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January 2003                                                 Volume 3 - Number 4

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Preparation and Mitigation...

IL and Terrorism/Bioterrorism Preparedness
Molly Weber
 
Illinois, like other states across the country, is actively expanding and strengthening its preparedness and ability to respond to a terrorist event following the terrorist attacks on Washington, DC and New York City in September 2001.  The state has created the Illinois Office of Homeland Security, the Illinois Terrorism Task Force, the State of Illinois Homeland Security Advisory System and a brochure for the public to complement the system, among numerous other activities involving state and local agencies, including the Illinois Department of Public Health.

In May 2000, Governor George Ryan signed an executive order creating the first-ever statewide Terrorism Task Force (ITTF).  The Task Force is charged with ensuring Illinois is prepared to respond to a terrorist attack.  The ITTF is building on cooperation and preparedness generated during planning for a possible Y2K crisis. 

The mission of the Illinois Terrorism Task Force is “to implement a comprehensive coordinated strategy for domestic preparedness in the state of Illinois, bringing together agencies, organizations and associations representing all disciplines in the war against terrorism (IL Homeland Security website, www.illinoishomelandsecurity.org).”  The Task Force is also responsible for ensuring rapid response capability and basic WMD first responder training throughout the entire state.  Illinois Emergency Management Agency Director Mike Chamness and First Deputy Director of the Illinois State Police (ISP) Doug Brown head the Terrorism Task Force.  (See Appendix A for a full Task Force membership list.)
The ITTF consists of nine standing committees, each focusing on a major issue in terrorism preparation and response.  The committees include:
•    Crisis Response, chaired by State Police;
•    Bioterrorism, chaired by Public Health;
•    Communications, chaired by the City of Chicago;
•    Training, co-chaired by the Illinois Fire Service Institute and the Illinois Law Enforcement Training and Standards Board;
•    Public Information, co-chaired by the Office of the State Fire Marshal and the Illinois National Guard;
•    Volunteers and Donations, chaired by the Governor’s Office;
•    Transportation, chaired by the Illinois Department of Transportation;
•    Information Technology, chaired by the Illinois Technology Office; and
•    Elected Officials, chaired by the Illinois Municipal League.

The Task Force also includes a working group to discuss continuity of business and government as well as a working group for the National Threat Advisory System issued by the National Office of Homeland Security. 

Throughout 2001, the Crisis Response/Prevention Committee focused its efforts on training the Weapons of Mass Destruction Teams (SWMD); obtaining related equipment; forming SWMD protocols and procedures; and generating partnerships with local emergency management, local police and fire service agencies and federal agencies.  The committee also conducted presentations to the public regarding Homeland Defense.

The SWMD mission is to “respond to a Weapons of Mass Destruction incident, anywhere in the State of Illinois, within 60 to 90 minutes of notification and to provide all avenues of assistance from the State of Illinois to the local Incident Command and the appropriate federal agencies responsible for the investigation and mitigation of such an incident (Homeland Security in Illinois, 28).”  The teams are composed of State employees from the Illinois State Police, Illinois Environmental Protection Agency, Illinois Department of Nuclear Safety, IEMA, IDPH, Illinois Secretary of State and the Office of the State Fire Marshal.
The Central Illinois SWMD team finished the three critical hazardous material training courses in June 2001.  These courses consisted of 125 hours of training conducted by the Illinois Fire Service Institute.  In early November, the North and South SWMD teams fulfilled two of the required courses; both teams completed the final course in January and graduated on January 11, 2002.  Several members of the SWMD teams also completed a sixteen hour Basic Concepts of Terrorism Course.  Further training in specific disciplines, conducted by a variety of SWMD agencies, is in the planning stages, as is advanced specialized training on the national level. 

Beyond the training activities, the Committee supervised the identification and specification of nearly $4.1 million dollars of equipment procured for the SWMD’s personnel (Homeland Security in Illinois, 10).  Partnerships were formed with local emergency management agencies, local fire service organizations, which include the MABAS and Combined Area Response Team, local police agencies, Illinois National Guard Civil Support Team and the FBI, including both the Chicago and Springfield divisions.  The Committee acts as the liaison between the ITTF and the FBI.

The fundamental objectives tasked to the Bioterrorism Committee include: study of current health issues, including potential biological agent release scenarios; define public health response and prevention methods; organize a consistent and clear message regarding public action recommendations; and assess results of state and local exercise, threats and real incidents.  The Committee is also responsible for forming Illinois’ plan to manage medical material from the National Pharmaceutical Stockpile (NPS), maintained by the CDC.

The Training Committee was formed to delineate and prioritize a training program.  The Illinois Fire Service Institute (IFSI) and the Illinois Law Enforcement Training and Standards Board (ILETSB) co-chair this committee, which includes representatives from numerous state agencies.  The Committee retooled a concept program originally approved and implemented in May 2000 after the events of September 11, 2001.  The work of Chief John Eversole and the special operations staff of the Chicago Fire Department implemented following the Federal anti-terrorism legislation in 1996-98 served as a framework for Illinois’ current training program.    The ultimate goal of the terrorism training program is to advance local, regional and state interagency and unified command response to a terrorist event of any kind, while at the same time prepare for any significant emergency necessitating interagency coordination.  The program focuses on three primary groups important in any incident response, SWMD teams, first responders, and all state and local government employees and key local decision-makers within the elected, appointed and private spheres.  (Detailed objectives of the Illinois training program are provided in Appendix B.)

The State training program conducted 968 classes, with 15,052 first responders, in addition to 3,127 officials and citizens, attending the Governor’s Homeland Security Regional Training Seminars, compiling 145,276 student hours of training in 2002.  The seminars’ training schemes were generated from national terrorism and HAZMAT curriculum and standards established for first responders.  A group of statewide instructors formed following a series of Train-the-Trainer workshops, with instructor kits produced and distributed.

The efforts of the Illinois training program have produced three operational and deployable SWMD teams; an anti-terrorism curriculum and capable instructors; a fully-functioning inter-agency command and control system to coordinate counter-terrorist response; and twenty-seven HAZMAT Level A technical teams, in addition to five Level B teams, more than thirty special rescue teams, bomb squads, dog teams and other special operations teams ready for deployment.  Not only have many of these personnel attended training in Illinois, but several have also completed training at the national level. 

The City of Chicago chairs the Communications Committee, which focuses on interoperable communications within Illinois.  To effectively respond and manage an emergency or incident all agencies, fire, law enforcement, or emergency management, must be able to communicate with one another.  This committee is further divided into four subcommittees to address fire, health, incident/emergency management and police.  The primary goal of the Communications Committee is to design a plan, involving equipment, use of technology, Internet, and Intranet, to enhance information dissemination between federal, state and local agencies.

Providing vital information to the public concerning homeland security and preparing in the event of an emergency is the responsibility of the Public Information Committee.  Illinois has designed a state homeland security website (www.illinoishomelandsecurity.org).  The website provides a variety of information related to terrorism and preparedness and other relevant topics.  In the future, emergency responders will be able to access precise information using an electronic signature or limited access basis.   The ability for responders to conference via the Internet to share information and assistance in managing a specific threat is in progress as well.  Currently, emergency responders have access to video conferencing, allowing voice and visual communications; it is operable at hundreds of locations in each region of Illinois.  The committee is also generating a series of public announcements, which will be available in English, Spanish and with closed captioning.  Several county health and emergency departments have produced terrorism preparedness and response brochures for the public, including McLean, Cook and Kane counties, which are also available on their websites.

In February 2002, ITTF created the Volunteers and Donations Committee to analyze volunteerism during terrorist incidents and everyday settings, as well as managing the high volume of donations that pour in during a destructive event.  To help manage the entire incident, the Committee is looking into designing “disaster asset management software,” a web-based application for agencies to use to “collect, classify and manage non-tactical emergency management assets in a manner so as to allow rapid acquisition before, during and after an emergency (Illinois Homeland Security, 16).”  It will also manage government assets and public donations, ranging from food, personnel and hardware.  This committee is also charged with creating an approach to develop and integrate President Bush’s Citizens Corps program.  The enormity of the job tasked to the Committee led to a split into three subcommittees: Volunteers, Donations and Citizen Corps.

The Transportation Committee was formed, “to maximize security of the Illinois transportation system for the movement of people and goods by ensuring that transportation professionals have available and utilize the tools, training, and methods jointly considered most effective to protect our citizens and Illinois’ investments in transportation infrastructure (Illinois Homeland Security, 16).  Within their realm is the task of forming recommendations and proposals regarding transportation safety and all things related to establishing and maintaining that safety and security.  The group must include industry leaders when researching and creating their findings and plans. 

    The ITTF, working within the Illinois Office of Homeland Security, has created the State of Illinois Homeland Security Advisory System.  Illinois’ system mirrors recommendations of the system created by the National Homeland Security Office.  The Task Force published a set of guidelines to assist county and municipal governments implement the advisory system.  The handbook outlines the dissemination of threat condition advisories within Illinois (see Appendix C for dissemination flowchart), as well as details what each threat condition means and the actions officials should take for each condition.  It also includes a sample checklist to ensure all key officials and departments have been notified when an advisory is posted.
   
The Illinois Office of Homeland Security and the Task Force have partnered with the American Red Cross to produce the brochure, “Homeland Security Begins at Home.”  The pamphlet details actions citizens can take to prepare at every level contained in the Homeland Security Advisory System.
Illinois is pursuing Federal grants to fund many of the large-scale projects implemented by the ITTF.  One such grant program is the CDC and HRSA Bioterrorism Preparedness and Response Grants, administered by the Department of Health and Human Services at the national level.  On January 10, 2002, President George W. Bush signed legislation appropriating $2.9 billion for Health and Human Services (HHS) for the purpose of preparing for the bioterrorism threat.  States, local governments and the private sector will work with HHS to construct the new public health infrastructure necessary in the face of such a threat and to increase and generate new research into bioterror diseases.

Illinois’ grant application to the HHS was submitted on April 12, 2002.  The IDPH along with the City of Chicago and additional federal projects will oversee the funds.  The money will be used to build on the efforts IDPH began following the State Homeland Security Bill put forward by Governor George Ryan.  The federal money will be used to further current projects involving complete bioterrorism preparedness plans, improving infectious disease surveillance and investigation, prepare hospital systems for large casualty events, enlarge public health laboratory and communications capacities.  Some of the major individual projects include:

•    Development of Illinois National Electronic Disease Surveillance System (I-NEDSS) – It will expedite information transfer from clinical information systems in the health care industry to local health departments (LHD) and IDPH, via the Internet;
•    Establish a Hospital Health Alert Network (HHAN) in addition to expansion of the HAN network used between LHDs and the IDPH;
•    Facilitate the development of model regional hospital preparedness plans;
•    Provide direct funding to hospitals to implement core preparedness standards; and
•    Establish core preparedness standards for the three-tiered facility classification system.

      (Illinois Homeland Security, 32)

On June 7, 2002, HHS Secretary Tommy Thompson announced Illinois would receive an initial package of $20,841,525 from the CDC and HRSA Bioterrorism Preparedness and Response grant program, while the City of Chicago would receive $10,255,397.  Once Illinois sufficiently addresses the weaknesses HHS highlighted within their plan the state will receive an additional $3,271,079.  To receive the full funding allocation, Illinois must provide in depth plans for receipt of the National Pharmaceutical Stockpile, as well as regional plans for the vaccination or distribution of antibiotics to the whole population within a period of three to five days.  Also, HHS requires plans in each hospital region for a surge of 500 acutely ill patients.  Each hospital must establish an isolation area in their emergency departments, with the intent of preventing the spread of communicable diseases (Letter to IL from Director of HHS/Office of Public Health Preparedness).  In total, Illinois will receive $30,140,755 and the City of Chicago will receive $12,819,246 (IDPH website, www.idph.state.il.us).  A detailed breakdown of the HHS funding is outlined in Appendix D.

Illinois has made great strides since the formation of the Illinois Terrorism Task Force in May 2000, particularly in the last year.  Many of the implementations within Illinois follow along the recommendations produced by the Executive Session on Domestic Preparedness, John F. Kennedy School of Government, Harvard University in the memorandum, Intergovernmental Dimensions of Domestic Preparedness, to Tom Ridge, Director of the National Office of Homeland Security in November 2001.  In the area of preparedness, the Session advocates “cross-jurisdictional and cross-professional cooperation and coordination between agencies, non-governmental private and not-for profit organizations and levels of government that are not accustomed to working together.”  Illinois exemplifies this in the progress the Terrorism Task Force has made since its inception.  MABAS, HAN/HHAN, I-NEDSS and the Illinois Integrated Justice Information Systems (IJIS) Initiative, as well as the SWMD, IMERT and Technical Response Teams (TRT) are all examples of cross-communication and cooperation.

Illinois’ training program focuses on terrorism and mass casualty events, but does so in an all-hazards approach.  The equipment the state has purchased and the training received by first responders can translate to a vast area of incidents, whether man-made or naturally occurring.  The Session states that by using an all-hazards approach, “response agencies will use plans and skills regularly, thus ensuring that agencies are well versed in response protocol, and experienced in working together (Intergovernmental Dimensions of Domestic Preparedness).”  The training conducted in Illinois also meets the principles of specialized training in bioterror response and sustained training to maintain skills.
   
The Executive Session on Domestic Preparedness emphasizes the need for interoperability in all areas.  Currently, ITTF has a committee established concentrating on establishing interoperability of all communications systems in Illinois.  Concurrently, training in incident command is on-going throughout the state.  All of     the state’s Special Operations Teams are part of or in the process of becoming part of the statewide response plan, having signed on to a set of standards, procedures, inventories and minimal qualifications.  All incident operations equipment is also undergoing standardization whenever possible.
   
The sum total of the ITTF’s activities shows that Illinois has placed interoperability and, most importantly, the preparation and security of its citizens as top priorities.  The state has made great strides in preparedness and response plans since the ITTF was formed in 2000, but still has a fair amount to accomplish in interoperability of all aspects of communication and expansion of HAN/HHAN networks.  It must also aggressively pursue actions necessary to bring the hospitals to an acceptable level of preparedness.  Illinois would definitely benefit funding preparedness funding currently stalled in Congress.  If the government wants to prepare and protect the homeland for a future attack, the $3.5 billion in first responder assistance sought by President Bush throughout the last year needs to be approved by the 108th Congress.  The money would help Illinois and other states continue building and strengthening their preparedness, as well as maintain their current level of readiness.  The key to successful preparation is maintenance.

Appendix A
Illinois Terrorism Task Force Membership

Illinois Emergency Management Agency, Chair
Illinois Department of State Police, Vice Chair
Illinois Environmental Protection Agency
Illinois Law Enforcement Training and Standards Board
Illinois Department of Military Affairs
Illinois Department of Nuclear Safety
Illinois Department of Public Health
Illinois Fire Service Institute
Illinois Office of the State Fire Marshal
Illinois Attorney General’s Office
Secretary of State Police
American Red Cross
Illinois Department of Transportation
Illinois Department of Agriculture
Illinois Department of Corrections
Cook County ESDA
Dupage County ESDA
Federal Bureau of Investigation (North)
Federal Bureau of Investigation (South)
Governor’s Office
Illinois Association of the Chiefs of Police
Illinois Emergency Services Management Association
Illinois Fire Chief’s Association
Illinois Sheriff’s Association
Kane County ESDA
Lake County ESDA
Mutual Aid Box Alarm System (MABAS)
North Aurora ESDA
IL Association of Public Health Administrators
City of Chicago
Illinois College of Emergency Physicians
Illinois Hospital & Healthsystems Association
Associated Fire Fighters of Illinois
US Attorney’s Office
Illinois Education Association
Archer-Daniels-Midland (ADM)
Regional Superintendent of Schools
Illinois Municipal League
Central Management Services

Appendix B
ITTF Training Committee – Training Objectives

The following eight training objectives are part of Illinois’ multi-year program:

1.    Train the State Weapons of Mass Destruction Teams (SWMD) and individual SWMD team members to a level of competency that will permit them to safely enter, exit and function within an isolation hot zone at a terrorist event.
2.    Establish a statewide program of training for local first responders to provide a basic level of knowledge and skills for first response and initial scene management and incident command.
3.    To provide incident command systems training that will ensure that incident commanders, local and State Emergency Operations Center process and protocols can effectively direct emergency response and coordinate with federal response to a terrorist incident.
4.    Provide technical training for specialized response teams (HAZMAT, specialized rescue, bomb squad, Technical Rescue Teams, dog teams, etc.) that can be deployed statewide in a crisis.
5.    Make terrorism awareness information available locally, regionally and at the state level.
6.    Provide events and information that will achieve “buy-in” for implementation of critical homeland security programs by local region and state government and public organization decision-makers.
7.    Provide weapons of mass destruction/homeland defense training to public health and medical preparedness and response staff.
8.    Provide training and education to assist in prevention, preemption and intelligence fusion.  This new objective was established to address a need for crisis management training in addition to consequence management training.
(Homeland Security in Illinois, 13)



Appendix C
 
(IL Emergency Management Agency)


Appendix D

Illinois
Status of Funds Under HHS Cooperative Agreements Issued By CDC and HRSA
June 6, 2002


                     Public Health Preparedness       Hospital Plan       TOTAL
                                    (CDC)                             (HRSA)

1. Total amount allocated under    $26,201,381                $3,939,374             $30,140,755
    HHS formula       
2. Amount initially available for     $5,240,276                $787,875           $6,028,151
    State’s use (20% of the formula
    Allocation)
3. Additional amount being made     $20,841,525                $0           $20,841,525
    available after review of State
    plan
4. Amount subject to further         $119, 580*                $3,151,499**       $3,271,079
    consideration prior to release


* HHS will work with the State to resolve questions regarding the proposed use of $119, 5880 for the upgrade of agricultural laboratory space.

** HHS will work with the State to obtain the additional information needed to complete the review and present the work plan to Secretary Thompson for approval.



(U.S. Department of Health and Human Services)


Acronyms

CART – Combined Area Response Team
CDC – Centers for Disease Control
CST – National Guard Fifth Civil Support Team
HAN/HHAN – Health Alert Network/Hospital Health Alert Network
HRSA – Human Resources and Services Administration
IDPH – Illinois Department of Public Health
IEMA – Illinois Emergency Management Agency
IFSI – Illinois Fire Service Institute
ILETSB – Illinois Law Enforcement Training and Standards Board
IMERT – Illinois Medical Emergency Response Teams
I-NEDSS – Illinois National Electronic Disease Surveillance System
ISP – Illinois State Police
ITTF – Illinois Terrorism Task Force
LHD – Local Health Department
MABAS – Mutual Aid Box Alarm System
NPS – National Pharmaceutical Stockpile
SWMD – State Weapons of Mass Destruction teams
TRT – Technical Response Teams


For further information concerning terrorism and bioterrorism preparedness and response, in particular details related to Illinois, please visit the following websites:

U.S. Department of Homeland Security     www.whitehouse.gov/homeland
IL Office of Homeland Security        www.illinoishomelandsecurity.org
FBI                        www.fbi.gov
Federal Emergency Management Agency    www.fema.gov
IL Emergency Management Agency        www.state.il.us/iema
American Red Cross                www.redcross.org
IL Department of Nuclear Safety        www.state.il.us/idns
IL Department of Public Health        www.idph.state.il.us
IL Environmental Protection Agency        www.epa.state.il.us
IL State Police                    www.isp.state.il.us
Office of the State Fire Marshal        www.state.il.us/osfm
U.S. Dept. of Health & Human Services    www.hhs.gov


Bibliography
“Bioterrorism: Facts and Information.” Kane County Health Department. www.kanehealth.com

Illinois Office of Homeland Security.     http://www.illinoishomelandsecurity.org
    “County and Municipal Government Guidelines for Implementation of the State of
Illinois Homeland Security Advisory System.”
“Homeland Security Begins at Home.”
“Homeland Security in Illinois.”

“IDPH Submits Proposals to Spend $29.4 Million for Bioterrorism Preparedness.” Public Health
Futures Illinois Newsletter. http://app.idph.state.il.us/phfi_apr2002.asp

“Illinois Homeland Security Update.” Illinois Municipal League. http://www.iml.org/newspub/

“Illinois Receives $20 Million for Bioterrorism Preparedness Plan.” Illinois Department of
Public Health. http://www.idph.state.il.us/home.htm

Illinois Department of Public Health Intranet System. Courtesy of Henderson County
Health Department.

“Illinois Status of Funds Under HHS Cooperative Agreements Issued By CDC and HRSA.” U.S.
Department of Health and Human Services.  www.hhs.gov/ophp/funding/illinois.html

Intergovernmental Dimensions of Domestic Preparedness. The Executive Session on Domestic
Preparedness, John F. Kennedy School of Government, Harvard University. Cambridge,
MA: Nov. 2001.

Kelly, John and Stark, David. Crisis, Recovery, Innovation: Responsive Organization after
September 11th. Center on Organizational Innovation, Columbia University. New York,
NY: May 2002.

“Letter to IL from Director of HHS/Office of Public Health Preparedness.” National Association
of County and City Health Preparedness. http://www.naccho.org

National Office of Homeland Security. http://www.whitehouse.gov/deptofhomeland/

Skove, Thomas M. “Going Forward after September 11: Emergency Response and
Preparedness.” Roetzel & Andress: Newsletter. Nov. 2001.

“What You Can Do.” McLean County Health Department.
http://www.mclean.gov/Health/Bioterrorism.htm

“Update – Illinois Hospital Emergency Preparedness Grant Program.”  Illinois Hospital
Association. http://www.ihatoday.org