Background and Organization

The purpose of the KY Emergency Operations Plan (KYEOP) is to define the general responsibilities of emergency response agencies, their partners, and the organizational structures required when activated to respond to emergencies, disasters, and technological incidents [all hazards] affecting the Commonwealth of KY and its citizens.

This all-hazards emergency plan is described and required in KY Revised Statue (KRS) 39A and is activated upon order of the Governor of the Commonwealth of KY, the Director of KY Emergency Management, or their authorized representatives. Parts of this plan or the entire plan are automatically activated when:

• A general declaration of a disaster or an emergency by local, state, or federal authorities, or

• Required by the size and level of impact of a catastrophic event, or
• Required to implement actions necessary to place emergency personnel on active readiness levels for an impending incident or scheduled event.

This plan is the cornerstone document of the Commonwealth Comprehensive Emergency Management Program established to support an integrated emergency management system, providing for adequate assessment and mitigation of, preparation for, response to, and recovery from the threats to public safety and the harmful effects or destruction resulting from all major hazards.

Cabinet for Health and Family Services (CHFS) is the primary state agency responsible for coordinating and regulating health, medical, and social support services during emergencies or disaster events. During such circumstances, the Department for Public Health (DPH) is responsible for coordinating:

• Assessment of public health and medical needs
• Disease surveillance
• Mobilization of trained health and medical personnel and emergency medical supplies
• Provision of public health environmental sanitation services
• Food safety and security
• Disease and vector control
• Safety and security of drugs
• Biologics and medical devices distributed via the SNS program
• Establishment and staffing of special medical needs shelters and mass fatality management
• Handling, analysis, and identification of hazardous materials

MCH has specific Continuity of Operations Plans (COOP) in place to address nutrition for pregnant women and children through the WIC program, access to dieticians, and an outbreak plan through the Division of Epidemiology and Health Planning. During mass emergencies in other states, KDPH has assembled nursing strike teams to join Public Health efforts in other states. Nurses from MCH have been part of these teams as KDPH strike team leaders in years past. During COVID-19, MCH nurses operated as Subject Matter Experts for the COVID-19 Hotline, and ongoing program guidance.

The KDPH Continuity of Operations Plan (COOP) has procedures and protocols in place detailing how KY would assure newborn metabolic screening and critical congenital heart disease (CCHD) processes would be maintained during an emergency. COOP also addresses programmatic plans for maintaining metabolic foods and formula services.

As these plans evolve to meet an ever-increasing changing response landscape, MCH is consulted each year to provide information specific to the needs of the KY MCH population. Title V leadership is part of DPH preparedness and response planning process. The Assistant Director serves as the MCH representative.

COVID-19 Response

Beginning in March 2020, many operations were needed to respond to COVID-19. MCH collaborated with OB/GYNs, MOD, and others for rapid development of education opportunities, hospital guidelines, and webinars for caring for women with COVID-19 during pregnancy. Dissemination of information occurred via the State Health Operations website, CHFS media system, and a multitude of distribution lists. MCH staff from across the division provided subject matter expertise and continue to support this effort to reduce negative outcomes in KY. Local health departments were significantly affected by the pandemic. Many LHD staff were entirely devoted to the local response efforts, thereby creating staffing shortages for other programs in MCH. In-home programs and direct care services quickly had to adapt to alternative methods of service delivery. Single point pick-up locations or door drop-off of nutritional supplies, cribs, and other materials were created, essentially within days. Additionally, it cannot be understated the impact COVID-19 had on local hospitals, with staffing shortages related to the pandemic response. Access to care was impeded by the state-of-emergency stay-at-home orders and the unwillingness among individuals not to seek care. Alternatively, those who would normally see their regular physician sought care in emergency rooms, thereby further adding strain on the healthcare system.

One of the most significant impacts COVID-19 was the transitioning of staff to working from home. As a result, as in like most organizations and agencies, MCH and OCSHCN staff saw a substantial increase in virtual meetings as the primary form of communication and information sharing. As a response to pandemic restrictions, MCH became a convener, attender, or leader of multiple organized stakeholder meetings. This was challenging early on but led to an increase of cross-collaboration for population outreach, service provision and virtual educational opportunities, improved communications, and linkage of many stakeholders with shared purpose or mission, and in some cases, an increase in workforce to meet the increasing demand for state needs. The increased use of telehealth has been one encouraging result of the pandemic. MCH quickly identified essential and non-essential services for KY women and children. Programs such as WIC, foods & formula, and newborn screening were considered essential early in the pandemic. Some programs were put on hold or delayed, and some staff were temporarily reassigned to assist with pandemic response.

Emergency response plans were updated, and continue to be updated, to include lessons learned throughout the pandemic response.