JEFFERSON CITY - Missouri's health department director came under fire for its lack of specific state policies dealing with Ebola during a public forum on Wednesday.
Health Department Director Gail Vasterling repeatedly deferred to guidelines from the Centers for Disease Control and Prevention and federal government policies during questioning from senators and did not know the answers to several technical questions.
Vasterling did not yet know what Missouri hospital would take Ebola cases, whether a travel ban was possible, whether emergency responders have enough equipment, or at what point the health department would be contacted if a first responder encountered an Ebola case. She could not recall whether there had been any discussion of Ebola in Cabinet meetings with Gov. Jay Nixon.
Senators also questioned whether the health department has authority to require Ebola reporting, which Vasterling said is already listed as a reportable disease. However, she acknowledged that there is no requirement for 911 responders to immediately inform the health department of a case.
In a recent false Ebola report in Cole County the health department was not immediately notified about the possible case.
Sen. Kurt Schaefer, R-Columbia, said he didn't know exactly how long it took for the hospital to notify the health department, but that it might have been longer than most would expect.
"The hospital had the information, you didn't have the information and you didn't have it until they gave it to you," he said.
In response to a senator's question, Vasterling acknowledged that she did not have either a medical or scientific background. She was an attorney.
Schaefer suggested after the forum that the health department director should be required to have a medical or scientific background.
"I think that maybe we should look at the statuatory change that the director of the department of health should be someone with either a medical background or scientific background," he said.
Schaefer also said one of the state's biggest concerns regarding Ebola is communication.
"There's still a lot of ambiguity, on actually who is in charge," Schaefer said after the forum.
"There doesn't appear to be a chain of command here where someone says, 'by golly, that's my job, I'm the person in that position and I'm gonna set those protocols and make sure they're carried out;' and no one is willing to step up to the plate and say that," Schaefer said.
The senate panel members also questioned whether the health department had created its own policies on Ebola beyond what the federal government and the CDC had already issued.
Two weeks ago, the Department of Public Safety held a two-day training exercise for groups that would respond to an Ebola case, said DPS Deputy Director Andrea Spillars. These groups included first responders, law enforcement and local public health agencies.
Vasterling said the health department has issued health alerts and passed along "CDC guidance" to local agencies and other public health officials throughout the state.
"Do you have any role other than clearinghouse of information for CDC or are you actually making decisions and making protocol," Schaefer asked.
"I guess I'm not understanding the difference between me saying, this is the protocol and me saying, these are the criteria, this is what you need to do if you get a call, and this is what you should wear if you go out there," Vasterling said.
Senators also proposed travel restrictions in Missouri.
Schaefer asked if all 911 responders in Missouri would have access to the appropriate containment outfits. Vasterling said local public health departments have enough money to "do what we need them to do."
When questioned about the Missouri Emergency Response Commission Vasterling said the health department does not have a member on the commission, which responds to public health and environmental emergencies. Schaefer said the health department is required by law to have a member on the commission.