Region 1 Standard Operating Guidelines (SOG)
Annual Pre-Event Planning
OBJECTIVE: Effective and Efficient Pre-Event Planning: Includes all 15 CDC Public Health Capabilities. Depending on the nature of the emergency, there may be a need to dispense medication at an Emergency Dispensing Site (EDS SOG); perform disease investigations (Disease SOG); ensure safe food and water (Food/Water SOG); monitor safe housing (Housing SOG); assist with sheltering (Shelter SOG); and all emergencies will likely depend on effective Risk Communications (PIO SOG) and include individuals with functional and access needs (FNSS SOG).
SPECIAL CONSIDERATIONS:
· Most emergencies have a public health component, so Local Public Health (LPH) officials should work closely with Response Partners on All Hazards Emergency Plans.
· Depending on the nature of the emergency, it is likely that there will be a need for at least some Risk Communications/Public Information as this is an essential LPH response tool (PIO SOG).
CONCEPT OF OPERATIONS: This guide assumes continuous pre-event planning and is NOT a substitute for any Plan, Laws, Regulations or Official Forms. It assumes all planning follows these common steps:
1. Assess Current Situation/State
Assess Organizational Roles and Responsibilities
Assess Resource Elements
o Planning
o Skills/Training
o Equipment/Technology
Assess Performance
o Data Collection
o After Action Reports and Improvement Plans
o Continuous Quality Assurance process
2. Determine Goals
Review Jurisdictional Inputs
o Existing data from jurisdictional hazards and vulnerability analyses
o Emergency management plans
o Funding considerations (e.g., guidance or funding requirements from related federal preparedness programs)
o Previous strategic plans or planning efforts
o Previous state and local accreditation efforts
o CDC’s Strategic National Stockpile Technical Assistance Review results
o After Action Reports/Improvement Plans
o Previous performance measure results
Prioritize Capabilities and Functions
o Bio-surveillance
o Community resilience
o Countermeasures and mitigation
o Incident management
o Information sharing
Capacity Priorities to Consider:
o Missing/incomplete priority resource elements
o Performance/ability is substantially lower than needed
o Risks and threats to the public health, medical, and mental/behavioral health system
o Ability to close gaps and develop capability is greatest
o Evidence-based practice
Develop and Prioritize Short and Long term goals
3. Develop Plans
Plan Organizational Initiatives
o Group Goals as appropriate that can be addressed together
o Identify partners needed to reach Short-Term Goals
o Engage in concrete activities to meet Goals
Plan Capability Building / Sustain Activities
o Building and Sustaining includes partnerships, MOUs, stakeholders, technical assistance, training, exercises, resources, equipment, and technology.
o Scaling Back when priorities, barriers or resources change.
Plan Capability Evaluations / Demonstrations
o Plans
o Demonstration of Capabilities through routine activities, exercises, real world events
· Collect Data related to Capability Measures
· Evaluations/After Action Reports
· Quality Assurance and Improvement Plans
Assumptions:
· Local Public Health (LPH) officials follow the National Incident Management System (NIMS) and Incident Command System (ICS).
· All activities are documented and tracked.
· Public Health will play either a lead or supporting role, depending on the scope of the event. LPH may be the Incident Commander (IC) or be asked by the IC or his designee to:
o Assess the Public Health situation
o Contact public and private partners who work with LPH
o Provide information and Risk Communications (Public Information) to the public and responders
o Inspect facilities to ensure compliance with minimum environmental and health safety standards.
o Provide sampling, testing and interpretation
o Investigate diseases
o Recommend rationing standards
o Assist with volunteer management
o Advise on Individuals Requiring Additional Assistance and those with Access and Functional Needs
Instructions: Page one is a table of contents (TOC). Each item in the TOC points to a section with a checklist of actions to consider, including:
Section 1: Planning and Mitigation: procedures common to all incidents and addresses all 15 CDC public health capabilities which should be addressed in coordination and cooperation with stakeholders and response partners. Many public health emergencies include multiple issues such as safe food, water, air, housing, disease prevention, public information, etc. Consider consulting multiple SOGs.
Section 2: Training and Exercises: specific and all hazards training and exercise actions that support the 15 capabilities.
☒ Check Boxes: Can be used to track action items considered or acted upon. In the Resource/Assigned Column find and add resources: items, plans, people.
µ Starred Items are critical tasks that should always be considered in any large scale Emergency/Incident
Grey shaded area indicate suggested risk communication activities
Region 1 Standard Operating Guide: Annual Pre-Event Planning 2.26.13 Page 29
Region 1 Standard Operating Guidelines (SOG)
Annual Pre-Event Planning
TABLE of CONTENTS
1. Planning and Mitigation /Begin Within
1.1 Community Preparedness /Ongoing Partnerships
1.2 Community Recovery / Ongoing Partnerships1.3 Emergency Operations Coordination / Immediately
1.4 Emergency Public Information and Warning / Update CERC Annually
1.5 Fatality Management / Partner with Hospitals
1.6 Information Sharing
1.7 Mass Care (Sheltering)
1.8 Medical Countermeasures Dispensing (EDS) / Update EDS Annually
1.9 Medical Material Management and Distribution
1.10 Medical Surge (Alternate Care Sites)
1.11 Non-Pharmaceutical Interventions (NPI)
1.12 Public Health Laboratory Testing
1.13 Public Health Surveillance & Epidemiological Investigation
1.14 Responder Safety and Health
1.15 Volunteer Management
2. Training and Exercises / Begin Within
2.1 ICS/NIMS / Immediately
2.2 Emergency Support & Response: PIO, Legal Nuts & Bolts, Behavioral Health, Disease Surveillance, MAVEN / Within 1 year
2.3 Public Health Capacity Building: LPHI, MHOA, MAHB, DPH, DEP, ServSafe, / Ongoing
2.4 Partnerships/Networks / Ongoing
2.5 Exercises and Improvement Plans / Ongoing, at least annually
Planning Quick Overview: Emergency Planning is a primary responsibility of the BOH. Plans should include:
µ PEP: Personal Emergency Plan (PEP); Food Establishment/Business Emergency Plan; School Emergency Plan (SEP);
µ HVA: Hazard and Vulnerability Assessment
µ All Hazard Emergency Plan: including FNSS Functional Needs Support Services (IRAA); Disease Surveillance, I & Q
µ COOP: Continuity of Operations Plans
µ PIP/CERC: Public Information Plan; Crisis + Emergency Risk Communications Plan - Joint Information Systems (JIS)
µ Sheltering: both local and regional sheltering, including FNSS
µ EDS: Emergency Dispensing Site Plan
µ Health Care Coalition Plans: public health, health care, mental health, public safety and community partners.
µ Volunteer Management Plan: includes both affiliated and unaffiliated spontaneous volunteers (SUV)
1. Planning and Mitigation
1.1 Community Preparedness /Resources/Notes
Definition: Community preparedness is the ability of communities to prepare for, withstand, and recover — in both the short and long terms — from public health incidents. By engaging and coordinating with emergency management, healthcare organizations (private and community-based), mental/behavioral health providers, community and faith-based partners, state, local, and territorial, public health’s role in community preparedness is to do the following:· Support the development of public health, medical, and mental/behavioral health systems that support recovery
· Participate in awareness training with community and faith-based partners on how to prevent, respond to, and recover from public health incidents
· Promote awareness of and access to medical and mental/behavioral health resources that help protect the community’s health and address the functional needs (i.e., communication, medical care, independence, supervision, transportation) of at-risk individuals
· Engage public and private organizations in preparedness activities that represent the functional needs of at-risk individuals as well as the cultural and socio-economic, demographic components of the community
· Identify those populations that may be at higher risk for adverse health outcomes
· Receive and/or integrate the health needs of populations who have been displaced due to incidents that have occurred in their own or distant communities (e.g., improvised nuclear device or hurricane)
µ Personal Emergency Preparedness Plan (PEP)
µ Business/Food Establishment Emergency Plan
µ School Emergency Plan (SEP) / Everyone should have a plan.
See Region 1:
PEP, SEP and FE Templates
µ Hazard and Vulnerabilities Risk Assessment (HVA)
Definition of Risk
Potential Hazards and Risks
Probability of Risk
Mapping of Risks
Community involvement in Risk Assessment Process
Relation of Risk to health systems
High Impact Risk to public health, medical and behavioral health systems
o Pandemic Flu; SARS, etc.
o Large Earthquakes that disrupt power and transport
o Hurricanes and flooding
o Ice/Snow Storms with long term power outages
o Chemical/Radiological Event
o Animal/Agricultural Disease
µ Written Public Health All-Hazards Plan with FNSS: / Planning Partners include:
- State/Local Health Depart.
- Emergency Management
- Chief Elected Officials (CEO)
- Hospitals
- EMS
- Law Enforcement
- Fire
- DPW
- Transportation
- Dispatch/Communications
- Mental Health Services
- Social Service Agencies
- Long-Term Care (LTC)
- Community Based Org. (CBO)
- Faith Community
Public Health, medical, mental health services for entire population, including vulnerable individuals/groups who may require C-MIST support services for IRAA (Individuals Requiring Additional Assistance)/ FN (Functional Needs)
Community Environmental Health and Safety (Safe Food, Water, Air, Housing, etc.)
Disease Surveillance and Investigation
Needs of individuals concerned about adverse health effects
Risk Communications/Public Information
Family Reunification
Pet Services
Psychological First Aid
Decontamination
Isolation and Quarantine
Distribution of Medical Materials (EDS)
Debris and Waste Management
Burial Management
Personal Protective Equipment (PPE) and Workforce Protection
MOU/ MAA with CBO who can assist in maintaining health services
Function 1: Determine risks to the health of the jurisdiction / Work with Planning Partners
Task 1: Identify Essential Public Health, Health and Mental Health Services
Environmental Health (Local Health Departments)
Disease Investigation (Local Health Department, Public Health Nurses)
Medical Surge (Hospitals)
Medical Care (Medical Providers, Clinics)
Medications (Pharmacies, SNS)
Behavioral Health (Mental Health Providers)
Medical Transport (EMS)
Fatality Management (ME, Hospitals, Funeral Homes, Cemeteries) / Include community stakeholders in assessing and prioritizing risks and hazards.
Task 2: Identify services that support mitigation of disaster health risks.
Social Services Agencies
Mental Health Services
Substance Abuse Services
Faith Community Services (Food Pantries, Kitchens, Shelters)
Elder Services
Hospitals
Clinics and Medical Providers
Cultural Organizations
Service Organizations (Kiwanis, Rotary, Shriners, etc.)
Voluntary Organizations Active in Disasters (VOAD): Salvation Army, American Red Cross, Religious Organizations, / Community Health Assessment (CHA)
Community Health Improvement Plans (CHIP)
IRAA/Functional and Access Needs Planning
Hazard Vulnerability Assessment (HVA)
Fatality Management Plans
Continuity of Operations Plan (COOP)
VOAD/COAD Plans
EMS Area Plans
Function 2: Build community partnerships to support health preparedness
Task 1: Community sectors to engage include:
Business
Community Leadership
Cultural and Faith-Based Groups
Emergency Management
Healthcare
Social Services
Housing and Sheltering
Media
Mental/Behavioral Health
State Office of Aging/Elder Services
Education and Childcare / Encourage medical professionals to join MRC
Task 2: Engagement strategies for priority community groups
Participate in existing partnerships/groups such as REPC/LEPC
Create new partnership groups
Engage and document community input on priorities, policies, plans
Provide and document outreach to support Agency Emergency Plans
Task 3: Engage social service/Faith CBO to ensure essential services
Document roles such as providing Rest Centers, behavioral health support, Recovery efforts
Task 4: Continuous quality assurance process with partners
Task 5: Identify trusted community spokesperson(s)
Function 3: Engage community organizations to foster public health, medical and mental health social networks / Ensure plans identify culturally competent strategies to support community resiliency
Task 1: Ensure community groups know how to connect with Public Health
Task 2: Ensure community service providers are connected to Public Health
Task 3: Create community networks to disseminate information
Function 4: Coordinate training or guidance to ensure community engagement in preparedness efforts / Especially include strategies to address the needs of children
Task 1: Integrate resilience strategies into all education and training / Support/promote MRC
Task 2: Support/promote emergency education/training
Task 3: Support/provide emergency education support for agencies to provide PEP to their clients
Risk Communications: Community Preparedness / Resources/Notes
Update Responders and Public on preparedness activities; Personal Emergency Planning (PEP) and volunteer opportunities (MRC, CERT). / This establishes the LPH as a source of credible information
1.2 Community Recovery
/Resources/Notes
Definition: Community recovery is the ability to collaborate with community partners, (e.g., healthcare organizations, business, education, and emergency management) to plan and advocate for the rebuilding of public health, medical, and mental/ behavioral health systems to at least a level of functioning comparable to pre-incident levels, and improved levels where possible.µ Written Continuity of Operations Plan (COOP)
Essential Public Health Services/Tasks. Ensure:
o Safety of LHD Staff
o LHD Finance and Operations
o Safe Food, Water, Air, Housing,
o Disease Surveillance and Investigation
o Isolation and Quarantine
o Risk Communications
o High Risk Complaint investigation
o Enforce essential public health laws/regulations
o Maintain and protect Essential/Vital Records
Essential and scalable Workforce and contingency Staffing strategies such as partnering with neighboring communities and volunteers
Ability to limit Worksite access to protect Workforce
Essential Roles at least 3 deep
Contracts include the requirement that Staff work during emergencies and take on new roles
Delegation of Authority and Leadership succession