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AYER — On a scale from one to 10, Ayer rates a nine. That’s only because nobody gets a 10 in Ken Gikas’ reckoning.

It also means that no other community in Region II of the Massachusetts Public Health Emergency Preparedness Coalition is better prepared to handle an emergency that requires the distribution of vaccines, medication or inoculation services to large numbers of people.

“If an incident occurred, Ayer could react well,” said Gikas, the program consultant for Region II, serving 20 communities in Worcester County. “Ayer has been very, very cooperative. It’s been my pleasure to work with its people.”

Region II is comprised of 74 municipalities in Central Massachusetts. It’s responsible for assisting those communities with public-health emergency planning and preparation. It also contains the largest number of communities and includes the largest geographical land mass of the 16 coalitions in the commonwealth. Its headquarters is in Worcester.

The Board of Health has led the town’s efforts to comply with a federal mandate that Ayer have a plan to be self-sufficient in the event of an emergency, said Chairman Marilyn McMillan, such as the outbreak of a pandemic illness or the result of an act of terrorism.

“How quickly and well we respond to the emergency is the key,” she said. “Knowing what to do, who’s doing it, where and when is essential to our planning for managing an emergency.”

The BOH has been diligent in developing its plan to increase the likelihood of averting a disaster, according Region II’s guidelines.

The plan is expected to take its “final” form by Dec. 31, 2008, said McMillan, after the board and Region II have begun vetting it with a range of “table-top” and “real” exercises simulating the kinds of emergency scenarios that could occur.

The “table-top” exercises will likely begin during the third calendar quarter of 2008, said Gikas, with “real” exercises following in the fourth.

“The scope of those ‘real’ exercises will depend on the personnel available and the funds Ayer can allocate for doing the exercises,” he said.

And the “final” form doesn’t mean the plan’s done, said McMillan and Gikas.

“Ayer’s plan is a living, breathing document,” said Gikas. “It’s never done because people, procedures, processes and hazards change. The keys to eliminating panic, helping people manage their fears and limiting the effects of the spread of an infectious disease in an emergency are ongoing education, preparation and a simple, evolving plan.”

“We’re refining our plan on a regular basis,” said McMillan.

The Homeland Security Act mandates that all municipalities be self-sufficient in emergency management while executing a response plan based on a nation-wide planning template, she said. In the case of an emergency, every community would essentially follow the same methods and procedures, she said, but under the guidance of locally based and prepared public-health officials and practitioners, and public-administration, public-safety and transportation departments.

The main ingredient in the town’s plan, as with every other community in Region II, the state and the nation, is its Emergency Dispensing Site (EDS).

Ayer’s EDS will be the high school. It’s there that the town will, in an emergency situation, address the spread of infectious disease and distribute most of the services required.

People aged 70 and older and those with special needs won’t have to report to the high school for EDS assistance. According to the board’s plan, the town will deploy teams of health-care practitioners and public-safety officials to distribute emergency health services to the elderly and those with special requirements.

The operational part of Ayer’s plan calls for the distribution of appropriate health-care services to 80 percent of Ayer’s 7,800 residents in the two days following the EDS’ activation, said Gikas.

Region II performance forecasts estimate that one nurse, with two general staff assistants, can inoculate or vaccinate 30 people per hour, he said. Health-care practitioners to distribute services, including dentists, doctors, emergency medical technicians (EMTs), legal professionals, paramedics, pharmacists, nurses, veterinarians, etc., will be drawn from volunteers among Ayer’s and the Nashoba Associated Boards of Health’s resource pools.

The fourth and fifth days will include the mobile distribution teams’ work among the elderly and those with special needs and wind down the administrative and operational ends of EDS.

Ayer will use local cable TV and the town’s Web site to distribute information regarding the emergency and Ayer’s EDS to the community, said McMillan.

“Ayer would also likely employ Reverse 911,” said Gikas. “Ayer’s dispatchers would send a ‘911’ message to every home in town alerting residents to the emergency, the EDS’ activation and the procedures to follow.”

The board’s plan is subject to the approval of organizations over the next year that include, but aren’t limited to, the town’s Board of Selectmen, town administrator, and public-safety departments and individuals, said McMillan.

Gikas declined to identify those departments and individuals before the plan’s acceptance for security reasons.

As well, Ayer’s plan will include a map of the town, EDS’ location, a transportation plan, security plan, staffing resources, a human-resource mobilization procedure and logistics plan.