The Great Lakes Border Health Initiative

1. The Great Lakes Border Health Initiative presented DATE to GROUP NAME

2. What is GLBHI? • A collaborative effort between jurisdictions in the U.S. & Canada to enable infectious disease surveillance and facilitate communication

3. Who is GLBHI?

4. History of GLBHI • Before 2004

5. History of GLBHI • Before 2004

6. History of GLBHI • Now

7. History of GLBHI • 2004 • Early Warning Infectious Disease Surveillance • Michigan and Ontario • Border Health Initiative • 2005 • New York, Wisconsin, Minnesota • Great Lakes Border Health Initiative

8. History of GLBHI • 2006 • MI-HAN enrollment: Ontario • Ohio • 2007 • Epi-X enrollment: Ontario • Pennsylvania & Indiana

9. History of GLBHI • 2008 • CIOSC enrollment: United States

10. Organization

11. About the Committees • Members include: • State/Provincial representatives • Local public health representatives • Tribal/First Nations representatives • Federal representatives • US/Canadian co-chairs • Scheduled to meet monthly to bi-monthly

12. About the Steering Committee • Members • Co-chairs of subcommittees • State/Provincial leads • Other key representatives • Directs the actions of the subcommittees • Tasks determined by grant agreement • All participating organizations represented

13. About the Lab Subcommittee • Routine surveillance sharing • Lab capabilities • Sharing of protocols • Exploring import-export permits from CDC & PHAC

14. About the Legal Subcommittee • Data Sharing Agreement • Evaluates privacy laws and policies of potential new partner states • Provides legal counsel for other committees as issues/questions arise

15. About the Food Protection & Defense Subcommittee • Newest subcommittee • Currently working to establish relationships and communications channels between critical partners

16. About the PH Communication Subcommittee • Communication links & tools • Communication Guideline • Communication System Matrix • Reportable Disease List • Epi-X & CIOSC enrollment exchange

17. About the Ad hoc Subcommittees • Education & Training • Emergency Response • Direct Care

18. Tools for Collaboration • Face-to-face meetings • Communication pathways • Federal • Local/Regional • Data Sharing Agreement • Infectious Disease Emergency Communications Guideline

19. Infectious Disease Emergency Communications Guideline

20. IDECG Decision Tree

21. IDECG Decision Tree

22. IDECG Decision Tree • Might the event have a serious public health impact across the border? • Event due to unknown agent with unpredictable public health impact • Event due to known agent with the following factors: • Unusual disease pattern • Previously eradicated agent • Known agent, but new for the geographical region • Potential to cause epidemic, even if no or few human cases are being identified • Indication of treatment failure • Known potential to cause severe illness • Accidental or intentional release of dangerous, banned or restricted chemical or radioactive agent

23. IDECG Decision Tree

24. IDECG Decision Tree • Is there significant risk of international spread? • Evidence of epidemiological link to similar events in other countries • Need to alert in regard to the potential for cross border movement of the agent, vehicle or host • Cross border assistance is needed to detect, investigate, respond and control the current event, or prevent new cases. • Inadequate human, financial, material or technical resources

25. IDECG Decision Tree

26. IDECG Decision Tree • Might international travel or trade restriction be necessary? • Similar events in the past have resulted in international restriction on trade and/or travel across the border • The source is suspected or known to be a food product, water or any other goods that might be contaminated that has been exported/imported across the border • The event might have occurred in association with an international gathering • The event has caused requests for more information by cross border officials or media

27. Emergency Contacts

28. State Maps

29. Immediately Notifiable Diseases • Epi-developed list • “Pick up the phone and call now” diseases • Trumps the Decision Tree

30. Immediately Notifiable Diseases

31. Data Sharing Agreement

32. Data Sharing Agreement • Ratified by all GLHBI partners • All states vetted by Legal Subcommittee prior to Steering Committee approval • Privacy laws and policies

33. GLBHI Directory • For non-emergency usage • State, local, federal and tribal contacts • Available by request

34. GLBHI Website • www.michigan.gov/borderhealth • Overview of GLHBI • Explanation • Brochure • Poster

35. GLBHI Website • www.michigan.gov/borderhealth • Tools for Border Health • Important Documents, Best Practices & Helpful Resources • Related Organizations • Local Travel Resources for Americans and Canadians • International Travel Resources for Americans and Canadians

36. GLBHI Website • www.michigan.gov/borderhealth • News & Updates • GLBHI Calendar • GLBHI annual conference presentations available online • Other important reports and happenings • GLBHI News & Updates Archive

37. Recent & Future Efforts • Learning from the past: • Historical mapping of regional influenza progression • Functionally exercising an infectious disease emergency in the GLBHI region • Pursuing northern border consistency • Continuing quality improvement of tools/systems • Long-term strategizing

38. Michigan GLBHI Contacts Questions?? Diane Krueger, Project Coordinator kruegerd@michigan.gov 517-335-6533 Carol Somers, Support Staff somersc@michigan.gov 517-373-4501