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Emergency Preparedness Public


									                    Public Health Emergency Preparedness and Response
                                                                                  Tamah Alsup League, R.N., B.S.N.
                                                                      Nurse Planner Region 4 East Central Oklahoma
                                                                      Emergency Preparedness & Response Services

Role of Public Health During Times of Disaster
     Protect and promote health, prevent disease and injury
     Ensure effective coordination of all resources necessary to respond to the environmental, health and
        medical needs of the population

Homeland Security Presidential Directives
   HSPD-5: Management of Domestic Incidents
       Establishes NIMS and All-Hazards Planning
   HSPD-8: National Preparedness
       Designates Public Health a Response Agency as part of the National Response Plan
   HSPD-21: Public Health & Medical Preparedness
       Catastrophic Health Events
                       Man-Made Disasters including Terrorist Attacks
                       Other Naturally Occurring Events including Pandemics

Emergency Operations Plan (EOP)
    Primary Emergency Management Protocol for Disaster Response Operations
    Contains 15 Emergency Support Functions (ESF)
    ESF #8: Public Health and Medical Services
    State Coordinating Agency – Oklahoma State Department of Health
           State Level:     Commissioner of Health
           Local Level:     County Health Department Administrator
                     “County Health & Medical Coordinator”

Public Health & Medical System Response
   Response Involves:
    All those components of the public health and medical system required to triage, treat, medicate and
        provide on-going care to the population affected
    Local, regional, state or national level

Public Health & Medical System
    Health departments
    Hospitals
    EMS and non-emergent medical transport providers
    Private practitioners and clinics
    Nursing homes
    Home health agencies
    Pharmacies and pharmaceutical suppliers
    Therapists and mental health providers
    Hospice providers
    DME suppliers
    Other
System Challenges
     Largely consists of private practitioners and private institutions that function independently
     May be competitors
     Poor communication between agencies/disciplines
     Prone to uncoordinated response efforts
     Can easily exceed capacity of the providers – medical surge

Medical Surge
   Medical Surge –
       An increase in the number of sick or injured patients beyond limits considered to be normal
   Surge Capacity –
       The ability to treat or provide care to an increasing number of patients that challenges or exceeds normal
       operating capacity
   Surge Management –
       The ability to manage patient flow in order to coordinate use of all available resources with the intent to
       not overwhelm the infrastructure

Surge Management
     Hospital Beds and Emergency Departments
     Field Treatment Facilities
     Physician Offices and Clinics
     Health Departments/Mass Medication
     Decontamination and Isolation Capacity
     Mental Health Services
     Laboratory Testing
     Pharmaceuticals
     Mass Fatalities
     Public Information
     Other

Capabilities Based Planning
    “Planning, under uncertainty, to provide capabilities suitable for a wide range of threats and hazards
        while working within an economic framework that necessitates prioritization and choice.”
    Federally Funded Capability Enhancement Grants
             Public Health Emergency Preparedness (CDC, HHS)
             Hospital Preparedness Program (ASPR, HHS)

Overarching Requirements
    NIMS Compliance
    Specialized Education and Training
    Coordinated Drill and Exercise Program
    At-Risk Population Planning
    Pandemic Influenza Planning
    Volunteer Management
System Enhancement Initiatives
     Implementation of Statewide Mass Medication/Immunization Strategy (MIPS)
     Strategic National Stockpile Receipt and Distribution Program
     Public Health Emergency Operations Center (Situation Room)
     Regional Public Health Response Teams
     Expanded Laboratory Capability and Capacity
     Enhanced Disease Reporting Capabilities
     Establishment of Oklahoma Health Alert Network (OK-HAN)
     Public Health Responder Database
     Development of Crisis and Emergency Communication Plan
     Public Health Videoconferencing System
     Enhanced 2-Way Communication Systems
     Information Technology Enhancements
     State, Local and Tribal Pandemic Influenza Plans
     Continuity of Operations Planning (COOP)
     Specialized Training and Education
     State Drill and Exercise Plan
     State Special Needs/At-Risk Populations Task Force

Tiered Response System
    Medical Surge Capacity & Capability System (MSCC)
     Multi-Level Response System
     Six–tier Construct
     Individual HCF to Federal Assistance
     Integration with Emergency Operations Plans (EOP)
     Responsibility rather than Authority

Medical Surge Capacity & Capability System
   Tier I - Management of individual healthcare facility (HCF) assets
   Tier II - Organization of individual healthcare assets into a single functional unit – or coalition
   Tier III – HCF integration with other response disciplines to maximize capacity and capability
   Tier IV - State-level response in support of jurisdictional incident management
   Tier V -Coordination of multi-state assistance in support of response operations
   Tier VI - Federal response and assistance

Oklahoma’s ESF-8 Response System
   Key Tier I and II Public Health Response Partners (Local)
    Hospitals and Treatment Centers
    EMS Agencies
    Clinics and Other Providers
    Metropolitan Medical Response System (MMRS)
    Medical Emergency Resource Centers (MERC)
   Key Tier III and IV Public Health Response Partners (Regional and State)
    Regional Medical Response System (RMRS)
    Medical Emergency Resource Centers (MERC)
    Medical Reserve Corps (MRC)
    Other State Agencies
   Key Tier V Public Health Partners (Interstate)
    FEMA Region VI ESF-8 Response Coordination Group
   Key Tier VI Public Health Partners (Federal)
    FEMA Region VI Office of Emergency Preparedness
    National Disaster Medical System (NDMS)
    Strategic National Stockpile (SNS)
The Future
    Areas of Focus
            Individual and Community Level Preparedness
            Continuity of Operations Planning (COOP)
            Response Assessment and Continuous Improvement
    Challenges
            Funding Concerns
            Other Real World Events
            Mission Creep
            Short Timelines
            Burnout
            Apathy

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