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									 CDC Preparedness and
  Response Activities

Prevent, Detect, Investigate,
 Control, Recover, Improve
      Presentation Outline
• CDC preparedness and response
  activities overview
• Description of basis and authority of CDC
  response
• CDC management structure
• Field management structure
• Overview of deployment process and
  supporting incident management structure
DEOC 21   770-488-7100 24/7
                                          CENTERS FOR DISEASE
                                        CONTROL AND PREVENTION
                                                  CDC WASHINGTON                                                                                               OFFICE OF CHIEF OF
                                                       OFFICE                                                                                                         STAFF




                                                   OFFICE OF CHIEF                                                                                                  OFFICE OF
                                                                                                                                                                   ENTERPRISE
                                             OPERATING OFFICER
                                                                                                                                                                 COMMUNICATION

                                                                                                    OFFICE OF THE
                                                 OFFICE OF CHIEF OF                                   DIRECTOR                                                OFFICE OF STRATEGY
                                                   PUBLIC HEALTH
                                                                                                                                                                AND INNOVATION
                                                      PRACTICE



                                                                                                                                                                    OFFICE OF
                                                  OFFICE OF CHIEF                                                                                                  WORKFORCE
                                                  SCIENCE OFFICER                                                                                                  AND CAREER
                                                                                                                                                                  DEVELOPMENT




                       Coordinating Office For                                                  Coordinating Center for
Coordinating Office                                         Coordinating Center for                                                  Coordinating Center                 Coordinating Center
                      Terrorism Preparedness                                                    Health Information and
     of Global                                               Environmental Health                                                         for Health                        for Infectious
                      & Emergency Response                                                              Services
      Health                                                 and Injury Prevention                                                       Promotion                            Diseases




                                                                              National Center for
                                                                                                                                                   National Center for Birth
                                                                             Environmental Health /                                                                                                                National Institute for
                                                                                                                   National Center for                   Defects and                   National Center for HIV ,
                                                                               Agency for Toxic                                                                                                                    Occupational Safety
                                                                                                                    Health Marketing                    Developmental                  STD , & TD Prevention
                                                                            Substances and Disease                                                                                                                      and Health
                                                                                                                                                          Disabilities
                                                                                    Registry *


                                                                                                                                                      National Center for
                                                                            National Center for Injury             National Center for                 Chronic Disease                   National Center for
                                                                             Prevention and Control                 Health Statistics               Prevention and Health                Infectious Diseases
                                                                                                                                                           Promotion




                                                                                                                 National Center for Public        Office of Genomics and               National Immunization
                                                                                                                   Health Informatics                Disease Prevention                        Program
                          Division of Emergency Operations


                                             Phil Navin
                                          Division Director




            Mark Wooster                                                    Bruce Burney
             Chief Health/                                                 Deputy Division
            Science Officer                                                    Director




                                                                                             Tom Reynolds
Cheryl Stauss          Joseph Spalviero                       Mike Daley
                                                                                              Plans/Trng./
    DBS                   Operations                           Logistics
                                                                                              Info. & Exer
                                 Preparedness Goals
        Pre –Event                              Event                          Post-Event
Prevent                           Detect                                 Recover
1)    Increase the use and        3)    Decrease the time needed to      7)   Decrease the time
     development of                     detect chemical, biological,          needed to restore
     interventions known to             radiological agents in tissue,        health services and
     prevent human illness              food or environmental                 environmental safety
     from chemical,                     sample that cause threats to          to pre-event levels.
     biological, radiological           the public’s health.
     agents and naturally                                                8)   Increase the long-
     occurring health threats.    4)    Improve the timeliness of             term follow-up
                                        information regarding threats         provided to those
2)    Decrease the time                 to the public’s health as             affected by threats to
      needed to classify                reported by clinicians and            the public’s health.
      health events as                  through electronic early
      terrorism or naturally            event detection in real time
      occurring in partnership
                                  Investigate                            Improve
      with other agencies
                                  5)    Decrease the time to identify    9)   Decrease the time
                                        causes, risk factors, and             needed to implement
                                        appropriate interventions for         recommendation from
                                        those affected by threats to          after-action reports
                                        the public’s health.                  following threats to
                                                                              the public’s health.
                                  Control
                                  6)    Decrease the time needed to
                                        provide countermeasures
                                        and health guidance to those
                                        affected by threats to the
                                        public’s health
             Guiding References
● HSPD-5, 8 (2003): Established policies to strengthen the
  preparedness of the Unites States to prevent and respond to
  terrorist attacks, major disasters and all-hazards.

● National Response Plan: An all-discipline, all-hazards plan
  that establishes a single, comprehensive framework for the
  management of domestic incidents.

● National Incident Management System: The National Incident
  Management System (NIMS) provides a consistent approach
  for Federal, State, and local governments to work effectively
  and efficiently together to prepare for, prevent, respond to,
  and recover from domestic incidents, regardless of cause,
  size, or complexity .
         Guiding References cont.
● Target Capabilities List (TCL): 36 essential capabilities that should be
  maintained and developed by government.

● Universal Task List (UTL): A menu of tasks that may be performed
  during mitigation, preparedness, response and recovery from a major
  event.

● National Planning Scenarios: A listing of 15 plausible terrorist attacks
  and natural disasters that would stretch the Nation’s prevention and
  response capability.

● National Preparedness Goals: Planning, under uncertainty, to provide
  capabilities suitable for a wide range of threats and hazards by using
  risk-based target levels of capability, which enables entities to prioritize
  needs, update preparedness, allocate resources and deliver
  preparedness programs.

● CDC Emergency Operations Plan with Annexes
         National Response Plan:
         The Guiding Principles for
            Domestic Incidents
● An all-discipline, all-hazards plan

● Establishes a single, comprehensive framework
  for the management of domestic incidents

● Provides the structure for Federal support

● Consists of the Base Plan, Emergency Support
  Function Annexes (ESF), and Incident Annexes
     National Incident Management
            System (NIMS)
• A system that provides a consistent nationwide
  approach for incident management
• Requires Federal, State, tribal, and local
  governments to work together before, during,
  and after incidents
• Involves preparing for, preventing, responding
  to, and recovering from domestic incidents
• All causes, sizes, and complexities of incidents
• Common terminology, structure, processes
                          The 15 ESFs
1: Transportation            6: Mass Care, Housing,     11: Agriculture and
Department of                Human Services             Natural Resource
Transportation               Department of Homeland     Department of Agriculture/
                             Security, American Red     Food and Nutrition Service
                             Cross
2: Telecommunications        7: Resource Support        12: Energy
and Technology               General Services           Department of Energy
National Communications      Administration
System

3: Public Works and          8: Public Health and       13: Public Safety and
Engineering                  Medical Services           Security
Department of Defense/       Department of Health and
Army Corps of Engineers      Human Services
4: Firefighting              9: Urban Search and        14: Community Recovery,
Department of Agriculture/   Rescue                     Mitigation, and Economic
Forest Service               Federal Emergency          Stabilization
                             Management Agency          US Small Business
5: Emergency                                            Administration
Management                   10: Oil and Hazardous
Federal Emergency            Materials Response         15: Emergency Public
Management Agency            Environmental Protection   Information and External
                             Agency                     Communications
 ESF 8: Public Health and
    Medical Services
Primary Functional Agency:
   Department of Health and Human Services

Purpose/Mission:
   Provide coordinated Federal assistance to
   Supplement State and local resources in
   response to public health and medical care needs
   following a major disaster or emergency

Support Agencies:
  USDA, DOD, DOE, DOJ, DOT, VA, AID, ARC,
  EPA, DHS/FEMA/EPR, GSA, NCS, and USPS
      ESF 8 Responsibilities
• Assessment of public          • All-hazards consultation
  health/medical needs            and technical assistance
                                  and support
• Medical care personnel
                                • Mental health care
• Public health surveillance      assistance
• Medical equipment and         • Public health and medical
  supplies                        information
• Patient evacuation            • Vector control assistance
• Patient care                  • Potable water/waste water
• Safety and security of          and solid waste disposal,
  human drugs, biologics,         and other environmental
  medical devices, veterinary     health issues
  drugs                         • Victim identification /
• Food safety and security        mortuary services
• Agricultural safety and       • Veterinary services
  security                      • Blood products and
• Worker health/safety            services
                      Director’s Critical
               Information Requirements (DCIR)

• Report disease outbreaks that are above the base line for the
  seasonal or geographic norm.
• Report H5N1 human to human transmission.
• Report any chemical, biological, nuclear threats or events.
• Report deaths from an infectious disease above normal base line.
• Report media interest for any accidental or intentional agent or
  toxin release/use.
• Report vaccine adverse affects resulting in death.
• Report food borne illness resulting in large numbers affected.
• Report accidental death/injury of CDC personnel.
• Report requests for use of CDC aircraft.
                     Notification Process
                                                        CDC
                        State
                     Department
                      of Health
                                      Department
                                                        DEOC                   OD/OCOO
                                       of Health                       CCHIS             DSNS
         Public                       And Human
                                       Services


                                               Department      NIOSH                            ATSDR
Clinician                                      of Homeland
                                                 Security
                        State
                         and                                                   On-call
                       Federal                                                 SMEs
                       Partners                                OWCD                               SME
  Federal                                        National
Emergency
                                                Response
Management
  Agency                                          Center


           State                         Strategic                OSEP                      CCEHIP
        Emergency                      Information
        Management                   and Operations
          Agency        Federal           Center
                       Bureau of                                           CCHP      CCID
                     Investigation
CDC RESPONSE SYSTEM TIERED PHASES
    HHS Response/ RL 0 - 5

                                                                                     Response
                                                                              Incident Manager
                                                             Alert             Full DEOC IM Staffing
                                                 DEO Director:                 Deploy CDC Resources
                                                    CIO/ ATSDR SME            Monitor Incident
                                                     Alerted
                                                                               Deploy SMO
                                                    Mission Analysis
                                                     Reviewed                  IAP development

                                                 Increased Activity:           Gather intelligence

                                                    Federal & State create    Report Information
                                                     COP                      On-Scene:
                                  Watch             Conduct Planning-IAP      IRCT/SMO/ESF#8
                             DEOC Opns Chief
                                                    Deployment Preparation    SMO manage deployed
                             DEOC Core Staff
                                                                                resources
                             Global Monitoring

                                                 CDC DCIR’s
                         CDC TIERED RESPONSE

                             ALERT- RESPONSE
STAFF IN DEOC




                                       TIER 3
                                TIER 2 100-232
                WATCH
                         TIER 1 60-100
                TIER 0    30-45
                  3-7
                         EVENT INTENSITY
                                   CDC / HHS
        Hurricane Phases to Tiers Chart
Timeline                   HHS               CDC Phases                CDC
                          Phases                                     Response
June 1, 2006           Normal Operations   CDC Pre-Event Phase     Watch Mode
Hurricane Season                           Prepare for Hurricane
Begins                                     Season
H-168 to H-96          Phase 0             Phase 0                 Alert Mode

                                                                   Response Mode
                                                                       Tier 1
H-96 to Landfall       Phase I             Phase I
    H-96 to H-72            Stage 1              Stage 1
                                                                       Tier 2
    H-72 to H-48            Stage 2              Stage 2

    H-48 to                 Stage 3              Stage 3
    Landfall                                                           Tier 3
Landfall to start of   Phase II            Phase II
Phase III
Demobilization         Phase III           Phase III               Tailored to
and Deactivation                                                   Requirements
Phase
       Basic ICS Structure

               INCIDENT COMMANDER



                           PIO
             SAFETY
                          LIAISON




OPERATIONS   PLANNING     LOGISTICS    FINANCE AND
                                      ADMISTRATION
       CDC Event Management Challenges


•   Stabilize management structure
•   Core elements the same for all events
•   CDC-wide NIMS training and education
•   Reporting hierarchy
•   Synthesizing information received from field
•   Personnel accountability
•   Refining and exercising the plans
              Command vs Management

• Incident Command (IC)
   –   On scene control over resources
   –   Authority to direct missions
   –   Decision authority to resolve on scene issues
   –   Accountable for success or failure
• Incident Management (IM)
   –   Coordinate, gather information, analyze and recommend
   –   Provide technical assistance through SME’s to the IC
   –   Provide resources as requested by the IC to the scene
   –   No direct authority over field resources
   –   Monitor agency-provided resources in the field.
   –   Agency resources under the Operational Control (OPCON) of the IC.
         Sample Transition from Functional Organization to IMS
          Functional CC/CO/                                                                         IMS Planning Section
         NIOSH Organizations                                                                          Response Mode
                                                                                                         PANFLU


Coordinating Center for                                                                                        Planning Section
           CCID
  Infectious Disease
         (CCID)




       National Center for HIV,
                CCID
        STD & TD Prevention
             (NCHSTP)
                                                                        Technical Specialty Unit                                                Documentation Unit                   Situation
                                                                                                                                                                                Information Systems
                                                                                                                                                                                        Unit




         National Center for
                 CCID
         Infectious Disease
                (NCID)

                                   Infectious Disease                                                                                                                                 Surveillance
                                      Emergency         Envirol/Occup
                                                          Medical                Emergency             Immunizations Team                                    Incident                 BIOSENSE
                                                                                                                                                                                       Systems
                                           Team
                                       Response          Health Team             Chronic Team
                                                                                  Response                 Medical
                                                                                                            (CCID)
                                                                                                                                  Injury Team            Incident Action Plan
                                          (CCID)             Unit                                                                                           Action Plan
                                          Unit                                         Unit                   Unit

        National Immunization
                 CCID
              Program
                 (NIP)
                                                                                                                                                                                       Informatics
                                                                                                                                                                                      Gathering
                                                                                                                                                             Information
                                     Clinical Care      Vector/Rodent                                     Immunization            Environmen                 Operations
                                                                             Displaced Persons                                      Injury
                                                                                                                                         t


                                                                                                                                                                                     BIOWATCH
                                                                                                                                                                                  Other Intel Gathering
                                       Partner/            Partner/
                                                         Chem/Nuc
                                                                                    Partner/
Coordinating Center of                Volunteer
                                      Quarantine         Volunteer            Mental Health (HAT,
                                                          Liaison                 Volunteer
                                                                                 Resilience)
   Planning Section
  Health Promotion                                                                                                                   Mortuar                After Action
       (CCHP)                                                                                                                       Trauma
                                                                                                                                       y                       Lessons
                                                                                                                                                         After Action Review
                                                                                                                                                                Review/
                                                                                                                                                              Learned
                                                                                                                                                                                           GIS
                                    Epidemiology/       Environmental
                                    Mortuary
                                     Sureillance         Food/Water


       National Center for Birth
       Defects & Development                                                                                                                                After Action
                CCID
             Disabilities                                                                                                                                     Lessons
                                                                                                                                                            Demob Planner
             (NCBDDD)
                                                                                                                                                              Review/
                                                          Mortuar                                                                                            Learned
                                       Mortuar           Veterinary                                                                                                                     EARS
                                                                                                                                                                                        Weather
                                     Hospitals              y
                                         y

         National Center for
          Chronic Disease
         Prevention & Health
                CCID                                      Mortuar
                                                         Mortuary
              Promotion                Mortuar              y
                                    Laboratory
             (NCCDPHP)                   y




       Office of Genomics and
                 CCID
         Disease Prevention
               (OGDP)
         Transition from Current Organization to IM for
                               TASKS
        Task Accountability, Authority, and Responsibility
         PLANNING                           RESPONSE
                                     WHO Phases
   0             1            2           3            4             5                 6


Coordinating Centers                                           IMS       = Authority
     and CIOs
   Accountable
                                                    Team Leads and members are
                        Provide                       responsible for coordination,
                         Team                       planning and execution of tasks
                       Resources


Coordinated
                                         Accountability remains with CC/CO/NIOSH
 by Chief
  Health                Guidance
Officer (Jim
  Leduc)

               Responsibility and authority for coordination
               and execution transitions to Team leads and
                     Incident Management System
                                    CDC Incident Management Structure

                                                                                                                                                                    CDC  Incident Commander


                                                                                                                                                                   Director                                                                                                     ESF 8
                                                                                                                                                                                                                                                                                 Area
                                                                                                                                                                                                                                                                                  CoTPER


                                                                                                                                                                                                                                                                              Coordinator

                                                                                                      CO/CC CoTPER


                                                                                                                                                                  Incident
                                                                                                                                                               Incident Manager                                                          Field
                                                                                                                                                                 Manager                                                                 SMO
                                                                                                 CDC LNO-  CoTPER

                                                                                                   HHS

                                                                                                                                                                                                             Deputy
                                                                                                                                                                                                           Chief Health
                                                                                                                                                                                                            Manager
                                                                                                                                              Ethics                                                        Incident
                                                                                                                                                                                                             Officer
                                                                                                                                                                                                           Operations


                                                                                                                                     Deputy
                                                                                                                                  Senior Ops                                                                 Senior
                                                                                                                                                                                                             Deputy
                                                                                           LNO                                      Manager                                                                 Manager
                                                                                                                                    Incident
                                                                                                                                    Officer                                                                 Science
                                                                                                                                                                                                            Incident
                                                                                                                                   Operations                                                              Operations
                                                                                                                                                                                                            Officer



                                                                                                                                         Incident
                                                                                                                                         Safety &                                                         Manager                                 Manager
                                                                                                      JIC                                Manager                                                          SNS LNO                                  OGC
                                                                                                                                         Security                                                         Incident                                Incident




                                                                       Operations                                                                                                                     Planning                                                                                      Planning
                                                                                                                                                                                                                                                                                                    Logistics                               Planning
                                                                                                                                                                                                                                                                                                                                         Finance/Admin
                                                                        Section                                                                                                                       Section                                                                                        Section                                Section
                                                                                                                                                                                                                                                                                                                                             Section




   EOC                                                                                        EOC
                                                                                             EOC                                                                                                                                                                                                                Incident
                Joint Information                                    Operations                                                                                   Technical
                                                                                                                                                               Technical Experts                                            Documentation            Situation
                                                                                                                                                                                                                                                    Information                         Medical
                                                                                                                                                                                                                                                                                       Support                   Medical   Procurement
                                                                                                                                                                                                                                                                                                                              Medical                Finance
Management
Lead LNO                Bran        Personnel Resource
                                           Bran                        Branc               Management
                                                                                          Management                                                                                                                                                                                                            Support                              Finance
                     Center                                        Support Branch                                                                               Specialty Unit
                                                                                                                                                                    Branch                                                      Unit                    Unit
                                                                                                                                                                                                                                                      Systems                          Branch
                                                                                                                                                                                                                                                                                        Supply                   Supply        Supply
                                                                                                                                                                                                                                                                                                                             Branch                  Branch
                                                                                                                                                                                                                                                                                                                                                     Branch
                         ch         Management Branch
                                            ch                            h                 Branch                                                                                                                                                                                                               Teams


                                                                       Request forfor                                                     Environmental/                                                                                               Surveillance
    Duty            Labor              Commissioned Corp.               Request                Duty                    Infectious
                                                                                                                        Emergency          Occupational              Chronic /
                                                                                                                                                                     Emergency          Immunizations         Medical                                                                    EAR
    DHS           Clinician                                        Assistance/Request                                 Response Unit
                                                                                                                     Disease Team           Medical Unit                                 / Medical Unit
                                                                                                                                                                                           Misc Team                                 Incident
                                                                                                                                                                                                                                                        Systems
                                                                                                                                                                                                                                                        BIOSENSE                        Comms                                Non-
                                                                                                                                                                                                                                                                                                                              EAR                    Cost
                                                                                                                                                                                                                                                                                                                                                     EAR
   Officer           atory                Coordinator                  Assistance /           Officer                                      Health Team             Response Unit
                                                                                                                                                                   Injury Team                              Health Team             Incident        (BIO, Intell, BIOWATCH,
                                                                     for Information
                                                                                                                                                                                                                                   Action Plan
                                                                                                                                                                                                                                   Action Plan       TESS, EARS, NEDSS,                   S                                 Medical                Tracking
                                                                                                                                                                                                                                                                                                                                                       S
                                                                                                                                                                                                                                                        VAERS, BRFSS)                                                          S

   Watch        Public Health
                 Communit                     Training/               Action Request
                                                                      Action request          Watch
                                                                                              Watch                    Mortuary
                                                                                                                     Laboratory            Vector/Rodent        Displaced Persons        Immunization        Environment
                                                                                                                                                                                                            Clinical Care
   DHHS                                  Training/Briefing                Mission                                                                                                                                                                     Informatics                          EAR
   Team           y Health
                 Workforce                    Briefing                Forms/Mission
                                                                           Forms/             Team
                                                                                              Team                                                                                                                                                                                       Travel
                                           Coordinator
                                                                       Assignments
                                                                       Assignments
                                                                                                                                                                                                                                                        Gathering
                                                                                                                                                                                                                                                                                            S                                 EAR
                                                                                                                                                                                                                                                                                                                           Requisition
                                            Coordinator                                                              Partner/Volunteer     Partner/Volunteer                                                                       Information                                                                             Management              Finance
                                                                                                                                                                                                                                                                                                                                                     EAR
                                                                                                                      Quarantine            Chem/Nuc
                                                                                                                                               Liaison
                                                                                                                                                                Mental Health (HAT,
                                                                                                                                                                 Partner/Volunteer        Anti-biotic/
                                                                                                                                                                                            Mortuary           Mortuary
                                                                                                                                                                                                             Hospitals                                                                                                          S
                 Community
                                                                                                                                                                    Resilience)            Anti-viral                              Operations                                                                                                       Policy
                                                                                                                                                                                                                                                                                                                                                       S
   Audi
   Visual/        Epidem                     Health                                            Audi
                                                                                               Visual/                                                                                                                                                  Other
                 Outreach &                                                                 Audio Visual/
   FDA
     o             iology                Deployment                                               o
                                                                                           Communication             Epidemiology/         Environmental
Communication    Education                    and
                                         Coordinator                 TaskLiais
                                                                          Tracker          Communications              Mortuary
                                                                                                                      Surveillance            Food/Water          Birth Defects
                                                                                                                                                                      Mortuary                Epi-Aid
                                                                                                                                                                                               Mortuary
                                                                                                                                                                                                             Community
                                                                                                                                                                                                               Mortuary
                                                                                                                                                                                                                                                     Intelligence
                                                                                                                                                                                                                                                       BIOWATCH
      s                                      Safety                       on                      s                                                                                                            Health                                 Gathering                        Facilities
                                                                                                                                                                                                                                   After Action
                                                                                                                                            Veterinary
                                                                                                                                              Mortuary                                                                             After Action
                                                                                                                                                                                                                                     Review/
                                                                                                                                                                                                                                    Lessons
                                                                                                                                                                                                                                                                                                                                                     EAR
                                                                                                                                                                                                                                                                                                                                                   Vouchers
                                                                                                                                                                     Mortuary
                                                                                                                                                                     Injury              Select Agents
     IT          Enterprise               Deployment                                             IT                                                                                         Mortuary                                 Review/
                                                                                                                                                                                                                                    Lessons                                                                                                           S
                                                                             Task
                                                                   Senior Management
                                                                                                IT                                                                                                                                  Learned
   Suppor
    EPA                                    Rostering                                          Suppor                                                                                                                                Learned
                                                                   OfficialTracker
                                                                            Coordinator      Support                                                                                                                                                        GIS                          Trans.
      t                                                                                           t                                          Mortuary
                                                                                                                                            Mortuary
                                                                                                                                                                     Mortuary
                                                                                                                                                                    Trauma
                                                                                                                                                                                                                                                                                        Support
                   Environ
                Policymakers                                                                 Informatics
                                                                                            Informatics
                                                                                                                                           Worker Safety
                                                                                                                                             Mortuary                                                                              After Action
                                                                                                                                                                                                                                     Demob                                                                                                        Personnel
 Informatics        mental                International
                                           Volunteer                                                                                         & Health                                                                               Lessons                                                                                                        EARS
    ARC                                                                  State
                                                                     State/Local                                                                                                                                                     Review/
                                                                                                                                                                                                                                     Planner                                                                                                       Policy
   Support                                 Coordinator
                                          Coordinator                                          Support
                                                                                              Support                                                                                                                               Learned             Weather
                                                                                                                                                                                                                                                         EARS
                                                                        Liaison
                                                                     Coordinator                                                                                                                                                                                                       Receiving/
                                                                                                                                            Chemical
                                                                                                                                             Mortuary                                                                                                                                    EARS
                                                                                                                                                                                                                                                                                       Distribution
                  Media                                                                      Informatics
 Informatics                                                                                   Admin
    DoD                                                               International
                                                                          Federal              Support
   Support
                                                                      Coordinator
                                                                          Liaison
                Information
                     Che
 Informatics    Management
                    mical
     FBI                                                            Deployed Team
                                                                    Deployed Team
   Support
                                                                        Liaison
                                                                     Coordinator
                 Research
 Informatics
  Partners
   Support

                    Rad/
 Informatics        Web
 Foundation         Nuc
   Support


                   Global
                                                                                                                                                                                  Proposed Incident Management System (IMS)
                                                             =    Event
                                                                                                                                                                                                                                                                                                                           Revised:
                                                                 Specific                                                                                                                                                                                                                                              5/26/06 14:15 PM
                       Operations Section

                                Operations
                                 Section




                                                       EOC
                                                      EOC
Personnel Resource         Operations Support
                                  Branc             Management
       Branc                                       Management
Management Branch               Branch
                                    h
          h                                          Branch



                                Request for
                                   Request for          Duty
    Commissioned            Assistance/Request
                                  Assistance /         Officer
   Corp. Coordinator          for Information



                             Action Request
                              Action request           Watch
                                                       Watch
    Training/Briefing
   Training/Briefing              Mission
                             Forms/Mission
                                  Forms/               Team
                                                       Team
       Coordinator
     Coordinator               Assignments
                              Assignments


                                                        Audi
                                                    Audio Visual/
      Deployment                                        Visual/
                                                          o
                              Task Liaiso
                                   Tracker         Communications
                                                    Communications
      Coordination                    n



      International
      Deployment                                         IT
                                                        IT
                                     Task
                            Senior Management
       Coordinator
       Rostering            Official Coordinator      Support
                                                      Support
                                   Tracker



      International
       Volunteer                                      Informatics
                                                     Informatics
                                   State
                              State/Local               Support
                                                       Support
       Coordinator
      Coordinator                Liaison
                              Coordinator


                                                      Informatics
                               International
                                   Federal              Admin
                                                        Support
                               Coordinator
                                   Liaison



                              Deployed Team
                              Deployed Team
                                  Liaison
                               Coordinator
                             Planning Section
                                                                                Planning
                                                                                Section




                                        Technical Specialty
                                          Technical Experts                                                                            Situation
                                                                                                                                       Information
                                                                                                        Documentation Unit
                                               Unit
                                               Branch                                                                                     Unit
                                                                                                                                         Systems



                                                                                                                                         Surveillance
                    Environmental/                                                                                                        Systems
  Infectious
   Emergency         Occupational              Chronic /
                                               Emergency       Immunizations/            Medical
                      Medical Unit                               Medical Unit                                                            (BIO, Intell,
 Response Unit
Disease Team         Health Team             Response Unit
                                             Injury Team         Misc Team             Health Team                  Incident Action
                                                                                                                  Incident Action          BIOSENSE
                                                                                                                                      BIOWATCH, TESS,
                                                                                                                         Plan
                                                                                                                        Plan            EARS, NEDSS,
                                                                                                                                       VAERS, BRFSS)

Laboratory
  Mortuary           Vector/Rodent        Displaced Persons     Immunization            Environment
                                                                                       Clinical Care
                                                                                                                                         Informatics
                                                                                                                                           Gathering
Partner/Volunteer   Partner/Volunteer
                     Chem/Nuc            Mental Health (HAT,
                                           Partner/Volunteer     Anti-biotic/                                       Information
 Quarantine             Liaison                                    Mortuary                  Mortuary
                                                                                           Hospitals
                                            Resilience)           Anti-viral                                        Operations


Epidemiology/        Environmental                                                                                                    Other Intelligence
  Mortuary                                                                             Community                                          BIOWATCH
 Surveillance         Food/Water               Mortuary
                                           Birth Defects          Epi-Aid
                                                                   Mortuary              Mortuary                                        Gathering
                                                                                         Health

                                                                                                                   After Action
                                                                                                                    After Action
                       Mortuary
                     Veterinary
                                               Injury
                                               Mortuary         Select Agents
                                                                   Mortuary                                           Lessons
                                                                                                                 Review/Lessons
                                                                                                                      Review/
                                                                                                                      Learned
                                                                                                                     Learned
                                                                                                                                             GIS
                       Mortuary
                      Mortuary
                                               Mortuary
                                              Trauma


                     Worker Safety                                                                                  After Action
                       Mortuary
                       & Health                                                                                      Lessons
                                                                                                                  Demob Planner
                                                                                                                      Review/
                                                                                                                     Learned              Weather
                                                                                                                                           EARS

                       Mortuary
                      Chemical
          Logistics/F&A Sections
                 Logistics
                 Planning                                 Planning
                                                      Finance/Admin
                  Section                                 Section
                                                         Section




                             Incident
 Support
  Medical                     Medical   Procurement
                                           Medical                     Finance
                                                                      Finance
                             Support
 Branch
  Supply                       Supply     Branch
                                            Supply                     Branch
                                                                      Branch
                              Teams




   Comms
    EARS
                                        Non-Medical
                                           EARS                 Cost Tracking
                                                                    EARS




    Travel
     EARS                               Requisition
                                           EARS
                                        Management                Finance
                                                                    EARS
                                                                   Policy



  Facilities

                                                                  Vouchers
                                                                   EARS


Trans. Support


                                                                 Personnel
                                                                  EARS
                                                                  Policy
 Receiving/
    EARS
 Distribution
                                   DHS
                                  (ESF # 8)
           PFO
            &                                            DHHS
                                                         (ESF # 8)
           JFO

                                                                          SOC/EMG
                         ESF # 8
States            Senior Health Official &                CDC
                                                     Dr. J L Gerberding
                          IRCT



         CDC
 Senior Mgmt Officials                                                          DEOC
        (SMO)


                                                                         Incident      Chief Health
                                                                        Manager           Officer
                                                                       (Phil Navin)   (Steven Redd)

                                                       Deputy IM                                  Deputy Health
                                                        Officer                                      Officer
                                                  (Mr. Bruce Burney)                              (Toby Merlin)



         Chief OPNS                Chief PLANS
                                                                                                                 Public Health
                                                                Chief LOG              Chief FINANCE        Information Integration
              &                         &
         Science OPS                                                                                                Center
                                  Science PLANS
         Potential CDC Missions

● Conduct PH needs assessments and
  environmental assessments.
● Disseminate risk communication messages.
● Provide vaccinations and medical supplies.
● Conduct disease surveillance.
● Provide mental health assessments and
  response.
● Deployment of pharmaceuticals and medical
  supplies.
                                     How is Assistance Deployed?
                                    The Mission Assignment Process
Mission Assignment Processing


  START                                      Requests are made by the Governor of the affected State when the
                                             response is beyond the capabilities of the State and Federal assistance is
                                             requested. Local governments, volunteer organizations, private sector
                       1.1                   state agencies can identify the needs through the State.                                                                                  1.10
State




                 State Requests
                  Assistance by                                                                                                                                                  State Provides
                                                      Action
                Completing Action                                                                                                                                                   Required
                                                     Request
                  Request Form                                                                                                                                                   Signatures and
                                                      Form
                (ARF) and Sends                                                                                                                                                  Sends Back to
                    to FEMA                                                                                                                                                          FEMA




                                                                                                                                                                                        1.9
                       1.2                                                                                                                                                                                                 1.11
                                                                                                      1.3b                                                                      FEMA Issues a
               FEMA Receives ARF                                                                                                                                               MA and Sends to                      FEMA Receives
                  and Issues to                             What Type of
FEMA




                                                                                   Other        Response is                                                                    State for Required                   Signed MA and
                                                         Federal Assistance
                 Appropriate ESF                                                               Attended to by                                                                      Signatures                       Issues to IRCT/
                                                           is Requested?                                                  An MA is a work order issued by FEMA to a
               Based on the Type of                                                           Appropriate ESF                                                                                                          ESF8 for
                                                                                                                          Federal agency directing completion of a
                Federal Assistance                                                                                        specific task, and citing funding, other                                                  Execution of the
                   Requested                                                                                              managerial controls, and guidance. An MA is                               Mission             Mission
                                                                                                                          issued in anticipation of, or response to, a                            Assignment
                                                                                                                          Presidential declaration of a major disaster or
                              Public Health and Medical Services                                                          emergency.



                       1.3a                                                                                                                                                                                                1.12
               IRCT/ESF8 Receives                                                                                                                                                                                      IRCT/ESF8
                ARF from FEMA for                                                                                                                                                                                   Receives MA and
              Processing and Notifies                                                                                                                                                                                 Executes the
              Secretary's Operations                          1.5                                                                                                                                                        Mission
                                                                                                                  Who is the
              Center (SOC) to Expect                                                                              Appropriate
DHHS




                                                                                              OPDIV
                                                   SOC Receives ARF
                       ARF                                                                                         OPDIV?
                                                    and Tasks ARF to
                                                     the appropriate                                                                                     1.7                            1.8
                       1.4                          OPDIV to Process                       1.6b
                                                                                                                                                                               IRCT/ESF8 Sends                             END
                                                       the Request
                                                                                     Response is                                                SOC Receives                   Completed ARF to
                                                                                    Attended to by                                            Completed ARF and               FEMA for Processing
              IRCT/ESF8 Sends ARF                                                    Appropriate                                               Forwards to IRCT/                 and for Mission
                                                                                                                  OPDIV(CDC)
                     to SOC                                                             OPDIV                                                       ESF8                        Assignment (MA)
                                                                                                                                                                                    Number


                                                                                                                                                                            ACRONYMS:
                                                                                                                     1.6a                                                   ARF: Action Request Form
OPDIV - HHS




                                                                                                                                                                            CIO: Center/Institute/Office
                                                                                                          Lead CIO Receives ARF                                             DHHS: Department of Health and Human Services
                                                                                                         and Discusses the Mission                                          ESF: Emergency Support Functions
                                                                                                          Capability and Develops                                           FEMA: Federal Emergency Management Agency
                                                                                                          SOW and Costing for the                                           MA: Mission Assignment
                                                                                                          Mission and Provides to                                           IRCT: Incident Response Coordination Team
                                                          The SOW provides the feasibility of the
                                                                                                                    SOC                                                     SOC: Secretary's Operations Center
                                                          mission and answers the questions:
                                                                                                                                                                            SOW: Statement of Work
                                                          Who? What?
                                                          Where? When? How? How much?                                                                                       Note: There are 3 types of MAs (1) Federal Operations Support
                                                                                                                                                                            (FSO), (2) Technical Assistance (3)Direct Federal Assistance
                    Hurricane Single-State
                    Command Structure

                                                            Secretary
                                                             Chertoff
                     Texas                                     DHS

   Governor                                     HHS     IIMG      FEMA   HHS LNO
                      PFO-RITA



                            JFO-Austin
    State                                OPEO
    EOC
                              SCO/
                              FCO

                      ESF#
      SMO                      OPEO
                        8

                                                                                   HHS Support
                                                                                     CDC
State DOH     CDC    HRSA      VA     OFRD            FDA                           Support
CDC Senior Management Official:

            Role in

     Emergency Response
      SMO - Primary Emergency
        Response Functions
• Oversight of
  CDC resources
  in the state
  during an
  emergency
  event

• Provide
  technical
  assistance to the
  state
     SMO - Primary Emergency
       Response Functions
• Provide situational
  awareness for both
  the state and CDC

• Act as a point of
  connection for state
  and federal
  response systems
  and interact with
  other response
  partners
               Oversight of CDC
                 Resources
• Responsible for
  CDC resources and
  personnel activated
  or deployed to state
  under the IRCT
• Assure maximum
  coordination of CDC
  resources with
  DHHS and State
  Health Official to
  support State
  requirements
               CDC Field Response
                   Structure               State DOH



                     CDC Senior         Incident Response
Joint Field       Management Official   Coordination Team
Office (JFO)           (SMO)                  (IRCT)

    Locally                             Provides on-site
  conducts                              information from
   incident                               all sources to
management                                 Secretary's
and Federal                             Command Center
 Assistance               CDC             for passing to
coordination          Field Teams        other Operating
                                            Divisions,
                                          Agencies, etc
          When a CDC
        Mission is Over….
● Rotation, every two to three weeks
● Containment or mitigation of the
  event
● State reassumes roles
● SOC returns to normal operations
● RRCC returns to normal operations
            CDC Event
       Management Challenges
● Stabilize management structure
● Core elements the same for all events
● Reporting hierarchy
● Synthesizing information received from
  field
● Personnel accountability
● Refining and exercising the plans
● CDC-wide NIMS training and education
                      Additional Resources
Federal Emergency Management Agency (FEMA)          www.fema.gov

ICS
• IS-100 Introduction to Incident Command System, I-100
       http://training.fema.gov/EMIWeb/IS/is100.asp
• IS-200 Basic Incident Command System, I-200, for Federal Disaster Workers
       http://www.training.fema.gov/EMIWeb/IS/is200.asp
NIMS
• IS-700 National Incident Management System (NIMS), An Introduction
       http://training.fema.gov/EMIWeb/IS/is700.asp
NRP
• IS-800 National Response Plan (NRP), An Introduction
       http://www.training.fema.gov/EMIWeb/IS/is800.asp

National Emergency Management Association (NEMA)
    http://www.nemaweb.org
•   NEMA-CDC Incident Command System for Executives: Training Package
       http://www.nemaweb.org/?1100
               Additional Resources
National Wildfire Coordinating Group (NWCG) www.nwcg.gov/default.htm

There are six courses in the NWCG ICS curriculum:

•   I-100 ICS Orientation (Self-study; Module 1)
        http://www.nwcg.gov/pms/forms/ics_cours/i100/I100text.pdf
•   I-200 Basic ICS (Modules 2-6)
        http://www.nwcg.gov/pms/forms/ics_cours/i200/i200.pdf
•   I-300 Intermediate ICS (Modules 7-11)
        http://www.nwcg.gov/pms/forms/ics_cours/i300/i300.pdf
•   I-400 Advanced ICS (Module 12-15)
        http://www.nwcg.gov/pms/forms/ics_cours/i400/i400.pdf
•   I-401 Multi-Agency Coordination (Module 16)
        http://www.nwcg.gov/pms/forms/ics_cours/i401/i401.pdf
•   I-402 ICS for Executives (Module 17)
        http://www.nwcg.gov/pms/forms/ics_cours/i402/i402.pdf
              Director’s Emergency
               Operations Center

●   Operational 24/7/365
●   Uses Incident Command - FLOP
●   Conducts Information Management
●   Space for Agency LNOs
●   Complete Logistics
●   Redundant Communications
●   Functional Area Action Officers


               770-488-7100
    Questions?
Success for the future….
                                 Acronyms
•   HSPD: Homeland Security Presidential Directive
•   NIOSH National Institute of Occupational Safety and Health
•   OWCD: Office of Workforce and Career development
•   OSEP: Office of Security and Emergency Preparedness
•   CCHP: Coordinating Center for Health Promotion
•   CCID: Coordinating Center for Infectious Disease
•   CCEHIP: Coordinating Center for Environmental Health and Injury Prevention
•   ATSDR: Agency for Toxin Substances and Disease Registry
•   DSNS: Division of Strategic National Stockpile
•   OD/OCOO: Office of the Director/ Office of Chief Operation Officer
•   CCHIS : Coordinating Center for Health Information Service
•   SME: Subject Matter Expert
•   ESF: Emergency Support Function
•   ICS: Incident Command System
•   NIMS: National Incident Management System
•   OPEO: Office of Preparedness and Emergency Operations
•   FLOP: Finance, Logistics, Operations, and Planning (Sections of ICS )
•   IRCT: Incident Response Coordination Team
•   LNO: Liaison

								
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