Texas Department of State Health Services and HealthHealth

Texas Department of State Health Services and Health/Health Preparedness and Human Services Commission/2 -1 -1 Texas Information & Referral Network

2 -1 -1 Texas Connecting People and Services Texas Department of State Health Services and Health/Health Preparedness and Human Services Commission/2 -1 -1 Texas Information & Referral Network

Texas H 1 N 1 Public Health Emergency Response * * * * Texas Department of State Health (DSHS) Services Overall Responsibility H 1 N 1 2009 Spring Outbreak Response H 1 N 1 2009 -2010 Outbreak Enhanced Response DSHS Roles and Responsibility 2 -1 -1 Texas Information & Referral Network (TIRN) Roles and Responsibility – Infrastructure – Fiscal Intermediary – 2 -1 -1 Texas Area Information Center Coordination 2 -1 -1 Area Information Center Role DSHS Medical Staff Role

2 -1 -1 Medical Call Center - Statistics Integrated with 2 -1 -1 to include medical guidance for general population on September 25, 2009; ended on March 31, 2010 Total number of calls answered during Phase 2 of Epidemic: 91, 676 Total number of TIRN calls: 54, 716 Total number of medical calls: 36, 960 – 21, 162 from medical providers • Mostly for assistance on vaccine ordering and shipping – 15, 793 from the general public • • About 50 percent from sick people needing guidance Also questions on vaccine location and vaccine safety 4

* * * Texas H 1 N 1 Public Health Emergency Response Tools Utilized (Insert DSHS Intake Screen) (Insert Scoreboard Screen) (Insert KB Screen) (Insert Flu Locater Screen)

Tools Used * H 1 N 1 Flu Intake System * Scoreboard * Knowledge Base * Google Flu. Locator * H 1 N 1 Flu Reporting System

* * * Texas H 1 N 1 Public Health Emergency Response Tools Utilized (Insert DSHS Intake Screen) (Insert Scoreboard Screen) (Insert KB Screen) (Insert Flu Locater Screen)

* * * Texas H 1 N 1 Public Health Emergency Response Tools Utilized (Insert DSHS Intake Screen) (Insert Scoreboard Screen) (Insert KB Screen) (Insert Flu Locater Screen)

* * * * Search Word: Search for a word in Subject, Summary, Source, Description or Taxonomy. Event: Taxonomy: City County: Statewide Start Date: Choose Date Time: End Date: Choose Date Time:

Knowledge Base – Search Results Subject Date Event Taxonomy Total Referrals H 1 N 1 Vaccines - May 2010 San Antonio 78216 Article ID: 8381 05/04/10 01: 06 PMH 1 N 1 Novel Influenza Flu Vaccines 18 H 1 N 1 Vaccines Ongoing Bastrop 78602 - Bastrop County (STATEWIDE) Article ID: 8822 05/05/10 12: 50 PMH 1 N 1 Novel Influenza Flu Vaccines 1 H 1 N 1 Vaccine – Ongoing Hays County 78666 Article ID: 9563 05/05/10 09: 54 AMH 1 N 1 Novel Influenza Flu Vaccines Ongoing H 1 N 1 vaccines available Burnet County 78654 Article ID: 9604 05/13/10 12: 50 PMH 1 N 1 Novel Influenza Flu Vaccines Ongoing H 1 N 1 vaccines available Llano County 78634 Article ID: 9605 05/13/10 12: 51 PMH 1 N 1 Novel Influenza Flu Vaccines Ongoing H 1 N 1 vaccines available Blanco County 78606 Article ID: 9603 05/13/10 12: 54 PMH 1 N 1 Novel Influenza Flu Vaccines 0 0

Knowledge Base – Search Results Summary The San Antonio Metropolitan Health District will be offering free H 1 N 1 vaccines (mist and injections) for the general public and specific high risk groups County: Bexar City: San Antonio Zip Code: 78216 Location: Good Health! at Goodwill (by appointment only) Loop 410 @ Blanco Rd. San Antonio, TX 78216 Phone: (210) 525 -0059 Web Site: http: //www. sanantonio. gov/health/h 1 n 1. html Description Good Health! at Goodwill (by appointment only) Loop 410 @ Blanco Rd. San Antonio, TX 78216 Description: The San Antonio Metropolitan Health District will be offering free H 1 N 1 vaccines (mist and injections) for the general public and specific high risk groups. Eligibility: None Fees: None Documents Needed: None Intake: Call 210 -525 -0059 for an appointment Hours of Operation: May 2010 - Weekdays by appointment; call for information Service Area: San Antonio

www. Texas. Flu. org 12

Flu Vaccine Locator

How does a call get routed? Dallam Sherman Hansford Ochiltree Lipscomb Hartley Moore Hutchinson Roberts Hemphill Oldham Potter Carson Gray Wheeler Deaf Smith Randall Armstrong Donley North Central Texas Fort Worth Region* North Texas Region Panhandle Region* Parmer Castro Swisher Briscoe North Central Texas Dallas Region* Collingsworth Hall Texoma Region* Childress Hardeman Bailey Lamb Hale Cottle Motley Floyd Wilbarger North East Texas Region Wichita Foard South Plains Region* Clay Hockley Lubbock Crosby Dickens Yoakum Terry Lynn Garza Kent King Baylor Knox Montague Archer West Central Texas Region Grayson Lamar Fannin Red River Bowie Haskell Jack Young Wise Denton Collin Hopkins Hunt Throckmorton Gaines Permian Basin Region* Borden Scurry Fisher Martin Howard Mitchell Nolan Jones Shackelford Taylor Callahan Parker Palo Pinto Tarrant Loving El Paso Winkler Ward Culberson Ector Crane Reeves Midland Sterling Coke Glasscock Coleman Erath Brown Reagan Tom Green Irion Gregg Navarro Hill Anderson Limestone Burnet Llano Williamson Terrell Val Verde Lee Austin Fayette Caldwell Comal Alamo Region* Kinney Uvalde Deep East Texas Region Chambers Jefferson South Central Texas Region* Gulf Coast Region* Colorado Guadalupe Gonzales Bexar Orange Liberty Harris Central Texas Region* Bryan/ College Station* Hardin Montgomery Bastrop Hays Bandera Tyler Washington Kendall Real Polk San Jacinto Waller Kerr Edwards Brewster Grimes Burleson Travis Blanco Walker Brazos Kimble Gillespie Presidio Milam Newton Mason Sutton Madison Menard Crockett Sabine Jasper Schleicher Pecos Angelina Trinity Robertson Heart of Texas Region San Augustine Houston Leon Falls Bell Jeff Davis Shelby Nacogdoches Freestone Lampasas San Saba Rio Grande Region* Cherokee Bosque Mc. Lennan East Texas Region Panola Rusk Coryell Mc. Culloch Harrison Henderson Hamilton Concho Cass Marion Smith Ellis Somervell Mills Upton Upshur Van Zandt Johnson Eastland Comanche Runnels Wood Kaufman Hood Andrews Rains Dallas Stephens Titus Camp Rockwall Dawson Franklin Delta Stonewall Concho Valley Region Hudspeth Cooke Morris Cochran Medina Fort Bend Lavaca Galveston Wharton Southeast Texas Region* Brazoria Wilson De Witt Middle Rio Grande Region Maverick Zavala Frio Atascosa Jackson Karnes Matagorda Victoria Goliad Dimmit La Salle Mc. Mullen Live Oak Refugio San Patricio Webb South Texas Region - - Jim Wells Duval Nueces Kleberg Zapata Jim Hogg Brooks Kenedy Starr Tip of Texas Region* Hidalgo Golden Crescent Region Calhoun Bee Willacy Cameron Aransas Coastal Bend Region

What happens when someone dials 2 -1 -1? Dial 2 -1 -1 Press 1 for English Press 2 for Spanish Welcome to 2 -1 -1 Texas! Option 1: Information and Referral Press 0 for other languages Press 3 for TTY *Current choices are French, German, Vietnamese, Cantonese, Mandarin, and Farsi **Option 4 is active only during a disaster, and may not be active throughout the state of Texas Service Selection Option 2: Eligibility Support Services Option 3: Office of Inspector General Option 4 Disaster Information**

What happens when caller selects Option 1? Warm/Cold Transfer To Eligibility Support Services Assess Caller’s Need Call Answered by Certified Call Specialist Language Selection SLA 80/60 Available 24/7 Prioritize Need Search Database For Resources Contract with Caller National Average I&R Call lasts 3 -7 minutes Advocate if Necessary Warm/Cold Transfer To Local Office Warm/Cold Transfer To Local Resources

What happened when someone dialed 2 -1 -1 During H 1 N 1 Pandemic? Dial 2 -1 -1 Press 1 for English Press 2 for Spanish Welcome to 2 -1 -1 Texas! Option 6: Information about the flu*** Press 0 for other languages Service Selection Press 3 for TTY * Current choices are French, German, Vietnamese, Cantonese, Mandarin, and Farsi ** Option 4 is active only during a disaster, and may not be active throughout the state of Texas ***Option 6 activated for H 1 N 1 Option 1: Information and Referral Option 2: Eligibility Support Services Option 3: Office of Inspector General Option 4 Disaster Information** Option 1: General Information and Referral Option 2: Speak with a Medical person

Reporting - Call Distribution H 1 N 1 FLU INVESTIGATION Department of State Health Services Date Range: 8/23/2009 8 AM - 10/27/2009 11: 59 PM Printed: 10/28/2009 7: 05: 46 AM Page 7 of 7 Call Date Call Type 12 A 1 A 2 A 3 A 4 A 5 A 6 A 7 A 8 A 9 A 10 A 11 A 12 A 1 P 2 P 3 P 4 P 5 P 6 P 7 P 8 P 9 P 10 P 11 P Total 10/27/2009 General Public 0 10/27/2009 Medical Provider 0 0 0 0 8 9 23 28 2 11 27 32 21 22 27 32 10/26/2009 General Public 2 10/26/2009 Medical Provider 0 0 0 4 1 2 0 16 43 Grand Totals 17 21 14 25 35 36 17 18 14 26 19 31 14 12 28 30 19 25 11 0 29 24 22 27 45 23 24 19 30 26 21 23 17 14 2 1 4 0 17 2 7 290 0 248 Total: 538 1 13 0 1 7 1 3 313 0 276 Total: 589 2237 25 26 25 13 21 99 245 694115 0 1163 1251 1057103 9 116 3 989 993 841 633 406 369 330 407 227 15403

Cumulative Report – General Public Reporting Period: 8/24/2009 -03/31/2010 LANGUAGE English REASON Number of Calls 13645 Worried Well 5958 Sick 2424 Resources 867 Guidance 3141 Other 1172 Physician Consultation 83 Transferred to I&R 301 Spanish Other Total 2100 1003 448 142 354 161 2 38 23 6 0 2 7 0 15793 6984 2878 1009 3497 1340 85 66 1 368

Cumulative Report – Medical Provider Reporting Period: 8/24/2009 -03/31/2010 * * TYPE Doctor Hospital School Business Pharmacy Long-Term Day. Care Local Health Other Total REASON Number of Calls 16563 527 774 180 449 979 24 208 1466 21167 * Anti-Viral * * 34 5 8 1 12 0 0 2 7 69 General Information 5764 179 209 62 117 292 9 56 469 7157 * Imm. Trac 1413 132 118 7 91 92 5 45 321 2224 * * Provider Regis 4300 218 344 61 175 293 10 77 475 5953 * Vaccine * * Transferred To I&R 10824 274 284 149 234 686 7 119 785 16 0 4 1 3 1 0 0 5 13362 30

Texas H 1 N 1 Public Health Emergency Response * Project Funding – Public Health Emergency Response (CDC) – DSHS – 2 -1 -1 Texas

* * Texas H 1 N 1 Public Health Emergency Response Lessons Learned – Anticipate Need – Identify Scalability – Develop Policies – Identify IT Needs and Preposition – Develop Daily Operational Standards Stand Ready to Ramp Up

Contact Information Teena Edwards, Dr. PH, MSN, RN Outcome and Evaluation Coordinator - CPS Acting Pandemic Influenza Coordinator - CPS MACC/Call Center Manager/Liaison Texas Department of State Health Services 512 -458 -7111, ext 6257 Teena. edwards@dshs. state. tx. us Beth Wick, LCSW, CIRS Program Manager HHSC/2 -1 -1 Texas I&R Network 512 -483 -5110 Beth. wick@hhsc. state. tx. us