Emergency Support Function #8 – Public Health and …

1 Emergency Support Function #8 Public Health and Medical Services Annex January 2008 ESF #8 Public Health and Medical Services Annex ESF #8-1 ESF Coordinator: Department of Health and Human Services Primary Agency: Department of Health and Human Services Support Agencies: Department of Agriculture Department of Commerce Department of Defense Department of Energy Department of Homeland Security Department of the Interior Department of Justice Department of Labor Department of State Department of Transportation Department of Veterans Affairs Environmental Protection Agency General Services Administration Agency for International Development Postal Service American Red Cross INTRODUCTION Purpose Emergency Support Function (ESF) #8 Public Health and Medical Services provides the mechanism for coordinated Federal assistance to supplement State, tribal, and local resources in response to a Public Health and medical disaster, potential or actual incidents requiring a coordinated Federal response , and/or during a developing potential Health and medical Emergency .

2 The phrase medical needs is used throughout this annex. Public Health and Medical Services include responding to medical needs associated with mental Health , behavioral Health , and substance abuse considerations of incident victims and response workers. Services also cover the medical needs of members of the at risk or special needs population described in the Pandemic and All-Hazards Preparedness Act and in the National response Framework (NRF) Glossary, respectively. It includes a population whose members may have medical and other functional needs before, during, and after an incident. Public Health and Medical Services includes behavioral Health needs consisting of both mental Health and substance abuse considerations for incident victims and response workers and, as appropriate, medical needs groups defined in the core document as individuals in need of additional medical response assistance, and veterinary and/or animal Health issues.

3 Scope ESF #8 provides supplemental assistance to State, tribal, and local governments in the following core functional areas: y Assessment of Public Health /medical needs y Health surveillance y Medical care personnel y Health /medical/veterinary equipment and supplies y Patient evacuation y Patient care y Safety and security of drugs, biologics, and medical devices y Blood and blood products y Food safety and security Emergency Support Function #8 Public Health and Medical Services Annex ESF #8-2 ESF #8 Public Health and Medical Services Annex January 2008 y Agriculture safety and security y All-hazard Public Health and medical consultation, technical assistance, and Support y Behavioral Health care y Public Health and medical information y Vector control y Potable water/wastewater and solid waste disposal y Mass fatality management, victim identification.

4 And decontaminating remains y Veterinary medical Support Policies The Secretary of Health and Human Services (HHS) leads all Federal Public Health and medical response to Public Health emergencies and incidents covered by the NRF. The response addresses medical needs and other functional needs of those in need of medical care, including assistance or Support in maintaining independence, communicating, using transportation, and/or requiring supervision. The Secretary of HHS shall assume operational control of Federal Emergency Public Health and medical response assets, as necessary, in the event of a Public Health Emergency , except for members of the Armed Forces, who remain under the authority and control of the Secretary of Defense. The Secretary of HHS, through the Office of the Assistant Secretary for Preparedness and response (ASPR), coordinates national ESF #8 preparedness, response , and recovery actions.

5 These actions do not alter or impede the existing authorities of any department or agency supporting ESF #8. HHS coordinates all ESF #8 response actions consistent with HHS internal policies and procedures ( , HHS Concept of Operations plan for Public Health and Medical Emergencies, and the National Disaster Medical system (NDMS) Four Partner Memorandum of Agreement). ESF #8 Support agencies are responsible for maintaining administrative control over their respective response resources after receiving coordinating instructions from HHS. The Emergency Management Group (EMG), operating from the HHS Secretary s Operations Center (SOC), coordinates the overall national ESF #8 response for the ASPR and maintains constant communications with the National Operations Center (NOC). All headquarters and regional organizations (including those involved in other ESFs) participating in response operations report Public Health and medical requirements to the appropriate ESF #8 representative operating in the National response Coordination Center (NRCC), the Regional response Coordination Center (RRCC), or the Joint Field Office (JFO) when activated.

6 The Joint Information Center (JIC) will be established to coordinate incident-related Public information, and is authorized to release general medical and Public Health response information to the Public . When possible, a recognized spokesperson from the Public Health and medical community (State, tribal, or local) delivers relevant community messages. After consultation with HHS, the lead Public Affairs Officer from other JICs may also release general medical and Public Health response information. Emergency Support Function #8 Public Health and Medical Services Annex January 2008 ESF #8 Public Health and Medical Services Annex ESF #8-3 In the event of a zoonotic disease outbreak and in coordination with ESF #11 Agriculture and Natural Resources, Public information may be released after consultation with the Department of Agriculture (USDA).

7 In the event of an oil, chemical, biological, or radiological environmental contamination incident, ESF #8 coordinates with ESF #10 Oil and Hazardous Materials response on the release of Public Health information. As the lead agency for ESF #8, HHS determines the appropriateness of all requests for release of Public Health and medical information and is responsible for consulting with and organizing Federal Public Health and medical subject-matter experts, as needed. CONCEPT OF OPERATIONS General Upon notification, the ASPR alerts identified HHS personnel to represent ESF #8, as required, in or on the: y Domestic Readiness Group (DRG). y NOC (Planning Element or Watch). y NRCC. y RRCC/JFO. y National/regional teams. y JIC. y Other Federal, State, or tribal operations centers as required by the mission.

8 HHS notifies and requests all supporting departments and agencies to participate in headquarters coordination activities. The ASPR may request ESF #8 Support agencies and organizations to provide liaison personnel to the HHS Headquarters command locations. HHS Headquarters and ESF #8 staff provide liaison and communications Support to regional ESF #8 offices. Regional ESF #8 staff may be assisted by supporting Federal partners and HHS components. ESF #8 staff in the RRCC or JFO will conduct a risk analysis, evaluate, and determine the capability required to meet the mission objective and provide required Public Health and medical Support medical assistance to State, tribal, and local medical and Public Health officials. In the early stages of an incident, it may not be possible to fully assess the situation and verify the level of assistance required.

9 In such circumstances, HHS may provide assistance under its own statutory authorities. In these cases, every reasonable attempt is made to verify the need before providing assistance. During the response period, HHS has primary responsibility for the analysis of Public Health and medical assistance, determining the appropriate level of response capability based on the requirement contained in the action request form as well as developing updates and assessments of Public Health status. ORGANIZATION Headquarters The Secretary of HHS leads the ESF #8 response . ESF #8, when activated, is coordinated by the ASPR. Once activated, ESF #8 functions are coordinated by the EMG through the SOC. Emergency Support Function #8 Public Health and Medical Services Annex ESF #8-4 ESF #8 Public Health and Medical Services Annex January 2008 During the initial activation, HHS coordinates audio and video conference calls with the ESF #8 supporting departments and agencies, and Public Health and medical representatives from State, tribal, and local officials, to discuss the situation and determine the appropriate initial response actions.

10 HHS alerts and requests supporting organizations to provide a representative to the EMG to provide liaison Support . Public Health and medical subject-matter experts (including partners representing all appropriate populations, such as pediatric populations, populations with disabilities, the aging, and those with temporary or chronic medical conditions) from HHS and ESF #8 organizations are consulted as needed. Regional HHS coordinates ESF #8 field response activities according to internal policies and procedures. HHS may designate a Senior Health Official to serve as the senior Federal Health official in the JFO. Regional ESF #8 staff are ready to rapidly deploy, as the Incident response Coordination Team Advance (IRCT-A) to provide initial ESF #8 Support to the affected location. As the situation matures, the IRCT-A will receive augmentation from HHS and partner agencies transitioning into a full IRCT capable of providing the full range of ESF #8 Support to include medical command and control.