OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21 st CENTURY BIOTERRORISM PREPAREDNESS AND EMERGENCY...

OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21st CENTURY

BIOTERRORISM PREPAREDNESS AND EMERGENCY RESPONSE

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALSOFFICE OF PUBLIC HEALTH

Public Health Preparedness

And Response for Bioterrorism

Presented by

Madeline W. McAndrew State Public Health Official

5 February 2003

Building A Successful “Total Force” Response Capacity



Keys to Building a Successful “Total Force” Response Capacity

CommandCommand

ControlControl

CoordinationCoordination

CommunicationCommunication

IntelligenceIntelligence



Public Health Awareness

Ebola SmallpoxAIDS

“Where do our weaknesses and vulnerabilities lie? The greatest of our war machines will not protect our forces against the deadly pathogen. Their

stealth and precision surpass the complexity of human imagination. Their vectors are fully competent. Their tactics have been perfected over millennia.

Their mission…invade and destroy the unsuspecting and unprotected .” Brian Blalock, Osan Air Base, Korea, 2001



Securing the Homeland

Public Health is integral to the National Security Strategy.

Enhancing Security on the HomelandEnhancing Security on the Homeland

Environmental Health InitiativesEnvironmental Health Initiatives

Domestic Preparedness Against Domestic Preparedness Against Weapons Mass DestructionWeapons Mass Destruction



Public Health is an intelligence gathering agency.

Information superiority is obtained via surveillance,

collection and control of vital health statistics and

parish specific disease information and trends.




Public Health is part of a national disease reporting

and surveillance network.

• Centers for Disease Control and Prevention

• State and local laboratory network

• Hospital, EMS, physician, coroner, veterinarian disease reporting





Local Law EnforcementLocal Law Enforcement Military/DoDMilitary/DoD FBI/DOJFBI/DOJ

HospitalsHospitals Public HealthPublic HealthLaboratoriesLaboratories VeterinariansVeterinarians

LSPLSP

CDC/DHHSCDC/DHHS

Law Enforcement Sensitive • Criminal Investigation • Security Clearance • Criminal Surveillance

Patient Sensitive • Medical Investigation • Controlled Access • Disease Surveillance

CROSSING THE GREAT DIVIDE

Prevention and Deterrence Continuum is Intelligence DrivenPrevention and Deterrence Continuum is Intelligence Driven

CoronersCoroners

Intel LinkIntel Link




Emergency ManagementEmergency Management

Public HealthPublic Health

State PoliceState Police

Law Enforcement Sensitive • Criminal Investigation • Security Clearance • Criminal Surveillance

Patient Sensitive • Medical Investigation • Controlled Access • Disease Surveillance

Prevention and Deterrence Continuum is Intelligence DrivenPrevention and Deterrence Continuum is Intelligence Driven

CROSS POLLINATION PARADIGM



State Public Health OfficialState Public Health OfficialPublic Health Assistant Secretary Public Health Assistant Secretary

Madeline W. McAndrewMadeline W. McAndrew

Center for Health PromotionCenter for Health PromotionInformation and PolicyInformation and Policy

Center for Center for Community HealthCommunity Health

Center for Center for Preventive HealthPreventive Health

Infectious Disease Epi

Laboratory Services

Engineering/H2O Safety

Sanitarian Services

Environmental Epi

Vital Records

OPH Emergency ResponseOPH Emergency ResponseCDC BT Grant CDC BT Grant

DHH Communications

OPH Human ResourcesOPH Human Resources

DHH Emergency Response DHH Emergency Response

Center for Center for Environmental HealthEnvironmental Health

HRSA/Hospital GrantHRSA/Hospital Grant

Nursing Services

Pharmacy Services

Bureau of EMS

Regional OfficesRegional Offices

TB Prevention & Control

STD Services

Immunization Services

Administrative & Technical Administrative & Technical

Public Health Incident Command Structure

PIO

C2

Plans

Finance

Ops



OPHOPHLaboratoryLaboratory

DirectorDirector

OPH IT OPH IT DirectorDirector

Public HealthPublic HealthVeterinarianVeterinarian

Chief ofChief ofNursingNursingServicesServices

State State PharmacyPharmacyDirector Director

(NPS)(NPS)

OPH OPH EmergencyEmergencyResponse Response

DirectorDirector

State EMSState EMS

OPH OPH ImmunizationImmunization

Medical Medical DirectorDirector

State State EpidemiologistEpidemiologist

Center Center DirectorsDirectors

Assistant State Assistant State Health OfficerHealth Officer

Public Health Public Health Assistant Assistant SecretarySecretary

DOJDOJ

FEMAFEMA

EPAEPA

CDCCDC

State Level Public Health Command and Control

LSP HAZM ATLSP HAZM ATResponse UnitResponse Unit

LOEPLOEPState EOCState EOC

Louisiana Louisiana State PoliceState Police

EOCEOC

DHH Emergency DHH Emergency ResponseResponse

LANGLANG6262ndnd CST/WMD CST/WMD

Dept. Environmental Dept. Environmental QualityQuality

MMRS MMRS

DHH SecretaryDHH Secretary

Isolation & Isolation & QuarantineQuarantine



DiologicsDiologicsOperatorOperator

PHPHVetVet

TB/STDTB/STDDirectorsDirectors

OPHOPHLaboratoryLaboratory

DirectorDirector

StateStateEpidemi-Epidemi-ologistologist

EnvironEnvironEpiEpi

DirectorDirector

ContractingContractingOfficerOfficer

DHHDHHTeleComTeleCom

AgentAgent

ITITDirectorDirector

FinanceFinanceDirectorDirector

DHHDHHPurchasingPurchasing

AgentAgent

CHCHCenterCenterDirectorDirector

PPHIPPHICenterCenterDirectorDirector

OPHOPHHumanHuman

ResourcesResources

PHPHCenterCenterDirectorDirector

ENVSENVSCenterCenterDirectorDirector

HANHAN

NPSNPSCoordinatorCoordinator

CDC BTCDC BTAdvisorAdvisor

BTBTDirectorDirector

BT BT OperationsOperations

OfficerOfficer

Public HealthPublic HealthAssistant SecretaryAssistant Secretary

&&OPH Medical DirectorOPH Medical Director

DHH Public Affairs/PIODHH Public Affairs/PIO DHH Emergency ResponseDHH Emergency Response

OPH Legal CounselOPH Legal Counsel LSP OfficerLSP Officer LANG OfficerLANG Officer

LDHHLDHHSecretarySecretary

CDC LiaisonCDC LiaisonMetro City HDMetro City HD

LiaisonLiaison

Public Health Emergency Operations Center and Incident Command

PharmacyPharmacyDirectorDirector

Immuniza-Immuniza-tionstions

DirectorDirector

NursingNursingDirectorDirector

EMSEMSDirectorDirector

VitalVitalRecordsRecords

PIOPIO

C2C2

PlansPlans

FinanceFinance

OpsOps

HNBC GISHNBC GIS

Radio ComRadio Com

RunnerRunner

EmergencyEmergencyAction CellAction Cell

IT SupportIT Support

EOCEOC SupportSupport



Public Health Command and Control

88

66

44

33

C2C2

OPH

C2C2

C2C2

Regional PH C2

State PH C2

PH Headquarters

State PH Lab

55

77

11

9922



Public Health Command and Control Expanded

C2C2

OPH

77 88

66

5544

22

33 11

99

c2c2

C2C2

Regional PH C2

State PH C2

Parish Health Unit

State PH Lab



Statewide Command and Control Network

C2C2

LSP

C2C2

DHH

5544

11

A

IC

I

DL

77

99

33

B

CDCCDC

88

22

C2C2 C2C2

LANG

State EOC

C2C2

C66

B

OPH

C2C2

DEQ

LHA/DRC

C2C2

OPH

MMRS

C2

LSP

LOEP



Public Health “Total Force” Response Capacity

1

3

9

87

11

22

33

55

6

44

7 8

99BATBAT

CATCAT

ERTERT

C2C2

PIOPIO

CETCET

44

6

55

78

99

1133

22

PATPAT

99

87

6

5544

33

22

11

44

6

55

78

99

1133

22

99

8877

66

5544

33

22

11

Communications/IT

Immunization Teams

Incident Response Teams

Regional Command/Control Teams

State Level PH Teams



Regional EpidemiologistRegional Epidemiologist

Disease Surveillance Spec.Disease Surveillance Spec.

Regional SanitarianRegional Sanitarian

Regional NurseRegional Nurse

Public Health ER CoordinatorPublic Health ER Coordinator

Regional Administrator/C2Regional Administrator/C2

Regional Medical DirectorRegional Medical DirectorTEAM CHIEFTEAM CHIEF

Regional EngineerRegional Engineer

COMMET/IT TeamCOMMET/IT Team

Administrative Support TeamAdministrative Support Team

Facility Manager/C2Facility Manager/C2

ParishParishEOCEOC

OPHOPHCCCC

StateStateEOCEOC

Hospital ED

Biological Aug. Teams (3)Biological Aug. Teams (3)

Immunization Teams (9x2)Immunization Teams (9x2)

Pharmacy Teams (2)Pharmacy Teams (2)

Public Affairs (2)Public Affairs (2)

Chemical Aug. Teams (2)Chemical Aug. Teams (2)

Epidemic Surveillance Epidemic Surveillance Response Teams (2)Response Teams (2)

Deployable S

upport Team

s

PH Nurse PH Nurse

PH Sanitarian PH Sanitarian

Disease Intervention Spec.Disease Intervention Spec.

Regional Public Health Command Center

OPH Medical DirectorOPH Medical Director

FBI

LSPLSPLocal Local Law Law

NPS

Regional Public Health Incident Response Team



Public Health ClerkPublic Health Clerk


Public Health NursePublic Health Nurse


Public Health Nurse Public Health Nurse

Immunization ConsultantImmunization Consultant

EMT ParamedicEMT Paramedic

HRSA Hospital Nurse HRSA Hospital Nurse








HRSA Hospital Nurse HRSA Hospital Nurse

Regional Medical DirectorRegional Medical Director

Regional Immunization Teams



ID Epidemiologist 1ID Epidemiologist 1



ID Epi Supervisor ID Epi Supervisor


Assistant State EpidemiologistAssistant State Epidemiologist

State EpidemiologistState Epidemiologist

State Health OfficerState Health Officer

DHH Emergency Resp. DHH Emergency Resp.




ID Epi SupervisorID Epi Supervisor


TB Inter. Spec. TB Inter. Spec.

TB Inter. Spec. TB Inter. Spec.

STD Inter. Spec. STD Inter. Spec.

STD Inter. Spec. STD Inter. Spec.

State PH OfficialState PH Official

Admin SupportAdmin Support





Regional Incident ResponseRegional Incident Response


Regional Incident ResponseRegional Incident Response

DHH Public Info OfficerDHH Public Info Officer

State Level Epidemic Response Teams



Env EpiEnv Epi

Env EpiEnv Epi

Env Epi PhysicianEnv Epi Physician

Env Epi Supervisor Env Epi Supervisor

Env EpiEnv Epi

Env EpidemiologistEnv Epidemiologist

Center DirectorCenter DirectorEnvironmental ServicesEnvironmental Services

State Health Officer/C2State Health Officer/C2

DHH Emergency/Plans DHH Emergency/Plans Response DirectorResponse Director

State PH OfficialState PH Official





Env EpiEnv Epi

LSP HAZMATLSP HAZMAT

LSP HAZMAT LSP HAZMAT











Dept. Environmental QualityDept. Environmental Quality


LSPLSPEOCEOC

Regional Medical Director/C2Regional Medical Director/C2

Regional IncidentRegional IncidentResponse Team Response Team


DHH Public Info OfficerDHH Public Info Officer

StateStateEOCEOC

State Level Chemical Augmentation Team



Public Health Preparedness Challenges

Preparedness and Readiness

Education and Training

Cultural Shift

Integration and Cross Pollination

Communication Gaps

Risk Communication and Public Info

Continued Funding

OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21 st CENTURY BIOTERRORISM PREPAREDNESS AND EMERGENCY...

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Transcript of OFFICE OF PUBLIC HEALTH…LEADERSHIP FOR THE 21 st CENTURY BIOTERRORISM PREPAREDNESS AND EMERGENCY...