munications systems including a statewide 800 MHz radio network tied in with the highway patrol, a state medical radio network that provides communication with hospitals and agencies, and satellite phones for all deployable assets. North Carolina also has uniform statewide EMS protocols, which ensure standardization of care and effective oversight, and a statewide triage guideline using a one-tag system across the entire state.

SPURRING REGIONAL COLLABORATION AND PLANNING

Jennifer Hamerlinck, a public health nurse and director of the Emergency Management Agency in Mercer County, Illinois, observed that there are two scenarios that create a demand for integration: prospectively in the form of regionally funded disaster planning sessions or retrospectively from “lessons learned” during an emergency response.

Regional Preplanning Sessions

Conducted by the Centers for Disease Control and Prevention (CDC), Hamerlinck’s Mercer County was selected as the regional community lead for the Community Partnerships for Pandemic Influenza Planning Project. Funded through the Illinois Department of Health, the project conducted a series of five tabletop exercises focused on engaging a number of different sectors and agencies to examine essential healthcare services, legal and ethical implications, shared services and resources, communication and triage, home health care, and campus response at universities. Together, project participants collaborated to plan for necessary essential services during a pandemic influenza outbreak. Action items identified at the workshops were the need for a regional taskforce, memoranda of understanding, expanded partnerships, and education, as well as the need to incorporate untraditional local resources like faith-based groups, school superintendents, and private physicians. The five exercises boasted over 250 participants from the region, with approximately 60–100 attendees at each exercise representing the Emergency Management Agency, EMS, hospitals, physicians, public health, local officials, law enforcement, coroners, and others.

One of the tools developed from the project that Hamerlinck found particularly useful was a “determining essential services spreadsheet” that allows an agency to determine the number of essential and nonessential staff on any given day by incorporating staffing and patient census variables. This tool could cross over into any response planning by changing the labels, Hamerlinck said.

Dedicated federal grant funds proved essential to integrating emergency response efforts in Montana as well, described the emergency services coordinator for Chouteau County, Linda Williams. In 2004, a Homeland Se-



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