Public Health Emergency Preparedness- A CT Perspective

1. Public Health Emergency Preparedness- A CT Perspective Charles Brown, MPH CADH

2. Overview of Learning Objectives 1. Review the development of public health preparedness planning in CT to include reaction to Anthrax attacks, planning for Category A agents and development of regional planning models. 2. Discuss the concept of Emergency Support Functions and how diverse disciplines within Health and Medical Services support each other during an incident. 3. Discuss the functional role of regional support for health and medical service agencies and how the 3 C's (Communication, Collaboration and Coordination of Resources) enable regional response structures.

3. Local Public Health in CT • Local Public Health in Connecticut • Full-time Municipal • Health Districts • Part-time Departments • Differences in Capabilities • Differences in Capacity

5. Status of Preparedness • Before 9/11/01 • Agencies did not have preparedness focus • Lack of relationships with traditional first responders • Relationships between LHDs spotty • 9/11 and Anthrax Attacks • Changed how PH was viewed • Oxford Anthrax Death • LHDs responded

6. Plan Development • PHERPs • Overarching plan for response • Annex to LEOPs • PHERP Annexes • Smallpox • Pan Flu • Mass Dispensing • Mass Vaccination

7. Development of Regions • No county government structure • No statutory authority • Evolved from 42 to 10 to 5 • 42 Smallpox Planning Areas • Since consolidated to 41 Mass Dispensing Areas • 10 Bioterrorism Planning Areas • 5 PH Preparedness Regions • Align with DESPP (DEMHS) regions

8. Emergency Support Functions

9. ESF-8 • Health and Medical Services • Hospitals • EMS • Public Health • Behavioral Health • CHC • LTC • Other Health Agencies

10. How Disciplines Cooperate • Depends upon the emergency • Mass Casualty • PH Emergency • Situational Awareness • Affects operational posture • Provides opportunity to contribute

11. Preparedness Regions in CT

12. Functional Role of Regions • Region is more than the sum of the parts • Function of the region is support • Local Incident Command stays in charge • Regional resources support local responses • No regional role without a local request to activate the regional plan

13. Three C’s • Communication • Collaboration • Coordination

14. Communication • Protocols • Defined message types and associated responses • Methods • Blast Email • Blast Fax • Phone message

15. Collaboration • If you can help, you do • Intrastate Mutual Aid

16. Coordination • Coordinate Resources • Primarily personnel • PH Specific material • Resource Management is Key • Closest not always best • Ring Theory of Deployment

17. Regional Coordination Centers • Provide nexus of information and coordination in an emergency

18. How? • Multiple methods will be used to communicate information throughout ESF-8: • Phone, fax, and email • WebEOC, Everbridge and Maven are not written in the plan yet, but we are looking into how to integrate them. This is forthcoming. • RICS and the Duty Officer will still be notified of an event, then communication will go to the ESF-8 Chair or Section head. • Information will be disseminated down through the discipline specific channels as needed. • For Public Health- there are specific types of messages that may be sent out with a required action in a given timeframe.

20. Notification with RESP Activation Local agency determines that there is the potential need for regional resources Contact Duty officer Duty officer determines actions necessary to assist LHD. Send communication to the public health section chair (PHSC) Regional Public Health Advisory Regional Public Health Stand-by Notice

21. LHDs acknowledge receipt of message PHSC notifies Region LHDs with alert type via phone, fax, email The PHSC will follow-up with non-responding agencies via phone or voice communication Upon receipt of the Regional Public Health Stand-by Notice, LHDs should perform an inventory of their available resources, both material and human, by completing an Individual LHD Response Resource Inventory Sheet The Regional Coordination Center will ensure that all regional partners have responded to the Regional Public Health Stand-by Notice The Regional Coordination Center will report the data on available public health resources to the Liaison Officer (or equivalent) at the incident site The Regional Coordination Center will compile the data on available regional public health resources

22. Incident Related Communication Matrix Region 3 ESF-8 Public Health & Medical Services RESF 8 – Regional Emergency Support Function 8 (Health & Medical) RCC = Regional Coordination Center (Region 3 or ESF-8) Escalating Mutual Aid CT-DPH – for regulatory reporting requirements Ever-Bridge Notification Event Alert RESF-8 Communication Network / intra-discipline / section communication RESF 8 Section / Duty Officer- notification & initial coordination as needed RESF-5 Duty Officer (via RICS) – Duty Officer / plan (RESP) activation Local ESF-8 stakeholder communicates with:

23. Incident Related Communication Matrix Region 3 ESF-8 Public Health & Medical Services Regional Public Health / Medical Services Emergency CT-DPH – for regulatory reporting requirements / resource coordination Establish communication w/requesting authority -situational awareness and Coordinate requested resources w/through local organizations / jurisdictions & State (DPH ECC/DEMHS EOC) situation / status report. RCC Activation: Monitor Partial Full RESF-8 Communication Network / intra-discipline / section communication RESF-5 Duty Officer (via RICS) – Duty Officer / plan (RESP) activation Local ESF-8 stakeholder communicates with: EverBridge Notification/ Event Alert Local ESF-8 communicates with RCC / ESF-8 to Stand Down