Annex E 24/7 EMERGENCY CONTACT PROTOCOL

Annex E 24/7 EMERGENCY CONTACT PROTOCOL PRIMARY AGENCY: Cascade City-County Health Department INTRODUCTION Purpose The purpose of this protocol is to provide a point of contact for coordinating the response to an emergency with the CCHD Emergency Response Team after-hours, on holidays and weekends. SCOPE See the CCHD Emergency Response Plan. Assumptions For CCHD emergency response involvement, the following assumptions are implied: 1. The Cascade City-County Health Department has been assigned the responsibility of protecting the health of the citizens of Cascade County during an emergency or disaster. 2. Since emergencies or disasters can occur at any time, the CCHD point of contact from the Emergency Response Team must be available at all times in order to protect the public s health. CONCEPT OF OPERATIONS After-Hours Calls In order to provide all-hours access to CCHD officials, certain personnel can be reached by the answering service for all after hours emergencies. The Prevention Services Division Manager is responsible for assuring after-hours, holiday, and weekend coverage. After-Hours HAN Messages During normal business hours, email will serve as the prime method of receiving HAN messages. After-hours, on-call duty individuals will receive emergency HAN messages via text messaging. AFTER HOURS CALL: INITIAL ACTIONS Receive Call During all non-business hours, emergency management agencies, as well as health care providers will be instructed to use the CCHD answering service for emergencies only. This after-hours number is available to providers on the reportable disease list that is circulated annually. For other 1 st responder agencies (i.e., police, fire, EMS etc.), the Cascade City-County Health Department 1 Emergency Response Plan- Annex E: 24/7 Emergency Contact Protocol Updated: July 2011, March 2012, February 2013, January 2015, March 2015

Preparedness & Communications Officer, through the LEPC, is responsible for ensuring that those agencies have the current contact information. The after-hours number is also posted on CCHD s website. By calling the phone number, 454-6955, individuals will contact Mathews Answering Service who will forward the message, including the contacts telephone number to the first available CCHD official. Officials will be attempted in the following order: Prevention Services Division Manager, Preparedness & Communications Officer, Health Officer and Emergency Planner. The numbers for each official are as follows: Health Officer 406-868-0549 Prevention Services Division Manager 406-899-4189 Emergency Planner 406-868-0548 Preparedness & Communications Officer 406-788-7300 Once the message is passed on to the CCHD official, they will be responsible for contacting other Emergency Response Team members as needed. Review Incident Information Once the official has received a call from the answering service and has obtained the facts and discerns the situation, they will need to determine whether to contact other CCHD officials or whether the circumstance can wait until the next working day. If the situation requires that information be faxed or e-mailed, the contacted official will instruct the individual reporting to fax or e-mail that information to the Health Department or other designated location. Health Department fax number: (406) 454-6959 Health Officer: thouston@cascadecountymt.gov Prevention Services Division Manager: tsmith@cascadecountymt.gov Emergency Planner: jolberding@cascadecountymt.gov Preparedness & Communications Officer: mcalandra@cascadecountymt.gov Respond to Call In the event that immediate action needs to be taken, all members of the emergency response team will be notified immediately. They will be advised to meet at the Health Department or other designated location in order to devise a plan of action. AFTER HOURS CALL: CONTINUING ACTIONS Notify Responders and Additional Personnel All or selected CCHD staff members may need to be contacted and/or asked to report for duty. In these situations, CCHD Leadership Team members possess a master contact list of all staff members. When instructed, Leadership Team members can use this list to contact Division staff. A corresponding spreadsheet is also available to track calls and staff members responses (see PRO 340102.00 Conducting an Emergency Call Down). Cascade City-County Health Department 2 Emergency Response Plan- Annex E: 24/7 Emergency Contact Protocol Updated: July 2011, March 2012, February 2013, January 2015, March 2015

Other emergency responders will be notified as necessary using Attachment 1: Contacts or the Health Alert Network contact list. Each of these contain multiple means of contacting responders, healthcare providers, and other public health and response partners. HAN MESSAGE: INITIAL ACTIONS Receive Message During normal business hours, email will serve as the prime method of receving HAN messages. During after-hours, holidays, and weekends, emergency HAN messages will be sent via text message. CCHD email addresses and phone numbers that are currently registered with the DPHHS HAN system and the State Surveillance Coordinator are as follows: Michelle Calandra, Preparedness & Communications Officer mcalandra@cascadecountymt.gov, 406-788-7300 Janelle Olberding, Emergency Planner jolberding@cascadecountymt.gov, 406-868-0458 Tanya Houston, Health Officer thouston@cascadecountymt.gov, 406-868-0549 Review Message Information When a HAN message is received, the Preparedness & Communications Officer will immediately evaluate the content of the message and determine an appropriate response. If the Preparedness & Communications Officer is unavailable, the Emergency Planner will evaluate the message. In the event that both of these individuals are unavailable, the Health Officer will evaluate the message. Respond to Message Appropriate responses to HAN messages may include forwarding the message to appropriate partners and/or contacting other members of the emergency response team. Health Advisories or Updates can be forwarded on the next business day. Alerts are reserved for emergency situations and will likely need to be disseminated immediately. See PRO 340101.00 Responding to Health Alert Network Messages and TSK 340101.01 TSK Sending a Health Alert Network Message. HAN MESSAGE: CONTINUING ACTIONS Update Health Alert Network Contacts The Emergency Planner will conduct regular checks and tests to ensure that Health Alert Network contacts and contact information are up to date. Note Health Alert Network messages may be generated by CCHD for local distribution. Local public health situations and events, such as disease outbreaks, may create the need for CCHD to generate a Health Alert Network message and send to local agencies, organizations, and individuals. The Preparedness & Communications Officer will work with the Health Officer and Prevention Services Division Manager to generate message Cascade City-County Health Department 3 Emergency Response Plan- Annex E: 24/7 Emergency Contact Protocol Updated: July 2011, March 2012, February 2013, January 2015, March 2015

content, develop and/or gather necessary attachments, and determine appropriate target audience. ADDITIONAL RESPONSIBILITIES Primary Agency Testing In order to ensure that the 24/7 system functions properly, CCHD will perform tests periodically. System testing is the responsibility of the Preparedness & Communications Officer and will occur, at a minimum, one time annually. CCHD may also participate in the quarterly test coordinated by DPHHS. Evaluation For system evaluation purposes, all calls, whether actual or system tests, will be properly documented on CCHD-approved phone logs as soon as reasonably possible. Phone logs are located in the Emergency Response Manual. See attached After Hours Call Log. Annex Development and Maintenance The development and maintenance of this protocol is the responsibility of the CCHD Preparedness & Communications Officer. Cascade City-County Health Department 4 Emergency Response Plan- Annex E: 24/7 Emergency Contact Protocol Updated: July 2011, March 2012, February 2013, January 2015, March 2015

AFTER HOURS CALL LOG CALL RECIPIENT: Date: Time: Agency Calling: Name of Caller: Description of Incident: Location of Incident: Resources or Assistance Requested: On Scene Contact: Actions Taken By Call Recipient (include time) ie: notifications, etc. Name: Agency: Contact #: Additional Comments: X Signature of Call Recipient: Cascade City-County Health Department 5 Emergency Response Plan- Annex E: 24/7 Emergency Contact Protocol Updated: July 2011, March 2012, February 2013, January 2015, March 2015

Cascade City-County Health Department AFTER-HOUR EVENT CHECKLIST GENERAL INCIDENTS Use this checklist as a guideline for after hour events. Record the following information: Hazard Assessment What is the type of hazard? What specific PH consequences are possible? Is a communicable disease suspected? Are there potential impacts to PH facilities or hospitals? What is the anticipated severity of the hazard? Potential escalation of impacts? Is the hazard ongoing or is it anticipated? What is the possible duration of the hazard? Intelligence Identify the number of injuries and fatalities Identify potential contamination of water systems, public property, food sources, air Identify impacts to infrastructure effecting PH facilities Are any city/county departments impacted or responding to the incident? Are there any requests for PH assistance? Protective Actions Have any public warnings been issued or anticipated? Are evacuations currently underway or anticipated? Are public sheltering activities underway or anticipated? Call Recipient Actions Conference call with PH staff and / or partners Notifications Other Cascade City-County Health Department 6 Emergency Response Plan- Annex E: 24/7 Emergency Contact Protocol Updated: July 2011, March 2012, February 2013, January 2015, March 2015

340102.00 CONDUCTING AN EMERGENCY CALL DOWN 1 of 2 Effective Date: 03/11/2014 340102.00 PROCEDURE (DRAFT) Public Health Standard(s): Cancels: See Also: 340100.00 POL 24/7 Emergency Contact and Communication 340103.00 PRO Conducting an Emergency Call Down Drill Approved by: PRO-340102.00 CONDUCTING AN EMERGENCY CALL DOWN Action by: Health Officer or Designee Division Managers or Designees Revised: 03/11/2014, 02/25/2015 Next Revision Due: As Needed Action: 1. Initiates call down by contacting Division Managers. 2. Locates Call Down Sheet and Instructions on emergency jump drive. 3. Enters the time calling starts in the appropriate box on the spreadsheet. 4. Uses the Emergency Contact List to contact necessary division staff. a. Electronic copies of the list are on emergency jump drives; each Leadership Team member also has a hard copy. b. Try additional numbers listed if a staff member cannot be reached at the first number (e.g. call cell phone if staff member is unreachable by home phone). c. Not all staff may be needed to report immediately. The Health Officer will help determine which staff members should report immediately. 5. Records the time the call is placed in the Time Called box. If the call is a non-response (busy signal, no answer, voicemail, wrong number, correct person unavailable) skip to step 10. Staff may have a number of questions for you about the event, what they are needed for, how long their assistance is required, caring for their families, and other issues. The Health Officer, or designee; Prevention Services Division Manager; and Emergency

340102.00 CONDUCTING AN EMERGENCY CALL DOWN 2 of 2 Planner will prepare pre-scripted answers to questions such as these on a Frequently Asked Questions (FAQ) sheet. You will be provided this FAQ sheet before making your calls. Any additional concerns should be directed to the Health Officer. 6. Follows script to obtain necessary information CCHD is experiencing a public health emergency and needs your assistance. This is not a drill. Are you able to report to CCHD s Main Campus? How long would it take you to respond? 7. Records Y or N in Able to Report box of sheet. 8. Records response time in Time Needed to Report box. 9. Finishes call. Continue for all division staff, then skip to Step 13. 10. Leaves a message if possible. CCHD is experiencing a public health emergency and needs your assistance. This is not a drill. Please call [designated number] to let CCHD Leadership know if you are able to report to the CCHD Main Campus and how long it would take you to report. 11. Notes the type of non-response and whether a message was left in the Response box of the sheet. 12. Note the time call backs are received in the Time Called/Call Returned box of the sheet. 13. Note the time all calls are completed on the sheet. 14. Call the Health Officer when you have completed your calls. a. Do not wait for call backs. Continue to record calls as they are received. b. Report to CCHD if instructed by Health Officer. # # # Revised: 03/11/2014, 02/25/2015 Next Revision Due: As Needed

340101.00 - RESPONDING TO HEALTH ALERT NETWORK MESSAGES 1 of 2 Effective Date: 01/22/2014 340101.00 PROCEDURE (DRAFT) Public Health Standard(s): Cancels: See Also: 340100.00 POL 24/7 Emergency Contact and Communication 340101.01 TSK Sending a Health Alert Network Message Approved by: PRO-340101.00 RESPONDING TO HEALTH ALERT NETWORK MESSAGES Action by: Health Officer, Preparedness & Communications Officer, or Preparedness & Communications Assistant Action: 1. Receives Health Alert Network (HAN) message, either by email or text message. 2. Reads the entire message and attachments. 3. Determines what action is necessary based on message type. Health Alerts should be forwarded immediately when the situation affects the health and safety of Montana s citizens, in particular the residents of Cascade County and the surrounding area (north central Montana). Health Advisories or Health Updates that may affect the local area should be forwarded but can wait until the next business day when there is no immediate risk to the health and safety of Montana s citizens, in particular the residents of Cascade County and the surrounding area (north central Montana). Health Updates or Info Service Messages should not be forwarded when the information does not apply to the health and safety of Cascade County or north central Montana residents. Revised: Next Revision Due: As Needed 4. Determines the target audience. Target audiences may include, but are not limited to, public health and health care partners, EMS, fire/rescue, law enforcement, sanitarians and schools.

340101.00 - RESPONDING TO HEALTH ALERT NETWORK MESSAGES 2 of 2 5. Determines content of forwarded message. Information may be added to improve or update the content of the message. 6. Confers with the Health Officer and Prevention Services Division Manager regarding the action, intended audience and message contents. Health Officer and Prevention Services Division Manager Preparedness & Communications Officer or Designee 7. Approves the message. The Health Officer and/or Prevention Services Division Manager may suggest changes or additions to the HAN message. 8. Incorporates any changes or additions suggested by the Health Officer and/or Prevention Services Division Manager. 9. Attaches any applicable fact sheets or other supplemental information to the HAN message. 10. Releases the message to the previously determined target audience. See 340101.01 TSK Sending a Health Alert Network Message. # # # Revised: Next Revision Due: As Needed

340101.01 SENDING A HEALTH ALERT NETWORK MESSAGE 1 of 2 Effective Date: 01/22/2014 340101.01 TASK (DRAFT) Public Health Standard(s): Cancels: See Also: 340100.00 POL 24/7 Emergency Contact and Communication 340101.00 PRO Responding to Health Alert Network Messages Approved by: TSK-340101.01 SENDING A HEALTH ALERT NETWORK MESSAGE Once it has been determined that a HAN message should be forwarded, the Preparedness & Communications Officer or designee shall: 1. Open the Cascade County HAN template #1 File Location: z:\_corp_data\health Department\shared\Prevention Services\PHEP\HAN Info and Other Contact Lists 2. Choose the message type: Alert, Advisory, or Update. The original message will determine the message type. See PRO 340101.00 Responding to Health Alert Network Messages for an explanation of each message type. 3. Delete the other two options on line two. 4. Add the date and time message will be sent into the appropriate space. 5. Insert the message into the appropriate space. 6. Describe any action that is requested in the appropriate space. 7. Ensure that the contact information listed is correct. 8. Insert the completed HAN template into the body of an email. 9. Attach any relevant CCHD fact sheets (PDF version) to the email. 10. Attach any relevant information fact sheets, news release, etc. received in the original message. 11. Send the email by blind carbon copy to the predetermined target audience, see 340101.00 PRO Responding to Health Alert Network Messages, and carbon copy to the Health Officer, Prevention Services Division Manager, Preparedneess & Communications Officer, Preparedness & Communications Assistant and DPHHS. Revised: Next Revision Due: As Needed

340101.01 SENDING A HEALTH ALERT NETWORK MESSAGE 2 of 2 HAN Contact List file location: z:\_corp_data\health Department\shared\Prevention Services\PHEP\HAN Info and Other Contact Lists 12. Convert the completed template into a PDF file. 13. Combine the PDF template, the PDF fact sheet and any other attachments into one PDF file. 14. Save the new combined PDF. Save the file as YYYYMMDD_HANMessage_Topic. Location to save file: z:\_corp_data\health Department\shared\Prevention Services\PHEP\HAN Info and Other Contact Lists\Forwarded HAN msg. Jan. 2010 present\current Year # # # Revised: Next Revision Due: As Needed