Synopsis: The Tennessee Public Health Association works in support of local health departments throughout Tennessee. The Tennessee Department of Health has invested considerable resources for training and grant funding over the past two years in support of the health councils in each of the state’s 95 counties. TPHA’s project harnessed the strengths of two diverse communities to address the health impacts of extreme heat days on older Tennesseans and individuals with disabilities while providing guided practice enabling health council members to put their state-sponsored training into practice.

Challenge or Purpose: The purpose of this project was to evaluate capabilities and examine issues related to a rural community’s response to an extreme weather-related event. The segments of the population targeted in each of the rural counties were older Tennesseans over age 65 and individuals with disabilities.

Solution: Using a tabletop exercise developed for public health and emergency personnel to plan a response to weather related events in Tennessee, TPHA adapted the exercise for use by community members with diverse backgrounds to address the health impacts of extreme heat on older Tennesseans and individuals with disabilities. Working with a rural county health department and local emergency preparedness and response coordinators, the strengths of a community were brought together to develop creative and impactful solutions often not possible by government entities alone as they are limited by internal processes and procedures and budget constraints. Many solutions were determined that can be integrated into most any county-wide response to a weather-related event or other large-scale emergency response situation. For example, law enforcement mentioned during one of the exercises that older residents tend to remain in their homes when they should evacuate because they don’t want to leave their pets behind. Local medical reserve corps members responded that they will be offering a program soon to temporarily shelter pets when evacuation orders are issued, and pets must be separated from their owners.

Results: While the primary deliverable of the tabletop exercise was a planned response to an extreme-heat event in two rural Tennessee counties, the result is broader reaching. The exercise proved to establish a process by which a county health council comprised of businessmen and businesswomen, nonprofits, local politicians, educators, churches, community volunteers and others can develop meaningful responses to most any health issue impacted by climate change. Instead of a one and done plan that is placed on a shelf and rarely revisited, this process has introduced the need for ongoing training on climate-change, health impacts, responsibilities of professionals and supplemental roles that can be filled by community members. The process amplified each voice around the table and set the course for further planning activities thereby leading to better informed community health assessments and more robust community health improvement plans.

Lessons Learned: Spend time clarifying roles and responsibilities of professionals in attendance. In doing so, more profound needs are uncovered such as limitations of available programs or liability concerns of community organizations. These needs are then considered in the imaginations of community members unencumbered by government regulations and protocols with results proving to be far more meaningful and enduring overtime. Talk through the proposed solutions to address the gaps, e.g. cooling stations proposed during extreme heat days could be more practically operated by local organizations that already have energy sources and volunteers that can be used during power outages. However, concerns about the increased liability exposure during use of their facilities was a nonstarter until someone at a meeting mentioned that Tennessee recently passed a law mitigating this liability during emergency situations. Community members have varied and, in the case of emergency situations, somewhat limited backgrounds and understandings so facilitating conversations and probing responses are essential. Finally, don’t perceive this as a one-and-done exercise. Supplement the findings (indicated by lack of or limited solutions) of the exercise with ongoing training and continue planning the community response even if it takes days, weeks or months – practice, practice, practice.

Contact Information

Kimberly Harrell
[email protected]
Phone number: 615.426.1667
Tennessee’s SACCHO, Tennessee Public Health Association and its funding arm, Tennessee Public Health Foundation