Each capability standard identifies priority resource elements that are relevant to both routine public health activities and essential public health services. Considerations for a network of sites may include, The selection of dispensing/administration sites should be adapted to the incident, and sites may include, S/T1: Personnel trained to dispense/administer medical countermeasures. S/T1: Personnel trained and knowledgeable on the Strategic National Stockpile (SNS) formulary and trained on FMS implementation. S/T3: (Priority) Personnel trained, as appropriate for their roles, in level A, B, or C OSHA PPE standards awareness and technical response trainings. Procedures may include, P4: (Priority) Network of sites for dispensing/administering medical countermeasures. E/T3: Information technology equipment in quantities sufficient to meet incident or event objectives, such as projectors, computers, and audio/video teleconferencing equipment. The 2018 Public Health Emergency Preparedness and Response Capabilities: National Standards for State, Local, Tribal, and Territorial Public Healthpdf icon recognizes the maturity and experience jurisdictional public health emergency preparedness and response programs have gained since 2011. CDC recommends that communications be cleared, as appropriate, and address, P7: (Priority) Procedures in place to ensure responders are properly demobilized after a response. E/T1: Materiel and equipment to process, store, and release human remains for final disposition. The public health consequences of disasters and emergencies initially affect local jurisdictions. There are different forms of chronic kidney disease and many receive different types of treatment for it. P3: Established channels for stakeholder communications, such as standing meetings, electronic messaging, e-mailed communications, and web conferencing. E/T2: Respirator fit testing kit with a certified fit for public health responders. Partner with jurisdictional emergency management agencies when developing intra- and inter-state public health mutual aid and resource sharing agreements with neighboring jurisdictions for the provision of community recovery support resources and services. (See Capability 3: Emergency Operations Coordination and Capability 9: Medical Materiel Management and Distribution), P4: (Priority) Procedures in place to determine responder eligibility for deployment based on medical readiness, physical and mental/behavioral health screenings, background checks, and verification of credentials and certifications. Additional tools are included to provide resources for more inclusive communication planning that will offer time-saving assistance for state, local, tribal, and territorial public health and emergency management planners in their efforts to reach at-risk populations in day-to-day communication and during emergency situations. Identify current jurisdictional and federal laws and policies that authorize, limit, or protect the exchange of information relevant to emergency situational awareness. Task 2: Promote training and guidance for community partners. Task 5: Coordinate care for service animals. Documentation should include training date(s) and manner of training delivery, such as formal or “train the trainer.”. Task 4: Demobilize distribution operations. P1 (Priority): Procedures in place to assess medical countermeasure inventories and determine the need for additional medical countermeasures. The 2018 Public Health Emergency Preparedness and Response Capabilities: National Standards for State, Local, Tribal, and Territorial Public Health describes the components necessary to advance jurisdictional public health preparedness and response capacity. Medical materiel: For the purposes of Capability 9: Medical Materiel Distribution and Management, any equipment, apparatus, or supplies that are needed to prevent, mitigate, Definition: Information sharing is the ability to conduct multijurisdictional and multidisciplinary exchange of health-related information and situational awareness data among federal, state, local, tribal, and territorial levels of government and the private sector. Identify NPI recommendations based on science, risks, resource availability, and legal authorities. Task 3: Complete incident assessments. This may include requesting and using National Emergency Medical Services Information System (NEMSIS) data elements. In the context of the capability standards, the term “incident” is used to describe any scenario, threat, disaster, or other public health emergency. Facilitate and advocate for collaboration among government agencies and Function Definition: Assess internal agency surveillance and epidemiologic investigation systems and implement quality improvement measures within jurisdictional public health agency control. Task 1: Determine the public health response role. The SAMS Partner Portal is one of the ways CDC controls and protects this information. E/T1: Central repository or database for the collection, recording, and storage of antemortem and postmortem data. P3: Verification of professional volunteer diplomas, licenses, certifications, credentials, and registrations in accordance with federal and state laws using the state’s ESAR-VHP or other programs, as appropriate. It also includes the ability to expand these systems and processes in response to incidents of public health significance. Procedures should reflect relevant cultural, religious, family, and burial practices. P2: (Priority) LRN for Chemical Threats Preparedness (LRN-C) member laboratories with LRN-C Quality Assurance Program ”Qualified” status achieved through the successful participation in proficiency testing challenges. E/T2: Information system(s) for dispensing and administering medical countermeasures, such as inventory tracking systems to manage medical countermeasure supplies or state IISs to track vaccinations given to individuals. P5: (Priority) Regularly updated and verified list(s) of identified stakeholders who will share, receive, and distribute surveillance reports. The process included individual work groups for each of the 15 capabilities along with four additional cross-cutting work groups to address at-risk individuals with access and functional needs, tribal populations, environmental health, and pandemic influenza. P1: (Priority) LRN for Biological Threats Preparedness (LRN-B) Reference laboratories with proficiency in LRN-B testing methods and the ability to accurately test for agents as defined in the LRN-B Standard Laboratory Checklist. Coordinate with health care partners to facilitate access to and promote the availability of mental/behavioral and medical support for responders, as necessary. 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. Task 4: Ensure health screening and identification of access and functional needs. P3: Decision support matrix to help determine when to scale up or scale down JIS operations. S/T2: Personnel trained in health communication and cultural competency. Support the jurisdictional incident management system to determine the public health medical surge role within the Incident Command System (ICS). Testing may include clinical specimens and food, water, and other environmental samples. The National Preparedness System outlines an organized process for everyone in the whole community to advance their preparedness activities and achieve the National Preparedness Goal, “A secure and resilient nation with the capabilities The capabilities also support topics such as pandemic influenza, environmental health, at-risk populations, and tribal populations. Control myths and rumors within the jurisdiction using media and digital outlets, including television, Internet, radio, social media, and newspapers. procedures may include, P2: Incident closeout briefing for the public. P1: (Priority) Response procedures in place to detail how the agency manages and responds to Agreements may include, (See Capability 9: Medical Materiel Management), P7: Procedures in place to coordinate with response partners responsible for decontamination of individuals at congregate locations, if necessary. P2: Procedures in place to track and monitor media, which may include, S1: Public information personnel trained in incident management and information systems operations. Recommended trainings may include, (See Capability 10: Medical Surge and Capability 15: Volunteer Management). Procedures may include, (See Capability 3: Emergency Operations Coordination, Capability 6: Information Sharing, and Capability 13: Public Health Surveillance and Epidemiological Investigation). Task 4: Demobilize mass care operations. Function Definition: Support activities to ensure that human remains, associated personal effects, and official documentation are safely and accurately recovered, processed, transported, tracked, recorded including death certificates, stored, and disposed of or released to authorized person(s) according to the jurisdictional public health agency role and fatality management procedures. Prep Your Health: Chronic Kidney Disease Care in an Emergency. Function Definition: Develop recommendations to identify and facilitate access to resources, such as personnel and subject matter experts, record keeping, and physical space to address fatality management needs resulting from an incident in accordance with public health agency jurisdictional roles and standards outlined in jurisdictional fatality management procedures. P5: Laws, statutes, policies, and procedures that ensure jurisdictional public health agencies have the authority to collect and share a uniform set of jurisdictional health-related data associated with diseases, exposures, or injury conditions of public health importance. Task 5: Ensure personnel are trained in the functions they may fulfill. P1: Standard operating procedures in place to manage a response. Jurisdictional public health agencies are not expected to simultaneously and completely address all identified issues, gaps, and needs across all capabilities in the short term. Task 3: Conduct after-action reviews and develop after-action reports and improvement plans. Coordinate with FBI field office to complete this workshop. The public health agency role in fatality management activities may include supporting. Task 6: Coordinate with jurisdictional emergency management agencies to support mutual aid agreements with neighboring jurisdictions to provide recovery services. S/T2: Personnel trained in volunteer management. Clarify state, local, tribal, and territorial public health information roles and confirm communication support and coordination needs. Task 4: Support electronic mortality reporting. P11: Procedures in place to create, clear or approve, and disseminate medical surge guidance to inform the population of where and when to seek care as well as the appropriate use of 911 and acute care health systems during an incident or event. (See Capability 3: Emergency Operations Coordination and Capability 15: Volunteer Management), P7: Systems and procedures to mobilize communication activities and roles applicable to the incident or event, such as information gathering, information dissemination, operations support, and liaison. S/T1: Personnel with awareness of current national policy and leading practices for biological, chemical, and radiological (if LRN-R is established) threat preparedness attained through regular participation in LRN national meetings, if available. Equally important, resource elements described within each capability function are not representative of all potential resource types or the quantities that may be required. Considerations for making messages accessible for individuals with access and functional needs may include, (See Capability 1: Community Preparedness and Capability 4: Emergency Public Information and Warning). Through engagement and coordination with a cross-section of state, local, tribal, and territorial partners and stakeholders, the public health role in community preparedness is to. Task 1: Support the safe management of human remains. S/T6: Personnel who regularly perform LRN testing, including those identified for surge capacity, trained annually in appropriate safety procedures. Examples of revisions include the addition of public health mission-ready packaging and the importance of identifying jurisdictional public health agency lead or support roles based on incident characteristics. Function Definition: Request and receive medical countermeasures at the jurisdictional level and ensure receipt of medical countermeasures at dispensing/administration sites based on incident characteristics. S/T2: Personnel trained to conduct tabletop, functional, and full-scale exercises in accordance with the Homeland Security Exercise and Evaluation Program (HSEEP) in order to test and evaluate jurisdictional medical countermeasure strategies. Gathering health and basic needs information using valid statistical methods allows public health and emergency managers to make informed decisions. P3: (Priority) Identified lead or jurisdictional authority to initiate medical materiel distribution operations based on incident triggers and incident characteristics. Activities may include, 11For example, the Food Emergency Response Network, National Animal Health Laboratory Network, and the Environmental Response Coordinate with community partners and stakeholders to implement existing training and educational programs that incorporate community-based approaches to preparedness and recovery. EMAC offers assistance during governor-declared states of emergency or disaster through a responsive, straightforward system that allows states to send personnel, equipment, and commodities to assist with response and recovery efforts in other states. Task 5: Develop a transition plan for implementing and monitoring corrective actions. Activate necessary public health functions and support mutual aid according to the public Learn More. Distribution site: Locations that receive medical countermeasures for eventual transport to dispensing/administration sites. P5: Procedures in place to ensure adequate supplies for packaging and shipping are available 24/7, including procedures to rapidly procure additional supplies when needed. P2: (Priority) Procedures in place to dispense/administer medical countermeasures to public health responders and critical workforce either pre-incident or during the early stages of an incident. E/T2: Registration systems for individuals requiring decontamination or medical tracking. Recommended training may include FEMA IS244.B: Developing and Managing Volunteers. Function Definition: Assess the impact of an incident on the public health system in collaboration with jurisdictional partners and stakeholders to prioritize public health, emergency management, health care, mental/behavioral health, environmental health, and applicable human services recovery needs. Task 3: Develop the public health incident management structure. S/T2: Personnel with cultural competency training as related to fatality management. Site-specific standard operating procedures and staffing plans for medical countermeasure dispensing/administration, such as processes to order and receive medical countermeasures, Existing infrastructure and resources that may be available for use, such as the network of vaccine administration sites supported by the Vaccines for Children program or mail order pharmacy systems, Alternate approaches for reaching tribal populations, including cross-jurisdictional agreements, Alternate approaches for populations that may be difficult to reach, such as individuals who are undocumented, incarcerated, or experiencing homelessness and individuals who reside in long-term, Alternate approaches for providing effective communication in multiple formats to account for the access and functional needs of at-risk individuals who may be disproportionately impacted by a public health incident or event, including children, pregnant women, older adults, and others with access and functional needs as well as communities that may be disproportionately impacted by a public health emergency, Alternate approaches for providing medical countermeasures, such as direct to patient or home delivery, Methods to track and monitor countermeasures dispensed, administered, or used across the network of sites, Hospitals, primary care, or other health care facilities, Community or faith-based organization facilities, Federal facilities, such as Department of Defense and Veterans Affairs facilities, as applicable, Workplace sites or occupational health clinics, Doctor offices and other outpatient facilities, Requirements for licensing or certifying personnel providing medical countermeasures as determined by the jurisdiction, Training to manage a potentially diffused network of dispensing/administration sites, such as vaccine administration through community pharmacies, Necessary credentialing or background checks to assure personnel qualifications, Training to ensure operational competence and familiarity with jurisdictional incident command structure, Training to ensure adherence to clinical dispensing/administration protocols, Training to communicate with and support those with access and functional needs, such as sign language interpreters, Initial assessment of jurisdictional medical countermeasure inventories and supporting infrastructure prior to requesting mutual aid or federal assistance, Inventory assessment and management throughout the incident response, for example, tracking inventory use and redeploying inventory to accommodate surges caused from under or overutilization of medical countermeasure dispensing/administration sites, Assessments and procedures to identify and maintain ancillary medical countermeasure supplies, Assessment of local inventories and medical countermeasure caches to determine initial supply or resupply needs, Identification of local pharmaceutical and medical supply wholesalers, Decision tree to guide the process for requesting or ordering additional medical countermeasures and account for the status of emergency declarations, Adherence to regulatory standards required for maintaining jurisdictional medical countermeasure caches, such as U.S. Food and Drug Administration (FDA) standards, including current good manufacturing practices, appropriate Drug Enforcement Administration (DEA) registrations, and the ability to track medical countermeasures rotation, Procedures to properly store and package unit-of-use doses according to pharmacy laws and manufacturer specifications, Procedures for freeze-dried vaccine that must be reconstituted with a diluent, Procedures to outline requirements for receiving vaccines when jurisdictional vaccine provider agreements are in place, such as the Vaccines for Children program, Procedures to legally accept and manage controlled substances, including registration with the DEA, Procedures to consider and incorporate other specific medical countermeasure dispensing/ administration storage and handling needs, Name of the drug, generic or brand, or vaccine, Site where medical countermeasure was dispensed/administered, Materiel-handling equipment, such as pallet jacks, handcarts or dollies, scissor-lifts, and forklifts, Primary and backup cold chain management equipment, such as portable, insulated containers for transporting temperature-sensitive medical countermeasures, refrigerators, thermometers, and other equipment needed to meet storage and handling requirements, Ancillary medical supplies and durable medical equipment, Infrastructure supplies and systems, such as paper supplies, copiers, computers, printers, Internet/ network access to support site inventory management, white boards, desks, vests, line tape, signage, and consent forms, Activation procedures for dispensing/administration sites may specify elements, including, Demand estimate (number of people planning to visit the site), Estimated throughput and vaccination capacity, Number of personnel and shifts required to operate the site throughout the incident, Plan to accommodate access and functional needs of at-risk individuals who may be, Mechanisms to address legal and liability barriers may include, Liability for private sector participants, Property needed to dispense/administer medical countermeasures, Identifying and activating security personnel, Implementing crowd management measures at and around sites, Collaborating with law enforcement and emergency management, Tailored messages to meet the specific information needs of the intended audiences, including, Guidance from relevant federal or jurisdictional agencies, Information about site locations, operating hours, and known risks and benefits, Information that is standardized or harmonized within a jurisdiction or across jurisdictions, such as, Information for populations that are specifically targeted to receive medical countermeasures, Information for populations that are not targeted to receive medical countermeasures to ensure that, Materiel-handling equipment, such as pallet jacks, handcarts or dollies, and forklifts, Equipment to ensure proper storage and handling of medical countermeasures, such as refrigerators and temperature tracking for cold chain management. Task 2: Coordinate the delivery of essential public health services. Function Definition: Conduct or support monitoring and surveillance activities to identify potential volunteer safety and health needs. situation and determine emergency response operations applicable to jurisdictional needs. P2: Procedures in place to identify points of contact and establish a clearance process to verify and approve communication products, including talking points, social media messages, public information, and external-facing documents. E/T4: Equipment and Internet connection, as needed, to access an individual’s immunization status as found in an immunization registry, or information about medical conditions as found in an electronic health record. Alert and assemble personnel who will support medical countermeasure dispensing/administration according to the roles, responsibilities, and resources needed to achieve medical countermeasure coverage goals. 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