• State emergency management working with state health (or public health, as applicable) for requests for federal public health and medical resources such as the Strategic National Stockpile, National Disaster Medical System, or declarations related to health emergencies.

Key Issues for Emergency Management

Emergency management provides a critical nexus on which a major public health and medical response depends for success. The specific relationship between the other ESFs and ESF-8 are described in the introductory text (Chapter 1) along with an expanded overview of emergency management’s importance to public health and medical incident response. A brief summary is included here to facilitate discussion and consideration during stakeholder meetings.

Emergency management should play an active role in facilitating and maintaining multiagency coordination with local public health, hospitals, emergency medical services (EMS), and other health care organizations; otherwise, it is extremely likely that the response will be negatively impacted. Pre-event planning specific to the role emergency management will play and the responsibilities of public health, hospitals, health care coalitions, and EMS agencies in various scenarios is critical to successful response. Lead agency designation and who represents the interests of the key ESF-8 stakeholders at the jurisdictional emergency operations center (EOC) is also a key issue to address prior to an incident as well as to confirm during an incident, so that roles and responsibilities are clear. Emergency management will likely play a lead role in community infrastructure protection, logistical support, situational awareness and information gathering, and facilitation of public information and risk communication dissemination. Public health will have the lead role in community-based health interventions (with logistic support from emergency management), policy development, containment measures, health surety (food and water safety, etc.), and public message development. Ensuring that the emergency management/public health relationship is synergistic prior to an incident will enable each discipline to concentrate on their responsibilities, maximize their respective resources and talents, and avoid duplication. This should also avoid confusion and unrealistic assumptions about the powers and abilities of each agency. This can only occur through joint planning, exercising, and response, which can begin with the structured discussions outlined in this project.

For the purpose of this toolkit, local and state public health will take the lead with their health care organizations and health care coalitions on the implementation of crisis standards of care (CSC) when conditions require. In some states, the state EMS office may reside within the department of health and be included in the leadership role. Emergency management will have a critical supporting role. Additional discussion about roles and responsibilities in planning for and implementing CSC is available in the Institute of Medicine’s (IOM’s) 2012 report Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response. This report also includes planning and implementation templates that outline core functions and tasks.

DISCUSSION AND DECISION-SUPPORT TOOL

Building on the scenarios and overarching key questions presented in Chapter 3, this tool contains additional questions to help participants drill down on the key issues and details for emergency management. It also contains a chart that provides example emergency management indicators, triggers, and tactics, and



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