Recent real-life events, such as the Pulse night club shooting and the October 1 Las Vegas shooting have highlighted the need for health and emergency responders to prepare for Active Shooter/Attacker events. Currently, Active Shooter/Attacker and Mass Casualty Event rates as one of NCW HERC’s top ten threats identified in the 2017-2018 NCW HERC Hazard Vulnerability Assessment (HVA.)
On September 18th, 2018 NCW HERC members came together as a group to discuss plans in response to a mass casualty event. Over one hundred participants from hospitals, emergency medical services, emergency management, public health, law enforcement and other health and emergent responders participated in round table discussion. All twelve counties were linked together virtually to share discussions, finds of best practice and areas for improvement.
Key response areas discussed included medical surge in response to a mass casualty event, activation of mass fatality plans when counties have exceeded fatality capacity and activation of family assistance centers related to significant need to aid in recovery.
Synthesis of information collected during the exercise is currently being tabulated and will guide future plan development, training and exercising.
Please welcome NCW HERC in welcoming Bert Nitzke, as its new WISCOM SME. A little about Bert:
"My Name is Bert Nitzke your new NCW HERC WISCOM SME, I am currently from the Wausau area. I’m currently a Fire Chief for a department in Clark County. I am also an instructor for TEEX (Texas A&M University) where I instruct emergency preparedness courses and conduct full scale exercises throughout the nation.
My background in WISCOM comes from my time working at Wisconsin State Patrol when WISCOM officially was born and implemented back in 2009-2010. Here I worked exclusively with the program and on my fire department even today, created and managed talk groups on WISCOM.
I’m excited to share my WISCOM experience and education with all of you on this valuable tool in interoperability within the NC Region 2.
I can be contacted at any time with WISCOM questions or troubleshooting at
Nitzkebert@gmail.com or call or text at (715) 897-1508."
Bert will be contracted with NCW HERC through June 2019 to help with WISCOM redundant communications objectives, set forth by NCW HERC.
Check out the following articles contributed to EMS industry news website EMS1.com by NCRTAC Coordinator Michael Fraley.
Please feel free to share these with your EMS providers.
In May, NCW HERC put out a request to its membership requesting identification of caucus representatives for the 2018-2019 NCW HERC Board. In June, NCW HERC elected two representatives from respective fields including: Hospitals, Public Health, Emergency Management, Emergency Medical Services, Trauma, and Clinics. Related to Centers for Medicare & Medicaid Services (CMS) changes, that took effect November 2017, NCW HERC added an additional “CMS” caucus to assure representation of the interests of NCW HERC’s newly identified partners in preparedness. A link to the 2018-2019 board can be found below. Board members are intended to serve as voices for their respective sectors concerns in emergent events and help relay information from their sectors to the coalition and vice versa.
In May, Robert Kadlec, M.D. with the Assistant Secretary for Preparedness (ASPR) released a statement advocating for a “regional disaster health response system.” The article details the work of healthcare coalitions like NCW HERC and outlines the future of coalitions in the nation. The full article can be found at the link below:
While attending the Healthcare Coalition Leadership Course at the Center for Domestic Preparedness (CDP), a large topic of conversation was HIPAA in emergency situations and the lack of clarity amongst healthcare professionals on this subject. Course instructors provided a guidance document linked below for clarification. This document can also be found in the “Tools” section of the website.
In June eight NCW HERC members were able to attend the CDP with other coalition members from around the country. Partnering with Minnesota and Washington, NCW HERC discussed best practices identified over the past decade, readying healthcare for emergent, catastrophic events. Attendees commented that the course was remarkably beneficial in “self-actualization” of NCW HERC and provided the coalition with “heading for years to come.”
On 4.23.18 it was reported by the La Crosse and Trempealeau County Health Departments that an out of state traveler was diagnosed with measles. High exposure has been identified, between 4.13.18 and 4.16.18, at venues, hotels, a resort and several restaurants in the state of Wisconsin. A link to the formal press release can be found below.
Since March 8, 2018, Illinois has had at least 160 people present to Healthcare facilities with serious unexplained bleeding. The preponderant number of patient presentations were in Illinois. Cases have also recently been reported Wisconsin. Laboratory investigation confirms brodifacoum exposure in at least 60 patients. There are at least 3 fatalities. At least 7 synthetic cannabinoids product samples related to this outbreak have tested positive for brodifacoum. At least one synthetic cannabinoids product has tested positive for both synthetic cannabinoid AB-FUBINACA and brodifacoum.
For more information visit:
In March, NCW HERC collaborated with Marshfield Medical Center, and numerous other NCW HERC members, to test the coalition’s ability to collaborate, simulating a patient evacuation. The exercise proved to be quite successful, being able to coordinate the evacuation of 120 patients in ninety minutes. Many areas for improvement were also identified. An After Action Report has been drafted and is projected to be finalized mid-May for member viewing. Please contact NCW HERC with questions related to this exercise.
WISCOM radios are a redundant communication, intended to quickly lead to a common operational picture. Instead of multiple phone calls, one radio transmission will notify all regional facilities. With the installation of Aspirus Wausau’s WISCOM Radio, all fifteen hospitals in region 2 have now completed the first phase of an interoperability project. This also links NCW HERC hospitals to hospitals in other regions greatly increasing success in preparedness and response.
To improve comfort in using WISCOM radios: NCW HERC conducts biweekly “Roll Call Drills”, provides instructional YouTube videos, and has usage documents. Additional Resources can be found below
Coalition members that have not already done so, and are attending the March 14, 2018 CST Facilitated Discussion and After Action Review, should register via the “Survey Monkey” link, by March 12, 2018.
Registration Link: https://www.surveymonkey.com/r/6ZMNYKL
With the Coalition Surge Test (CST) fast approaching, many questions have been asked related to EMTALA, 1135 waivers and crisis standards of care. During the CST exercise, regional partners will simulate a hospital evacuation. Two documents provided by the Office of Preparedness and Emergency Health Care (OPEHC) and ASPR TRACIE help clarify these questions when faced with catastrophic events, like a hospital evacuation. You can find these documents linked below and in the website “Tools” section.
NCW HERC identified “Cyber Attack” as its number one threat in its 2017-2018 “Hazard Vulnerability Assessment”. At the February NCW HERC hospital meeting, cyber security and cyber hygiene was a main topic of discussion. Questions what came up were: “What is your organization doing to protect from and mitigate cyber threats?” Also, “How is your organization collaborating with Information Technologies (IT) to ensure a common operating picture?” These are vital questions that all NCW HERC members should conduct an introspective assessment on. Some resources identified can aid in these preparation efforts. These links will also be added to the website “Tools” section.
ASPR TRACIE Cybersecurity Resources:
U.S Department of Health & Human Services: Protecting the Healthcare Digital Infrastructure: Cybersecurity Checklist:
United States Secret Service Cyber Hygiene & Cyber Security Recommendations:
NCW HERC is pleased to formally announce its formal collaboration with the Medical College of Wisconsin- Central Wisconsin. NCW HERC is working closely with Linnea Blomberg, M.D. Candidate, Class of 2020 in her "Community Scholarly Project". Over the next two years NCW HERC will collaborate with Linnea to develop and bolster preparedness planning in North Central Wisconsin.
At the January 10th NCW HERC Board meeting, Linnea presented a synthesized document covering key considerations for each county in Region 2. These considerations are summaries of multiple tools including: HHS’s emPOWER, the CDC’s Social Vulnerability Index (SVI), census.gov, and County Health Rankings.
This tool is intended to help guide and provide considerations when the coalition and its members are developing and updating plans. The tool can be found in the “Tools” section of the website, or HERE.
CDC's Influenza Division produces a weekly influenza surveillance report, FluView. Seasonal influenza activity increased sharply in the United States. New York City and 26 states experienced high Influenza Like Illness (ILI) activity levels. Puerto Rico and nine states experienced moderate ILI activity.
(Released for distribution by Departmetn of Health and Human Services 01/05/18.)
Healthcare and Public Health Sector partners-
Below is a link to a report on the Recently Publicized Widespread Processor Vulnerabilities from the Healthcare Cybersecurity and Communications Integration Center (HCCIC). Please note the report is TLP: WHITE.
HCCIC: Report on Recently Publicized Widespread Processor Vulnerabilities
A statement by FDA Commissioner Scott Gottlieb, M.D., update on recovery efforts in Puerto Rico, and continued efforts to mitigate IV saline and amino acid drug shortages.
You are invited to the Wisconsin Office of Emergency Communications’ Regional Outreach Meetings! The purpose of these meetings is to provide an update to stakeholders on the status of the new, nationwide public safety broadband communications initiative known as FirstNet; provide guidance on evaluating service options for public safety agencies; next steps for public safety broadband in Wisconsin; and solicit input into the Interoperability Report that will be submitted to the State Legislature in 2018.
The meetings will be held between Jan 22 & 26 with a meeting being held in Wausau Jan 23. CLICK HERE for a full information sheet including more dates and locations and details about the program.
NCW HERC would like to take a minute to thank Tamarah Scholze for her leadership and efforts in preparing region 2 and its members for healthcare emergencies. Tamarah had been an active member in the coalition, dating back to 2005, and served as coalition chair until personal reasons required her to step away. NCW HERC wishes Tamarah all the best with her future, where ever it may take her!
ASTHO recently released a document: "A Peer Assessment of Preparedness Activities’ Impact on the Public Health and Medical Response", detailing findings from the Pulse Night Club shooting. This document summarizes the public health and medical preparedness activities that supported the response to the June 12, 2016 Pulse nightclub shooting in Orlando, Florida. It also explores preparedness program gaps brought to light during the response. This report is based on information gathered from an Orlando site visit conducted January 11‐12, 2017 by two peer assessors and several subsequent conference calls with key responders. ASTHO provided analytical and technical support for this project.
Wisconsin Statewide Intelligence Center (WSIC) released an Analytical Note, October 27, 2017. The note is intended for wide distribution discussing "The Basics of Ransomware: A Guide for Wisconsin Businesses." The note covers ways to improve cyber hygiene and what to do if your organization is victim of a cyber incident.
An updated document of Fentanyl Safety Recommendations for First Responders has been released by the federal government. The document includes information for EMS, fire and law enforcement first responders about fentanyl exposure and methods to limit the risk. The document goes on to review management of suspected exposures and responders symptomatic of ingestion. Letter-size and poster-size versions are available for printing and sharing.
(Message from Bill Oemichen) I am very pleased to advise you that Caitlin Washburn has accepted the position as the State Trauma Program Coordinator within our office and will assume her new position on October 2. As many of you know, Caitlin has been working in our office since January of 2016 in a variety of roles, including excellent service since early June as the interim State Trauma Program Coordinator. As you may also know, Caitlin recently earned her Juris Doctorate (J.D.) degree from the University of Wisconsin – Madison and earned Bachelor of Science degrees in both Biochemistry and Legal Studies with Distinction from the University of Wisconsin – Madison in 2013 where she is a member of Phi Beta Kappa Honor Society. Caitlin’s extensive education, administrative and program experience, and her evident enthusiasm for all things public health make her an outstanding permanent addition to our OPEHC team.
Please join me in welcoming Caitlin to this important role.
William L. Oemichen, Director
Office of Preparedness & Emergency Health Care
Wisconsin Department of Health Services
The first of the much expected facility planning toolkits has been made available. DHS has developed a number of toolkits to help non-hospital CMS facilities meet the emergency preparedness rule. Additional toolkits are in the DHS approval process and will be posted soon. Download the kits HERE.
Email from Bill Oemichen, Director of the Office of Preparedness & Emergency Health Care.
With much reluctance, I have significant news to announce regarding our preparedness leadership in the Office of Preparedness and Emergency Health Care: Lisa Pentony, after 15 years of skilled and dedicated service to the cause of health emergency preparedness within the Division of Public Health (DPH), is leaving us to take on a new role in the Division of Care and Treatment Services (DCTS) in DHS. She asked me to share that it was a very difficult decision for her, but one that she feels is right for her at this point in her career and life. She further stated that it has been her privilege to have worked with and learned from such incredible partners like all of you.
All of us who are Lisa’s colleagues in the Office of Preparedness and Emergency Health Care are more than sad to see her go, but we hope you will join us in wishing her well in her new role. DCTS is truly lucky to have a talented and thoughtful leader like Lisa joining their ranks.
Lisa’s last day with our office is this Friday, September 1, 2017. Our staff is dedicated to continue with our work and support of all of you, with the excellence that Lisa has always cultivated. Going forward, please contact Joe Cordova at 608-267-9010 for information on the Public Health Preparedness Program or Michelle Seitz at 608-267-6833 for information on the Healthcare Preparedness Program. Of course, regardless of topic, you may also reach out to me at 608-267-7178.
William L. Oemichen, Director
Office of Preparedness & Emergency Health Care
Wisconsin Department of Health Services
We are please to announce that Robbie Deede has been hired to be the new NCW HERC Coordinator.
Robbie Deede, RN BSN is a graduate of University of Wisconsin-Oshkosh School of Nursing. He has an extensive background in primary care pediatrics and achieving community wellness through the “Maternal Child Health Life Couse Model.” While working for Oneida County Health Department, he assisted in achieving “Public Health Accreditation Board(PHAB)” certification and served as Preparedness Coordinator. During this time, Robbie aided in the development of multiple documents, plans and policies in Pandemic Response, Mass Care, Mass Fatality and Community Readiness to improve county and regional wellness. Many efforts have been shared as best practice by the State of Wisconsin. Through efforts such as these, he was awarded the 2017 Carol Graham Scholarship for emerging leadership in public health.
Robbie’s commitment to community extends beyond practice. He is an avid volunteer, operating "Hodag BMX", a 100% volunteer, non-profit club focused on community youth development. In 2016, he asked to participate in the "Rhinelander Parks Task Force" to engage the community on matters related to parks in Rhinelander, WI.
Robbie advocates for strong partnership building, stating: “We need to understand the importance of working together in strengthening our community every day. We are going to need each other in time a crisis and still need to be a community after crisis.”
Please mark your calendars for this event on November 8th, from 1030-1200. Location to be determined.
This will be an overview of the upcoming Coalition Surge Test (CST). This is a requirement of the Hospital Preparedness Program for annual exercising 2017-2022, and core partner collaboration and input is identified as essential. Core Partners include: Emergency Management, Public Health, Emergency Medical Services, and Hospitals. This overview will be conducted collaboration with Wisconsin Department of Health Services Office of Preparedness and Emergency Health Care and the North Central Wisconsin Healthcare Emergency Readiness Coalition (NCW-HERC).
The CST is designed to help health care coalitions (HCCs) identify gaps in their surge planning through a low- to no-notice exercise. The exercise’s foundation comes from a real-world health care system disaster challenge—the evacuation of a hospital or other patient care facility. The CST tests a coalition’s ability to work in a coordinated way to find appropriate destinations for patients using a simulated evacuation of at least 20 percent of a coalition’s staffed acute-care bed capacity. Assistant Secretary for Preparedness and Response (ASPR) has indicated there is an increased willingness to penalize states for poor performance/reporting by withholding funds.
Again, core partner contribution is essential to the success of the CST. Thank you for considerations in making arrangements to attend this meeting.
The Stop the Bleed campaign stresses the importance of bystander intervention to stop severe bleeding. Over the last year the Wisconsin Healthcare Coalitions have given 10,000 tourniquets to law enforcement officers across the state. A number of lives already been saved by tourniquets including this one in Rock County.
Michelle Seitz has been in the health emergency preparedness field for many years. Michelle brings more than sixteen years of experience in emergency preparedness, response and recovery planning for healthcare and public health agencies. She holds a Bachelor’s Degree of Science in Emergency and Disaster Management, a Master’s Degree of Science in Homeland Security Management as well as having real life experience increasing local, regional and national response efforts.
Michelle has been a national leader in pediatric preparedness, sitting on the Executive Committee of the National Pediatric Disaster Coalition and has experience working in the emergency management field in a hospital for seven. Earlier in her career she worked in public health preparedness. She will begin April 3.
Congratulations to the NCW HERC member organizations awarded this year's project grants. the NCW HERC recieved applications for over $130,000 worth of projects but unfortunately we only had about $80,000 to award. After careful review and scoring the Board of Directors awarded a total of $85,327 to the following projects.
|Ascension Saint Clare's Hospital||$4,000||WI Trac computer display|
|Ascension Saint Michael's Hospital||$600||HAM radio|
|Ascension Saint Michael's Hospital||$4,000||WI Trac computer display|
|Oneida County Emergency Management||$4,960||WI-CAMS|
|Aspirus Wausau Hospital||$10,500||Electronic Incident Command Pilot|
|Aspirus Wausau Hospital||$3,000||WI Trac computer display|
|Ascension Saint Clare's Hospital||$16,895||Emergency shelter (portable building)|
|Aspirus Riverview Hospital||$12,285||Patient DECON hot water heater|
|Aspirus Wausau Hospital||$9,833||Flexmort cooling blanket|
|Aspirus Wausau Hospital||$6,000||ENPC course|
|Ascension Saint Joseph's Hospital||$4,233||HAZMAT supplies|
|Ascension Saint Michael's Hospital||$6,840||PAPRS|
|Marathon County Emergency Management||$2,179||Trench rescue training|
Highlighting the importance of WISCOM as a communication option within the region and across the state, the NCW HERC will be providing additional training on the WISCOM radio system to hospitals and possbily other HERC partners in the region. The HERC has contacted with Mark Schroeder to provide the training. He will be in contact with hospitals to set up training in the near future.
©2018 North Central Wisconsin Healthcare Emergency Readiness Coalition