Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine 1 Preparing for and Responding to Bioterrorism: Information for the Public Health Workforce

UW Northwest Center for Public Health Practice 2 AcknowledgementsAcknowledgements This presentation, and the accompanying instructor’s manual, were prepared by Jennifer Brennan Braden, MD, MPH, at the Northwest Center for Public Health Practice in Seattle, WA, for the purpose of educating public health employees in the general aspects of bioterrorism preparedness and response. Instructors are encouraged to freely use all or portions of the material for its intended purpose. The following people and organizations provided information and/or support in the development of this curriculum. A complete list of resources can be found in the accompanying instructor’s guide. Patrick O’Carroll, MD, MPH Project Coordinator Centers for Disease Control and Prevention Judith Yarrow Design and Editing Health Policy and Analysis; University of WA Washington State Department of Health Jeff Duchin, MD Jane Koehler, DVM, MPH Communicable Disease Control, Epidemiology and Immunization Section Public Health - Seattle and King County Ed Walker, MD; University of WA Department of Psychiatry

UW Northwest Center for Public Health Practice 3 Emergency Response Planning

UW Northwest Center for Public Health Practice 4 Emergency Response Planning Learning Objectives Identify the different agencies involved in response to a bioterrorism event Identify the different agencies involved in response to a bioterrorism event Describe the Incident Command System and how this system may be integrated into an agency’s bioterrorism response plan Describe the Incident Command System and how this system may be integrated into an agency’s bioterrorism response plan Identify factors to consider and include in the development of a local emergency response plan Identify factors to consider and include in the development of a local emergency response plan Identify the different agencies involved in response to a bioterrorism event Identify the different agencies involved in response to a bioterrorism event Describe the Incident Command System and how this system may be integrated into an agency’s bioterrorism response plan Describe the Incident Command System and how this system may be integrated into an agency’s bioterrorism response plan Identify factors to consider and include in the development of a local emergency response plan Identify factors to consider and include in the development of a local emergency response plan

UW Northwest Center for Public Health Practice 5 Emergency Response Planning Learning Objectives Describe national and local efforts in the area of BT preparedness and response Describe national and local efforts in the area of BT preparedness and response Describe the roles of public health in bioterrorism preparedness and response Describe the roles of public health in bioterrorism preparedness and response Describe national and local efforts in the area of BT preparedness and response Describe national and local efforts in the area of BT preparedness and response Describe the roles of public health in bioterrorism preparedness and response Describe the roles of public health in bioterrorism preparedness and response

UW Northwest Center for Public Health Practice 6 Bioterrorism Preparedness and Response Crisis and Consequence Management Crisis management: law enforcement response to terrorist acts Crisis management: law enforcement response to terrorist acts Local, state, and federal law-enforcement agencies Local, state, and federal law-enforcement agencies Consequence management: response to the disaster focusing on the alleviation of damage, loss, hardship, or suffering Consequence management: response to the disaster focusing on the alleviation of damage, loss, hardship, or suffering Public health, medical, and emergency mgt personnel Public health, medical, and emergency mgt personnel Falls under ESF-8 (Health & Medical Services) of Federal and State Disaster Response Plan Falls under ESF-8 (Health & Medical Services) of Federal and State Disaster Response Plan Crisis management: law enforcement response to terrorist acts Crisis management: law enforcement response to terrorist acts Local, state, and federal law-enforcement agencies Local, state, and federal law-enforcement agencies Consequence management: response to the disaster focusing on the alleviation of damage, loss, hardship, or suffering Consequence management: response to the disaster focusing on the alleviation of damage, loss, hardship, or suffering Public health, medical, and emergency mgt personnel Public health, medical, and emergency mgt personnel Falls under ESF-8 (Health & Medical Services) of Federal and State Disaster Response Plan Falls under ESF-8 (Health & Medical Services) of Federal and State Disaster Response Plan PDD-39

Community Preparedness A Coordination of Efforts Partnerships between public health and: Partnerships between public health and: Clinicians and health care facilities Clinicians and health care facilities Law enforcement Law enforcement Public safety: fire, HAZMAT Public safety: fire, HAZMAT Emergency management Emergency management Coordinate response across agencies at the local, state, and federal levels Coordinate response across agencies at the local, state, and federal levels Partnerships between public health and: Partnerships between public health and: Clinicians and health care facilities Clinicians and health care facilities Law enforcement Law enforcement Public safety: fire, HAZMAT Public safety: fire, HAZMAT Emergency management Emergency management Coordinate response across agencies at the local, state, and federal levels Coordinate response across agencies at the local, state, and federal levels

UW Northwest Center for Public Health Practice 8 Local Emergency Response Planning Committees (LEPCs) Established under the Emergency Planning and Community Right-to-Know Act Established under the Emergency Planning and Community Right-to-Know Act Membership includes a wide variety of stakeholders in the community Membership includes a wide variety of stakeholders in the community Develop comprehensive plans to prepare for and respond to hazardous substance emergencies Develop comprehensive plans to prepare for and respond to hazardous substance emergencies Established under the Emergency Planning and Community Right-to-Know Act Established under the Emergency Planning and Community Right-to-Know Act Membership includes a wide variety of stakeholders in the community Membership includes a wide variety of stakeholders in the community Develop comprehensive plans to prepare for and respond to hazardous substance emergencies Develop comprehensive plans to prepare for and respond to hazardous substance emergencies

National Responders Health and Human Services (HHS) Health and Human Services (HHS) Centers for Disease Control and Prevention (CDC) Centers for Disease Control and Prevention (CDC) Federal Emergency Management Agency (FEMA) Federal Emergency Management Agency (FEMA) FBI FBI Environmental Protection Agency (EPA) Environmental Protection Agency (EPA) Department of Agriculture Department of Agriculture Department of Defense Department of Defense Health and Human Services (HHS) Health and Human Services (HHS) Centers for Disease Control and Prevention (CDC) Centers for Disease Control and Prevention (CDC) Federal Emergency Management Agency (FEMA) Federal Emergency Management Agency (FEMA) FBI FBI Environmental Protection Agency (EPA) Environmental Protection Agency (EPA) Department of Agriculture Department of Agriculture Department of Defense Department of Defense

State and Local Responders Health care providers and facilities Health care providers and facilities Local and state health departments Local and state health departments Emergency management agencies Emergency management agencies Search and Rescue, EMS, and HAZMAT teams Search and Rescue, EMS, and HAZMAT teams Volunteers Volunteers Health care providers and facilities Health care providers and facilities Local and state health departments Local and state health departments Emergency management agencies Emergency management agencies Search and Rescue, EMS, and HAZMAT teams Search and Rescue, EMS, and HAZMAT teams Volunteers Volunteers Law enforcement, National Guard Law enforcement, National Guard State emergency management agency State emergency management agency Political leaders Political leaders Community service organizations Community service organizations

UW Northwest Center for Public Health Practice 11 The Emergency Response System Emergency occurs and is detected by… Local citizenHealth surveillance systemClinician/hospital Local health jurisdiction Local emergency management office Calls 911 Local law enforcementFireEMSHAZMAT FBI State health dept State Emergency Mgt Dept

UW Northwest Center for Public Health Practice 12 Incident Command System Definition A model for how to conduct and coordinate efforts in response to an emergency A model for how to conduct and coordinate efforts in response to an emergency Required to be used in HAZMAT incidents; also used in other types of emergencies Required to be used in HAZMAT incidents; also used in other types of emergencies Five major components Five major components Command Command Planning Planning Operations Operations Logistics Logistics Finance/administration Finance/administration A model for how to conduct and coordinate efforts in response to an emergency A model for how to conduct and coordinate efforts in response to an emergency Required to be used in HAZMAT incidents; also used in other types of emergencies Required to be used in HAZMAT incidents; also used in other types of emergencies Five major components Five major components Command Command Planning Planning Operations Operations Logistics Logistics Finance/administration Finance/administration

UW Northwest Center for Public Health Practice 13 Incident Command System Some Basic Principles Unity of command Unity of command Each person in an organization reports to only one designated person Each person in an organization reports to only one designated person Unified command structure Unified command structure Used when more than one agency responds Used when more than one agency responds All agencies involved in response establish a common set of objectives and strategies All agencies involved in response establish a common set of objectives and strategies Unity of command Unity of command Each person in an organization reports to only one designated person Each person in an organization reports to only one designated person Unified command structure Unified command structure Used when more than one agency responds Used when more than one agency responds All agencies involved in response establish a common set of objectives and strategies All agencies involved in response establish a common set of objectives and strategies

UW Northwest Center for Public Health Practice 14 Incident Command System Some Basic Principles Modular organization (expands or contracts as required) Modular organization (expands or contracts as required) Common terminology Common terminology Common names/titles used for all personnel and equipment Common names/titles used for all personnel and equipment Modular organization (expands or contracts as required) Modular organization (expands or contracts as required) Common terminology Common terminology Common names/titles used for all personnel and equipment Common names/titles used for all personnel and equipment

UW Northwest Center for Public Health Practice 15 Differences in Public Health and Law Enforcement Investigations Public Health Law Enforcement Event Recognition Surveillance or calls from clinicians Announced by attacker or otherwise evident Initial Data Collection Hypothesis generation Questioning witnesses and suspects, follow-up on tips Goal of Investigation Effective disease prevention and control measures Prevention and deterrence of future attacks, arrest of perpetrators Adapted from: Butler et al. EID, 2002

UW Northwest Center for Public Health Practice 16 Emergency Operations Plan A document that A document that Assigns responsibility to organizations and individuals for carrying out specific actions at projected times and places in an emergency that exceeds the capability or routine responsibility of any one agency Assigns responsibility to organizations and individuals for carrying out specific actions at projected times and places in an emergency that exceeds the capability or routine responsibility of any one agency A document that A document that Assigns responsibility to organizations and individuals for carrying out specific actions at projected times and places in an emergency that exceeds the capability or routine responsibility of any one agency Assigns responsibility to organizations and individuals for carrying out specific actions at projected times and places in an emergency that exceeds the capability or routine responsibility of any one agency BT and Emergency Response Plan Clearinghouse bt.naccho.org

UW Northwest Center for Public Health Practice 17 Emergency Operations Plan Types of Plans Describes the response to any emergency affecting the agency, county, or state Describes the response to any emergency affecting the agency, county, or state Health-related emergency response plan a subset of overall EOP Health-related emergency response plan a subset of overall EOP Lead and supporting agencies in an emergency depend on the type of emergency Lead and supporting agencies in an emergency depend on the type of emergency Roles designated by emergency support function (ESF) Roles designated by emergency support function (ESF) ESF 8 = health and medical services; public health agency has lead role in response activities ESF 8 = health and medical services; public health agency has lead role in response activities Describes the response to any emergency affecting the agency, county, or state Describes the response to any emergency affecting the agency, county, or state Health-related emergency response plan a subset of overall EOP Health-related emergency response plan a subset of overall EOP Lead and supporting agencies in an emergency depend on the type of emergency Lead and supporting agencies in an emergency depend on the type of emergency Roles designated by emergency support function (ESF) Roles designated by emergency support function (ESF) ESF 8 = health and medical services; public health agency has lead role in response activities ESF 8 = health and medical services; public health agency has lead role in response activities

UW Northwest Center for Public Health Practice 18 Emergency Operations Plan State and Local Roles Public health terrorism plan integrated into or annexed to overall state/county EOP Public health terrorism plan integrated into or annexed to overall state/county EOP Local government responds first Local government responds first State government State government Assists local when capabilities overwhelmed Assists local when capabilities overwhelmed Responds first in certain emergencies Responds first in certain emergencies Works with federal government when federal assistance necessary Works with federal government when federal assistance necessary Public health terrorism plan integrated into or annexed to overall state/county EOP Public health terrorism plan integrated into or annexed to overall state/county EOP Local government responds first Local government responds first State government State government Assists local when capabilities overwhelmed Assists local when capabilities overwhelmed Responds first in certain emergencies Responds first in certain emergencies Works with federal government when federal assistance necessary Works with federal government when federal assistance necessary WA's Emergency Management Plan

UW Northwest Center for Public Health Practice 19 Developing a Local Public Health Emergency Operations Plan Establish a planning team Establish a planning team Analyze capabilities and hazards Analyze capabilities and hazards Current resource base Current resource base Geographic factors affecting response Geographic factors affecting response Special needs populations Special needs populations Develop and implement the plan Develop and implement the plan “Work” the plan “Work” the plan Regular drills to: Regular drills to: Ensure understanding of procedures/roles Ensure understanding of procedures/roles Test and update procedures Test and update procedures Establish a planning team Establish a planning team Analyze capabilities and hazards Analyze capabilities and hazards Current resource base Current resource base Geographic factors affecting response Geographic factors affecting response Special needs populations Special needs populations Develop and implement the plan Develop and implement the plan “Work” the plan “Work” the plan Regular drills to: Regular drills to: Ensure understanding of procedures/roles Ensure understanding of procedures/roles Test and update procedures Test and update procedures Emergency Mgt Guide for Business and Industry

UW Northwest Center for Public Health Practice 20 Legal Issues to Consider in Planning for a Health Emergency What is the legal authority for: What is the legal authority for: Undertaking actions to protect public health and safety? Undertaking actions to protect public health and safety? Enforcing quarantine of infected individuals? Enforcing quarantine of infected individuals? Waiving legal liability to emergency workers? Waiving legal liability to emergency workers? Provision of disaster services by coroners, medical examiners, or mortuary workers? Provision of disaster services by coroners, medical examiners, or mortuary workers? Access to, use of, and reimbursement for private sector resources in an emergency? Access to, use of, and reimbursement for private sector resources in an emergency? What is the legal authority for: What is the legal authority for: Undertaking actions to protect public health and safety? Undertaking actions to protect public health and safety? Enforcing quarantine of infected individuals? Enforcing quarantine of infected individuals? Waiving legal liability to emergency workers? Waiving legal liability to emergency workers? Provision of disaster services by coroners, medical examiners, or mortuary workers? Provision of disaster services by coroners, medical examiners, or mortuary workers? Access to, use of, and reimbursement for private sector resources in an emergency? Access to, use of, and reimbursement for private sector resources in an emergency?

UW Northwest Center for Public Health Practice 21 Legal Issues to Consider in Planning for a Health Emergency What are the legal responsibilities of different agencies/officials in emergency response? What are the legal responsibilities of different agencies/officials in emergency response? What is the scope of authority of different agencies/officials in emergency response efforts? What is the scope of authority of different agencies/officials in emergency response efforts? How do local laws compare with state and federal laws? What circumstances warrant early state or federal involvement? How do local laws compare with state and federal laws? What circumstances warrant early state or federal involvement? What are the legal responsibilities of different agencies/officials in emergency response? What are the legal responsibilities of different agencies/officials in emergency response? What is the scope of authority of different agencies/officials in emergency response efforts? What is the scope of authority of different agencies/officials in emergency response efforts? How do local laws compare with state and federal laws? What circumstances warrant early state or federal involvement? How do local laws compare with state and federal laws? What circumstances warrant early state or federal involvement?

UW Northwest Center for Public Health Practice 22 Workplace Emergency Response Plans Workplace-specific emergency operations plan Workplace-specific emergency operations plan Plan should include a bioterrorism component Plan should include a bioterrorism component Be familiar with your agency’s plan Be familiar with your agency’s plan Who activates it and when it might be activated Who activates it and when it might be activated Your responsibilities Your responsibilities Evacuation plans Evacuation plans Communication procedures (i.e., phone tree/call-down roster) Communication procedures (i.e., phone tree/call-down roster) Workplace-specific emergency operations plan Workplace-specific emergency operations plan Plan should include a bioterrorism component Plan should include a bioterrorism component Be familiar with your agency’s plan Be familiar with your agency’s plan Who activates it and when it might be activated Who activates it and when it might be activated Your responsibilities Your responsibilities Evacuation plans Evacuation plans Communication procedures (i.e., phone tree/call-down roster) Communication procedures (i.e., phone tree/call-down roster)

UW Northwest Center for Public Health Practice 23 National Preparedness 1999 Initiative National Bioterrorism Preparedness and Response Initiative National Bioterrorism Preparedness and Response Initiative 1999 DHHS Initiative to prepare the nation to respond to potential BT activity 1999 DHHS Initiative to prepare the nation to respond to potential BT activity CDC designated lead in upgrading nation’s public health capacity and in developing a BT preparedness and response plan CDC designated lead in upgrading nation’s public health capacity and in developing a BT preparedness and response plan National Bioterrorism Preparedness and Response Initiative National Bioterrorism Preparedness and Response Initiative 1999 DHHS Initiative to prepare the nation to respond to potential BT activity 1999 DHHS Initiative to prepare the nation to respond to potential BT activity CDC designated lead in upgrading nation’s public health capacity and in developing a BT preparedness and response plan CDC designated lead in upgrading nation’s public health capacity and in developing a BT preparedness and response plan More on 1999 Initiative...

UW Northwest Center for Public Health Practice 24 National Preparedness CDC Activities CDC bioterrorism preparedness and response activities CDC bioterrorism preparedness and response activities Preparedness and prevention Preparedness and prevention Detection and surveillance Detection and surveillance Diagnosis and characterization of biological and chemical agents Diagnosis and characterization of biological and chemical agents Response Response CDC bioterrorism preparedness and response activities CDC bioterrorism preparedness and response activities Preparedness and prevention Preparedness and prevention Detection and surveillance Detection and surveillance Diagnosis and characterization of biological and chemical agents Diagnosis and characterization of biological and chemical agents Response Response More on CDC program...

UW Northwest Center for Public Health Practice 25 National Preparedness CDC Activities, cont. CDC bioterrorism preparedness and response activities CDC bioterrorism preparedness and response activities Education and training Education and training Improved communication systems Improved communication systems Health Alert Network Health Alert Network Laboratory Response Network Laboratory Response Network National Pharmaceutical Stockpile National Pharmaceutical Stockpile CDC bioterrorism preparedness and response activities CDC bioterrorism preparedness and response activities Education and training Education and training Improved communication systems Improved communication systems Health Alert Network Health Alert Network Laboratory Response Network Laboratory Response Network National Pharmaceutical Stockpile National Pharmaceutical Stockpile More on CDC program...

UW Northwest Center for Public Health Practice 26 National Preparedness Other DHHS activities Medical Consequence Management: HHS Office of Emergency Preparedness (OEP), expanding efforts to develop medical response capabilities at local and national levels Medical Consequence Management: HHS Office of Emergency Preparedness (OEP), expanding efforts to develop medical response capabilities at local and national levels

Community Preparedness Role of Public Health Coordinate preparedness and response activities Coordinate preparedness and response activities Requires collaboration with medical professionals, first responders, and other partners Provide information to health professionals, government leaders, and the public Provide information to health professionals, government leaders, and the public Coordinate preparedness and response activities Coordinate preparedness and response activities Requires collaboration with medical professionals, first responders, and other partners Provide information to health professionals, government leaders, and the public Provide information to health professionals, government leaders, and the public 27

Community Preparedness Role of Public Health Detection and evaluation of biological disaster Detection and evaluation of biological disaster Requires robust surveillance, epidemiology, and disease investigation infrastructure, plus new detection methods Requires robust surveillance, epidemiology, and disease investigation infrastructure, plus new detection methods Facilitate medical management of exposed persons Facilitate medical management of exposed persons Provide information on diagnosis, treatment, prophylaxis, and infection control issues Provide information on diagnosis, treatment, prophylaxis, and infection control issues Detection and evaluation of biological disaster Detection and evaluation of biological disaster Requires robust surveillance, epidemiology, and disease investigation infrastructure, plus new detection methods Requires robust surveillance, epidemiology, and disease investigation infrastructure, plus new detection methods Facilitate medical management of exposed persons Facilitate medical management of exposed persons Provide information on diagnosis, treatment, prophylaxis, and infection control issues Provide information on diagnosis, treatment, prophylaxis, and infection control issues 28

Community Preparedness Role of Public Health Coordinate and engage state and federal resources Coordinate and engage state and federal resources Education, training, and information Education, training, and information Surveillance, disease case and outbreak investigation Surveillance, disease case and outbreak investigation Coordinate and engage state and federal resources Coordinate and engage state and federal resources Education, training, and information Education, training, and information Surveillance, disease case and outbreak investigation Surveillance, disease case and outbreak investigation Public Health Preparedness and Response Capacity Inventory 29

Community Preparedness Role of Public Health Inventory and address deficiencies in regional resources Inventory and address deficiencies in regional resources Hospital response capacity/preparedness Hospital response capacity/preparedness EMS/first responder capacity/preparedness EMS/first responder capacity/preparedness Mass treatment and prophylaxis Mass treatment and prophylaxis Mortuary capacity/preparedness Mortuary capacity/preparedness Law enforcement/security Law enforcement/security Inventory and address deficiencies in regional resources Inventory and address deficiencies in regional resources Hospital response capacity/preparedness Hospital response capacity/preparedness EMS/first responder capacity/preparedness EMS/first responder capacity/preparedness Mass treatment and prophylaxis Mass treatment and prophylaxis Mortuary capacity/preparedness Mortuary capacity/preparedness Law enforcement/security Law enforcement/security 30

UW Northwest Center for Public Health Practice 31 Summary of Key Points BT preparedness and response requires coordination between public health, clinicians, emergency management, first responders, and law enforcement officials. BT preparedness and response requires coordination between public health, clinicians, emergency management, first responders, and law enforcement officials. The Incident Command System is a hierarchical and unified system of managing an emergency response involving single or multiple agencies. The Incident Command System is a hierarchical and unified system of managing an emergency response involving single or multiple agencies. All agencies should include a bioterrorism component in their overall emergency response plan. All agencies should include a bioterrorism component in their overall emergency response plan. BT preparedness and response requires coordination between public health, clinicians, emergency management, first responders, and law enforcement officials. BT preparedness and response requires coordination between public health, clinicians, emergency management, first responders, and law enforcement officials. The Incident Command System is a hierarchical and unified system of managing an emergency response involving single or multiple agencies. The Incident Command System is a hierarchical and unified system of managing an emergency response involving single or multiple agencies. All agencies should include a bioterrorism component in their overall emergency response plan. All agencies should include a bioterrorism component in their overall emergency response plan.

UW Northwest Center for Public Health Practice 32 Summary of Key Points Emergency response planning in public health includes: Emergency response planning in public health includes: Development and evaluation of detection systems Development and evaluation of detection systems Development and evaluation of policies and response procedures Development and evaluation of policies and response procedures Awareness of relevant laws Awareness of relevant laws Evaluation and coordination of resources Evaluation and coordination of resources Education and training Education and training Emergency response planning in public health includes: Emergency response planning in public health includes: Development and evaluation of detection systems Development and evaluation of detection systems Development and evaluation of policies and response procedures Development and evaluation of policies and response procedures Awareness of relevant laws Awareness of relevant laws Evaluation and coordination of resources Evaluation and coordination of resources Education and training Education and training

UW Northwest Center for Public Health Practice 33 Resources National Centers for Disease Control and Prevention Centers for Disease Control and Prevention Emergency Preparedness and Response branch 24-hour notification telephone number [(770) ] Emergency Preparedness and Response branch 24-hour notification telephone number [(770) ] CDC Public Inquiry Hotlines: CDC Public Inquiry Hotlines: English(888) Español (888) English(888) Español (888) National Domestic Preparedness Office: National Domestic Preparedness Office: M-F 8am-5pm EST M-F 8am-5pm EST Centers for Disease Control and Prevention Centers for Disease Control and Prevention Emergency Preparedness and Response branch 24-hour notification telephone number [(770) ] Emergency Preparedness and Response branch 24-hour notification telephone number [(770) ] CDC Public Inquiry Hotlines: CDC Public Inquiry Hotlines: English(888) Español (888) English(888) Español (888) National Domestic Preparedness Office: National Domestic Preparedness Office: M-F 8am-5pm EST M-F 8am-5pm EST Bioterrorism Web site:

UW Northwest Center for Public Health Practice 34 Resources Washington State Washington State Department of Health Washington State Department of Health Communicable Disease Epidemiology Communicable Disease Epidemiology hour emergency number hour emergency number (206) (206) Julie Wicklund, BT Surveillance Epidemiologist (206) Julie Wicklund, BT Surveillance Epidemiologist (206) Washington State Emergency Management Division Washington State Department of Health Washington State Department of Health Communicable Disease Epidemiology Communicable Disease Epidemiology hour emergency number hour emergency number (206) (206) Julie Wicklund, BT Surveillance Epidemiologist (206) Julie Wicklund, BT Surveillance Epidemiologist (206) Washington State Emergency Management Division

UW Northwest Center for Public Health Practice 35 Resources Emergency Management State Emergency Management duty officer State Emergency Management duty officer Regional Emergency Coordinator,Region X Regional Emergency Coordinator,Region X FBI FBI Western WA and after hrs, Statewide: Western WA and after hrs, Statewide: (206) (206) Eastern WA: (509) Eastern WA: (509) Federal Emergency Management Agency (FEMA) Federal Emergency Management Agency (FEMA) Incident Command System Self-study Course Incident Command System Self-study Course State Emergency Management duty officer State Emergency Management duty officer Regional Emergency Coordinator,Region X Regional Emergency Coordinator,Region X FBI FBI Western WA and after hrs, Statewide: Western WA and after hrs, Statewide: (206) (206) Eastern WA: (509) Eastern WA: (509) Federal Emergency Management Agency (FEMA) Federal Emergency Management Agency (FEMA) Incident Command System Self-study Course Incident Command System Self-study Course

UW Northwest Center for Public Health Practice 36 Resources Emergency Response Planning Bioterrorism and Emergency Response Plan Clearinghouse Bioterrorism and Emergency Response Plan Clearinghouse Washington State Comprehensive Emergency Management Plan Washington State Comprehensive Emergency Management Plan Emergency Management Guide for Business and Industry (FEMA) Emergency Management Guide for Business and Industry (FEMA) Bioterrorism and Emergency Response Plan Clearinghouse Bioterrorism and Emergency Response Plan Clearinghouse Washington State Comprehensive Emergency Management Plan Washington State Comprehensive Emergency Management Plan Emergency Management Guide for Business and Industry (FEMA) Emergency Management Guide for Business and Industry (FEMA)