March 9, 2020

March 9, 2020
Commissioners Robert ‘Pits’ DeArmond, Scott Blain, and Bill Bullock; Commissioners’ Secretary Barbara Daniel; Administrative Officer Angela Newell; Clerk and Recorder Christine Stovall; Sanitarian Cortney Lynde, Superintendent Assistant Lori Kane; Beartooth Billings Clinic CEO Kelley Evans; Beartooth Billings Clinic Director of Community Services Brandi Mains, Beartooth Billings Clinic Community Relations Coordinator Maggie Karas; Public Health Nurse Sheila Boggio; Red Lodge Chief of Police Jason Wells; Public Health Nurse Roberta Cady; Beartooth Billings Clinic Emergency Preparedness Contractor Jason Mahoney; Red Lodge Fire Chief Tom Kuntz; DES Coordinator Tom Kohley; Deputy DES Coordinator Annie Gillespie; Public Health Officer Dr. Bill George; Red Lodge Fire Rescue Public Information Officer Amy Hyfield; Sheriff Josh McQuillan, and MSU Nursing student Megan Hogue were present.
10:00 Dr. George gave overview of the current COVID-19 situation reporting 566 cases in 34 states. A number of states have declared a state of emergency and instituted school closures due to relatives having exposure. States are doing more testing are therefore finding more cases. Much is still unknown about the virus. At this time the country is in containment mode as there are no cities with widespread infection. Protocols will shift to mitigation once there is widespread infection. Noted COVID-19 is spreading quicker than flu and is deadlier than flu. Experts hope that with more testing mortality rates will go down, but it has not yet.
Kohley gave an overview of last week’s meeting. Commissioners authorized additional nursing staff for Public Health and stood up an Incident Management Team. Kohley has met with professionals experienced in Incident Command (IC). Bernard met with Jason Mahoney and Dr. George on Sunday. Discussed phases in planning cycle, vulnerable populations, role of the management team vs. the role of other facilities’ administration (daycares, senior assisted living, etc.). Kohley discussed the difference in this response vs. a fire in that the State will not dispatch IC team like they would in a fire; the incident will have to be mostly managed internally.
Kuntz noted there is general national agreement that the virus is going to have a large economic effect, though the extent cannot be known at this time. The County needs to balance its role in mitigating the impact.
Mahoney provided an overview of Yellowstone County’s Unified Health Command and encouraged immediate stakeholder involvement and implementation of emergency plans locally.
Evans noted that the Montana Department of Public Health and Human Services recommended that hospitals stand up their own Hospital Incident Command and partner with other entities in their counties.
Commissioner Bullock stated that FEMA is not involved at this time. As County Health Officer, Dr. George has the authority to mandate closures of schools and business owners, should it become necessary.
Cady stated that Public Health is in the preparedness phase. Boggio sent prevention guidelines to all school superintendents and met individually to discuss triggers that would cause schools to shut down and reported that the general sentiment is that when the first case reaches the County, schools will close.
Kuntz noted the cascade effect from individual decision makers. For example, one school closure could have a cascade effect on multiple other organizations (other schools, daycares, Boys & Girls Club) and parents (ex: first responders) will need to stay home to care for children who are home. The team needs to adopt broad decision-making processes so that single decisions don’t have unanticipated, negative effects.
Cady stated that if a suspected case arrives at the clinic, the protocol is to contact Public Health who will consult with the state epidemiologist who will determine if the patient meets criteria for a Person-Under-Investigation or testing. The patient will home quarantine for 14 days and communicate via tele-medicine.
Mahoney, Kuntz and Kohley discussed command structure options, roles, and responsibilities. Mahoney and Kohley will be joint Incident Commanders.
Discussion regarding allocation of funds. Commissioner Bullock moved to allocate $5k for COVID-19 planning activities; Commissioner DeArmond seconded; motion carried. Evans offered that Beartooth Hospital will match $5k.
Newell warned of possible Information Technology risks citing an increase in opportunistic criminal activity due to COVID-19.
Evans expressed concern over mask supply; Kuntz added that they are unable to complete mask fit testing so as not to deplete their supply. McQuillan would like to add a pre-screening triage to dispatch procedures.
12:00 Adjourned.

Respectfully submitted: Barbara Daniel, Commissioners’ Secretary