2013 NEHA AEC – July 9-11, 2013 1

Rosebud, SD July 1‐10, 2012

Community Health & Service Mission Benefits

• Allows teams to come together from across the nation to exercise public health assessment and intervention planning abilities

• Increases operational readiness by improving disaster response preparation

• Fosters a cross‐cultural experience by creating partnerships

Background

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Partners

Remote Area Medical (RAM)

Indian Health Service (IHS) 

United States Public Health Service (USPHS)

Remote Area Medicalwww.ramusa.org 

Operation Fortitude

• Goals

– Improve operational readiness

– Increase public health assessment and intervention planning skills for continuity and recovery

– Foster a cross cultural experience

– Enhance team cohesion

(Source: OFRD Briefing Document to the ASH)

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Operation Fortitude

• Teams in Rosebud

– Rapid Deployment Team (RDF‐5)

– Mental Health Team (MHT‐5)

– Services Access Team (SAT‐5)

– Applied Public Health Team (APHT‐5)

Rapid Deployment ForceRDF‐5

RAM Clinic

• Patient Count:  976

• Total Services: 1418

• Value of Services: >$188,159

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RAM Dental Operations

• Extractions: 130

• Fillings: 294

• Cleanings: 107

RAM Vision Operations

• Glasses: 402

RAM Medical Operations

• General Medical: 480

– Glucose screenings

– Immunizations

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MHT‐5

• MHTs provide behavioral health services and support to responders and communities

– Psychiatrist

– Pharmacist 

– Social Worker

– Psychologist

– Epidemiologist

– Physician Assistant

– Psychiatric Nurse

– Nurse Practitioner

– Physician

– Information Technologist

SAT‐5

• SATs focus on enhancing access to essential community services

– Nurse

– Social Worker

– Psychologist

– Pharmacist

– Dietician

– Public Health Specialist

– Project Manager

MHT/SAT‐5

• Case management

• Community outreach

• Let’s move

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Public Information Team

• Daily Public Service Announcements & live from the RAM event

• Broadcasted health messages

Applied Public Health Team 5Rosebud, South Dakota, July 2012

APHT Organization Chart

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Preventive Medicine

Preventive Medicine

• 25 Foot Exams

• Took part in administering 90 TDAP immunizations

• 101 HIV/AIDS & STD surveys

Health Education

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Health Education

• 85 diabetes health and wellness consultations

• 12 adult and youth outreach sessions

Engineering

• Updated the IHS housing Inventory

• Wastewater Operators’ Meeting

• First COSTEP on CHASM

Environmental Health

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Environmental Health

• Facility Inspections Conducted (100% completed)– 13 Institutional buildings (e.g. shelters, businesses) 

– 8 Food Kitchens

– 1 Indoor Air Quality Follow‐up in Juvenile Detention Center

– 1 Solid Waste

– 2 Campground/Recreation

– 2 Playgrounds

• Occupant restraint surveys– Front seat occupants restrained = 35.7%

Epi/Surveillance

• Environmental Health Questionnaire

• Rosebud WIC Breastfeeding Program

Environmental Health Questionnaire

• Collaborated with IHS Environmental Health program

• Surveyed RAM participants to assess public’s EH needs

• 336 surveys completed

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EH Questionnaire Highlights

• Top EH concerns– Violence

– DUI injuries

– Healthy housing

– Rodent, insect & animal control

• Impact – Survey findings will be used to direct EH services to community’s needs

– Will help establish positive relationship between Rosebud and new EH regional manager

Rosebud WIC BreastfeedingSupport Program

• WIC mandated to provide breastfeeding support

• Developed 2 automated systems to track client services provided

• Annual breastfeeding survey

Rosebud WIC Impact

• Improved staff efficiency, increasing time available to provide client services

• Improved data quality and reporting

– Enables staff to better target services to clients’ needs

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Veterinary

Veterinary• Visited 2 facilities that employ horses as healers and teachers

• Outcomes– 27 horses examined– 12 horses vaccinated and dewormed– 2 injured horses treated– Data management system created for tracking horse health

– Recommendations given for: vaccinations, deworming, hoof care, dental care, diet, facility management, training, and emergency preparedness

Veterinary

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Doctorin’ Glucose Screening

Lens Making Immunization

APHT‐5 Supported RAM Event

Housekeeping

“In any great endeavor, it is not enough for a person to depend solely on himself.”

‐ Lakota Proverb