Charles Brown, MPH CADH

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.

 Local Public Health in Connecticut  Full-time Municipal  Health Districts  Part-time Departments  Differences in Capabilities  Differences in Capacity

 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

 PHERPs  Overarching plan for response  Annex to LEOPs  PHERP Annexes  Smallpox  Pan Flu  Mass Dispensing  Mass Vaccination

 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

 Health and Medical Services  Hospitals  EMS  Public Health  Behavioral Health  CHC  LTC  Other Health Agencies

 Depends upon the emergency  Mass Casualty  PH Emergency  Situational Awareness  Affects operational posture  Provides opportunity to contribute

 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

 Communication  Collaboration  Coordination

 Protocols  Defined message types and associated responses  Methods  Blast  Blast Fax  Phone message

 If you can help, you do  Intrastate Mutual Aid

 Coordinate Resources  Primarily personnel  PH Specific material  Resource Management is Key  Closest not always best  Ring Theory of Deployment

 Provide nexus of information and coordination in an emergency

 Multiple methods will be used to communicate information throughout ESF-8: Phone, fax, and 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.

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

PHSC notifies Region LHDs with alert type via phone, fax, 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 PHSC will follow- up with non- responding agencies via phone or voice communication 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 compile the data on available regional public health resources The Regional Coordination Center will report the data on available public health resources to the Liaison Officer (or equivalent) at the incident site LHDs acknowledge receipt of message

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) Local ESF-8 stakeholder communicates with: RESF-8 Communication Network / intra- discipline / section communication CT-DPH – for regulatory reporting requirements RESF 8 Section / Duty Officer- notification & initial coordination as needed RESF-5 Duty Officer (via RICS) – Duty Officer / plan (RESP) activation Ever-Bridge Notification Event Alert Ever-Bridge Notification Event Alert Escalating Mutual Aid

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