Public Health Emergency Preparedness & Response (PHEPR) for San Francisco
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1 Public Health Emergency Preparedness & Response (PHEPR) for San Francisco Tomás Aragón, MD, DrPH 1 Erica Pan, MD, MPH 2 1 Health Officer & Director, Population Health & Prevention, SFDPH 2 Acting Director, Public Health Emergency Preparedness & Response San Francisco Department of Public Health January 18, Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
2 Outline Introduction & Background 1 Introduction & Background Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
3 Population Health & Prevention (formerly Community Health & Safety) 3 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
4 Some definitions Introduction & Background Public health emergency preparedness The capability of the public health systems, communities, and individuals, to prevent, protect against, quickly respond to, and recover from health emergencies, particularly those whose scale, timing, or unpredictability threatens to overwhelm routine capabilities. Public health systems A complex network of individuals and organizations including govermental public health agencies, the healthcare delivery system, homeland security and public safety, employers and business, academic, communities, and the media, that must work together to promote public health. 4 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
5 Public health disaster impact model Adapted from Disaster Impact Model, Chapter 6 in Lindell MK, Prater C, & Perry RW. Introduction to Emergency Management, John Wiley & Sons, 2007 (1st Ed) 5 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
6 Public Health Systems Introduction & Background Modified from Institute of Medicine, The Future of Public Health in the 21st Century, The National Academies Press, 2002 (1st Ed) 6 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
7 California Systems Model for Disaster Response (UC Berkeley) 7 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
8 All-hazards preparedness & response All hazards Earthquakes and other natural hazards; Technological hazards (e.g., oil spills); Chemical and radiological threats; and Bioterrorism & emerging infectious diseases Recent examples affecting Bay Area 1989 Loma Prieta Earthquake; 1991 Oakland Hills Firestorm; 2001 Anthrax white powder incidents; 2003 Severe Acute Respiratory Syndrome (SARS); 2009 Pandemic influenza A (H1N1); and 2010 San Bruno PG&E gas pipe explosion. 8 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
9 High priority, all-hazards public health capabilities (CDC) PHEP Cluster (7) PHEP Capabilities (15) Community resilience Community preparedness Community recovery Information management Emergency public information / warning Information sharing Biosurveillance Epidemiologic surveillance / investigations Public health laboratory testing Countermeasures / mitigation Responder safety and health Medical countermeasure dispensing Fatality management Non-pharmaceutical interventions Mass care Incident management Surge management Emergency operations coordination Med supplies management & distribution Volunteer management and recruitment Medical surge 9 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
10 Guiding principles for PHEPR planning Coordinate, manage, and leverage existing grants & DPH preparedness activities Use representative stakeholder advisory board to inform and guide priorities; Address gaps & issues identified during H1N1 response Prioritize capabilities essential in addressing all hazards; Prioritize special needs (vulnerable) populations and communities; Preserve and support existing core public health readiness (infectious disease and environmental health threat readiness, community health response teams, etc.); Build trust through transparency, inclusiveness, responsiveness, and accountability; 10 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
11 Distinct functions from other Sections Lead and coordinate public health preparedness & response planning for SF/DPH; Conduct PHEPR needs assessments and evaluations; Lead public health emergency preparedness exercises; Develop and implement emergency preparedness core competency training and compliance program for DPH workforce and CBOs; Support & fund DPH programs and preparedness activities; Represent DPH at city, regional, state, and national meetings; Expand organizational cross-training and community collaborative partnerships; Provide technical assistance to city and community stakeholders; Provide a model and training tools for other local health departments nationwide (e.g., NACCHO APC); and Lead/coordinate emergency preparedness grant applications. 11 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
12 Interaction with other stakeholders (partial list) Local Government SF Fire, Police, Sheriff, and Emergency Management Departments; San Francisco Disaster Council; San Francisco Unified School District; and San Francisco Medical Examiner. Community-based San Francisco Hospital Council; Expanded Avian/Pandemic Influenza Task Force; American Red Cross Bay Area Chapter; San Francisco Interfaith Council; and Neighborhood Emergency Response Teams (NERTs). Regional Association of Bay Area Health Officials (ABAHO); Bay Area Cross Sector Partners in Preparedness; SF Bay Area Biowatch Advisory Committee; Bay Area Mass Prophy Working Group; and Region II PHEP/HPP Coordinators. 12 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
13 Section staffing (interim) Introduction & Background Transition section team Staff supported by existing grants Staff supported by general fund (small proportion) Core planning team (to be convened) DPH representatives (including from Community Programs, SFGH, LHH, PHP) Department of Emergency Management Other representatives (TBD) 13 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
14 Section Funding/Budget information CDC Public Health Emergency Preparedness (PHEP) grant CDC Public Health Emergency Response (PHER) H1N1 grant CDC Hospital Preparedness (HPP) grant Cities Readiness Initiative (CRI) CDPH Pandemic Influenza grant NACCHO Advanced Practice Center State Homeland Security Grants Program Metropolitan Medical Response System (MMRS) Bay Area Urban Area Security Initiative (Bay Area UASI) CDC Heat Grant Gilead for ABAHO Coordinator 14 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
15 Entities to which Section will report San Francisco Department of Public Health San Francisco Department of Emergency California Department of Public Health (CDPH) California Emergency Medical Services Authority (EMSA) California Emergency Management Agency (Cal EMA) DHHS / Centers for Disease Control and Prevention (CDC) Department of Homeland Security (DHS) National Association of City & County Health Officials (NACCHO) 15 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
16 Brief history and context justifying new section Initial CDC preparedness initiatives targeted smallpox, bioterrorism, pandemic/avian influenza (CDCP & BIDEU); Over last few years, language and intention has broadened to all hazards response; Parallel CDC initiative for hospital preparedness to develop medical surge planning (OPP and EMS); SF/DPH-wide preparedness and coordination has been a gap; This was a high priority item noted from our experience during 2009 H1N1 Pandemic; Multiple other important emergency preparedness activities occurring throughout DPH, but limited staffing or funding for coordination and support; Need high level and equitable representation for other funding sources channeled through Dept of Homeland Security and other non-health focused funding; 16 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
17 Introduction & Background Assemble transition section to meet existing grant requirements (HPP, CRI, PHEP/PHER, etc.); Convene core DPH planning team with DPH-wide representation (SFGH, CP, EMS, EHS, etc.); Conduct CCSF/DPH strategic planning with external, neutral facilitator; During transition, minimize disruptions in existing services and employment; and Honor existing grant commitments to staff and partners through end of grant period 17 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
18 Public health preparedness web resources Infectious Disease Emergencies (SFDPH) SF Department of Emergency Management Are you prepared? (San Francisco) California Department of Public Health Centers for Disease Control & Prevention (CDC) 18 Drs. Tomás Aragón & Erica Pan, PHP/SFDPH Public Health Emergency Preparedness & Response
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