and local governments to determine if radiological emergency plans can be implemented (Kelkenberg, 2004). FEMA also plays the significant role of educating the public about radiological emergency preparedness (Kelkenberg, 2004).

FEMA has a memorandum of agreement with the U.S. Army for the CSEPP program. Similar to REP, the Army is responsible for onsite preparedness and response, and FEMA is responsible for offsite preparedness and response in the surrounding community (Kelkenberg, 2004). Some useful documents have been created through this program and may be applicable to other preparedness programs. For example, Oak Ridge National Laboratories has developed training materials on sheltering in place that would be applicable to other emergency preparedness scenarios (Kelkenberg, 2004). CSEPP also includes an exercise component, which involves both the site itself and the surrounding community (e.g., emergency management agency, health department, hospitals). FEMA evaluates the local community’s performance in the exercise and, based on the findings, recommends how the community partners’ emergency response plans should be improved (Kelkenberg, 2004).

FEMA’s Community Hazards Emergency Response Capability Assurance Program (CHER-CAP) consists of a planning, training assessment, and exercise process for all-hazards response operations (Kelkenberg, 2004). It consists of looking at a community’s emergency response plans, coupling the plan with a risk assessment, identifying training to fill in the gaps in the plan, and then doing a tabletop exercise and peer-evaluated full-scale exercise to identify areas for improvement (Kelkenberg, 2004).

Sample Questions, Strategies, and Methodologies for Evaluation Research on Public Health Preparedness Exercises and Proxy Events

The committee has identified several possible questions, strategies, and methodologies that could be considered by CDC in evaluation and experimental research in public health preparedness. These include:

  • Examining the effect of a proxy event on two similar communities with different public health infrastructure and capabilities.

  • Conducting “placebo-controlled” trials comparing the response of two similar communities to a proxy event, false alarm, or to an unannounced exercise. One community previously conducted one or more exercises (or employed other methods) to test its preparedness, while the other did not. Compare response times, smoothness of interagency coordination, functionality of communication channels, and other aspects of their response.

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