S2AY Rural Health Network: Collaboration of Public Health Departments Enables Rapid Response

By Derrik Chrisler, S2AY Rural Health Network
The S2AY Rural Health Network, Inc., founded in 1997, is an affiliation of eight public health departments serving the
Finger Lakes and Southern regions of NY State. The Network has a Finger Lakes Public Health Alliance (FLPHA) Memorandum of Understanding, which facilitates the sharing of mutual aid across jurisdictional county lines in the event of a public health problem. The Cross-Jurisdictional Sharing arrangement is an Intermunicipal Agreement between nine counties, including Monroe (not rural) along with Livingston, Steuben, Yates, Schuyler, Chemung, Ontario, Wayne and Seneca.
Trust is imperative in any function but especially important when working with multiple jurisdictions such as is the case with the FLPHA MOU. The member counties have a long history of collaboration with one another and have developed beneficial relationships built on trust and understanding. Most of the member counties have been working together since 2002, and the founding counties have been collaborating since 1997 at the time of inception of the Network.
While the partner counties work together on many and varied projects, an example of the long standing trust and confidence shared between members can be seen through the most recent activation of the agreement. During November of 2015 there was a public health emergency identified as a Hepatitis A Response as a result of the infection of a food worker located in Seneca County. The outbreak was identified on November 12, 2015 and by 3:00PM, the Public Health Director had communicated with the NYSDOH and notified the County Manager that they would be activating the Intermunicipal Agreement. All member counties responded positively to the request and provided staff, supplies and other resources as required, starting with a large public clinic on Saturday, November 14.
Clinics were held each day during the period, November 14th-20th, additionally it was discovered from follow up investigations that a second food service worker at a different local restaurant had tested positive for Hepatitis A. As a result additional clinics were held on December 3rd,7th and 10th. Seneca County only has a population of about 35,000 people, and has only two nurses, and two nursing supervisors. Without the extensive assistance provided through the
mutual aid plan, which would not have developed and executed if it wasn't for the history and trust shared between the member counties, there is absolutely no way residents could have been vaccinated in time for the vaccination to be effective.
The FLPHA MOU has seen great success as a collaborative tool between all members. FLPHA Mutual Aid Agreement was critical in obtaining staff to start up the initial two clinics during the Hepatitis A situation. Member county partners responded quickly to the request for assistance. The use of the Integrated Health Alert & Notification System (IHANS) to rapidly notify FLPHA partners and activate the Mutual Aid Agreement was a significant strength during the process.
While this emergency in Seneca County has been the only instance that has required the full activation of the FLPHA MOU since its inception, the member counties have also seen success through other preventative preparedness activities such as drills and regular updating and tweaking of the existing plan and processes.
The S2AY Rural Health Network is a unique collaboration of Public Health Departments serving the Finger Lakes region. The counties that are located in the Finger Lakes and Southern Tier have a strong sense of identity and connectedness to the region as a whole, and the Public Health Directors of the eight counties meet together every month. Monroe County, our urban partner, is included in FLPHA because they are so much larger than all of the rural counties combined, and in any kind of great disaster will be key to keeping the region safe. This sense of togetherness and long history of working successfully has cultivated a strong sense of regional identity and pride to be a member of the S2AY Network.
Members of the S2AY Rural Health Network have been working together since its inception in 1997. The counties and staff from the Network have worked in collaboration on countless projects over the last 20 years and will continue to do so into the future.
The FLPHA MOU has had sufficient senior level support from key members within each supporting county. The Public Health Directors participated and provided input into the guiding policies and procedures, as well as solicited input from the Senior Public Health Educators and Emergency Planners from each county. The MOU had to be approved by nine county attorneys. After the document was reviewed and finalized, the Public Health Directors presented it to either their County Legislature or County Board of Supervisors as a resolution to be approved. All county elected officials or supervisors approved the resolution to adopt the Intermunicipal Agreement for the defined services.
Most recently, the Network was awarded a small grant from the Center for Sharing Public Health Services to improve the regionalization capabilities of the FLPHA MOU. The objectives outlined within this project are to improve on the existing FLPHA agreement based on weaknesses identified during the recent activation. Efforts will be spent to better operationalize efforts during a public health emergency specific to policies and procedures for outbreaks.