Section IV: Healthcare Systems

PIRA_Section IV: Healthcare Systems_TEST - FINAL
Form Approved
OMB Number: 0920-0879
Expiration Date: 03/31/2018

Introduction
Background
The 2009 H1N1 influenza pandemic underscored the importance of communities
being prepared for potential threats to public health security. Because of its
unique abilities to respond to infectious, occupational, or environmental incidents,
the Centers for Disease Control and Prevention (CDC) plays a pivotal role in
ensuring that state and local public health systems are prepared for these and
other public health incidents.
The identification of the novel influenza A (H7N9) virus illnesses in China in 2013
highlights the importance of influenza pandemic preparedness. To date, the
reported case fatality ratio from human H7N9 infections is more than 30%.
Should the H7N9 virus mutate to allow for sustained human-to-human
transmission, it appears capable of causing severe disease in all ages. To better
prepare for such a scenario, it is important to understand the collective ability of
our nation to prepare for and respond to a pandemic of substantially different
epidemiology than the 2009 H1N1 pandemic.
State and local public health departments are first responders for public health
incidents. To better prepare these agencies to respond, CDC provides funding
and technical assistance for state, local, and territorial public health departments
through the Public Health Emergency Preparedness (PHEP) cooperative
agreement. CDC’s Public Health Preparedness Capabilities: National Standards
for State and Local Planning provide national standards that help state and local
public health departments strengthen their ability to respond to all hazards,
including influenza pandemics, and build more resilient communities. Consistent
with this approach, the following Pandemic Preparedness Readiness
Assessment for State and Local Public Health Planners specifically aligns with 11
public health preparedness capabilities and administrative preparedness
planning goals.
Overview
The Pandemic Preparedness Readiness Assessment for State and Local Public
Health Planners promotes state, local, and territorial public health preparedness
and immunization program collaboration through the administration of a self-

assessment designed to measure jurisdictional readiness to respond to an
influenza pandemic. Although the content of this assessment does not
encompass every contingency or element necessary to effectively respond to an
influenza pandemic, CDC technical experts in differing programs have helped to
arrange content within the following seven priority planning areas:
1.
2.
3.
4.
5.
6.
7.

Vaccination Planning
Epidemiology and laboratory
Medical Care and Countermeasures
Healthcare Systems
Community Mitigation
Public Information and Communication
Public Health and Immunization Workforce

Information collected from the assessment will not be used to score or
competitively rank public health emergency preparedness or immunization
programs. Rather, this assessment is designed to identify preparedness gaps,
as well as promising state, local, and territorial preparedness practices.
Assessment results will be used by the CDC to inform technical assistance and
future program improvement initiatives.
Definitions
Allocation: Amount of pandemic influenza vaccine available for ordering.
Allocating: Process of dividing available vaccine among CDC’s PHEP awardees
or among registered pandemic influenza vaccine providers and facilities within an
awardee’s jurisdiction.
Critical infrastructure personnel (CIP): The full list of CIP is defined in Guidance
on Allocating and Targeting Pandemic Influenza Vaccine; U.S. Department of
Health and Human Services (HHS)/U.S. Department of Homeland Security
(DHS); 2008 Guidance on Allocating and Targeting Pandemic Influenza Vaccine
Distribution: The process of transporting pandemic influenza vaccine from one
location to another.
Enrollment: The process of enabling registered healthcare providers and facilities
to legally provide pandemic influenza vaccine.
Ordering: Process of requesting pandemic influenza vaccine from either the
federal, state, city, or local government. Orders can be placed against an
allocation or independent of allocation.
Non-pharmaceutical interventions (NPIs): Those interventions that can mitigate
transmission of influenza and do not involve medical countermeasures. NPIs

include voluntary home isolation, school closures, respiratory etiquette, hand
hygiene, and routine cleaning of frequently touched surfaces and objects.
Peak vaccine administration capacity: The highest rate at which a jurisdiction is
able to provide pandemic influenza vaccine to its population; CDC recommends a
peak vaccine administration capacity of at least 10% of the population per week.
Point of dispensing (POD) / mass vaccination clinic: Location for dispensing
medical countermeasures, specifically for vaccine, during an influenza pandemic
response. Located in a public or private space, this clinic is designed to
vaccinate a large group of persons over a short time period. The POD or clinic
might target the entire population or people in specific priority or high-risk groups.
Public and/or private entities can manage a POD or clinic.
Closed POD: Point of dispensing/vaccination clinic closed to the general public
and open only to a specific group (e.g., staff of a participating business or
healthcare personnel in a specific hospital).
Open POD: Point of dispensing/vaccination clinic open to the general public,
specifically to provide vaccine, during an influenza pandemic response.
Recruitment: The process of soliciting healthcare providers and facilities
interested in and willing to provide pandemic influenza vaccine.
Registration: The submission of required information, similar to an application, by
healthcare providers or facilities interested in providing pandemic influenza
vaccinations.
Retail-based clinics: Non-pharmacy businesses that sell retail products (e.g.,
Walmart, Target) and serve as PODs/mass vaccination clinics.
School-located vaccination clinics: Vaccination clinics that target students and
are typically held on school grounds.
Public reporting burden of this collection of information is estimated to average 30 minutes per
response, including time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing information. An agency may not
conduct or sponsor, and a person is not required to respond to a collection of information unless it
displays a currently valid Office of Management and Budget control number. Send comments
regarding this burden estimate, or any other aspect of this information collection, including
suggestions for reducing this burden to CDC/Agency for Toxic Substance and Disease Registry
Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333;
Attention: PRA (0920-0879).

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Section IV: Healthcare Systems
Goal: Awardee healthcare systems will be fully prepared and integrated with
public health and emergency management during an influenza pandemic
response.
Assumptions: During a severe influenza pandemic, healthcare systems may
experience:
• A surge in patients;
• Shortages of equipment and supplies, including medications; and
• Significant staff absenteeism.
(End of Page 2)

Section IV: Healthcare Systems
Please select your jurisdiction:

mAlabama
mAlaska
mAmerican Samoa
mArizona
mArkansas
mCalifornia
mChicago
mColorado
mCommonwealth of the Northern Mariana Islands
mConnecticut
mDelaware
mFederated States of Micronesia
mFlorida
mGeorgia
mGuam
mHawaii
mIdaho
mIllinois
mIndiana
mIowa
mKansas

mKentucky
mLos Angeles County
mLouisiana
mMaine
mMaryland
mMassachusetts
mMichigan
mMinnesota
mMississippi
mMissouri
mMontana
mNebraska
mNevada
mNew Hampshire
mNew Jersey
mNew Mexico
mNew York
mNew York City
mNorth Carolina
mNorth Dakota
mOhio
mOklahoma
mOregon

mPennsylvania
mPuerto Rico
mRepublic of Palau
mRepublic of the Marshall Islands
mRhode Island
mSouth Carolina
mSouth Dakota
mTennessee
mTexas
mU.S. Virgin Islands
mUtah
mVermont
mVirginia
mWashington
mWashington, DC
mWest Virginia
mWisconsin
mWyoming

Please select your position:
mPHEP Director
mHealthcare Preparedness Program Director
mOther (please specify) ____________________

(End of Page 3)

Section IV: Healthcare Systems
1. Does your jurisdiction recommend plans to reduce the surge on both hospital
emergency departments and acute care units?
mYes
mNo, but in development
mNo >>>> Skip to Page 6: 3. Which methods do your plans recommend to
assist healthcare systems within your jurisdiction to address significant staff
absenteeism because of illness or the need to care for family (please check all
that apply)?

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Section IV: Healthcare Systems
2. If yes, please check the methods of surge reduction your jurisdiction
recommends in plans:
(Alternate care systems*: Use of messaging and triage systems to direct patients
to the level of care appropriate to meet their needs)
qImmediate Bed Availability (IBA)
qEssential healthcare services
qAlternate care systems* (please specify) ____________________
qStressing use of appropriate healthcare partners (pharmacy, private, and
public healthcare clinics, physical practices, and mental health)
qOther (please specify) ____________________

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Section IV: Healthcare Systems
3. Which methods do your plans recommend to assist healthcare systems within
your jurisdiction to address significant staff absenteeism because of illness or the
need to care for family (please check all that apply)?
qPlans do not include recommendations around staff absenteeism
qEmergency System for Advanced Registration of Volunteer Health
Professionals (ESAR-VHP)
qMedical Reserve Corps
qPublic health mutual aid system
qHealthcare Preparedness Program (HPP) mutual aid system
qState emergency response team
qState nurses response team
qOther (please specify) ____________________

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Section IV: Healthcare Systems
4. Has your jurisdiction’s state Strategic National Stockpile (SNS) coordinator
communicated with key stakeholders to ensure they know what SNS assets they
may receive during a pandemic
mYes
mNo, but in development
mNo

>>>> Skip to End Page: Survey Submitted

(End of Page 7)

5. Please indicate all partners that have been integrated in the state or
jurisdictional SNS planning (please check all that apply).
qLocal public health
qEmergency management
qHealthcare facilities and/or systems (e.g., hospital systems, Federally
Qualified Health Centers, etc.)
qPublic health mutual aid system
qHPP mutual aid
qESAR-VHP Strike Team
qState emergency response team
qState nurses response team
qOther (please specify) ____________________

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