IGA AMD RE EMERGENCY MANAGEMENT WITH ADHS.PDF

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT
1740 W. Adams, Room 303
Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Sr. Procurement Specialist
Contract No: ADHS12-007891 Amendment No. 7
Gabriel Vigil
Emergency Preparedness Program
It is mutually agreed that the Intergovernmental Agreement referenced is amended as follows:
1. Effective July 1, 2013, replace Price Sheet, Page Two (2), of Amendment Six (6), with Price Sheet, Amendment Seven
(7). The Total Price Sheet is $2,691,758.72.
2. Effective July 1, 2013, Replace Attachment A, Amendment Four (4), Pages Three (3) through Fifteen (15), with
Attachment A, Pages Four (4) through Twenty Four (24), of this Amendment Seven (7).
All other provisions of this agreement remain unchanged.
CONTRACTOR SIGNATURE
Maricopa County Department of Public Health
Contractor Name Contractor Authorized Signature
4041 N. Central Ave, Suite 1400
Address Printed Name
Phoenix AZ 85012
City State Zip Title
CONTRACTOR ATTORNEY SIGNATURE This Intergovernmental Agreement Amendment shall be effective the
Pursuant to A.R.S. § 11-952, the undersigned public agency attorney date indicated. The Public Agency is hereby cautioned not to commence
has determined that this Intergovernmental Agreement is in proper any billable work or provide any material, service or construction under
form and is within the powers and authority granted under the laws of this IGA until the IGA has been executed by an authorized ADHS
the State of Arizona. signatory.
State of Arizona
Signed this ______ day of _______________________ 20____
Signature Date
Printed Name Procurement Officer
Attorney General Contract No. P0012012000033, which is an RESERVED FOR USE BY THE SECRETARY OF STATE
Agreement between public agencies, has been reviewed pursuant to
A.R.S. § 11-952 by the undersigned Assistant Attorney General, who Under House Bill 2011, A.R.S. § 11-952
has determined that it is in proper form and is within the powers and
authority granted under the laws of the State of Arizona. was amended to remove the requirement
that Intergovernmental Agreements be filed
with the Secretary of State.
Signature Date
Assistant Attorney General
Printed Name:
1

ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT 1740 W. Adams, Room 303
Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Sr. Procurement Specialist
Contract No: ADHS12-007891 Amendment No. 7
Gabriel Vigil
Emergency Preparedness Program
3. Delete in its entirety, Terms and conditions, Provision Eighteen (18), Health Insurance Portability and Accountability Act
of 1996 (HIPAA), and replace with the following:
Health Insurance Portability and Accountability Act of 1996
The Contractor warrants that it is familiar with the requirements of HIPAA, as amended by the Health Information
Technology for Economic and Clinical Health Act (HITECH Act) of 2009, and accompanying regulations and will comply
with all applicable HIPAA requirements in the course of this Contract. Contractor warrants that it will cooperate with the
Arizona Department of Health Services (ADHS) in the course of performance of the Contract so that both ADHS and
Contractor will be in compliance with HIPAA, including cooperation and coordination with the Arizona Strategic
Enterprise Technology (ASET) Office, Statewide Information Security and Privacy Office (SISPO) Chief Privacy Officer
and HIPAA Coordinator and other compliance officials required by HIPAA and its regulations. Contractor will sign any
documents that are reasonably necessary to keep ADHS and Contractor in compliance with HIPAA, including, but not
limited to, business associate agreements.
If requested by the ADHS Procurement Office, Contractor agrees to sign a ―Pledge To Protect Confidential Information‖
and to abide by the statements addressing the creation, use and disclosure of confidential information, including
information designated as protected health information and all other confidential or sensitive information as defined in
policy. In addition, if requested, Contractor agrees to attend or participate in HIPAA training offered by ADHS or to
provide written verification that the Contractor has attended or participated in job related HIPAA training that is: (1)
intended to make the Contractor proficient in HIPAA for purposes of performing the services required and (2) presented
by a HIPAA Privacy Officer or other person or program knowledgeable and experienced in HIPAA and who has been
approved by the ASET/SISPO Chief Privacy Officer and HIPAA Coordinator.
4. Delete in its entirety, Terms and Conditions, Provision Four (4), Contract Administration and Operation, Section 4.13,
Scrutinized Businesses.
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ARIZONA DEPARTMENT OF
HEALTH SERVICES
INTERGOVERNMENTAL AGREEMENT (IGA) AMENDMENT 1740 W. Adams, Room 303
Phoenix, Arizona 85007
(602) 542-1040
(602) 542-1741 Fax
Sr. Procurement Specialist
Contract No: ADHS12-007891 Amendment No. 7
Gabriel Vigil
PRICE SHEET
Fixed Price
Description Quantity Unit Rate Extended Price
CDC Deliverables for Public Health Emergency 1 $2,691,758.72 $2,691,758.72
Preparedness - PHEP
Total $2,691,758.72
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Contract Number INTERGOVERNMENTAL AGREEMENT
ADHS12-007891 Attachment A
Arizona Department of Health Services
Bureau of Public Health Emergency Preparedness
PHEP Cooperative Agreement Grant
Public Health Emergency
Preparedness Deliverables
BP2
Budget Year 2013-2014
REGIONS
CENTRAL NORTHERN
SOUTHEASTERN
WESTERN
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Contract Number
INTERGOVERNMENTAL AGREEMENT
ADHS12-007891
Attachment A
1. PROGRAM REQUIREMENTS:
1.1 Arizona follows the established Emergency Medical Services boundaries to identify regions. The four
identified regions are Northern, Central, Southeastern, and Western Regions. See Appendix 3 for
reference.
1.1.1 Central Region PHEP partners include: Gila County, Maricopa County, Pinal County, and Gila
River Indian Community.
1.1.2 Northern Region PHEP partners include: Apache County, Coconino County, Navajo County,
Yavapai County, Hopi Tribe, Navajo Nation, and White Mountain Apache Tribe.
1.1.3 Southeastern Region PHEP partners include: Cochise County, Graham County Greenlee
County, Pima County, Santa Cruz County, Pascua Yaqui Tribe, San Carlos Apache Tribe, and
Tohono O’Odham Nation.
1.1.4 Western Region PHEP partners include: La Paz County, Mohave County, Yuma County,
Cocopah Tribe, Colorado River Indian Tribes, Fort Mohave Indian Tribe, Kaibab – Paiute
Tribe, and Quechan Tribe.
1.2 Partnership/Coalition Meetings (Central, Northern, Southeastern, and Western Regions)
The designated Public Health Emergency Coordinator or representative will attend ADHS Healthcare
Coalition meetings within their region. These meetings will provide an opportunity for collaboration
with healthcare facilities, county, state, tribal, and other response partners. Partnerships/coalitions
shall continue to plan and develop memoranda of understanding (MOU) to share assets, personnel
and information. Coalition members shall maintain plans to unify ESF-8 management of healthcare
during a public health emergency, and integrate communication with jurisdictional command in the
area.
1.3 Reporting
Progress on these deliverables, performance measures, and activities conducted with funds from this
grant will be reported in a timely manner for the Mid-Year and end of year report. These documents
will be submitted to ADHS.
1.4 Financial Requirements
1.4.1 Performance
Failure to meet the deliverables and performance measures described in the Scope of
Work may result in withholding from a portion of subsequent awards.
1.4.2 Match Requirement
The PHEP award requires a 10% ―in-kind‖ or ―soft‖ match from all the grant participants.
Each recipient must include in their budget submission the format they will use to cover
the match and method of documentation. Failure to include the match formula will
preclude funding.
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Contract Number
INTERGOVERNMENTAL AGREEMENT
ADHS12-007891
Attachment A
1.4.3 Inventory
Provide by mid-year, a completed Inventory List to include all capital equipment (dollar
amount above $5000). Inventory list will be provided to ADHS.
1.4.4 Budget Spend Plan
Budget spend plans will be completed and submitted to ADHS after contractor signature.
Your budget spend plan needs to be reviewed and approved by ADHS before funding is
released.
1.4.5 Grant Activity Oversight
Maintain a full-time, part-time, or appointed public health emergency preparedness
coordinator to have responsibility for oversight of all grant related activities. Preparedness
coordinator to have responsibility for oversight of all grant related activities. Cooperate
and coordinate with ADHS in completing on- site visits pursuant to, and in compliance with
Standard Operating Procedures for Sub-Recipient Monitoring.
1.4.6 Employee Certifications
PHEP Recipients are required to adhere to all applicable federal laws and regulations,
including OMB Circular A-87 and semiannual certification of employees who work solely
on a single federal award. These certification forms must be prepared at least
semiannually signed by the employee or a supervisory official having firsthand knowledge
of the work performed by the employee. Employees that are split funded are required to
maintain Labor Activity Reports (to be provided as requested). These certification forms
must be retained in accordance with 45 Code of Federal Regulation, Part 92.42
1.4.7 Activities and Purchases
Activities conducted under and purchases made with this award will be kept specific to the
deliverables outlined in this document. Other activities and purchases, in line with the
CDC grant guidance for BP 2 or previous budget period deliverables may be allowed if
assurances are made that all assigned deliverables for BP1 will be completed. Approval
for this will be on a case by case basis and conducted by ADHS.
1.5 Exercises
1.5.1 Participate in the 2013-2014 ADHS Training and Exercise Planning Workshop. Provide the
agency specific HSEEP compliant Training and Exercise Plan (TEP) to ADHS no later than
September 6, 2013.
1.5.2 Support and participate in at least one ADHS sponsored HPP and PHEP/SNS exercises.
Exercise participation and support activities may include exercise play, simulation,
participation in communication pathways, partial or full activation of emergency operation
centers, and participation in exercise design and evaluation meetings. Submit the After Action
Reports (AARs) and Improvement Plans (IP) for each exercise to ADHS by June 10, 2014.
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Contract Number
INTERGOVERNMENTAL AGREEMENT
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Attachment A
1.6 Corrective Actions
Track and manage corrective actions identified in responses and exercises. Ensure after action
reports (AAR) and improvement plans (IP) are generated for any public health emergency exercise or
real world event in which the public health entity participates and has a role. After a standalone, DSNS
drill an executive summary and an IP must be provided to the ADHS SNS Coordinator.
1.7 Emergency Notification System
Provide ADHS with an updated ―County/Tribal Public Health Emergency Contact Information Sheet.
This should include contact information for the primary, secondary, and tertiary individual for the Public
Health Incident Management System (e.g. Incident Commander, Operations, etc.) The contact
information for each individual shall include: ICS title, individual’s name, non- emergency position title,
office telephone number, mobile telephone number, home telephone number, and email address
loaded into ADHS Health Service Portal by September 30.
2. CAPABILITIES:
2.1 Capability 1: Community Preparedness
Definition: Community preparedness is the ability of communities to prepare for, withstand, and
recover — in both the short and long terms — from public health incidents. By engaging and
coordinating with emergency management, healthcare organizations (private and community- based),
mental/behavioral health providers, community and faith-based partners, state, local, and territorial,
public health’s role in community preparedness is to do the following:
2.1.1 Support the development of public health, medical and mental/behavioral health systems that
support recovery
2.1.2 Participate in awareness training with community and faith-based partners on how to prevent,
respond to, and recover from public health incidents
2.1.3 Promote awareness of and access to medical and mental/behavioral health 2 resources that
help protect the community’s health and address the functional needs (i.e., communication,
medical care, independence, supervision, transportation) of at-risk individuals
2.1.4 Engage public and private organizations in preparedness activities that represent the
functional needs of at-risk individuals as well as the cultural and socio-economic, demographic
components of the community
2.1.5 Identify those populations that may be at higher risk for adverse health outcomes
2.1.6 Receive and/or integrate the health needs of populations who have been displaced due to
incidents that have occurred in their own or distant communities (e.g., improvised nuclear
device or hurricane)
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Contract Number
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Attachment A
2.1.7 Budget Period Short Term Goal:
2.1.7.1 Goal 1. The State in collaboration with emergency management and homeland
security will disseminate the Jurisdictional risk assessment for evaluation and
analysis regarding risks to the public health. Local and Tribal health will develop a
regional approach to address planning gaps.
2.1.7.2 Goal 2. Review written plans to ensure that they include a policy and process to
participate in existing (e.g., led by emergency management) or new partnerships
representing at least the following 11 community sectors: business; community
leadership; cultural and faith- based groups and organizations; emergency
management; healthcare; social services; housing and sheltering; media;
mental/behavioral health; state office of aging or its equivalent; education and
childcare settings.
2.2 Capability 2: Community Recovery
2.2.1 Definition: Community recovery is the ability to collaborate with community partners, (e.g.,
healthcare organizations, business, education, and emergency management) to plan and
advocate for the rebuilding of public health, medical, and mental/behavioral health systems to
at least a level of functioning comparable to pre-incident levels, and improved levels where
possible.
2.2.2 This capability supports National Health Security Strategy Objective 8: Incorporate Post-
Incident Health Recovery into Planning and Response. Post-incident recovery of the public
health, medical and mental/behavioral health services, and systems within a jurisdiction is
critical for health security and requires collaboration and advocacy by the public health
agency for the restoration of services, providers, facilities, and infrastructure within the public
health, medical and human services sectors. Monitoring the public health, medical and
mental/behavioral health infrastructure is an essential public health service.
2.2.3 Budget Period Short Term Goal:
Goal 1: Establish a statewide baseline for post-incident recovery and make recommendations
for systemic improvement for the state of Arizona PHEP stakeholders by developing an
assessment tool in order to evaluate healthcare system recovery, behavioral health care, and
human services recovery needs, along with resource availability.
2.3 Capability 3: Emergency Operations Coordination
2.3.1 Definition: Emergency operations coordination is the ability to direct and support an event or
incident with public health or medical implications by establishing a standardized, scalable
system of oversight, organization, and supervision consistent with jurisdictional standards and
practices and with the National Incident Management System.
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Contract Number
INTERGOVERNMENTAL AGREEMENT
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Attachment A
2.3.2 Budget Period Short Term Goal:
2.3.2.1 Goal 1: ADHS will acquire situational awareness information in order to determine if
and to what extent Health Emergency Operations Center (HEOC) activation is
necessary in order to provide a statewide public health common operating picture.
This short-term goal will demonstrate the ability of the HEOC to collect the essential
elements of information from the Local Health Departments.
2.3.2.2 Goal 2: WebEOC access and the application will be extended to the 15 local Health
Departments and any Tribes who request access to the application. This short-term
goal will be measured by the execution of the WebEOC application with statewide
partners.
2.3.2.3 Goal 3: Sustain the Health Emergency Operating Center (HEOC) functionality by
ensuring competency in staff assembly times, training, and job specific functions.
2.4 Capability 4: Emergency Public Information and Warning
2.4.1 Definition: Emergency public information and warning is the ability to develop, coordinate,
and disseminate information, alerts, warnings, and notifications to the public and incident
management responders.
2.4.2 Budget Period Short Term Goal:
2.4.2.1 Goal 1: Leverage existing technologies to communicate with and inform the
response partners and the general public during operational exercises, on-going
drills, and responses. This short term goal will be measured and tracked through the
documentation of drills and through the qualitative and quantitative evaluation of
exercises and responses in After Action Reports and Improvement Plans (AAR/IPs).
2.4.2.2 Goal 2: Sustain the ability of state, local, and healthcare facility public information
officers to coordinate, develop, and disseminate public information through the
conducting of and evaluation of at least one operational exercise. The ability of public
information officers to determine the need for public information systems establish
and participate in information systems, and establish avenues for public interaction
and exchange will be quantitatively and qualitatively evaluated in the context of an
AAR/IP.
2.5 Capability 5: Fatality Management
2.5.1 Definition: Fatality management is the ability to coordinate with other organizations (e.g., law
enforcement, healthcare, emergency management, and medical examiner/coroner) to ensure
the proper recovery, handling, identification, transportation, tracking, storage and disposal of
human remains and personal effects; certify cause of death; and facilitate access to
mental/behavioral health services to the family members, responders and survivors of an
incident.
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Contract Number
INTERGOVERNMENTAL AGREEMENT
ADHS12-007891
Attachment A
2.5.2 Budget Period Short Term Goal:
2.5.2.1 Goal 1. Identify specific roles and support functions between Arizona Department of
Health, county Public Health, law enforcement, medical examiners, and private sector
partners during a Fatality Management response.
2.5.2.2 Goal 2. Coordinate between internal and external partners to facilitate access to
resources when demand on local jurisdiction exceeds capacity to support fatalities
from an incident. Ensure resource request are in accordance with public health
jurisdictional standards and practices and as requested by lead jurisdictional
authority. This will result in the development and implementation of resource request
process.
2.5.2.3 Goal 3. Survey county and tribal partners to identify training in support of Fatality
Management operations to include: mental/behavioral health services, death
notification, relief to families, and spiritual care. Utilization of a survey prior to and
post training will measure increased knowledge.
2.6 Capability 6: Information Sharing
2.6.1 Definition: Information sharing is the ability to conduct multijurisdictional, multidisciplinary
exchange of health-related information and situational awareness data among federal, state,
local, territorial, and tribal levels of government, and the private sector.
2.6.2 Maintain or Have Access to a Notification System
Jurisdictions shall maintain or have access to a notification system to share health updates
and alerts, including epidemiological, clinical, and situational awareness data, with key
healthcare partners.
2.6.3 Provide Emergency Notification System Contact Information and Participate in
Bimonthly Communications Drills.
Jurisdictions shall provide ADHS with emergency contact information sheets semi-annually
and participate in Bimonthly Communication Drills. Drill results will be provided to ADHS after
each drill.
2.6.4 Budget Period Short Term Goal:
2.6.4.1 Goal 1. Conduct multi-jurisdictional and multi-disciplinary exchange of health related
information and situational awareness with all County and Tribal and local ESF-8
partners statewide. This short-term goal will be measured by 8% increased
membership to the interoperable communication systems such as the Health Alert
Network.
2.6.4.2 Goal 2. Disseminate accurate and appropriate information to the County and Tribal
and local ESF-8 partners statewide. This goal will be measured by the development
of an information generation/sharing protocol.
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Contract Number
INTERGOVERNMENTAL AGREEMENT
ADHS12-007891
Attachment A
2.7 Capability 7: Mass Care
2.7.1 Definition: Mass care is the ability to coordinate with partner agencies to address the public
health, medical, and mental/behavioral health needs of those impacted by an incident at a
congregate location. This capability includes the coordination of ongoing surveillance and
assessment to ensure that health needs continue to be met as the incident evolves.
2.7.2 Budget Period Short Term Goal:
2.7.2.1 Goal 1. Determine the jurisdictional public health roles and responsibilities in
conjunction with Emergency Support Function 6, 8, and 11 partners. . Consolidation
of information will result in the completion of a statewide plan that will support Mass
care operations.
2.7.2.2 Goal 2. In conjunction with state and local partners, including emergency
management and Red Cross collaborate to identify a tool for health screening of
individuals during shelter operations. Some elements of the tool may be, immediate
medical needs, mental health needs, sensory impairment or other disability,
medication use, need for assistance with activities of daily living, and substance
abuse. The outcome will be a recommendation to the Emergency Preparedness
Task Force for inclusion in a standard operating procedure for the intake process
during shelter operations and the clarification of the request process for needed
supplies in support of shelter operations for access and functional needs..
2.8 Capability 8: Medical Countermeasure Dispensing
2.8.1 Definition: Medical countermeasure dispensing is the ability to provide medical
countermeasures (including vaccines, antiviral drugs, antibiotics, antitoxin, etc.) in support of
treatment or prophylaxis (oral or vaccination) to the identified population in accordance with
public health guidelines and/or recommendations.
2.8.2 Budget Period Short Term Goal:
2.8.2.1 Goal 1. ADHS, County, and Tribal partners will meet quarterly to share best
practices and lessons learned from Exercises for the rapid dispensing of medical
countermeasures during a public health emergency. Collaborative review will occur
during the Arizona Local Public Health Emergency Response Association
(ALPHERA) and Regional Coalition meetings. By the end of BP2, all County, State,
and Tribal plans will have been reviewed in their entirety.
2.8.2.2 Goal 2. Coordination between SNS Coordinator and epidemiological staff will
streamline the incorporation of investigation data into the SNS request process.
2.8.2.2.1 Develop or Update Medical Countermeasure Dispensing Plans
Written plans should include: standard operating procedures that provide
guidance to identify the medical countermeasures required for the
incident or potential incident; protocols to request, receive, distribute,
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Contract Number
INTERGOVERNMENTAL AGREEMENT
ADHS12-007891
Attachment A
dispense, and manage medical countermeasures within 48 hours of
request. Planning should include all memoranda of understandings or
other letters of agreement with state/local/tribal partners; and written
agreements (e.g., memoranda of agreement, memoranda of
understanding, mutual aid agreements or other letters of agreement) to
share resources, facilities, services, and other potential support required
during the medical countermeasure dispensing activities. Update/ revise
SNS Plans based upon training improvements, quarterly meeting notes,
identified threats and regional risk assessments, partner involvement and
post plans onto ADHS Health Service Portal.
2.9 Capability 9: Medical Materiel Management & Distribution
2.9.1 Definition: Medical materiel management and distribution is the ability to acquire, maintain
(e.g., cold chain storage or other storage protocol), transport, distribute, and track medical
materiel (e.g., pharmaceuticals, gloves, masks, and ventilators) during an incident and to
recover and account for unused medical materiel, as necessary, after an incident.
2.9.2 Budget Period Short Term Goal:
2.9.2.1 Goal 1: ADHS, County, and Tribal partners will meet quarterly to share best
practices and lessons learned from Exercises for Medical Materiel Management and
Distribution of medical countermeasures during a public health emergency.
Collaborative review will occur during the Arizona Local Public Health Emergency
Response Association (ALPHERA) and Regional Coalition meetings. By the end of
BP2, all County, State, and Tribal plans will have been reviewed in their entirety.
2.9.2.2 Goal 2: Collaborate with the Arizona Board of Pharmacy (AZBP) to develop a query
protocol of pharmacies during a public health emergency. The protocol will support
ADHS in determining the current standard inventory of medical countermeasures and
will allow for streamlined request of medical countermeasures. By the end of BP2,
the protocol will be an annex to ADHS SNS Plan.
Participate in Inventory Management System quarterly drills in support of medical
material management and distribution of medical countermeasures.
2.9.3 Drill Requirement
Each County will conduct at least two different SNS drills utilizing the Target Metric template
provided by DSNS/ADHS. An executive summary and improvement plan must be submitted
for each drill. Jurisdictions shall provide ADHS with the Target Metrics by January 10, 2014
and April 25, 2014 respectively.
2.9.3.1 Staff notification, acknowledgement and assembly
2.9.3.2 Site activation: notification, acknowledgement and assembly
2.9.3.3 Facility Setup
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Contract Number
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Attachment A
2.9.3.4 Pick List Generation
2.9.3.5 Dispensing Throughput
2.9.4 Cities Readiness Initiative (CRI) Drill Requirement
Each CRI will conduct at least three different SNS drills utilizing the Target Metric template
provided by DSNS/ADHS. An executive summary and improvement plan must be submitted
for each drill. Jurisdictions shall provide ADHS with the Target Metrics by January, 10, 2014,
and April 25, 2014 respectively.
2.9.4.1 Staff notification, acknowledgement and assembly
2.9.4.2 Site activation: notification, acknowledgement and assembly
2.9.4.3 Facility Setup
2.9.4.4 Pick List Generation
2.9.4.5 Dispensing Throughput
2.9.4.6 Public Health Decision Making Tool
2.10 Capability 10: Medical Surge
2.10.1 Definition: Medical surge is the ability to provide adequate medical evaluation and care
during events that exceed the limits of the normal medical infrastructure of an affected
community. It encompasses the ability of the healthcare system to survive a hazard impact
and maintain or rapidly recover operations that were compromised.
2.10.2 Budget Period Short Term Goal:
2.10.2.1 Goal 1. Coordinate jurisdiction's healthcare response through the collection and
analysis of health data to define the needs of the incident and available healthcare
staffing and resources. This will be measured by the results of monthly
communication drills, and expansion of data being requested during Medical Surge
exercises/operations.
2.10.2.2 Goal 2. As part of the regional Health Care Coalitions, help define public health role
and the processes to obtain information relating to situational awareness in support
of medical surge operations. This process will be tested in exercises during BP2.
2.11 Capability 11: Non-Pharmaceutical Interventions
2.11.1 Definition: Non-pharmaceutical interventions are the ability to recommend to the applicable
lead agency (if not public health) and implement, if applicable, strategies for disease, injury,
and exposure control. Strategies include the following:
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Attachment A
2.11.1.1 Isolation and quarantine
2.11.1.2 Restrictions on movement and travel advisory/warnings
2.11.1.3 Social distancing
2.11.1.4 External decontamination
2.11.1.5 Hygiene
2.11.1.6 Precautionary protective behaviors
2.11.2 Budget Period Short Term Goal:
2.11.2.1 Goal 1. Maintain and enhance existing plans to address NPIs for multiple incidents.
Communication plans will be updated and/or maintained to share intervention
activities with partners and the public. Plans will also include processes to address
vulnerable populations as well as procedures to enable the scalable implementation
of the intervention
2.12 Capability 13: Public Health Surveillance and Epidemiological Investigation
2.12.1 Definition: Public health surveillance and epidemiological investigation is the ability to
create, maintain, support, and strengthen routine surveillance and detection systems and
epidemiological investigation processes, as well as to expand these systems and processes
in response to incidents of public health significance.
Local public health partners should maintain the capacity for surveillance, investigation, and
control of infectious diseases and public health incidents. Partners should work with ADHS
to accomplish these functions if capacity is limited at the local level.
Electronic exchange of personal health information should meet applicable patient privacy-
related laws and standards, including state or territorial laws. These include the Health
Insurance Portability and Accountability Act, the Health Information Technology for
Economic and Clinical Health Act, and standards from the National Institute of Standards
and Technology and the Office of the National Coordinator for Health Information
Technology of the U.S. Department of Health and Human Services
Written plans should include processes and protocols to gather and analyze data from
reportable condition surveillance (i.e., conditions for which jurisdictional law mandates name-
based case reporting to public health agencies). Jurisdictions should plan to receive
Electronic Laboratory Reporting for reportable conditions from healthcare providers using
national Meaningful Use standards.
2.12.2 Participate in State Testing of the Communicable Disease On-call System
Jurisdictions shall participate in tests of the communicable disease on-call system, and shall
ensure that sufficient staff are identified and trained to participate in all system tests.
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Attachment A
2.12.3 Provide ADHS Staff with Contact Information for MEDSIS Liaison Semi-annually
Jurisdictions shall provide ADHS staff with contact information for the MEDSIS liaison on a
semi-annual (every 6 months) basis. MEDSIS liaison responsibilities include
requesting/approving new users and notifying ADHS when users no longer require access.
The MEDSIS liaison shall also participate in the MEDSIS quarterly meetings. Arizona utilizes
MEDSIS to conduct reportable disease surveillance.
2.12.4 Conduct Outreach to Delayed Reporters
Jurisdictions shall conduct outreach to delayed reporters (entities reporting cases of disease
later than timeframes allowed by Arizona Administrative Code). Delayed reporters can be
identified through quarterly timeliness reports generated by ADHS or county-specific
surveillance systems. Report on the percentage of delayed reporters educated about
timeliness of reporting.
2.12.5 Participate in Epidemiology Trainings and Exercises
Jurisdictions shall participate in the Epidemiology Surveillance and Capacity (ESC) meetings
(at least 10 out of 12), ―How to‖ Presentations (at least 80%) and the Arizona Infectious
Disease Training and Exercise. Attendance will be monitored by ADHS for use in grant
reporting.
2.12.6 Conduct Investigations of Reported Urgent Diseases and Public Health Incidents
Investigation actions should include the following as necessary: case identification, specimen
collection, case investigation/characterization, and control measure implementation.
2.12.7 Report All Identified Outbreaks Within 24 Hours
Jurisdictions shall Report all of identified outbreaks to ADHS within 24 hours; include
documentation on outbreak investigation activities as part of your mid-year and end-of-year
reports to ADHS. At a minimum, include the information identified in Appendix 1.
2.12.8 Submit Outbreak Summaries to ADHS
Outbreak summaries must be submitted to ADHS within 30 days of outbreak closure for all
outbreaks investigated.
2.12.9 Initiate Control Measures within the Appropriate Timeframe
Indicate time of control measure initiation in the case management screen of MEDSIS. If
MEDSIS case management screen is unavailable, document control measure timeliness in a
data collection tool. See Appendix 2 for details related to control measure initiation and
selected diseases.
2.12.10 Develop a plan to address and/or identify non-reporters
Local jurisdictions shall develop a brief plan to identify non-reporters and provide outreach to
these reporters. (i.e., review all healthcare facilities in the jurisdiction and cross-check with
cases reported in MEDSIS to identify non-reporters.)
2.12.11 Complete monthly performance measure report form
Jurisdictions shall complete the monthly PHEP performance measure report form distributed
by ADHS for use in identifying gaps in timeliness of reporting and monitoring outbreaks in
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the jurisdiction. Performance measure report information will be utilized for mid-year and end-
of-year grant reporting.
2.12.12 Budget Period Short Term Goal:
2.12.12.1 Goal 1. Maintain and enhance public health informatics infrastructure, including
the state- wide electronic disease reporting system (MEDSIS), electronic
laboratory reporting and syndromic surveillance systems to allow state and local-
level epidemiologists to better collect data, track health events and analyze
disease trends. This goal will be measured by the number of reports generated
using the various surveillance systems, the integration of a new outbreak module
into MEDSIS and the increase in the number of laboratories reporting
electronically to ADHS.
2.12.12.2 Goal 2. Create and maintain protocols for investigation and communication and
provide monthly trainings to improve the ability of health departments in Arizona to
identify outbreaks and determine the source of infection or exposure. Goal
measured by the number of trainings held throughout the grant period, the
number of investigations initiated and by the percent of epidemiologists meeting
CSTE Epidemiology Tier 1 core competencies.
2.13 Capability 14: Responder Safety and Health
2.13.1 Definition: The responder safety and health capability describes the ability to protect public
health agency staff responding to an incident and the ability to support the health and safety
needs of hospital and medical facility personnel, if requested.
2.13.2 Budget Period Short Term Goal:
2.13.2.1 Goal: Conduct gap assessment to determine the percent of healthcare coalitions
that have systems and processes in place to preserve healthcare system
functions to protect the coalition member employees (including non-healthcare).
2.14 Capability 15: Volunteer Management
2.14.1 Definition: Volunteer management is the ability to coordinate the identification, recruitment,
registration, credential verification, training, and engagement of volunteers to support the
jurisdictional public health agency’s response to incidents of public health significance.
2.14.2 Budget Period Short Term Goal:
2.14.2.1 Goal: Enhance the Volunteer Response Program for the members of the
Healthcare Coalitions and volunteer organizations by developing updated plans,
guidelines, forms and training as well as promote the utilization of the State
Volunteer Management System (ESAR-VHP) at the local level to increase the
credentialed volunteer database by 8%. The outcome will be measured by
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increased revised/updated plans, new standard operating procedures, and forms
for healthcare coalitions, ESF 8 partners, and local volunteer organizations for
volunteer management and increased utilization of the AZ ESAR-VHP database
for all volunteer organizations in Arizona.
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Attachment A
Table 1- Deliverables “At a Glance”
PROGRAM REQUIREMENTS APPLICABLE TO ALL PARTNERS
1 Partnership/Coalition Meetings Attendance: Designated PHEP Coordinator or representative will attend
meetings within their region
2 Reporting: Mid-Year and End of Year Reports
3 Financial Requirements: Performance, Match Requirement, Inventory, Budget Spend Plan, Grant Activity
Oversight, Employee Certifications, Activities and Purchases
4 Exercises: Participate in the 2013-2014 ADHS Training and Exercise Plan Workshop, Provide ADHS agency
specific HSEEP TEP no later than September 6, 2013
5 Exercises: Conduct and Participate in at least one ADHS Sponsored HPP and PHEP/SNS Program Exercises
and Public Health.
6 Exercises: Submit at Least One After Action Report from HSEEP Compliant Exercise or Real Event to ADHS by
June 10, 2014
7 Corrective Actions: Develop and maintain Tracking Tool for AAR/IPs
GOALS/OBJECTIVES
1 Community Preparedness: Local and Tribal health will develop a regional approach to address planning gaps
identified
Community Preparedness: Review/update written plans to ensure they include policy and process to participate
in partnerships representing at least the 11 identified community sectors
2 Community Recovery: Evaluate healthcare system, behavioral health care and human services recovery needs,
along with resource availability.
3 Emergency Operations Coordination: Local Health Departments gain access to WebEOC for their identified key
staff
4 Emergency Public Information: Conduct regularly scheduled, ongoing communications drills with ADHS to
ensure equipment and staff are ready for real-world responses
5 Fatality Management: Identify specific roles and functions during a Fatality Management response
6 Information Sharing: Provide Emergency Notification System Contact Information and Participate in System
Tests
7 Mass Care: Identify Local Health roles and responsibilities to provide health services, and shelter services during a
mass care incident
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8 Medical Countermeasure Dispensing: Meet with ADHS SNS Coordinator quarterly to review Medical
Countermeasure Dispensing Plans for the alignment of State and Local deployment of medical countermeasures
Medical Countermeasure Dispensing Drills Non-CRI: Each County conduct at least two different SNS drills
provide ADHS the target metrics by January 10, 2114 and April
25, 2014
Medical Countermeasure Dispensing CRI: Cities Readiness Initiative (CRI) Drill requirement, Each County
conduct at least three different SNS drills provide ADHS the target metrics by January 10, 2114 and April 25, 2014
9 Medical Materiel Management & Distribution: Participate in ADHS quarterly inventory Management System
drills
10 Medical Surge: Participate in ADHS monthly communication drills with healthcare system partners
10 Medical Surge: Assist Coalition in developing processes for obtaining coalition-level situational awareness
11 Non-Pharmaceutical Interventions: Review plans to ensure the address NPIs for multiple incidents, updated
plans as required to share intervention activities with partners and the public
13 Public Health Surveillance and Epidemiological Investigation: Participate in State testing of the
communicable disease on-call system- Counties Only
Public Health Surveillance and Epidemiological Investigation: Provide ADHS Staff with Contact Information
for MEDSIS Liaison Semi-annually
Public Health Surveillance and Epidemiological Investigation: Conduct outreach to delayed reporters (entities
reporting cases of disease later than timeframes allowed by Arizona Administrative Code)- Counties Only
Public Health Surveillance and Epidemiological Investigation: Participate in at least 80% of the Epi
Surveillance and Capacity meetings
Public Health Surveillance and Epidemiological Investigation: Conduct investigations of reported urgent
diseases and public health incidents.
Public Health Surveillance and Epidemiological Investigation: Report All Identified Outbreaks within 24 Hours
(see Appendix 1)
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Public Health Surveillance and Epidemiological Investigation: Submit Outbreak Summaries to ADHS (within
30 Days of Outbreak Closure for all Outbreaks Investigated)
Public Health Surveillance and Epidemiological Investigation - Mitigation Actions: Initiate Control Measures
within the Appropriate Timeframe (see Appendix 2)
14 Responder Safety and Health: Complete a gap assessment survey to identify system and processes in place to
preserve and maintain healthcare system functions and provide an inventory of Personal Protective Equipment.
15 Volunteer Management: Complete a volunteer needs assessment provided by ADHS which will include,
identification of situations that would necessitate the need for volunteers in healthcare organizations, estimations of
the anticipated volunteers, resource needs, identification of the health professional roles and known liability issues.
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APPENDIX 1
Outbreaks include all notifiable cases and clusters, but should exclude: conjunctivitis, strep throat/group A streptococcal
infection, influenza-like illness, RSV, lice, scabies, HIV, STD, and TB.
Outbreak Reporting Table – July 1, 2013-June 30, 2014:
# of outbreak # of outbreaks # of outbreaks with # of outbreak # of outbreak
reports received investigated specimens investigations with investigations with
collected (human reports generated complete reports or
or animal) summary forms
submitted to ADHS
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APPENDIX 2
1. Initiation of control measures can include:
1.1 Initiation of an appropriate control measure
1.2 A recommendation for initiation of a control measure
1.3 A decision not to initiate or recommend a control measure
1.4 Documented inability to initiate a control measure despite an effort to do so
2. Selected reportable diseases include: Botulism, Shiga toxin-producing E. coli, Hepatitis A, Measles, Meningitis,
Tularemia: reference appendix 2 for table of control measures and initiation timeframes requirements.
Public Health Control Measures and Timeframes:
Disease /agent Example control measures Initiation timeframe
Botulism Identification of potentially Within 24 hours of initial case
exposed individuals Identification identification
/ recovery of suspected source of
infection, as applicable
E. coli (STEC) Contact tracing Within 3 days of initial case
Education: contacts as identification
applicable
Exclusions: child care, food
handling as applicable
Hepatitis A, Acute Contact tracing Education: Within 1 week of initial case
contacts Immunization identification
(active/passive) administered
or recommended to contacts,
as appropriate
Measles Contact tracing Within 24 hours of initial case
Education: contacts identification
Immunization (active/passive)
administered or recommended
for susceptible individuals
Isolation: confirmed cases
Meningococcal Disease Contact tracing Education: Within 24 hours of initial case
contacts Prophylaxis identification
administered or
recommended for susceptible
individuals
Tularemia a) Identification of potentially a) Within 48 hours
exposed individuals b) within 48 hours of initial case
b) identification of source of identification
infection, as applicable
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APPENDIX 3
CENTRAL REGION
County
GILA
MARICOPA
PINAL
Tribal
GILA RIVER INDIAN COMMUNITY
NORTHERN REGION
County
APACHE
COCONINO
NAVAJO
YAVAPAI
Tribal
HOPI TRIBE
NAVAJO NATION
WHITE MOUNTIAN APACHE TRIBE
SOUTHERN REGION
County
COCHISE
GRAHAM
GREENLEE
PIMA
SANTA CRUZ
Tribal
PASCUA YAQUI TRIBE
SAN CARLOS APACHE TRIBE
TOHONO O'ODHAM NATION
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WESTERN REGION
County
LA PAZ
MOHAVE
YUMA
Tribal
COCOPAH TRIBE
COLORADO RIVER INDIAN TRIBES
FORT MOJAVE INDIAN TRIBE
KAIBAB - PAIUTE TRIBE
QUECHAN TRIBE
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