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The Potassium Iodide (KI) Community Awareness and Education Program

State: MI Type: Promising Practice Year: 2018

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Monroe County Health Department
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The Potassium Iodide (KI) Community Awareness and Education Program
The Potassium Iodide (KI) Community Awareness and Education Program The Monroe County Health Department is located in Monroe, Michigan and within the 10 Mile EPZ of the Enrico Fermi 2 Nuclear Power Plant. According to the Monroe County Emergency Management Division, there are 97,825 permanent residents living within the 10 Mile EPZ of the power plant. There also are people who commute to work in the 10 Mile EPZ and others, such as travelers, staying in area hotel rooms. In the unlikely event of a serious accident at the nuclear power plant one form of radiation, radioactive iodine, could be released into the air. This type of radiation can be stored in the thyroid gland from exposure to radioactive iodine. Potassium Iodide (KI) protects the thyroid from cancer by filling it up with a safe form of iodine so it cannot take in the radioactive iodine. Prior to April 2016, only 15% of the 10 Mile EPZ population had picked up KI. Though it is better to evacuate in a radiological event, and the public should always follow the direction of emergency management, the Monroe County Medical Reserve Corps (MRC) educated the public on the value of procuring a box of KI for each family's emergency kit and shared emergency preparedness information with them. Project goals: 1. To increase KI public awareness to protect the population and explain its effect on citizens' health in the unlikely event of a General Emergency in the 10 Mile EPZ of the Fermi Nuclear Power Plant. 2. To maximize residents' interest in receiving KI at specific local pharmacy locations. The Monroe County MRC worked diligently from April 2016 through April 2017 to develop and build a close relationship with all community partners that needed to be aware of the Potassium Iodide (KI) Community Awareness and Education Program. MRC requested, held meetings and communicated regularly with Monroe County Emergency Management, Detroit Edison Representatives, Kroger Pharmacy Representatives, Meijer Pharmacy Representatives, and the State of Michigan Department of Health and Human Services to ensure these pre-identified players were aware of and supported our education and outreach efforts. Every MRC email communication relating to the project was shared with all key players. In addition, the Monroe County MRC unit met three (3) times to brainstorm, plan and implement the KI Campaign. Key players were invited to these meetings also. The Monroe County MRC communicated with the State of Michigan Department of Health and Human Services (DHHS) to procure the voucher and education materials from them, and to ensure it understood the KI distribution process accurately. The Monroe County MRC was committed to sharing only messages approved by the MDHHS. Kroger donated the staffing time for their Pharmacists to attend four (4) community events with the Monroe County Medical Reserve Corps: Triumph Academy Open House/Emergency Preparedness Expo; 3rd Annual Emergency Preparedness Expo; Earth Day; and the Celebrate Children Festival. A minimum of two pharmacists attended each event; five pharmacists attended Earth Day. At these events, MRC Volunteers shared KI Fact Sheets to educate why they should request the free KI for their emergency kits, assisted with voucher completion, and also shared a plethora of emergency preparedness literature. In total, Monroe County MRC volunteers worked in tandem with Kroger Pharmacists who dispensed KI to 354 families at four community events. Meijer Pharmacists also expressed great interest in attending, but Kroger sent so many staff we did not require Meijer participation. This project was a success because we had pharmacists at events to directly dispense the KI. Our good relationship with the pharmacies was the key to the success of this project. In addition, MRC volunteers distributed hundreds of KI Fact Sheets and KI Vouchers in face-to-face encounters with the public. We do not know how many of these vouchers were redeemed at the pharmacy. This was one lesson learned: pharmacies do not keep electronic records in regards to KI dispensing; instead they put the completed vouchers in an envelope and, when it is full, send it to the State of Michigan for processing. The Monroe County MRC website is: www.co.monroe.mi.us/publichealthMRC
Many people living within the 10 Mile EPZ of the Enrico Fermi 2 Nuclear Power Plant are unprepared for a radiological event should there be a release from the power plant and a General Emergency is declared. There is a lack of understanding including the use of Potassium Iodide (KI). The population of Monroe County, Michigan is approximately 152,000 people. According to Monroe County Emergency Management, 97,825 persons live within the 10 Mile EPZ of the Enrico Fermi 2 Nuclear Power Plant. Despite the no-cost access of KI, only 15% of the population in Monroe and neighboring Wayne County has utilized this resource since 2009, according to the Michigan Department of Health and Human Services. In 2015 and early 2016, a total of 130 homes and 3 businesses picked up KI. At our four events August 2016 – April 2017 KI was dispensed directly to 354 families. In addition, Mall of Monroe management worked with Kroger to procure KI for all its business tenants. The Enrico Fermi 2 Nuclear Power Plant mails an informative DTE Preparedness Booklet annually to those addresses within the 10 Mile EPZ in Monroe. Inside the booklet are a KI Fact Sheet and KI Voucher from the MDHHS with instructions to take the voucher to a select pharmacy for the free KI to be dispensed. People must read the multipage booklet to learn about KI. In 2009, there was an article in the Monroe Evening News regarding the KI program. Most people are very interested in the face-to-face education encounter MRC offered and wanted preparedness information. Having pharmacists at local events where people can have their questions answered by a professional, receive the KI directly, and save a trip to the store is a huge timesaver. Mothers of young families were particularly interested and wanted to learn more to keep their families safe. Every year, people receive the DTE Preparedness Booklet, but it becomes routine and many do not read it. People appreciate the face-to-face reminder that this awareness campaign provided. One of our MRC volunteers, a firefighter, suggested a novel idea of dispensing KI at a Charter School Back-to-School Open House where his children attend. That school's administration is particularly interested in preparedness as the facility is located within the 10 Mile EPZ. The first MRC KI community event entailed assisting in organizing an emergency preparedness event at this Back-to-School Open House to dispense KI directly. MRC remained committed to only share accurate and pertinent information from a trusted authority. One of our original goals was to not incite panic with the KI Program as it has been available since 2009; KI is not new and we were very conscious to not scare or upset the community. To make the dispensing of it non threatening , we suggested contacting several agencies for this back-to-school kick off. We assisted in organizing a small community expo that included MRC helping parents with vouchers and pharmacists dispensing KI to them. MRC contacted our American Red Cross partner to offer fire extinguisher simulator demonstrations. The Monroe YMCA also attended the community expo, held in the gymnasium of the school, along with Monroe Bank and Trust. The small expo was well-received by the families, and the variety of vendors was appropriate for an elementary school setting. MRC received positive press in the Monroe News in regards to our participation. This was a new endeavor for Monroe County. We are not aware of anyone else doing a face-to-face outreach campaign to communicate the benefits of KI.
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MRC agreed to the following at the beginning of the project: 1. Understanding all print materials generated by our group must be approved by the Monroe County Health Department prior to dissemination, and all pre-identified partners be contacted regarding this MRC project and our efforts. 2. Consensus MRC needs to be educated about KI. 3. Agreement our MRC needs as many partners as possible to assist us with this positive educational outreach effort to create and share one message. 4. Agreement a focus on social media may help us reach the public. 5. We did not want to recreate the wheel.” MRC was committed to developing and building a close relationship with all community partners that needed to be aware of the Potassium Iodide (KI) Community Awareness and Education Program. MRC requested and held meetings and/or communicated regularly with Monroe County Emergency Management, Detroit Edison Representatives, Kroger Pharmacy Representatives, Meijer Pharmacy Representatives, and the State of Michigan Department of Health and Human Services to ensure all key players were aware of and supported our education and outreach efforts. All MRC email communication relating to the project was shared with all key players during the entire budget period. Following the meetings with the above parties, three MRC Meetings were held to brainstorm and implement the project. All key players were invited to participate in all MRC Meetings. The State of Michigan directive states KI should be dispensed only to those living, working, or going to school in the 10 Mile EPZ. The timeline for the practice was April 2016 through April 2017 until the NACCHO Challenge Award funding became exhausted. Suggestions were always welcome from all parties. Ironically, at the same time MRC was implementing its positive KI outreach campaign, a second grassroots group Alliance to Halt Fermi 3 with the theme Got KI?” was also focusing on KI, but with much negativity to DTE. The Alliance to Halt Fermi 3 was going door-to-door to request support that KI be mailed to all homes and businesses in Monroe County. The group also held a public forum Worried about a nuke accident?” that was front page news in our local newspaper. MRC did not wish to become associated with a negative KI campaign and worked hard to keep the two initiatives separate. However, the MRC Planner did contact the Alliance to Halt Fermi 3 leader to talk and sent KI Fact Sheets and KI Vouchers to her for the forum. The MRC Planner was graciously invited to appear on the forum panel, but due to a work conflict did not attend. The Monroe County Health Department hosts periodic Community Public Health Preparedness (CPHP) Meetings to share public health information and network with other agencies that would work together in an emergency. The MRC Planner shares and updates the group on its activities and projects at each meeting. In addition, MRC requests emails sent to CPHP members be forwarded on and shared with other interested parties. In addition, hundreds of KI vouchers, with accompanying education, were shared with the community through the Picnic in the Park, the Monroe County Health Department Health Fair, Community Public Health Preparedness (CPHP) Meeting, and numerous face-to-face encounters. However, these people must take the voucher to a select Kroger or Meijer Pharmacy to receive the KI. MRC requested Meijer Pharmacies place signage on their counters to educate customers that those living or working within the 10 Mile EPZ of Fermi are eligible to receive free KI. Kroger pharmacists investigated the suggestion to have a prerecorded KI blurb for people to listen to while on hold on the pharmacy telephone line. The MRC Planner also made the following presentations: KI information was shared with thirty (30) Monroe County school secretaries and support staff during a presentation at the annual School Reporting Seminar on August 18, 2016. MRC requested they take the information back to their schools and share by posting in a public place. Twenty-three (23) Eastern Michigan Student Nurses received KI Vouchers and accompanying education at a student nurse orientation at the Monroe County Health Department on September 7, 2016. Students were encouraged to share KI information in the community. Twenty-five (25) Monroe County Community College Student Nurses in a Leadership Class received KI vouchers and education at a presentation on Tuesday, October 18, 2016 at the college. Students were encouraged to share KI information in the community. MRC Planner presented to Eastern Michigan Nursing students and gave out 14 KI vouchers and education on 11/30/16. On January 6, 2017 the MRC Planner gave a college instructor 25 education and vouchers to disperse to the class she is teaching at MCCC. On January 11, 2017 the MRC Planner gave KI presentation to 14 students and 2 faculty at MCHD and distributed education and vouchers. February 21, 2017 MRC Planner gave 2 presentations to MCCC Students; one SNA group and the other a Leadership Class. Education and vouchers were available to all: 21 in one class and 35 in the other for a total of 56. Thursday, April 6, 2017 approximately fifteen (15 KI) vouchers and education were given out at a Mini Project Homeless Connect event at the Oaks Victory Village homeless shelter. A local Foot and Ankle specialist's office requested KI vouchers and education for their staff and patients. A link containing the details was sent to them on April 26, 2017. The Monroe County MRC received a total of 800 vouchers and education in English and Spanish. Some arrived in Arabic and those were given to another county so they could use them. The MRC Planner contacted individually every city, township and village administrator in Monroe County with a request to post KI vouchers and education on the community website and to post a hard copy of the same on a bulletin board. This was an ongoing project to share KI information 24/7 with our target audience. Most of those administrators contacted via phone on an individual basis were open to assisting. Our success rate was much less if the material was emailed to them without the accompanying phone call. It was the pharmacies idea to donate their staffing time and any travel expenses. This project would not have been as successful if MRC volunteers were only distributing the KI Vouchers one-by-one. MDHHS supplied two shipments of the KI Fact Sheets and KI Vouchers to us at no charge. MRC's largest expense was the Planner salary to plan MRC involvement in the community events, arrange for pharmacists and MRC Volunteers to participate, and to assist in publicizing the events using free social media, emails and press releases. With someone orchestrating the management of the event participation, there is very little expense involved in the project. It is important to target community events that are attended by large numbers of people that could be expected to reside in the 10 Mile EPZ to make the organization efforts worthwhile.
We learned many people do not know about KI and appreciate the opportunity to learn about it. From the Planner's personal perspective and experience at the community events, approximately 9 out of 10 people approached will be open to learning about KI and want to take a box home with them. Project goals: 1. To increase KI public awareness to protect the population and explain its effect on citizens' health in the unlikely event of a General Emergency in the 10 Mile EPZ of the Fermi Nuclear Power Plant. 2. To maximize residents' interest in receiving KI at specific local pharmacy locations. Twenty- three (23) MRC volunteers contributed 101 hours to reach an estimated 2,000 community members. We learned there is a considerable amount of face-to-face time on a one-on-one basis needed to explain what KI is and why the public should want it for their emergency kits. The educational outreach was time consuming and took a lot of effort. We misunderstood the KI inventory processes at Kroger and Meijer. We thought pharmacies would keep inventory numbers of the KI dispensed, but they do not keep electronic records on this. Instead, pharmacies collect the redeemed vouchers and when an envelope of them is full they send it to the State of Michigan. Thus, for this project we simply collected our numbers of boxes dispensed from the pharmacists at the conclusion of each event. Our numbers do not reflect the large numbers of KI that we expect to be reported at the state level from those persons redeeming the individual vouchers. Both Kroger and Meijer Pharmacies initially procured additional boxes of KI for this campaign so they did not run out. The pharmacies were extremely accommodating and helpful. The MRC Planner kept track of individual KI Fact Sheets and KI Vouchers distributed to small groups. However, we do not know the percentage of these that were redeemed. According to a December 6, 2017 email from Jennifer Beggs at the MDHHS our numbers are underreported to date. DHHS reports were analyzed as a starting point to understand how much KI was distributed since its implementation. No modifications were made as a result of the data findings.
The Planner learned the Monroe County MRC Unit took the project very seriously and wanted to do an outstanding job. Our MRC Volunteers were dedicated and happy to work on this project. One volunteer wrote a radio public service announcement, and another wrote a plan to include KI distribution in county schools. Kroger has contacted us following the conclusion of the project with a willingness to continue attending community events to dispense. Kroger rightfully enjoyed the recognition their generous community donation received, and their pharmacists seemed to enjoy collaborating and working with MRC Volunteers. One pharmacist is now a MRC volunteer due to his involvement and excitement about the project. His contributions were invaluable as he, prior to retirement, was in charge of all Kroger pharmacies in the State of Michigan. . Our MRC decided if we saved one person though our educational efforts we would be successful. Since 354 families at a minimum received KI, not including the many individual vouchers we expect were redeemed, we consider the project a success. Kroger offered to take KI with them to public flu clinics to continue to prepare those living, working or going to school in the 10 Mile EPZ. As funding for this project has ended, the Monroe County MRC is not actively working on the KI Project. As soon as additional funding is received, this project will be restarted. Once organized, the project can be replicated easily. We recommend these steps: 1. Adequate funding is available to staff/coordinate the project. 2. Communicate with all pre-identified partners so they know what MRC intends to do and supports the unit's goals and objectives. 3. Share all email communication with MRC volunteers and partners. 4. Ensure the MRC volunteers receive adequate training. 5. Identify large community events where there is a likely chance the target population will be in attendance. 6. Confirm there are adequate supplies including boxes of KI, required KI Fact Sheets and KI Vouchers for each event. 7. Assign MRC volunteers and locate volunteer pharmacists to staff the events to educate the public so EPZ residents can make an informed decision on whether to obtain it. 8. Share additional information/literature, including the importance of evacuation, to assist in emergency preparedness efforts.
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