1. Public Health System Training in Disaster Recovery (PH – STriDR) This work was supported by Centers for Disease Control and Prevention Cooperative Agreement 1U01TP

2. Disclaimer
The views expressed are those of the authors and do not necessarily reflect the official policy or position of the Uniformed Services University of the Health Sciences, the Department of Defense, or the United States Government.

3. Mission
The NCDMPH leads Federal and coordinates national efforts to develop and propagate core curricula, education, training and research in all-hazards disaster health.
Vision
A Nation of resilient communities with a competent health workforce prepared to respond and mitigate all-hazards disasters.

4. Training Program Structure
Four Sessions:
Session 1: Disaster Recovery Activities in the Local Public Health Agency
Session 2: Your Roles and Responsibilities in Disaster Recovery
Session 3: Personal/Family and Workplace Support Issues and Resources
Session 4: What does a successful disaster recovery look like?
PowerPoint presentations, small group discussions, large group discussions, individual activities
We value your knowledge and experience in this area and your participation is encouraged!

5. Session Schedule Date, time, location
How you will be notified of updates

6. Session 1: Disaster Recovery Activities in the Local Public Health Agency

7. Introductions Trainer Introduction Learner Introductions
Please go around the room and state your name and role in the health department.

8. Administrative Issues
Session Duration: 90 minutes
Exit and Restroom Locations
“Parking Lot”
Please Silence Your Cell Phone

9. Learning Objectives
List various types of natural and human-generated disasters that are likely to occur in your area.
Identify local public health agency recovery activities for disasters likely to occur in your area.

10. Definition of Disaster
“A sudden, calamitous event that seriously disrupts the functioning of a community or society and causes human, material, and economic or environmental losses that exceed the community’s or society’s ability to cope using its own resources.”
(International Federation of the Red Cross and Red Crescent Societies)

11. Disaster Statistics
Globally, the number of natural and technological disasters has increased steadily since 1960, as has the number of people affected by disasters.
Increasing severity of disaster impacts is influenced by the increase in magnitude of extreme weather events and an increase in exposure and vulnerability of human populations.
What are some recent disasters?
For More Information See: Frequency of Disasters, National Climate Assessment 2014:

12. Emergency Management Cycle
“Emergency management is the continuous process by which all individuals, agencies, and levels of government manage hazards in an effort to avoid or reduce the impact of disasters resulting from the hazards.”
Local public health agencies have a role in all four phases, including disaster recovery.
Citation: U.S. Department of Transportation Federal Highway Administration
U.S. Department of Transportation Federal Highway Administration

13. What is Recovery?
“[R]ecovery encompasses more than the restoration of a community’s physical structures to its pre-disaster conditions. Of equal importance is providing a continuum of care to meet the needs of the affected community members who have experienced the hardships of financial, emotional or physical impacts as well as positioning the community to meet the needs of the future.”
National Disaster Recovery Framework, 2011
For More Information See: ASTHO Fact Sheet on Disaster Recovery for Public Health:

14. Why Focus on Recovery?
The recovery phase can last a considerable length of time.
Activities in the recovery phase can be very influential for the health and well-being of the community.
Local public health workers have a significant role to play in community recovery.
Disaster recovery is an opportunity to build a more resilient and healthier community.
Disaster recovery is often overlooked, as focus has historically been on preparedness and response.

15. National Disaster Recovery Framework
The recovery phase is often divided into the short-term (days to weeks), intermediate-term (weeks to months), and long-term (months to years) recovery phases.
Decisions made early in the recovery process can have a cascading effect on recovery progress.
National Disaster Recovery Framework, 2011.
The National Disaster Recovery Framework (NDRF) is “a guide that enables effective recovery support to disaster-impacted States, Tribes, Territorial and local jurisdictions. It provides a flexible structure that enables disaster recovery managers to operate in a unified and collaborative manner. It also focuses on how best to restore, redevelop and revitalize the health, social, economic, natural and environmental fabric of the community and build a more resilient Nation.”
The recovery process can be described as a series of activities that move a community toward a successful recovery. Decisions made early in the recovery process can have a cascading effect on recovery progress. The recovery phase is often further divided into the short-term, intermediate-term, and long-term recovery phases. Short-term typically describes days to weeks after an event, intermediate describes weeks to months, and long term describes months to years.
The figure shows the relationship of preparedness and response activities to the short-, intermediate-, and long-term recovery activities described in the Framework.
For More Information See: National Disaster Recovery Framework
Citation: National Disaster Recovery Framework, 2011.

16. System View of Recovery
Local and state health departments are part of a larger National Planning System that synchronizes planning from the individual to the national level.
National Incident Management System (NIMS) and Incident Command System (ICS) are used to coordinate and communicate among levels.
Disaster recovery is community driven, based on public involvement, and a partnership among local agencies, jurisdictions, officials, and the state and federal government. (Long Term Community Recovery Planning Process, A Self Help Guide, FEMA 2005)
If the effects of a disaster exceed the state’s capability to respond, the governor can request federal assistance through the Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1988 (Stafford Act). The Stafford Act provides the legal authority for the federal government to provide assistance to states during declared major disasters and emergencies. In the absence of a specific request, the president may provide accelerated federal assistance where it is necessary to save lives or prevent severe damage. (ASTHO Emergency Authority and Immunity Toolkit, Robert T. Stafford Disaster Relief and Emergency Assistance Act)
The slide image shows the National Planning System, which includes guidance to support State, territorial, tribal, and local governments and to address the inclusion of individuals, communities, and businesses in planning efforts. The system provides a layered approach for synchronized planning at all levels. (FEMA IS-230.c, Fundamentals of Emergency Management, accessed on August 4, 2014).
For More Information See: Stafford Act, FEMA Fundamentals of Emergency Management: Long Term Community Recovery Planning Process, A Self Help Guide: Proposed Preparedness Rule under CMS:
FEMA IS-230.c Fundamentals of Emergency Management

17. System View of Recovery
Where is your agency in this diagram?
Thinking about the other levels in the diagram, who else does your agency coordinate with in disasters?
Where is your agency in this diagram? Think about where you fit into this picture. You likely fit in both the individual and jurisdictional levels. That means that your individual planning for recovery should be complementary to your jurisdictional planning, and so on up the levels.
Thinking about the other levels in the diagram, who else does your agency coordinate with in disasters? There are likely many individuals and organizations that your local public health agency will coordinate with in disaster recovery. (FEMA IS-230.c, Fundamentals of Emergency Management, accessed on August 4, 2014).
For More Information See: Stafford Act, FEMA IS-230.c Fundamentals of Emergency Management, Long Term Community Recovery Planning Process, A Self Help Guide, FEMA 2005, Proposed Preparedness Rule under CMS (introduction gives helpful overview of federal system):
FEMA IS-230.c Fundamentals of Emergency Management

18. Local Public Health Agency Recovery Roles and Responsibilities
Ensuring the continuity of health care services
Monitoring environmental infrastructure
Assessing and providing referrals to meet the needs of vulnerable populations
Initiating surveillance programs
Issuing health advisories and continuing open communication with the public
Allocating resources to match the public health needs of the disaster response and recovery
Restoring health services and environmental safety to pre-event levels
For More Information See: Public Health Management of Disasters Pocket Guide: ASTHO Factsheet for Disaster Recovery for Public Health:

19. Assessing Risk
Planning tools for assessing community risks and hazards include Hazard Vulnerability Analysis (HVA) and Threat and Hazard Identification and Risk Assessment (THIRA).
These can be used to assess the capability of a community to respond to and recover from specific hazards.
They can be used within a health department to assess organizational risk and capability to respond and recover.
Does the health department have one or both of these? Does the community?
HVA and THIRA can provide information on the likely hazards that may affect your area, and for which your local public health agency may play a role in recovery. If information from these documents can be shared with the learner, it can enrich the upcoming discussion about local public health agency roles in disaster recovery.
HVAs are required for accreditation by the Joint Commission, so many hospitals, behavioral healthcare facilities, homecare, and medical laboratories will have completed an HVA. (The Joint Commission, accessed August 4, 2014).
THIRAs are required by State Administrative Agencies (SAAs) receiving funding under the FY 2012 Homeland Security Grant Program (HSGP) and the Emergency Management Performance Grant (EMPG) program, and by the 31 Urban Areas receiving funding under the FY 2012 Urban Areas Security Initiative (UASI) grant program. (THIRA Frequently Asked Questions, accessed August 4, 2014).
If no local-level documents are available, you may find the following examples useful: NACCHO Hazard Vulnerability Analysis Example: Pima County: NACCHO Hazard Vulnerability Analysis Example: Elbert, CO: Threat and Hazard Identification and Risk Assessment, Portland Urban Area:
For More Information See: Hazard Vulnerability Analysis Page from the HHS Assistant Secretary for Preparedness and Response: THIRA Frequently Asked Questions: The Joint Commission:

20. Full Group Discussion (Optional)
If a jurisdictional or agency HVA or THIRA is available, share and discuss key points.

21. Full Group Discussion
As a group, list any probable hazards in your community.
Record the list on your flipchart.
Your trainer will transfer this list to the Master Copy of the Disaster Recovery Activity Worksheet.

22. Small-Group Activity
Break into small groups to fill in the Disaster Recovery Activity Worksheet for one natural disaster and one human-generated disaster from the list that was just created.
Please choose one person to complete the Disaster Recovery Activity Worksheet for your group.
Be sure to return the completed worksheet to the instructor.

23. Summary of Main Points
A number of natural and/or human-generated disasters could impact your community.
Your local public health agency can play a role in disaster recovery activities in your community.
These roles fit into a larger planning framework that includes both individual-level planning and higher levels of government.

24. Questions?

25. https://ncdmph.usuhs.edu/
Thank you!
Please visit the NCDMPH Website for more disaster health-related education and training resources.
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