Centers for Public Health Preparedness Cross-Border Preparedness Training A Compilation from the Centers for Public Health Preparedness Appendices September 2005
Appendix A Exemplar Group Process and Methods From March 2005 through August 2005, the Cross-Border Preparedness Tools Exemplar Group convened via conference calls and through one in-person meeting. The group s membership consisted of subject matter experts and other designated representatives from the CPHP network, CDC, and the ASPH. Representatives from the following centers participated in this group: Southeastern Center for Emerging Biologic Threats at Emory University, Ohio Center for Public Health Preparedness at Ohio State University School of Public Health, Heartland Center for Public Health Preparedness at Saint Louis University School of Public Health, South Central Center for Public Health Preparedness at Tulane University School of Public Health and Tropical Medicine & University of Alabama-Birmingham School of Public Health, University of California at Los Angeles Center for Public Health Disasters at University of California at Los Angeles School of Public Health, Upper Midwest Center for Public Health Preparedness at University of Iowa College of Public Health, University of Minnesota Center for Public Health Preparedness at University of Minnesota School of Public Health, National Biosecurity Center for Rural Health at University of Nebraska Medical Center, University of Pittsburgh Center for Public Health Preparedness at University of Pittsburgh Graduate School of Public Health, Florida Center for Public Health Preparedness at University of South Florida School of Public Health, and Northwest Center for Public Health Practice at University of Washington School of Public Health. At the beginning of this process, four members volunteered to serve as the primary points of contact and leadership for the exemplar group. The group then established a charter outlining the group s goals and developed a timeline for completion of group activities. The exemplar group found that 13 schools engaged in CPHP activities and/or offered resources related to cross-border preparedness. The group ascertained this information, with ASPH assistance, by searching the CPHP Preparedness Resource Center (www.asph.org/acphp/phprc.cfm) and the activity list of all 40 CPHP compiled by the CDC for fiscal year 2005. Group members then developed a brief questionnaire (Appendix C, Survey of Lessons Learned ), which they emailed to these schools to query them about cross-border lessons learned and best practices. Eleven schools responded. All information gathered was self-reported and the exemplar group did not attempt to validate respondents assessments. ASPH staff coordinated arrangements for conference call meetings and supported Internet communication and sharing of documents among group members. Additional communications involving group leaders, ASPH staff, and CDC liaisons took place between meetings throughout this period. To review the data collected and to plan for development of the final paper, group members held an in-person meeting on July 13, 2005, in conjunction with the national CPHP annual meeting in Boston. Immediately following that meeting, group members each began to draft portions of the final document, which were subsequently edited and finalized via conference calls and with assistance from ASPH staff. i Cross-Border Preparedness Training Appendix A
Appendix B Policy and Personnel Review and Alignment Policy and Resources A civil society is based on policies and procedures that create a set of expectations among the population. In the United States, the federal system provides for the sharing of power among the federal government, states, counties, and local communities. This model, which permits significant local autonomy, has proven to be an effective means of organizing and carrying out a range of beneficial services when the issue to be addressed is contained within a demarcated community. However, disasters that threaten multiple jurisdictions or overwhelm local resources require the marshalling of information and response capacity so as to decrease the potential for harm to all. The resulting tension between community independence and collective security must be addressed before coordinated action can be carried out. Every jurisdiction should review its lawful responsibilities, capacities, and prerogatives and take steps to achieve an effective understanding and/or alignment among neighboring jurisdictions. In the process all community resources should be analyzed to determine whether standards are in place that are appropriate for the use of employees and volunteers. Such jurisdictional reviews should identify issues that arise out of an examination of the policies that represent a community s standards. Such policies are minimally reflected in either state or federal constitutional provisions that set the boundaries on state incursions into personal rights. They may also be found in legislative determinations (i.e., laws) that establish operational jurisdictions and capacities as well as the standards of private sector regulation and litigation. Finally, such reviews should also identify and analyze associated administrative responsibilities, including both the structural and procedural guidelines for a public agency s response. The products of these reviews can provide the basis for both multijurisdictional policy discussions and for necessary training exchanges among the identified jurisdictions and agencies. Evidence also suggests that the most valuable means of establishing an effective cross- jurisdictional response system is through the staging, conduct, and analysis of tabletops, drills, and exercises. Successful development of decision-making simulations (DMSs) requires, of course, a thorough understanding of the personnel, functions, and mores of involved organizations and the issues each faces in an emergency. Examples of the development of such training components come from national, regional, and state experiences including the results from TOPOFF (Top Officials) Exercises 1, 2, and 3, the Forensic Epidemiology course, as well as examples of training components developed during judicial conferences. Information-sharing exercises help identify issues, such as the distinction between settled law and operating interpretations in areas with a bearing on organization, personnel, functions, and legal interoperability; external, supporting, and supported agency relationships; isolation and quarantine; multijurisdictional compacts; and the movement of assets. Personnel Within the broadly based challenge of aligning the resources of separate jurisdictions is the employment of perhaps the most valuable resource of each jurisdiction, namely, that of its personnel. Specific issues associated with this dimension include: Understanding how to ensure interoperability between jurisdictionally-based personnel classification systems that frequently have less than optimal comparability; Developing cross-jurisdictional response personnel capability/alignment (e.g., effective compacts for sharing personnel across borders); Providing for extraordinary competencies (e.g., crisis communications for emergency response); Establishing procedures for credentialing volunteers; and Addressing other legal issues associated with the use of personnel in disasters, such as liability for injury. Cross-Border Preparedness Training Appendix B ii
Appendix C Survey of Lessons Learned Cross-Border Preparedness Lessons Learned, Applications for Future Trainings and Partnerships What are the lessons learned and best practices that your CPHP has experienced regarding the planning, conducting, and evaluation of cross-border preparedness training that would be useful to others? Your lessons learned should be outlined within the context of the categories listed below. To respond, type your lessons learned under the appropriate category and include the name of all CPHP related activities/courses, along with the relevant contact person for each category. Save the document and return it to Rachel Shnekendorf rshnekendorf@asph.org) by no later than July 1, 2005. Planning Cross-Border Training Activities I. Assessing the Training Needs- please describe the methods/ approaches you have found to be most helpful in assessing priority training needs related to cross-border preparedness. II. Planning- please describe the methods/approaches you have found to be most helpful in Joint Planning (across geographical/agency or other jurisdictions) III. Topics- Related to the following topic areas, please describe the approaches you have used and the successes/challenges you have encountered. Topic Area Public Health Law Considerations Public Health Personnel Classification Systems and Taxonomies Approaches Used to Address Topic Successes/Challenges IV. Formats and Technologies Used-Please describe the formats and technologies you have used for delivery of cross-borders preparedness training. V. Evaluation of Cross-Border Training- Please describe approaches you have used to evaluate the success of the training. IV. Future recommendations- regarding Cross-Border training in preparedness iii Cross-Border Preparedness Training Appendix C
Appendix D Cross-Border Preparedness Training Contacts State Georgia Iowa Louisiana Michigan Minnesota Missouri Ohio Pennsylvania Texas Washington Center Southeastern Center for Emerging Biologic Threats Emory University www.secenterbiothreats.org Tonya Dixon, (404) 712-2452, tthorst@emory.edu Upper Midwest Center for Public Health Preparedness University of Iowa College of Public Health www.public-health.uiowa.edu/icphp Laurie Walkner, (319) 335-6836, laurie-walkner@uiowa.edu outh Central Center for Public Health Preparedness Tulane University School of Public Health and Tropical Medicine & University of Alabama-Birmingham School of Public Health www.southcentralpartnership.org/preparedness Ann Anderson, (504) 588-5397, ann.anderson@tulane.edu Michigan Center for Public Health Preparedness University of Michigan School of Public Health www.mipreparedness.org Yael Hoffman, (734) 615-9057, yhoffman@umich.edu University of Minnesota Center for Public Health Preparedness University of Minnesota School of Public Health www.sph.umn.edu/umncphp Amy Scheller, (612) 624-3962, sche0526@umn.edu Heartland Center for Public Health Preparedness Saint Louis University School of Public Health www.heartlandcenters.slu.edu/ hc_preparedness.htm J.P. Mayer, (314)-721-2684, mayerjp@slu.edu Ohio Center for Public Health Preparedness Ohio State University School of Public Health Frank Holtzhauer, (614) 293-9406, holtzhauer.2@osu.edu University of Pittsburgh Center for Public Health Preparedness University of Pittsburgh Graduate School of Public Health www.cphp.pitt.edu/upcphp Margaret Potter, (412) 383-2400, mpotter@pitt.edu Center for Biosecurity and Public Health Preparedness The University of Texas School of Public Health at Houston www.texasbiosecurity.org Robert Joyce, (713) 500-9427, Robert.T.Joyce@uth.tmc.edu Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine healthlinks.washington.edu/nwcphp/cphp Luann D Ambrosio, (206) 685-1130, ldambr@u.washington.edu Cross-Border Preparedness Training Appendix D iv