PARTIAL STRAWMAN DRAFT

HOSPITAL BIOTERRORISM PREPAREDNESS OPTIMIZATION

AN UNSOLICITED TASK ORDER PROPOSAL SUBMITTED

TO THE GREATER SOUTHEAST COMMUNITY HOSPITAL

by

Applied Health Systems LLC

2205 40^th Place, N.W. #1
Washington, D.C. 20007

Phone: (202) 965-5370 e-mail: riccampbell2000@yahoo.com

Rick Campbell, General Manager

Claude Lawrence Cornett, Jr., Senior Program Coordinator/Principal Investigator

Dr. Edward Cornett, Senior Medical Investigator

Robert Wilpbank, Senior Technical Systems Investigator http://www.MedicalAirSolutions.com

For Funding and Tasking Under:

Task-order Contract by Greater Southeast Community Hospital to Applied Health Systems LLC

Proposed Duration: One Year, with potential expansion for up to five years

Amount Requested: Not to exceed $2,000,000 for first Year. Potential doubling for each

additional year

Requested Starting Date: January 1, 2005

Type of Business: Contract and Consulting Services

Principal Investigator: Claude Lawrence Cornett, Jr.

Phone: (216) 216-583-0007 e-mail: lcornett@en.com

Business Contact: Rick Campbell

Phone: (202) 338-6079 e-mail: riccampbell2000@yahoo.com

Date of Submission: December 7, 2004 2:10 AM

This proposal may be subject to external review

TABLE OF CONTENTS

                                                            Page
 
 
ABSTRACT. . . . . . . . . . . . . . . . . . . . . . . . . .   3
SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . .   4
 Purpose . . . . . . . . . . . . . . . . . . . . . . . . 4
 Scope . . . . . . . . . . . . . . . . . . . . . . . . .  4
 Start up  . . . . . . . . . . . . . . . . . . . . . . . 7
 Implementation  . . . . . . . . . . . . . . . . . . . .  7
 
PROJECT PARTICIPANTS. . . . . . . . . . . . . . . . . . . .  8
 
BUSINESS AND FINANCIAL INFORMATION. . . . . . . . . . . . . 12
 
BIBLIOGRAPHY. . . . . . . . . . . . . . . . . . . . . . . .  13
 

ABSTRACT

This proposal is a task-order contract to provide services to help the Greater Southwest Community Hospital investigate, design and implement improvements to its preparedness for detecting and responding to suspected and actual bioterrorism. Aspects of the program include:

* A detailed evaluation of preparedness of the hospital and related resources

* The identification of equipment and programs needed to respond to incidents of different severity

* The rapid implementation of such improvements as are possible within the limits of immediately available resources

* Obtaining additional resources for further improvements and implementing these improvements.

* Coordination with related local, regional, national, and international programs.

Since the work is under a task-order contract, decision-makers will have the flexibility and authority to change priorities, schedules, funding, etc., as they deem necessary -- within the limits of available resources.

SUMMARY

The Purpose of this project is to rapidly determine and implement such improvements to the readiness of Greater Southeast Community Hospital (GSECH) to detect and respond to suspected and actual bioterrorism as are feasible within the limits of resources available. The project also involves the rapid identification of resources potentially available, obtaining these resources, and implementing and assessing the improvements that they make possible. While the program is focused on improving the ability of the hospital to provide services to patients exposed to Category A and B chemical and biological agents, other needs will be appropriately factor in.

The Scope of Work of the program may include (if requested by the hospital) assisting hospital personnel and contractors in:

I. Summarizing the current preparedness of GSECH for chemical and biological preparedness using the American Hospital Association Chemical and Bioterrorism Preparedness Checklist, and such other means as are necessary and appropriate

II. Implementing programs to improve hospital readiness, including:

A. The development of a comprehensive modus operandi to prepare for bioterrorism emergencies and providing related training, evaluations and incentives to hospital staff

B. The identification of the equipment needs associated with different numbers of patients and potential patients from terrorist incidents of varying severity

C. Increasing the number of available beds, intensive care units, respiratory isolation beds, quarantine areas, support equipment, etc. available for chemical and biological emergencies using:

1. Improvements to and/or expansions of hospital facilities -- including appropriate temporary utilization of hall and other space, improvements to and expansions of hospital ventilation, filtration, decontamination, personal protective equipment (including SCBA and other respiratory protection equipment), structures, etc.

2. The deployment and utilization of temporary facilities, including portable installations within and outside the hospital. These facilities may include decontamination, isolation, patient treatment, and/or related facilities

a. Stored at the hospital and

b. Available from other locations (including rapid deployment of field hospitals, equipment and personnel from military and other programs responding to emergencies) -- along with the hospital personnel, training and equipment needed to effectively interface with these resources

3. Appropriate Triage, including the cancellation of elective surgeries and the transfer of appropriate patients to other facilities to make more beds and facilities available to deal with urgent chemical and biological emergency needs

D. Improved inventories of vaccines, pharmaceuticals, antidotes on site, mechanisms to quickly obtain such substances from other sources, and the personnel and equipment needed to administer them to victims and potential victims

E. Improved collection, transportation, handling, identification, and analysis of specimens, along with the communication and interpretation of results

F. Appropriate systems to improve patient identification, tracking, scheduling, and related information processing and communication. The objective is to improve the speed, accuracy, quality, efficiency, and effectiveness of hospital services. Such services include the

1. Rapid identification and appropriate reporting and processing of constellations of symptoms for appropriate patient diagnosis, including those associated with exposure to chemical and biological agents

2. Interactive coordination of scheduling to deploy patients, medical personnel, services, and equipment where and when they are most efficiently interfaced (minimizing waiting time for patients, doctors and facilities), thus improving the capacity of the hospital to provide services with available personnel and equipment

Compliance with CDC, NIOSH, JCAHO and other pertinent requirements and recommendations will be considered throughout the program

This work includes identifying alternative approaches to meet the aforementioned objectives and summarizing their merits and limitations. Such studies are designed to help decision-makers make informed decisions on which alternatives to fund and authorize.

The first year of this project may proceed in several phases:

* Phase 1, Start-Up is an investigation and summary of what is known about the current preparedness and limitations of Greater Southwest Community Hospital and pertinent regional and national programs – along with plans for improvement, the identification of key contacts, and the prioritization of areas requiring more research.

* Phase 2 Evalation, will focus on:

- Tests and evaluations of existing and possible future programs

- Performing and summarizing surveys of pertinent capabilities, their limits, and options to improve preparedness

- Defining alternative general options for programs to improve preparedness, along with summaries of their merits, limitations, impacts, order of magnitude costs, and uncertainties

The objective is to provide decision-makers with information needed to select which actions to fund and implement.

* Phase 3, Remedial Action Design includes the costing and specification of actions selected by decision-makers in sufficient detail to budget and schedule projects and to procure them.

* Phase 4, Program Implementation may involve:

- The specification, selection, purchase, installation, testing, operation and maintenance of equipment and contracts providing access to additional equipment and services

- Training (including providing training films that include bloopers from footage gathered during field exercises)

- The development of new programs after those in authority decide which actions to authorize

Aspects of some of these phases may proceed simultaneously, in accordance with task orders and available resources.

Year 1

Start-Up: Key aspects include:

* Meetings between the client and project team members to determine immediate priorities, lines of communication, the schedule and nature for progress reports and other deliverables, etc.

* The drafting and issuance of appropriate task orders by the client. The contractor may draft some proposed orders for the client to consider

* Contacting individuals and organizations involved in recent bioterrorism readiness exercises in the area, including hospitals and first responders, the Department of Homeland Security, the Department of Defense, Washington DC and nearby health and emergency response agencies, contractors, and such additional stakeholder groups and organizations as are helpful in this effort to identify

- Pertinent surveys, recommendations, evaluations, contacts, etc.

- Available resources to improve communications and programs.

* The identification and prioritization of areas requiring more research

* On-line and in-person research to identify pertinent guidance, reports, contacts, programs, organizations, etc.

* Launching a project e-mail list and website

* Summarizing pertinent studies and findings

* Developing a work plan for the next phase of the project

See http://members.aol.com/lcorncalen/DC-BIOPRO.htm for text to be looted to help complete strawman draft

Implementation: Naturally, obvious actions that can and should be implemented immediately will be implemented when decision makers decide to do so, even in the earliest phases of the first year of the project. In so far as possible, project participants will inform decision makers of such situations as soon as appropriate information is available for their consideration.

Years 2-5

Implementation (continued) This phase of the project would focus on longer-term projects requiring additional funding, studies, etc.

Details will depend on the alternatives selected.

PROJECT PARTICIPANTS

CLAUDE LAWRENCE CORNETT, JR                                                        
890 Alhambra Rd., Cleveland, OH 44110-3179 (216) 692-2124   lcornett@en.com
 

OBJECTIVE

To use my 33 years of experience with environmental health and safety, monitoring, modeling, pollution control, waste management, regulations, risk assessment and project management to facilitate cost-effective programs.

EXPERIENCE

1994-Present, Cornett      Environmental Consulting, Ohio and Virginia   CONSULTANT
Provide and evaluate health and safety, emergency response, fugitive emission control, process safety, monitoring, modeling, pollution prevention, regulatory compliance, risk assessment, and site clean-up programs.
 
1992-1994 META, Gaithersburg, MD   SENIOR ENVIRONMENTAL SCIENTIST
Principal investigator responsible for human health impact assessment for the U.S. Department of Energy Environmental Restoration and Waste Management Programs. Evaluated waste management, site cleanup, health and safety, risk assessment, regulatory compliance, monitoring, modeling, pollution control, and risk communication policies and programs. 
 
1987-1992 Resource Applications, Inc., Burke, VA    SENIOR ENVIRONMENTAL MANAGER
Zone Program Manager for 21 person EPA Technical Assistance Team providing emergency response planning, training and program evaluation (in cooperation with FEMA) – along with other services. Performed, supervised, and provided oversight of remedial investigations, feasibility studies, health and safety programs, field operations, environmental monitoring, emergency response and remedial action program implementation at Superfund sites. Wrote key sections of U.S. Army Toxic and Hazardous Material Agency Health and Safety Program Manual and reviewed and implemented related programs. Audited, and wrote specifications for Ft. Detrick hazardous waste storage and transfer facilities. 
 
1986-1987 Engineering-Science, Fairfax, VA    SENIOR ENGINEER
Performed risk assessment studies and wrote detailed procedures and specifications for monitoring, health and safety, and emergency response during remedial actions at uncontrolled hazardous waste sites. Principal Investigator for the EPA Background Information Document for the Development of Regulations to Control the Burning of Hazardous Waste in Boilers and Industrial Furnaces, Volume III - Risk Assessment. Provided evidence and expert testimony for litigation. 
 
1985-1986 Rust International Corporation, Birmingham, AL       STAFF ENGINEER
Wrote "environmental compliance handbooks, summarizing legal requirements and providing detailed procedures for compliance with same. Wrote specifications for instrumentation, data processing, monitoring, pollution control, etc.
 
1981-1985 Consolidated Edison Co. of New York    ENVIRONMENTAL ENGINEER
Wrote and reviewed corporate environmental and health and safety policies and procedures. Provided training, wrote and reviewed specifications, coordinated environmental monitoring, modeling, compliance audits, record keeping and technical reports. Wrote sections of environmental impact statements and testimony on toxic emissions and impacts. 
 
1979-1981 Monsanto Research Corporation, Dayton, OH    RESEARCH ENGINEER
Coordinated health and safety, process and environmental monitoring, and wrote environmental reports for EPA and other clients. Summarized regulations and evaluated cost and availability of equipment and services to comply. Evaluated environmental issues and safeguards associated with recombinant DNA and nuclear waste incineration programs. Wrote monitoring and emergency response plans, along with EPA NPDES (water pollution) Treatability Manual and guidelines for risk assessment and permit application review.
 
1976-1979 Dalton.Dalton.Newport, Shaker Heights, OH    POLLUTION ANALYST
Evaluated environmental issues associated with National Institutes of Health and NASA programs. Provided modeling, summarized regulations, and wrote sections of environmental impact statements. Evaluated risk assessment methods, wrote DOE and EPA guidelines for monitoring and modeling environmental impacts of advanced energy technologies and U.S. DOT guidelines for monitoring and environmental impact assessment. Wrote detailed specifications for systems and services. Reviewed and recommended National Institutes of Health programs to prevent adverse environmental impacts 
 
1972-1976 Cleveland Division of Air Pollution Control    POLLUTION CONTROL ENGINEER 
Supervised, trained, and provided detailed health and safety and monitoring procedures for up to twelve technicians performing monitoring. Worked with NASA on environmental toxics monitoring, risk assessment, and receptor modeling

EDUCATION

M.S. Air Pollution Control Engineering, University of Cincinnati, 1972

B.S. Physics, Purdue University, 1969

OSHA Hazardous Waste Site Worker Protection and Supervisory Training,

DOE Risk Communication Training

American Management Association Supervisory Management Training,

EPA Technical Systems Audit Training

Microsoft Office Pro, Lotus, WordPerfect, Advanced Visual Basic, SQL, UNIMAP, TRC, HIWAY, IRIS, RADTRAN, CALINE, MEPAS, Java, JavaScript, HTML, Fortran, MS FrontPage, Dreamweaver, E-Commerce, CGI, PERL

Dr. Edward Cornett, DO, FAAEP 452 Otis Court Sagamore Hills, Ohio 44067 Tele: 216-224-1841 with voicemail Pager: 440- 303-0883
Profile
	Board certified emergency medicine physician with 15 years of practice experience. Board certified in emergency medicine via Practice track experience. Board certified Forensic examiner and consultant regarding medical documents. Interest in medical intelligence and epidemiologic issues. Familiar with indications and warning data regarding medical intelligence analysis. Language skills include Chinese [mandarin-conversational level]. Disaster Life support trained and certified.
Education
		Doctorate Ohio University College of Osteopathic Medicine, Athens, Ohio Board certified in Emergency Medicine. 1993, AAPS ,Board of Certification in EM Board certified Forensic Examiner, 1994, American college of Forensic Examiners ACLS certified, Current PALS certified, Current ATLS, certified, Current BDLS			1987
		Bachelor of Arts Cleveland State University			1977
Experience
		Staff Emergency Physician		9/88 to 6/97
		UHHS, Bedford Medical Center, Bedford, Ohio Director EMS service for surrounding communities QA/QD for Emergency Medicine Department
		Staff Emergency Physician	6/97 to 5/00
		PHS Richmond Heights Hospital Provided emergency care to the surrounding communities Medical Shenandoah County Virginia 5/03 to 10/03 Responsible for review deaths in the county and determine need for post mortem examination. Valley Health Systems, Inc. 5/03 to 10/03 Shenandoah Memorial Hospital Woodstock, VA Director of Emergency Medical Services, Woodstock Memorial Hospital, Woodstock, VA Director of EMS services, Shenandoah County, VA Director of EMS education St. John Westshore Hospital 10/03 current Westlake, Ohio .

BUSINESS AND FINANCIAL INFORMATION

ROUGH BUDGET TO BE GREATLY MODIFIED

		Phase 1		Phase 2		Phase 3		Year 1
	Burdened		3 Mo.		6 Mo.		3 Mo.	Total
	Rate per	Hours/		Hours/		Hours/
Who/What	Hr/Unit	Units	Cost	Units	Cost	Units	Cost	Cost
R. Campbell	$120	480	$57,600	960	$115,200	480	$57,600	$230,400
L. Cornett	$120	400	$48,000	960	$115,200	480	$57,600	$220,800
E.Cornett, MD R. Wilpbank	$190	160	$30,400	320	$60,800	320	$60,800	$152,000
Other Top ProfessionalS	$190	40	$7,600	480	$91,200	480	$91,200	$190,000
Other	$50	160	$8,000	480	$24,000	480	$24,000	$56,000
Suppl./Util	$6,000	3	$18,000	6	$36,000	3	$18,000	$72,000
Travel	$300	16	$4,800	40	$12,000	20	$6,000	$22,800
Lodging	$150	180	$27,000	360	$54,000	180	$27,000	$108,000
Misc.			$0		$0		$0	$0
Total			$201,400		$508,400		$342,200	$1,052,000
Double the above to provide funding for the hospital directly involved

BIBLIOGRAPHY (LINKS)

OSHA Best Practices for Hospitals Receiving Mass Casualties from Hazardous Substance Releases

http://www.osha.gov/dts/osta/bestpractices/html/hospital_firstreceivers.html

US HRSA Bioterrorism and Hospital Preparedness Commanders Guidebook

http://www.hrsa.gov/bioterrorism/resources/PreparednessResponseBioterrorism_ACommandersGuide.htm

Job Opening with DOD Contractor

http://jobs.saic.com/ajobbext3.nsf/alljobsbyrequestno/SVL098009?OpenDocument

Navy Expeditionary Medical Support Hospitals

http://www.findarticles.com/p/articles/mi_m0NQS/is_3_65/ai_90624344

Summary of 1992 Pentagon Attack Drill

http://www.9wusa.com/weather/weather_article.aspx?storyid=6192

Summary of May 2004 Emergency Preparedness Pentagon Drill http://www.defenselink.mil/news/Jun1998/n06091998_9806093.html

American Hospital Association Chemical and Bioterrorism Preparedness Checklist
http://www.hospitalconnect.com/aha/key_issues/disaster_readiness/content/MaAtChecklistB1003.doc

Bioterrorism Readiness Plan: A Template for Healthcare Facilities

http://www.cdc.gov/ncidod/hip/Bio/13apr99APIC-CDCBioterrorism.PDF

APIC Bioterrorism Resources Webpage

http://www.apic.org/Content/NavigationMenu/PracticeGuidance/Topics/Bioterrorism/Bioterrorism.htm

Summary of Preparations for CBN attacks by North Carolina Area Hospitals

http://www.dailytarheel.com/vnews/display.v/ART/2003/04/01/3e899764304f9

Unclassified Sections of DOD Report on Lessons Learned from 2001 Anthrax Letter Attacks

http://www.fas.org/irp/threat/cbw/dtra02.pdf

HRSA Tools for Evaluating of the Metropolitan Medical Response System Program: Phase I Report

http://www.hrsa.gov/bioterrorism/resources/ReportToolsEvaluatingMetroMedicalResponseSystem.htm

US Senate Appropriations Committee Hearings on 9/11, etc.

http://appropriations.senate.gov/hearmarkups/topics.cfm?code=hearings

April 28, 2004 Update on the State of Naval Medicine before Senate Appropriations Committee
http://appropriations.senate.gov/hearmarkups/record.cfm?id=220818

Free Model to Help Plan Large-Scale Antibiotic Dispensing or Vaccination Campaigns
http://www.hospitalconnect.com/aha/key_issues/disaster_readiness/resources/HospitalReady.html

Commercial Products for Preparedness for Nuclear, Biological and Chemical Attack

http://www.uscav.com/productinfo.aspx?productid=7356&tabID=139

Bioterrorism Books (compiled by Texas DSHS)

http://www.tdh.state.tx.us/library/bt-books.htm

A 2002 National Assessment of State Trauma System Development, Emergency Medical Services Resources, and Disaster Readiness for Mass Casualty Events
http://www.hrsa.gov/trauma/survey/default.htm

Construction: Infection Control Risk Assessment

http://www.premierinc.com/all/safety/resources/construction/

Infection Control In A Hospital During A Construction Project

http://www.esmagazine.com/CDA/ArticleInformation/coverstory/BNPCoverStoryItem/0,2500,102638,00.html