2013 HOSA-OSG Internship August 5-9: Day 3

This morning we met at the Department of Health and Human Services… the Hubert Humphrey Building. There was a quote on the wall that he made that I thought was very appropriate. “The moral test of a government is how that government treats those who are in the dawn of life – the children; the twilight of life – the elderly; and the shadows of life – the sick, the needy and the handicapped.”

We started our tour in the SOC – the Secretary’s Operations Center with Daniel Finnen. He explained what the operations center did. It is a communications center manned 24/7/365. Its purpose is to be a focal point of the US concerning a public health and/or a medical emergency event. In the event of an emergency, the SOC supports decision making by collecting, analyzing and disseminating information to decision makers.

There are 4 sections: The watch officer, information management support, GIS support and Information tech support. The SOC only deals with federal response. The watch officers maintain situational awareness of all public health and medical events and incidents with a potential national impact. The IMS facilitates the information sharing process by generating reports and briefs. The GIS does geospatial analysis and creates visualization products and ITS provides tech support.

The SOC can connect directly to the Office of Secretary, Assistant Secretary for Preparedness and Response, Office of Emergency Management. There are many computer applications being used including the WebEOC, GIS map, SOC portal, MedMap, HAvBED.

The National Response Framework makes a single framework to be used by all for codes, communications and processing, so as to pull all groups and agencies together.

The HHS role in this is the coordinator and primary agency for ESF#8 (Emergency Support Functions). 8 is public health and medical services.

The primary resources are MRC, NDMS, PHS, Strategic National Stockpile (meds and supplies in secret locations all over the US), CDC, FDA, NIH.

#8 Responsibilities include mass fatality management, decontamination, victim ID, health surveillance, veterinary medicine support, health and medical support, patient care and evacuation.

Preparing for incidents and events. Incidents are unplanned – you prepare if able, and Events are planned – prestaging is done.

Response and recovery can take many, many days to get people back on their feet.

We then met with Dawn Alley, PhD, the Senior Policy Advisor for the Office of the Surgeon General. She works with strategic partnerships related to initiatives of the OSG. Much of what affects health is behavior, relationships and the community. The Affordable Care Act provides leverage to get patients to think beyond the MD’s office to improve health. To prevent disease, things must happen in the community.

National Prevention Council – 20 federal departments and agencies to provide coordination and development to improve health from the federal level. The NPC is beginning to engage other components to improve the populations health.

The Affordable Care Act now provides opportunity to make that change.

“Evidence based things turn into policy”

There is evidence that just providing foods to areas do not solve the problems of the relationship between food and health. (Just because you provide fresh fruit at the grocery store doesn’t mean people will buy it and eat it.) Access must be coupled with education.

The USDA has recipes that meet dietary guidelines at a low cost. But getting people to access these and follow them comes with education.

We then met with Ted Kennedy, the head of response operations…not the Ted Kennedy you may be thinking of…the “other” Ted Kennedy…not relation to the Kennedy clan. He had a fabulous PPT with so much info I could not keep up.

“All bleeding eventually stops and fires go out…it is about how that process happens.”

It used to be resources, but now its about coordination and communication.

Organizations that functioned very well individually failed when working together.

The NIMS philosophy: Words mean something, incidents should be managed, standardization helps. NIMS was created for the safety of the responders and accomplishment of objectives.

TEDS RULES: Don’t become a victim, Be self sufficient and self sustainable, Speak the language and Get engaged.

“The disaster site is not the place to exchange business cards” Get to know each other before the disaster. The Feds will support, but never supplant the local authorities. All disasters are local and to get federal support, the governor must request help and president my declare an emergency.

“We deploy assets and the field applies them”

“Lets go in and chat death and save lives”

The challenge is to get the right asset or resource to the right place at the right time with the right support.

After lunch, we went to the three senator’s offices. The senate was not in session so we met with each of their aides. We were escorted by Natalie Torentinos who is part of Washington HOSA (a lobbyist basically). We presented to each of the aides what HOSA was, how it operates at the chapter, area, state and national level, the benefits for students to be a part of the HOSA CTSO, how it connects to HSTE and CTE and the importance of academic achievement for HOSA students, as well as the benefit of professionalism that is gained through HOSA activities. Only one of the three had heard of HOSA. We also discussed with each aide the Affordable Care Act. We discussed with each the need for continued education at the high school and collegiate level in the area of health care professions and the need for federal support to ensure this need is met, as the population is aging and health care needs are rising.

First Senator Ted Cruz (R) from Texas. Aide Kenny Stein. We spoke about what the Senator was doing to support Career and Technical Education at the local level. Kenny informed us that most of these decisions were made at the state level. He did go on to inform us that Senator Cruz is a huge supporter of education in the senate, and is working on getting more funding for students.

Second Senator Marco Rubio (R) from Florida. Aide Maggie Dougherty. She informed us that career and technical education should be state based, but at least stated that there needs to be stronger dialogue regarding the solutions to ACA issues. She informed us that Senator Rubio has a strong passion for students who have a goal set for their future. His family is dealing with some health problems, and the Senator has a huge interest in our nations health care and its health care providers. Intern Devindra Persad, resident of Rubio's state, informed the Legislative Assistant on how HOSA is impacting the Miami community. He also shared his HOSA story with the representative. In return, the assistant gave Devindra information about local offices that he can visit to better represent HOSA.

Third Senator Kay Hagen (D) from North Carolina. Aide Josh Teitelbaum. This aide was very familiar with the ACA, as Senator Hagen voted “for” it. He obviously had read it and had answers to most of our questions as to how it would operate. He stated Hagen was the chair of the sub-committee on children and families and active in Title 7 and 8 funding regarding nursing education. He stated the Senator works with an emphasis on primary care with an expanding pool of health care professionals. Also that she is supportive of the core provisions, including access for all, tax credits and improved Diabetes care, but there are still some areas she disagrees with. All must be gotten into the health insurance pool. Tax credits will help people buy insurance. To pay back the government for the credits, the AMA, nursing associations and hospitals who were in support of the bill we willing to accept decrease in profit from current insured as there would be a greater customer base which would increase profits over time. HOSA could be used to educate on the need for everyone to sign up for insurance. Go to the available exchanges to get insurance if you are not offered affordable insurance by your employer. To help ensure physicians don’t abuse the system, there will be penalties for hospital re admissions. The way to prevent re admissions is to do preventive care up front through nurse phone calls and through discharge planning on admission. Also bonus payments would be given to PCP’s so as to get them to go into an area of need – PCP rather than specialty.

We ended our evening by having dinner with the interns, ENS Draude, Captain Tosatto, and HOSA representative Nancy Allen. The interns then had the chance to embark on a breathtaking tour of our nations capital with Captain Tosatto and ENS Draude.