Proposed Deliverables for Local Public Health



Public Health Emergency Preparedness (PHEP)

Deliverables for Local Public Health

Budget Period 11

(August 10, 2011 – August 9, 2012)

Introduction

The following deliverables establish requirements for the Regional Emergency Preparedness Coalitions (Coalitions) for local and regional emergency preparedness planning and demonstration activities for Budget Period 11 (BP11), the first year of the new 5-year Cooperative Agreement from the Centers for Disease Control and Prevention (CDC). The deliverables are intended to be consistent with the CDC’s Public Health Preparedness Capabilities: National Standards for State and Local Planning (Capabilities), and may be revised during the grant year as required by CDC guidance or as determined in collaboration with the Local-State Advisory Council (LSAC). Revisions to the deliverables will be distributed in writing to regional coalitions through their Regional Coordinators and LSAC Representatives.

As noted in the materials distributed as part of the Local Concurrence Process for BP11, MDPH expects to undertake work related to nine (9) of the CDC Capabilities. We have identified local deliverables associated with (five) 5 of these capabilities:

Capability 1 Community Preparedness Capability 3 Emergency Operations Coordination Capability 4 Emergency Public Information and Warning Capability 8 Medical Countermeasure Dispensing

Capability 15 Volunteer Management

This document organizes the deliverables by capability, and identifies cross-cutting deliverables as well. It is our intent to develop deliverables for BP11 that are consistent with requirements under previous PHEP grants, and that focus on maintaining and documenting work done to date. The key new element for this year is the CDC requirement under the Community Preparedness capability for jurisdictions to conduct Hazard Risk Assessments that focus on the associated risk to public health and health care systems. During BP11 EPB will work with local health and other partners to identify an appropriate assessment tool and methodology.

In addition to the narrative description of deliverables, we have included a table at the end of the document that lists the deliverables due by quarter, to provide a more concise picture of the work flow.

Goals for BP11

The BP11 deliverables are intended to maintain, enhance, and document core preparedness work undertaken by the Coalitions over the course the previous Cooperative Agreement. By the end of BP11, MDPH anticipates that we will have a full assessment of the status of state and local health preparedness activities that align with the CDC Capabilities. Key areas of focus will include:

• Joint development of strategies to assess how the state, coalitions, and individual boards of health currently meet the identified priority resource elements that include: written policies and procedures for the identification of vulnerable populations (e.g., Individuals Requiring Additional Assistance, or IRAA), and all-hazards jurisdictional risk assessments that focus specifically on health impact of identified risks;

• Documentation of best practices and strategies for building partnerships to promote health preparedness;

• Completion or updating of written, NIMS-compliant plans (all-hazards, EDS, CoOP), including the update of pandemic response components to reflect lessons learned during the H1N1 Influenza response and recovery;

• Compilation, testing, and updating of 24/7 contact lists;

• Completion of Emergency Dispensing Site (EDS) Technical Assistance Reviews (TAR) and CDC-required metrics for testing EDS operational capabilities;

• Documentation of completion of ICS trainings for appropriate personnel, including PIOs;

• Documentation of mutual aid agreement status; and

• Revision of multi-year exercise plans.

In BP11, coalitions should prioritize the use of PHEP funds to plan for and carry out necessary activities focused on these deliverables. As required under CDC Funding Opportunity Announcement and guidance, each coalition must develop a work plan and budget that link proposed expenditures to one or more of the capabilities selected for BP11. In light of the delay in releasing deliverables for BP11, EPB will work with coalitions and host agencies to revise or amend previously submitted work plans and budgets if necessary.

Capability 1: Community Preparedness

[Capabilities, p 16]

During BP11, MDPH will work with the Coalitions to begin addressing Community Preparedness guidance related to Function 1, assessing the risks to health within coalition communities, and Function 2, building community partnerships to support health preparedness. [See Capabilities at page 17] Both of these functional areas include a specific focus on development of written policies and procedures to identify and address the needs of IRAA. The deliverables identified under each of these functions will facilitate an assessment of current capacity to achieve these functions at the local, coalition, and state level.

Function 1: Hazard Vulnerability Assessment

According to the CDC, the jurisdictional risk assessment should identify the following elements:

• Potential hazards, vulnerabilities, and risks in the community [and region] related to the public health, medical, and mental/ behavioral health systems;

• The relationship of these risks to human impact, interruption of public health, medical, and mental/behavioral health services; and

• The impact of those risks on public health, medical, and mental/behavioral health infrastructure.

While Massachusetts has not conducted a hazard vulnerability or risk assessment (HVA) that meets the criteria set forth by CDC, much work has been done through MEMA to identify hazards and risks across the Commonwealth. As part of the Massachusetts Risk-based Funding pilot project required for this year, EPB will work with local health and other response partners to identify and pilot during BP11 an appropriate health-focused hazard vulnerability assessment/risk assessment tool (HVA) that can be implemented through the Coalitions at a date to be determined in consultation with the LSAC. As part of this work, Coalitions should develop strategies to:

• Identify and review existing risk assessment reports available through municipal agencies, local or regional emergency planning committees, regional planning councils, homeland security councils, hospitals and other healthcare facilities, etc;

• Obtain and review the most recent hazard mitigation plan completed for each community within the Coalition;

• Identify and describe IRAA within each community and across the regional coalition, using data from local, regional, state, and federal sources (e.g., census data) [similar to TAR 5.7];

• Work with local emergency management officials to develop or enhance local plans for addressing the needs of IRAA; and

• Develop and implement strategies to recruit local residents and incorporate them within local and regional efforts to identify and prioritize jurisdictional hazards and health vulnerabilities.

Outcomes: Each coalition will:

1. Develop an overview of currently available information regarding the state of Hazard Vulnerability Analysis in their region. The summary will include the following elements:

• a summary of existing local plans for addressing needs of IRAA along with identified gaps and a work plan to address those gaps;

• a list of the existing HVAs and mitigation plans by community;

• identification of the five most common hazards as identified in the HVAs and hazard mitigation plans that may have a significant impact on public health;

• identification of which coalition members have or have access to GIS services within their communities.

Each coalition will submit a written overview with all of the above elements to their Regional Coordinator no later than August 9, 2012.

[EPB will provide a template for coalitions to use in completing this overview no later than December 31, 2011.]

2. Participate in at least one HVA/risk assessment training activity designated by MDPH by August 9, 2012.

Function 2: Expand Community Partnerships

During BP11, EPB will work with local health and other response partners to identify best practices and strategies to expand local and state health participation in existing or new partnerships representing at least the 11 community sectors identified in the Capabilities: business; community leadership; cultural and faith-based groups and organizations; emergency management; healthcare; social services; housing and sheltering; media; mental/behavioral health; state office of aging or its equivalent; education and childcare settings. [See Capabilities, p. 19].

As part of this work, Coalitions and local health should:

• Discuss and share strategies to expand local and regional partnerships that support health preparedness, with a particular focus during BP11on identifying and partnering with mental and behavioral health organizations, and other organizations in their communities that serve and advocate on behalf of IRAA;

• Build or enhance existing collaborative relationships with emergency management, public safety, human services, education, businesses, faith communities, and community-based organizations that support health preparedness, with a particular focus during B11 on identifying and working to address gaps in partnerships within the identified community sectors;

• Ensure that coalition meetings and planning activities encourage and incorporate participation from other sectors involved in public health preparedness, including local hospitals and healthcare facilities, large behavioral health or human service organizations, businesses, and faith communities; and

• Participate to the extent possible in local/regional emergency planning committees (LEPC\REPC) or other planning groups to strengthen relationships with local planning and response partners.

Outcomes: Each coalition will:

1. Develop an overview of existing emergency preparedness partnerships within the region and plans to expand those partnerships to include the following information:

• communities that regularly participate in LEPC/REPC or similar planning group meetings and submit the list along with barriers to greater participation;

• activities and efforts to expand partnerships across the 11 identified

community sectors;

• public health, medical, and mental/behavioral health networks in their jurisdiction and gaps;

• confirmation that coalition or community written plans include a process and procedures to facilitate collaboration with local Medical Reserve Corps (MRC), MA Responds, Community Emergency Response Teams (CERT), and other groups that may provide volunteers during a public health emergency.

Each coalition will submit a written overview with all of the above elements to their Regional Coordinator no later than June 11, 2012.

[EPB will provide a template for coalitions to use in completing this overview no later than December 31, 2011.]

Capability 3: Emergency Operations Coordination

[Capabilities, p 27]

During BP11, EPB will work with local health and the coalitions to develop and disseminate consistent guidance related to activation and coordination of emergency operations at the local, coalition, and state levels. As in previous budget periods, EPB will continue to track completion of appropriate ICS training at the state and local level. Working with the LSAC, relevant MDPH Bureaus, and other response partners, EPB will develop standard operating procedures (SOP) for the department operations center (DOC), including activation levels and notification procedures. EPB will also review, revise, and disseminate SOPs currently in place for the ESF8 desk at the State Emergency Operations Center (SEOC). As part of this process, EPB will share with the coalitions copies of templates, activation matrixes, job action sheets, and other materials that may be adapted to local and coalition use.

Outcomes: Each coalition will:

1. Ensure that local health members of the coalition (a) identify health staff, volunteers, and other municipal personnel who may be activated to fill incident command positions in the event of a public health emergency, and (b) provide a summary of plans to staff incident command positions to the Regional Coordinator by March 9, 2012.

2. Ensure that (a) all personnel funded with PHEP dollars complete at least ICS 100 and Tier One NIMS training as described on page 30 of the Capabilities, and (b) local and regional public health personnel, board members, and others who may be called on to fulfill management and/or PIO responsibilities in a public health emergency complete NIMS training to the appropriate levels, as indicated in Attachment B.

3. Submit to the Regional Coalition by December 9, 2011 a spreadsheet that identifies by community (a) staff and board members who have completed required courses and the courses each has completed, and (b) additional individuals who need to complete required courses, and their timeline for completion. Coalitions shall submit an updated spreadsheet to the Regional Coordinator no later than August 9, 2012.

Capability 4: Emergency Public Information and Warning Capacity

[Capabilities, p 36]

Outcomes: Each coalition will:

1. Include in the information submitted for Outcome 1 under Emergency Operations Coordination above a list of the designated Public Information Officer(s) for each community in the coalition.

2. Provide a list of coalition members who have completed crisis and emergency risk communication training, along with the level of training completed, to the Regional Coordinator no later than March 9, 2012.

Capability 6: Information Sharing

[Capabilities, p 55]

Local health deliverables for BP11 are intended to ensure that communities and coalitions have established redundant mechanisms to share information within and outside of the coalition, and to develop a common operating picture during an emergency. Each coalition is required to compile and maintain up-to-date contact information for communities that is shared within the coalition and with MDPH, and to ensure that sufficient personnel from each member community are registered on the HHAN and able to receive and send HHAN message according to guidelines issued by MDPH.

Outcomes: Each coalition will:

1. Submit an updated 24/7/365 contact list to the Regional Coordinator each quarter.

2. Conduct at least one (1) 24/7/365 contact list drill during BP11 and submit confirmation of the drill results to the Regional Coordinator using the DPH-metrics form no later than August 9, 2012.

3. Ensure that each community in the coalition has at least two (2) individuals registered on the HHAN and trained to receive HHAN messages. Ongoing

4. Submit to the Regional Coordinator by June 11,2012 documentation that at least two (2) coalition-wide HHAN drills have been conducted, and that gaps identified during the first drill using the DPH-provided metrics form are addressed through an improvement plan and corrections assessed as part of subsequent drills during BP11.

Capability 8: Medical Countermeasure Dispensing (MCMD)

[Capabilities, p 71]

Over the course of the 5-year Cooperative Agreement, MDPH and local health departments will continue work to enhance the solid infrastructure that is currently in place to support and ensure rapid and effective medical countermeasure dispensing. The deliverables under this capability are intended to maintain ongoing local health activities related to planning for and exercising Emergency Dispensing Sites and completing the Technical Assistance Review (TAR). The focus of the local health deliverables for BP11 will be to meet TAR requirements and demonstrate priority resource elements identified for Functions 3 and 4 of this capability. [Capabilities, p. 71]

Outcomes: Each coalition shall:

1. Submit to the Regional Coordinator no later than June 11, 2012 written confirmation that 100% of the communities within the coalition have an updated, NIMS-compliant EDS plan, developed in collaboration with emergency management, law enforcement, and other key response partners, that identifies 1 or more EDS for use by members of the community and is integrated into the public health all-hazards plan.

2. Submit to the Regional Coordinator no later than March 9, 2012 a completed CDC call down metric as confirmation that 100% of the communities within the coalition have completed a call down drill.

3. Submit to the Regional Coordinator by June 11, 2012 a completed facility notification metric as confirmation that 100 % of communities within the coalition have conducted at least 1 test of the Notification Protocol of their EDS plan, and

4 Submit to the Regional Coordinator by June 11, 2012 a completed facility set up metric as confirmation that 100 % of communities within the coalition have conducted at least one Facility Set-up Drill. In addition, an HSEEP-compliant after action report for the Facility Set-Up drill must be submitted to the Regional Coordinator within 60 days after completion of the drill. (All required metrics and a template for the After Action Report can be found in the EDS Toolkit. EPB has also approved an AAR template developed by Region 4B as acceptable to meet this deliverable).

5. Working with the Regional Coordinator and SNS staff, ensure that (a) each community completes and submits a TAR to the Regional Coordinator according to a timeline established by the CDC (to be no later than July 19, 2012), and (b) TAR Improvement plans for each community, individually or compiled for the whole coalition, are submitted to the Regional Coordinator by June 30, 2012.

6. Submit to the Regional Coordinator by December 9, 2011, (a) a description of the coalition’s strategy and timeline to implement mutual aid agreements, including the percentage of communities that have adopted the coalition’s mutual aid agreement; (b) a copy of the mutual aid agreement the coalition is pursuing (if any); (c) a written description of how the coalition will ensure the ability to share resources, facilities, services, and other support required during MCMD activities if is not pursuing a mutual aid agreement. [See, Priority Resource Element P1, Capabilities p. 75]

Cross-Cutting Activities

Coalitions and local health departments have made considerable progress made in planning, training, exercising, and other preparedness activities supported through the previous PHEP Cooperative Agreement(s). These cross-cutting deliverables, not aligned with any specific capability, are intended to ensure that efforts started in previous years will be maintained and enhanced to the extent possible..

For Plan Maintenance, each coalition will:

1. Submit bi-annual reports on the status of community and coalition all hazards (including IRAA components), Continuity of Operations, and EDS plans, along with a timeline for addressing any identified gaps by March 3, 2012 and August 9, 2012

For Completion of PHEP Deliverables, each coalition will:

2. Submit confirmation to the Regional Coordinator by December 9, 2011 that the coalition has allocated funding and hired at least one (1) .5 FTE planner or coordinator to assist the coalition in meeting deliverables and reporting requirements.

3. Ensure that all communities within the coalition that receive direct support under the PHEP grant are (a) participating in the coalition, and (b) providing appropriate documentation of efforts to meet the deliverables of the PHEP. “Direct support” includes but is not limited to formula-based local allocations, funding for proposals submitted by a community or group of communities, funding for travel to out-of-state conferences or meetings, and receipt of equipment or services purchased with PHEP funds. Participation in the coalition includes at a minimum providing 24/7/365 contact information and participating in preparedness exercises. Provide as part of each quarterly fiscal report an affirmation that all coalition members receiving direct support through PHEP funding are in compliance with the attached community participation guidance.

5. Make a good faith effort to schedule and hold a coalition meeting to review and vote on concurrence with the BP12 draft application provided by EBB in accordance with policies and procedures developed by EPB and the LSAC.

For Exercises and Drills each coalition will:

1. Update and submit to the Regional Coordinator by December 9, 2011 its HSEEP-compliant multi-year Exercise Plan to include exercises required in these deliverables and other exercises, if any, planned by the coalition or communities within the coalition for BP11.

2. Notify the MDPH Exercise and Training Manager and the Regional Coordinator prior to participating in planning for any exercise or drill that is supported in whole or in part by PHEP funds. Any community or coalition conducting an exercise supported with PHEP funds in BP11 must submit an HSEEP-compliant After Action Report/Improvement Plan to the MDPH Training and Exercise Manager no later than 60 days following completion of the exercise. Failure to provide timely notification may result in withholding of or reduction in funding available for the exercise or drill. Ongoing through budget period

For Coalition Operating Procedures each coalition will:

1. Review, update as necessary, and approve or re-affirm existing Principles of Operation during BP11. Coalition Principles of Operation must clearly state the coalition purpose, membership, governance, election and terms of officers, process for establishing committees, process for coalition approval for determining use of PHEP funds, and amendment process.

2 Provide a copy of current operating principles to MDPH along with the first quarterly report submission. .

3. Submit to the Regional Coordinator by August 9, 2012 a copy of updated operating principles or a statement that the coalition has affirmed the principles submitted with the first quarterly report

4. Provide as part of each quarterly fiscal report an affirmation that all coalition members receiving direct support through PHEP funding are in compliance with community participation guidance.

Attachment A

PHEP Deliverables Summary Chart

|Deliverable |Due Date |

| |(deliverables may be due in |

| |more than 1 quarter) |

|Quarter 1 – August 10 – December 9, 2011 |

|Submit a description of the coalition’s strategy and timeline to implement mutual aid agreements |December 9, 2011 |

|Submit a spreadsheet identifying staff and board members who have completed required NIMS and ICS courses |December 9, 2011 |

|Hire or contract for services of at least one (1) .5FTE planner |December 9, 2011 |

|Provide a copy of current coalition operating principles to MDPH |December 9, 2011 |

|Update coalition HSEEP-compliant multi-year Exercise Plan |December 9, 2011 |

|Quarter 2 – December 10, 2011 – March 9, 2012 |

|(a) Identify health staff, volunteers, and other municipal personnel who may be activated to fill incident |March 9, 2012 |

|command positions in the event of a public health emergency, and (b) Provide a summary of plans to fill | |

|incident command positions | |

|Provide a list of the designated public health PIOs for each community |March 9, 2012 |

|Provide a list of coalition members who have completed crisis and emergency risk communication training |March 9, 2012 |

|Initiate and evaluate an EDS call-down drill utilizing the CDC metric document |March 9, 2012 |

|Provide a status report on the following plans: All Hazards; COOP, EDS, IRAA |March 9, 2012 |

|Quarter 3 – March 10 – June 11, 2012 |

|Submit overview of coalition efforts to expand partnerships |June 11, 2012 |

|Conduct two(2) HHAN drills |June 11, 2012 |

|Test protocols to initiate the EDS site /facility notification plan according to the jurisdiction’s EDS plan |June 11, 2012 |

|to test operation readiness | |

|Conduct an EDS Facility Set-up Drill utilizing the CDC metrics document |June 11, 2012 |

|Submit documentation that 100% of communities within the coalition have an updated plan |June 11, 2012 |

|Quarter 4 – June 12 – August 9, 2012 |

| |June 30, 2012 |

|Review, update, and approve Coalition Principles of Operation during the current grant year |June 30, 2012 |

|Complete the TAR tool as required by CDC |June 30, 2012 |

|Identify 1 or more gaps in EDS planning and develop an improvement plan to address those gaps |June 30, 2012 |

|Submit an overview of coalition activities regarding HVA/risk assessment |August 9, 2012 |

|Participate in at least one HVA/risk assessment training activity |August 9, 2012 |

|Conduct a 24/7/365 contact list drill at least once during the grant year |August 9, 2012 |

|Provide a status report on the following plans: All Hazards; COOP, EDS, IRAA |August 9, 2012 |

|Submit a copy of updated operating principles or a statement that the coalition has affirmed the principles |August 9, 2012 |

|submitted with the first quarterly report | |

|Quarterly |

|Each coalition will update its 24/7/365 contact list |Quarterly |

| Provide as part of each quarterly fiscal report an affirmation that all coalition members receiving direct |Quarterly |

|support through PHEP funding are in compliance with community participation guidance | |

|Ongoing |

|Ensure that (a) all personnel funded with PHEP dollars complete at least ICS 100 and Tier One NIMS training |Ongoing |

|and (b) anyone who may be called on to fulfill management and/or PIO responsibilities in a public health | |

|emergency complete NIMS training to the appropriate levels | |

|Ensure that each community in the coalition has at least two (2) individuals registered on the HHAN and |Ongoing |

|trained to receive HHAN messages | |

|Notify the MDPH Exercise and Training Manager and the Regional Coordinator prior to beginning or |Ongoing |

|participating in planning for any exercise or drill that is supported in whole or in part by PHEP funds | |

Attachment B

ICS Training Levels Chart

[pic]

Attachment C

Community Participation in Coalition Activities

According to the CDC, the purpose of the PHEP program is “to develop emergency-ready public health departments by upgrading, integrating and evaluating state and local public health jurisdictions preparedness for and response to public health emergencies with federal, state, local, and tribal governments, the private sector, and nongovernmental organizations (NGOs).” Through the emergency preparedness coalitions, the DPH Emergency Preparedness Bureau (EPB) provides PHEP funds to communities to become “emergency ready”.

To ensure that Massachusetts is prepared to effectively respond to large or small public health emergencies, communities are expected to make good faith efforts to actively participate in coalition activities and fulfill all annual deliverables. Failure to make a good faith effort to achieve grant deliverables may affect eligibility for future funding. After consultation and concurrence by LSAC, EPB has identified a series of deliverables that must be fulfilled by communities in order to be eligible to receive direct support under the PHEP grant. “Direct support” includes but is not limited to formula-based local allocations, funding for proposals submitted by a community or group of communities, “mini-grants”, funding for travel to out-of-state conferences or meetings, and receipt of equipment or services purchased with PHEP funds

The following specific deliverables have been established as those that must be met by any community receiving direct support from the PHEP grant:

• Community Preparedness Activities – Each community must complete a summary of existing municipal plans for addressing IRAA; compiling HVAs; and expanding partnerships with other emergency preparedness stakeholders in their community and region.

• Plans – each community must verify that is has a written, NIMS-compliant all-hazards public health response plan..

• Points of contact – each community must provide emergency points of contact including at least two (2) contacts that can be reached 24/7/365, and two (2) contacts registered and trained on the Health and Homeland Alert Network (HHAN).

• Communication drills – each community must complete the EDS call down and site notification drills listed in the EDS-related deliverables; and conduct or participate in one 24/7 contact drill during the year.

• Technical Assistance Review (TAR) -- Each community must complete the TAR tool as required by CDC, with technical assistance and support from Emergency Preparedness Bureau staff including the Regional Coordinators and members of the SNS team.

• Operating Principles -- Communities must agree to abide by coalition principles of operation or other documents that reflect coalition operating procedures. Communities are expected to work cooperatively with the coalition’s host agent to ensure the grant’s reporting requirements and spending guidelines are met.

• Communities must agree to act in accordance with federal and state: (1) grant guidance, (2) conflict of interest rules and regulations, and (3) all applicable procurement requirements

Upon request, EPB work with coalitions to support implementation of this requirement.

-----------------------

Question 3: Are you:

• Environmental Health Strike team leader

• Epidemiology Rapid Response Team leader

• EDS Manager

• Departmental Operations Center (DOC) staff

• Staff that may be assigned to the State Emergency Operations Center (SEOC)

OR

Are you likely to be an Incident Commander for an operational period of greater than 24 hours?

Question 1: Are you:

• Emergency/Immunization Clinic Staff

• EDS staff

• Environmental Health staff

• Program staff

• Public Health personnel that would assist in a disaster setting

YES

Response to Q 1-4 if ‘No’:

No additional ICS training required.

Question 2: Are you:

• Environmental Health Strike team member

• EDS Section leader

• Epidemiology Rapid Response Team member

• Supervisor staff

NO

Response to Q1: if ‘Yes’

• IS – 700

• ICS – 100

YES

Response to Q 2 if ‘Yes’:

• IS – 700

• ICS – 100

• ICS – 200

Response to Q3 if ‘yes’:

• IS – 700, ICS -100, ICS-200, ICS-300

YES

Question 4: Are you :

• A Department Head with multi-agency coordination system responsibilities

• Area Commander

• Departmental Operations Center (DOC) Manager

•

NO

Response to Q4 if ‘yes’: IS – 700, ICS-100, ICS-200, ICS-300, ICS-400 (IMPORTANT: See pg 2 for note on ICS 400).

NO

NO

YES

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