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U.S. Department of Health and Human Services

2.2 The Healthcare Coalition Baseline Operations

For the Healthcare Coalition to be immediately available to conduct response actions in a no-notice, sudden onset emergency, two functions must be continuously operational even during times of non-response: 1) the ability to rapidly receive information and notify Coalition members of an emergency,[2] and 2) a decision-making process to determine whether additional Healthcare Coalition actions are necessary.

The manner in which these functions are addressed may vary from one Coalition to another. What does not vary is the need for a continuous baseline capability to conduct these two functions so they are operational at the outset of any incident. The authors of this handbook propose two entities to help the Coalition maintain readiness for immediate response: Healthcare Coalition Notification Center and Healthcare Coalition Duty Officer. These functions constitute the baseline operations of the Healthcare Coalition and may be conducted at minimal expense and burden to the Coalition.

2.2.1 Healthcare Coalition Notification Center

The Healthcare Coalition Notification Center provides notifications (both initial and ongoing) to Coalition member organizations regarding an emergency. It may also notify Jurisdictional Agencies (Tier 3) about a developing situation within a healthcare organization. The information that prompts notifications may originate within the healthcare community, public sector authorities, or other sources (e.g., the media). The Notification Center’s roles and responsibilities include:

  • To receive information that a situation is occurring that might affect Coalition member organizations (Tier 1) and convey emergency notification to members and relevant Jurisdictional Agencies (Tier 3)
  • To receive specific messages from Jurisdictional Agencies (Tier 3) for transmission to healthcare organizations (e.g., notification of a large transportation incident)
  • To receive messages from a Coalition member organization for transmission to other members or to Jurisdictional Agencies (e.g., power outage at a hospital)
  • To maintain connectivity with relevant organizations, including other Healthcare Coalitions in nearby jurisdictions
  • To contact the Healthcare Coalition Duty Officer, as appropriate, to clarify message content and message urgency, or to determine the most appropriate method for sending notifications.

To accomplish these roles, the following requirements are proposed for the Healthcare Coalition Notification Center:

  • The Notification Center must be staffed 24/7 by trained and qualified personnel. The position that conducts the Center’s actions is designated in this text as the Coalition Notification Center Technician, but some other title may  be  substituted.[3]
  • The capability to receive and send information via telephone, radio, e-mail, facsimile (fax), and other redundant messaging modalities.
  • Ability to receive television and commercial radio broadcasts.
  • Rapid connectivity with jurisdictional authorities (Public Health, EMS, Emergency Management, Law Enforcement, etc.) as well as Coalition member organizations.
  • Ability to conduct large capacity teleconferencing.
  • Redundant communications with primary and emergency backup power.

The authors use the word “center” to emphasize that this should be a physical location with the ability to perform these critical functions. At the same time, the Healthcare Coalition Notification Center typically should not be an expensive, stand-alone facility dedicated only to this purpose. To promote cost-effectiveness, the Healthcare Coalition Notification Center may best be collocated at an already continuously staffed facility that can meet the information and communications requirements noted above. For example, a private ambulance dispatch center has been successfully used for this purpose in several Coalitions. Healthcare facilities that operate as the regional hospital resource have also performed this function. Alternatively, Coalitions may use an established public sector resource, such as a municipal communications center, for this function; however, the Coalition must be able to access these systems when needed and not just when the public sector has declared an emergency.

An alternate Coalition Notification Center should be identified so these functions can be maintained if the primary center is affected by a hazard impact or if the center’s other responsibilities during a disaster prevent it from performing Coalition activities. Backup centers must be able to perform the same functions as the primary center. To maintain this backup capability, the alternate site may intermittently assume the role of the primary Notification Center during baseline operations.

Healthcare Coalition Notification Center Technician

This position operates the Coalition Notification Center and monitors baseline information 24/7 for any health-related anomalies that might signal the need for a response by the Healthcare Coalition. The Coalition may establish protocols to help the technician identify incident parameters that require immediate notification to Coalition member organizations and the Coalition’s Duty Officer. When initial incident information does not clearly indicate the need for a notification, the technician contacts the Coalition’s Duty Officer (see below) to further discuss whether a notification is required. These procedures are described in greater detail in Chapter 3.

Personnel serving as the Coalition Notification Center Technician should have the following qualifications:

  • Expert ability to operate the communication equipment for Coalition notification activities
  • Operational level of understanding about the Healthcare Coalition’s purpose and its emergency response mechanisms
  • Operational knowledge and skill for developing and transmitting straightforward notification messages using Coalition templates (see Section 3.3).

The technician position must be staffed 24/7; however, it may be performed by a trained and qualified professional whose primary job is private sector EMS dispatch, poison center operations, or other position that is always immediately available. It is important to identify a backup for this position so notifications to the Coalition can be maintained despite a surge in other duties.

2.2.2 Healthcare Coalition Duty Officer

This on-call position must be available for initial consultation to the Notification Center Technician, to Coalition members, and to jurisdictional authorities (Tier 3) as the representative of the Healthcare Coalition. The Duty Officer serves as the Coalition’s liaison to Jurisdictional Agencies during the initial stages of an incident and may contact Jurisdictional Agencies to obtain relevant information about an incident to share with the Coalition member organizations.

Potential responsibilities of the Duty Officer include:

  • Provide consultation to the Notification Center Technician (upon the technician’s request) regarding whether a potential or actual situation warrants a notification to Coalition members. The Duty Officer also provides advice on the content or urgency of the notifications being disseminated.
  • Obtain incident information (pre-HCRT activation) that is relevant to healthcare organizations and disseminate it to the Coalition member organizations.
  • Determine whether to activate the HCRT and the initial staffing plan for an activated HCRT.
  • Upon activation of the HCRT, the Duty Officer may become the HCRT Leader or assume another position and brief personnel as they are assigned to the HCRT.

Personnel staffing the Healthcare Coalition Duty Officer position should have the following qualifications:

  • Expert knowledge of their home organization’s emergency management program and EOP.
  • Operational knowledge of the Healthcare Coalition’s EOP and methods for interacting with relevant jurisdictional authorities.
  • An operational understanding of NIMS and MAC System operations (NIMS compliance requires successful completion of IS 100.a, 200.a, and 700.a web-based courses through FEMA’s Emergency Management Institute). Additional courses focused on MAC System concepts are also recommended, such as IS 701.[4]
  • Endorsement for this role from their home organization.
  • Ability to take calls for a defined period of time (e.g., a week) and respond to all potentially emergent communications requests.
  • Ability to carry a reliable, mobile contact method (cellular telephone, two-way pager, text messaging device) at all times while staffing the Duty Officer position.[5]


  1. Some Coalitions may rely on public sector notification systems being activated. These Coalitions are encouraged to develop notification processes and procedures (even if using public sector technology) that are immediately available to the Coalition for incidents that do not reach the level of public sector emergencies (e.g., power outage at a hospital).
  2. The Healthcare Coalition should establish training requirements for this position during preparedness activities (see Chapter 6)
  3. FEMA Emergency Management Institute, IS 701, NIMS Multiagency Coordination System. Available at:
  4. Established Healthcare Coalitions usually roster backup Duty Officers in case there is a problem contacting the primary Duty Officer.

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  • This page last reviewed: February 14, 2012