Task 2: Provide essential information to those who receive medical countermeasures. Accommodations for populations with access and functional needs may include, P3: Procedures in place to disseminate situational awareness information to jurisdictional emergency management agencies and to alert partner organizations during a response requiring mass care services based on the jurisdictional public health agency lead or support role. E/T2: Primary and backup communications equipment to transmit information inside and outside the emergency operations center, with contact numbers and radio frequencies stored with corresponding equipment. Task 1: Engage subject matter experts to assess exposure or transmission. P1 (Priority): Procedures in place to assess medical countermeasure inventories and determine the need for additional medical countermeasures. P2: Procedures in place for information sharing with fusion centers or comparable state centers or agencies in order to provide and receive relevant intelligence information that may influence the response. Situational awareness requires not only coordinated information collection to create a common operating picture (COP), but also the ability to process, interpret, and act upon this information. Definition: Medical materiel management and distribution is the ability to acquire, manage, transport, and track medical materiel during a public health incident or event and the ability to recover and account for unused medical materiel, such as pharmaceuticals, vaccines, gloves, masks, ventilators, or medical equipment after an incident. The Stafford Act was signed into law on November 23, 1988, as an amendment to the Disaster Relief Act of 1974 (Public Law 93-288). Task 1: Engage community partners and other stakeholders to support risk-mitigation. Task 1: Prepare for adverse event reporting. Ensure coverage for extended operational periods, as applicable. Distribution sites must be validated as appropriate to receive, store, and distribute medical countermeasure assets. situational awareness information that indicates when a jurisdictional incident with public health Assist health care organizations and health care coalitions with monitoring and activating alternate care facilities, as requested. Promote training initiatives for community partners and other stakeholders within public health, health care, human services, mental/behavioral health, and environmental health sectors. Assess medical materiel response needs based on risk-based scenarios, identify available jurisdictional resources to support medical materiel distribution, and identify potential distribution challenges. P2: (Priority) Defined public health agency roles and responsibilities for responder safety and health, such as conducting public health assessments, potable water inspections, field interviews, and points of dispensing staffing, related to identified jurisdictional risks established in conjunction with partner agencies. Coordinate with partner agencies as necessary to conduct food and water safety inspections at congregate locations. Task 3: Develop the public health incident management structure. S/T1: Personnel trained to use PPE for all hazards, including infection control, chemical safety, and  radiation safety, including management of potentially exposed persons, decontamination, and dosimetry. P1: Procedures in place for when the public health agency may designate a lead PIO or provide public information support within emergency operations plans, job action sheets, or other applicable documentation. The LRN is charged with maintaining an integrated network of state and local public health, federal, military, and international laboratories that can respond to bioterrorism, chemical terrorism, and other public health emergencies. P3: Procedures in place for public health preparedness and response based on jurisdictional risk Task 4: Support electronic mortality reporting. P1: (Priority) Written agreements, such as contracts or MOUs, with partners to implement appropriate plans for NPIs, including provisions of support services, such as care for dependent children, notification of family, and provision of food, shelter, water, and communication channels, to individuals during isolation or quarantine scenarios. This may include requesting and using National Emergency Medical Services Information System (NEMSIS) data elements. Coordinate with community partners and stakeholders from within and outside the jurisdiction to educate the community regarding recommended public health services through unified messaging. P2: Procedures in place for family notification, depending upon public health agency fatality management lead or support role(s). Task 1: Define the role of the public health agency in medical surge. The National Preparedness System has six parts that include identifying and assessing risk, estimating capability requirements, building and sustaining capabilities, planning to deliver capabilities, validating capabilities, and reviewing and updating. Procedures may include, (See Capability 3: Emergency Operations Coordination, Capability 6: Information Sharing, and Capability 13: Public Health Surveillance and Epidemiological Investigation). Today, the PHEP program funds 62 cooperative agreement recipients: 50 states, four localities, and eight territories and freely associated states. P10: Notification procedures to detail how laboratory results suggestive of an outbreak or exposure will be reported or messaged to appropriate health investigation partners using secure contact methods per LRN notification policies or laboratory-specific policies. For the purposes of Capability 6, partners and stakeholders may include the following: Function Definition: Identify intra- and inter-jurisdictional stakeholders to participate in information exchange, and determine and periodically reassess stakeholders’ needs for bi-directional information sharing. Implement voluntary or mandatory restrictions on movement, as needed, in coordination with relevant jurisdictional officials, partners, and stakeholders. agencies and other partners to develop staffing pools that include federal, regional, state, Task 1: Communicate incident-specific safety and health risks to volunteers. Recommended procedures for notification and information sharing may include, (See Capability 3: Emergency Operations Coordination, Capability 6: Information Sharing, Capability 8: Medical Countermeasure Dispensing and Administration, Capability 11: Nonpharmaceutical Interventions, and Capability 13: Public Health Surveillance and Epidemiological Investigation). Prep Your Health: Chronic Kidney Disease Care in an Emergency. P1: Decision matrix indicating questions for public health leadership and recommendation options based on existing community risk assessments and incident severity. Identify potential responder safety and health risks based on responder monitoring and surveillance findings. P5: (Priority) Primary and backup distribution sites capable of receiving, staging, storing, and distributing medical materiel, regardless of the originating supply source, such as the Strategic National Stockpile (SNS), the state immunization program receiving vaccine from Biomedical Advanced Research and Development Authority (BARDA), other vaccine distributors, or commercial sources. Determine appropriate clinical, epidemiological, and environmental-related public health actions to mitigate threats, hazards, risks, or incidents based on current public health science-based standards. Exercises, events, or incidents should be documented and after- action reports and corrective action plans should be developed and implemented. Task 3: Support population monitoring and decontamination services. S/T2: Personnel trained on HSEEP AAR and IP guidelines. P1: (Priority) Integrated recovery coordination plan that accounts for the jurisdictional public health agency lead or support roles. Together, all the distribution site and all the dispensing/ administration sites constitute a network of receiving sites. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. agency and other Emergency Support Function (ESF) #8 partners. These sites could include regional distribution sites (RDSs), local distribution sites (LDSs), or any other facility noted in the jurisdiction’s planning documents. E/T5: (Priority) Laboratory Information Management System (LIMS) that is routinely updated and maintained in order to send testing data to CDC according to CDC-defined standards. Staffing plans may include site leads, alternates, security staff, logistics support staff, and Drug Enforcement Administration (DEA) registrant(s) to sign for controlled medical countermeasures, Badging and credentialing requirements for personnel at sites, Training for response personnel and volunteers, including orientation materials, job action sheets, and other training resources or strategies, Procedures to request additional personnel from outside the jurisdiction, such as from the National Guard or Medical Reserve Corps (MRC) based on state and local mutual aid agreements in coordination with the jurisdictional emergency management agency, Procedures for immediate contracting of additional trained distribution support personnel based on state and local emergency procurement practices, Designation of security leads and contact information, Coordination within and across jurisdictional sovereignty lines for law enforcement and security agencies to secure personnel and facilities, Physical measures, such as cages, locks, and alarms to secure materiel within the distribution site, Security measures for transporting materiel, such as escorts and securing of designated roadways, Security measures at alternate distribution sites, Cybersecurity measures, such as protection of personally identifiable information and prevention of unauthorized use of social media, Response time(s) for mobilizing initial transportation resources, Warehouse characteristics, including loading dock type and quantity, staging and storage footprint, and cold chain resources, Delivery vehicle characteristics, including compatibility of the vehicle(s) with loading dock, presence of lift gate, and capacity for full pallet, Receiving site characteristics, including compatibility to receive a full pallet, loading dock type, and on-site equipment, Medical countermeasure characteristics, including the total quantity, weight, and size of the shipments, storage and handling requirements, and packaging, Distribution plan characteristics, including the number of delivery vehicles that can be allocated simultaneously, routes, and security escorts, Compliance with Inventory Data Exchange (IDE) standards or interoperability with CDC information systems, Ability to track the name of drug, quantity, National Drug Code number, lot number, dispensing/ administration site, expiration date, and unit configuration of issue, such as case, box, or bottles, Backup systems for redundancy, such as alternate inventory management software, electronic spreadsheets, or paper-based systems, Physical security measures, such as cages, locks, and alarms, Defined request triggers, indicators, thresholds, and validation strategies to guide decision-making, Identification of individuals within the jurisdiction empowered with the authority to request federal, state, local, tribal, and territorial assets, such as emergency management representatives, senior health officials, and elected representatives with statutory authority to request mutual aid, Strategies to use local circulating inventories and existing jurisdictional medical countermeasure caches, Strategies to use existing infrastructure, such as state immunization programs with experience in vaccine ordering and distribution through the Vaccines for Children Program, Special provisions that may affect medical materiel request procedures, Stafford Act vs. non-Stafford Act declarations, Declarations of a public health emergency, Procedures to coordinate with U.S. Department of Health and Human Services (HHS), as required, Procedures to request medical materiel through the Emergency Medical Assistance Compact (EMAC), Protocols to ensure compliance with regulatory standards, including, U.S. Food and Drug Administration (FDA) standards, Current Good Manufacturing Practices (cGMP), Procedures to obtain medical materiel outside of the SNS, such as pandemic influenza vaccine anticipated to be supplied in coordination with the jurisdiction’s immunization program and CDC’s centralized distributor for publicly funded vaccines, Processes to justify requests for medical countermeasures and other medical materiel, Facility characteristics, such as docks, open floor space, and climate, Maintenance of cold chain integrity according to storage and handling guidelines, Storage and access of controlled substances, Security measures, including personnel, physical security, and other security measures, Respective roles and responsibilities of public health agencies, transportation partners, and other relevant entities, Additional information about medical materiel received, including receipt date, time, and name of individual who accepted custody of materiel, Current available quantity of medical materiel, Distribution strategy, such as distribution through established channels or direct-ship from vendor, Specifics of the requested medical materiel, including item type, size, quantity, intended use, and other relevant information to aid fulfillment choices, Requestor (or other point of contact) information, Law enforcement and security agencies that secure personnel, transportation, and facilities, Incident management personnel, such as command staff or general staff, Critical information required to determine the areas of strength and areas for improvement following an incident, A timeline to ensure completion of after-action reporting and development of corrective action or IPs. Task 2: Identify personnel with the necessary skills to fulfill required incident command and< Release public health and health care information through pre-identified procedures based on jurisdictional processes, such as systems and spokespersons in coordination with the JIC. Task 4: Identify, protect, and ensure information exchange with disproportionately impacted populations. In partnership with key stakeholders, create a transition plan based on the jurisdictional public health agency lead or support roles to integrate implementation and monitoring of corrective actions into day-to-day agency operations. P3: Designated individual(s) responsible for coordinating emergency response activities, such as personnel safety, sample collection, methods training, plans, guidance, and outreach to sentinel laboratories and first responder communities. Recommended systems may include WebEOC, inventory tracking systems, such as the Inventory Management and Tracking System (IMATS), and the jurisdiction’s immunization information system. Task 6: Coordinate with jurisdictional emergency management agencies to support mutual aid agreements with neighboring jurisdictions to provide recovery services. Task 7: Return displaced individuals to pre-incident medical environments. Generally, jurisdictional public health agencies build, sustain, or potentially scale back organizational initiatives based on the most recent assessment of needs, gaps, priorities, and goals. Task 3: Support additional health care services. E/T1: Access to national and jurisdictional adverse event reporting systems, such as VAERS, FDA MedWatch, or local reporting systems. Alerts can convey 1) urgent information for immediate action, 2) interim information with actions that may be required in the near future, or 3) information that requires minimal or no action by responders. S/T5: Personnel from LRN-C laboratories who participate in the LRN-C biannual technical meeting, formerly known as Level 1 surge capacity meeting. Function Definition: Maintain real-time situational awareness of medical materiel management and distribution in order to address emerging needs for resupply, security, transportation, and use of receiving sites. Targeting of critical workforce groups would depend on severity of the threat, the risk of severe illness by age group, medical countermeasure supply, and the accompanying disruption to security, society, and the economy. Joint Information System (JIS): Integrates incident information and public affairs into a cohesive organization designed to provide consistent, coordinated, timely information during crisis or incident operations. Briefing topics should include, Required identification for rostering and badging volunteers, Procedures to assign volunteers to other response agencies, Informing volunteers how to report to appropriate incident management leads, such as volunteer coordinators or off-site incident command, Ensuring all volunteers follow standardized, in-processing requirements, Identifying duties spontaneous volunteers can perform, Verifying credentials of spontaneous volunteers, Managing spontaneous volunteers who are not assigned to the appropriate job functions or tasks based on their skills and the needs of the response, Registering spontaneous volunteers for future emergency responses, Referring spontaneous volunteers who are not aligned with an identified partner organization to other organizations, such as nonprofits or MRC, Procedures to collect contact information from each volunteer responder, Formal check-out or out-processing activities to document volunteer health status including physical and mental/behavioral, as applicable, before volunteers leave the worksite, Procedures to identify volunteer responders with incident-related delayed or long-term adverse health effects. Documentation should include training date(s) and manner of delivery, such as formal training or “train the trainer.”. Through EPIC’s partnerships, CDC can more effectively reach some of the people most vulnerable to public health threats. The ACE team also provides training in conducting rapid epidemiologic assessments after chemical releases. Task 2: Conduct health surveillance at congregate locations. P1: (Priority) Documentation of incident-specific responder safety and health risks, threats, and necessary precautions identified by the jurisdictional public health agency in collaboration with partner agencies. National Emergency Medical Services Information System (NEMSIS): A national database that is used to store emergency medical services (EMS) data from U.S. states and territories. plans, coordinated with the jurisdictional emergency management agency, to facilitate state requests for federal resources through HHS Regional Emergency Coordinators (RECs). This capability focuses on dispensing and administering medical countermeasures, such as vaccines, antiviral drugs, antibiotics, and antitoxins. Strategies based on the jurisdictional public health agency role may include, (See Capability 1: Community Preparedness and Capability 14: Responder Safety and Health). Assemble public information personnel at a physical location or virtually to establish roles and responsibilities. For the purposes of Capability 14: Responder Safety and Health, responders are defined as public health agency personnel. S/T3: Biological, chemical, and radiological (if LRN-R is established) threat laboratory personnel trained annually on chain of custody procedures. E/T2: Human remains pouches, facilities, and other equipment and locations to store human remains. Preventative maintenance and service agreements must be provided for all equipment listed on the LRN-B equipment list. Antemortem information is gathered and compared to postmortem information when confirming a victim’s identification. Laboratory Network. P4: (Priority) Public health and health care system coordination procedures that account for public health and medical materiel management, inventory assessments, and personnel and equipment resource requests from jurisdictional and other ESF #8 partners as the incident evolves. P4: Procedures in place to coordinate case management or other support to assist in the transition to pre-incident medical environments or other applicable medical settings, as requested by health care organizations based on the public health lead or support role. Since ratification and signing into law in 1996 (Public Law 104-321), 50 states, the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin Islands have enacted legislation to become EMAC members. Promote and facilitate reporting of adverse events, disseminate relevant trend data to applicable entities, such as federal agencies, jurisdictional government agencies, and health response partners, and monitor emerging data to inform potential modifications to medical countermeasure strategies. E/T2: Capacity for 24/7 health alerting (using phone or other alerting or notification methods), including Incident characteristics and logistical conditions may include, E/T2: Inventory management system(s) to coordinate and account for medical materiel receipt and distribution, such as CDC’s Inventory Management and Tracking System (IMATS). Critical workforce: For the purposes of Capability 8: Medical Countermeasure Dispensing and Administration, this term refers to personnel required to maintain critical infrastructure. S/T2: Personnel identified in advance of an incident or event who can adequately fill, lead, or support public health incident management roles, including arrangements to staff multiple emergency Founded in 1993, this system of voluntary reporting allows such information to be shared with the medical community or the general public. incident public health agency lead or support role. E/T2: Systems to ensure the electronic management and exchange of information, including laboratory test orders, samples, results, and other information, with jurisdictional partners and stakeholders. Some medical countermeasures, like pills or devices, can be provided to an individual for self-administration. Health care professionals are required to report certain adverse events and vaccine manufacturers are required to report all adverse events that come to their attention. Document actions within written after-action reports (AARs) and improvement plans (IPs) and implement corrective actions based on jurisdictional public health lead or support roles. P3: Procedures in place to integrate community and faith-based partner roles and responsibilities for each stage of a public health incident or event. Stay informed about ways to keep you and your loved ones safe when a public health emergency happens. Identify cases of illness, injury, immunization status, and exposure within mass care populations. (See Capability 1: Community Preparedness, Capability 3: Emergency Operations Coordination, Capability 4: Emergency Public Information and Warning, Capability 6: Information Sharing, Capability 7: Mass Care, Capability 9: Medical Materiel Management and Distribution, Capability 13: Public Health Surveillance and Epidemiological Investigation, and Capability 15: Volunteer Management). Task 2: Develop procedures to distribute medical materiel. S/T2: (Priority) Laboratory personnel certified in a shipping and packaging program that meets national and state or territorial requirements. Reporting adverse events may occur on a national,jurisdictional, or even dispensing site level. LRN-C Level 1 laboratories that own and maintain at least two instruments each listed on the LRN-C equipment list. Definition: Medical countermeasure dispensing and administration is the ability to provide medical countermeasures to targeted population(s) to prevent, mitigate, or treat the adverse health effects of a public health incident. This approach provides financial resources to help build public health emergency response capability both nationally and at state, local, tribal, and territorial government levels. S/T1: Personnel trained on medical materiel and equipment recovery according to manufacturer and jurisdictional guidelines. Create and execute a health resource demobilization plan in conjunction with partner and stakeholder organizations to de-escalate the response as appropriate to the incident. Instead, jurisdictions should periodically reprioritize the capability standards they pursue based on regularly updated jurisdictional inputs, including risk assessment findings. S/T2: Personnel trained in demobilization procedures as relevant to the public health incident management role. The emergency resources, which include approximately 8,000 medical and support personnel, come from federal, state and local governments, the private sector, and civilian volunteers. S/T4: Personnel who perform LRN protocols trained in LRN methods and able to demonstrate proficiency and competency in compliance with applicable regulations, such as Clinical Laboratory Improvement Amendments (CLIA) from regulatory agencies, such as the Centers for Medicare and Medicaid Services (CMS), College of American Pathologists (CAP), or other regulatory equivalent. The SAMS Partner Portal is one of the ways CDC controls and protects this information. Tier 1 capability standards form the foundation for public health emergency preparedness and response. Public Health Ontario has conducted laboratory testing and collaborated with healthcare partners to expand testing capacity since the outset of COVID-19. The first step in the assessment phase is to determine which organizational entities within the jurisdiction are responsible for each domain, capability standard, and applicable capability resource elements. China has been implementing emergency psychological crisis interventions to reduce the negative psychosocial impact on public mental health, but challenges exist. Maintain medical materiel integrity in accordance with established safety and manufacturer specifications during transport and distribution. Many different kinds of communities, including communities of place, interest, belief, and circumstance can exist both geographically and virtually, such as online forums. Coordinate with stakeholders to support the provision of culturally appropriate mental/behavioral health services to incident survivors, family members of the deceased, and responders. The PHEP program underwent an internal review in 2015 to identify opportunities to strengthen program tools, resources, and guidance. Definition: Emergency operations coordination is the ability to coordinate with emergency management and to direct and support an incident or event with public health or health care implications by establishing a standardized, scalable system of oversight, organization, and supervision that is consistent with jurisdictional standards and practices and the National Incident Management System (NIMS). Test clinical specimens and food, water, and other environmental samples according to designated laboratory type and level in order to identify biological, chemical, or radiological threat agents. Task 4: Conduct shift change briefings. P2: (Priority) Procedures in place to review and update the role-based public health directory that supports public health alert messaging. Proficiency testing challenges: Determines the performance of individual laboratories for specific tests or measurements to monitor the laboratories’ continuing performance. P5: Procedures in place for personnel to notify and report for duty. U.S. CDC's Strategic National Stockpile (SNS) contains large quantities of pharmaceuticals and medical supplies which can be requested if there is a public health emergency severe enough to cause state and local supplies to run out. S/T1: Personnel or volunteers from partner agencies who will support information gathering, information dissemination, operations support, and liaison roles during an incident. Category: public health emergency management Partner, Train, Respond: Increasing Global Emergency Management Capacity Countries in Africa are no strangers to major disease outbreaks that can result in illness and death of millions of people. Inventory Management P1: (Priority) Personnel trained and assigned to fill public health incident management roles, as applicable, to a medical surge response to include emergency operations center (EOC) staffing at agency, local, and state levels as necessary. 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