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U.S. Department of Health and Human Services

Integration With Other Tiers

The jurisdictional (Tier 3) response system integrates with other tiers primarily through its information management function. The capability to collect, analyze, and disseminate aggregated data should always be operational, even if only at a baseline level during times of non-response. This enables healthcare coalition (Tier 2) leaders to be notified of upcoming meetings or changes to the jurisdictional response system. It also facilitates timely incident response by providing key medical personnel (e.g., Tier 2 coalition managers) with the earliest reports of hazards that may have significant medical implications.

During incident response, a robust jurisdictional (Tier 3) information management function within the Planning Section continually processes data received from the Tier 2 coalition to obtain real-time situation status on HCO operations. This situation status information is reported back to the data sources and is also used for Tier 3 incident action planning. Integration of this information into jurisdictional (Tier 3) action planning, and providing jurisdiction IAP action plan information to the HCOs promotes coordination of response actions between tiers. For example, plans to shut down roads or public transportation systems in an area may greatly affect the ability of healthcare personnel to reach local HCOs. Having this concern communicated via the Tier 2 liaison to the UC is beneficial in helping Operations Section personnel under UC (or in the EOC) develop tactics that will not interfere with HCO activities. In a similar way, an adequate information management function can provide much needed guidance to medical practitioners during an incident.

Example: In an unusual infectious disease outbreak, a jurisdiction's public health authority may issue health advisories that contain practitioner guidelines on patient evaluation, treatment modalities, and methods for reporting suspect cases. Medical practitioners benefit from the ability to access this information as incident circumstances evolve because it is both medically sound and it carries jurisdictional public health authority for implementation. The application of this guidance across a jurisdiction promotes hazard impact containment through evaluation and treatment efficiency and consistency, data reporting for incident profiling, and indications for altering or improving medical therapy or other recommendations.

The New York City Department of Health and Mental Hygiene website is an excellent public health model for disseminating accurate, timely, and authoritative medical guidance.

The jurisdictional (Tier 3) ICS integrates with State authorities (Tier 4) primarily through its information management function. Timely processing and dissemination of incident and response parameters enable the Governor to determine the need for declaring a formal emergency or requesting Federal support. Such information also makes it possible to link affected intrastate jurisdictions so they can coordinate response efforts. Finally, it facilitates the coordination and distribution of State tactical mutual aid to areas with the greatest need.

The integration of jurisdictional and State entities with responsibility for emergency preparedness and response is a primary mission of several Federal initiatives. One example is the DHS-funded Metropolitan Medical Response System (MMRS) program. The MMRS provides funding and guidance to select highly populated jurisdictions (124 as of FY 2003) to develop plans, conduct training and exercises, and acquire pharmaceutical caches, PPE, and other capabilities necessary to respond to a mass casualty and/or mass effect event. It also requires planning integration with State (Tier 4), neighboring interstate jurisdictions (Tier 5), and Federal (Tier 6) entities. The MSCC Management System provides an effective platform for health and medical disciplines to coordinate/integrate capabilities acquired or developed through the MMRS.

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  • This page last reviewed: February 14, 2012