EMERGENCY PREPAREDNESS: INTEGRATED COMMUNITY SOLUTIONS
(EPICS)
A Partnership Between Orange
County and the State of Indiana
The EPICS Project, the planning of which was initiated in January 1998, is a partnership between the Orange County Commissioners, 25 public safety and health care agencies in Orange County and parts of Crawford County, the Indiana State Department of Health, the State Emergency Management Agency, and the Intelenet Commission. The project addresses how entire communities can organize themselves and prepare for emergencies of all kinds. This issue has assumed an even greater importance in the aftermath of the September 11, 2001 terrorist attacks in New York City, Washington, D.C., and near Pittsburgh, PA, and the subsequent anthrax terrorist incidents, which occurred through our postal system.
The
EPICS Project makes strategic uses of telecommunications and information
technology to enhance emergency preparedness in Orange County. These technology tools help bridge the
distances that separate rural agencies, enable them to improve communication
and coordination, and create the potential for the delivery of new services,
including public education. While the
EPICS model was designed and developed for replication in rural areas, it is
also applicable in metropolitan communities.
The
development and early operational phases of the project, during which
substantial county, state, and federal resources were provided, ended on
December 31, 2001. Orange County is now
responsible for management, growth, and continued funding of the project, as
the activities and technology resources become fully incorporated into the
service-providing and social fabric of the community. EPICS public safety agencies, through their town and county
councils, have assumed the costs of their own telecommunications/Internet
connections.
Orange County is located in the extreme south central part of Indiana. The three population centers of Paoli—the county seat, Orleans, and French Lick/West Baden are located in the upper half of the county, and smaller towns and villages are dispersed throughout the remaining geographic areas. The Hoosier National Forest occupies over half the county. The population is 19,306 and the per capita income is $18,999, which places Orange County among the poorest counties in the state. Prior to implementing the EPICS Project, Orange County was underserved by the existing information infrastructure in the state, due to its rural nature and limited resources; but the county’s three public school corporations and three public libraries were connected to the Internet through grant programs administered by the state’s Intelenet Commission. Orange County is a partial, medically underserved area. Crawford County, which has two health clinics participating in the EPICS Project, is a medically underserved and health-professional shortage area.
A Model for Transforming Rural Public Safety and Health Care Services
Through Telecommunications and Information Technology
In
devising a community wide approach to emergency preparedness, the EPICS Project
involves two principal groups: (1) 25 public safety and health care agencies,
and (2) the residents, businesses, and other institutions, such as schools and
libraries, in Orange County. The
preparedness efforts of these two groups are envisaged as mutually reinforcing,
and together they provide an integrated community solution, increasing the “net
safety” of the county over time. The
scope of emergencies includes, but is not limited to, forest, residential, and
commercial fires; floods, tornadoes, and high winds; winter storms; limited
seismic activity; highway, aircraft, and railroad accidents; hazardous
materials; missing persons and elderly homebound emergencies; and health
emergencies—including bioterrorism. The
scope of potential emergencies is dynamic and can expand over time, as domestic
terrorist incidents, or “school shootings” with the resulting attention to
school safety, clearly illustrate.
Emergencies are planned for and services are provided by public safety and health care agencies acting singly or in various combinations. For example, the mission of the county emergency management agency is largest in scope among the public safety agencies, as it must coordinate the planning and preparedness activities of fire, law enforcement, transportation, and health agencies—all of which are geographically dispersed throughout the county—relative to a significant number of multi-dimensional threats to public safety. Other emergencies may be responded to through different service-providing combinations, such as fire and law enforcement agencies, transportation and law enforcement agencies, and so forth. The recent anthrax terrorist incidents underscored the need for health and law enforcement agencies to work closely together in the future. Individual fire, law enforcement, transportation, and health agencies provide their own dedicated services in the towns and county, yet there are also occasions when the scope or severity of an emergency requires like agencies to come to the aid of another, as when several fire departments are needed to extinguish a large fire.
With these factors in mind, the general requirements in the EPICS Project are (a) to enable more effective communication and coordination among workers in any combination of interagency public safety and health services, (b) to develop new applications in the individual or collective service areas, depending upon the community needs, and (c) to leverage telecommunications and information technology in meeting these requirements. Once agencies have implemented these capabilities and acquired a measure of proficiency with the technology tools, they should be able to chart their own future directions in leveraging information technology to support emergency preparedness efforts in the county.
The
technological centerpiece of the EPICS Project is a local telecommunications
network that connects the county emergency management agency; seven fire/EMS
departments; the county ambulance service; four town police departments and the
county sheriff; four street departments and the county highway department; and
four rural clinics, the hospital, and the county health department to each
other. The network is an “external
instrument of cohesiveness” among these 25 agencies, providing the channels for
communication and information sharing.
E-mail, general and private list serves, and multi-agency scheduling
software provide the capabilities at the application level to support
communication, coordination, information distribution and sharing, and work
flows for any service-providing combination among the 25 agencies (i.e., like
or mixed interagency services). Through
the local network and the Internet, public safety and health care agencies
within Orange County can execute administrative, policy, and service functions
with their counterparts in state and federal government. In addition, each local agency can access
the vast health and safety information resources of the World Wide Web to
support a variety of functions. While
the network and these software tools are no substitute for meeting and working
together in face-to-face situations, they create efficiencies and serve as a
catalyst for generating and maintaining closer service-providing relationships
among the agencies over time. The
network connections, computers, and communication/information-sharing software
are valuable, irreplaceable “emergency preparedness resources” in the county.
Emergency
Management Services
The
local telecommunications network enables coordinated emergency planning,
preparedness, and mitigation efforts among the 25 public safety and health
agencies. An electronic version of the
county emergency operations plan is now available to all agencies, and updates
of the plan can be easily distributed through the network, allowing agencies to
be “on the same page.” The resources
are in place to enable coordinated, online development of future emergency
operations plans, and the network can also be used to coordinate planning with
adjacent counties and the State Emergency Management Agency, in the event that
disasters exceed the resource capabilities of Orange County. Two-way video capabilities permit
communications with the State Emergency Management Agency during an emergency,
if the infrastructure is not disabled; and the computing network can also
support recovery operations. The
network served as a distribution channel for providing time-sensitive,
electronic information to county agencies in the aftermath of the September 11
terrorist incidents. Agencies can
formulate lessons learned during emergencies, and they can be electronically
stored and shared with all agencies to improve operational capabilities during
future emergencies.
Health Services
The
local network connects the Orange County Health Department, the Bloomington
Hospital of Orange County emergency room, and four rural health clinics; thus,
it is a step toward coordinating the delivery of health care services in the
county. An electronic patient record
keeping system, Visual Petra (www.petrasystems.com),
has been developed and is presently shared by the emergency room and two rural
clinics, which provides an additional measure of coordination in health care
delivery. Since patients may be treated
at multiple facilities, the records are available when and where they are
needed. The network supports
teleradiology services between the rural hospital in Paoli and its parent
hospital in Bloomington, IN, which is nearly 50 miles away; and physicians in
both locations are able to view identical computer images of CT scans as they
discuss diagnostic and treatment implications.
The clinics can use their digital cameras to support teledermatology
services, which are available at www.ruralconsult.com
through the Midwest Center for Rural Health.
Web-based services for the enhanced treatment of diabetes are being
developed in a partnership with the Indiana University School of Medicine,
Department of Endocrinology in Indianapolis.
A partnership with Medical Care and Outcomes, Inc., Indianapolis, will
soon make follow-up care and treatment compliance monitoring services available
to the clinics, which will integrate the total treatment regimen of
clients. Clinics and the hospital can
use the vast health information resources on the WWW for patient and staff education,
and clinical problem solving. Primary
care physicians in Orange County were able to participate in a recent two-way
video workshop on bioterrorism, which was sponsored by Clarian Health in
Indianapolis. Clinic and hospital web
sites contain an e-mail interface, which supports communication with clients
throughout the community.
Fire/Emergency Medical Services
Fire/EMS
vehicles in Orange County do not have onboard, global positioning systems, so
drivers must rely on their personal knowledge for locating emergency
destinations. This can sometimes be
difficult in rural areas, especially if a remote responder is not familiar with
the area. In EPICS working group
meetings, it was determined that when the county’s 911 operator fields a call
from the community, a digital map is simultaneously displayed, which pinpoints
the location of the caller. Through a
software application devised in partnership with the developer of the
911-operator station, we are now able to send facsimile maps to fire/EMS departments
and the county ambulance service, making it easier for public safety workers to
find their destinations in emergencies and increasing the likelihood they will
save lives and property.
County
law enforcement agencies identified the importance of sharing information in an
EPICS working group session. The county
sheriff and the four town police departments are now able to develop digital
case files and accident reports in their own facilities and share this
information electronically with each other, the county prosecutor, and four
contiguous Indiana State Police posts, which creates an important new law
enforcement capability. The system
incorporates Indiana State Police forms in all locales. The courts will soon be involved in this
effort through the county prosecutor.
Orange County is the first in the state to adopt this type of system on
a countywide basis.
All
EPICS agencies have information sites on the World Wide Web, which were made
available through the Intelenet Commission’s IN-map Program. They provide health & safety information
that is tailored to the needs of Orange County residents (e.g., emergency
operations plan, CPR training and health screening announcements, safety
preparedness checklists, etc.), and residents can communicate with public
safety and health professionals through an e-mail interface on each agency’s
home page. The Orange County
Cooperative Extension Service (CES) has also developed a variety of disaster
education resources. All of these web
sites are assembled into Orange County Safety Net (http://epics.co.orange.in.us). Orange County Safety Net is
linked to Indiana Safety Net (www.state.in.us/safetynet), a state
web site that provides 12 different categories of health and safety information
to Indiana’s residents.
Orange
County’s educational institutions have telecommunications/Internet connections,
which will enable them to access these and other health and safety information
resources. The three public school
corporations and three public libraries are connected to the Internet through
grant programs managed by the Intelenet Commission, and Orange County’s CES
office has a T-1 connection, which is made available through a partnership with
IHETS, Purdue CES, and Orange County government. Other T-1 circuits are available at the Area Learning Center in
Paoli and the South Central Area Vocational School in Rego. Health and safety information from Orange
County/Indiana Safety Net will be incorporated into structured projects for students and residents in K-12 classrooms,
public libraries, and 4-H programs.
Some of these educational activities will correspond to selected
events throughout the year, such as Severe Weather Awareness Week and Public
Health Week. Students may involve their
parents in projects such as conducting home health and safety
assessments—including the availability of essential first-aid supplies. Health and public safety officials will work
with local educational institutions in developing and delivering these
programs. The local/state network also
enables delivery of continuing education programs for health and public safety
workers. Web-based applications
can be delivered to the doorstep of each agency, and two-way video, distance
education services can be made available at T-1 sites throughout the county.
Leadership of the EPICS Project shifted from the state to the local level in January 2001 and commenced with the formation of the EPICS Advisory Council. The EPICS Advisory Council, which meets monthly, coordinates planning and development of interagency services that use the local/state/national information infrastructure, and it is intended as a forum for managing and growing the project over its life cycle.
Representatives from each of the five EPICS service areas—health, emergency management, fire, law enforcement, and transportation—participate on the EPICS Advisory Council, which reports to the county commissioners. Representatives also function as coordinators of working groups in the five EPICS service areas. The working groups help to assess county service needs, develop new services that use the information infrastructure, and promote overall health and safety in the county. EPICS Advisory Council members are:
Commissioner Charles Hall, District 2
Randy Clark, Helix Technology (Chairperson)
Philip Bruce, EPICS Project Manager
Norman Cundiff, Orange County Emergency Management Director
Patrick Cassidy, Orleans Fire Department
Richard Dixon, Orange County Sheriff’s Department
Donald Smelser, Orange County Engineer
Bob Lineberry, Orange County Highway Department
Linda Wells Freiberger, South Central Family Health Care
Andy Boston, Orange County Cooperative Extension Service
Trisha Adams, Hoosier Uplands
Hazel Katter, Indiana State Department of Health
Bob Demuth, State Emergency Management Agency
EPICS Project Management Meetings
EPICS Project Management Meetings are held quarterly (last Wednesday of March, June, September, and December). The project management meetings include the EPICS Advisory Council, all local and state agencies participating in the EPICS Project, other state & community stakeholders, and interested residents, including the local press.
Project Funding and Resources Profile
EPICS
Partners collaborated to secure funding and resources of more than
$600,000. The Orange County Commissioners,
the EPICS Advisory Council, and the 25 public safety and health agencies are
responsible for continued funding of the project. The funding and resources profile is expected to grow as new
partners join the project.
Orange County Commissioners contributed $8,000 for a public safety server,
so that public safety and health agencies can create, store, retrieve, and
share critical information resources.
Build Indiana Fund provided $56,000 for the
purchase of 21 computers for public safety agencies, training, and
supplies. Funds were obtained through
support of State Representative Jerry
Denbo and State Senator Becky Skillman.
Indiana State Department of
Health
contributed $390,000 in federal block grant funds, through the Centers for
Disease Control and Prevention, for computers, video units, digital cameras,
telecommunications services for Orange County health agencies, and development
of advanced telemedicine applications.
State Emergency Management
Agency is
contributing the time and expertise of their Emergency Operations Center
Coordinator and the Regional Coordinator.
They are engaged in planning and training, and they participate on the
project management team.
Intelenet Commission contributed $146,000 for
project management services during the development phase of EPICS, content
development, and telecommunications services for public safety agencies.
Orange County’s 25 public
safety and health care agencies are contributing their time and effort to make the
project work to support the public safety and health missions of Orange County
and the State of Indiana. The public
safety agencies pay for their own network/Internet connections.
Orange County Commissioners
Orange County Emergency Management Agency
Orange County Sheriff’s Department
Paoli Police Department
Orleans Police Department
French Lick Police Department
West Baden Springs Police Department
Orange County Rural Fire Department District 1
Orange County Rural Fire Department District 2
Paoli Fire Department
Southeast Fire Department
Orleans Fire Department
French Lick Fire Department
West Baden Springs Fire Department
Orange County Highway Department
Paoli Street Department
Orleans Street Department
French Lick Street Department
West Baden Springs Street Department
Orange County Ambulance Service
Orange County Health Department
Bloomington Hospital of Orange County
South Central Community Health Care
Patoka Family Health Care Center
Crawford County Family Health Care
Comprehensive Health Care
Indiana State Department of Health
State Emergency Management Agency
Intelenet Commission
Charles
W. Hall
Orange
County Commissioner, District 2
205
E. Main Street
Paoli,
IN 47454
(812)
723-3600 or (812) 723-2212
Philip D. Bruce, Ph.D.
EPICS
Project Manager
(317)
873-6344
Hazel
Katter, HSD
Local
Liaison, Office of Rural Health
Indiana
State Department of Health
(317)
233-7679
R.L.
(Bob) Demuth
Coordinator,
Emergency Operations Center
State
Emergency Management Agency
(317)
232-5392
Norman
Cundiff
Orange
County Emergency Management Director
205
E. Main Street
Paoli,
IN 47454
(812)
723-3600
EPICS
Document Revised January 2002: pdbruce/hkatter