In 2017, DSLR began updating the capabilities in response to lessons learned from public health emergency responses, updates to public health preparedness science, revised guidance and resources, findings from internal reviews and assessments, subject matter expert feedback from the practice community, and input from allied federal agencies and professional associations. The capabilities update focused on streamlining language and aligning content with new national standards, updated science, and current public health priorities and strategies. The capabilities also support topics such as pandemic influenza, environmental health, at-risk populations, and tribal populations.
The National Preparedness Goal describes a vision for preparedness nationwide and identifies 32 core capabilities necessary to achieve that vision across five mission areas: Prevention, Protection, Mitigation, Response, and Recovery. Although only one of the 32 core capabilities within the National Preparedness Goal specifically focuses on public health and medical support (Public Health, Healthcare, and Emergency Medical Services), many of the core capabilities relate to and contain public health and medical considerations that are necessary to successfully achieve a secure and resilient nation.
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Lessons learned from public health emergency responses, updates to public health preparedness science, revised guidance and resources, findings from internal reviews and assessments, subject matter expert feedback from the practice community, and input from allied agencies all contributed to capability updates. In addition, representatives from professional associations, including the Association of Public Health Laboratories (APHL), the Association of State and Territorial Health Officials (ASTHO), the Council of State and Territorial Epidemiologists (CSTE), the National Association of County and City Health Officials (NACCHO), and the National Emergency Management Association (NEMA) were instrumental in helping to shape the updated capability content.
The 2018 Public Health Emergency Preparedness and Response Capabilities: National Standards for State, Local, Tribal, and Territorial Public Health recognizes the maturity and experience jurisdictional public health emergency preparedness and response programs have gained since 2011. As with the 2011 version, technical content is informed by applicable guidance, science, practice, and input from subject matter experts. Examples of revisions include the addition of public health mission-ready packaging and the importance of identifying jurisdictional public health agency lead or support roles based on incident characteristics. Other revisions include updates to public health informatics, vaccine administration, coordination of infectious disease response, chemical laboratory requirements, environmental health, disaster epidemiology, and additional considerations for protecting the safety of emergency responders and volunteers. Unlike the 2011 version, this 2018 update does not include programmatic performance measures. However, jurisdictional public health agencies are encouraged to use the updated content to foster their own evaluation strategies.
Successfully attaining capability resource elements is defined as the ability to demonstrate that a jurisdictional public health agency either has (on hand or within existing plans and documents) or has access to (partner agency or organization has the jurisdictional authority or responsibility for the resource and evidence exists that agreements regarding roles and responsibilities are in place) the resource element. Strategies that address challenges and barriers for fully attaining capability resource elements should help inform jurisdictional planning, training, and exercise initiatives.
Partners and stakeholders:As referenced throughout the capabilities, partners and stakeholders refer to the diverse array of groups and individuals that public health agencies should engage to support the preparedness and response needs of the whole community. Many different kinds of communities, including communities of place, interest, belief, and circumstance can exist both geographically and virtually, such as online forums. A whole community approach attempts to engage the full capacity of the private and nonprofit sectors, including businesses, coalitions, faith-based organizations, disability organizations, and the public, in conjunction with the participation of federal, state, local, tribal, and territorial governmental partners.
Function Definition: Identify the public health risks of an incident or event and coordinate with subjectmatter experts to help determine the scale of incident management operations.
Task 1: Identify key public information personnel. Identify public information officers (PIOs), spokespersons, and trained support personnel, such as subject matter experts to implement jurisdictional public information and communication strategies.
Task 2: Clarify, document, and communicate the jurisdictional public health agency role(s) in fatality management. Coordinate with subject matter experts and cross-disciplinary partners and stakeholders to clarify, document, and communicate the public health agency role in fatality management based on jurisdictional risks, incident needs, and partner and stakeholder authorities.
P2: (Priority) Definition of the jurisdictional public health agency role for fatality managementestablished in coordination with jurisdictional authorities, subject matter experts, and other crossdisciplinarystakeholders. Recommended activities to establish roles may include
Function Definition: Develop recommendations to identify and facilitate access to resources, such as personnel and subject matter experts, record keeping, and physical space to address fatality management needs resulting from an incident in accordance with public health agency jurisdictional roles and standards outlined in jurisdictional fatality management procedures.
Task 1: Develop jurisdiction-specific strategies to prepare for medical countermeasure dispensing/administration . Coordinate with subject matter experts, partners, and stakeholders to develop strategies to dispense/administer medical countermeasures based on jurisdiction-specific risks, resource availability, and incident characteristics. Strategies should consider allocation methods for scarce resource scenarios.
P1: (Priority) Multidisciplinary planning group(s), consisting of subject matter experts and key partners, to formulate and confirm medical countermeasure dispensing/administration strategies and roles.
S/T2: Personnel trained to conduct tabletop, functional, and full-scale exercises in accordance with the Homeland Security Exercise and Evaluation Program (HSEEP) in order to test and evaluate jurisdictional medical countermeasure strategies.
S/T3: Personnel trained to conduct tabletop, functional, and full-scale exercises in accordance with the Homeland Security Exercise and Evaluation Program (HSEEP) guidance to test and evaluate jurisdictional medical materiel management and distribution strategies.
8 Subject matter experts from the HHS Office of the Assistant Secretary for Preparedness and Response Hospital Preparedness Program made significant contributions to the updates for Capability 10: Medical Surge
Function Definition: Collaborate with subject matter experts and community representatives to make recommendations for NPIs based on incident characteristics and subject matter expertise in applicable specialties, such as epidemiology, laboratory, surveillance, health care, chemistry, biology, radiology, social service, emergency management, and law enforcement.
Task 1: Engage subject matter experts to assess exposure or transmission. Assemble subject matter experts to assess the severity of exposure or transmission at the jurisdictional level and the need for NPIs.
S/T2: Personnel or agencies with legal expertise authorized to advise individuals on legal or regulatory aspects of NPIs. Ensure the appropriate legal guidance needed for interventions, such as quarantine, isolation, and mandatory orders to close events or order evacuations.
P5: (Priority) PPE recommendations for responders, including public health responders, developed in conjunction with partner agencies and risk-specific subject matter experts, such as physicists within radiation control programs.
Task 1: Conduct responder safety and health monitoring and surveillance. Ensure the appropriate level of safety monitoring and health surveillance for responders based on identified risks, jurisdictional responder roles, and subject matter expert recommendations.
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