Intro to Pan Flu Continuity of Operations Planning for LHDs

1. Intro to Pan Flu Continuity of Operations Planning for LHDs Richard Rosselli, MPH NC Center for Public Health Preparedness

2. Learning Objectives Learn about WTC attack and its impact on LHD COOP planning Understand a process for creating an LHD COOP plan Identify key components of pan flu COOP plans Learn how to access tools on the NCCPHP pan flu COOP planning website

3. WTC Attack Impact on NYC DOHMH

4. WTC Attack Impact on NYC DOHMH 8:45 AM and 9:03 AM AA#11 and UA#175 crash into WTC ~ 9:15AM NYC DOHMH sets up an �EOC� and sends rep. to the City�s EOC at 7 WTC

5. WTC Attack Impact on NYC DOHMH

6. WTC AttackImpact on NYC DOHMH ~ 10:00 AM - Health department begins to receive walking wounded (~50 total) 10:05 AM and 10:28 AM � Towers fall ~11:30AM - DOHMH sets up WTC-related surveillance systems Surveillance efforts hampered due to damage to IT and telecommunications systems Lack of qualified personnel available � many DOHMH employees could not be reached 5:20 PM � 7 WTC falls due to intense fires

7. WTC AttackImpact on NYC DOHMH Sept. 12/13 No Internet or land lines at DOHMH Difficult to access sites below Canal Street DOHMH relocates to Public Health Lab Sept 13 � City EOC established at Pier 92 after �failed� EOC at NYPD Academy

8. WTC AttackImpact on NYC DOHMH WTC Response Activities Hospital-based surveillance for WTC-related injury Providing rescue worker protections (e.g., masks) Removal of contaminated food from abandoned sites in Lower Manhattan Impact on Traditional Public Health Activities Vital stats (birth/death) delayed Restaurant inspection and pest control activities curtailed Limited �routine� surveillance and foodborne disease investigations

9. WTC AttackLessons Learned for DOHMH COOP Internal Communications Need for effective two-way communication between leadership and employees Hotline and website for employees Human Capital Establish mental health support for employees (EAP) Mandate �mental health� days to relieve stress Vital Records Must have IT included in planning to determine set-up requirements for alternate sites Facility Need for employees to have familiarity with alternate site

10. WTC Attack Comparison to Pandemic Influenza Differences from pandemic influenza COOP Immediate failure of critical physical infrastructure during WTC No need for social distancing Continuity strengthened by the assistance of agencies from outside the affected area Similarities to pandemic influenza COOP Length of response Loss of personnel/burnout

11. The COOP Planning Process

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13. Step 1: Engage Leadership Jan. 25th DHHS memo sent to all local health directors LHD leadership must make COOP planning a priority Continuity of government is a public expectation Leadership input needed during the planning process (e.g., prioritization)

15. Step 2: Create a COOP Team Must have diverse representation from all key public health units Include department heads, if possible Should include key reps from IT, security, HR, legal counsel and administration Helps achieve buy-in for the plan Appoint a COOP team coordinator and note-taker for the process Consider input from partner agencies, especially EM

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17. Step 3: List and Describe All LHD Services List all routine services provided by the LHD Pandemic influenza response activities should not be listed Don�t forget to include services that support your public health activities (e.g., IT, HR etc.) List out services in spreadsheet

18. Step 3: List and Describe All LHD Services Potential methodologies for collecting LHD service data Employee surveys (e.g., staff skills survey) Individual interviews (e.g., snowball technique) Focus groups (may build interest/buy-in for COOP planning)

20. Step 4 & 6 - Prioritize LHD services Prioritize LHD services identified in Step 3 Factors that influence criticality Services that align with the core mission Services that satisfy regulatory requirements Services that, if terminated, will endanger lives Services that provide financial stability to the agency? Should be completed by May 31, 2010

21. Step 4 & 6 - Prioritize LHD services

22. Step 4 & 6 - Prioritize LHD services Reinforce Services that must continue and may even be expanded during an emergency Run Services that must run and have a high priority to the community, regulations and health outcomes Reduce Services that may have some critical functions, but majority can be reduced Remove Services that can be stopped in order to shift resources to more critical functions

23. Step 4 & 6 - Prioritize LHD services

25. Step 5 � List Essential Personnel and Resources Tie LHD services to the personnel and resources needed to complete them List personnel by role (e.g., communicable disease nurse) not by name List all equipment, records or documents required to deliver the service Example: Foodborne outbreak interview might require std. outbreak investigation forms, telephone, access to database, etc.

27. Step 7� Draft COOP Plans Use completed spreadsheets to inform the plan Write out processes necessary to articulate the critical functions, document the needed resources, and describe strategy for continuity Consider use of existing templates (e.g., FEMA) Pan Flu COOP must be complete by May 2011

29. Pan flu annex to all-hazards LHD COOP plan vs. section of the pan flu plan Review and identify any LHD role in the county COOP plan (liaise with EM) Assure integration between the LHD all-hazards COOP and the county all-hazards COOP

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31. Step 9 -12: Education, Training and Exercises Plans are no good if no one knows about them Create trainings and exercises for staff to raise awareness of the plan Everyone needs to understand their emergency role Personnel need to understand that they may be asked to perform different activities from their typical job during an emergency and should be cross-trained Need to stress that all LHD services and personnel are important, even those that are not highly prioritized

32. Step 9 & 12 � Education, Training and Exercises Validate assumptions of the plan with exercises Testing will reveal areas of plan that need to be reworked or improved Someone or some team within the LHD needs to regularly update plan on annual basis

33. 3 Key Facets of Organizations

34. Strategies to Strengthen Organizational Resiliency

35. Common Components of Pan Flu COOP Plans

36. Common Components of a Pan Flu COOP Annex Essential Functions Orders of Succession Delegation of Authority Continuity Facilities Continuity Communications Vital Records Management Human Capital Test, Training and Exercise Devolution of Control and Direction Reconstitution FEMA Pandemic Influenza COOP Annex Materials (http://www.fema.gov/government/coop/index.shtm)

37. Pan Flu COOPOrders of Succession Fill in at least 3 deep for every critical position Must assure that successors are well trained Legal review of successor plans

38. Pan Flu COOPContinuity Facilities Modify existing facilities to reduce exposure Telecommuting Consider which LHD services can be provided this way Assure secure remote access to vital records (IT) Feasibility in isolated/rural areas

39. Pan Flu COOPContinuity Communications List communication equipment/systems e.g., telephone, fax, 800 MHz radios, hotlines Need for frequent testing and training on equipment Must assure 2-way communication with staff

40. Pan Flu COOPVital Records Management More than just an IT server issue Assure staff knowledge re: vital records is not lost to the organization Critical information should only be stored on networks, not individual hard drives List vital records for essential functions in spreadsheet

41. Pan Flu COOPHuman Capital Sig. pandemic impact on human capital Describe how employee health would be protected Social Distancing (alternate work schedules) PPE/Fit Testing Antivirals Encourage family preparedness planning Impact of school/day care closure may increase staff absenteeism

42. NCCPHP Pan Flu COOP Website

43. Questions? For Technical Assistance with COOP planning: Richard Rosselli, MPH rrosselli@unc.edu (919) 966-6287 Heather Gates (PHRST 5, 6 and 7 only) hkgates@bellsouth.net (828) 698 - 5068