2. Capability Cliff Notes Series PHEP Capability 3—Emergency Operations Coordination What Is It And How Will We Measure It? For sound, click on the megaphone and then move arrow away from icon

3. Sound File Glitches These presentations have sound files that can be heard by clicking on the megaphone in the lower right corner, when the presentations are in Slide Show mode only. However, the slide will automatically forward to the next slide, or the sound will halt, if the arrow is left on the megaphone icon, due to an unavoidable glitch. To hear sound files, please move arrow away from megaphone icon as soon as it is clicked.

4. 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)

5. 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?

6. Emergency Operations Coordination Functions What Can Health Departments Do to Make Emergency Operations Efficient and Effective? 1.Conduct preliminary assessment to determine the need for public health activation 2.Activate public health emergency operations 3.Develop incident response strategy 4.Manage and sustain the public health response 5.Demobilize and evaluate public health emergency operations

7. Capabilities and Measures Resources The presentation will be an overview of what the functions and tasks mean, linked to the performance measures. Please note that since the capabilities PDF document has come out, more performance measures have been developed. If performance measures have come out since the creation of the capabilities document below, they have been included in these tutorials following their function slide, even if the PDF lists that there are no measures for that function. For functions that still have no measures, questions for health departments to begin thinking about measures have been included instead. For exact lists of the capabilities and performance measures, and data collected for the measures, documents can be found at these links: For Capabilities, Functions, and Tasks: http://www.cdc.gov/phpr/capabilities/DSLR_capabilities_July.pdf For Performance Measures: http://www.colorado.gov/cs/Satellite/CDPHE-EPR/CBON/1251643573938

8. 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? 1.With jurisdiction officials, analyze the emergency conditions to decide the appropriate level of activation based on complexity and severity of the incidents. 2.During each incident, determine whether public health has the lead role, a supporting role, or no role. These roles are defined as follows: o 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. o 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. o No role: There is no public health implication 3.Define incident command and emergency management structure for the public health event according to one of the Federal Emergency Management Agency (FEMA) types. For types, please see this link: http://training.fema.gov/EMIWeb/IS/ICSResource/assets/IncidentTypes.pdf http://training.fema.gov/EMIWeb/IS/ICSResource/assets/IncidentTypes.pdf

9. Function 1 Measurement How does the CDC measure if health departments have correctly assessed the level of activation necessary? There are no performance measures for this task. However to measure public health assessment, consider the following questions: Were there ESF 8 issues in the incident that the health department could address? What were they? Were there issues in the incident that the health department could not address? What were they? Who did the health department need to work with to address ESF 8 issues? Were these partners engaged? What department needed to do most of the work to deal with a particular problem? What resources (staff, equipment, etc) did the health department need to address the public health part of the response to the incident?

10. Function 2: Activate public health emergency operations Tasks: What are the tasks needed when a health department activates operations? 1.Before an event or incident, identify incident command and emergency management activities for which public health is responsible. 2.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). 3.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:

11. Function 2: Activate public health emergency operations Tasks Cont’d: What are the tasks needed when a health department activates operations? 4.Before an event or incident, identify primary and alternate physical locations or a virtual structure to serve as the public health emergency operations center. 5.At the time of an event or incident, notify designated incident command staff that their department will be responding and they may be needed. 6.In preparation for or at the time of an incident, assemble designated staff at the appropriate emergency operations centers.

12. Function 2 Measurement How does the CDC measures if health departments have activated staff to deal with the incident appropriately? How much time did it take for staff covering the activated public health roles to report for immediate duty? This time can be measured by: Start time: Date and time that a designated person began notifying staff to report for immediate duty. Stop time: Date and time that the last staff person who was notified to cover a lead role reported for duty. Time Target: The goal is for everyone needed in a lead role to be available to perform their duties in 60 minutes or less. All of the data elements collected for this measure that help determine the scope of the incident can be viewed in the PHEP Performance Measures Guidance on pgs 26-28: http://www.colorado.gov/cs/Satellite/CDPHE- EPR/CBON/1251643573938http://www.colorado.gov/cs/Satellite/CDPHE- EPR/CBON/1251643573938

13. Function 3: Develop incident response strategy Tasks: How should health departments plan a response? 1.Produce or contribute to an approved Incident Action Plan before the start of the second operational period. 2.Disseminate the Incident Action Plan to public health response staff. 3.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: o What was accomplished in the previous operational period? o What needs to be done in the next operational period?

14. Function 3 Measurement How does the CDC measures if health departments have developed an appropriate incident response? Was a written Incident Action Plan approved before the second operational period that was given to needed staff involved in the response? What kind of incident was it? Did it outline achievable objectives? Did it assign roles, and what roles were assigned? Who was involved in the plan? For a full list of data elements collected for this measure, please see the PHEP Performance Measures Guidance on pgs 36-38: http://www.colorado.gov/cs/Satellite/CDPHE-EPR/CBON/1251643573938 http://www.colorado.gov/cs/Satellite/CDPHE-EPR/CBON/1251643573938

15. Function 4: Manage and sustain the public health response Tasks: How should health departments manage an incident response? 1.Coordinate operations for the public health response (e.g., phone calls, meetings, and conference calls). 2.Track and account for all public health resources during the public health response. 3.Maintain situational awareness using information gathered from medical, public health, and other health stakeholders (e.g., fusion centers). 4.Conduct shift change briefings between outgoing and incoming public health staff to communicate priorities, status of tasks, and safety guidance.

16. Function 4 Measurement How does the CDC measure if health departments have responded to an incident appropriately? There is no performance measure associated with this function. However, for health departments to measure effectiveness, consider the following questions: How complete was the health department’s understanding of the situation from a public health perspective? How complete was the health departments information from other agencies? How complete did it need to be? Did everyone who needed information to do their jobs, have it? Can the health department track back everything that was done, by whom it was done, and what resources were used to do it?

17. Function 5: Demobilize and evaluate public health emergency operations Tasks: What should health departments do after the response? 1.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. 2.Conduct final closeout of public health operations including the turnover of documentation, an incident debriefing, and a closeout with the responsible officials. 3.Produce an After Action Report (AAR) for public health operations to identify improvement areas and promising practices. 4.Implement Improvement Plan (IP) items (e.g., project work plans and evidence of improvement actions) that have been assigned to public health. 5.Track the progress of Improvement Plan items assigned to public health through a corrective action system.

18. Function 5 Measurement How does the CDC measure if health departments have completed actions needed to close out the incident? Was an After Action Report and an Improvement Plan completed? How soon after the incident was a report done and shared with needed staff and officials? This is measured by: Start time: Date the public health emergency operations were completed? Stop time: Date the draft AAR and IP were submitted for clearance within the public health agency? For a full list of data elements collected for this measure, please see the PHEP Performance Measures Guidance on pgs 29-30: http://www.colorado.gov/cs/Satellite/CDPHE-EPR/CBON/1251643573938 http://www.colorado.gov/cs/Satellite/CDPHE-EPR/CBON/1251643573938

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