Building Local Level Partnerships for Rural Emergency Preparedness

Date: Wednesday, May 10, 2023
Duration: approximately 60 minutes

Featured Speakers

	Meghan Melnick, Senior Research Associate with NORC at the University of Chicago Walsh Center for Rural Health Analysis
	Margaret Staab, Healthcare Readiness and Response Coordinator, Region 5 Big Horn Basin Healthcare Coalition
	Mike Moore, Deputy Chief and Training Officer at Southern Stone County Fire Protection District
	Dianne Connery, MLS, MS, Director of Pottsboro Area Library

First in a 3-part webinar series on rural emergency preparedness highlighting the role partnerships and collaboration play for rural communities when planning, responding, and recovering from disasters and emergencies. It will feature four speakers sharing their experiences of working across local agencies, planning with partners, and building collaboration to help in their emergency preparedness efforts. The webinar will also share key points on the topics of collaboration and partnerships at the local level from the Rural Emergency Preparedness and Response Toolkit, which is currently available on our website. The toolkit and webinar were supported with funding from the Centers for Disease Control and Prevention (CDC).

Case studies featured in this webinar:

From This Webinar

Transcript

Kristine Sande: Good afternoon, everyone. I'm Kristine Sande and I'm the program director for the Rural Health Information Hub. And I'd like to welcome you to today's webinar where we'll be talking about building local level partnerships for rural emergency preparedness. I have just a few housekeeping items to run through before we begin. First, we've provided a PDF copy of the presentation in the RHIhub website, and that's accessible through the URL that's on your screen. And now it is my pleasure to introduce our speakers for today's webinar. Our first speaker is Meghan Melnick. Meghan is a senior research associate at the NORC Walsh Center for Rural Health Analysis. She is a qualitative and mixed methods' researcher in the areas of public health systems, environmental health, and public health emergency preparedness, among other public health topics. Her work focuses on advancing the evidence base around public health practice and rural community health programs.

Next is Margaret Staab, and she has served for six years as the Healthcare Readiness and Response Coordinator for the Region five Big Horn Basin Healthcare Coalition. Wyoming's Healthcare Preparedness Program enhances community and healthcare preparedness, improves medical surge capacity, and supports healthcare organizations during emergency response and recovery through five regional healthcare coalitions around the state.

Deputy Chief Mike Moore is a 23-year member of the fire service with a passion for inspiring fire service leadership, incident command, fire ground strategy and tactics, and training program development. He currently serves as the chief training officer for Southern Stone County Fire Protection District in southwest Missouri, a combination department that covers 280 square miles in southwest Missouri, which responds to over 3000 calls per year.

Dianne Connery has been committed to rural public libraries since 2010. She has actively invested in efforts to improve digital inclusion in rural communities. She is passionate about inspiring others and advocating for the work of rural libraries with an emphasis on community resilience. The Pottsboro Library was named one of the top three best small libraries in America in 2017. Ms. Connery was honored as an innovator in Library Journals' Movers and Shakers class of 2021, and she was selected as the 2022 Texas Small Community Librarian of the Year. And with that, I'll turn it over to Meghan.

Meghan Melnick: Hello everyone. My name is Megan Melnick, and as Kristine said, I'm a senior research associate at NORC at the University of Chicago. And today I'm happy to introduce the Rural Emergency Preparedness and Response toolkit. The toolkit was produced by the NORC Walsh Center for Rural Health Analysis and the Rural Health Information Hub. This toolkit is a resource designed to support and strengthen rural preparedness and response programs. The NORC Walsh Center is part of the public health research department at NORC at the University of Chicago, where we conduct policy analysis, research and evaluations to address the needs of rural communities. RHIhub is a national clearinghouse on rural health issues and supports healthcare and population health. Their website offers an online library of resources like topic guides, podcasts, and the toolkit that we'll discuss today. The Rural Emergency Preparedness and Response toolkit provides information and resources for rural communities implementing emergency planning, response and recovery efforts.

It was developed to help rural and tribal communities, healthcare facilities, and other organizations serving rural populations by providing access to evidence-based and promising models and resources to support them in preparedness and response. A key focus of our work has been to establish a rural evidence base. Evidence-based toolkits are an important step in disseminating successful programs and strategies. And this toolkit is unique because it combines evidence, expert advice, and the actual experiences of rural communities into one easy-to-use resource to support successful rural health programs. The toolkit is available at ruralhealthinfo.org/toolkits/emergency-preparedness. It's comprised of six modules and each module focuses on different considerations for rural preparedness and response programs. The modules address the steps in emergency planning, response and recovery, cross-cutting issues and key considerations, the types of public health emergencies and disasters for which rural communities may need to respond, methods for considering for assessing the impact of the emergency or disaster and funding resources and support.

There's also a set of 31 case studies with insights from rural leaders and organizations who have faced many different types of disasters and many different rural settings. You'll find guidance on and examples of partners and collaboration throughout the toolkit. For example, in module one, it introduces rural emergency preparedness and response. It includes definitions and unique considerations for rural communities. It also includes information on collaborating with partners. So let's talk a little bit more about that. One of the things we talk about in the toolkit is that it's important to maintain a base of partners to grow, expand, and engage in all emergency activities. These relationships should stay active even when not responding to an emergency. This can be achieved by formalizing partnerships like MOUs for example. But when creating partnerships, rural communities should look beyond organizations only focused on health and safety. Partners may be at the local, state and national level, and we'll hear more about the different types of partners from our speakers.

Partnerships are a great resource during an emergency, but it's also important to engage partners at each step. So, including partners in the planning process to conduct needs assessments, determine strategies and activities, and define roles for those activities are great ways to involve partners initially. In the response phase, be sure to communicate with your network and recruit the necessary resources to coordinate and deliver response activities. When moving to the recovery phase, identify community needs and connect them with resources, assess the response to your partners and disseminate what you've learned. So this was just some of the information available in the Rural Emergency Preparedness and Response toolkit. Be sure to visit ruralhealthinfo.org to learn more and I'll turn it over to our first speaker. Thank you.

Margaret Staab: All right. The Big Horn Basin Healthcare Coalition wrote their charter in 2014, and we became a 501(c)(3) last year. Our funding is through the hospital preparedness grant, which is a federal grant that's written and administered by the state of Wyoming, but all five healthcare coalitions have become 501(c)(3). We are local administrators of a federal grant that's written by the state, kind of confusing. And our coalition covers four counties in rural frontier, northwest Wyoming. Our borders are Montana, Hillsdale National Park, and the Wind River Indian Reservation. This map shows the region, it's outlined in red. As you can see, it's pretty darn big. We do have some challenges. Our area is larger than the states of Massachusetts and Connecticut combined, and we have a population of fewer than 55,000 people except in the summer when it swells because of tourists. Our population density is 3.8 people per square mile, and a lot of that land like 80% or 70%, I forget the statistic, is federally owned.

We're surrounded by a ring of mountains with a high desert, stunning rock formations, rivers, creeks and streams, is a huge area with a very sparse population. And so coordinating healthcare delivery brings special challenges to the coalition. Just imagine getting an ambulance up to mountain paths that are covered with snow. Anyway, there's a picture of skiing at our local mountain, that's actually my son. So, we have a lot of things to consider, including working with federal entities; it's not something that we do in our coalition on a regular basis. But the partnership, well, they're not written partnership agreements, but we know the people who do contact and everybody steps up to the plate in the emergency. That's what collaboration and cooperation are all about. We are actually, I didn't write this down, but working on getting MOUs signed with a variety of entities, organizations in our four-county area in case of an emergency response situation primarily for transportation and for sheltering if needed

Neither one of those is probably going to be needed, but we want everything in place just in case it is. Anyway, we share a border with Wind River Indian Reservation. It's largely in central coalition, but we do also have some reservation land in our Edgemont area, and that means also coordinating with the BIA. And annually we do what's called an HVA, which is a risk assessment to identify what risks are most likely to have an impact on a healthcare facility in the surrounding community. The coalition combines them from our six hospitals and does a coalition HVA and some environmental examples of hazardous vulnerabilities include flooding, especially in Hot Springs County because of the Boysen Dam and the location of the healthcare facilities in Thermopolis, Wyoming. Wild land fires are always a huge concern, not only the risk of evacuation but also the risk of smoke inhalation and burns, of course, potential earthquakes, tornadoes, severe winter weather is a huge concern. Which is why we invest heavily in generators, not the coalition itself, but emergency management primarily.

And other vulnerabilities include physical vulnerability, economic vulnerability, and social vulnerability. That's just a picture of a wild land fire up in the mountains. They happen with monotonous regularity and the Wyoming Army National Guard UH-60 Black Hawk helicopter takes off from Laramie Regional Airport in Wyoming to assist in fighting the Keystone Fire July 6th in 2017. Visible at left is the helicopter's water bucket. The National Guard helps with firefighting, the National Guard also if requested by emergency management, the governor of the state of Wyoming will step in and assist with response situations. During the pandemic, they assisted local healthcare facilities with some staffing needs. We're having a big exercise June 14th and the National Guard is actually putting it on, the Vigilant Guard and they're flying a Black Hawk helicopters up to Powell, Wyoming to help deal with an exercise scenario that involves radiation and an active shooter.

We're all quite excited about it. It will be a regional response for our entire coalition. So this is just a list of all of our current members. We're always looking to increase our membership and increase our partnerships and collaboration with additional healthcare providers and emergency responders in the four county region. And we had an ice jam event in March in a town about 10 miles from where I live. When the mountains thaw and then the snow melts and the rivers flow high, the ice breaks up and we have ice jams frequently, almost every year in some locations. Anyway, this tells about the response situation. The healthcare coalition was not involved in this. This was an emergency response. It's just an example of an environmental hazard that can happen and the level of response that we have in our communities at a moment's notice. Thank goodness, neighbors help neighbors.

We have to help neighbors, help's not coming from anywhere else. We're too isolated. We're too far away. Cheyenne's in the opposite corner of the state, so it would take them five hours to get anybody here from Cheyenne, which is the state capital of Wyoming. Rural partnerships, our goal is to actively engage stakeholders in our local hospital preparedness program, which is HPP, and in our healthcare coalition, which is HCC, which is confusing. And key stakeholders include fire, emergency medical services, which is ambulances, law enforcement, school districts, as well as the full spectrum of healthcare providers. When we have full scale exercises; we had one last June in Lovell, Wyoming, involving WBI, which is energy producing, gas producing local business. They participated and let us use their property as this staging area. Anyway, when we have full scale exercises, lots of people use that for their exercise, for their organization, and they participate, including dispatch, law enforcement, fire and search and rescue and local industries.

We have really good turnouts. Last year we had about 80 people all together, including the local hospital which had a big presence. North Big Horn Hospital in Lovell participated, which was unheard of and it all went very smoothly. And of course, we learn things we need to learn about and that's the purpose of an exercise. We'd rather learn about them during an exercise than an annual event. And this is just an example of a different picture of Wyoming than our mountains and tells why it's called Red Canyon. It's not actually in our coalition, but we have areas like this in our coalition. I just like this picture, the woman and her dog is standing on the red rocks. So we have lots and lots of established relationships. This tells about the National Guard active shooter exercise and radiation spill. And I'm going to start reading here.

We are focusing on linking disparate networks together. So it's to focus their attention on improving health security capabilities law enforcement at the Northwest Community College in Powell, Wyoming. Search and rescue, fire emergency management services, EMS, ambulances, public health and hospitals will all be involved. And what the coalition does currently under the capabilities that are required now by the federal grant is assist with coordinating the acquisition and distribution of needed supplies and supporting coordinated response and unify command across sectors use the NIMS or the Hicks uniformly depending on the situation. We provide a lot of training to build workforce capacity and resilience and to increase the capability and readiness and response abilities of our healthcare partners. Training includes national incident management training, Stop the Bleed, active shooter, decontamination, advanced burn life support and more. Our exercises are designed to test our annexes and increase our ability to respond quickly to a medical search incident.

The state of Wyoming and our healthcare coalition are also involved in the mountain, it should say plain, sorry; Regional Disaster Coalition and participated in a tabletop exercise last August with them. Our coalition during the pandemic decided we needed a cache of PPE and decom supplies. Protective gear was purchased with federal funding. During the pandemic, ventilators were needed at the hospitals. We also invested in radios for communication. Getting in supplies such as gloves, masks and booties was a challenge during the height of the pandemic. If you haven't seen it, this is a hazmat gear, needed during a chemical spill event at the railroad, for example, also a radiation event at the college. It's needed for a number of things. We have a lot of oil and gas producers here, and sometimes there's accidents out in the oil field. The more prepared we are as an organization, the better equipped we'll be to support our communities when responding to an emergency.

A lack of understanding of organizational and community preparedness may culminate in undue stress and exhaustion during times of emergencies but also in anticipation of future emergencies. Normalizing a culture of preparedness and utilizing key response concepts outside of an emergency provides an opportunity to educate and empower staff while bringing value to the goal at hand. There we go. I must be done.

Mike Moore: Good morning. Good afternoon. My name is Mike Moore. I serve as the Deputy Fire Chief for Southern Stone County Fire. We're located in the southwest portion of Missouri. We are a heavy tourist area. And so July the 19th this year will mark our fifth year remembrance of the duck boat incident that occurred on Table Rock Lake, which shares three counties and a number of different jurisdictions. And we'll talk a little bit more about the cooperative efforts during this mass casualty incident. So to kind of give you a little bit of a background, the duck boats had been quite a staple in the Branson area. Tourists would be able to get onto this kind of an amphibious vehicle. It gets its term duck from the World War II era, DUKW. And so they just kind of took the duck part, but what it was was an amphibious vehicle that could go on land and as well in water.

So tourists would come and the duck boat would drive them around Branson and they could see some of the highlights, some of the different things that are in Branson. And then it would go over the Table Rock Dam and then there would be a ramp that the duck would go down the ramp, splash in and kind of go around the lake around the Branson Belle, which is a kind of mockup of a steamboat. And they do shows on the Branson Belle quite frequently during the summertime. So on this particular day, there were a number of duck boats who were carrying tourists throughout Branson and into Table Rock Lake. And we had some very serious storms, squalls that came through, which isn't necessarily unusual, but this one in particular was almost of a radical nature. It was unlike anything that we'd really seen in this area with this type of a squall where we were actually seeing very high waves out in the lake.

Table Rock Lake is an Army Corps of Engineer lake created by Table Rock Dam. And so at that particular point, there were two ducks that were out in Table Rock Lake and when this squall came in, there were also passengers on the Branson Belle. And if you type in duck boat incident Branson into a YouTube video search, there is actual video of passengers on the showboat that were taken of the duck boats. One was kind of struggling and the other one was trying to get through that squall and obviously one was able to make it to the shore and the other one did not. There were 31 individuals on this particular duck that sank. Of those 31 individuals, 17 individuals perished. This happened pretty close to about seven o'clock in the evening when we were given the dispatch of a duck that had sank. We proceeded obviously toward the scene and our duty officer of the day had immediately declared a mass casualty just simply based on the fact that this was probably going to be 20 to 30 individuals in the water, in the storm.

So we announced a mass casualty incident right away. One of the things that I guess, and I've mentioned this before, is when I arrived on scene near the birth of the Branson Belle, one of the things that caught my attention very quickly was the personal flotation devices. They were a bright red and there were a number of those in the birthing area around the Branson Belle. And I was, immediate, my thought, "Wow, that's a lot of people in the water." And as I kind of got a little closer to the situation, I noticed that many of those life vests, they were just floating. There was nobody there.

If you take a Google map and you look at where the Dewey Short Center for the Army Corps of Engineers, they have a kind of visitor center there. There's a peninsula that comes off of where Table Rock Dam is, and then the Dewey Short Center and the Branson Belle are all on this peninsula. Well, the boundaries for Stone County were set up before the dam was built. And so consequently, this little peninsula is still in Stone County, although it's kind of a ways out of our jurisdiction, but it's still in Stone County. So you have Taney County, which is where Branson is. Branson has their own fire department. There's Western Taney County Fire Protection District that also covers the kind of the area around that peninsula. And then Southern Stone County Fire Protection District where we cover 280 square miles of Stone County. We go down to the Arkansas border.

Table Rock Dam is very big, and so there's a lot of different jurisdictions that cover it. And so even in this little particular situation, geographically, it covered Western Taney Fire Protection District. Branson Fire Rescue was also involved in that Southern Stone County fire. We have two different EMS agencies, so there's Taney County Ambulance District as well as Mercy EMS, which is part of Mercy Healthcare Systems. So we had a number of different, and of course Stone County Sheriffs, Taney County Sheriffs. So we had a lot of different emergency agencies that were involved in this mass casualty incident. So when we talk about cooperative work and cooperative effort between these different emergency services, anybody in the audience who is familiar with how well law enforcement and EMS and fire service folks, it can be a struggle to make that work. When you take those agencies that may work together some of the time and you put them in this kind of a mass casualty incident, it can be very daunting.

It can be a very difficult task of bringing all these disciplines together and making them work. But with that being said, we all understood that there was obviously an incident that we knew was going to affect our area for an extended period of time.

One of the things that was a difficulty was communications because we had different agencies using different frequencies of communication. Some people had VHF radios, some people were working off UHF radios and also off of a digital system or most which is what's used in the state of Missouri for digital communication. So we had a communication issue where we had to actually designate folks in the incident command system. In the incident command post, we had a unified command. So we had a representative obviously with Southern Stone. We had representative from Western Taney. Our medical branch was with TCAD and Mercy. So they were able to communicate with their units without us having to worry about checking on a number of frequencies. So that made it very easy. One of the things that we also found out was that accountability was almost impossible. It was nearly impossible for any accountability to be had because you had so many different agencies coming in and you had so many different apparatus coming in, personnel coming in. Accountability was very tricky.

Once we established the operations branch, I was the operations branch along with a battalion chief from Western Taney. We got onto the Branson Belle. We had three cardiac arrests that were being tended to by civilians. We had obviously the Branson Belle itself had a number of individuals, civilians who were participating in active rescues, trying to get people out of the water. And that could have potentially been a disaster in and of itself, but fortunately, we were able to get folks out of the water, try to resuscitate them, and those outcomes were not good. But it was very difficult for us initially to determine who was a part of the Branson Belle and who was not.

So that kind of accountability can be very difficult. The bottom line really for us was that we knew that the first few minutes were just going to be catastrophic. They were going to be chaotic. And so we had some wonderful responders who were able to step up into those different roles that we asked them to perform from different agencies and they were able to work together. We understood also that this was of a national news situation. We were receiving phone calls from national news agencies. I had no idea how they were getting ahold of my phone number, other agency leadership phone numbers. They were receiving phone calls from the media. So we had to work together on how we were going to be transparent with the information or what we were doing as agencies and making sure that we were doing the right thing. And sometimes that can be very difficult when you're dealing with different agencies and different leaderships in different agencies. They might have a different view of the media. They may have a different view of how agencies work together.

Just to finish up a little bit, I would say that there are a couple of things that I would cooperatively emphasize. One is lessons learned versus lessons identified. We identified a lot of things. We identified a lot of gaps, we identified a lot of communication issues, so we identified them, but that's not necessarily; we haven't necessarily come even after five years later. There are some things that we're still learning. So there's lessons identified cooperatively versus lessons learned. And second, I would say that very proud of how we were as a community able to come together and be able to demonstrate. I think as the previous speaker, our motto is neighbors helping neighbors. And so we have a lot of tourists that come in and we want to treat them like neighbors, and we want to treat them with respect. So cooperatively using the incident command system was also imperative.

Kristine Sande: All right. Thanks Mike. And we'll get Dianne's slides up here and turn it over to you, Dianne.

Dianne Connery: So, I am coming to you from the Pottsboro Library in Pottsboro, Texas. We're about 90 miles north of Dallas, a rural town, 25-2600 people. And on the border with Oklahoma, there's a big lake recreation area near us. So I'll be talking about our emergency response to the big freeze that we had in February of 2021. And I did want to mention whatever view or image you have of a library in your mind, forget that because that's really not what we do. We're not a traditional library. In a rural community, I suspect like many of yours that there are not a lot of social services, other kind of government services available. So the library becomes the community hub. And if you have not had the opportunity to partner with your local library, I hope you will consider it. So we're kind of on our own.

As the earlier speakers mentioned, we have to, when disaster strikes, take care of ourselves until first responders can get here. And a library's role from the beginning was connecting people to information they need. And in a small town, there are limited methods or pathways of communication. We don't have a newspaper, we don't have a TV station. There's a lot of people who don't have access to the internet. So much of our information is passed just word of mouth over the phone, that kind of thing. And then also keeping in mind when a disaster strikes, a small town has limited capacity to respond to it. So in our case, if there is a broken water pipe, the city manager is literally out with a shovel digging holes to get things repaired. So I'll talk about the freeze we had and the role we played. So in Texas, we have our own power grid and the power grid shut down for up to seven days for many people throughout Texas.

And in our case, the water system shut down as well, which I had never even really considered as being possible, but it shut down as well. So there was a little snow on the ground, but not a lot of snow. Early on the recommendation was go out and shovel snow to be able to flush your toilets. So as a library, we connected with ranchers and people who had wells outside of town and had them use their trucks to bring it into the library. And then people who could get to the library bring whatever kind of container they had to come pick up water. And we had water that was safe for drinking and then water that was just to be used for flushing. And then we had some of those ranchers go around town because water's heavy to carry and we knocked on doors like, "Do you need water?"

And so distributed in that way. Then when the TV stations were up and running, we had them share information for us and we've got them on speed dial, which is a really nice thing about a rural community. They're always looking for news and positive news especially. So they were able to help us get the word out. One local restaurant because their power was out, their food was in danger of going bad. So they offered to cook the food that they had, prepare hot meals if we could bring them well water, which we did. And so then we brought that food back to the library and distributed those meals. So it really was about people wanting to help each other, reaching out to their neighbors who they knew might be in bad shape. We had volunteers coming to the library to get water to distribute. In one case, there was a woman who was home bound and was almost bedridden and she could not get to her toilet.

She was not able to put water in her toilet tank to flush. And at some point that starts to become a health issue. So we had volunteers who were willing to go into her home and fill up toilet tanks. So just good people. So we did trying to make light of it, not being able to flush your toilets. We had a local supplier who within about an hour we ask him for porta-potties. He delivered them to the library parking lot. And then we put this up on social media. Everyone poops. Don't take library books into the porta-potty just because there are some apartment complexes, housing authority, a more densely populated area right around the library so people could come here. And then as more things in the larger city got up and running like Sam's opened just for water distribution. And so we had volunteers go pick up bottled water and then distribute through the library.

And so, one of the things we learned when communication methods were down was Code Red was a way about three or four days in that the city and county started getting messages out to people in the community. I have since learned that Code Red considers a good rate of adoption for their service to be about 15%, which leaves a lot of people out of that method of communication. That's one thing libraries can do is help people sign up for Code Red because some people are unsure about how to do it. So again, it's just information and awareness. The next slide is just to show again that a TV station provided coverage and just strategically, that's always good for us as a library because we are constantly battling against the stereotype of what kinds of services a library offers. And it's important for us that people in the community know that we provide essential services.

The next slide shows after the event, when we started kind of debriefing what went on. There was a lot of negative feedback to local government that they couldn't see what our city government had been doing. Some of it behind the scenes. And so there was a lot of praise for the library, but negative talk about the city, which was not what we wanted because we're a subdivision of the city. And so we wanted to take those lessons identified, lessons learned that Mike spoke of. We wanted to use it for good going forward. So what did we learn? And we held a community conversation where we invited Office of Emergency Management as well as city government and the community to come together and talk about how can we be better prepared the next time. And so one of the things that was discussed was just this idea of neighbors helping neighbors and phone trees, getting people to identify their close neighbors who needed help.
One thing that kept me up and running was just, bottom right, you see this small charging station has solar panels. So I was able to keep my phone and laptop charged throughout the event. And then upper right will show you we have some portable routers that if you are within distance of one of our local internet providers, you can take those routers and get access to the internet. Next slide is what we decided to do through the Office of Emergency Management was to offer their civilian emergency response training. It's a FEMA program and it was a nine-week course, very in depth, and all those people who had so much energy around the discussion of how can we be better next time, met at the library for nine weeks and had these, how you clear a building if there's been a tornado or a collapse, all the way to tourniquets, to triage, all sorts of things.

So this was another way that we could get information flowing in our community. So we trained about 10 people with this CERT training. And then we're now on the list of office emergency management when things come up, how can citizens help? Because one thing that we learned is at some point there were these outside organizations who had, for instance, United Way had a semi-truck full of blankets, but they didn't know who in Pottsboro to contact to get those distributed. Afterwards with the debrief, we met, so they have my number now, that they would know how to make that happen. The next slide shows unfortunately, just a recent warning, we got our power grid. They're already warning as more and more people have moved to Texas, we're likely to have brownouts this summer. And so as a library, we want to encourage people to be proactive and start thinking now about what they can do to be prepared for this kind of event.

And the next slide will show, this was last week, American Public Health Association had a super interesting webinar I attended. The connection between climate change and mental health interventions. And so it went into detail. As is often the case with the library, we get in on one, one thing gets us started, and then it's amazing to see this web of how it plays out. But I definitely see emergency response and disaster preparedness as one of the roles of a community library, especially rural library. So now the Council of Government, which represents a three county area, has asked me to participate in emergency resilience planning. They've got a grant, I think it's a three-year grant and it's a train, the trainer model. I'll be working with all the public libraries in a three county area that in case of disaster, how can those libraries help small businesses in their area be resilient?

A lot of that is around digital inclusion, which is an interest of mine. And so there's a lot of talk about this in the library world. There've been libraries around the country that have responded to various kinds of disasters, hurricanes and floodings, et cetera. And because so much of it is an issue of communication and information, I just think it's very fitting that this is a place where rural libraries need to be involved.

Kristine Sande: I'd just like to thank our speakers for their great presentations. Really interesting work that you've all have done both in preparation and response to the disasters in your communities and enjoyed hearing about all of the partnerships and sometimes the unexpected partners. And I think that helps us think more broadly about who should be at the table. Dianne, have you found that since this incident you've maybe been included more in the discussions at the local level about emergency preparedness?

Dianne Connery: Yes. I've definitely been advocating for a place at the table. So we actually as a library have formed our county's broadband coalition to bring some of that bead money that's coming. And I think when you're talking about disasters, digital inclusion is a big part of what's needed to respond to those things. So yes, I have been included and I am glad to see it.

Kristine Sande: I think we don't always think of libraries off the top of our head, but it makes perfect sense when in an emergency situation like that, where there are so many things to be done and in a rural area only so many people to do them. So any last comments by any of the speakers?

Dianne Connery: Well, I would love to pick people's brains about if we are preparing for a three-county area, what we can do to help small businesses be resilient and come back from disasters. I'm going to be planning that curriculum, so I am looking for sources of input about what small businesses would need to do.

Margaret Staab: Dianne, this is Margaret. One of the things you could do that we have here, our local emergency planning meetings, it's called LEPC. Emergency Management coordinates them, and it's a variety of first responders and emergency management, public health, but also a lot of small businesses. We have a lot of industry, bottling company, a Pepsi distribution, for example, oil and gas. Anyway, they all show up and discuss about, "Okay, what do we need to do in case of a disaster? What do we need? We need generators, we need radios, we need communication." Our coalition just sponsored people getting GETS cards if they want for communication on their cell phone, it's free. It's through the government. And most people had them in hospitals, but a lot of people didn't. We do have a couple questions here on the chat too. One is, how do you all build and maintain relationships before disaster habits?

And another is how do you facilitate partnerships across various organizations, community partnerships or agencies? How do you ensure communications consistent with all these partnerships that not over saturate or repeat information? So if anyone wants to answer those, I can tell you for the coalition, we have four counties and that's the main purpose of a healthcare coalition or any kind of coalition, is to build and maintain relationships before a disaster happens. And how we facilitate partnerships is we provide training, we provide exercises, we provide some supplies. That's not that big, big purpose here. And as far as communication, it's emails basically or texts or whatever. So Mike or Diane, do you have answers to those questions?

Dianne Connery: I can speak to that. We're always looking for additional funding. So one of the things we've learned are cross-sector partnerships for applying for grants are attractive to funders. And the other thing I've learned for cross-sector partnerships to be successful is not to just wait for a grant and then get together and apply. That it really is important for us to have these ongoing meetings and relationships. So then when something becomes available that we already know each other and what our interests are and our capacity. And so one of the pros, I guess, of a small town is kind of the usual suspects are at a lot of things. So we see each other frequently and get to know each other through work on various boards and that kind of stuff. But there is a lot of interest around emergency preparedness now, and it's something with climate. I learned that Texas had the most frequent natural disasters in the last 40 years of any state. And so it's just information, learning about these things that I had never really thought of, but we need to be thinking about.

Kristine Sande: Right. So Dianne, there's another question regarding your statement there. Since we're all in frontier disasters, do you not necessarily receive disaster funding? What are you using to fund preparedness efforts?

Dianne Connery: Office of Emergency Management, for instance, provided the training. United Way has been a great partner to us, but then we're looking at USDA grants. But I think with some businesses coming in to our area, again, it's just about partnerships. But a lot of what we've done has not cost anything. It's just about opening up lines of communication.

Kristine Sande: Great. Thank you. Well, I think since we're coming up against the end of the hour, we will wrap up. Thanks again everybody for joining us today and to the speakers for their really interesting presentations and to our participants for joining us.