Section III.E2.b.iv. MCH Emergency Planning and Preparedness

The Health Response and Licensure Section is located within the Public Health Division in the North Dakota Department of Health and Human Services (NDDHHS). This section is home to the Emergency Preparedness and Response (EPR) Unit, which is dedicated to creating and promoting a state of readiness and prompt response to protect the health of North Dakotans during catastrophic events, large scale disasters, and emergencies. This mission is accomplished by coordinating education, assessment, planning, response, and support services involving public health providers, private medical providers, public safety agencies and government officials. The EPR Unit provides local and state public health guidance, planning, coordination, response, and funding for large scale emergencies. These activities include coordination and funding of incident command and control, disease control, laboratory services, communications systems, public information, medical supplies, equipment, pharmaceuticals, and training.

Also within this section is the Emergency Medical Systems (EMS) Unit. The mission of the EMS Unit is to integrate the processes, protocols, technologies, policies, and practices that are designed to provide the best possible health outcome for individuals and communities every day and during emergencies and disasters.

The EPR Unit has many response plans posted on their website: https://www.hhs.nd.gov/health/emergency-preparedness-and-response/redacted-response-plans. The plans available on the website have been redacted to remove names and sensitive information. Other plans which are too sensitive to post on a public website (e.g., response to terrorism events), are available on request. All the plans on the NDDHHS website are technical descriptions which are intended for the use of response partners, including other North Dakota state and federal health agencies. The public can review the plans, ask questions, or make comments. These emergency response plans are a process of continuous improvement and are revised as procedures change or as more is learned through exercises, real events, and partner feedback. The plans provide guidelines for action during a disaster/emergency, rather than a set of rules which must be followed during an event. The plans do not have specific sections for the maternal and child health (MCH) population, but considerations for the MCH population are incorporated into aspects of the plans.

Title V program staff were not directly involved or consulted in the planning and development of the state’s emergency operation plans. However, the Healthy and Safe Communities Section Director, who also oversees Title V, is a member of the Public Health Division’s Senior Leadership Team and provides insight and feedback into emergency preparedness planning.      

The Public Health Division of NDDHHS works closely with the North Dakota Department of Emergency Services (DES) on emergency planning and preparedness. DES conducts planning, coordination, communications, and operations for the safety and security of all citizens of North Dakota.

When communication plans, tools or strategies are developed as part of statewide preparedness for addressing impacts of disasters and emerging threats on the MCH population, Title V staff are consulted and involved in these efforts. Working with schools during COVID-19 is a good example of this involvement. In July 2020, the Title V Director was asked to form a COVID-19 school response team. The Title V School Health Specialist was assigned to lead the COVID-19 School Response Team and several other Title V staff were activity engaged in this team (e.g., Special Health Services (SHS) Director, SHS Program Administrators, MCH State School Nurse Consultant, Community Engagement Director). Many processes, procedures, strategies, and tools were developed, disseminated, and implemented as part of the COVID-19 school response. Many of these tools can still be found on the NDDHHS website at https://www.hhs.nd.gov/health/coronavirus.            

Title V program staff also participate in the development of coordination plans to enhance statewide preparedness for addressing impacts of disasters and emerging threats on the MCH population. The need for a formalized contingency plan has been a longstanding conversation with partners at the University of Iowa’s State Hygienic Lab, which currently processes North Dakota’s newborn blood spot specimens. Contingency planning for an emergency helps to ensure the availability of critical resources, the continuity of operations, and sets standards for entities participating in the activation of the plan. Although it is anticipated that babies born in North Dakota during an emergency would continue to be screened thorough the Iowa State Hygienic Lab, efforts are being made to establish additional contingency plans if this process would be interrupted at any point during such emergency. In the past year, a master’s level nursing practicum student assisted the North Dakota Newborn Screening and Follow-Up Program with the initiation of a contingency plan. Adhering to established standards and maintaining continuity of testing and follow-up play critical roles in the screening, diagnosis, referral, and treatment of disorders identified in newborn screening, especially during a public health emergency.

The SHS Unit recognized that the pandemic resulted in health care disruptions and significant strain on families, especially those of children with special health care needs (CSHCN). SHS implemented advancements in programs to ensure that families have access to additional medications through special prior authorizations, direct shipping of necessary metabolic formula, and care coordination from state-level staff. Because of the positive response, many of these programmatic changes have remained in effect.