Travis County Commissioners Court
May 5, 2009,
Item 13
13.
will be taken up at 9:30 a.m.
- receive briefing and take appropriate action regarding the recent flu development and resulting public health issues in Travis County.
>>
>> good morning, my name is pete baldwin the emergency management coordinator for Travis County.
we have a lot of people at the table.
we will get around to all of the introductions here in just a moment.
but I did want to tell you status of where we are right now.
then I知 going to let david lurie and dr. Wong give you -- give you an updated status on the actual medical public health issues.
currently our eoc is still activated.
we are having conference calls every morning at 8:30 about all of our partners, regional.
that includes Williamson and hays county to get a better feel of what the situation, how it is unfolding as we go.
we are monitoring it.
we are working very closely with our health and human services partners on both sides of the county and city.
trying to keep people informed and you should be on a daily basis getting a status report of what we call our situational report every -- somewhere around noon or 1:00 in the afternoon.
so -- so we -- as we continue to monitor this, it's -- it's sort of unknown as to where it's going right now.
there be some trends out there, but we did want to come to you and let you know that we are still very much in the game on this.
before I turn it over to sherri I知 sorry, do you want to --
>> just by way of introduction, for those who might be listening, I wanted to remind folks that the Travis County and the city of Austin work collaboratively around public health in our community, so therefore we will hear from our partners at the city, david lurie and dr. Phil wong.
>> all right.
thank you, good morning, judge Biscoe, Commissioners.
appreciate the opportunity to provide this update.
as you are probably aware, it's a very dynamic situation.
the h 1 n 1 virus is a novel virus, one that we have not experienced before, so because of that there's a good bit of unpredictability.
one of the challenges is keeping people informed in terms of the development.
so we really appreciate this opportunity.
I know that pete has been briefing you on a weekly basis.
as he mentioned a daily report coming out of the office of emergency management.
that's our tool, we would encourage you to keep track of developments through that communication.
and, also, I want to echo what both pete and sherri have said in terms of we plan together, city and county and a whole host of other partners regionally, around major challenges in the community.
and we have activated a number of systems to help us monitor this particular situation and the county has been very engaged, I appreciate, we all appreciate the office of emergency management, pete's involvement, sheriff's department, a number of other representatives there and also working closely with sherri and her staff.
so it's a very strong partnership, very effective and we are continuing to -- to track developments and -- and scale our response accordingly.
just a little bit of quick data, and again this changes every day.
we had a report from the centers for disease control and prevention around 11:00 a.m.
each day.
we get an update in terms of what's going on internationally and nationally.
but as of yesterday, there were 286 laboratory confirmed cases of h 1 n 1 in the united states.
and 41 of those were in the state of Texas.
here locally in Travis County, we have one confirmed case from cdc and one probable case and these two cases we have been tracking for some time now, from -- from the point where the information first became available to us and we have really not treated them differently in terms of probable or confirmed.
the assumption is when you have a probable case it's going to be confirmed.
so in terms of how individuals are treated, as far as the medication and the clinical response and in terms of how we respond as far as public health interventions, they're the same.
so I really want to emphasize that because I know that there was information yesterday about a -- finally actually a confirmed case.
it doesn't change the intervention.
it doesn't change our strategies in terms of what we have been doing.
in fact, we can all expect that there will be more cases as time goes on because the virus is in the community and that -- that will continue to -- to occur.
the important point, which we keep emphasizing is the prevention strategies and recommendations, the very clear issues around hygiene, hand washing, cover -- cover when you cough or sneeze and also people who are experiencing flu-like symptoms to stay home from work or school and if those symptoms develop into something more severe, for example, a temperature in excess of 100-degrees, consult with their primary care physician.
so people can do a lot in terms of hygiene, but also in terms of being responsible as far as self isolating, staying home, so they don't potentially infect other people in the community or family members.
and those are really the most effective public health tools available to us at this time.
we have a lot of information on the county website, the city website, they are all linked up with the state department of health services, the center for disease control and prevention.
there are also telephone lines available.
I want for the public to state again the department state health services hotline, there this is also on the website, 888-777-5320.
we have heightened our surveillance activities, working very closely with the health care community, health care providers, hospitals, so forth, really focusing on anyone who is exhibiting flu-like symptoms, making a clinical assessment in those cases where rapid testing is appropriate.
also doing some initial testing.
so people are confirmed to have any form of flu, they can immediately get treatment and into -- into that system.
the public information group has been activated, also, through the emergency operations center, so we have public information officers working together.
again to get this information out because the most important element I think in this circumstance is to have an informed -- an informed public.
we also have a team and the county has been involved in this.
working on some of the human resources related issues.
we have been sending out some communication at the city and I believe we'll be doing so if they haven't already at the county in terms of keeping the workforce informed.
also advising them in terms of preventive measures, in terms of staying home from work if that's appropriate.
and the other thing that we have initiated with the city and we will also be coordinating with the county is sort of a disease surveillance system, if you will, within the workforce where we track the health of the workforce.
and if we are identifying or experiencing any change relative to -- to flu-like illnesses and symptoms so that we can -- we can manage that and be supportive of our -- of our workforce as well.
and as this develops, there may be some other human resource kinds of policies or questions that may emerge and so we think that it's real important that we have a teamworking proactively in that regard and identifying what those issues might be.
again we want an informed community, we want a very well informed workforce as well.
so with that I think I might ask dr. Wong if he would like to add some information from sort of the medical health perspective.
he is the medical director in our health and human services department.
>> thank you.
I think that you pretty much covered it well.
I mean, I think the only points that I would reiterate are again we're -- we now have one confirmed, one probable, but we certainly anticipate that as the backlog testing and things come out, we will over the next days and weeks we will have additional cases confirmed and probables that are reported back to us.
I think that we now have more information from regarding all of the information efforts and other activities, regarding the epidemiology of this, what it's doing in our communities so that the -- so that the decision making based on these results will have -- again will be more informed and decisions on -- on thing like school closures and other things that are based on additional information that we now have.
so I think that's -- that would be the only thing that I would add.
>> so for the average person, seeing your primary care physicians make sense, those who -- those who don't have one and may not have the resources to -- to seek out help.
so for indigent residents, what's our direction.
>> I would answer that judge Biscoe in two ways, one is we have set up a system specifically to this issue with the -- with the safety net providers and our social service agencies and our neighborhood centers, both city and county.
and what we're doing there is we're focusing on the sites and the entities that interact most directly with the population that you have described.
>> okay.
>> and through that system individuals can contact those resources and they can do -- an initial screening and we have a system set up where they then will process that through that system and our safety net health care providers have identified some -- some committed some capacity to be able to serve individuals to do that -- that screening assessment and rapid testing.
so I would advise anyone in that situation to -- to contact a neighborhood center within the city and county or if they are working directly with any of our social service providers to contact those organizations and they can work through -- work through that system.
>> where are we on the -- on the -- right now
>> [indiscernible] where are we on the -- on the flu shots status as far as folks being able to take flu shots?
where are we on that?
>> let me mention a couple of things about that.
again, as I said, this is a novel virus, so at the current time there is not a vaccine that protects people specifically for this particular virus.
but I知 going to ask dr. Wong --
>> okay, because I致e heard that something -- go ahead, doctor, I知 going to go ahead and let you speak.
>> right, the h1n1 virus is not included in the current seasonal flu vaccine.
although you know they are looking at and assessing whether that will be -- on the development of something a vaccine for that.
in terms of -- of seasonal flu, you know, again, it's not really shown to be protective of -- for this -- for this particular virus.
>> is it true if you have symptoms and they go untreated in all likelihood the situation gets worse?
>> you know, one of the things again we have been doing an assessment and getting clinical reports from all of the providers in the community.
what's fortunate thus far it has been a mild course of the illness.
actually, you know, it's been comparable or even somewhat milder than seasonal flu thus far.
we need to maintain our vigilance to see if there is any changes in it over time.
but thus far the actual clinical course has been relatively mild.
>> well, doc, the reason why I asked that question, because the question was posed to me to some degree there had been deaths that's been attributed to I guess this particular strain of the swine flu.
my question is if this is not a part, then what has caused those deaths.
>> at this point the the only death in the united states has been from a child that came up from mexico and was treated at a houston hospital.
what has been concerning, everyone is trying to continue to sort the information out, that in mexico there were a number of deaths.
there have been a number of deaths.
those numbers again as they have been clarifying some of the numbers counts have been coming down as they actually verify that they are associated with this virus.
but again at this time there has been only one death that has been identified as being related to this particular virus.
that was in a child that came from mexico.
>> thank you.
>> so what's the court asked to do today?
>> well, before -- before I go any further, I wanted stacy to introduce herself and give you her title that we will be seeing more of her as we do a lot more of this public awareness stuff wand come to the court and everything.
>> good morning, my name is stacy, I知 the assistant emergency management coordinator for Travis County.
I have been with pete now for about five years.
and -- and I really appreciate you having me here.
look forward to seeing you more.
>> I think what -- where we want to move from here, we have some h.r.
issues that we would like to -- to address at this point in time.
and -- and as you said, put those out for the court's consideration, whether or not there's actual action on them today or not.
but we have some ideas and issues that we would like to bring forward to the court.
one of the things that we will probably bring you back to discuss next week, as david said they have put in, in the disease surveillance tool for tracking and we want to discuss that issue with county to track the workforce to see if that's something that we need to do or we want to do, I think that's a very valuable tool.
that's something that we will be bringing back to you next week for discussion.
>> if I may before hrmd sort of takes over, if I could ask david to just give us a brief overview of the information that's been shared with city staff and the tracking system that you have implemented.
>> well, we have -- we of course are continuing to communicate regularly with the workforce, the main messaging again has been about the prevention measures for our workforce, both in terms of -- of their own benefit, but also they become spokespersons for the organization and they can extend that out into the community.
and also the information about, you know, staying home from work if in fact you are experiencing symptoms. But then beyond that, we have also, as we have indicated here, initiated this disease surveillance or tracking system and I知 going to ask dr. Wong to say a little bit about -- about the benefit of that and how that -- how that operates.
>> sure, setting up this tracking system, both in the work site, again working with 11 school districts on this similar system is to identify, keep track of the absenteeism and see if the rates are changing over time, if there's any spikes in those, try to actually follow up on some of the -- some of the absences that are related specifically to influenza like illness.
that gives us over time numbers to see if there's spread going on in the workforce and it's very important for us to remain in control over this situation.
>> I would just like to add, dr. Wong sort of reminded me with that comment.
I stated earlier about the great partnership that we have, how many people are engaged regionally.
the school districts in particular have been very, very proactive related to this and that as you can imagine makes a significant difference and I just wanted to, you know, acknowledge their engagement and how beneficial that is from a public health perspective.
both for their students but again for the broader community and their family and staff and so forth.
>> that's a great point that you bring up.
I also want to, you know, put out to the school districts a thank you for -- for their targeted response.
there's nothing historical about it.
nice to see.
I understand one of the Pflugerville elementaries, timberman closed down -- timmerman closed down because of a confirmed case.
>> possible.
>> probably.
>> possible.
>> possible case.
it's small, it's tiny and close quarters.
so -- so I just wanted to put it out to the school districts their response has been just really gratifying to see.
>> thank you.
>> > human resource reaction?
or response?
>> yes.
linda Moore smith, director of human resources, initially, last week the clinic administrator sent out an e-mail county-wide informing the employees of of course the h1n1 virus and some of the preventive option that's are available, so that was our initial response.
in the mean time, staff has worked collaboratively with the internal department to prepare for your consideration.
a draft notice to the county-wide workforce.
as well as the more detailed communication to elected and appointed officials on how to handle the situations that might arise from a lay standpoint and other matters that will crop up within the workplace.
in addition to that, we have received a very detailed and we think very appropriate newsletter type of communique from our employee assistance program that deals specifically with the virus and also communicating preventive type of mechanisms and options for employees to -- to undertake.
what we would like very much to do is to finalize the -- the memorandums that you have received I believe as draft documents and to get those out to the employees as well as the elected and appointed officials as soon as possible.
we are suggesting in there are any -- if there are any critical questions, that they access their primary care physician, but also keep in mind we do have our clinic here.
if there are direct questions we have doctors on staff they could make calls to or get in immediately to visit with.
there are options available on how we would want to communicate that information.
we recognize that not all employees are connected to our intranet system.
so there are options that we would want to propose to you that we would get this information into the actual hands of all employees.
not much unlike we communicate through payroll and of course we know there's not a payroll period coming up, but we would ensure that every employee gets a hard copy of the information that we would want to have distributed.
we have worked with the
>> [indiscernible] as well as hhs, county office, that's our internal team.
we would want to continue that in order to get these finalized documents for you to get approval to get out.
>> okay.
I guess with the -- has there been any posting on I guess the city and also the county's website to let those folks who do not have -- well, primary physicians and -- and the folks that depend on our clinics, are there locations that are specified on these websites to let everyone know that there is a -- there are locations that they can go to see about these situations if they have symptoms?
has that also been done, addressed, or is it already there?
I知 asking, I知 posing the question.
>> that's okay.
>> I think on our website and the city's website there is extensive information about symptoms and -- and phone numbers for information.
and -- and, you know, what we would consider to be appropriate public health messages.
I feel very confident that folks who would read that information would be able to find several resources in terms of how to -- how to either receive medical attention or ask questions about symptoms or anything that the public might need related to this -- this virus.
>> but I guess my question was specific locations, specific locations available for the public to know if they are experiencing symptoms as I think the judge indicated earlier and kind of
>> [indiscernible] with me, those particular persons out there that do not have primary care physicians --
>> well, our website has our --
>> that's what I asked.
>> our community center locations, now whether it's linked to this page or not, I can check on that and we can certainly work with it to make sure that -- happens, that there's a link from the -- from the influenza page to the actual locations.
but the -- but the addresses and phone numbers are on the health and human services website.
>> I guess that I would like on to pose the same thing to the city.
if there's a short coming on that sherri that may be something that we need to look at.
same question to the city as far as looking at some of these -- the outreach facilities.
>> Commissioner Davis a couple of things.
first of all, all individuals should be encouraged to seek out their normal, you know, primary care health care provider, just as they would with, you know, seasonal flu.
as you can imagine there's been these last weeks there was quite a surge in terms of emergency department visits at the hospitals and we really want to encourage people to again respond to this as they would to seasonal flu and if they are experiencing symptoms, first start with their primary care provider with that provider.
if they do not have a primary care provider, they should follow standard practice.
for example go to 211 and get a list of safety net providers in the communities and work through that.
now the third tier of this which we created which was another source for people who absolutely cannot get into the system through those mechanisms, and that would be through our social service agencies and our neighborhood centers.
what we could do Commissioner, I think what I知 hearing in your suggestion is perhaps put something on the website that would be more specific about the fact that those neighborhood centers would be a resource for people for this particular purpose.
so --
>> that's the resolution that I was kind of speaking to just that tier that you mentioned and of course the tier --
>> what we have been doing, this just started yesterday, sort of evolving.
what we have been doing is encouraging the neighborhood centers and social service agencies who work regularly with individuals in need, to make them aware, you know, of this -- of this service.
so it's kind of being directed on that side.
but there might be some things that we can do as far as the website or communications for -- for people to become more aware of that resource.
we will definitely look into that.
>> I would appreciate that, thank you.
>> so do we need to approve the -- this draft memo in your backup?
>> in concept we would want you to approve that which would authorize us to complete that and any input that you would provide and distribute it.
>> okay.
I see -- I see the memo, a longer one.
>> the longer one -- the briefer one to the employees primarily focuses on prevention techniques.
and that the much shorter one -- but at the same time provides what we feel and what has been proven to be he have effective means of preventing.
that's basically of course the general influenza preventive techniques of -- of covering your mouth and nose when you cough, washing hands often, not touching your eyes, nose, mouth, keeping the germs away from your mouth and contact with sick people.
in general that's the one, the shorter one that would go to the workforce, along with -- proposing a very good article we feel from the alliance workforce partners of employee assistance programs, which provides again information on protecting employees as well as their families.
the more detailed one that would go to elected and appointed officials are really focusing on that particular memo focuses on how they would handle employee situations that would come up within the workplace.
flexible work time if need be, how lead time would be handled and general we are proposing as most of the other employers are doing, that an employee's regular leave time would be used in there is a need for -- if there is a need for them to be away.
we are also taking a look at means of tracking.
we have taken a look at the
>> [indiscernible] model and think that we can probably benefit from having a tracking system in terms of Travis County that would have departments of course reporting absences so that we, too, can get a better feel for the impact within the workplace.
so in concept I guess there are several things that we are asking for today.
conceptually your approval on the draft memo for us to finalize to employees and elected and appointed officials, the other would be your -- your approval for us to actually release this.
I keep saying payroll -- but the concept is to get it into the lands of all employees, parole those without access to our intranet system.
so those are the major points that we would like for you to consider today so that we can move forward.
>> it would only take a day or two to finalize these two memos and distribute them, is that correct.
>> that's correct.
>> I don't know that I would wait until the 15th.
>> no.
move that we authorize hrmd to final these these two memos and distribute them to the targeted folks.
>> along with that I would like to include suggestions we brought up before, outreach, especially for folks that do not have insurance to go to primary care physicians, they should have access to our clinics.
but all means, I think -- by all means I think the city and county should make sure these locations are ready and available.
for folks that are not even aware, if they become victims of the symptoms of these particular virus.
I think it's really appropriate to maybe include those things that we have just mentioned with mr. Lurie and also with sherri.
>> just one additional point in terms of communication to employees.
that we consider also a voice mail notice to employees that they may expect to receive this one page prevention notice that will be going out before the end of this week for sure.
and we would propose that -- that the judge consider making that announcement to the workforce through our electronic telephone system.
>> okay.
Commissioner Davis' recommendations are friendly to the maker of the motion.
>> thank you.
>> that was seconded by the whole court, wasn't it?
any -- any opposition to it?
we will include it.
>> are we going to make it
>> [inaudible - no mic]
>> okay.
>> we will request this item be reposted for next week for updates and additional --
>> is this wording sufficient do you think?
>> yes, sir.
>> we will work with the county attorney.
>> judge, Commissioners, gus pena I have a couple of concerns from the community.
number one, you know, as has been stated here, employees might not have access to internet or web or a computer.
I would also echo and piggyback that a lot of the community might not have input or access to the community.
one of the gripes that we have heard from families is number one -- I知 very grateful that partnerships are being made with the school district.
that's very important.
but a lot of the students have not gotten the information to be able to take it to their parents.
first and foremost, non-english speaking parents.
I think I brought this up to pete as he departed last week.
if there was some sort of p.s.a.
spanish public service announcement in spanish for the non-english speaking residents and taxpayers of the city of Austin and Travis County to be made aware of what is going on.
also good point y'all beat me to the punch judge and Commissioners, number one indigent people.
number two the clinics and the locations.
my suggestion would be, this is going to cost some money, I don't know how y'all are going to do it, but well worth it to save the lives of people who don't understand what age -- this influenza they call it to put some announcements in the community papers that are -- that are in spanish that are -- that our fellow taxpayers can receive the information just as we who understand english can.
also, another thing also is all this information need to be made aware to the taxpayers, not just english speaking, but those who do not understand -- children might understand english and pray tell this is what they said in school, but I値l be honest with you, I have one child at the school district, I have not received any kind of information whether english or spanish from the school district.
I知 very concerned about that.
if I am not well informed to what's going on in the Travis County and city of Austin, a lot of people are not getting information they need to be educated.
another thing also please, please the telephone number (888)777-5320 is very important to the location and all of the information about this influenza.
all the people hear about is going on in mexico in the spanish television networks and they are not hearing the straight skinny from the united states of america.
ms., please, I use that word again, inclusive, be inclusive of everybody to be inform so a person that is informed will be kept hopefully healthy.
I don't know if you have a response for that, but I would like to hear it --
>> what I will say is we will bring this back to the attention of our school safety consortium, which is the -- all of the school districts that have schools in Travis County.
tell them about your concerns of not having received this and suggest they may want to do that very quickly.
>> in addition to that, the memorandum that we will be releasing
>> [indiscernible] will be in both english and spanish.
as well as the alliance for partners document is also the same.
english and spanish.
>> okay.
>> and I would again echo this, you know, I thank you all very much for doing that for employees.
remember there's a bigger, broader citizenry out there also that is not getting the information.
I知 very concerned.
a lot of people that I talked to esl when they became temporary resident in the immigration control reform act of 1986.
look, can you do something about it.
they won't come over here and speak over at the city council.
I知 going to say this,
>> [speaking in spanish]
>> that is something we need to get out and convey out to our spanish speakers, you know.
maybe a lot of the asian american community.
my fellow vietnamese Austinites are not bilingual.
thank you for allowing us to speak.
we have grave concerns.
we want everybody to be healthy and educated to what parameters and services are available out there.
thank you very much.
>> could this perhaps go on channel 17?
have we thought about the call?
>> I mentioned to sherri just a few minutes ago, that channel 17 could very well be an option for us to consider in our communications.
we would certainly include that.
>> I think that would be a good thing.
>> can I make another suggestion?
because a lot of people might not have cable.
I知 the bearer of bad news here, but bearer of good news.
this is a univision station here.
maybe you can collaborate with.
they will be more than happy to do that.
they have been very good about public awareness.
community newspapers, a lot of our immigrant population, my fellow spanish speaking citizens and taxpayers read a lot of the community papers, it's free, they are free and they are more in tune with what's going on with the newspapers.
a suggestion I guess.
>> the churches are also.
>> yes, ma'am, there you go.
>> share information with people in the pews diocese sent out a letter throughout the community.
hoping they are getting the message there in english and spanish as well.
>> the bearer of bad news, I am a catholic have been all my life.
I never got a notice whether in english or spanish, diocese needs to be more aware of the fact that it's not getting the word out to our catholics much less the people out there in the community who are not catholic.
>> they need to send another letter.
>> yes, ma'am, sure.
>> I know that people get it.
>> thank you for bringing that up, thank you.
>> thank you all very much.
>> I guess maybe we can further address outreach.
>> yes,.
>> any more discussion of the motion?
all in favor?
that passes by unanimous vote.
we will have it back on next week, let's address additional outreach efforts.
all right.
>> thank you.
>> thanks.
>> just to clarify, judge, we will be releasing this information this week, though.
>> okay.
>> sooner the better.
>> okay, great, thank you.
The Closed Caption log for this Commissioners Court agenda item is provided by Travis County Internet Services. Since this file is derived from the Closed Captions created during live cablecasts, there are occasional spelling and grammatical errors. This Closed Caption log is not an official record the Commissioners Court Meeting and cannot be relied on for official purposes. For official records please contact the County Clerk at (512) 854-4722.
Last Modified:
Tuesday, May 5, 2009 5:41 PM