Public Health Emergency - Leading a Nation Prepared
Requests for Federal public health and medical support should specify the need for assistance, rather than ask for specific Federal assets. Thus, a key component of preparedness planning for emergency managers is determining the precise capabilities of the State, Tribal, and jurisdictional response systems, and establishing the process for recognizing when Federal public health and medical assistance may be indicated. Some basic considerations for preparedness planning are the following:
With a Stafford Act Declaration, the defined need for Federal assistance is transmitted via an Action Request Form (ARF) from the State EOC to the Operations Section within the DHS/FEMA JFO. The ARF delineates who, what, where, when, and how much assistance is needed. Staff at the JFO reviews the eligibility of the ARF under the Stafford Act (i.e., is the need beyond the response capabilities of local, State, or Tribal authorities?) and, if it is eligible, converts the ARF into a mission assignment. The mission assignment is a work order by FEMA to a Federal agency that directs completion of a specific task. Depending on the need, FEMA will issue the mission assignment to the Primary Agency of the ESF with responsibility in that functional area. As the Primary Agency for ESF #8, HHS is issued mission assignments related to the provision of public health and medical assistance. Once a mission assignment is issued, the EMG then determines, based on its internal resources and those of its OPDIVs and ESF #8 partners, the most appropriate way to accomplish the mission.
As Hurricane Katrina showed, the process for requesting and mobilizing Federal assistance can be time-consuming and cumbersome to meet urgent public health and medical needs in a disaster. HHS RECs have begun working with State public health and medical planners in their region to pre-identify areas where Federal public health and medical assistance will likely be necessary in an emergency or disaster. This may allow for the pre-scripting of common mission assignments so they can be issued quickly in a disaster. State public health and medical planners should work with their respective RECs to define areas where pre-scripted mission assignments may be warranted.
In the event that public health and medical assistance is activated under ESF #8, Federal resources will be tactically integrated into the appropriate State, Tribal, or jurisdictional ICS. This is essential because Federal assets are meant to support State, Tribal, and jurisdictional response efforts, not supplant them. To facilitate integration, Federal response teams should be briefed on how an emergency response is being managed at the State, Tribal, or jurisdictional level (where the primary incident management is occurring, who the lead management authority is, etc.).
On behalf of ESF #8, the IRCT receives tactical direction (e.g., instructions on where to report) from the appropriate State, Tribal, or jurisdictional authorities. Before Federal ESF #8 assets arrive on scene, a primary point of contact or liaison should be established. This may be the State's senior public health official or his/her designee. For State public health and medical planners, other critical preparedness planning considerations include the following:
Although Federal ESF #8 response teams will coordinate with State, Tribal, and jurisdictional incident management on tactical issues, the EMG, as directed by the ASPR, provides overall strategic direction to the IRCT Leader. The coordination of incident planning and response activities among Federal agencies occurs at the JFO.
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