What Is It And How Will We Measure It? Capability Cliff Notes Series PHEP Capability 3—Emergency Operations Coordination What Is It And How Will We Measure It?

Learning Objectives Become familiar with Capability Functions Become familiar with Tasks that complete the Functions Understand how these Functions and Tasks are measured or may be measured in the future (Performance Measures)

Emergency Operations Coordination Emergency operations coordination is the ability to direct and support an incident with a system of organization and supervision according to standards and practices of the National Incident Management System. How can health departments efficiently coordinate their activities in emergency operations?

Emergency Operations Coordination Functions What Can Health Departments Do to Make Emergency Operations Efficient and Effective? Conduct preliminary assessment to determine the need for public health activation Activate public health emergency operations Develop incident response strategy Manage and sustain the public health response Demobilize and evaluate public health emergency operations

Capabilities and Measures Resources The presentation will be an overview of what the functions and tasks mean, linked to the performance measures. The performance measure for this capability is Staff Assembly: 3.1 Time for pre-identified staff covering activated public health agency incident management lead roles (or equivalent) to report for immediate duty. Start Time: Date and time that a designated official began notifying staff to report for immediate duty to cover activated incident management (IM) lead roles Stop Time: Date and time that the last staff person notified to cover an activated incident management lead role reported for immediate duty Performance Target: Awardees must establish a performance target of 60 minutes or less for this measure. Specific data elements can be found in the 2014 Performance Measures and Specifications Guidance, on the OEPR website, pages 24-28 at the following link: https://www.colorado.gov/pacific/cdphe/hpp-and-phep-performance-measures-and-capabilities

Function 1: Conduct preliminary assessment to determine the need for public activation Tasks: What can health departments do to determine at what level to activate? At the time of an incident, work with jurisdictional officials (e.g., other agency representatives; elected or appointed leadership officials; epidemiology, laboratory, surveillance, medical, and chemical, biological, and radiological subject matter experts; and emergency operations leadership) to analyze data, assess emergency conditions and determine the activation levels based on the complexity of the event or incident. Activation levels should be consistent with jurisdictional standards and practices. During each incident, determine whether public health has the lead role, a supporting role, or no role. These roles are defined as follows: Lead role: Public health has primary responsibility to identify what needs to be done, how to do it, and task other supporting agencies in the appropriate activities. Example of situation in which public health has lead role: An influenza outbreak. Supporting role: Public health may be tasked to fulfill public health activities by another lead agency, when there are public health implications. Example of situation in which public health has a supporting role: Oil spill. No role: There is no public health implication Define incident command and emergency management structure for the public health event or incident according to one of the Federal Emergency Management Agency (FEMA) types. FEMA incident type may have an impact on training and accreditation requirements and may help determine what level of resources are needed and how to request more resources using standardized language for emergency response. For types, please see this link: http://training.fema.gov/EMIWeb/IS/ICSResource/assets/IncidentTypes.pdf

Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Matrix showing public health involvement in potential incidents based on jurisdictional risk assessment Process for acting upon information indicating incident with public health implications At least one representative trained at a minimum to the CDC definition of Responder Training level Tier 4 Communications equipment with a primary and backup system

Function 2: Activate public health emergency operations Tasks: What are the tasks needed when a health department activates operations? Before an event or incident, identify incident command and emergency management activities for which public health is responsible. Before an event or incident, identify a staff pool who have the skills to address the public health issues in an incident. The staff pool should include public health subject matter experts, Incident Commander, Section Chiefs, Command Staff, and support positions (e.g., Informational Technology Specialist). Before an event or incident, identify specific staff to serve in the needed roles for as many operational periods as necessary for continuous staffing during activation. Tasks continued on the next slide:

Function 2: Activate public health emergency operations Tasks Cont’d: What are the tasks needed when a health department activates operations? Before an event or incident, identify primary and alternate physical locations or a virtual structure (owned by public health or have access to through a memorandum of understanding or other written agreements) that will serve as the public health emergency operations center. At the time of an event or incident, notify designated incident command staff of public health response. In preparation for or at the time of an incident, assemble designated staff at the appropriate emergency operations centers.

Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Standard operating procedures for the public health EOC Job action sheets for incident command positions and roles in a public health emergency List of staff that can fill the incident management roles Check-in/check-out list for personnel and equipment arriving at the incident Mutual aid and other agreements to support ESF-8 related activities NIMS certification based on discipline, level, and jurisdictional requirements Back-up equipment in the event of system failure or power loss in the public health EOC Communications equipment for information transmission inside and outside the EOC IT equipment in quantities sufficient to meet event/incident objectives

Function 3: Develop incident response strategy Tasks: How should health departments plan a response? Produce or contribute to an approved Incident Action Plan before the start of the second operational period. Disseminate the Incident Action Plan to public health response staff. Revise and brief staff on the Incident Action Plan at least at the start of each new operational period. Incident Action Plans must include the following: What was accomplished in the previous operational period? What needs to be done in the next operational period?

Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: NIMS training for staff participating in incident action plans P1. Template for producing incident action plans

Function 4: Manage and sustain the public health response Tasks: How should health departments manage an incident response? Coordinate operations for the public health response (e.g., phone calls, meetings, and conference calls). Track and account for all public health resources during the public health response. Maintain situational awareness using information gathered from medical, public health, and other health stakeholders (e.g., fusion centers). Conduct shift change briefings between outgoing and incoming public health staff to communicate priorities, status of tasks, and safety guidance.

Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Process to ensure continued performance of pre-identified essential function SOPs for response management Protocol describing how to respond to an incident regardless of the nature of the incident Training on jurisdictionally identified EOC incident supporting software Training on health department plans and procedures during a public health response NIMS training for staff participating in emergency operations

Function 5: Demobilize and evaluate public health emergency operations Tasks: What should health departments do after the response? Return resources to a condition of “normal state of operation” as appropriate. This may include archiving records and restoring systems, supplies, and staffing to a pre-incident ready state. Conduct final closeout of public health operations including the turnover of documentation, an incident debriefing, and a closeout with the responsible officials. Produce an After Action Report (AAR) for public health operations to identify improvement areas and promising practices. Implement Improvement Plan (IP) items (e.g., project work plans and evidence of improvement actions) that have been assigned to public health. Track the progress of Improvement Plan items assigned to public health through a corrective action system.

Task Elements There are elements that health departments should keep in mind to address different aspects of the tasks: Demobilization procedures for public health operations P2. After action report/improvement plan template P3. Incident close-out briefing template S1. HSEEP policy and exercise training

Questions? Please contact: Rachel Coles Program Evaluator--CDPHE 303-692-2764 rachel.coles@state.co.us