Requesting Federal Assets

1. Requesting Federal Assets Peter Alvarez Emergency Management Specialist Introduction to SNS Operations Course Jun 14, 2017

2. Purpose To provide participants with an overview of the various mechanisms for requesting federal assistance and/or medical countermeasures during an emergency * A Guide to Preparedness, V11: Chapter 4: Requesting Strategic National Stockpile Assets

3. Learning Objectives At the end of this session, participants will be able to . . . • Determine when to request federal assistance. • Understand the request process for federal assistance with and without a federal disaster declaration. • List three situations when SNS assets can be deployed without a coordinated federal response.

4. Requesting federal assistance

5. When to Request Federal Assistance • All disasters are local • State government support localities and coordinates resources & capabilities • Two options for assistance when needed • Emergency Management Assistance Compact (EMAC) • Federal assistance • Don’t wait for all the details • Request the capability you need, not the specific assets

6. Requesting Federal Assistance4 Request Types • Presidentially Declared Emergency or Major Disasters • Public Health Emergency • Emergency Declaration • Major Disaster Declaration • No Emergency Declarations • Isolated, Individual or Time Critical Cases

7. Knowledge Check 1

8. True/False: State health officials should wait to request the required federal assistance until they fully understand the public health emergency that is occurring. • True • False

9. request process

10. Request for Assistance Process

11. Request for Assistance Process

12. Request for Assistance Process

13. Request for Assistance Process

14. Knowledge Check 2

15. In the absence of a federal disaster declaration, who should the governor contact to request assistance in a public health event? • CDC EOC at 770-488-7100 • FEMA Headquarters • Federal Bureau of Investigation • Deptof Homeland Security

16. DSNS: When do we deploy? • Federal government may direct deployment prior to declaration. • HHS ASPR can also direct deployment when: • Credible threat exists or incident is imminent • State makes request • Clinician requests

17. Knowledge Check 3

18. True/False: The federal government can deploy medical countermeasures without a formal state request in certain situations. • True • False

19. National Special Security Events • “NSSE” – an event of national or international significance determined by DHS to be a potential target for terrorist or criminal activity • RNC/DNC • G8 Summit • Inauguration • With or without state request

20. Isolated or Small-Scale Incidents • SNS is single source for several MCMs • Vaccina Immune Globulin • Botulism Antitoxin • Prussian Blue • Anthrax Immune Globulin • CDC/SNS can also help link clinicians with other federal resources and/or manufacturers when appropriate.

22. request processsmall-scale or time critical emergency

23. Request ProcessSmall-scale or Time-critical Emergency

24. Request ProcessSmall-scale or Time-critical Emergency

25. Request ProcessSmall-scale or Time-critical Emergency

26. Request ProcessSmall-scale or Time-critical Emergency

27. Request ProcessSmall-scale or Time-critical Emergency

28. Knowledge Check 4

29. True/False: HHS and the CDC Director has delegated release authority to the DSNS director for the deployment of a small amount of medical countermeasures • True • False

30. DSNS Team Room response

31. DSNS Team Room Operations • Deployment of assets approved • Team Room Activation • DSNS staff alerted (within 90 min) • ICS-based • Flexible & scalable • Small events – specific personnel • Large events – specific sections or entire Team Room staff

32. Assessment & Approval • Obtain specifics from requestor • Who (population exposed) • What (define threat / agent) • Where (location) • When (timeline of event) • How (distribution method of agent) • Team Room • Conduct analysis • Conduct preliminary planning (assets, time, partners, cost) • Provide recommendation to leadership for approval • Materiel specifics • Deployment teams (if applicable)

33. Deployment of Assets • Team Room coordinates with requestor • Coordinate delivery location, times, POC • Provide delivery details • Materiel, configuration, estimated time of arrival (ETA) • Deployment Teams – POC, ETA • Provide assistance as required • Team Room continues to monitor situation

34. Requesting Additional Assets • Level of federal response determines process • Supplies could become limited • Personnel is available • Inventory tracking is important

35. Knowledge Check 5

36. True/False: To request additional assets, SLTT planners should request assistance through the established emergency management process (IRCT) or through collaboration with the HHS REC. • True • False

37. Summary • Federal assistance is requested when state and local resources are overwhelmed. • Requests for federal assistance can be made during emergencies of all types. • SNS assets may be deployed without a federal response when a credible threat exists or at the request of a state or clinician. • Key information requests related to the SLTT response may come directly from the DSNS

38. Group Activity: The Request Call • SCENARIO: • Monday June 12th- the South Dakota Department of Health was notified by area hospitals of an increase in patients experiencing influenza like illness. No definitive diagnosis was forthcoming and lab tests were still pending. • Contract tracing reveals all symptomatic people attended Friday night (June 9th) high school football games in their hometown. • Early am Tuesday June 13th – one abnormal chest film and other prelim lab tests lead to a suspected diagnosis of inhalational anthrax; SDDH is notified.

39. Class Discussion • What do we know? • What do we need to know?

40. Class Discussion • What do we know? • What do we need to know? • Define the threat, if known • Describe the exposed population • Identify location (local? Statewide?) • Timeline of event that lead up to discovery of threat • Distribution method of agent/threat, natural or manmade?

41. Class Discussion • Define the threat • Inhalational & Cutaneous Anthrax • Describe the population affected • Approximately 3,000 + people potentially exposed • Sioux Falls 1,000 • Yankton 1,000 • Vermillion 1,000 • Where it has occurred – which cities / counties • Sioux Falls , Minnehaha Co. (pop. 172K) • Yankton, Yankton Co. (pop. 23K) • Vermillion, Clay Co. (pop. 11+K)

42. Class Discussion • When we think it occurred • Friday June 9th, early evening, HS Football games • How we think it occurred • Aerosolized spore spread, vector unknown at this time. • What we need • Enough of the appropriate oral antibiotics to initiate mass prophylaxis for ~200,000 people

43. Now….make the call • SDHD/ Gov’s Office call to CDC EOC • 770-488-7100 • CDC Watch officer will answer and give us a bridge line to call in about 30 min • Conference Call will convene with SMEs from CDC, SNS, HHS, ASPR REC, DSLR, etc • Bridge line is a Conf. call where we are expected to: • Describe the situation as best you can at this time • Discuss your shortfalls in capability and what you need from federal government • Not expected to answer epi questions during this simulation.

44. QUESTIONS? • For more information please contact Centers for Disease Control and Prevention • 1600 Clifton Road NE, Atlanta, GA 30333 • Telephone, 1-800-CDC-INFO (232-4636 /TTY: 1-888-232-6348 • E-mail: cdcinfo@cdc.gov Web: www.cdc.gov • The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.