Priority Area: Community Preparedness
Community Preparedness - Effective Emergency Response and Recovery
Planning and preparation are the foundation of effective emergency response and recovery. Since September 11, 2001, it has been clear that public health has a crucial role to play in any emergency, whether naturally-occurring or resulting from a deliberate act.
The New York State Department of Health (NYSDOH) has worked closely with local health departments (LHDs) and other key partners to make sure that every county is ready for the unexpected. New York State is susceptible to all types of public health threats including natural disasters and severe weather (e.g., blizzards, ice storms, floods); outbreaks and incidents (e.g. salmonella, E. coli infection); radiation emergencies (e.g., dirty bombs, nuclear blasts); chemical emergencies (e.g. chlorine, nerve agents); bioterrorism (e.g. anthrax, plague, smallpox); and, mass casualties (e.g. explosions, blasts). Such contrasting events pose big challenges to health emergency preparedness planning, as do the state's demographics:
- 13% of New Yorkers are age 65 and older;
- 15% live below the poverty level;
- 20% are foreign born;
- 28% speak languages other than English at home; and
- Seven federally-recognized and two state-recognized Indian tribes live on reservations within New York State.
New York State's preparedness planning assumes that every person in the state is at risk for some hazard or event. An all-hazards approach is crucial to respond to all types of emergencies including biological, chemical, radiological, and weather related. Information on preparing for all types of emergencies can be found on the NYSDOH webpage: Emergency Preparedness.
When a health emergency occurs, a quick and effective public health response is crucial to reduce injury, prevent or control illness, and save lives. For that reason, the NYSDOH Prevention Agenda priority area targeting Community Preparedness aims to empower LHDs and their community partners across the state to promote local readiness, foster community resilience and ensure comprehensive, coordinated and effective responses if disaster strikes.
- During the next five years, the percentage of the population living within a jurisdiction with a State-approved emergency preparedness plan will continue to be 100%. Baseline: 100% (Program data, 2007)
Indicators for Tracking Public Health Priority Areas
County Strategies and Partners Matrix
The County Strategies and Partners Matrix for Community Preparedness was compiled from the 2010-2013 community health assessments submitted in 2009 by 5 local health departments. It describes how local health departments collaborate with hospitals and community organizations to plan and address this priority to improve population health outcomes.
- Communities that select Community Preparedness as one of their Prevention Agenda priorities can select a number of indicators to measure their progress.
Indicator: Percentage of the population living within jurisdictions with emergency preparedness plans that address:
- Comprehensive, all-hazards planning;
- Isolation and quarantine of persons exposed to, or infected with, a communicable disease;
- Pandemic influenza; and
- Continuity of operations to maintain essential public health services for the public during emergencies.
Why is this important?
In New York State, all residents should live in jurisdictions with emergency preparedness plans.
Community Preparedness Timeline
|Years||Local and State Preparedness Planning and Response Goals|
|2002-2004||Local Health Departments (LHDs) developed all-hazards Public Health Emergency Preparedness and Response Plans in collaboration with their lcocal jurisdictions.|
|2005||LHDs developed local Isolation and Quarantine Plans|
|2006-2007||LHDs developed local Pandemic Influenza Preparedness and Response Plans|
|2008||LHDs updated their local Strategic National Stockpile plans to fufill new federal criteria|
Since 2001, LHDs have collaborated with NYSDOH on local and state preparedness planning and response goals. LHDs have completed different aspects of comprehensive, all-hazards plans for each year and have made great strides in local planning and partnerships. LHDs, in partnership with their key partners, have exercised their plans in local and statewide drills. In 2008, 33 LHDs and 64 hospitals participated in the New York State Full Scale Logistics Exercise (NYFLEx). NYFLEx tested how well local partners requested and received NYSDOH medical assets needed to treat and care for people with pandemic influenza. Through NYFLEx, improvements were implemented, including expediting the appropriate medical assets request process at the local level.
Indicator: Number of LHDs (outside of New York City) that have aggregate overall scores of at least 79 for their Strategic National Stockpile (SNS) Technical Assistance Reviews (TAR)
Why is this important?
During a widespread disease outbreak, natural disaster or terrorist attack, the ability to quickly get pharmeuticals and other medical supplies to affected individuals is a matter of life and death. The NYSDOH relies on LHDs to provide mass prophylaxis, i.e., to dispense pharmaceuticals and other medical supplies to affected populations in response to emergencies.
LHDs conduct Strategic National Stockpile planning and exercises to assure timely request, receipt, storage and distribution of these supplies. During 2007-2008, counties' County Strategic National Stockpile (SNS) plans were updated and then evaluated using the CDC's Technical Assistance Review (TAR) tool. The tool evaluates each plan against 12 functional areas including security planning, dispensing, and training and exercising.
All 57 LHDs outside of New York City had baseline assessments of their SNS plans. The average SNS TAR score for 2008 for all LHDs outside of New York City was 65. Cities Readiness Initiative (CRI)* jurisdictions had an average score of 90, while non-CRI jurisdictions averaged 57. For 2009, the average SNS TAR score for all LHDs outside of New York City was 78. Cities Readiness Initiative (CRI)* jurisdictions had an average score of 98, while non-CRI jurisdictions averaged 73.
*NOTE: The Cities Readiness Initiative (CRI) is a federally-funded effort to prepare major U.S. cities and metropolitan areas to effectively respond to large-scale bioterrorist events by dispensing antibiotics to their entire identified populations within 48 hours of the decision to do so. The program was originally established in 2004 with 21 cities selected based on criteria such as population size and potential vulnerability to bioterrorism threats. The program has grown to now include a total of 72 metropolitan statistical areas (MSAs), with at least one CRI MSA in every state.
The CRI areas in New York State include the counties of Albany, Schenectady, Saratoga, Schoharie, Erie, Niagara, Putnam, Rensselaer, Nassau, Rockland, Suffolk and Westchester and the city of New York.
2009 County Aggregate TAR Scores
* The plans for these counties are still under review.
Indicator: Percentage of LHDs that acknowledge alert notifications sent by the New York State Department of Health without use of electric grid power and primary land-line telephone service, within 60 minutes of receipt.
Why is this important?
In an emergency, regular means of communication may not work. The ability to quickly receive and share information to reduce risk and save lives is crucial. To test this ability, the NYSDOH Integrated Health Alerting and Notification System (IHANS) was used to initiate alerts. Notification was sent simultaneously to all public health and tribal nation participants. Participants were contacted by IHANS on their cell phones, were given a phone number to a phone bridge, and were instructed to immediately call the number using the same cell phone on which they were contacted to demonstrate 2-way communications capability, without using land line phones. Results of the drill indicated:
- 74% of the LHDs (42/57) responded within 45 minutes; and
- 26% of the LHDs (15/57) did not confirm receipt of the call within 60 minutes.
The NYSDOH is working with LHDs that could not confirm receipt of the call within 60 minutes to improve their emergency communication systems.
Indicator: Percentage of LHDs that have involved the public in preparedness initiatives to educate, promote resilience, and/or solicit feedback on local health emergency planning.
Why is this important?
Unless community members are informed and involved in the planning process, preparedness and response efforts will fall short. It's not enough to give out information. Local planners must solicit information from the people they serve and use that information to improve the service they provide.
In 2010, all 57 upstate LHDs were required to conduct community engagement activities to solicit public participation on health emergency issues and incorporate their findings into preparedness plans. These engagement activities focused on 2009 H1N1 influenza. Useful feedback on how to respond to the needs of the elderly, individuals with disabilities or mental health issues, among other populations, was obtained and is being used to refine future plans.
The Community Meetings on Pandemic Influenza Final Report is available online.
New York State Department of Health Programs
Office of Health Emergency Preparedness
The NYSDOH Office of Health Emergency Preparedness (OHEP) is responsible for the coordination and management of all activities for public health and healthcare facility preparedness. This includes preparedness planning, and ensuring that emergency plans work in drills, exercises and real life. OHEP's primary responsibilities include the following:
- Coordinates preparedness activities with all 58 LHDs, state and local emergency managers, acute care hospitals, nursing homes, adult care facilities, the State's Office of Homeland Security and Emergency Services, and the 23 Disaster Preparedness Committee (DPC) State agencies.
- Coordinates the NYSDOH planning for the request, receipt, storage and distribution of the federal Strategic National Stockpile (SNS), a national repository of pharmaceutical and medical supplies designed to supplement and re-supply states in the event of a national emergency.
- Manages and maintains the NYSDOH's Medical Emergency Response Cache (MERC), which contains pharmaceuticals, medical supplies and equipment including beds, ventilators, masks, respirators, gloves, etc. that are not available from the SNS. MERC assets will be used to bridge the gap from the time an emergency starts until receipt of SNS supplies.
- Manages the NYSDOH's Medical Volunteer Management System. This statewide, coordinated medical volunteer program ensures that there are enough medical personnel to staff hospitals and alternate care facilities and to help dispense medications during an emergency.
- Coordinates the Health Emergency Response Data System (HERDS), an electronic, real-time tool that is used to assess the needs and status of healthcare facilities during an emergency. HERDS can be used to help determine the need for Alternate Care Sites if all hospital beds are full during an emergency. It is also used to manage evacuation for healthcare facilities in hurricane flood zones across the state.
Preparedness Planning Partners
The Office of Health Emergency Preparedness works with a number of partners including:
- Adult Care Facilities
- Centers for Disease Control and Prevention
- Hospice Programs
- Nursing Homes
- State and Local Emergency Managers
- State and Local Law Enforcement
- State Office of Homeland Security
- State Education Department
- 58 Local Health Departments
- Tribal Nations
A wide variety of resources for families, schools, health care providers and others is available on the NYSDOH Emergency Preparedness webpage.
Additional information may be found on the following websites:
- New York State Emergency Management Office
- New York State Association of County Health Officials
- Public Health Preparedness - National Association of City and County Health Officials
- Emergency Preparedness and Response - Centers for Disease Control and Prevention
- Get Ready Campaign - American Public Health Association
- Ready - Plan. Prepare. Stay Informed. (on-line emergency planning tools) - U.S. Department of Homeland Security Resources
- Emergency Disaster Response and Preparedness - The American Red Cross
- Preparedness - Association of State and Territorial Health Officials