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U.S. Department of Health and Human Services

Building resilience at the regional level

Key Accomplishments: Regional Emergency Coordinators

When disaster strikes communities can become overwhelmed by the public health and medical impacts. When this happens ASPR’s Regional Emergency Coordinators (RECs) are there to help coordinate federal support. To be effective, they can’t just swoop in the day of a disaster and start offering services that might not be needed or providing direction that might not be the best way forward for a community in need.

They need to establish solid working relationships with state, local, tribal, and territorial health officials. RECs must be in continual contact. They get to know their state and local partners and maintain a rapport with public health and emergency management staff and anticipate a state’s needs during a disaster. They become experts in the federal public health and medical resources available to help communities.

Preparing and providing customized disaster health support

RECs are the face of ASPR for state and local partners to prepare for the health impacts of disasters and to respond when disaster strikes. The bulk of a REC’s time is spent on preparedness efforts, from providing technical assistance and sharing lessons learned between health departments to participating in training exercises and state and regional drills. Because of the strong relationships RECs forge, state and local partners can be comfortable discussing preparedness gaps with the RECs which means the federal government can be ready to assist and bridge those gaps in a disaster.

Part of building these relationships includes developing disaster operational plans with partners and then participating in exercises where disasters are simulated to see where gaps might still exist. Threats continue to evolve, so disaster plans and drills must, too. The goal is to ensure everyone in the disaster response system is fully prepared and capable of responding when needed most.

In the Gulf Region for example, RECs worked with state health officials to develop plans to evacuate hundreds of patients quickly in a disaster to hospitals across the United States and to notify families of the patients’ new locations. In the mid-Atlantic, RECs helped state health staff improve their emergency plans and the states now have estimates of how many patients emergency departments in their states can handle in a disaster and how many medical shelters states may need in responding to the health impacts of disasters. RECs aided health officials in nine Midwestern states and California on plans to handle the thousands of injuries and deaths that are expected in catastrophic earthquakes along the New Madrid fault line in the Midwest and the San Andreas and Hayward fault lines in California.

Since ASPR and HHS provide critical services to state and local partners during emergencies, the RECs must make sure they are trained and prepared to do their part when disasters strike. RECs train on how to lead a response team as part of a national response and how to communicate effectively during a disaster to ensure people are connected to important health and human services. All this training ensures RECs are ready to go whenever they are called into action.

Hurricane Sandy, power outages and prepared partners

When communities need help during disasters, RECs lead the federal public health and medical response. They connect state and local partners to federal services, federal medical teams, and federal expertise the community needs to recover. RECs helped communities across the country meet public health and medical needs in 177 incidents and national special security events in 8 years.

While most of the attention during Hurricane Sandy’s trek up the East Coast was given to New York and New Jersey, this storm also hit Region 3 hard. Pennsylvania, Maryland, Virginia, West Virginia, and Delaware – the states that make up Region 3 – all had Presidential Disaster Declarations, and there were over 4 million people without power throughout the region. In western Pennsylvania and West Virginia, blizzard conditions presented severe challenges for power restoration; residents went days without electricity.

In the years leading up to this storm, RECs worked very closely with their state, local, and private sector partners to ensure mistakes from Hurricanes Katrina and Rita were not repeated. The RECs led a multi-jurisdictional gap analysis and spearheaded a resilience pilot project with five area hospitals.

When Sandy hit Region 3, these preparedness investments paid off. At the peak of the storm response, only five hospitals and 36 nursing homes needed to use back up power. Only one facility, a small nursing home in Pennsylvania, needed to evacuate. 

ASPR coordinated the public health and medical response for the federal government with our RECs providing incident response coordination in the disaster zones. ASPR can deploy thousands of medical providers, Federal Medical Stations, and caches of supplies, all commanded by the RECs on incident response coordination teams.  

Learning from each disaster

RECs learn from each disaster and they work with their partners to apply those lessons learned to make the next response stronger and more capable of protecting health. During Hurricane Matthew, the Region 4 RECs had daily calls with their Unified Planning Coalition, a partnership created by state and federal partners after Hurricane Katrina. The coalition had been meeting quarterly to discuss preparedness and response, best practices, and opportunities for collaboration and support.

These meetings paid off when Hurricane Matthew headed for Region 4. During the daily conference calls before, during, and after landfall, affected states were comfortable describing their needs, capabilities, and any gaps with Region 4 RECs who helped coordinate federal support.

These discussions helped state governments quickly and effectively identify their needs and request resources from the federal government. Region 4 RECs were also able to provide information to state partners through ASPR’s emPOWER initiative. This allowed public health officials to coordinate with first responders to ensure patients dependent on electricity for medical devices could be contacted and evacuated before it became critical to their health.

Evolution of the REC program at ASPR

Because of its commitment, partnerships and planning, ASPR can deploy support quickly to its partners and begin helping communities recover faster. ASPR is better able to serve these communities because RECs already know state and local partners before urgent work begins. These relationships are critical to ASPR’s success, and they lead to greater readiness and response.

  • This page last reviewed: February 08, 2017