Building Partnerships with Community and Other Government Agencies

1. Building Partnerships with Community and Other Government Agencies Presenter: Sharon Warnecke ARNP, MSN Coordinator of Health Services School District of Lee County

2. Introduction Community based programs e.g. the H1N1 vaccine program, require community-wide support in order to succeed. Partnerships, coalitions and collaborations are some of the key strategies for promoting health and delivering social services associated with disease prevention.

3. What is partnership? A Partnership is defined as a formal agreement between 2 or more parties that have agreed to work together in pursuit of a common goal. The primary organizational concern is linking or bringing people together in mutually beneficial relationships and figuring out if individual responsibilities and contributions blend to produce extraordinary creative results.

4. Genesis of Partnership • Failure of existing efforts to address the problem ( need for innovation) • Scarcity of resources • Competition for clients • Recognition of mutual needs or purpose and shared responsibility for the problem as well as the solution etc.

5. Lee County Florida

7. April 2009 • The world health organization announced the emergence of a new, unique influenza A virus that had not been seen in humans until the spring of 2009. • The outbreak began in Mexico and is believed to have killed 200 people and to have caused more than 1000 cases of severe breathing problems in that country.

8. In Lee County an early case of the virus is identified in an 11 year boy who attended Spring Creek Elementary school in Bonita Springs. • Other cases begin to show up in Lee County and several other Florida counties. • The Lee County Health Department (LCHD)activates an epidemiology plan to isolate and care for these children and to provide Tamiflu to family members and others who were in contact with the children.

9. H1N1 Virus

10. Progress of disease • Late Spring, 120 cases were identified in 17 states • By June, there were 30,000 confirmed cases in 74 countries • June 11th, Dr. Margaret Chan, Director-General of World Health Organization (WHO) confirms an influenza pandemic

11. First celebrity death from H1N1, Swine Flu ……..and we know who gave it to him! Poor Kermit

12. Due to the uncertainty of how quickly the H1N1 virus would spread and how virulent it might become, information and guidance from the scientific community was sometimes contradictory and changed frequently. • County health departments were given federal funds for a vaccination campaign and were guided by constant information and updates from DOH and CDC. Mass clinics were mandated but how the clinics were to be designed, how many and where they were offered as well as how the high-risk groups would be reached were all decisions to be made by the individual county health departments.

14. H1N1 Vaccine anticipated 9/09

15. Process Of Partnership Development The following steps are important to partnership building efforts. • Do your homework. • Have an idea of what you are looking for from your partners. • Form you community plan. • Assess readiness.

16. Process Of Partnership Development(continued) • Look for the right organization. • Typically, this is an organization that values partnership behaviors, such as sharing of information. • This organization also places high value on the success of the community. • Successful partnerships are based on trust and shared interest.

17. Process Of Partnership Development (continued) • Find the right person/persons. • The most effective person is someone who is community-is community- based and enthusiastic about the research project. • This person should be an advocate for your project.

18. Process Of Partnership Development (continued) • Be open to other ideas. • Having formed the plan, be prepared for potential partners to bring other ideas to the process.

19. Process Of Partnership Development (continued) • Make clear agreements, preferably in writing. • If all partners have formally agreed on their expectations for partnerships, there will be less possibility for disagreements later on.

20. Response Preparation • Incident Response System (IRS) • Chain of command authority for carrying out decisions including vaccinating the public, particularly high-risk individuals • Timely and accurate communication • The right personnel in the right positions • Safety of all operations • Incident Action Plan (IAP) • IAP’s were written each week beginning 9/29/09 and ending with IAP#15 covering the last clinics 3/3-17/2010 • Used to provide info, serve as an on-going record and used in planning and operations meetings

21. Partnersand Volunteers • Lee County Emergency Management • Enabled LCHD to gain knowledge quickly and apply the system throughout the implementation of the Campaign. • LCEM developed and managed the non-medical volunteer application process and mobilized a vast volunteer base. • Worked with LCHD to produce a manual which contained info, protocols and phone numbers for just about any situation that could occur at a clinic, from needle-sticks to unruly clients.

22. Lee County School District • Meetings were held with Superintendent of Schools and HS principals. All offered complete support. • High schools were ideal venues for the mass clinics. • Located in all areas of the county • Allowed access to entire county • Ample parking • Long hallways for potential long client lines • Large cafeterias with lots of seating and tables for vaccinating large groups of people.

23. Other partners and volunteers • Lee County Chapter of American Red Cross • Southwest Florida Medical Reserve Corps • Community Emergency Response Teams • JROTC • Lee Co Sheriff’s Office • Cape Coral Police Department • EMS • Many community and civic groups

24. Temporary Staffing Agencies • Express Employment Professionals provided: • Florida-licensed nurses to serve as vaccinators and screeners • Qualified persons to help staff the H1N1 Flu Line • Staff to enter vaccination data into the Florida Shots System • Staff to assist with administrative and reporting tasks

25. Planning Lee Counties Mass Vaccination Clinics • Meetings, meetings and more meetings • In-house meetings with LCHD staff • Daily then weekly meetings at the Emergency Operations center (EOC) • Cancelling clinics for insufficient vaccine? • Planning, staffing, informing the public in time • School availability to reschedule if needed

26. School site visits Site visits to each high school and alternative site were integral to planning and implementation. • Traffic plan for entering and exit discussed • Parking • Client flow to and from the cafeteria planned • Training and supply rooms and break rooms for staff • Registration, screening and vaccinating areas mapped out • Shelters in case of inclement weather • Seating areas for clients who “feel faint” near RN’s

27. Training • Medical professionals were familiar with HIPAA, all others were required to read a hand-out on the patient privacy act and listen to a brief training on the subject. • Training leader s were assigned and they brought their group to a quiet area for job-specific training. • Vaccinators and screeners received both verbal and written instructions on all vaccine protocols. • Workers who emerged as strong leaders gained leadership roles at the clinics, particularly in non-medical roles.

28. Training continued • Workers who emerged as excellent were invited to come back again and again. • A series of smaller neighborhood clinics were planned after the mass clinics to reach additional minority populations. Training for these clinics was done in advance at an evening clinic at the health department. These clinics helped to address the needs of those with poor English skills or other issues that were difficult in the larger mass clinics.

29. Finance, Logistics and Supplies Difficult to determine because no history to look to and no way to determine how many may participate. • Staff, equipment and supplies had to be in place prior to first clinic • All H1N1 expenses were carefully monitored and sent to Finance Section Chief including payments for Agency nurses used as “shooters and screeners”. • Supplies were inventoried as they arrived , loaded into supply trucks and delivered to each site.

31. Advantages Of Community Partnerships • By coordinating service providers, partnerships can develop comprehensive plans, eliminate duplication, allow members to specialize in their functions, link and integrate partners’ activities. • These benefits improve efficiency, making better use of more limited resources. • Partnerships build communities. • The use of community partners made the H1N1 mass vaccination clinics very successful.

32. Sustaining Successful Partnership: Governance Processes (Continued) • Meetings should be orderly and clearly directed, with agendas minutes etc. • Decisions should be made in a participatory manner. • Member led decision making reduces obstacles and facilitates agreement in some partnerships.

33. Sustaining Successful Partnership: Governance Processes (Continued) • Since partnerships involve members from different disciplines, races, genders and cultures, the greatest challenge is to create equality and satisfactory working relationships. • Partners need to develop mutual respect, understanding and trust in order for the association to develop. • Allowing time at the start of partnerships for members to learn about each other is crucial.

34. Sustaining Successful Partnership: Governance Processes • Cultivating patience and a willingness to learn and compromise are also important. • Creating relationships of equality between community members and professionals is a major challenge. • For partnerships to succeed professionals should identify with the ordinary community member.

35. QUESTIONS?????