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Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
Public Health 101: What Every Emergency Manager Needs to Know
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Public Health 101: What Every Emergency Manager Needs to Know

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Presented at The International Association of Emergency Managers (IAEM) 2010 Annual Conference with Nicole Errett, Baltimore City Mayor\'s Office of Emergency Management

Presented at The International Association of Emergency Managers (IAEM) 2010 Annual Conference with Nicole Errett, Baltimore City Mayor\'s Office of Emergency Management

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  • 1. Public Health 101 - What Every Emergency Manager Needs to Know International Association of Emergency Managers Conference November 2nd, 2010 Nicole Errett Baltimore City Mayor’s Office of Emergency Management Brian Spendley Hagerty Consulting1 IAEM 2010
  • 2.  Define Public Health and its core concepts  Describe the U.S. Public Health Preparedness Infrastructure  Discuss  H1N1  Identify funding opportunities  Identify implications of PPACA (Health Reform) on emergency planning assumptions2 IAEM 2010
  • 3. Public Health Definition Public Health definition and prevention3 IAEM 2010
  • 4.  “…assuring conditions in which people can be healthy.”  Goals (the three P’s)  Prevent Disease  Promote Health  Prolong Life  Two major defining characteristics  Deals with prevention instead of curative aspects of health  Focuses on population-level interventions, not individual level4 IAEM 2010
  • 5.  3 Core Functions  Assessment  Policy Development  Assurance5 IAEM 2010
  • 6.  Primary Prevention  Prevent the outcome before it occurs (e.g. vaccination)  Secondary Prevention  Early detection (e.g. screenings)  Tertiary Prevention  Prevent the outcome from getting worse (e.g. treatment)6 IAEM 2010
  • 7.  Primary Prevention  Prevent the outcome before it occurs (e.g. planning, hazard mitigation, gap analysis, training and exercises)  Secondary Prevention  Early detection (e.g. surveillance)  Tertiary Prevention  Prevent the outcome from getting worse (e.g. emergency management operations)7 IAEM 2010
  • 8.  Undergraduate Degree Programs (BS, BA)  Master Degree Programs (MS, MPH, MHS, ScM, MHA)  Doctoral Degree Programs (PhD, ScD, DrPH, MD with residencies in preventative medicine)8 IAEM 2010
  • 9.  You’re not alone!  Most public health professionals in the United States are not formally trained:  Health department personnel  Clinic workers  Public health consultants  Emergency managers9 IAEM 2010
  • 10. Core Concepts What are the major components of a public health education?10 IAEM 2010
  • 11.  Biostatistics  Epidemiology  Health Policy and Management  Environmental Health  Social/Behavior Health Sciences11 IAEM 2010
  • 12.  Creates and applies methods for quantitative research in health sciences (JHSPH).  Science of obtaining, analyzing and interpreting data in order to understand and improve human health (UNC).12 IAEM 2010
  • 13.  How can we apply past incidents to accurately predict future events?  Statistical significance  Methods  Example: Baltimore City Code Red  Does Energy Assistance Program enrollment correlate with the impact of a Code Red day or a Code Red season?13 IAEM 2010
  • 14.  The study of the distribution and determinants of health and disease in human populations to enable health services to be planned rationally, disease surveillance to be carried out, and preventative and control programs to be implemented and evaluated (World Health Organization).14 IAEM 2010
  • 15.  Identifying disease clusters and priority populations  Where are your vulnerable populations located?  Example: H1N1  Initial confusion over disease severity and mode of transmission  Strategically placing H1N1 – novel influenza immunization clinics  Quality assurance15 IAEM 2010
  • 16.  Addresses all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviors. It encompasses the assessment and control of those environmental factors that can potentially affect health (World Health Organization).  Includes occupational health, risk assessment and toxicology16 IAEM 2010
  • 17.  Risk assessment and toxicology  Hazard mitigation planning  Risk = Probability * Severity  Risk is relative  Hospital Hazard Analysis (required by the Joint Commission) takes advantage of Public Health risk assessment strategies  HAZMAT  PPE  Building materials  Implications of 9/11 on air quality17 IAEM 2010
  • 18.  Health policy  Study of the policy process as it related to health  Identify the problem  Determine magnitude  Analyze the problem  Propose solutions  Evaluate solutions  Health management  Study of health administration and leadership, including application of quality assurance and leadership strategies to the health arena18 IAEM 2010
  • 19.  Policies  PAHPA  NHHS  PPACA  Emergency Plans  Quality Assurance and Improvement  HSEEP compliance  Grant guidance  Training and exercises  Management  NIMS19 IAEM 2010
  • 20.  Addresses the behavioral, social and cultural factors related to individual and population health and health disparities over the life course. (ASPH)20 IAEM 2010
  • 21.  Health communications  How do we get people to listen to us?  Preparedness planning, immunizations, evacuations  Health Belief Model  Cues to actions, perceived barriers  Theory of Reasoned Action  Behavioral intention is the most important predictor of actual behavior  How can we change that?21 IAEM 2010
  • 22. Public Health in the United States Research, Practice, and Infrastructure22 IAEM 2010
  • 23.  Where is public health researched?  Academia  Schools of Public Health  “Community Health”  Health departments  Private and Public Sector  Where is public health practiced?  Health departments and agencies  Emergency management offices and agencies  Government agencies  Private Sector23 IAEM 2010
  • 24.  What is the foundation?  Pandemic and All Hazards Preparedness Act (PAHPA)  National Health Security Strategy (NHSS)24 IAEM 2010
  • 25.  The purpose of the Pandemic and All-Hazards Preparedness Act is to “improve the Nation’s public health and medical preparedness and response capabilities for emergencies, whether deliberate, accidental, or natural.  Ratified in December 2006.25 IAEM 2010
  • 26.  Amended the Public Health Service Act to establish a new Assistant Secretary for Preparedness and Response (ASPR)  Called for a quadrennial National Health Security Strategy (NHSS)26 IAEM 2010
  • 27.  Major Program Areas  Biomedical Advanced Research and Development Authority (BARDA) and Medical Countermeasures  Emergency Support Function (ESF) #8: Public Health and Medical Response: Domestic Programs  Emergency Support Function (ESF) #8: Public Health and Medical Response: International Programs  Grants  At-Risk Individuals  National Health Security Strategy (NHSS)  Situational Awareness: Surveillance, Credentialing, and Telehealth  Education and Training27 IAEM 2010
  • 28.  What is it?  National Health Security is a state in which the nation and its people are prepared for, protected from, and resilient in the face of health threats with potentially negative consequences.  Two Goals  Build community resilience  Strengthen and sustain health and emergency response systems.  No unfunded mandates; aligns with the NRF and NSS.28 IAEM 2010
  • 29.  Department of Health and Human Services (DHHS)  Food and Drug Administration (FDA)  National Institute of Health (NIH)  Assistant Secretary for Preparedness and Response (ASPR)  Center for Disease Control and Prevention (CDC)  Environmental Protection Agency (EPA)  Department of Homeland Security (DHS)29 IAEM 2010
  • 30.  Created under PAHPA  Lead the nation in preventing, preparing for, and responding to the adverse health effects of public health emergencies and disasters.  Focus:  Preparedness planning and response;  Building federal emergency medical operational capabilities;  Countermeasures research, advance development, and procurement;  Grants to strengthen capabilities of hospitals and health care systems in public health emergencies and medical disasters.30 IAEM 2010
  • 31.  Mission: Collaborating to create the expertise, information, and tools that people and communities need to protect their health – through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.  emergency.cdc.gov31 IAEM 2010
  • 32.  WIDELY varied structures and authorities  ME: 5 state agencies, 2 city health departments, 5 tribal agencies, 492 municipal health officers  MA: 6 state agencies, 1 county health department, 4 regional health districts, 351 municipal boards of health  NY: 2 state agencies, 58 city/county health departments  MD: 6 state agencies, 24 local county health departments32 IAEM 2010
  • 33. Discussion H1N1 Novel Influenza33 IAEM 2010
  • 34. Now show me the money! Federal grant opportunities in emergency management and public health preparedness34 IAEM 2010
  • 35.  Federal Funding  Fiscal Year (October 1st – September 30th)  Funding announcements can occur at any time throughout the fiscal year and often notifications to the State Single Point of Contact (SPOC)  Two forms:  Discretionary Grants  Formula / Block Grants  Approval can take 3-9 months35 IAEM 2010
  • 36.  Department of Homeland Security  FEMA Administered  Health and Human Services  ASPR  CDC  Department of Defense (limited PH impact)36 IAEM 2010
  • 37.  American Recovery & Reinvestment Act (ARRA)  Buffer Zone Protection Program (BZPP)  Citizen Corps Program National Emergency Technology Guard (NET Guard) Pilot Program  Commercial Equipment Direct Assistance Program (CEDAP)  Competitive Training Grants Program (CTGP)  Drivers License Security Grant Program (DLSGP)  Emergency Management Performance Grant (EMPG)  Emergency Operations Center (EOC) Grant Program  Freight Rail Security Grant Program (FRSGP)  Homeland Security Grant Program (HSGP)  Interoperable Emergency Communications Grant Program (IECGP)  Intercity Passenger Rail (Amtrak)  Intercity Bus Security Grant Program (IBSGP)  Nonprofit Security Grant Program (NSGP)  Port Security Grant Program (PSGP)  Regional Catastrophic Preparedness Grant Program (RCPGP)  Tribal Homeland Security Grant Program  Transit Security Grant Program (TSGP)3  Trucking Security Program (TSP)7 IAEM 2010
  • 38.  Purpose: to assist state and local governments in enhancing and sustaining all-hazards emergency management capabilities  State Administrative Agency (SAA) or State’s EMA are eligible to apply  FY 2010: $329.8 Million38 IAEM 2010
  • 39.  Purpose: to build capabilities at state and local levels and to implement goals/objectives in state homeland security strategies and initiatives in State Homeland Security Preparedness Report  25% dedicated towards law enforcement terrorism prevention  Funds allocated based on  Minimum amounts legislatively mandated  Risk Methodology  Effectiveness  FY 2010: $842 Million39 IAEM 2010
  • 40.  Purpose: enhance regional preparedness in 64 major metropolitan areas  25% dedicated towards law enforcement terrorism prevention  FY 2010: $823.5 million  10 highest risk (Tier I) eligible for $524,487,600  Remaining 53 (Tier II) eligible for $308,032,40040 IAEM 2010
  • 41.  Purpose: Supports integration of emergency management, health, and medical systems into a coordinated response to all hazard mass casualty incidents  Augmented existing local operational response systems before the incident occurs  124 MMRS jurisdictions  FY 2010: $39.36 Million41 IAEM 2010
  • 42.  Purpose: bring community and government leaders together to coordinate community involvement in emergency preparedness, planning, mitigation, response and recovery.  FY 2010: $12.48 Million42 IAEM 2010
  • 43.  Purpose: support target-hardening activities to nonprofit organizations that are at high risk of a terrorist attack and are located within one of the UASI areas  Funds based on risk analysis, effectiveness, and integration  FY 2010: $19 Million43 IAEM 2010
  • 44.  Purpose: Enhance catastrophic incident preparedness in 11 high risk areas, support regional coordination, including development of plans, protocols and procedures, and share deliverables  FY 2010: $33.6 Million44 IAEM 2010
  • 45.  Purpose: provides funding directly to help eligible tribes prepare for risks associated with potential terrorist attacks  FY 2010: up to $10 Million45 IAEM 2010
  • 46.  Public Health Emergency Preparedness Program (PHEP)  Hospital Preparedness Program (HPP)  Preparedness and Emergency Response Research Center (PERRC)  Centers for Public Health Preparedness (CPHP)46 IAEM 2010
  • 47.  Nearly 85% of CDC budget goes towards grants/contracts  Awards ~$7 Billion annually47 IAEM 2010
  • 48.  Purpose: to support preparedness capability and capacity in state, local, tribal and public health departments  FY 2010: $690,259,21148 IAEM 2010
  • 49.  Purpose: support and enhance state and local public health preparedness and response infrastructure  Goals  Strengthen and sustain PH workforce  Increase lab capability and capacity  Strengthen disease surveillance activities  Plan/implement mass vaccination  Develop effective risk communication  Develop effective communication mitigation  Purchase/protect PPE, antivirals and pandemic supplies for Public Health workforce  Train/educate Public Health workforce  Address gaps, meet challenges of PH preparedness  New vaccination program guidance introduced September, 2010  To date: $1.35 Billion through 4 phases  CDC Administered49 IAEM 2010
  • 50.  Purpose: enhance ability of hospitals/health care systems to prepare for and respond to bioterrorism and other public health emergencies  Administered by ASPR  FY 2010: $390,500,00050 IAEM 2010
  • 51.  Administered by CDC to accredited Schools of Public Health  PERRC includes research projects; many schools apply to practice oriented research projects  CPHP are training oriented grants. Most trainings are open to State/local EM and PH51 IAEM 2010
  • 52. Health Reform: Patient Protection and Affordable Care Act (PPACA) What is it? How does it affect planning assumptions?52 IAEM 2010
  • 53.  Individual Mandate  By 2014, all Americans must have health insurance  $695 or 2.5% household income fine  Exceptions for financial hardship (income to cost ratio >8%, earn too little pay for federal income tax, religious objections, Native Americans, uninsured <3 months)  Employer Mandate  Employer with 50 or more employees must provide minimum coverage or pay penalty53 IAEM 2010
  • 54.  Health Insurance Exchange  Subsidies  Transparency  Medicaid Expansion  133% Federal Poverty Line54 IAEM 2010
  • 55.  Minimum Coverage  Cannot deny coverage for pre-existing conditions  No lifetime caps on benefits allowed  Preventative services are not subject to co-pay and deductibles  Mental health parity55 IAEM 2010
  • 56.  Reduces uninsured by 32 million in 2019 (CBO Estimate)  Illegal aliens, individuals who think they cannot afford the cost even with the subsidy, and those that would rather pay the penalty remain uncovered  Decreases vulnerability  May decrease cost  Increases transparency56 IAEM 2010
  • 57. Questions? Nicole Errett nicole.errett@baltimorecity.gov Baltimore City Mayor’s Office of Emergency Management Brian Spendley brian.spendley@hagertyconsulting.com Hagerty Consulting57 IAEM 2010

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