Task 2: Determine response activation levels based on the complexity of the incident or event. P1: (Priority) Procedures in place to develop information and public health alert messages. Consider collaborative strategies and activities, which may include. events that may constitute a public health emergency of international concern, together with the health measures it has taken in response to those events. Procedures may include. Jurisdictional public health agencies are not expected to simultaneously and completely address all identified issues, gaps, and needs across all capabilities in the short term. Medical Reserve Corps (MRC): A national network of local groups of volunteers engaging local communities to strengthen public health, reduce vulnerability, build resilience, and improve preparedness, response, and recovery capabilities. Function Definition: Produce or provide input to incident action plans containing response strategies appropriate to the incident and as described in NIMS during one or more operational periods. Ensure the appropriate level of safety monitoring and health surveillance for responders based on identified risks, jurisdictional responder roles, and subject matter expert recommendations. Jurisdictions should use these operational considerations to develop their public health agency response strategies in greater alignment with the jurisdictional public health agency ESF #8 role. Procedures should reflect relevant cultural, religious, family, and burial practices. Health department staff need readily accessible information and guidance to: The Public Health Emergency Response Guide is a valuable resource for public health professionals who have the following roles and responsibilities: Information in the guide is consistent with the doctrine, concepts, principles, terminology, and organizational processes in the National Response Framework (NRF) and the National Incident Management System (NIMS). Generally, jurisdictional public health agencies build, sustain, or potentially scale back organizational initiatives based on the most recent assessment of needs, gaps, priorities, and goals. Personnel assembly can occur at a physical location, like an emergency operations center (EOC), virtual location, such as conference calls or web-based interfaces, like WebEOC, or combination of both physical and virtual locations. Identify response priorities to ensure the continuation and recovery of critical public health functions. P11: Procedures in place to create, clear or approve, and disseminate medical surge guidance to inform the population of where and when to seek care as well as the appropriate use of 911 and acute care health systems during an incident or event. and Tracking System (IMATS): A CDC information technology (IT) platform developed with input from state and local jurisdictions that allows public health agencies to track medical countermeasure inventory down to the local level during an event, monitor reorder thresholds, and support warehouse operations, including receiving, staging, and storing inventory. Update recommendations for NPIs as indicated by the incident, including increasing or decreasing frequency or implementing new interventions. 11. PART A– Staff Health & Wellbeing: Occupational Health in the Context of COVID-19. P2: (Priority) Procedures in place that indicate how the public health agency will engage with health care coalitions and other response partners in the development and execution of health and medical response plans, integrating the access and functional needs of at-risk individuals who may be disproportionately impacted by a public health incident or event to meet incident and medical surge needs. coordination with the MRC. P5: Coordinated procedures to communicate with HHS Regional Health Administrators (RHAs); regional directors; state, local, tribal, territorial, or county agencies; and HHS RECs to address the access and functional needs of patients during the demobilization of medical surge efforts. These procedures may include, (See Capability 13: Public Health Surveillance and Epidemiological Investigation and Capability 15: Volunteer Management). In the context of the capability standards, the term “incident” is used to describe any scenario, threat, disaster, or other public health emergency. Task 2: Coordinate with partners to provide required resources. NIMS provides a consistent nationwide framework and approach to enable government at all levels (federal, state, local, tribal, and territorial), the private sector, and nongovernmental organizations (NGOs) to work together to prepare for, prevent, respond to, recover from, and mitigate the effects of incidents regardless of the incident’s cause, size, location, or complexity. S/T1: Personnel trained to locate or map at-risk populations using GIS, social vulnerability indexes, and other community assets, such as partnerships with human services and other safety net services to integrate aggregate data or client and consumer lists. From Capability 1: Community Preparedness to Capability 15: Volunteer Management, jurisdictional public health agencies must be adaptable when responding to public health threats and emergencies within the context of their communities and in alignment with incident characteristics. Procedures may include, P3: (Priority) Jurisdictional procedures in place to identify critical information sharing requirements (situational awareness information) for partners and stakeholders. Indicators for delayed or long-term adverse health effects may include, Injuries and illness incurred during deployment, Concerns, such as political and public, expressed by others, Collection of after-action information during out-processing to identify lessons learned and support corrective action planning, Out-processing interview and data collection, Pre-deployment baseline assessments and review of activity logs, Functional roles, assignments, and corresponding competencies, Description of necessary skills, knowledge, such as language proficiency and expertise on access and functional needs, or credentials for each volunteer task or role, Timeline for mobilizing and assembling volunteers, Plan and triggers for when to activate volunteers including deployments, Jurisdictional authorities that govern issues of volunteer liability and scope of practice, Partner organizations’ promotion of public health volunteer opportunities, Registration requirements for ESAR-VHP, MRC, or other pre-identified partner groups, such as the American Red Cross or CERTs, Efforts to continually engage volunteers through routine community health promotion activities, Identification and administration of appropriate trainings for volunteers, Documentation of the volunteer affiliations, such as employers and volunteer organizations at federal, state, local, tribal, and territorial levels to assist in minimizing “double counting” of prospective volunteers, Medical health, such as immunization status, medications, and pre-existing conditions, Basic triage skills, psychological first aid, and self-care, Basic and advanced disaster life support (American Medical Association’s [AMA] National Disaster Life Support Program), Access and functional needs during a disaster response, MRC TRAIN (as applicable to the jurisdiction), Privacy and confidentiality of information collected during emergency response, Other skills and courses identified by the jurisdiction for specific roles, Introduction to Incident Command System (IS-100), Incident Command System (IS-300) and Advanced ICS Command and General Staff (IS-400) for volunteer leaders that will hold key leadership positions, Processes to describe how the jurisdictional public health agency requests volunteers, Processes to determine the best use of available volunteers based on mission and capabilities, Processes for the jurisdictional public health agency to request federal resources, such as personal protective equipment (PPE), response-specific vaccinations, and response teams, that include a clear statement of need, list of requested asset(s), and role of the requested asset(s), if applicable, Plans for communications between state and local health departments about volunteer needs and assignments during an incident, Plans to provide volunteer pre-deployment briefings that describe incident conditions and assignment details. (See Capability 8: Medical Countermeasure Dispensing and Administration). Task 1: Monitor environmental health and safety at congregate locations. Identify courses of action to address persistent or emergent recovery issues and coordinate among health care, emergency management, education, nonprofit, and social services partners to design solutions, plans, and services based on jurisdictional public health agency lead or support roles. P1: (Priority) Procedures in place to assess jurisdictional response effectiveness with local public health agencies, data submitters, affected populations, and other key partners and stakeholders after the acute phase of a threat or incident. 13For example, contractors, volunteers, emergency medical services (EMS), law enforcement, fire departments, hospital and medical services personnel. CERT offers a consistent, nationwide approach to volunteer training and organization on which professional responders can rely during disaster situations, which allows them to focus on more complex tasks. Task 4: Engage trusted community spokespersons to deliver public health messages. Determine the needs of the jurisdiction to recover medical materiel and scale down medical materiel management operations. Provide public health data to jurisdictional health care organizations or health care coalitions to support activation of plans, if required, to maximize scarce resources and prepare for shifts into and out of conventional, contingency, and crisis standards of care. Request or obtain medical materiel to meet the needs of the jurisdiction based on incident characteristics. Depending upon the organizational structure of the funded jurisdictional public health agency, directly funded PHEP recipients may share PHEP funding with local public health agencies, tribes, and native-serving organizations. The review identified the need for CDC to implement several public health emergency preparedness improvement initiatives, including the Capabilities Update Initiative, the formal process CDC used for revising the Public Health Preparedness Capabilities: National Standards for State and Local Planning. Broselow tapes: Color-coded strips of paper inscribed at length-based intervals with information on the use of fluids, pressors, anticonvulsants, and resuscitation equipment. Identify and prioritize jurisdictional risks, risk-reduction strategies, and risk-mitigation efforts in coordination with community partners and stakeholders. The National Preparedness System outlines an organized process for everyone in the whole community to advance their preparedness activities and achieve the National Preparedness Goal, “A secure and resilient nation with the capabilities Coordinate with CDC’s Division of Global Migration and Quarantine (quarantine station), port authorities, and jurisdictional officials to manage and detain passengers at ports of entry, as applicable to the incident, including security and law enforcement support, notification of family, and provision of food, shelter, water, and communication channels. Establish a reliable inventory management system to track medical materiel and exchange inventory-related data with CDC throughout the distribution process. National Preparedness Goal: Defines what is meant for the whole community to be prepared for all types of disasters and emergencies. Definition: Emergency operations coordination is the ability to coordinate with emergency management and to direct and support an incident or event with public health or health care implications by establishing a standardized, scalable system of oversight, organization, and supervision that is consistent with jurisdictional standards and practices and the National Incident Management System (NIMS). Task 4: Verify data authenticity. Guidance provided to local jurisdictional public health agencies should ideally describe development priorities for capability standards and capability functions. Network of dispensing/administration sites: The jurisdiction-specific list of all sites where the targeted population can receive medical countermeasures, whether dispensing of pills or vaccine administration. Weekly Webinar Series and Online Community of Practice. Task 2: Manage medical materiel. Info for the General Public . Task 1: Coordinate with jurisdictional emergency management to establish a public health JIC or a virtual JIC and participate in a JIS as needed. Communication message strategies should be designed to account for individuals with sensory or mobility disabilities and individuals with cognitive, intellectual, developmental, mental, or other disabilities. P3: Verification of professional volunteer diplomas, licenses, certifications, credentials, and registrations in accordance with federal and state laws using the state’s ESAR-VHP or other programs, as appropriate. Task 5: Implement and track progress on improvement plan(s). P2: (Priority) Procedures in place for how the jurisdictional public health agency and jurisdictional partners and stakeholders will assess, conduct, monitor, document, and follow up with public health, emergency management, health care, mental/behavioral and environmental health, and human services needs to support jurisdictional recovery efforts. Recommended considerations may include, (See Capability 8: Medical Countermeasure Dispensing and Administration, Capability 9: Medical Materiel Management and Distribution, Capability 12: Public Health Laboratory Testing, Capability 13: Public Health Surveillance and Epidemiological Investigation, and Capability 15: Volunteer Management), P5: Jurisdictional patient-tracking and disease surveillance systems operated in conjunction with state and local emergency management, EMS, health care organizations, and other jurisdictional partners. Targeting of critical workforce groups would depend on severity of the threat, the risk of severe illness by age group, medical countermeasure supply, and the accompanying disruption to security, society, and the economy. Examples of dispensing/administration sites include open PODs, CPODs, vaccination clinics, pharmacies, and other sites in the community that meet requirements for dispensing/administration sites. Summary of Authority and Actions Under Public Health Code Regarding Public Health Emergencies . Function Definition: Monitor ongoing health-related mass care support and ensure health needs continue to be met as the incident response evolves. P2: Procedures in place for family notification, depending upon public health agency fatality management lead or support role(s). Together, all the distribution site and all the dispensing/ administration sites constitute a network of receiving sites. Task 1: Conduct a public health jurisdictional risk assessment. The World Health Organization did not declare the ongoing Ebola outbreak in the Democratic Republic of the Congo, which has now spread to Uganda, a public health emergency … Task 3: Conduct death reporting. Medical countermeasure needs may be determined by analyzing factors, which may include, (See Capability 3: Emergency Operations Coordination, Capability 9: Medical Materiel Management and Distribution, Capability 12: Public Health Laboratory Testing, and Capability 13: Public Health Surveillance and Epidemiological Investigation), P2: (Priority) Procedures in place to guide the dispensing/administration of medical countermeasures. P1: (Priority) Procedures in place to ensure the completion, verification, and documentation of responder safety and health training prior to and during an incident to ensure jurisdictional public health personnel and supporting surge capacity personnel are prepared to respond to emergencies and understand the jurisdictional Incident Command System. Agreements may be established for services, which may include. response operations, and finalize response activities with after-action processes. It also includes the ability to report timely data, provide investigative support, and use partnerships to address actual or potential exposure to threat agents in multiple matrices, including clinical specimens and food, water, and other environmental samples. Systems should be capable of interfacing with pertinent databases and meet necessary computing power and technical specifications. NEMSIS is a universal standard for how patient care information resulting from an emergency 911 call for assistance is collected. Task 7: Inform the public, responder agencies, and other partners of recommendations for NPIs . Relevant laws and policies may include, P7: Guidelines for information exchange that requires security clearances, such as information exchang with the Federal Bureau of Investigation (FBI), state bureau of investigation, fusion centers, or agents with a “need to know.”. Task 4: Support volunteer emergency response training. Task 1: Coordinate public health and health care emergency management operations. The Stafford Act constitutes the statutory authority for most federal disaster response activities, especially as they pertain to the FEMA and FEMA programs, and gives FEMA the responsibility for coordinating government-wide relief efforts. As a result, all state, local, tribal, and territorial emergency response stakeholders must be prepared to coordinate, cooperate, and collaborate with cross-sector partners and organizations at all governmental levels when emergencies occur, regardless of the type, scale, or severity. Consideration should be given to, E/T1: Systems to accept, process, analyze, exchange, and share surveillance and epidemiological data across multiple disciplines. Health care professionals are required to report certain adverse events and vaccine manufacturers are required to report all adverse events that come to their attention. P4: Procedures in place for how the public health agency, based on the jurisdictional public health agency mass care role, will coordinate with partners and stakeholders to provide specialty food items that address the nutritional needs or requirements of young children, pregnant or postpartum women and infants, older adults, and individuals with access and functional needs, such as communication, maintaining health, independence, services and support, and transportation needs (CMIST framework). Laboratory Response Network (LRN): A coordinated network of public health and other laboratories for which CDC provides standard assays and protocols for testing biological and chemical terrorism agents. S/T1: Supplemental inventory management personnel trained and ready to sustain medical materiel distribution throughout the response. E/T1: Information systems that meet national data standards for interoperability as identified by CDC, other federal agencies, such as the Office of the National Coordinator for Health Information Technology, or other standards development organizations (SDOs). Implement site-specific security measures to ensure facility safety, personnel safety, product integrity, and crowd management when dispensing or administering medical countermeasures. Task 2: Establish a network of dispensing/administration sites. Task 2: Evaluate the structural needs of the jurisdictional incident management system. CDC began updating the capabilities in response to lessons learned from public health emergency responses, updates to public health preparedness science, revised guidance and resources, findings from internal reviews and assessments, SME feedback from the practice community, and input from allied federal agencies. Coordinate with subject matter experts and cross-disciplinary partners and stakeholders to clarify, document, and communicate the public health agency role in fatality management based on jurisdictional risks, incident needs, and partner and stakeholder authorities. Preventative maintenance and service agreements must be provided for all equipment listed on the LRN-B equipment list. Definition: Information sharing is the ability to conduct multijurisdictional and multidisciplinary exchange of health-related information and situational awareness data among federal, state, local, tribal, and territorial levels of government and the private sector. P2: (Priority) Written agreements with receiving sites and transportation partners to ensure distribution of medical materiel. Recommended procedures include those to safely package, document, and ship suspicious samples. More than 1,000 employees of the Centers for Disease Control and Prevention have signed a letter calling on the agency to declare racism a public health crisis. Task 2: Support jurisdictional partners and stakeholders to identify services to reduce and mitigate identified jurisdictional public health risks. coordinated with the jurisdictional incident, unified, or area command structure. Include responders and volunteers in this registration process, as needed, Processes to coordinate with organizations trained in decontamination to establish external decontamination stations at designated sites and removing or storing contaminated materials, Facilitating referrals or transfers of individuals to emergency housing (accessible housing as needed) and to immediate or follow-up medical care, How the public can access reliable information and sources for obtaining official information, such as hotlines, websites, radio station or public service announcements, social media, and television, Populations recommended to seek medical care, When and where the public should or should not seek medical care, if applicable, How to prevent infection or exposure, including hand washing and other protective behaviors applicable to an incident, Locating CRCs based on the amount of space needed, the anticipated magnitude of the incident, and population needs of the community, Establishing crowd management operations, including the development of process flow or triage procedures and the distribution of patient information sheets during population monitoring, Using on-site equipment to monitor external contamination, Planning for and addressing the access and functional needs of at-risk individuals who may be disproportionately impacted by a public health incident or event to allow them to access and move through the CRC, Facilitating referrals of individuals experiencing psychological trauma to mental/behavioral health services, Establishing and maintaining contacts with federal agencies for equipment, personnel, and expertise, Methods for evaluating public understanding of information messages about NPIs, Indicators of compliance with interventions, such as findings from on-site inspections and participation in active monitoring, Tracking of environmental changes, such as wind direction, that may impact the need for or effectiveness of interventions, Surveillance methods to monitor ongoing rates of transmission, contamination, or infection and severity of exposure, including, Systems to be used for electronic laboratory reporting (ELR), electronic case reporting (eCR), environmental monitoring, and other epidemiological reporting, Sharing surveillance information between community partners and jurisdictional public health agencies, Establishing a common operating picture between the jurisdictional public health agency and the health care system, Following up with persons or households participating in NPI(s), which may involve registries, call lines, or periodic follow-up observations, Protecting confidential information or personal identifiers, including secure receipt and storage of sensitive information, non-laboratory response health care providers, Procedures to secure and deploy surge personnel, equipment, and facility resources for short-term (days) and long-term (weeks to months) response efforts, Procedures for triage and management of surge testing, which may include, Referral of samples to other LRN laboratories within or outside the jurisdiction using mechanisms and guidance made available by the LRN, Prioritization of testing based upon sample type, Prioritization of testing based upon risk or threat assessment, Procedures for regular maintenance of redundant testing supplies, Processes to designate alternate testing facilities for short-term duration in case of localized infrastructure failure, Agreements with other agencies to take over critical testing, as appropriate, Procedures to address personnel shortages, Procedures to address operational loss of laboratory facilities, Deployment of new technologies and specialized methods, Engagement in multicenter validation studies, Participation in priority partnership exercises, Provision of high throughput surge testing capacity, Assistance with quality initiatives, including network training programs and proficiency testing remediation, Maintenance of registration with Federal Select Agent Program, Provision of resources to ship isolates to CDC for further clarification, Preventative maintenance contracts and service agreements for equipment and instruments described within applicable LRN protocols, procedures, and methods, Protocols, including timelines, to send and receive data from local LIMS to CDC and other partners, Local codes mapped to federal standards, such as Data Integration Requirements for LRN-B and LRN-C, Dedicated information technology (IT) support personnel to maintain and update LIMS or contractual agreements with LIMS vendors that are familiar with national standards, such as LIMS integration, Public Health Laboratory Interoperability Project, and industry standards, such as logical observation identities, names, and codes; systematized nomenclature of medicine; Health Level 7 (HL7), to configure the LIMS, Periodic validation of LIMS functionality and message structure, Alternate data sharing strategies in the event of a failure in the LIMS or CDC-provided systems for LRN data exchange, LRN-B, LRN-C, and LRN-R (if LRN-R is established) member laboratories within the jurisdiction, including jurisdictional sentinel laboratories, and non-LRN public health laboratories, such as those identified in COOP planning for example, environmental, agricultural, veterinary, and local public health, Federal laboratory networks and member laboratories for example, the Food Emergency Response Network, National Animal Health Laboratory Network, and the Environmental Response Laboratory Network, Poison control centers that can serve as supporting resources for exposure incidents, Health care providers or clinical laboratories that may be packaging and shipping samples and, subsequently, receiving sample results during a response, Epidemiologists who interface with hospitals, public health agencies, and laboratories, Procedures for communicating with sentinel laboratories in the event of a public health incident, Policies developed in coordination with jurisdictional stakeholders for handling biological, chemical, radiological, nuclear, and explosive incidents, Coordination with first responders who may initially identify overt exposure incidents, Coordination with Civil Support Teams (CSTs) to establish partnerships between CSTs and the public health laboratories with respect to field analysis of unknown samples, Coordination with local law enforcement and Federal Bureau of Investigation (FBI) field offices for screening and triage procedures for environmental samples, such as biological, chemical, radiological, and explosive materials, Coordination with emergency management officials and other relevant entities, such as fusion centers supporting an emergency response, including incidents when the Emergency Management Assistance Compact (EMAC) is activated, Updated contact list for state, local, tribal, and territorial law enforcement and first responder units, such as HazMat and poison control center, who are approved to perform screening and triage procedures on unknown samples, Select agent and toxin regulations (if applicable), Biosafety or biosecurity plan (applicable even if laboratory is not select agent registered), LRN-R: Radiation Safety and Security Plan (if LRN-R is established), Other protocols, as needed, to ensure adherence to applicable federal, state, local, tribal, and territorial regulations related to transport of clinical specimens and hazardous and radiological materials, A valid select agent registration number (LRN-B Advanced Reference laboratories only). 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