package
The primary receptacle contains the infectious substance and must be watertight to
prevent leakage. These can be made of glass, metal, or plastic and should include
screw-top tubes, flame-sealed glass ampoules, or rubber-stopped glass vials fitted
with metal seals. Screw caps should be fastened with tape for extra safety.
b. Secondary Package
One or more primary receptacles are placed in a water-tight secondary package.
Absorbent material, sufficient to absorb the entire contents of the primary
container(s), must be placed between the primary and secondary package. The
secondary package should be labeled with name, address, and telephone number of
the shipper.
c. Outside Package
The secondary package is placed into the outer packaging, which must be of
sufficient strength to contain and protect the contents within. Outer packages must be
UN-certified, signified by having a UN specification mark on the outside ofthe
package. Shipping regulations require that an itemized list of contents be placed
between the secondary package and outer package.
Below is an example of packing for shipping of samples to the Washington State Public
Health Laboratory.
Croll Sec:tkiO at Pr0p8' Pacj(lng
Packing and Labeling t>f Infectious Substances
Environmental Samples
Collection of environmental samples of concern is normally done by HAZMA T teams as
part of their response to a contaminated scene. HAZMA T teams should follow their
normal procedures for sampling and packaging of the materials.
36
B. Clinical Samples
1. Collection of diagnostic samples is normally done in clinical facilities. Confirmatory
testing is done by WPHL. WPHL will perform confirmatory testing for the following
diseases: Anthrax, Botulinum toxin, Tularemia, Plague, Brucellosis, Meliodosis, and
Vaccinia.
2. Confirmatory testing for smallpox is currently performed only by the CDC.
3. Currently, DOH has guidelines for clinical laboratories for the following diseases:
Smallpox, Anthrax, and Plague, Tularemia, and Botulinum toxin.
C. Questions on shipping of environmental and clinical samples should be directed to the
Washington State Public Health Laboratory at (206) 418-5400 during business hours or
(206) 418-5500, a 24-hour number.
37
Kittitas County Public Health Department
Isolation and Quarantine
(Adapted/rom: Public Health -Seattle & King County Isolation and Quarantine Response Plan
Version 2)
AnnexB
Table of Contents
1. INTRODUCTION 39
II. PURPOSE OF PLAN 39
III. PLANNING ASSUMPTIONS 39-40
IV. RESPONSIBILITIES 40-4i
A. Kittitas County Public Health Department
B. Local Law Enforcement
C. Prosecuting Attorney's Office
D. Community Based Organizations
v. CONCEPT OF OPERATIONS 41-45
A. Determination of Need for Isolation or Quarantine
B. Initiation of Requests for Voluntary Compliance
C. Involuntary Detention
D. Release from Isolation or Quarantine
38
I. INTRODUCTION:
Isolation is the separation of infected persons from others during the period of communicability.
Quarantine is the limitation of freedom of movement of well persons who are suspected to have
been exposed to an infectious agent. Quarantine lasts as long as the usual incubation period of
the infectious agent. Persons assigned to care for infectious or potentially infectious individuals
must be protected as well as patients.
II. PURPOSE OF THE ISOLATION AND QUARANTINE RESPONSE PLAN:
A. Establish the decision making criteria used by the County Health Officer to determine when
isolation and/or quarantine beyond the capacities of communicable disease practices is necessary
to minimize health impact of a disease outbreak.
B. Identify the authorities, roles, and responsibilities of KCPHD and partner agencies in the
situation of a disease outbreak requiring isolation and quarantine (I & Q) of one or more
individuals.
C. Describe procedures and activities for accomplishing 1& Q of large numbers of individuals in
the county.
E. Describe procedures for staffing a dedicated facility for I & Q of persons who cannot stay in
their homes or who do not have a suitable home environment.
F. Define roles and responsibilities for KCPHD, local health care partners, and local response
agencies during an outbreak requiring isolation and/or quarantine.
G. Describe how communications and coordination will occur between KCPHD, local and state
entities during such an incident.
H. Assist KCPHD and response partners to limit the spread of infectious diseases, illness, and
death within Kittitas County.
III. PLANNING ASSUMPTIONS:
This plan applies to communicable disease occurrences requiring isolation and quarantine that
may exceed day to day capabilities. While I & Q are techniques used in the everyday
management of infectious disease, this plan does not apply to the prevention and control of
sexually transmitted diseases, or routine operation of communicable disease management.
A. Isolation and quarantine planning efforts must incorporate and address the unique needs and
circumstances of vulnerable populations including the homeless, limited English proficiency
populations, persons with special medical needs, etc.
39
B. All policies and procedures to assure the care of protected health information apply. Policies
and procedures recognize that KCPHD may make necessary disclosures to protect the health of
the public.
C. Isolation and quarantine may be necessary beyond Kittitas County; therefore KCPHD win
coordinate with other counties and regions, but is not responsible for planning or execution of I
& Q efforts beyond county lines.
D. Large scale I & Q incidences will require many public health resources and volunteers as well
as coordination with multiple communities, health care, and first responder agencies.
E. KCPHD may utilize I & Q as one of several tools to reduce the spread of communicable
disease; KCPHD will focus on gaining voluntary compliance from ill or exposed persons and
implementing the least restrictive means possible to reduce the spread of infection.
F. KCPHD will coordinate closely with healthcare providers and healthcare facilities to assist
with achieving voluntary compliance of ill or exposed persons.
G. 1& Q may require the involuntary detention of individuals who may pose a threat to the
public's health and whom do not cooperate with requests from the Health Officer.
H. An individual's cooperation with voluntary isolation and quarantine will be assumed in good
faith unless there is evidence to the contrary. Depending on the circumstances, information
collected by KCPHD during monitoring may be used as evidence of non-cooperation.
VII. RESPONSIBILITIES:
A. In the event of a reported or suspected case of a communicable disease, which requires
isolation or quarantine, the Health Officer may at his or her sole discretion issue an emergency
detention (health order) causing a person or group of persons to be immediately detained for
purposes of isolation or quarantine. The local Health Officer has three options for initiating the
quarantine or isolation of an individual including issuing a voluntary request, an emergency
involuntary detention order, or a court order for an involuntary isolation or quarantine. KCPHD
will be responsible for the following activities:
1. KCPHD will be the lead agency in the management of a communicable disease
outbreak.
2. The Health Officer will assess the public health threat, evaluate potential
consequences based on established criteria, and determine whether isolation and/or
quarantine are necessary in any given outbreak situation.
3. The local Health Officer may initiate the isolation or quarantine of individuals as a
protective action to limit the spread of infectious agents or contaminants to others.
4. When possible, KCPHD will seek the cooperation and compliance of infected or
exposed individuals in abiding by I & Q requests. However, under specific
circumstances, KCPHD may immediately order or seek a court order to detain infected or
exposed individuals and place them in isolation or quarantine.
40
5. In all cases where 1& Q are considered, KCPHD will ensure basic needs are
addressed.
6. KCPHD will implement local and regional surveillance and disease and health
management services that comply with clinical protocols and federal, state, regional and
local regulations, laws and guidelines.
7. KCPHD will be the lead clinical and administrative manager of any non-hospital
isolation or quarantine facilities that are established.
B. Local Law Enforcement agencies will be responsible for the following activities :
1. Assist with service of Notice of Civil Detention to clients, ifneeded.
2. Consult with KCPHD for cases requiring transportation for the purposes of
involuntary isolation or quarantine.
3. Execute arrest warrants related to I & Q cases.
C. The Prosecuting Attorney's Office will be responsible for the following activities:
1. Petition the court ex parte to authorize involuntary detention, once need is determined
by the local Health Officer.
2. Represent KCPHD in any petition or appeal hearings required to carry out involuntary
isolation or quarantine of individuals.
3. Coordinate with KCPHD and local raw enforcement to serve notice necessary to
achieve isolation or quarantine.
D. Community based organizations may be requested to assist with personal needs of patients
affected by I & Q.
VIII. CONCEPT OF OPERATIONS:
Determination of Need for Isolation or Quarantine
A. The local Health Officer will determine the need for and authorize the use of isolation and/or
quarantine as strategies to control or slow a communicable disease outbreak.
B. The Incident Commander with advice from the local Health Officer will determine whether
an isolation or quarantine facility should be activated.
C. KCPHD will seek voluntary compliance with requests for isolation or quarantine, unless the
local Health Officer determines the following conditions are present, making it necessary to
immediately initiate involuntary detention for the purposes of isolation or quarantine:
1. There is reason to believe that the individual or group is, or is suspected to be, infected
with, exposed to, or contaminated with a communicable disease or chemical, biological,
or radiological agent that could spread to or contaminate others if remedial action is not
taken; and
41
'-
2. There is a reason to believe that the individual or group would pose a serious and
imminent risk to the health and safety of others if not isolated or quarantined; and
3. Seeking voluntary compliance would create a risk of serious harm.
D. Initiation of Requests for Voluntary Compliance with Isolation or Quarantine
The Communicable Disease (CD) Investigations Team (consisting of the Community Health
Supervisor, other public health nurses, regional epidemiologist, public health clerk, and other
staff as necessary) will:
1. Initiate contact with the individual or group suspected of being infected or exposed.
2. Determine whether interpretation services are needed to facilitate communication with
the person; if so, coordinate this issue with interpreter services to provide a certified
medical interpreter.
3. Maintain documentation related to cases including dates and times of all verbal and
written communications.
4. Verbally communicate the following information to the individual or group:
a. Explain the circumstances regarding the infection or exposure, the nature and
characteristics of the illness , and the potential for infection of others. (Provide
written material when available.)
b . Request that the individual or group isolate or quarantine themselves.
c. Explain the process isolation and qUdrantine, what is expect~d of each
individual, how KCPHD will support their needs, and how long they must remain
under isolationor quarantine.
d. Ifnecessary, explain that the local Health Officer has authority to issue an
emergency detention order or petition the court ex parte for an order authorizing
involuntary detention if the individual or group does not comply with the request
for isolation or quarantine.
E. If an individual is a patient in a hospital, make contact with hospital staff as well as the
patient to ensure hospital-based isolation and appropriate infection control measures are
practiced, if indicated.
F. Complete a written request for voluntary compliance with isolation or quarantine instructions
to include the location and dates of isolation or quarantine, suspected disease, medical basis for
isolation or quarantine, and relevant patient information. Provide copies to the local Health
Officer, Prosecuting Attorney, and patient.
G. Alert the local Health Officer and Prosecuting Attorney about situations in which a person or
group indicate unwillingness to comply. Recommend consideration of the initiation of
involuntary detention if warranted.
H. Coordinate with the Regional Epidemiologist regarding the issuance of requests for voluntary
compliance with isolation or quarantine instructions.
42
1. Contact the identified individual to evaluate the suitability oftheir residence for isolation or
quarantine; determine whether evaluation can be implemented using a telephone questionnaire or
if an in-person review is necessary.
J. Immediately deliver an informational packet to the individual placed in isolation or
quarantine. Provide appropriate instructions and training, if needed, regarding the packet
contents, KCPHD expectations, and infection control measures [Note: patients isolated within
healthcare facilities may only require an informational packet; the healthcare facility may
address training needs and infection control issues for the patient].
K. Verify that the individual is at a specific location and monitor their health status.
1. Develop a schedule of daily check-in calls for each individual under isolation or
quarantine.
2. Continue conducting daily check-in calls with each individual until they are released
from isolation or quarantine.
L. Record information gathered during check in calls.
M. Respond to irregularities such as changes in health status and failure to respond to call(s)
[e.g. request law enforcement or KCPHD staff to drive by; make contact with the patient's
healthcare provider, personal contacts or employer, etc.].
If repeated attempts to locate individuals subject to isolation or quarantine, including telephone
calls and site visits, are unsuccessful, coordinate with the Incident Commander, Prosecuting
Attorney, and the local Health Officer regarding the need to pursue involuntary detention.
N. Document all requests for assistance. Include the nature and specific type of assistance
requested, and the date and time the request was made, including contact and phone number.
Reasonable requests for assistance could include food, water, clothing, shelter, means of
communication, medication, medical care, special needs related to cultural and religious beliefs,
and legal representation.
O. Follow up with referral agencies on requests for assistance as staffing and time allow.
P. Coordinate with hospital discharge planners to provide KCPHD with appropriate notice
regarding the discharge of isolated patients.
Q. Ensure that patients are aware of the continuing requirements of isolation and appropriate
infection control measures.
R. Involuntary Detention for Purposes of Isolation or Quarantine.
The local Health Officer may authorize initiation of involuntary detention for the purposes of
isolation or quarantine under the following conditions:
43
1. There is reason to believe that the individual or group is, or is suspected to be, infected
with, exposed to, or contaminated with a communicable disease or chemical, biological,
or radiological agent that could spread to or contaminate others if remedial action is not
taken; and
2. There is reason to believe that the individual or group would pose a serious and
imminent risk to the health and safety of others if not detained for purposes of isolation or
quarantine; and
3. KCPHD has made reasonable efforts, which have been documented, to obtain
cooperation and compliance from the individual or group with requests for medical
examination, testing, treatment, counseling, vaccination, decontamination of persons or
animals, isolation, quarantine, or inspection and closure of facilities, or the local Health
Officer has determined that seeking voluntary compliance would create a risk of serious
harm.
S. The local Health Officer may petition the Superior Court for an order authorizing continued
detention for up to 30 days following the initial 10-day detention, pursuant to WAC 246-100-
040(5). In order to grant the petition, the court must find clear, cogent, and convincing evidence
that isolation or quarantine is necessary to prevent a serious and imminent risk to the health and
safety of others. If necessary, the local Health Officer may petition the Superior Court for one
additional 30-day period of detention, pursuant to WAC 246-100-040(6).
T. The Kittitas County Prosecuting Attorncy's Office will represent the local Health Officer in
court proceedings for involuntary detention.
U. The Kittitas County Prosecuting Attorney will coordinate with and brief law enforcement
officials for the jurisdiction(s) in which emergency detention orders or court orders will be
served. If necessary, the Prosecuting Attorney will request law enforcement support for
enforcement of detention orders.
V. The Communicable Disease Investigation Team Leader will provide technical information to
law enforcement regarding the nature of the illness and appropriate protective actions and
equipment to be used during enforcement of orders.
W. The Incident Commander, local Health Officer, Prosecuting Attorney, and logistics will
resolve issues related to locations for detained persons. Detentions will occur in the least
restrictive settings possible that do not endanger the health of the public.
X. KCPHD will provide monitoring and support services to persons involuntarily detained,
using the protocols applicable to persons who are voluntarily complying with requests for
isolation or quarantine. Modified protocols may be necessary if the location for detention is a
correctional facility or other secure residential facility.
Y. Release from Isolation or quarantine will include the following:
44
1. The local Health Officer will release an individual or group from voluntary
compliance with isolation or quarantine when isolation or quarantine is no longer
necessary as a strategy to control a communicable disease.
2. The local Health Officer will release an individual or group from involuntary
detention for purposes of isolation or quarantine based on if the individual is no longer
suspected to be infected with, exposed to, or contaminated with a communicable disease
or chemical, biological, or radiological agent; or the individual is no longer deemed to
pose a serious and imminent risk to the health and safety of others if released from
isolation or quarantine.
3. If release of a detained person is authorized before the expiration of a detention order,
the Prosecuting Attorney's office will coordinate the activities necessary to accomplish
release.
45
Kittitas County Public Health Department
Medical Countermeasures and Material Management
AnnexC
Table of Contents
I. PURPOSE 47
II. ASSUMPTIONS AND LIMIT A nONS 47
III. COMMAND AND CONTROL 47-48
IV. RESPONSIBILITIES 48-49
V. OPERATIONS 49-52
VI. ATTACHMENTS
Attachment A Medical Countermeasure Points of Dispensing 53-54
Attachment B POD Agreements 55
Attachment C Patient Registration Form 56
Attachment D Local Mass Clinic Facility Worksheet 57
Attachment E Antiviral Withdrawal Form 58-59
I
,/
"
46
I. PURPOSE:
This plan describes the process for requesting, receiving, managing, distributing, and dispensing
medication in an emergency, including any supplies from State, Federal, or private sources. The
US Department of Homeland Defense and US Centers for Disease Control and Prevention
(CDC) manage the Strategic National Stockpile (SNS) at the national level; the Washington
State Department of Health (DOH) manages the SNS at the Washington State level, and KCPHD
manages the SNS within Kittitas County.
II. ASSUMPTIONS AND LIMITATIONS:
A. From the time DOH receives the request for supplies, it will take approximately 6 to 18 hours
to distribute its contents to the local health jurisdiction (LHJ). Managed inventory deployed
from the federal level would take from 12 to 24 hours.
B. Additional staffing, supplies, and logistical resources will be needed in a large scale
emergency in Kittitas County to implement medical countermeasures.
C. A successful large-scale distribution of medical resources requires the involvement and
participation of a wide-range of community organizations, businesses, and volunteers.
D. Deployment of medical countermeasures is dependent on an accurate and timely
identification of the disease or bio-terrorist agent that constitutes the public health threat.
E. The number of medical personnel qualified to administer vaccine or dispense
pharmaceuticals, and the number of available volunteers to perform support functions, will
dictate the rate at which residents are treated. Residential estimates within Kittitas County 2014
are as follows:
Unincorporated 18,890
Incorporated 23,210
Cle Elum 1,870
Ellensburg 18,440
Roslyn 895
South Cle Elum 530
F. KCPHD lacks the staffing needed to operate all Points of Dispensing (PODs) required in
immunizing or administering chemoprophylaxis to Kittitas County residents.
G. When chemoprophylaxis supplies are limited, KCPHD will develop a prioritization plan in
accordance with recommendations from the CDC and/or from DOH. The health officer will
coordinate this prioritization.
III. COMMAND AND CONTROL:
A. Specific recommended policies for LHJs and Tribes for the State of Washington concerning
emergency medical countermeasures are listed as follows:
47
1. State of Washington policy dictates that only the Governor or the Governor's designee
may request the assistance ofthe Centers for Disease Control and Prevention's Division
of Strategic National Stockpile. Local jurisdictions should request specific assistance or
resources from the state. The state processes and determines the source of the needed
resources.
2. DOH recommends to LHJs that a single family member may be allowed to pick up a
regiment of emergency medical countermeasures for each family member or household
member listed on the screening and dispensing formes). The age and weight of each
person under 75 pounds must be listed.
3. DOH recommends that an unaccompanied minor is any minor over the age of 15 and
may be allowed to pick up any needed emergency medical countermeasures for
themselves and their immediate family members as described above in 2.
4 . DOH recommends that the identification needed to receive emergency medical
countermeasures is the name, age, and address recorded on the screening and dispensing
forme s). Proof of residency is not recommended and should not be used to determine the
need of a medical countermeasure, which may save the life of the citizen in question.
5. DOH is not a law enforcement agency and recommends that the use of force should be
at the discretion of law enforcement professionals and their agencies. Any use of force
should be as a last resort in order to control an aggressive situation, protect citizens from
harm, or to protect the lifesaving resources.
6. DOH policy is that all victims of any public health emergency will be treated with
respect, dignity, and equality. In an incident that the needed countermeasures are in short
supply, medical countermeasures received will be supplied on a prorated allocation based
on the epidemiology of the disease agent.
7. Our nation's military members and their family members are included in population
estimates and will be provided emergency medical countermeasures based on their
exposure to the disease agent. The US Department of Defense may provide
countermeasures to active duty troops initially. In an event that the needed
countermeasures are in short supply, medical countermeasures will be supplied on a
prorated allocation.
IV. RESPONSIBILITIES:
A. KCPHD is the lead agency in Kittitas County for medical countermeasures and medical
material management and distribution. KCPHD is also responsible for an annual review and
update of this plan, for training mass dispensing/vaccination personnel, and for exercising the
medication distribution plan.
B. Other Kittitas County agencies may perform support functions as requested in accordance
with the Kittitas County Emergency Management Plan (CEMP). Specific responsibilities may
include:
1. Law enforcement may provide security and traffic control at PODs. Law enforcement
officer posts will be determined based upon need.
48
2. The Kittitas County Public Works Department or Kittitas County Search and Rescue
may assist with traffic control.
3. Kittitas County Medical Reserve Corp volunteers will assist with vaccine/and or
administer medicine.
4. Emergency Management will direct the County EOC and coordinate emergency
response activities in accordance with existing procedures.
5. Transportation for people with function or access needs may be available through
Hopesource and Ellensburg School District.
6. Fire and Emergency Medical Services and W Aserv volunteers may support clinic
operations, as needed.
v. OPERATIONS:
A. KCPHD (Via Kittitas County Emergency Management) will request deployment of resources
as circumstances warrant when the local Health Officer or designee determines it is necessary to
protect the public's health.
The determination to request resources from the state will be based upon the local Health
Officer's assessment of the need for additional medical materials based upon coordination with
the local hospital and other healthcare entities including pharmacies, healthcare providers, and
local officials.
Requests to the state would be in broad terms, for example, "prophylaxis medical
countermeasures for 30,000 against Tularemia."
B. Within Kittitas County, the following individuals may request the deployment of SNS
material and/or resources:
1. Local Health Officer, KCPHD Administrator, or designee
2. Local Emergency Response Coordinator (LERC) for KCPHD
3. Emergency Management Director for Kittitas County
4. Kittitas County Board of Health
C. Resupply of medical materials will be initiated as circumstances warrant. Any resupply
request will be coordinated by the Inventory Leader and will be approved by the Health Officer.
Requests for additional supplies will also be forwarded to the EOC for records.
D. Receiving SNS Material
1. The Washington State Department will be responsible for the following SNS activities:
a. Formally request the SNS from federal authorities
b. Receive and breakdown the SNS, repackage into unit doses, and affix labels.
c. Ship SNS resources to the POD locations designated by KCPHD
d. Assess resource request from KCPHD or Emergency Management Agency for
supplemental medications, vaccines, medical supplies, and equipment.
49
2. The Kittitas County Public Health Department will be responsible for the following
medication distribution activities:
a. Request needed resources via Kittitas County Emergency Management
b. Identify POD locations to be utilized
c. Prepare POD locations for operation
d. Dispense medications to and/or immunize residents
e. Coordinate security and management for resources deployed to Kittitas County
f. Follow guidelines from DOH and the CDC regarding dissemination of
resources and medication including priority distribution.
E. KCPHD will utilize local and county law enforcement for POD site security, perimeter
control, and facility access.
F. POD site selection will be determined by the local Health Officer. Because several locations
in Kittitas County are identified for possible consideration as medical countermeasure Points of
Dispensing sites (Attachment A) a list of POD site/agency partnerships from previous POD sites
is supplied (Attachment B). These sites provide for distribution of medication/vaccines and
other supplies in both the upper and lower portions of the county.
Depending upon the disease being addressed and the overall situation, the local Health Officer,
or designee, may decide to immunize or provide chemoprophylaxis for populations at risk or the
entire population of Kittitas County. The decision to use any of the mass vaccination/mass
dispensing site or PODs will be dictated by the needs of the emergency, the population to be
served, staffing requirements, and the availability of sites.
Incident Command staff, in conjunction with the local Health Officer may also consider utilizing
alternative push and pull dispensing methods, such as a drive-th_ru pharmacy, drive thru clinic,
in-house dispensing (large employers, hospital, etc.) or on-site dispensing Gail, nursing homes,
etc.)
G. Site setup will be handled by the appointed Inventory Leader. The Inventory Leader will
manage reception, storage, and maintenance of the supplies provided to the PODs. The number
of vaccination/dispensing stations needed at a site may change depending on the affected
population.
H. Certain pharmaceuticals require proper storage in order to maintain potency. All vaccines
will be kept at the advised temperature, ensuring no breaks in the temperature chain.
Refrigeration for pharmaceuticals will be accomplished by utilizing refrigerators on site at
facilities, by utilizing mobile refrigeration units, or by using temperature monitored (with a
thermometer) Styrofoam containers containing ice packs. The method will vary based on POD
location.
1. The Reception, Storage, and Staging (RSS) facility operated by the Washington State
Department of Health will be responsible for labeling pharmaceuticals. Individual unit of use
bottles are pre-labeled and any bulk material will be repackaged at the RSS or a contractor and
appropriate labeling affixed prior to shipment. The local Health Officer or designee will be
identified as the prescriber.
50
J. Tracking pharmaceuticals and/or vaccines with recipients will be accomplished using the
Patient Registration Form (Attaclunent C). The form will be used to obtain a patient's health
history, consent for treatment, and to track drugs/vaccines after distribution.
A family member may pick up medication only for other members in their immediate family.
(Recommendations from DOH suggest the widest definition of immediate family member such
as spouse, child, parent, partner, etc.) Situations requiring special consideration will be reviewed
by the Vaccine Administration Leader, pharmacist, or designee at the time of dispensing.
Persons age 15 and up are considered adults. Minors (age 14 and under) must be accompanied
by a parent/guardian to receive medication/vaccination. The parent/guardian will be asked to
sign a consent statement prior to the minor receiving medication/vaccination. Unaccompanied
minors will be evaluated on a case-by-case basis. Specific direction from DOH or CDC may
preempt local plans for distribution.
K. Dispensing may have a predetermined prioritization. Medical and emergency responders,
public health staff, and other critical personnel may receive their immunizations or
chemoprophylaxis before the general public in accordance with a prioritization determined by
the local Health Officer, the Centers for Disease Control and Prevention (CDC), and/or the
Washington State Department of Health.
Any adverse reactions to medication will be noted on the Patient Registration Form and any
adverse reactions to vaccinations will be entered through the Food and Drug Administration
(FDA) Adverse Event Reporting System (F AERS).
L. The decision to cease medical countermeasures operations and to return to normal operations
will be determined by the local Health Officer, or designee, following consultation with the local
hospital, healthcare professionals, and community partners on the status of the incident that
caused activation of the medication distribution.
M. All staff and volunteers must be credentialed prior to responding to an incident. Volunteers
must first register with Kittitas County Emergency Management as an emergency worker prior to
assisting in an emergency. Currently, credentialing of staff and volunteers will be conducted
through the Sheriffs Office in conjunction with WAServ (Emergency System for Advance
Registration of Volunteer Health Professionals) and Washington State Department of Health.
All staff is required to wear their county name badges when participating in a
dispensing/vaccination clinic.
Spontaneous volunteers may be utilized only upon verification of identification and
credentialing, and only if the nature of the crisis exceeds current staff and Medical Reserve
Corps (MRC) capacity. Spontaneous volunteers shall be subject to the same requirements as all
previously credentialed volunteers.
All volunteers will be required to show photo identification upon check-in at each venue.
Volunteers with professional credentialing should bring their licenses. If available, a photo copy
of each license will be made and stored in the volunteer's file. License numbers and expiration
dates will be recorded.
51
N. Volunteer training will be provided to personnel using just in time (JIT) training during the
initial briefing. JIT will be performed by the Incident Commander or designee and will include
relevant safety information as well as other necessary instructions.
o. Sanitation such as medical wastes will be disposed of tollowing the guidelines provided by
the Washington State Department of Health. All sharps will be disposed of in rigid sharps
containers that will be sealed following use. Appropriate medical waste will be "red-bagged,"
and placed in watertight, puncture-resistance containers for transportation. Other wastes will be
disposed of in the trash at the clinic site. If regular trash service is not provided at the clinic site,
KCPHD will contract with a commercial sanitation provider for a dumpster and collection
servIce.
52
'.
Attachment A: Medical Countermeasure Points of Distribution
Area School/Facility Address City Zip Code Phone Contact
Central Kittitas County 507N Ellensburg 98926 509-962-Administrator
Public Health Nanum 7515
Department Street
Central Grand Meridian 504 East Ellensburg 98926 (509) 962-Private
Mountain 1992 Owner(s)
View
Central Kittitas County 512N. Ellensburg 98926 (509) 962-Event Center
Teanaway Hall Poplar 7639 Director
Central Ellensburg High 1203 E Ellensburg 98926 (509) 925-School
School Capital 8013 Superintendent
Ave
Upper Cle ElumlRoslyn 2694 SR Cle Elum 98922 509-649-School
School District 903 4850 Superintendent
Walter Strom
Middle School
Upper Cle Elum Senior 719 E Cle Elum 98922 509-674-President
Center Third 7530
53
Number of Drive Tbru Vaccination Ceotel1l (Dvq or Points of Distribution Sites (PODs)
Per-DVC Patient Processing Rate
Name Formula
Nunfler of BriefiJ1g Room;
Number of Patients per
Bre!ing
Duraoon of Each Brefing
(Minutes)
Maxirwm Patient Flow Per
CIhl:, Given These
Panllreters (per Minute) #DlV/O!
MaxiJrurn Patient Flow Per
CIhl:, Given 1rese
Pararreters (per Hour) #DIV!O!
Clear Nunfler ofBrefing
Ro om;, Pawnts, and Duraoon
CeI5
Corrmmity Wide Flow Rate
Name Formula
Populaoon Size
Number of Days Iilr
ProphyJaxE
Corrmmity Wide Patient
Flow Rate (patients per
Minute)
Corrmmity Wide PatieJt
Flow Rate (patieJts per
Hour) #DlV/O!
Nunfler ofClhl:s Required
to Achieve ProphylaxS Goal
in Allotted Tirre #DIV/O!
Clear Populaoon S~, Nunfler of
Days, and Patient Flow Rate per
Minute
54
Attachment B: POD Site/Agency Partnerships
Name Role Contact Person Status
Kittitas County Use of Facility 962-7639 9.6.13 spoke to Event Center
Fairgrounds Director. No MOU needed.
Kittitas County Public Traffic 962-7253
Works control/security
Ellensburg School Facility usage and 925-8000
District Transportation
support
Cle ElumlRoslyn Facility usage 649-4850 MOU signed
School District
ARES/RACES Coordination of local 933-8218
operators
Hopesource Transportation 925-1448
assistance
Kittitas County Sheriff Security and traffic 509-962-7525 CEMP
control at all
facilities
Search and Rescue
Volunteer
Grand Meridian Parking lot usage for 929-5000 Verbal agreement and
Cinema triage in an 925-7757 previous use of location.
emergency
Upper Kittitas County Facility Usage 674-7530 MOU Signed
Senior Center (designated
emergency shelter)
Kittitas County Assistance
Pharmacies distributing medical
countermeasures
55
Attachment C: Patient Registration
Client Information:
Last Name I First Name 1 Middle Initial
Street Address City State/Zip Code Race/Ethnicity
(Mark all that apply)
Mailing Address (if different) City State/Zip Code o Native American or Alaskan
o Asian o White
Phone # 1 May we leave a message? O Y 0 I Phone #2 May we leave a message? 0 Y O N o Black or African American
N o Hi s pani c/La tin o 0
Birthdate Sex OM OF Marital Status: 0 Single o Married o Divorced
(MonthiDay/Year) Other o Separated o Widowed o Partnered
Primary Languag e Do you need an Regular Family Doctor or Clinic
inte Ll)reter?
If client is a minor or deoendent. please flU in iuformation about narent or lee:al 1!uardian:
Last Name First Name Middle Initial Relationship
o Mother o Father
Address City State/Zip Code o Foster Parent 0
Grandparent
Phone # 1 M ay we leave a mes sage? o Y 0 I Phone #2 May we leave a message? O Y ON o Legal Guardian
N o Other:
Health Insurance Info.·mation (mark all that aODlv):
o No insurance o Medicare o Medicaid o Private Insurance o Tricare o Other
Does the insurance cover immunizations? 0 Yes oNo o I don't know
Is there more than one health insurance company? DYes oNo
Is health insurance provided through an employer? 0 Yes oNo
PLEASE PRESENT INSURANCE CARDS AT TIME OF APPOINTMENT
56
Attachment D: Local Mass Clinic Facility Worksheet
+ Local Strategic National Stockpile8lass Clinic Facility Worksheet
"
County Namcc Public Health R~on #:
Facility Name: Facility Code:
F ac.ility Address: Location Cross Street :
Facility Owner: Facility Owner Phone:
Primary Point of Contact Alternate Point of Contact
Name/Title: Nametritle: :
Day Phone: Day Phone:
Ev~gPhone : Evening Phone:
DCell Phone ! DPager: DeeR Phone ': OPager:
email address : email:
Facility capacity: I SqfL Number of Parking Stalls : ,
LJ Facility use ~reeIllent in place _ 0 Fencing Qarollnd facility Darol,lJld loading ~
0 Electricity (adequate outlers in clinic area) 0 loading dock
0 Backul? powet_ ~our~ 0 Telephone availability, # of e."tternallin:es:
0 Adequace road access 0 (f1II.tj odwr items o!iit1in-erl ,,~~)
0 Walet source: 0 (tufd otJuu items ofl1lterQs[ hm-ej
0 ADArestrooms, # ofsta1ls : c:r (aJd othiu if.ems ofi itr«YillT Iwre)
D Sewer or 0 on-site sewage syst em 0 Adequate HVAC capacity to malnuin .J.normaT' temp in
clinic areafu tItr drugstora .~ guidelines; 6S-71 "f)
0 Helicopter l~ding pad: [) on-site ,' tl nearby 0 Plan customized to fit faCluty. following actachments
athletic fields comp le[~
0 AlL ~ation available: o Location map 0 site plan 0 clinic plan 0 needed equip list
Facili~ ~ Soordin~t~ \Vith: ----. --~.-
Local Hwtl1 Iurisdiction: Law Enforcement Agency:
Emergency lVIanagement : Frre Services :
Chief Elected Officials: F aci1ity Owner:
57
Attachment E:
Anmiral Withdrawal Farm I D~ ofR:equat:
F.:nn iKIsm.cb:ms:
1 _ DOH frMip!nq' Pl'4!pa'o!!cirrol:ss 0IITe! JbuSX' ft ~flIIRl ~ "U
.;ne ,if-~Si:. fia:m' .. ~c ju -..
2_ Ta, an!.".-OIIT -., meenmo:mpklle dlir f_.ln. o.,,=e ~.\etll! sCIII1Jhe fottm
===:::o<>.::.!:==,-"=.;c,,,:;-~ n :> e :d ~€~c;.h : ... ;= uSOns",ilm "."
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58
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59
Kittitas County Public Health Department
Pandemic Flu Response
I. INTRODUCTION
II. PLANNING ASSUMPTIONS
III. IMPACTS OF A PANDEMIC
IV. PHASES OF A PANDEMIC
V. CONCEPT OF OPERATIONS
AnnexD
Table of Contents
61-62
63-64
64
65
66-67
60
I. INTRODUCTION:
Pandemics are distinct from seasonal influenza epidemics that happen nearly every year.
Seasonal influenza epidemics are caused by influenza viruses that circulate around the world.
Over time, people develop some degree of immunity to these viruses and vaccines are developed
annually to protect people from serious illness. Pandemic influenza refers to a worldwide
epidemic due to a new, dramatically different strain of influenza virus. A pandemic virus strain
can spread rapidly from person to person and, if severe, can cause high levels of disease and
death around the world.
Pandemic viruses develop in two main ways. First, wild birds are the reservoir for all influenza
viruses. Most avian influenza viruses do not infect or cause significant disease in humans.
However, new pandemic influenza viruses can arise when avian influenza viruses acquire the
ability to infect and cause disease in humans and then spread rapidly from person to person.
Secondly, all influenza viruses experience frequent, slight changes to their genetic structure over
time.
The development of a novel virus means that most, if not all, people in the world will have never
been exposed to the new strain and have no immunity to the disease. It also means that new
vaccines must be created and are not likely to be available for months.
Flu pandemics have occurred throughout history. The influenza pandemic of 1918 caused more
than 500,000 deaths in the United States and more than 40 million deaths around the world.
Subsequent pandemics in 1957-58 and 1968-69 caused far fewer fatalities in the US, but caused
significant morbidity and mortality around the world. In 2009, the first US case ofHINI (swine
flu) was diagnosed. The CDC estimates that 43 million to 89 million people had HINI between
2009 and 2010 with 8,870 and 18,300 HINI related deaths.
61
Severe influenza versus pandemic influenza:
I ~ Pandemic Flu II Seasonal Flu I
Rarely happens (three times in 20th Happens annually and usually peaks in January or
century) February
People have little or no immunity because Usually some immunity built up from previous
they have no previous exposure to the virus exposure
Healthy people may be at increased risk for Usuall y only people at high risk, not healthy adults,
serious complications are at risk of serious complications
Health care providers and hospitals may be Health care providers and hospitals can usually
overwhelmed meet public and patient needs
Vaccine probably would not be available in Vaccine available for annual flu season
the early stages of a pandemic
Effective antivirals may be in limited Adequate supplies of antivirals are usually available
supply
Number of deaths could be high (The U.S. Seasonal flu-associated deaths in the United States
death toll during the 1918 pandemic was over 30 years ending in 2007 have ranged from
approximately 675,000) about 3,000 per season to about 49,000 per season. I Symptoms may be more severe I Symptoms include fever, cough, runny nose, and
muscle pam
May cause major impact on the general Usually causes minor impact on the general public,
public, such as widespread travel some schools may close and sick people are
restrictions and school or business closings encouraged to stay home
Potential for severe impact on domestic and Manageable impact on domestic and world
world economy economy
62
II. PLANNING ASSUMPTIONS:
A. An influenza pandemic will result in the rapid spread of infection with outbreaks throughout
the world. Communities across the state and country may be impacted at the same time.
B. Localities may not be able to rely on timely or effective mutual aid resources, State, or
Federal assistance to support local response efforts.
C. An influenza pandemic may occur in waves and last for 12 to 24 months.
D. Residents may be required to stay in their homes for a significant period during an influenza
pandemic; thus, residents will need public information, education and tools, so they are prepared
to take responsibility for basic needs (food, water, prescription medications, etc.)
E. Antiviral medication will be in extreme short supply. Administration of local supplies of
antiviral medication will be prioritized by KCPHD in accordance with CDC and DOH
guidelines.
F. A vaccine for the pandemic influenza strain may not likely be available for the first wave
following the emergence of the novel virus.
G. The number of ill people requiring care may overwhelm the local healthcare system.
1. KVH and clinics may have to modify their operational structure to respond to high
patient volumes.
2. The healthcare system may have to respond to increased demands with a decreased
workforce due to illness.
3. Demand for inpatient beds and assist ventilators could increase ten-fold and patients
will need to be prioritized for services.
4. There will be tremendous demand for urgent care services.
5. Infection control measures specific to management of influenza patients will need to be
developed and implemented in all healthcare facilities.
6. The health system may need to develop alternative care sites to relieve demand on the
hospital emergency department.
7. Emergency Medical Service responders will face extremely high call volumes.
8. The number of fatalities may overwhelm the resources of the Kittitas County
Coroner's Office and funeral home.
H. There will likely be significant disruption of public and privately owned critical infrastructure
including transportation, commerce, utilities, public safety, and communications.
1. Social distancing strategies aimed at reducing the spread of infection such as closing schools,
community centers, and other public gathering points, and canceling public events will likely be
implemented during a pandemic.
63
J. Some persons will be unable or unwilling to comply with isolation directives . For others,
social distancing strategies may be less feasible. It will be important to develop and disseminate
strategies for infection control appropriate for these environments and populations.
K. Risk communication will be critically important during all phases of planning and
implementation of a pandemic influenza response. The general public, healthcare system,
response agencies, and elected leaders will need continuous updates on the status of the
pandemic outbreak, impacts on critical services, the steps being taken to address the incident,
and steps the public can take to protect themselves.
III. IMPACTS OF A PANDEMIC:
Using the CDC's FluAid 2.0 model, calculations are based on current estimates based on
predictions from FluAid 2009.
64
IV. PHASES OF A PANDEMIC:
1
2
3
4
'5
6
POST
PEAK
PERIOD
No circulating animal
influenza virus has been
reported to have spread
to humans.
A circulating animal
influenza virus can
spread to humans and is
considered a threat.
A circulating animal
virus has caused disease
in some people.
A community-level
outbreak has been
verified.
The virus has caused
community-level
outbreaks in two or more
countries in one WHO
region.
The virus has caused
sustained community-
level outbreaks in at least
one other country in
another WHO region.
Levels of influenza have
dropped below peak
levels in most countries.
POST r Levels of influenza have
PANDEMIC returned to the levels
PERIOD seen for seasonal
influenza in most
countries.
Plan: Develop, exercise, and revise national influenza pandemic
preparedness and response plans.
Monitor & Assess:. Collaborate with other agencies to develop a
national surveillance system.
Communicate : Communicate real and potential risks of the virus .
Reduce Spread of Disease: Promote healthy behaviors in people
for self-protection. Plan for the use of vaccines.
Health Care Contimdty: Prepare the health system to scale up.
Plan: Lead rapid pandemic containment activities to limit the
spread of infection.
Mon ito r & Assess: Increase surveillance and share findings.
Communicate: Promote and communicate recommended
interventions to prevent and reduce risk.
Reduce 8pread of Disease: Implement rapid pandemic containment
operations and other activities.
Healtb Care Cont in uity ,: A~t!vate cOD~~ng~l1_C:Y l an ~
Plan: Coordinate and lead resources to reduce overall impacts of
the outbreak.
Mon itor & Assess: Continue surveillance to detect ensuing waves.
I Commun icate: Regularly update the public on any changes to the
status of the pandemic.
Reduce Spread of D is e ase: Implement individual, societal, and
pharmaceutical measures.
Health Care Continuity: Implement contingency plans for health
systems at all levels.
Plan: Plan for additional resources for possible future waves.
Monitor & Assess: Continue surveillance to detect subsequent
waves.
Communicate; Regularly update the public on any changes to the
status of the pandemic.
Reduce Spre-ad of Disease: Evaluate the effectiveness of the
measures used to update guidelines and protocols.
Health Care Continuity: Rest, restock, revise plans, and rebuild.
Plan: Review lessons learned. Share experiences. Replenish
resources.
Monitbr &_Assess: Evaluate the pandemic characteristics for next
time.
Commtmicate: Acknowledge contributions of all communities,
communicate the lessons learned.
Reduce Spread ofDise.ase: Evaluate all interventions used.
Healr h Care Continuity: Evaluate the response of the health
system. Share the lessons learned.
65
V. CONCEPT OF OPERATIONS:
Key response actions by phase as identified by the World Health Organization (WHO),
specifically "phase 4" when "community-level outbreaks has been verified."
A. PHASE 4
1. Disseminate surveillance guidelines to physicians, clinics, and hospitals
2. Track possible cases identified in Kittitas County
3. Establish case definition that aligns with Department of Health and Human
Services (HHS), CDC, and DOH.
4. The Public Infonnation Officer (PIO) or designee will develop infonnation
related to pandemic influenza activity and forward to media and news sources.
5. KCPHD will develop and disseminate guidelines regarding antivirals based on
guidance from CDC and DOH.
6. Develop public information messaging based on expected amounts of vaccine and
priority groups.
B. PHASE 5
1. Develop or refine protocol for active surveillance at KVH and other facilities.
2. Provide healthcare sites with instmctions about gathering samples from individuals
who display symptoms of influenza like illness (ILl) and who are at increased risk for
infection according to established guidelines.
3. PIO or designee will disseminate infonnation regarding status of outbreak to all
healthcare providers and other facilities at regular intervals.
4. Implement plans for requesting any available drugs through state, federal, or private
sources.
5. Monitor adverse reactions to antiviral medications under the guidance of CDC and
DOH.
6. Distribute antivirals to priority groups.
C. PHASE 6
1. Screen and/or quarantine international travelers recently arriving in Kittitas County
from an area known and/or suspected to be infected, following federal guidelines.
2. Continue to monitor workforce absenteeism within the community through reporting
from major employers.
3. Review surveillance data for potential risk factors that either prioritize or deprioritize
infected individuals for receiving antivirals and/or vaccine, following state and federal
guidelines.
4. Set up a call-in line for healthcare professionals to answer questions relating to the
pandemic (unpublished call in line -not for general public).
5. Distribute antivirals to priority groups.
6. Monitor adverse reactions as resources pennit.
7. Monitor any cases of resistance to antivirals.
66
8. Coordinate the processing of mass fatalities with Kittitas County Prosecuting
Attorney's Office and Coroner's Office.
D. WORKFOURCE MANAGEMENT AND SUPPORT
It is estimated that 30 to 50 percent of the workforce could be impacted by an influenza
pandemic. Likewise, an emergency on the scale of an influenza pandemic will have an
inevitable psychosocial impact not only on the individuals tasked with directly responding to the
outbreak, but the broader population as well. The stresses placed on the workforce by illness-
induced absenteeism, the long term nature of the emergency, and the mental health consequences
will need to be addressed.
1. Ensure that administrators, managers, and supervisors are familiar with and actively
encourage the use of tools and techniques for supporting staff and their families during
times of crisis.
2. Educate all staff on Mental Health First Aid.
3. Identify additional recourse that can be available to employees and their families
during and after a pandemic.
67
I. PURPOSE
II. SCOPE
Kittitas County Public Health Department
Emergency Communication Plan
AnnexE
Table of Contents
III. SITUATION OVERVIEW
IV. PLANNING ASSUMPTIONS
V . CONCEPT OF OPERATIONS
VIII. ATTACHMENTS
Attachment A Press Release Template and Tips
Attachment B Fax Machine Speed Dial Numbers
Attachment C 2417 Emergency Contact List
Attachment D Regional Satellite Phone Contact List
Attachment E Common Media Questions
Attachment F Recording Hotline Greetings
Attachment G Emergency Notification Tree
69
69
69
69
69-70
71-72
73-75
76
77
78-79
80-81
82
68
I. PURPOSE:
The purpose of communication from KCPHD is to issue information and respond to requests in a
timely manner and provide information 2417 during an emergency. KCPHD will strive to
maintain consistency of information distributed and preserve department credibility as well as
protect patient confidentiality and be sensitive to issues within the community.
II. SCOPE:
Information may be shared with various audiences including members of the public, community
partners, Board of Health members, Board of Health Advisory Committee (BOHAC) members,
KCPHD, members of the media, the Washington State Department of Health, and other local
health jurisdictions. KCPHD may use various methods of communication, especially during a
disruption of technology.
III. SITUATION OVERVIEW:
The department has a designated Public Information Officer (PIO) and a designated back-up
PIO. The PIO is responsible for the following during an emergency:
A. Under the direction of the Administrator or Health Officer, the PIO is responsible for all
emergency communications.
B. Represent KCPHD at a Joint Information Center (HC) if one is activated.
C. Coordinate message release with community partners if a joint release is issued.
D. Create all department press releases in emergency situations, even if the Incident Command
System (ICS) has been initiated.
E. Message clearance may be expedited to be approved by the Administrator of KCPHD only.
IV. PLANNING ASSUMPTIONS:
During a large scale incident, technology and certain communications may be unavailable. If
systems are down, the PIO will post regular updates at the front desk ofKCPHD. In addition to
physical signage we may use radio stations to broadcast information or HAM radio operators in
the county. People with access and functional needs including people with disabilities and
residents who are non-native English speakers will need to have access to understandable
communication during emergencies. KCPHD will make every attempt to provide information in
multiple languages as well as use printed information, including social media graphics from the
Washington State Department of Health.
V. CONCEPT OF OPERATIONS:
69
A. Reports from the public regarding potential health emergencies can be communicated to
KCPHD staff during business hours (9am to 5 pm, Monday through Friday) by calling the front
desk. After hours, the public should be directed to call 911. KITTCOM (911) has the
emergency contact numbers for KCPHD.
B. Reports from key stakeholders such as healthcare providers or other agencies (law
enforcement, hospital, emergency services, school personnel, etc.) should have access to the
emergency contact number for KCPHD. Communications to KCPHD key stakeholders may also
occur during business hours by fax or reporting through the Next Gen electronic medical records
system. Staff may also receive SECURES messaging alerts from Washington State DOH.
C. Responding to reports should be completed within 15 minutes of notification. All information
that is reported to KCPHD should be reviewed and analyzed as soon as possible. Staff should
follow the appropriate department confidentiality processes to assure data are maintained in a
secure and confidential manner.
70
Attachment A: Press Release Template and Tips
[ON AGENCY LETTERHEAD]
MEDIA RELEASE
Date: Month day, year
Contact: Name, Title, (509) 962-XXXX
[Title -Size 14 font, Bold]
Your title should capture the essence of your news to give media a "handle" for what information
will be in the news release.
[Lead sentence -Size 12 font, Times New Roman]
Your lead sentence is critical. You need to succinctly summarize the key elements of your news.
Some examples:
.' A dead crow found in Snohomish County has tested positive for West Nile Virus (WNV),
according to local health officials.
• Now is the time for families in King County to prepare for going back to school, and
Public Health -Seattle & King County recommends that the best place to start is by
making sure that all of your child's immunizations are up to date.
• Several Walla Walla residents are being treated for possible exposure to rabies after
confirmation of the first case of rabies in a cat in Washington State since 1976.
• The Centers for Disease Control and Prevention (CDC) today released new guidelines
that advise the use of alcohol-based hand rubs to protect patients in health care settings.
[Second and third paragraph]
Use a quote in your second or third paragraph to support your news and to convey some key
messages. The person quoted should be a leader or expert on the topic. Some examples:
• "The chance of human infection is very low -less than one percent of people who are
bitten by an infected mosquito will become severely ill," said M. Ward Hinds, MD,
MPH, head of the county's health department. "We knew that West Nile Virus would
arrive in western Washington, it was only a matter of when," he said.
• "This campaign will help more residents access this model program which offers
culturally-sensitive diabetes education and services," said King County Executive Ron
Sims.
• "Fortunately in Washington, rabies among both humans and animals is extremely rare,
but it is still a very frightening illness to many people," said Dr. Jo Hofmann, Department
of Health Communicable Disease Epidemiologist. "But rabies in humans can be
prevented if treatment begins soon after exposure."
-more-[indicates more pages follow]
71
The following paragraphs should provide important supporting information. Your news release
should usually be one page, but can be up to two pages. Sometimes a .second quote can be used
to convey additional key messages or to incorporate a second person's perspective.
### (indicates end of release)
Page 2 of
72
Attachment B: List of Fax Machine Speed Dial Numbers
To Send a Fax: (Must place 1 page in fax)
Press Search/Speed Dial and "#"; enter 3-digit speed dial number. Press start.
Health Care Providers
002 Valley Clinic 9-9254382
003 Family Health Clinic 9-9622003
004 Community Health Care 9-9621408
005 Cle Elum Medical Center 9-6745034
006 Dr Wells 9-9259358
007 Ellensburg Peds 9-9625438
008 EMS Coordinator 9-6742947
009 KVIM 9-9257604
010 Harris/O'Brien 9-9256948
011 Dr Sand 9-9258468
012 CWU Health Center 9-9631886
013 KVCHER 9-9337510
014 KVCHCEO 9-9258485
015 KVCHLab 9-933-8795
016 Cle Elum Urgent 9-6747794
017 Valley Natural 9-9251526
024 Planned Parenthood 9-9256732
098 Alpine Lakes Family 9-6745704
102 Sakura 9-9338705
103 Coroner's Office 9-9627022
104 Swedish Cle Elurri 9-6746806
Kittitas Valley Healthcare Laboratory Services
Region 7
018 Chelan Douglas
019 Okanogan HD
020 Rita Konzal (DOH)
021 Grant HD
022 Region 7 Risk Comm.
Kittitas Co Media
023 KXLE
025 NKC Tribune
026 Daily Record
027 KCWU
028 CWU Observer 9-9631027
8-5098666449-3110949
8-5094227142-3110949
8-5093976914-3110949
8-5097666519-3110949
8-4253398706-3110949
9-9627882
8-5096745571-3110949
9-9255696
9-9631688
73
Non Local Media
029 Spanish Radio 8-5094520541-3110949
030 IC.L\PP TV 8-5094533623-3110949
031 KIMANews 8-5095755526-3110949
032 Yakima Herald 8-5095777767-3110949
033 KNDO 8-5092252330-3110949
034 KNWR 8-5093366577-3110949
035 KNDA 8-5098542223-3110949
097 KCYUFOX41 8-5094579903-3110949
Emereeoc'y Res[!on ~
036 BOCC 9-9627679
037 Cle Elum Fire 9-6745771
038 Cle Elum/Roslyn Police 9-6742918
039 Craig Wilson 9-9337535
040 CWU Police 9-9632750
041 Ellensburg Police 9-9627281
008 EMS Coordinator 9-6742947
014 Eric Jensen 9-9258485
043 Fire District #1 9-9642022
044 F ire District #2 9-9337240
045 Fire District #4 8-5098562802-3110949
046 Fire District #51 8-4254346355-3110949
047 Regional Epidemiologist 8-5098866449-3110949
048 Prosecutor Office 9-9627022
049 KITTCOM 9-9258540
050 Fire Marshall 9-9627682
051 Sheriff 9-9627599
052 Kittitas Fire 9-9680223
053 Red Cross 9-9259156
054 Washington State Patrol 8-5096654007-3110949
055 Fire District #3 8-5096560121-3110949
056 Fire District #7 8-5096747263-3110949
057 Kit Valley Fire/Rescue 9-9627254
058 Rich Elliott 9-9337240
059 KC Hospital District #2 9-9627351
061 Comprehensive Mental Health 9-9251277
Pharmacies
062 Bimart Pharmacy 9-9625322
063 Cavallini's Pharmacy 9-6745622
064 Cle Elum Drug 9-6745660
74
065 Downtown Pharmacy 9-9251545
066 Fred Meyer Pharmacy 9-9620527
067 RiteAid Pharmacy 9-9256063
068 Safeway Pharmacy 9-9256044
069 Super One Pharmacy 9-9627785
ctel'ina rians
070 Critter Care 9-9255935
071 Ellensburg Animal Hospital 9-9257714
072 Mt Stuart Animal 9-9629220
073 Valley Veterinary 9-9256148
Schools
074 Ellensburg School Dist 9-9258025
075 Ellensburg High School 9-9258305
076 Lincoln Elementary 9-9258056
077 Morgan Middle School 9-9258200
078 Mt Stuart Elementary 9-9258407
079 Valley View Elementary 9-9258134
080 Kittitas School Dist 9-9684730
081 Kittitas Elementary 9-9683630
082 Kittitas MS/HS 9-9680342
083 Thorp School Dist 9-9642313
084 Cle Elum School Dist 9-6492404
085 Cle Elum HS 9~6493563
086 Cle Elum MS/Elem 9-6493634
087 Damman School Dist 9-9252591
088 Easton School Dist 9-656-2585
Long Term Care Facilities
099 Hearthstone 9-9254772
100 Kittitas Valley Rehabilitation 9-9257794
101 Royal Vista 9-9628276
75
Attachment C: 2417 Emergency Contacts List
Kittitas Count)' Emcrgcnc) Contacts List
Kittitas County Information Services (509) 962-7510 Jim Goeben
Central Washington University (CWU) Police (509) 963-2959 Mike Luvera
CWU Public Affairs (509) 963-1384 Linda Schactler
Kittitas Valley Healthcare Public Affairs (509) 933-7593 Amy Diaz
Kittitas County SherifflEmergency Management (509) 933-8206 Darren Higashiyama
Kittitas County Emergency Operation Center (509) 962-7678
Kittitas County Emergency Medical Services (509) 962-7683 Cheryl Burrows
Kittitas County Fire (509) 962-7274 John Sinclair
Kittitas County Fire District #7 (509) 649-3381 Richelle Risdon
Kittitas County Red Cross (509) 929-0331 Martha Read
Central Washington Comprehensive Mental Health (509) 925-9861 Dr. Harry Kramer
Ellensburg Police Department (509) 962-7280 Dale Miller
ARESIRACES (509) 962-3820 Gloria Sharp
Washington State Department of Health Duty Officer (360-888-0838 DOH Duty Officer
Washington State Department of Health Risk Communications (360) 236-4070 Laura Blaske
W A DOH Epidemiology and surveillance (206) 418-5518 Mike Boysun
Public Health Laboratory 2417 Emergency Telephone Service (206)418-5500
Drinking Water After-Hours Emergency Hotline 1-877-481-4901
Valley Lab 1-877-242-3999
Last updated 711/2014
76
Attachment D: Regional Satellite Phone Numbers
Re~ional Satellitt· Phone N u m hers
Kittitas County Emergency Management (254) 241-5879 Ellensburg
Region 7 Public Health
Kittitas County Public Health Department (254) 204-0588 Ellensburg
Kittitas County Public Health Department-fixed (254) 377-7046 Ellensburg
Chelan-Douglas Health District (254) 204-0589 Wenatchee
Chelan-Douglas Health District-fixed (254) 377-2969 Wenatchee
Grant County Health District (254) 204-0620 Moses Lake
Grant County Health District-fixed (254) 377-7250 Moses Lake
Okanogan County Public Health (254) 204-0626 Okanogan
Okanogan County Public Health-fixed (254) 377-5227 Okanogan
Region 7 Hospitals
Kittitas Valley Healthcare (254) 387-9399 Ellensburg
Okanogan Douglas Hospital (254) 387-3385 Brewster
Quincy Valley Med (254) 387-5984 Quincy
Samaritan Hea1thcare (254) 387-5985 Moses Lake
Wenatchee Valley Med Center (254) 387-3383 Wenatchee
Cascade Medical Center (254) 387-3388 Leavenworth
Coulee Comm. Hospital (254) 387-5783 Grand Coulee
Central Washington Hospital (254) 387-5784 Wenatchee
Columbia Basin Hospital (254) 387-7599 Ephrata
Lake Chelan Community Hospital (254) 387-3389 Chelan
Mid Valley Hospital (254) 387-5781 Omak
North Valley Hospital (254) 387-5780 Tonasket
Moses Lake Community Health (863) 200-5297 Moses Lake
Last updated 12/9/1 0
77
Attachment E: Common Media Questions
(Reprintedfrom: Covello, V. T, KeeQlIlg YOIl r Nead In II CrisIs: l?esvrllldlllg To ComlllllniCt:J.liofl ChaLleng¢s POSlld Ht! Bio-
l1!J:!:J1l.Mzll /11td E/l/srg lnght!irctipIIS ()J~Association of State and Territorial Health Officers (ASTHO), 2003 in press)
Journalists are likely to ask six questions in a crisis (who, what, where, when, why, how)
that relate to three broad topics: (1) what happened; (2) what caused it to happen; (3) what
it means. Specific questions include:
1. What is your name and title?
2. What are you job responsibilities?
3. What are your qualifications?
4. Can you tell us what happened?
5. When did it happen?
6. Where did it happen?
7. Who was harmed?
8. How many people were harmed?
9. Are those that were harmed getting help?
10. How certain are you about this information?
11. How are those who were harmed getting help?
12. Is the situation under control?
13. IIow certain are you that the situation is under control?
14. Is there any immediate danger?
15. What is being done in response to what happened?
16. Who is in charge?
17. What can we expect next?
18. What are you advising people to do?
19. How long will it be before the situation returns to normal?
20. What help has been requested or offered from others?
21. What responses have you received?
22. Can you be specific about the types of harm that occurred?
23. What are the names ofthose that were harmed?
24. Can we talk to them?
25. How much damage occurred?
26. What other damage may have occurred?
27. How certain are you about damages?
28. How much damage do you expect?
29. What are you doing now?
30. Who else is involved in the response?
31. Why did this happen?
32. What was the cause?
33. Did you have any forewarning that this might happen?
34. Why wasn't this prevented from happening?
35. What else can go wrong?
36. If you are not sure of the cause, what is your best guess?
37. Who caused this to happen?
78
38. Who is to blame?
39. Could this have been avoided?
40. Do you think those involved handled the situation well enough?
41. When did your response to this begin?
42. When were you notified that something had happened?
43. Who is conducting the investigation?
44. What are you going to do after the investigation?
45. What have you found out so far?
46. Why was more not done to prevent this from happening?
47. What is your personal opinion?
48. What are you telling your own family?
49. Are all those involved in agreement?
50. Are people over reacting?
51. Which laws are applicable?
52. Has anyone broken the law?
53. How certain are you about whether laws have been broken?
54. Has anyone made mistakes?
55. How certain are you that mistakes have not been made?
56. Have you told us everything you know?
57. What are you not telling us?
58. What effects will this have on the people involved?
59. What precautionary measures were taken?
60. Do you accept responsibility for what happened?
61. Has this ever happened before?
62. Can this happen elsewhere?
63. What is the worst case scenario?
64. What lessons were learned?
65. Were those lessons implemented?
66. What can be done to prevent this from happening again?
67. What would you like to say to those that have been harmed and to their families?
68. Is there any continuing the danger?
69. Are people out of danger? Are people safe?
70. Will there be inconvenience to employees or to the public?
71. How much will all this cost?
72. Are you able and willing to pay the costs?
73. Who else will pay the costs?
74. When will we find out more?
75. What steps need to be taken to avoid a similar event?
76. Have these steps already been taken? If not, why not?
77. What does this all mean?
79
Attachment F: Recording Hotline Greetings
The contact at Fairpoint Communications for additional phone tree assistance is Jackie Bostick.
Phone, 962-0318. Email.jbostick@fairpoint.com. In additional to the phone numbers below,
933-8245 can be used for a hotline, with password 84250.
Dial 962-0300, press *, enter 9627515, password is 7515. Select 3 to change the greeting, then
1 to change the greeting, and 2 to record a new mailbox greeting.
Hello, you have reached the Kittitas County Public Health Department.
If you have questions A, B, or C press one now. (Transfers to 9627589)
For all other public health questions press 2 now or stay on the line. [Pause up to four seconds,
then press #] (Rings through to 9627515)
Dial 962-0300, press *, enter 9627589, password is 7589. Select 3 to change the greeting, then
1 to change the greeting, and 2 to record a new mailbox greeting.
Please listen to the following three options before making your selections:
For information about A, press one. (Transfers to 5559621)
For information about B, press two. (Transfers to 5559622)
For information about C, press three. [Pause up to four seconds, then press #] (Transfers to
5559623)
Dial 962-0300, press *, enter 5559621, password is 1269. Select 4 for personal options, then 3
for greetings, then 1 to change the greeting, then 2 to record the greeting.
Topic A
During business hours, you will have the opportunity to talk to a staff member at the end of this
call, but please listen to this message first as it may answer your questions.
Message here.
If you would like to speak to a front desk staff member, please press 0 now. [Pause up to four
seconds, then press #] (Transfers directly to 9627515 without initial message again)
Dial 962-0300, press *, enter 5559622, password is 2269. Select 4 for personal options, then 3
for greetings, then 1 to change the greeting, then 2 to record the greeting.
Topic B
During business hours, you will have the opportunity to talk to a staff member at the end of this
call, but please listen to this message first as it may answer your questions.
Message here.
If you would like to speak to a front desk staff member, please press 0 now. [Pause up to four
seconds, then press #] (Transfers directly to 9627515 without initial message again)
80
Dial 962-0300, press *, enter 5559623, password is 3269. Select 4 for personal options, then 3
for greetings, then 1 to change the greeting, then 2 to record the greeting.
Topic C
During business hours, you will have the opportunity to talk to a staff member at the end of this
call, but please listen to this message first as it may answer your questions.
Message here.
If you would like to speak to a front desk staff member, please press 0 now. [Pause up to four
seconds, then press #] (Transfers directly to 9627515 without initial message again)
81
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82
I. PURPOSE
II. SCOPE
Kittitas County Public Health Department
ShelterIMass Care Plan
AnnexF
Table of Contents
III. CONCEPT OF OPERATIONS
Attachment A Shelter-Tool Form
84
84
84
85
83
I. PURPOSE:
KCPHD will be responsible for assessing conditions of emergency shelter facilities during
disasters, which include shelters for displaced individuals or for emergency workers responding
to the incident in order to protect the occupants of the shelter.
II. SCOPE:
Shelters include temporary housing for individuals who are displaced from their homes due to an
emergency or the temporary housing of individuals responding to the emergency that operate
within the local jurisdiction.
III. CONCEPT OF OPERATIONS:
KCPHD will ensure shelters meet appropriate health and safety standards. Staff will utilize the
Centers for Disease Control and Prevention (CDC) standard evaluation form (Attached) to
identify priority health and safety issues along with recommendations for improvements if
needed.
84
State Logo ENVIRONMENTAL HEALTH ASSESSMENT FORM FOR SHELTERS
'Agency /Organization Name _______________________ _
2Assessor NamelTitle ________________________________________ _
3Phone 4Email or Other Contact
II. FACILITY TYPE, NAME AND CENSUS DATA
5Shelter Type [] Community/Recovery 0 Special Needs 0 Other BARC Facility 0 Ves J No [] Unk/NA 7ARC Code __ _
80ate Shelter Opened __ 1 __ 1 __ (mm/dd/yr) 90 ate Assessed __ 1 __ 1 __ (mm/dd/yr) 10Time Assessed __ : __ ::J am [] pm
l l Reason for Assessment [] Preoperational [] Initial C Routine [] Other _______________________ _
12Location Name and Description ______________________________________ _
13StreetAddress __________________________________________ _
14City/County _____________ 15State 1BZipCode _____ 17Latitude/Longitude _____ -' _____ _
18Facility Contact / Title _________________ 19Facility Type '::1 School 0 Arena/Convention center e Other ____ _
20 Phone __ _ ____ 21Fax ______ -___ _ 22E-mailorOtherContact __________ _
23Cur rent Census ====""'"' 24Estimated CapaclW ===== 25Number of Residents ==== 26Number of Staff / Volun teers ==-__
III. FACILITY VIII. SOLID WASTE GENERATED
27Structural damage
28Security / law enforcement available
29 Water system operational
3O Hot water available
31HVAC system operational
32Adequate ventilation
33 Adequate space per person
34Free of injury loccupational hazards
35 Free of pest I vector issues
36Acceptable level of cleanliness
37Electrical grid system operational
38Generator in use , 39 If yes , Type
4olndoor te
43Safe food source
44Adequate supply
45Appropriate storage
46Appropriate temperatures
47Hand-washing facilities available
48Safe food handling
490ishwashing facilities available
50Clean kitchen area
53Safe water source
54Safe ice source
55Reported outbreaks, unusual illness I injuries
56Medical care services on site
v v'u ';)."J IIl,! services available
58Adequate laundry services
59Adequate number of toilets
BOAdequate number of showers
B1Adequate number of hand-washing stations
62Hand-washing supplies available
63Toilet supplies available
o Ves ::: No
D Yes o No
O Ves [j No
O Ves r:J No
O Ves e No
D Yes ::J No
D Yes ::J No
O Ves [J No
I::J Yes e No
fJ Ves LJ No
[] Ves o No
D Ves D No
[] Ves O No
D Yes O No
D Ves O No
D Yes O No
DVes D No
D Ves
[j Ves
O Ves
::Ves e No
C':: Yes CJ No
e Yes ::J No
o Yes O No
e Ves D No
e Ves o No
J Unk/NA
o Unk/NA
o Unk/NA
u Unk/NA
o Unk/NA
2 Unk/NA
:J Unk/NA
:::; Unk/NA
o Unk /NA
[] Unk/NA
[1 Unk/NA
D Unk/NA
[J Unk/NA
[] Unk/NA
CJ Unk /NA
[] Unk/NA
[] Unk/NA
D Unk /NA
'J Un kiNA
C Unk/NA
o UnkiNA
[] Unk/NA
C Un k/NA
[J Unk/NA
66Adequate number of collection receptacles 'J Ves C No C Unk/NA
67 Appropriate separation O Ves [] No Ll Unk/NA
68Appropriate disposal O Ves D No D Unk /NA
69Appropriate storage e Ves D No o Unk/NA
70Timely removal C Yes [j No I] Unk/NA
71 Types J Solid [] Hazardous [] Medical J Unk/NA
IX . CHILDCARE AREA
72Clean diaper -changing facilities
73Hand-washing facilit ies available
74Adequate toy hygiene
75Safe toys
76Clean food/bottle preparation area
77 Adequate child/caregiver ratio
D Ves e No o Unk /NA
O Ves D No D Unk/NA
r::: Yes [] No o Unk/NA
[] Yes o No LJ Unk/NA
::J Yes r:J No ::J Unk/NA
Ll Yes o Unk/NA
u Ves [j No :] Unk/NA
i= Ves 0 No 0 Unk/NA
[J Ves 0 No [] Unk/NA
8S
Kittitas County Public Health Department
I. PURPOSE
II. SITUA nON OVERVIEW
Continnity-of Operations
AnnexG
Table of Contents
Attachrrient A Working in a Public Heruth Emergency
Attachment B Emergency Succession Plan
87
87
88
89-92
86
I. PURPOSE:
Continuity of operations ensures that KCPHD is capable of conducting its essential mission to
protect and promote the health and environment of the people of Kittitas County during
emergencies and disasters.
II. SITUATION OVERVIEW:
KCPHD must continue to supervise the maintenance of all health and sanitary measures for the
protection of the public health within its jurisdiction, even during an emergency or disaster.
KCPHD has evaluated its daily operations as well as staffing needs, which are found within the
attachments, the policy Working with a Public Health Emergency and the Emergency Succession
Plan.
87
KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT
I. Purpose
DEPARTMENT POLICY & PROCEDURES
Working in a Public Health Emergency
The purpose of this policy is to provide Kittitas County Public Health Department (KCPHD)
employees with guidelines for working in a public health emergency.
II. Policy
A. EXpecrati.Oll;S : KCPHD employees may be expected to work during times of public health
emergencies. During a public health emergency, KCPHD shall make efforts to assist
employees in meeting this expectation.
B. Communication: Employees shall be informed in advance of where and when to report to
work. If the employee is unable to get to the assigned work site, the employee must
contact their supervisor as soon as possible.
C. Re"Spoos''bilitU;s : During a public health emergency, employees are expected to make
every effort possible to get to the assigned work site after caring for their own immediate
needs.
D. Compensation: Employees shall be compensated in accordance with Kittitas County
Personnel Policies.
III. Applicability
A. This policy applies to all KCPHD staff.
B. This policy is effective on the date both the Public Health Administrator and the Health
Officer have signed.
C. This policy is subject to review at least every five years.
~ JRI?0=zttf
Public Health Administrator Date
Revised November 2013
88
Policy Number: MT2010-1
Kittitas County Public Health Department
Policy and Standard Operating Procedures
EMERGENCY SUCCESSION PLAN
Purpose: In order to ensure the continuous coverage of executive duties critical to the ongo i ng
operations of Kittitas Cou nty Pub lic Health Department (KCPHD) and its services , the Board of Health
must adopt policies and procedures to guide an emergency succession plan in the event of an
unplanned and/or extended absence of the Administrator.
While the Board acknowledges that such an absence is highly improbable, it also believes that due
diligence in exercising its governance functions requires that an emergency executive succession plan
should be in place to ensure continuity in external relationships and in department functioning .
Policy: Ensure organ izational continuity in the event of an unplanned absence of the Administrator .
Definitions:
Temporary unplanned absence : a temporary unplanned absence is one that arises unexpectedly where
the Administrator is expected to return to his/her position once the events precipitating the absence are
resolved . Temporary is defined as 12 weeks or less .
Extended unplanned absence: an absence meeting the definition of a temporary unplanned absence
which extends beyond 12 weeks in duration.
Standard Operating Procedures :
I. Authority:
a. Board of Health: The Board of Health authorizes the Chair of the Board to implement the terms
of this emergency plan in the event of the unplanned absence of the Administrator and to make
modifications as he/she deems appropriate. Kittitas County Personnel Policies shall also apply.
b. Health Officer: According to RCW 70.05.070, the local health officer, acting under the direction
of the local board of health or under direction of the administrative officer appointed under
RCW 70.05 .040 or 70.05.03.5 , if any, shall:
• Enforce the public health statutes of the state, rules of the state board of health and the
secretary of health, and all local health rules , regulations and ordinances within his or her
jurisdiction including imposition of penalties authorized unde r RCW 70.":L19 A.030 and
70,11-8 . .130; the confidentiality provisions in RCW 70.24 ,105 and rules adopted to
implement those provisions, and filing of actions authorized by RCW 113 .70.190.
• Take such action as is necessary to maintain health and sanitation supervision over the
territory w ithin his or her jurisd iction ;
II. Communication of Event:
Last Updated : 8/19/2010; Approved by BOH 8/19/2010 Page 11
89
a. Upon learning of the necessary unplanned absence of the Administrator, the Community Health
Services Supervisor or Environmental Health Supervisor shall immediately inform the Chair of
the Board of Health.
b. As soon as feasible, the Chair ofthe Board shall convene a meeting with KCPHD Management
team to affirm the procedures prescribed in this policy or to make modifications as appropriate .
The KCPHD Management Team includes:
o Administrative Assistant II
o Assessment Coordinator
o Business Manager
o Community Health Services Supervisor
o Environmental Health Supervisor
o Health Promotion Manager
III. Assignment of Duties and Responsibilities:
When the Administrator is unable to perform the duties of the position due to a temporary
unplanned absence, the management team will share responsibilities for operations. The key
functions and duties of the Administrator will be accomplished as follows:
1iulH!tbll1! Staff Reiponalble
Communication · Serve as the organization's principal leader, Health Officer with support from:
representative, and spokesperson to the greater · Assessment Coordinator I
community_ · CHS Supervisor · EH Supervisor
• HP Manager
• Ensure that key funders/contractors are aware of the CHS Supervisor
change in KCPHD lead contract staff as appropriate. EH Supervisor
HP Manager · Ensure that accurate information relating to the Health Officer with support from :
condition of the agency is communicated to department · Assessment Coordinator I
staff. · CHS Supervisor · EH Supervisor · HP Manager
• Ensure communication between Board of Health and the Health Officer with support from :
Management Team. · CHS Supervisor · EH Supervisor · HP Manager
Support the Board of Health · Assist with preparation of Board of Health agendas, Health Officer with support from :
develop executive reports, and facilitate Board of Health • Administrative Assistant II
meetings. Assessment Coordinator I
• CHS Supervisor
• EH Supervisor · HP Manager
.-Address Board issues related to clarity of role, CHS Supervisor
Last Updated: 8/19/2010; Approved by BOH 8/19/2010 Page I 2
90
. hmatran ' SIaff ilelIJf9.!fsi"' •
governance, bylaws, policies, board structure and EH Supervisor
membership. HP Manager
• Assist with recruitment and orientation of new Board CHS Supervisor
members . EH Supervisor
HP Manager
Management Team Support · Convene and lead the management team. Health Officer with support from : · CHS Supervisor · EH Supervisor · HP Manager · Ensure fiscal oversight Business Manager · Maintain accountability for financial performance of Business Manager with support
department. from: · CHS Supervisor
• EH Supervisor · HP Manager · Administrative Assistant"
Operations · Ensure administrative level support of the overall Chair of the Board of Health
management of the department.
• Ensure continuity of service operations CHS Supervisor
EH Supervisor
HP Manager
Administrative Assistant"
• Ensure ongoing fiscal integrity and operations Business Manager · Authorize major expenditures Business Manager · Ensure timely billing/collections Business Manager · Ensure human resources compliance HR Director with support from:
• CHS Supervisor
• EH Supervisor · HP Manager · Administrative Assistant" · Prepare, submit and present department program CHS Supervisor
information to the BOCC Agenda as required. EH Supervisor
HP Manager · With support from
Administrative Assistant" · Ensure contract compliance
0 Processing new contracts through Kittitas County Administrative Assistant"
Prosecutor, Aud itor and BOH/BOCC Systems
including presentations at BOCC Agenda and BOH
meetings.
0 Fiscal reporting Business Ma na g~r
0 Program Tracking/Reporting Assessment Coordinator I
CHS Supervisor
EH Su pervisor
last Updated: 8/19/2010; Approved by BOH 8/19/2010 Page I 3
91
f\UIf/;trQn
IV. Authority for Decision Making:
a. The Board of Health shall continue to provide support and oversight during the unplanned
absence with the Chair of the Board taking the lead role . The Chair will have responsibility for
directly monitoring the work of staff completing the functions of the Administrator and will be
alert to the special administrative support needs for the duration of the unplanned absence .
b. The staff identified as the lead for the functions listed in the table above will have the ability to
take independent action in those areas in a manner which paraiiels that of the Administrator's
authority.
V. Extended Absences:
a. The Board of Health will follow Kittitas County Policy during extended absences and may modify
the emergency succession plan accordingly .
VI. Applicability
1. This policy is effective immediately and is subject to review every three (3) years or as needed .
C Jvuh ~t~ 6w&Nr V 0 ! ,}3/ J D
Admin strator Date
Last Updated : 8/19/2010; Approved by BOH 8/19/2010 Page 14
92
Kittitas County Public Health Department
Environmental Health
Table of Contents
Topic Page
I. Purpose 93
II. Planning Assumptions 93
III. Policies 94
IV. Responsibilities 94
V. Concept of Operations 94-95
I. Purpose
Environmental Health (EH) refers to the ability to reduce the risk of human contact with
environmental public health hazards in the event of an emergency. Reducing exposure risk pertains
to hazards such as contaminated food, air, water, solid waste, hazardous materials, and vectors
associated with exposure to infectious diseases, bacteria and pathogens.
II. Planning Assumptions
Based on the Kittitas County Hazard Identification and Vulnerability Assessment (HIV A), EH
response will most frequently address incidents involving flooding and wildfires. However,
historically, KCPHD has also responded to incidents involving solid waste, extended power outages,
and contaminated properties.
93 )
III. Policies
Incidents that require issued health orders, will follow the KCPHD Health Order policy
IV. Responsibilities
KCPHD will be responsible for the following activities:
Inspect the extent of damage to water and onsite sewage systems on properties within Kittitas County
resulting from natural or manmade disasters. Provide a subject matter expert for the Kittitas County
Emergency Operation Center.
Provide public information on safety precautions to reduce environmental exposure via press releases,
and media outreach.
Inform partner agencies as well as the general public of dangers associated with the emergency.
Ensure that all facilities regulated by the EH programs are not operational until facilities comply with
Kittitas County Code.
Coordinate with partner agencies to ensure environmental hazards are not accessible to the pubiic.
Regardless of the agency lead, KCPHD will assess the severity of hazard and overall health and
safety of the situation and ensure mitigation of the environmental hazard .
V. Concept of Operations
Agencies that KCPHD may coordinate with include Department of Ecology, Kittitas County
Community Development Services, fire response agencies, local law enforcement, Red Cross, solid
waste, City of Ellensburg, pest control, Washington State Department ofFish and Wildlife, Unites
States Forest Service, Washington State Department of Natural Resources and the Washington State
Department of Health.
KCPHD staff may become aware of an incident in the following manner:
A. Environmental Health Staff discover the incident
B. Information is received via the emergency, twenty four hour, phone line
C. Law enforcement contacts the department
D. Local owner/operator notifies KCPHD of the incident.
E. A member of the public relays the information.
F. Partner agencies inform KCPHD of the situation.
KCPHD may provide the following in response to an emergency:
A. Work with emergency management to identify existing or potential environmental hazards
during emergency incidents.
B. Provide emergency messaging to reduce environmental hazard exposure to Kittitas County
residents as well as emergency responders.
C. Provide prophylaxis to emergency responders
94
D. Provide safety recommendations to responders.
E. Coordinate with disaster relief agencies to prevent the spread of disease with
recommendations or inspections for drinking water systems, food service centers, waste
disposal, and sanitary provisions.
95
Kittitas County Public Health Department
Communicable Disease
Table of Contents
Topic
VI. Purpose
VII. Planning Assumptions
VIII. Policies
IX. Responsibilities
X. Concept of Operations
Page
97
97
97
97
97-98
96
VI. Purpose
Communicable disease refers to diseases that can spread from one person to another, or are spread
through food, water, or other vectors that are contaminated or infected. A communicable disease
outbreak may present challenges that require an emergency response. In addition, emergencies and
disasters may create conditions that foster outbreaks of communicable disease. Reducing exposure or
stopping exposure to these diseases is an important public health function.
VII. Planning Assumptions
KCPHD has responded to incidents involving Tuberculosis, E. Coli, and pertussis outbreaks.
Outbreaks of measles, salmonellosis, and a variety of other communicable diseases have been
reported recently in the state and the nation. Disasters have the potential to disrupt systems that
protect the public from communicable disease.
VIII. Policies
KCPHD staffwill follow disease-specific procedures, follow up, and reporting per Washington State
Department of Health requirements. Communicable disease response will follow the Communicable
Disease Reporting and Investigation policy (attachment *). Incidents that require issued health
orders, will follow the KCPHD Health Order policy (attachment *)
IX. Responsibilities
KCPHD will be responsible for the following activities:
Inform Kittitas County partner agencies and residents of 2417 disease reporting contacts
Receive information regarding notifiable conditions or disease outbreaks.
Complete necessary disease investigations related to the notifiable condition and/or outbreak.
Enter disease investigation data into the state's online reporting system. Implement exclusions within
childcares and/or school settings when necessary.
Request voluntary isolation and/or quarantine.
Provide a subject matter expert for the Kittitas County Emergency Operation Center.
Provide public information on safety precautions to reduce exposure via press releases, and media
outreach.
Inform partner agencies as well as the general public of dangers associated with the emergency.
Inform partner agencies and responders of required prophylaxis and precautions.
Provide communicable disease treatment, as applicable or coordinate clinical management with the
appropriate lead agency.
Regardless of the agency lead, KCPHD will assess the severity of hazard and overall health and
safety of the situation.
Mitigation for disease control may include quarantine, isolation, exclusion, or a specific health order
issued to prevent the spread of disease.
X. Concept of Operations
Agencies that KCPHD may coordinate with include Washington State Department of Health, Kittitas
Valley Healthcare, local medical providers, fire response agencies, local law enforcement, and Red
Cross.
KCPHD staff may become aware of an incident in the following manner:
97
A. Infonnation is received via a notifiable condition alert.
B. Infonnation is received via the emergency, twenty four hour, phone line
C. Law enforcement contacts the department
E. A member of the public relays the infonnation.
F. W A DOH infonns KCPHD of an associated disease outbreak or cluster
G. Partner agencies infonn KCPHD of the situation.
KCPHD may provide the following in response to an emergency:
A. Work with emergency management to identifY existing or potential disease exposure
during emergency incidents.
B. Provide emergency messaging to reduce exposure to Kittitas County residents as well as
emergency responders.
C. Provide prophylaxis to emergency responders and the public.
D. Provide safety recommendations to responders.
E. Coordinate with disaster relief agencies to prevent the spread of disease.
98
Kittitas County Public Health Department
Mass Fatality
Table of Contents
Topic
XI. Purpose
XII. Planning Assumptions
XIII. Policie~
XIV. Responsibilities
XV. Concept of Operations
Page
100
100
100
100
100-102
99
XI. Purpose
Mass fatality refers to an incident where more deaths occur within Kittitas County than local
resources can handle. The deaths may be caused by non-public health related reasons; however, the
purpose of this annex is to serve as guidance for deputy registrars to process death certificate
information.
XII. Planning Assumptions
According to the Kittitas County Coroner, an incident resulting in five deaths would be considered a
mass fatality, which would require assistance from resources outside of Kittitas County.
X!!I. Policies
Only deputy registrars may process death certificates for Kittitas County Public Health Department.
XIV. Responsibilities
KCPHD will be responsible for the following activities:
A. Receive demographic information from either receiving physician or coroner via Electronic
Death Registry System (EDRS)
B. Assess information input into the EDRS for completion
C. Assign a local file number and sign infonnation electronically in thc EORS
D. Submit EDRS information to the Washington State Department of Health.
XV. Concept of Operations
KCPHD will work closely with the Kittitas County Coroner, Kittitas County Emergency Manager,
and Washington State Department of Health.
KCPHD staff may become aware of an incident in the following manner:
A. Notification received via the emergency, twenty four hour, phone line
B. Law enforcement contacts the department
C. Kittitas County Coroner
D. A member of the public relays the information
E. Partner agencies inform KCPHD of the situation
KCPHD may provide the following in response to an emergency:
A. Work with emergency management and Kittitas County Coroner to provide deputy
registrars
B. Work as liaison between local deputy registrars and Washington State Department of
Health's EDRS
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C. Provide informationlRCW in regard to presumed deaths and situations where remains are
found, but not identified
D. Provide deputy registrars beyond KCPHD's normal business hours, as needed
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