Partnerships at Work in Public Health Planning

A key goal of the Virginia Department of Health’s emergency preparedness and response program is the identification and resolution of lessons learned through an aggressive drill and exercise program.  The sharing of best practices among the Commonwealth’s thirty-five health districts is an important component of the agency’s approach, which strongly encourages the standardization of plans and procedures, cross-jurisdictional interoperability, the minimization of costs – by avoiding duplicative efforts, for example – and the adoption of already proven strategies. 

In 2007, the VDH sponsored more than 40 state, regional, and local health-centric exercises. The department also participated in numerous exercises conducted by other agencies in which the VDH’s engagement was deemed appropriate. A well planned and well executed exercise almost always results in better coordination among all of the organizations and individuals involved – from senior elected officials and budget planners to community-based volunteer and non-profit organizations.  The health-centric exercises carried out by the Commonwealth, for example, have demonstrated that pandemic-response decisions not only affect and relate to numerous continuity-of-government issues but also require, partly for that reason, an in-depth examination of the legal authorities and ethical decisions that also are involved. 

Untested options on the delegation of authority, succession plans, absenteeism, social distancing, public countermeasures, resource prioritization, and post-event reconstitution must all be carefully thought through and addressed as expeditiously as possible. Sharing the lessons learned in the exercises completed and adjusting already-proven principles against a pandemic threat will go a long way to ensure that policy and planning needs are satisfied.  As difficult as decisions on such matters will be to make, the resolution of identified enhancement items will help decision-makers from the private sector as well as government sectors – and not only those involved in and/or under the jurisdiction of public health – be better prepared to meet the needs that have become apparent. But the goal will still be the same: to better serve the citizens of Virginia and the Commonwealth’s work force in future times of emergency.

Hurricanes, Shelter Plans, and Special Medical Needs

Without the detailed planning and affirmation of operational procedures made possible through inter-agency, multi-sector cooperation, training, and exercises, VDH’s capability to deliver needed assets to responders, and to the Commonwealth’s population at large, would be less than optimal. Neither VDH nor any other government agency is or can be independently effective in dealing with mass-casualty all-hazards events. Success can be achieved only through a network of working relationships linking the private sector with the Commonwealth’s emergency-management and homeland-security agencies.

The Metropolitan Medical Response System (MMRS), a strong supporter of VDH programs – and an organization through which many forward-looking initiatives have been made possible – provides an excellent example of how the partnership works.  Given Virginia’s vulnerability to hurricanes, the capability to shelter and/or evacuate medically fragile citizens is always a high priority. At the direction of Governor Timothy Kaine, the Commonwealth recently created new state-managed shelter plans that individually and collectively spell out the organizational structure, coordination needs, activation process, and operational support required for the administration of a general population shelter in which a special-medical-needs component is co-located.

State-managed shelters may be opened by the issuance of a “Governor’s Emergency Declaration” or as a mission assignment postulated by the Virginia Emergency Operations Center. The shelter plans previously mentioned are intended to be implemented if a large segment of the Commonwealth’s population has to be evacuated from a region – the Tidewater area, for example – when the sheltering capabilities of local and/or neighboring jurisdictions either are not available or already have been (or are reasonably expected to be) exceeded.

A Crosswalk Document for Community-Care Facilities

Virginia also recently enacted legislation requiring the preparation and promulgation of emergency plans by certain community-care institutions – specifically including nursing homes, assisted living facilities, and group homes. Not all of these facilities developed comprehensive emergency plans in the past, and some may not have the staff expertise required to develop an in-depth emergency preparedness program on their own.  However, significant progress in this area has been made over the past year and the facilities involved are being encouraged to ensure that their plans include adequate all-hazards response, evacuation, and sheltering provisions. 

To help in that effort, a “crosswalk document” listing not only the Commonwealth’s regulatory requirements but also the emergency-planning best practices recommended for a broad range of facilities has been developed and will soon be available for use. The crosswalk document was developed under the direction of the Virginia Department of Emergency Management, which worked in close cooperation with the Virginia Emergency Management Agency (which was particularly helpful in the completion of this initiative) and the Commonwealth’s Departments of Health, Social Services, Education, and Mental and Behavioral Health.

Through a comprehensive exercise program and collaborative public-private partnership, marked improvement is already apparent.  The examples cited all demonstrate the detailed degree of planning, networking, and operational proficiency that is required for preparedness and response efforts to be effective at all levels of government, anywhere in the nation.

Steven Harrison

Steven A. Harrison is the assistant director – emergency operations, logistics, and planning – for the Commonwealth of Virginia’s Department of Health. His principal duties involve: (a) various tasks related to and/or requiring a working knowledge of both Chempack and the Strategic National Stockpile; and (b) execution of Virginia’s own Hurricane Preparedness and Exercise Program. He also collaborates with other policy makers and decision making officials on the Cities Readiness Initiative and State Managed Shelter planning. Harrison, a graduate of the College of William and Mary, also holds a Master Exercise Practitioner certification and is pursuing a Master’s Degree in Homeland Security.



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