National Security: Regulation and Emergency Preparedness

1. CLEAR 2003 Session Friday September 12, 2003, 10:30AM National Security: Regulation and Emergency Preparedness Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

2. Tom Gottlieb, Moderator Vice President, Licensing Solutions VERSA Management Systems Inc. 110 North Kenilworth Avenue, #7-A Oak Park, IL 60301-1218 888-232-0224 tgott@versasys.com Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

3. Introducing Our Speakers Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

4. Topic Introduction • The relationship between regulation and emergency preparedness. • Are regulators doing enough? • Why now? Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

5. Dr. James Young Commissioner Ministry of Public Safety and Security 13th Floor, 25 Grosvenor St. Toronto, ON M7A 1Y6 416-314-3381 James.g.young@jus.gov.on.ca Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

6. Homeland Security • Risk to Canada of terrorism • Organization to combat • Bioterrorism Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

7. Germs as Weapons • They have ability to kill • Size of potential release (greater potential than nuclear) • Transmit person to person following initial release • causes damage / death • prolongs event • Delays between release • hard to trace • more panic • more damage Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

8. Severe Acute RespiratorySyndrome (SARS) • Terrorism? • Pandemic? Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

9. Hong KongThe Metropole Hotel Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

10. Feb 23, index case returns from Hong Kong March 5, index case dies at home March 7, case 2 in ER March 13, case 2 dies; 5 family members admitted Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

11. SARSMarch 12th – WHO Alert • Atypical pneumonia • Health workers most affected • Unidentified cause • Spreading in south-east Asia Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

12. Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

13. Outbreak Control • How do you stop an outbreak when: • Agent is unknown • Incubation period uncertain • Mode of transmission not entirely clear • No diagnostic test • No prophylaxis • No vaccine • No treatment R0 = population density x infectivity x time Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

14. Patient risk The Balancing Act • Infection Control • Medical Education Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

15. Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

16. All Cases Track Back to the Grace Hospital Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

17. Issues in SARS • Directives vs Guidelines • Locating Expertise • Licensing • out of province • retired Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

18. Issues in SARS • Potential Discipline • duties of care • working sick • Labour Issues • pregnancy • mask fitting Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

19. Judy Powell President American Association of State Counseling Boards Houston, Texas 936-321-6985 judy.powell@juno.com Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

20. Disaster Mental Health Training in Texas: A Work in Progress with Obstacles to Overcome Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

21. Setting the Stage • The mandate from the Governor’s Office • The quest for information and the procurement of materials for a disaster mental health course. Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

22. Understanding and Interpreting State Agency Structure • Poor information distribution between different agencies in different departments. • Difficulty for public to locate agencies and information in state government. Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

23. Computer System Challenges • Advantages of linked databases in disaster alerting. • Need to collaborate on most effective data retrieval structure in disaster Usefulness of immediate license verification from a disaster site. • Need for notation of special skills in each database • Need to motivate licensees to keep database accurate, because timely reporting is voluntary Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

24. Completion of the project • Funding for linked computer databases across all involved agencies, and funding to get the training course online. • Legislative mandate requiring disaster training and subsequent agency rules changes. • Making the system friendly to all users. • Deciding who has authority over the system. • Streamlining the system so that information distribution is complete. Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

25. Anne Coghlan Executive Director 416-963-7525 acoghlan@cnomail.org Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

26. Experiences Linked to the Mandate of a Regulatory Body Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

27. Regulatory Mandate • Qualifications for Entry to Practice • Standards of Practice • Professional Ethics • Continuing Competence Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

28. Entry to Practice • Health Human Resource Planning • Emergency Registration • Recruitment and Standby Status • Targeted Contact Specific to Disaster Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

29. Practice and Professional Standards • Maintenance of Standards • Identification of Need for New or Expanded Standards • Changes to Nursing Curricula • Advocacy Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

30. Professional Ethics • Duty to Care • Professional Judgement • Confidentiality Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

31. Continuing Competence • Maintenance of Competencies • Identification of new competencies required, or old competencies that need to be refreshed. Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

32. Communication • Members • Telephone Lines • Website • Nursing Students • Government • Public Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

33. Amy Jones Division Director Florida Department of Health, Medical Quality Assurance 4052 Bald Cypress Way Tallahassee, FL 32399-3251 850-245-4224 Amy_jones@doh.state.fl.us Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

34. Organizational Structure • Department of Health – Single health agency includes: • Division of Medical Quality Assurance – 37 health care professions • County health departments – 67 • Emergency Health Response Units • Various other divisions Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

35. Functions for Emergency Preparedness • County Health Departments • Primary planning for health services in an emergency • Oversee special needs shelters • Contact health care professionals willing to serve prior to emergency • GPS capabilities • Active member of emergency response team • Division of Medical Quality Assurance • Regulate health care professions • Part of renewal is specifying willingness to volunteer in an emergency and/or work in a special needs shelter • Disseminate names to the county health departments • Serve on Emergency Response Teams • Maintain special needs shelter registry Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

36. Tasks Accomplished and Benefits • Applied for and received federal grant funds to revise applications • Marketed volunteerism through professional associations and boards • Provide for online and electronic data files • Update with each renewal • Encourage boards to grant continuing education credit for volunteering • Incorporated it into discipline • $88,000,000 last year in free care • Better prepared for emergencies Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

37. Thanks to our Speakers! Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

38. Presentation Follow-up • Please pick up a handout from this presentation -AND/OR- • Please give me your business card to receive an e-mail of the presentation materials -OR- • Presentation materials will be posted on CLEAR’s website Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003

39. Questions? Presented at CLEAR’s 23rd Annual Conference Toronto, Ontario September, 2003