On Public Health Security - April 2013

April 2013

On Public Health Security

Providing a Gateway to National Public Health Security Partnerships

Dr. Ali S. Khan

Dear Partners,

I was honored to be an attendee and presenter at the 2013 Public Health Preparedness Summit held in Atlanta March 12-15. Each year, I look forward to the stimulating presentations and the opportunity to connect with colleagues and learn about best practices. The Summit Planning Committee, representing public health professionals across all levels of government, in addition to other subject matter experts, did an exceptional job of coordinating this event and bringing a unified representation of public health preparedness to this year’s agenda. As I reflect on my time at the conference, I am amazed at the breadth of partnerships that exist across all levels of the preparedness community. Here are just a few examples that my staff and I brought back from the Summit. In sharing this more broadly, I hope this can spark ideas of unique partnership opportunities you can replicate in your own communities.



Rhode Island Special Needs Emergency Registry

Since 2007, the Rhode Island Department of Health’s Center for Emergency Preparedness and Response (CEPR) has partnered with multiple entities throughout the state to create a voluntary registry for individuals with disabilities, chronic conditions, and other special medical needs called the Rhode Island Special Needs Emergency Registry (RISNER). This Registry allows the state and local first responders to see not only where people reside who might need special assistance during an emergency, but also what their self-identified needs are. Enrollment in the Registry does not guarantee assistance, but allows first responders to better plan for, prepare for, and respond to the needs of the community. The Rhode Island Emergency Management Agency (RIEMA) assists in the enrollment process; CEPR continually updates the data and coordinates outreach to municipal users, community organizations, and the general public; and local emergency managers log in to the Registry before and/or during an event for greater situational awareness about individuals who have registered and reside in their municipality. Outreach workers promote registration of citizens through community fairs/events, doctors’ offices, public housing facilities, home health care agencies, and durable medical equipment suppliers. The next planned upgrade to the Registry is the addition of an automated emergency notification system to contact enrollees by phone and email. Some of the best practices employed by locals in the past several storms have been well visits to enrollees; swapping out of enrollees’ oxygen containers; providing transportation assistance to shelters; and charging of their medical device batteries. 


Building a Healthcare Coalition in South Carolina

Hurricane season presents a yearly challenge to Charleston, South Carolina, which has suffered through several major hurricanes in recent memory, including Hurricane Hugo – a Category 4 storm that caused significant damage to the city and surrounding areas in 1989.  Recognizing the serious threat hurricanes pose to the city – both in terms of safety and health of the population as well as the economic health of the region – local public health emergency preparedness planners have worked closely with the state hospital association, local health care systems, mental health professionals, regional governments, local U.S. military bases, VA Medical Center, and other partner agencies to build the foundation for a robust healthcare coalition.  This group supports Emergency Support Function 8 by assisting with the coordination of local health and medical resources in the event of a disaster.  During a sharing session at the Summit, program staff emphasized no two communities are alike and one approach to healthcare coordination might not work in all areas; however, they emphasized the importance of building and sustaining these relationships and not waiting until a disaster strikes to exchange business cards.  This planning and coordination has improved the region’s ability to respond to smaller events, including the medical evacuation and repatriation of U.S. citizens following the 2010 Haiti earthquake.


Hurricane Sandy Response

Although hurricanes are not as familiar to New York as they are to South Carolina, the response to Hurricane Sandy in October 2012 highlighted the importance of partnerships across public health, health care, and emergency management.  This was made visible during the Summit session entitled “Health Care Facility Evacuation: The NYC Experience” which showcased the collaborative response led by the Healthcare Facility Evacuation Center (HEC), a New York State Department of Health led, interagency  coordination group that was co-located within New York City’s Office of Emergency Management. The HEC was activated to coordinate the evacuation of over 6,000 patients from 37 different facilities, including public hospitals, private hospitals, nursing homes and long-term care facilities. In order to effectively coordinate this effort, it integrated the efforts of governmental and non-governmental players at the city, state, and federal levels to manage the evacuations.  At the public sector level, in addition to staff from the New York State Department of Health, the HEC was staffed by New York City Office of Emergency Management, New York City Department of Health and Mental Hygiene, NY State Office of Mental Health, Metropolitan Transit Authority, New York City Health and Hospitals Corporation and Veterans Administration.  Private sector partners also played a crucial role in staffing the HEC, including Regional Emergency Medical Service Council of New York City, Greater NY Hospital Association and various nursing home associations.  Finally, the HEC acted as a liaison to additional federal government assets, such as the Disaster Medical Assistance Teams that staffed eight Special Medical Needs Shelters that were also set up in the city.  These public-private partnerships between all levels of government and private organizations were essential in ensuring the successful evacuation of a range of health care facilities throughout the New York City area.



In closing remarks from Jack Herrmann, Chair of the Summit Planning Committee and senior advisor and chief for public health preparedness at The National Association of County and City Health Officials (NACCHO), he challenged attendees to “not leave this conference without finding something you can take home to build your knowledge base, share with your professional colleagues, and enhance your agency’s work in public health preparedness.” In taking this to heart, I hope you are able to read about the partnerships above and use this information to fuel enhancements to your own preparedness initiatives by pursuing and fostering valuable partnerships.

Thank you,

Ali S. Khan, MD MPH

Assistant Surgeon General (retired) & Director

Office of Public Health Preparedness & Response

DHHS/Centers for Disease Control and Prevention

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CDC’s FY14 Budget

On Wednesday, April 10, the White House released the President’s budget request for Fiscal Year (FY) 2014.  CDC’s FY 2014 budget request of $1.334 billion for public heath preparedness and response is an overall decrease of $47.5 million below the FY 12 level.  This includes: a decrease of $8.219 million for state and local public health preparedness and response capability; a decrease of $1.09 million for CDC preparedness and response capability; and a decrease of $38.19 million for the Strategic National Stockpile (SNS). FY14 marks the implementation of the Working Capital Fund (WCF)  to promote cost control and efficiency within programs and service provider operations.


Get information: Avian Influenza A (H7N9) Virus

For up-to-date information on the new influenza A (H7N9) virus, please visit CDC’s Avian Flu webpage. We will update this information as it becomes available.


Pandemic and All Hazards Preparedness Reauthorization Act

President Obama signed the Pandemic and All Hazards Preparedness Reauthorization Act into law on March 13, 2013. For more details, read HHS Assistant Secretary Nicole Lurie’s statement.


Unable to attend the Summit?

Session recordings are available from the 2013 Public Health Preparedness Summit for six months at no additional cost to attendees. Visit the NACCHO Live Learning Center to access the recordings for free or to purchase individual session recordings.


CDC Welcomes American Red Cross

The next PHPR Director’s Seminar on Tuesday, April 23, 2013 will feature Ms. Gail McGovern, President and CEO of the American Red Cross.  The PHPR Director’s Seminars bring in leaders from government, academia and the private sector to address either innovative scientific research or best practices in leadership and governance.


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