How Local Health Departments Utilize PHEP Funding When Preparing For and Responding to a Public Health Emergency

NYC DHMH trains volunteers for Ebola outreach and education

NYC DHMH trains volunteers for Ebola outreach and education

Since 2002, the Centers for Disease Control and Prevention (CDC) Public Health Emergency Preparedness (PHEP) grant has provided support to public health departments across the nation, allowing them to build and strengthen their ability to respond to public health threats. At the local level, this investment has enabled local health departments (LHDs) and their partners to build preparedness capacity and enhance preparedness infrastructure. For example, many health departments use PHEP funding to support dedicated preparedness staff who work with community organizations such as hospitals, public safety, and municipal partners to develop all-hazards responses plans and conduct trainings and exercises. Others have utilized PHEP funding to establish and maintain the systems that enable early detection of diseases, rapid information sharing and public notification, and accountability for emergency response resources. As a result of these efforts, communities are more resilient and better prepared to respond to a wide range of threats.

Below are examples of how three LHDs utilized PHEP funding to prepare for and respond to recent public health emergencies:

2014-2015 Ebola Response – New York City Department of Health and Mental Hygiene
To prepare for a potential Ebola case, the New York City Department of Health and Mental Hygiene (NYC DHMH) partnered with the New York Department of Health, New York City Emergency Management, the Fire Department of New York City, emergency medical services (EMS), hospitals, and other healthcare facilities to develop and implement monitoring and response plans. A critical component of the plan was actively monitoring travelers who originated from one of the affected areas of West Africa. As of June 2015, over 3,200 individuals were screened at John F. Kennedy International Airport as they returned to the United States. Of those individuals, the LHD actively monitored 2,200 individuals, tested at least nine individuals who were considered persons of interest, successfully quarantined at least three individuals, and confirmed one case of Ebola — a doctor who returned home to New York City after volunteering in Guinea. In addition, NYC DHMH dispatched community outreach teams, including trained LHD staff members, to distribute over 100,000 “Am I at Risk” palm cards. These outreach teams canvassed 14 neighborhoods by going door-to-door answering questions from community members.

2014 Washington State Mudslide – Snohomish Health District
On Saturday, March 22, 2014, a massive mudslide buried a rural town in Snohomish County, WA. The mile long mudslide piled 15 million cubic yards to mud, clay, and wood across the Stillaguamish River, State Highway 530, and into a community of homes. The response relied heavily on Snohomish Health District working with community partners, including environmental health, law enforcement, EMS, and the medical examiner’s office to ensure the safety of food supplies for responders, conduct sanitation testing, and assess health concerns related to environmental exposures. The coordinated response was enabled by partnerships that had been built over time through participation in multi-agency trainings, exercises, and drills.

2013 Boston Marathon Bombing – Boston Public Health Commission’s Office of Public Health Preparedness
Each year on the day of the Boston Marathon, the Medical Intelligence Center (MIC), which serves as the department’s emergency operations center, is activated to support marathon activities. During the 2013 Boston Marathon, two bombs exploded near the finish line causing the MIC to transition from “usual” marathon activities like supporting injured runners to fatality management. Staffed by an interagency team led by the Boston Public Health Commission, the MIC successfully coordinated 236 patients transports to nine area hospitals within one hour of the response. An additional 800 people received care at the medial tent near the finish line, reducing the burden on emergency transport and preventing hospital surge. The Boston Public Health Commission was also in charge of coordinating family reunification, thereby working closely with their healthcare partners to ensure patient information was entered into appropriate systems as accurately as possible. In the weeks following the marathon, the Office of Public Health Preparedness also worked with other public health partners to dispatch over 200 mental health resources to those who had been affected by the bombing to conduct psychological first aid, post-traumatic stress management, and spiritual and emotional care.

Sustaining Investment in Local Public Health Emergency Preparedness
As the above examples demonstrate, LHDs have a critical role in preparing their communities for and responding to all-types of threats. PHEP funding supports LHDs to collaborate with partners to assess risks and prepare their community for all-hazards events. However, decreases in PHEP funding may threaten their ability to sustain current preparedness efforts and address emerging threats such as MERS CoV and the impacts of climate change. Since 2007, federal funding for the PHEP program has been cut by more than 30 percent. As reported in NACCHO’s 2013 National Profile of Local Health Departments, funding for emergency preparedness has dropped significantly, from $2.07 per capita in 2010 to $1.15 per capita in 2013. With more than 55 percent of LHDs relying solely on federal funding for emergency preparedness, continued funding deceases to both state and local health departments may have direct consequences on our nation’s ability to effectively prepare for, respond to, and recover to public health emergencies.

To read the full issue brief highlighting the impact PHEP funding has on LHDs’ capabilities, capacity, and response, click here.  Also, please let us know in the comments section below how PHEP funding has impacted your community’s ability to prepare for, respond to, or recover from a public health emergency.

NACCHO would also like to thank the following individuals for contributing content for the final report and discussing the impacts PHEP funding has had on LHDs’ preparedness capabilities:

  • Alison Jaffe-Doty, Public Health-Seattle & King County
  • Atyia Martin, Boston Public Health Commission
  • Carina Elsenboss, Public Health-Seattle & King County
  • Christopher Paquet, New York City Department of Health and Mental Hygiene
  • Julie Miller, Knox County Health Department (Ohio)
  • Michele Askenazi, Tri-County Health Department (Colorado)
  • Nancy Furness, Snohomish Health District (Washington)
  • Prachee Patel, New York City Department of Health and Mental Hygiene

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