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Plan Now for an Influenza Pandemic
Although public health influenza pandemic planning efforts began years ago, 2007 may find other organizations without a formal written plan.
A flu pandemic likely will cause high rates of absenteeism from work and school; up to 40 percent of employees may be home sick or caring for sick family members. A written plan will allow those who may need to step in during a pandemic to carry out duties and fill jobs. A pandemic flu plan should contain steps your organization will take to minimize the effects of a flu pandemic on the organization and the people it serves.
There is no single template for drafting a pandemic flu plan – plans should be tailored to the organization – but continuity of operations is an important concept to consider when planning for any emergency.
Continuity of operations planning for a pandemic determines how your organization will continue to provide needed products or services if up to 40 percent of employees or volunteers are home sick or caring for sick loved ones. This aspect often exists as a component of all-hazard or weather-related emergency plans, which already exist in most organizations.
Adapting existing emergency plans to include pandemic influenza is a good first step. During a pandemic, businesses may consider relaxing employee sick leave policies or implementing telecommuting. Schools should plan for extended closures with alternative teaching methods. Community groups need to recognize and plan for the danger of losing volunteers to illness or care-giving roles. Consider how an influenza pandemic may effect the organization, then address those issues in your emergency plan.
There are many resources available to aide planning efforts. Reach out to other organizations similar in size for help in drafting a plan. Local emergency management agencies and health departments may be able to provide some guidance. Planning resources are also available at http://www.ohiopandemicflu.gov.
The Centers for Disease Control and Prevention (CDC) has a variety of planning tools available including a software package called Flu Aid, designed to assist state and local level planners in preparing for an influenza pandemic; and FluSurge, a model which enables hospital administrators and public health officials to estimate the surge in demand for hospital-based services during an influenza pandemic.
The CDC also has checklists available to spark planning efforts for businesses, schools, communities and local government at http://www.pandemicflu.gov.
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Stay Informed
While lethal bird flu has been noted overseas, there is still the threat of illness from the virus in other parts of the world. The World Health Organization provides complete information about the evolving situation on its Web site: http://www.who.int/csr/disease/avian_influenza/en/
The Centers for Disease Control and Prevention (CDC) offers a free email subscription service, which allows CDC.gov users to receive notifications by e-mail when new information is available. With a subscription profile, you get the updated information on the items of interest to you automatically without having to return to the website and check for changes.
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State Agencies Exercise Plans and Provide Assistance to Ohio Schools
On February 1, fourteen state agencies and organizations participated in a tabletop exercise designed to test the statewide response to school closure in the event of a flu pandemic event. The key objectives of the exercise were to increase understanding of the responsibilities of all participating agencies; identify gaps in coordination between agencies; promote continued planning and refinement of current plans and promote understanding of inter-related decisions and related results. Representatives from the following organizations participated.
Late in 2006, ODH and ODE along with the Ohio Department of Mental Health, Ohio Psychiatric Association, Ohio Association of Elementary School Administrators and two Columbus schools presented a half-day pandemic flu planning workshop at the Ohio Prevention and Education Conference. The workshop provided attendees an overview of pandemic influenza, planning implications for schools and mental health concerns. A panel discussion rounded out the offerings as well as a preview of the Pandemic Influenza Toolkit for Ohio Schools.
The Pandemic Influenza Toolkit for Ohio Schools will be distributed to superintendents and local health districts later this month. Prepared by ODH with contributions by numerous state and local agencies and organizations, the toolkit contains school planning information, guidance on disease surveillance and reporting, infection control measures, sample media releases and more. Look for a copy to arrive at your school district office soon. Additional copies can be downloaded from the www.ohiopandemicflu.gov website.
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Best Practices - Bloom-Carroll Schools
To prepare Bloom-Carroll Schools for a potential pandemic, Prevention Coordinator Eric Landversicht has taken steps to educate the school board and district employees and worked with several state agencies to augment the district’s and county’s planning efforts.
"I found that planning works better when you can bring all the disciplines to the table,” Landversicht said of his approach.
Landversicht represents Fairfield County’s schools in an infectious disease planning group for the local Emergency Management Agency (EMA). This group is developing an infectious disease annex for the county’s emergency operations plan. They discuss how to best manage resources during outbreaks. For example, they have identified shelters, clinics and morgue resources in their county that can be used during a pandemic and will work with EMA and Red Cross in the event the school facilities are needed. They have also included law enforcement, agriculture and public safety organizations in their planning efforts.
“In working on our district plan it occurred to me we could streamline the planning process for the schools, emergency responders and EMA if we worked as a team to develop one plan that each school district would incorporate into their existing crisis plan. This could help relieve the strain on local resources and ensure all schools in the county are working in unison during a pandemic,” Landversicht said.
Fairfield County’s plan establishes a consistent process for monitoring symptoms and reporting absenteeism to the local health department and creates a close working relationship with the health commissioner. This will assist the county in making the decision when and how to close schools during a pandemic. Their plan also addresses infection control and education of parents and families in the community.
Along with Merrillee Taylor, emergency response coordinator at the Fairfield Department of Health, Landversicht arranged for a presentation to county superintendents by the local health department in January, timed to coincide with the release of the ODH Pandemic Influenza Toolkit for Ohio Schools. They provided information about avian flu, flu pandemics and other types of infectious disease events.
In February, Landversicht will participate in a regional pandemic flu functional exercise and plans to use that experience to help develop a coordinated school response. He is also inviting local Christian and private schools to participate in the development of the single county plan for schools. The final plan will be reviewed by all superintendents, the county health department and the EMA before being adopted by schools.
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Best Practices - Incarnation Catholic School
Submitted by Ann Woeste, RN, school nurse
At Incarnation Catholic School in Centerville, Ohio, we have made a conscious decision to quickly begin planning to prepare for a communicable disease outbreak.
In October 2006, we had a planning session and developed an informational program to present to all faculty. Our goals were simple:
- Have a plan in place for a communicable disease outbreak in our community.
- Continue the learning process for all students.
- Deliver factual, easy-to-read, informational material to families, staff and community as needed.
The plan included our main school goal - to provide a healthy environment in which to learn and grow. We then defined our objectives:
- Implementing our plan when a pandemic occurs.
- Developing an online learning system to ensure the continuity of learning during community crisis.
- Creating fact sheets and informational letters to distribute to families.
- Establishing criteria to minimize contact between people to prevent the spread of disease (AKA limitation of movement).
In our presentation, we defined epidemics and pandemics and the primary strategies for preventing pandemic influenza. Health precautions were stressed such as washing hands, cough etiquette and getting a vaccination when it becomes available. We included discussion on the needed emotional support during any time of crisis.
Our administration was supportive in our goals to ensure after-school activities would be cancelled to help slow the spread of the virus. They also guided us through developing online learning through e-mail and our “homework hotline.” Our phone chain was updated and distributed to all faculty members.
The in-service for our faculty members was very useful and facilitated many questions and great discussions. I am sure the faculty members are more aware now of the potential risks and the continuing chain of events that will occur if a pandemic does surface.
We continue to have ongoing discussions and are still actively working on the development of the forms specific to our school that we want to be available. Our plan will continue to be a work in progress. We continue to use available community resources and closely monitor what the local and state health departments are preparing.
Because of my frequent calls with questions to our local health department, I am included in a planning committee for the Combined Health District of Montgomery County to educate our school staff on pandemic flu (under the direction of Kathy Blossom our public health emergency preparedness educator). It is a great networking system providing information about what other area schools are doing.
In this month’s parent newsletter, we included an article about the potential for a flu pandemic and shared our goals. We provided parents information about health precautions encouraged at school and a reminder of when to keep children home. Our policy states that if a child is experiencing any of the following within the last 24 hours, they should be kept home to recover; temperature of 100 degrees or higher, vomiting, diarrhea, persistent cough or excessive fatigue. We ended the article with this statement, “Proper rest, nutrition, exercise and frequent hand washing will keep our students healthy and ready to learn. Keep covering those coughs and washing those hands.”
It is hoped as we continue to develop our plan for a communicable disease outbreak we will all learn valuable information. As we meet and discuss possible scenarios, we know we have much to learn. We also know we have much to gain as we work together as a community. Writing our plan and serving on the community committee has shown people working together can accomplish anything.
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Lake County Health Department Educates and Collaborates for Success
Submitted by Dawn Cole, Preparedness Specialist
The Lake County General Health District (LCGHD) focused its 2006 pandemic influenza preparedness efforts on collaboration and education. We developed message maps, fact sheets and articles for all phases of an influenza pandemic as well as a crisis communication plan, all of which have been shared with northeast Ohio regional public health partners. We are working with our local emergency management agency director and a consultant to revise the latest draft of our pandemic influenza plan to ensure it is compliant with the National Incident Management System and will be included with the county plans.
LCGHD chairs a Pandemic Flu/All-Hazards Committee that first met in 2006 to discuss various issues pertaining to pandemic influenza planning for Lake County. Membership consists of local law enforcement, fire departments, community groups, funeral homes, government agencies, universities, industry, public utilities, health care agencies, faith-based organizations, school systems and volunteer organizations.
LCGHD also conducted a pandemic flu tabletop exercise in August 2006. The purpose of the exercise was to give the participants an opportunity to test and evaluate plans, procedures and the decision-making processes involved in the response to a pandemic flu outbreak in the Northeast Ohio Regional Medical Response System area. In addition to LCGHD employees, many local businesses, health care providers, government agencies and community organizations participated in the tabletop (see table).
Lake County Tabletop Exercise Participants
Local Agencies |
Public Health and Health Care Providers |
Businesses |
Schools and Community Organizations |
- Lake County Emergency Management Agency (EMA)
- Lake County Department of Utilities
- Lake County Geographic Information System Dept.
- Lake County Mental Retardation and Developmental Disabilities
- Lake County Planning Commission
- Geauga County EMA
- Leroy Fire Dept.
- Mentor Fire Dept.
- Mentor Police Dept.
- Munson Fire Dept.
- Kirtland Fire Dept.
- Concord Fire Dept. |
- Cleveland Dept. of Public Health
- Geauga County Health District
- Conneaut Health Dept.
- Center for Health Affairs
- Euclid General Hospital
- Lake Hospital System
- Hospice of the Western Reserve |
- STERIS Corporation
- First Energy Corp.
- Laketran (local public transit system)
- Con-way
- Lubrizol Corp.
- Brunner Funeral Homes |
- Cleveland State University
- Lakeland Community College
- Mentor Public School System
- Ohio State University Extension
- Retired and Senior Volunteer Program (RSVP)
- Jehovah’s Witnesses |
All participants agreed the tabletop and subsequent discussion were beneficial and would assist them in their own pandemic planning efforts. This tabletop exercise was a precursor to a Northeast Ohio Regional Pandemic Flu Functional Exercise slated for February 2007.
LCGHD held a mass vaccination clinic in November 2006 in collaboration with local college nursing students, senior centers and law enforcement and a second mass vaccination clinic in December 2006 to test Secure Wireless Inventory Pharmaceuticals Emergency Response System, a computer system used to track mass distribution of medicines.
The brochure “Get Prepared - What your Family Can Do About Bird Flu” by Ohio Department of Health has been well received in Lake County and local senior centers, public utilities departments, universities and other groups have requested several copies. Other educational materials ordered for next year to intensify efforts of pandemic influenza planning awareness include the brochures “Pandemic Flu and Hygiene – A Key to Slowing its Spread,” “Seasonal Flu, Pandemic Flu and Bird Flu – What You Need to Know” and “How You Can Prepare for a Flu Pandemic” all by Channing Bete Co. Several copies of the DVD “Why Don’t We Do It In Our Sleeves?” about proper coughing and sneezing etiquette have also been purchased. This video is available from http://www.coughsafe.com
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LCGHD was invited to speak about pandemic influenza for an employee meeting at Kirtland County Club. We also spoke on pandemic influenza at the Lake County school superintendents meeting in January.
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Best Practice – Toledo-Lucas County Health Department
The Toledo-Lucas County Health Department has been working to raise awareness of a potential pandemic influenza since late 2005. The Toledo-Lucas County Health Department utilized the http://ohiopandemicflu.gov Web site to identify local planning partners.
Throughout the summer months, the department held seminars for institutes of higher education, hospitals, first responders, schools and church groups informing them of the potential for an influenza pandemic. The department created information packets with specific items for each audience. The health department staff also partnered with the University of Toledo to draft a specialized plan for area businesses. The business plan contains suggested pandemic influenza preparedness activities.
Raising awareness of an influenza pandemic among residents has also been a priority for the Toledo-Lucas County Health Department with the Wash Up, Stock Up and Listen Up campaign. Launched in July 2006, the campaign includes posters, billboards, credit-card-size supply lists, magnets, pens and television ads. The department used innovative distribution methods such as requesting its Division of Environmental Health to ask businesses undergoing an inspection to display the posters.
The Toledo-Lucas County Health Department distributed a family activity card (link to PDF) supplied by the Ohio Department of Health to schools and businesses and e-mailed it to city and county employees. They also continue to work to raise awareness of pandemic flu by speaking to various communities about the disease and how to prepare. They have drawn on various community resources such as the local chapters of the Area Office on Aging and American Red Cross as well as private residents to determine the best methods of distributing materials and information.
Future projects include a community volunteer management program – which is in pilot stage – and an informational pandemic flu summit tentatively scheduled for March.
If you would like more information on preparedness efforts in Lucas County, contact Eric Zgodzinski at (419) 213-4166.
Planning Suggestions for Faith-based Organizations
During an influenza pandemic – especially a severe one – congregants will turn to their faith and their church or synagogue for guidance. That’s why the faith-based community needs to be well informed of the steps local government may take during a pandemic and what they can do to prepare.
At the start of a pandemic, local health districts may need to close businesses, schools and churches to slow the spread of the virus. If the members of your congregation are informed of this possibility ahead of time, there is likely to be far less confusion during the transition to alternative styles of worship.
Faith-based organizations also play an important role as a trusted advisor to their members. Urging the members of your congregation to begin preparing for an influenza pandemic now may help save their lives when one occurs.
Church World Service
The Church World Service Emergency Response Program outlines several ways faith-based organizations can prepare and offers guidance on urging congregation members to prepare.
The following information was taken directly from the guide “The Religious Community as Disaster Educator – Planning, Prevention and Mitigation.” Click here to view the entire document.
The religious community can work on disaster prevention by:
- Building awareness about disaster-related issues among such groups as men’s and women’s societies, Sunday School classes, Boy and Girl Scouts and services clubs.
- Maintain contact lists that include:
- Pastors trained in crisis counseling.
- Public officials who want to avoid or mitigate an existing or potential problem.
- Agencies and people working on or responsible for addressing technological hazards in your local, county, state or territory governments.
- Meeting local agency officials and putting a “face” on the area of concern.
- Ask about plans for emergency services prior to a disaster in your area.
- Present specific concerns with factual information.
Churches can encourage their members to take some basic steps in their homes to prevent and lessen the effects of disasters or accidents:
- Developing a family disaster plan.
- Writing down emergency telephone numbers.
- Relocating or elevating appliances and electrical service entries in basements.
- Creating “safe rooms” for protection from tornadoes.
Planning considerations for churches:
- Knowing the hazard analysis for your area – what exists today and potential future hazards; possible sources of explosions, contamination and radiation.
- Adequate insurance on buildings and contents.
- Protection of vital records.
- Use of church facilities for shelters and other disaster response needs in cooperation with other care-giving agencies.
- The congregation’s resources – people and material – and how they can meet disaster needs.
- A telephone tree or system to check on church member needs when disaster strikes.
- Training for people in the community in disaster preparedness, fire suppression, first-aid, light search and rescue, emotional and spiritual care.
- Telephone numbers/addresses of out-of-town family members, judicatory staff, other support people and agencies.
- Disaster plans of families in the congregation.
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Preparing Employees for an Influenza Pandemic
If your business has been preparing for a flu pandemic, many of the items on your checklist should relate to preparing your employees both before and during a pandemic. These preparations require action by both employers and employees. The following actions were taken from the “Business Preparedness” A-Z checklist created by the Ohio Department of Health. Look at your checklist to determine whether your plan will adequately prepare employees.
| Forecast and allow for employee absences and develop policies specific to a pandemic such as additional sick-leave compensation and policies concerning when a previously sick employee may return to work. |
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Employer: Be prepared to deal with absenteeism of up to 40 percent and to implement rules to protect workers and minimize further spread of the virus in the workplace. Notify employees of policies that will be in effect during a pandemic.
Employee: Employees should understand how the employer’s policies may affect them during a pandemic and plan accordingly.
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| Implement an exercise or drill to test your plan periodically. |
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Employer: This is important to identify areas of improvement and could help alleviate employees’ concerns as well.
Employee: Participate in drills if applicable and consider how what you learn could impact your job responsibilities. |
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| Provide infection control kits (hand sanitizer/hand washing stations, tissues, waste receptacles). |
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Employer: Consider providing infection control kits in areas where people gather such as conference rooms, break rooms, cafeterias and restrooms. If there are procedures or policies that prevent employees taking personal protective measures, discuss with management in advance how to address these during a pandemic.
Employee: Evaluate your workspace and improve infection control where needed. Consider using alcohol wipes to periodically disinfect shared equipment such as telephones in your work area. Keep tissues nearby to prevent spreading germs. If possible, keep your own bottle of hand sanitizer in your work area. |
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| Evaluate employee access to and availability of mental health and social services such as community- and faith-based resources during a pandemic and improve services as needed. |
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Employer: An effective manager is familiar with the many facets of worker stress and takes a wide range of steps to integrate stress management strategies in the workplace. Besides assuring availability of outside services, you must assume shared responsibility for promoting a positive and healthy work environment and not rely exclusively on workers initiating their own self-care practices. You must also manage your own self-care. Address the following dimensions when designing a stress management plan that prioritizes environmental and organizational health:
- Effective management structure and leadership.
- Clear purpose, goals and training.
- Functionally defined roles.
- Administrative controls.
- Team support.
- Plan for stress management.
Employee: Understand stress-management resources available to you during a pandemic. Evaluate your current self-care practices and improve where needed. |
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| Offer links to reliable, up-to-date pandemic information from public health and emergency management sources |
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Employer: If your company has an Intranet site, consider using it to provide information to your employees. Other means of communication could include a television network, e-mail, memos, fliers in break rooms or intercom announcements. Determine what communication methods your company has available during times of crises.
Employee: Share information with your family. Awareness can help alleviate your family’s anxiety and improve your ability to weather the pandemic. |
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| Disseminate a quick guide to pandemic fundamentals such as signs of influenza, modes of transmission, personal and family protection and response strategies. |
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Employer: These materials are readily available from your local health department or other response agencies and on this Web site's publication library. Gather the information and provide to employees. You might consider disseminating the packages during a company meeting and asking the company nurse or pandemic flu plan coordinator to address the employees about the information they are receiving. Refer them to experts when needed.
Employee: Share this information with your families. Understand what your family can do to help prevent contracting the flu.
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| Understand the capabilities and plans of insurers, health plans and major health care facilities. |
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Employer: Your benefits administrator can assist with this assessment. He or she should also be aware of how local responders are planning to handle patient overflow. Some areas have contracted with schools to utilize their space for health care during a pandemic. Know what is planned for your community and communicate this information to employees.
Employee: Share this information with your family. Assess your readiness. |
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| Encourage pneumococcal and seasonal influenza vaccinations for employees as appropriate and following public health recommendations. |
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Employer: Although seasonal flu vaccines will not protect against pandemic influenza, they can prevent absenteeism due to seasonal flu and provide an opportunity to educate employees about the types of flu viruses and vaccines. Your benefits administrator or company nurse could assist you in organizing on-site vaccinations.
Employee: If you don’t normally get flu vaccinations, consider doing so. |
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| Develop platforms such as hotlines and dedicated Web sites for communicating pandemic status and actions to employees, vendors, suppliers and customers in a consistent and timely manner. |
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Employer: For a larger company, this capability might already exist for other emergencies. If this could benefit your company or decrease potential economic losses, evaluate the costs of these programs and implement accordingly.
Employee: Understand what information is available to you and to those you work with outside your company. |
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| Improve or upgrade up your company’s communication and technology infrastructure to support telecommuting and remote-access needs. |
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Employer: Assess your company’s capabilities and jobs that can be completed remotely. Work with your technology leader to plan for transitioning jobs to home-based sites in the event of a pandemic. In moving as many jobs as possible to remote locations, you will reduce the risk of spreading illness at your prime location. Identify jobs that can be completed remotely and assist employees in setting up home offices when appropriate.
Employee: If your job duties can be completed remotely, prepare your home. Identify a good place to set up your office. Be sure you have the network and telephone access you’ll need. Tell your family your schedule might change and how that may affect them. |
New Guidance for Workplaces from Occupational Safety and Health Administration (OSHA)
On February 6 , OSHA released new guidance on preparing workplaces for an influenza pandemic. Learn more here.
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Seasonal Flu Reminder
Seasonal flu viruses are unpredictable and can peak as late as March in Ohio. The Centers for Disease Control and Prevention provides a weekly update on flu activity on its Web site: http://www.cdc.gov/flu/weekly/usmap.htm
Form healthy habits to protect your self from seasonal flu viruses. Good health habits include:
- Eating a balanced diet including plenty of vegetables, fruits and whole-grain products.
- Drinking plenty of water and going easy on salt, sugar, alcohol and saturated fat.
- Exercising regularly. Thirty or more minutes of physical activity most days of the week can help boost your immunity.
- Getting plenty of rest. Sleep is shown to help your body fight off illness.
- Washing your hands thoroughly and often, especially before eating or cooking and after using the restroom. Use soap and water and scrub for 20 seconds.
- Trying not to touch your eyes, nose or mouth. Germs are often spread this way.
- Staying away from people who are sick as much as you can.
- Staying home from work or school if you are sick.
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Planning Resources
Printed Materials Available
The Ohio Department of Health also has a number of planning brochures for families available free of charge. Click here to see a PDF. If you would like brochures for distribution in your school district, employees or community members, send us an e-mail with the number of boxes (350 brochures per box) desired and your shipping address.
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Web Site Highlights
If you haven't discovered the publication library yet, check it out. All publications are listed on this page for download, some with areas you can customize for your employees. All of these documents are public and free for you to use in your schools.
A page has been created that offers documents in Spanish and links to sites providing health and pandemic flu information in Spanish.
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