October 2016
In this issue
Contracts in Process
MLCHC - Oct 14, 2016. The League is in the process of sending out contracts to eligible community health centers for the continued participating in the the MDPH Emergency Preparedness and Management program. Please watch your email and alert your leadership in order to get the contracts signed and returned to the League by October 31, 2016. Questions? Contact Tina Wright
Emerging Infectious Disease Exercise Series
MLCHC - Oct 1, 2016. Registration is open for community health centers and ambulatory care practices for regionally-based exercises on emerging infectious diseases (EID) on November 2, 9 and 16. Earlier this year, the League began this program with a series of webinars (recordings available online) and a one-day conference in the Spring (materials available online) will now culminate in tabletop exercises specifically designed for the realities of managing emerging infectious diseases in the outpatient care setting. The League invites your center to join us as we examine and enhance the ability of outpatient care settings to rapidly identify, appropriately isolate and effectively inform on the presence of infectious diseases.
Recognizing the various levels of staff involved with effectively managing care, the following staff are highly encouraged to participate in an exercise (please limit 4 staff per facility):
Suggested Representatives:
     - Director/Administrative Leader
     - Emergency Preparedness Manager/Lead
     - Primary Care Representative (MD and/or RN)
     - Infection Control/Infectious Disease Representative
Other Representatives may include:
     - Front line staff representative (clinical/administrative)
     - Specialty Population Representative (e.g. Pediatrics, Obstetrics, Oral Health, etc.)
     - Pharmacy Representative
     - Security Representative
     - Environmental Services/Facilities Management Representative

Please register by October 26th
. Please note that the exercises are regionally-based, however if you cannot attend the exercise for your region, you may opt into another region's exercise. Additionally, representatives from region 4AB (Metro Boston) may choose whichever exercise fits best with your center's operations. ( Don't know your region? Click here.)

November 2nd in Worcester MA (Western, Central and Northeastern regions)
November 16th in New Bedford MA (Metro Boston and Southeastern regions)

Questions about this training series? Contact me or Project Coordinator Nehemie Dubovic ( ndubovic@massleague.org). Thank you!
CMS Finalizes Rule Establishing Minimum Emergency Preparedness Requirements
MLCHC - Sept 28, 2016. In September, the Centers for Medicare & Medicaid Services (CMS) finalized a rule for healthcare providers participating in Medicare and Medicaid - including federally qualified health centers (FQHCs) - to ensure minimum emergency preparedness activities to increase patient safety, establish more coordinated response to disasters, and create a more prepared and resilient healthcare system. The rule surrounds four (4) focus areas: emergency plan, policies and procedures, communications plan, and training and testing program which includes annual exercise requirements. Each focus area is also intended to be based on an all-hazards risk assessment.
Click here to read the full rule. The League will present more information on this rule to health center emergency preparedness coordinators. Questions about this rule? Contact Tina Wright
Health & Medical Coordinating Coalitions (HMCCs)
MLCHC & MDPH - Sept 25, 2016. HMCCs are developing regional and cross-disciplinary capacity to plan for, respond to, recover from, and mitigate the impact of emergencies. Core disciplines of an HMCC are community health centers and ambulatory care organizations, emergency medical services, hospitals, long term care organizations, and public health. HMCCs have formed their executive/governing leadership with equitable representation from each of the five core disciplines and are meeting regularly. Health centers are asked to integrate into these coalitions and participate in their meetings and activities. For more information, see the contact information below for your health center's HMCC. http://www.bu.edu/sph-coalitions/

HMCC Region
HMCC Sponsoring Organization and Staff
1 (Western MA)
Franklin Regional Council of Governments - Mark Maloni
2 (Central MA)
City of Worcester, Division of Public Health - Colleen Bolen and Alissa Errede
3 (Northeast MA)
International Institute of Greater Lawrence - Mark Munroe
4C (Boston)
Boston Public Health Commission - Alison Randall
4AB (Metro Boston)
Cambridge Health Alliance - Christian Lanphere (interim)
5 (Southeastern MA)
Massachusetts Association of Health Boards - Brian Gallant

If you have questions or concerns about HMCCs, contact Tina Wright at twright@massleague.org
Flu Update
MIC Advisory - Oct 17, 2016. Preliminary data from the CDC and WHO on antigenically characterized influenza viruses circulating between May and September 2016 indicate that all influenza A (H3N2, H1N1) and influenza B (two distinct lineages) components of the 2016-7 influenza vaccine appear to be well matched to circulating strains. https://www.cdc.gov/mmwr/volumes/65/wr/mm6537a5.htm?s_cid=mm6537a5_w)

Annual influenza vaccination is recommended for everyone ≥6 months who does not have a specific vaccine contraindication. Vaccination of an individual offers protection to the person vaccinated as well as to those around them who may be at higher risk from influenza such as young children, the elderly, pregnant women, and those with underlying medical conditions.

There is no preferential recommendation for one vaccine type over another in any age group. However, for the 2016-7 influenza season, CDC has recommended that live attenuated influenza vaccine (LAIV4) also referred to as FluMist®, NOT be used based on information demonstrating the low effectiveness of the H1N1 component (see: http://www.cdc.gov/flu/about/qa/nasalspray.htm). CDC recommends inactivated influenza vaccine (IIV) in children and adults, and either standard dose or high dose IIV in those >64 years old. There is no preferred vaccine type within either of these groups.  A summary of CDC treatment guidelines is available at: http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm.

Antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who: is hospitalized; or has severe, complicated, or progressive illness; or is at higher risk for influenza complications. This includes:
  • children aged younger than 2 years;
  • adults aged 65 years and older;
  • persons with chronic pulmonary (including asthma), cardiovascular, renal, hepatic, hematological, metabolic, or neurologic disorders; and persons with immunosuppression;
  • women who are pregnant, or postpartum (within 2 weeks after delivery);
  • persons under 19 years old who are receiving long-term aspirin therapy;
  • persons who are morbidly obese (i.e., body-mass index >= 40); and
  • residents of chronic-care facilities.
Antiviral treatment can also be considered for suspected or confirmed influenza in previously healthy, symptomatic outpatients not at high risk on the basis of clinical judgment, especially if treatment can be initiated within 48 hours of illness onset. In prior years, localized shortages of influenza antivirals have been reported. Healthcare providers in Boston who become aware that patients are experiencing difficulty obtaining these medications are asked to contact the BPHC Medical Intelligence Center (MIC) by calling (617) 343-6920 or emailing MIC@bphc.org.

See the full advisory here: http://bphc.org/whatwedo/infectious-diseases/Pages/Healthcare-Provider-Alerts-and-Advisories.aspx
Training & Education Opportunities
Emerging Infectious Disease Exercise series - Nov 2, 9 and 16. See section above for details.
November 16th in New Bedford MA (Metro Boston and Southeastern regions)

Module I: All Hazard Awareness for Healthcare Personnel
- Nov 2, 2016, Webinar. This webinar introduces foundational knowledge to prepare personnel in healthcare settings for potential disaster situations that may be encountered in the course of their daily duties. Through this interactive webinar format, participants will learn about recognizing a potential disaster incident and its corresponding threats. They will also learn to use the algorithm RAIN (Recognize, Avoid, Isolate, and Notify) to take initial defensive response actions against natural disasters, terrorism, and chemical, biological, explosive, and radiological agents. With its focus on healthcare personnel, the course will conclude by presenting material on the topics of victim management, personal preparedness and personal protective equipment. https://delvalle.bphc.org/group_courses/group_course_display.php?gid=9

Bio Personal Protective Equipment Workshop
- Nov 14, 2016. This half-day training will focus on the realities of primary care and proper infection control for emerging infectious diseases (EID). The purpose of this workshop is to provide practical experience to community health center and ambulatory care staff in donning and doffing of bio-personal protective equipment (PPE). In addition to wearing bio-PPE, participants will also gain awareness of best practices for donning and doffing officer team leaders. CEUs for nursing available! Click here to register

Online courses are also available at http://delvalle.bphc.org/.   
Calendar Highlights
Oct 20 - Boston Conference Committee
Oct 20 - Government Affairs Committee
Oct 20 - Boston Healthcare Preparedness Coalition Meeting
Oct 21 - Leading Organizations in the Opioid Crisis Session
Oct 25 - Fall Membership Retreat & Full Board Meeting
Oct 26 - PCMH 2014 Standards Live Q&A Session
Oct 27 - Webinar: How to Complete Your Count of Public Housing Residents for 2016 UDS Report
Oct 28 - DRVS User Group
Oct 31 - Eye Care Support Group
Nov 1 - NCQA PCMH Online Training - GRIP Open Forum
Nov 2 - EID Exercise (Regions 1, 2, 3, and 4AB)
Nov 2-4 - NACHC FOM/IT Conference
Nov 4-5 -
Board Member Symposium
Nov 5 - Dimock Community Health Center Steppin' Out 2016
Nov 9 -
EID Exercise (Regions 4AB and 4C)
Nov 14 - Bio PPE Workshop

For more details and other health center events, visit http://www.massleague.org/Calendar/Calendar.php.  

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If you have any questions, comments or concerns, please do not hesitate to contact me. Thank you.


Tina Wright, Program Manager - Emergency Management & Public Information
Massachusetts League of Community Health Centers
40 Court Street, 10th Floor, Boston, MA 02108
617-426-2225 ext. 231,