Public Health Emergency - Leading a Nation Prepared
In its first ten years, ASPR built an emergency management structure that is nimble and responsive to the public health and medical needs that often result from disasters – from Hurricane Ike to the latest Zika outbreak. Today, health is recognized increasingly as a critical consideration in disaster readiness with health partners seen more and more as indispensable in community preparedness, response, and recovery.
ASPR began as a coordinator, drawing federal agencies together to respond to state requests for public health and medical support after a disaster. Today, ASPR has become the preferred central contact for other federal agencies and state health departments, a recognized expert and leader in the federal government in planning for and responding to the health impacts of disasters. A modern operations center, the Secretary’s Operations Center, now serves as the hub for continual situational awareness and response operations. The nexus ASPR created between public health, medicine and emergency management brought ASPR to lead the coordination for interagency responses, from Ebola and Zika to natural disasters and the Flint water crisis.
To improve preparedness community-wide, ASPR transitioned the Hospital Preparedness Program from a focus on buying equipment for individual hospital preparedness to holistic readiness across entire health care coalitions. By 2016 health care coalitions drew almost 30,000 members from all types of health care institutions, medical providers, public health, emergency management, law enforcement, and community organizations. Structured as almost 500 coalitions and growing, coalition members plan, train, drill, and respond together. ASPR also established field officers in each region as liaisons to share lessons learned and best practices between coalitions, state health departments, and federal programs.
Regional Emergency Coordinators in each region established strong relationships with state health preparedness staff and emergency management offices in each state and large cities. These relationships provide insight into potential and anticipated needs in disaster response and recovery, which in turn enable ASPR and its partner agencies to respond quickly in an emergency, in many cases based on informal requests before receiving formal requests for assistance.
Over the past decade, ASPR also integrated modern technology into health preparedness, response and recovery. ASPR developed one of the most robust GIS platforms in the federal government to overlay geographical data with data about weather, infrastructure and population demographics. The system, which ASPR calls GeoHealth, is one of the few federal GIS systems that also can be used by state government agencies to share data and situational awareness. It also is one of the few systems the public can use to view information on the potential health impacts of disasters.
ASPR also established a Fusion Center, where experts compile and analyze data from GeoHealth with information gleaned from social media and other sources. ASPR’s Fusion Center provides modern situational awareness and decision analytics to help leaders make sound decisions in response and recovery.
The emPOWER Initiative which ASPR launched over the summer of 2015 uses GeoHealth and Medicare claims data to support medically vulnerable populations in disasters. In 2016, at least 43 states, five territories, and three metropolitan areas requested and received emPOWER support to aid in responding to over 38 emergencies – including the Flint water crisis, Hurricane Matthew, severe floods in Louisiana, tornadoes, wildfires, and wide spread power outages, as well as planning activities ranging from national to county-level exercises in all 10 HHS regions.
ASPR also modernized and integrated response programs. The National Disaster Medical System (NDMS), with more than 5,000 intermittent federal employees, once deployed as large state-based teams. Today, NDMS draws on expertise from across the system to compose teams that are flexible and sized to match the community’s need after a disaster. Teams now can be on the ground within hours rather than days. Caches of NDMS equipment, too, are now standardized and deploy from centralized warehouses to meet ASPR teams.
The Medical Reserve Corps joined ASPR in 2014, bringing a network of 200,000 health volunteers to expand the nation’s response and recovery capability. MRC volunteers work with their communities to help keep people healthy during disasters and every day. They have worked with local public health agencies to conduct mass vaccination clinics, participated in emergency drills to test emergency plans, and helped respond to the Zika outbreak in Puerto Rico.
In addition, ASPR acted on lessons learned and stakeholder feedback to make other resources more flexible. Federal Medical Stations, which initially required gymnasium-size spaces, now can be deployed in smaller modules to fit the disaster need and space available.
What began as a narrow focus on bioterrorism and natural disasters has broadened in the past 10 years. ASPR now is called into action for all hazards – from infectious diseases like Ebola and Zika to national special security events like the President’s State of the Union Address.
In fact, ASPR’s emergency operations were activated for emergencies every day in 2016 and were activated more than 300 days a year for the past decade to support emergencies and national special security events. ASPR’s portfolio expanded beyond preparing and responding to emergencies and now includes leading federal coordination of recovery of health and social services in communities hit by disaster. ASPR experts have been involved in an increasing number of recovery operations each year with at least one active recovery engagement somewhere in the United States every day.
ASPR continues to improve and expand the array of services available to help communities prepare for, respond to and recover from emergencies. The goal is compelling: protect health and save lives in disasters.
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