Healthcare and the National Preparedness System

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Healthcare and the National Preparedness System

• 2007 Public Health Preparedness Conference
• Current Issues in Public Health Preparedness

• Columbia, MO
• September 26-27, 2007

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Michael W. Proctor, M.D.

• Regional Director of Extramural Training
• The University of Texas Health Science
  Center-Houston
• Center for Biosecurity and Public Health
  Preparedness

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Healthcare the National Preparedness System

• EDUCATIONAL OBJECTIVES

• Following the completion of this program, the
  audience will be able to
• Enumerate the components of the National
  Preparedness System.
• Describe how the various components of the
  National Preparedness System interconnect.
• Discuss the origins of the components of the
  National Preparedness System.
• Discuss the interaction of the Target Capability
  List in healthcare and public health planning and
  response.
• Describe the impact of the National Preparedness
  System especially the Target Capabilities List on
  current practice.

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Hey Johnny! This lady wants to know the
difference in all these fertilizers!
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Preparedness

• Build, sustain and improve the operational
  capability
• To prevent
• To protect against
• Respond to
• Recover from
• terrorist attacks, major disasters, and other
  emergencies.

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Preparedness

• Planning, training, and exercises.
• Personnel qualification and certification
  standards.
• Equipment acquisition and certification
  standards.
• Publication management processes and activities.

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National Preparedness System

• Developed under the authority of
• Homeland Security Act of 2002
• Presidential Directives HSPD 5, HSPD 8
• Comprised of six documents.
• National Preparedness Goal
• Planning Scenarios
• Universal Task List
• Target Capabilities List
• National Response Plan (NRP)
• National Incident Management System (NIMS)

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Homeland Security Presidential Directive (HSPD)
5

• Purpose
• To enhance the ability of the United States to
  manage domestic incidents by establishing a
  single, comprehensive national incident
  management system.
• To prevent, prepare for, respond to, and recover
  from terrorist attacks, major disasters, and
  other emergencies, the United States Government
  shall establish a single, comprehensive approach
  to domestic incident management.

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Homeland Security Presidential Directive (HSPD)
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Directed Sec. DHS to develop and administer

• National Incident Management System (NIMS)
• Core set of concepts, principles and
  terminology for incident command and multi-agency
  coordination
• National Response Plan (NRP)
• All-discipline, all-hazards plan

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Homeland Security Presidential Directive (HSPD)
8

• Defines
• All-hazards preparedness
• Domestic terrorist attacks
• Major disasters
• Other emergencies

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Homeland Security Presidential Directive (HSPD)
8

• First responder
• Law Enforcement
• Fire Service
• EMS
• Emergency management
• Public health
• Healthcare / clinical care
• Public works
• Skilled support personnel

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The National Priorities
Overarching Priorities

• Implement the National Incident Management System
  and National Response Plan.
• Expanded Regional Collaboration.
• Implement the Interim National Infrastructure
  Protection Plan.

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The National Priorities
Capability-Specific Priorities

• Strengthen Information Sharing and Collaboration
  capabilities.
• Strengthen Interoperable Communications
  capabilities.
• Strengthen CBRNE Detection, Response, and
  Decontamination capabilities.
• Strengthen Medical Surge and Mass Prophylaxis
  capabilities.

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National Preparedness System

• National Preparedness Goal
• Planning Scenarios
• National Incident Management System (NIMS)
• National Response Plan (NRP)
• Universal Task List
• Target Capabilities List

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National Preparedness System

• National
• Preparedness Goal

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Always listen to good advice...
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National Preparedness System
National Preparedness Goal

• Created under Homeland Security Presidential
  Directive (HSPD)-5
• Establishes a vision, capabilities, and
  priorities for national preparedness
• Utilized in conjunction with the three
  capabilities-based planning tools referenced in
  the Goal
• National Planning Scenarios,
• Universal Task List (UTL),
• Target Capabilities List (TCL)

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National Preparedness Goal

• Developed with extensive coordination with other
  Federal departments and agencies and consultation
  with
• State
• Local
• Tribal Governments
• The Private Sector
• Non-Governmental Organizations (NGOs).

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National Preparedness Goal
National Preparedness System

• Reorients how the Federal government proposes to
  strengthen preparedness of the USA to
• To prevent,
• To protect against
• Respond to,
• Recover from
• terrorist attacks, major disasters, and other
  emergencies.

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National Preparedness Goal

• The vision acknowledges that
• National preparedness is a shared responsibility.
  
• Each partner has a role to play.
• Governmental entities are responsible for leading
  efforts within their borders and involving
• The private sector
• Non-governmental organizations
• Citizens
• Preparedness involves four mission areas of
  prevention, protection, response, and recovery
• National preparedness involves not only achieving
  but sustaining capability at target levels

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National Preparedness Goal

• The Goal provides the means for the Nation to
  answer three fundamental questions
• How prepared are we?
• How prepared do we need to be?
• How do we prioritize efforts to close the gap?

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National Preparedness Goal

• These documents are not
• Micro-level plans that tell officials how to
  execute their assigned missions
• They do not impose a specific array of assets on
  each community
• They do not impose or a specific funding formula
  on each program

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National Preparedness Goal

• These documents identify core capabilities.
• Achievement
• Sustainment
• will transform the investment of homeland
  security funding in order to achieve the highest
  possible readiness.

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National Preparedness System

• NATIONAL PLANNING
• SENARIOS

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Always be ready for any surprises in life...
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NATIONAL PLANNING SCENARIOS

• Coordinated by the Homeland Security Council
  (HSC) in partnership with the Department of
  Homeland Security (DHS)
• 15 all-hazards planning scenarios for use in
  Federal, State, and local preparedness
  activities.
• Designed to be the foundational structure for the
  development of national preparedness standards
  from which homeland security capabilities can be
  measured
• Represent threats or hazards of national
  significance with high consequence.
• Analytical effort by federal homeland security
  experts, with reviews by state and local homeland
  security representatives

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NATIONAL PLANNING SCENARIOS

• Scenario 1 Nuclear Detonation 10-KT
  Improvised Nuclear Device
• Scenario 2 Biological Attack Aerosol
  Anthrax
• Scenario 3 Biological Disease Outbreak
  Pandemic Influenza
• Scenario 4 Biological Attack Plague
• Scenario 5 Chemical Attack Blister Agent
• Scenario 6 Chemical Attack Toxic
  Industrial Chemicals
• Scenario 7 Chemical Attack Nerve Agent
• Scenario 8 Chemical Attack Chlorine Tank
  Explosion
• Scenario 9 Natural Disaster Major
  Earthquake
• Scenario 10 Natural Disaster Major
  Hurricane
• Scenario 11 Radiological Attack Radiological
  Dispersal Devices
• Scenario 12 Explosives Attack Bombing Using
  Improvised Explosive Devices
• Scenario 13 Biological Attack Food
  Contamination
• Scenario 14 Biological Attack Foreign Animal
  Disease
• (Foot and Mouth Disease)
• Scenario 15 Cyber Attack

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NATIONAL PLANNING SCENARIOS
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NATIONAL PLANNING SCENARIOS
Scenario Outline Each scenario in the National
Planning Scenarios follows the same general
outline, which is as follows

• Scenario Overview
• - General Description
• - Detailed Scenario

• Planning Considerations
• - Geographical Considerations
• - Timeline/Event Dynamics
• - Assumptions
• - Mission Areas Activated

• Implications
• - Secondary Hazards/Events
• - Fatalities/Injuries
• - Property Damage
• - Service Disruption
• - Economic Impact
• - Long-Term Health Issues

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National Preparedness System

• National Incident Management System
• (NIMS)

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Don't let the situation confuse you...
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National Preparedness System

• National Incident Management System

• a consistent nationwide approach for federal,
  state, tribal, and local governments to work
  effectively and efficiently together to prepare
  for, prevent, respond to, and recover from
  domestic incidents, regardless of cause, size, or
  complexity.
• (HSPD-5)

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National IncidentManagement System

• Key Concepts
• A nationwide system applicable to all levels of
  government
• Focus on interoperability and compatibility
• National standardization

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National Incident Management System (NIMS)

• NIMS is not

• An operational incident management plan
• A resource allocation plan
• A terrorism / WMD-specific plan
• Designed to address international events

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National Incident Management System

• NIMS is

• A core set of
• Doctrine
• Concepts
• Principles
• Terminology
• Organizational processes
• Applicable to all hazards !

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NIMS Components

• Command and Management
• Preparedness
• Resource Management
• Communications and Information Management
• Supporting Technologies
• Ongoing Management and Maintenance

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National Incident Management System

• Command and Management

• Incident Command System
• Multi-agency Coordination Systems
• Public Information Systems

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National Incident Management System
Incident Command System

• Developed by an interagency task force working in
  a cooperative local, state, and federal
  interagency effort called FIRESCOPE in the 1970s
• Proven on-scene, all-hazard concept
• Interdisciplinary and organizationally flexible
• Appropriate for all types of incidents
• ICS represents organizational best practices
  and has become the standard for incident response
  across the country

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National Incident Management System
Command and Management (ICS)

• Common terminology
• Organizational resources
• Manageable span of control
• Organizational facilities
• Use of position titles
• Reliance on an Incident Action Plan
• Integrated communications
• Accountability

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National Incident Management System
Incident Command System

• ICS requires
• Common terminology
• standard titles for facilities
• standard titles of positions
• Clear text
• Discourages use of agency specific codes or
  jargon
• Plain English

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National Incident Management System
Incident Command System

• Organizational resources
• Includes
• Personnel
• Facilities
• Equipment and supplies
• Requires typing by capability

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National Incident Management System
Incident Command System

• Manageable span of control
• From 3 to 7 reporting elements per supervisor
• 5 reporting elements per supervisor is optimum

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National Incident Management System
Incident Command System

• Incident Action Plan (IAP)
• Communicate incident objectives
• Are based on operational periods
• Are disseminated throughout the incident
  organization

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National Incident Management System
Incident Command System

• Integrated communications
• Hardware systems
• Planning for use of all frequencies and resources
• Procedures for transferring information
  internally and externally

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National Incident Management System
Command and Management

• Incident Command System (ICS)
• Multi-agency Coordination Systems
• Multiple concurrent incidents.
• Incidents that are non-site specific, such as
  biological terrorist incidents.
• Incidents that are geographically dispersed.
• Incidents that evolve over time.

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National Incident Management System
Incident Command System (ICS)
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National Incident Management System
Unified Command Representatives From Local
Jurisdictions (Law Enforcement, Fire Service,
EMS, etc.)
Operations
Planning
Logistics
Finance
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National Incident Management System
Area Command

• A system established to
• Oversee the management of multiple incidents that
  are each being managed by an ICS organization
• Oversee the management of large incidents that
  cross jurisdictional boundaries

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National Incident Management System
Area Command

• Particularly relevant to public health
• emergencies because these incidents
• are typically
• Non-site specific
• Not immediately identifiable
• Geographically dispersed and evolve over time

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National Incident Management System
Area Command

• Functions
• Sets overall strategy and priorities.
• Allocates critical resources according to the
  priorities.
• Ensures that incidents are properly managed.
• Ensures that objectives are met.
• Ensures that strategies are followed.

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National Incident Management System
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National Incident Management System
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National Incident Management System
Preparedness

• What Is Preparedness?
• Actions to establish and sustain prescribed
  levels of capability
• Ensures mission integration and interoperability

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National Incident Management System
Preparedness
Planning
Corrective Actions
Evaluating
Continual Cycle
Training
Exercising
Equipping
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National Incident Management System
Preparedness Planning

• Plans describe how resources will be used.
• Plans describe mechanisms for
• Setting priorities
• Integrating entities/functions
• Establishing relationships
• Ensuring that systems support all incident
  management activities

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National Incident Management System
Preparedness

• Planning, training, and exercises
• Personnel standards
• qualification
• certification
• Equipment acquisition certification standards
• Publication management processes
• Mutual Aid
• Emergency Management Assistance Compacts
  (EMAC)

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National Incident Management System
Preparedness Planning

• Types of Plans
• Emergency Operations Plans
• Procedures
• Preparedness Plans
• Corrective Action and Mitigation Plans
• Recovery Plans

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National Incident Management System
Personnel Qualifications Certification

• Development of standards including
• Training
• Experience
• Credentialing
• Currency requirements
• Physical and medical fitness

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National Incident Management System
Equipment Certifications

• Facilitate development of national equipment
  standards, guidelines, and protocols
• Review and approve equipment meeting national
  standards

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National Incident Management System
Publication Management

• The development of naming and numbering
  conventions
• Review and certification of publications
• Methods for publications control
• Identification of sources and suppliers for
  publications and related services
• Management of publication distribution

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National Incident Management System
Mutual Aid Emergency Management Assistant
Compacts (EMACs)

• Jurisdictions at all levels are encouraged
• to enter into agreements with
• Other jurisdictions
• Private-sector
• Non-Governmental Organizations (NGOs)
• Private organizations

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National Incident Management System
Training and Exercises

• The NIMS Integration Center will
• Facilitate development and dissemination of
  national standards, guidelines, and protocols.
• Facilitate use of modeling/simulation.
• Define general training requirements and approved
  courses.
• Review / approve discipline-specific training
  requirements.

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National Incident Management System

• Preparedness

• Continuous cycle of
• Planning
• Training
• Equipping
• Exercising
• Evaluating
• Taking action to correct and mitigate
• Linked to HSPD-8

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National Incident Management System
Resource Management

• Coordination and oversight of
• Tools.
• Processes.
• Systems.
• NIMS affects the way resources are
• managed.

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National Incident Management System
Resource Management

• Four primary tasks
• Establishing systems
• Activating the systems
• Dispatching resources
• Deactivating resources

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National Incident Management System
Resource Management Concepts

• Standardize identification, allocation and
  tracking
• Classify by kind and type
• Implement credentialing system
• Incorporate resources from private sector and
  Non-Governmental Organizations (NGOs)

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National Incident Management System
Resource Management Principles

• Advance planning
• Resource identification and ordering
• Resource categorization
• Use of agreements
• Effective management

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National Incident Management System
Communications and Information Management

• NIMS identifies requirements for
• Communications
• Information management
• Information sharing

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National Incident Management System
Communications and Information

• Facilitate a common operating picture for
• Incident management
• Information management
• Interoperability standards

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National Incident Management System
Communications Information Management

• Principles
• Common operating picture
• Accessible across jurisdictions and agencies
• Common communications and data standards

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National Incident Management System
Supporting Technologies

• NIMS provides systems to standardize
• Voice and data communications
• Information management
• Data displays

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National Incident Management System
Supporting Technology

• Principles
• Interoperability and compatibilities
• Technology support
• Technology standards
• Broad-based requirements
• Strategic planning and Research Development

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National Incident Management System
Ongoing Management and Maintenance

• National Integration Center (NIC)
• Provide strategic direction for and oversight of
  NIMS
• Supports routine maintenance continuous
  refinement of the system
• http//www.fema.gov/nims
• http//www.nimsonline.com/

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Relationship NIMS and NRP
NIMS aligns command, control, organization
structure, terminology, communication protocols,
resources and resource-typing for synchronization
of response efforts at all echelons of government.
National Incident Management System (NIMS)
Used for all events
Incident
DHS integrates and applies Federal resources
both pre and post incident.
Local Response
Resources, knowledge, and abilities from
Federal departments agencies.
State Response or Support
Federal Response or Support
National Response Plan (NRP)
Activated forincidents of national significance.
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National Preparedness System

• National Response Plan
• (NRP)

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Always look at where you're going...
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National Preparedness System

• National Response Plan (NRP)

• The NRP is built on the template of the National
• Incident Management System. It provides the
  structure
• and mechanisms for coordinating federal support
  to
• state, local and tribal incident managers

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The National Response Plan

• Homeland Security Presidential Directive- 5
  (HSPD-5) directed that a new National Response
  Plan be developed to

• Align Federal coordinating structures,
  capabilities, and resources
• Ensure an all-discipline and all-hazards approach
  to domestic incident management

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National Response Plan

• Key Concepts
• Single comprehensive national approach
• Federal coordination structures/mechanisms
• Direction for incorporation of existing plans
• Consistent approach to managing incidents

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The National Response Plan

• Uses NIMS to establish a framework for
  coordination among Federal, State, local, tribal,
  nongovernmental, and private-sector organizations
• Addresses the complete spectrum of incident
  management activities
• Builds on what works from previous plans and
  incident response
• Forges new approaches and mechanisms to address
  todays threats

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The National Response Plan

• The NRP incorporates relevant portions of, and
  upon full implementation, supersedes, the
  following plans
• Federal Response Plan (FRP)
• Interagency Domestic Terrorism Concept of
  Operations Plan (CONPLAN)
• Federal Radiological Emergency Response Plan
  (FRERP)
• National Contingency Plan (NCP)
• Incorporates key concepts from NIMS, HSOC, PFO,
  JFO, Emergency Support Functions (ESFs)

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Components of NRP
BASE PLAN
Concept of Operations, Coordinating Structures,
Roles and Responsibilities, Definitions, etc.
APPENDIXES
Glossary, Acronyms, Authorities, and Compendium
of National Interagency Plans
EMERGENCY SUPPORT FUNCTION ANNEXES
Groups capabilities resources into functions
that are most likely needed during an incident
(e.g., Medical, Transportation, Mass Care, etc.)
Support Annexes
Describes common processes and specific
administrative requirements (e.g., Health,
Public Affairs, Worker Safety , etc.)
Incident Annexes
Outlines core procedures, roles and
responsibilities for specific contingencies (e.g.,
Bio, Radiological, Cyber, HAZMAT Spills)
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The National Response Plan

• Applicability/Scope

• Provides the national framework for domestic
  incident management
• Applies to all Federal departments and agencies
  that may be requested to provide assistance
  during an Incident of National Significance
• Including
• Major disasters, emergencies, and terrorist
  incidents
• Other events requiring DHS assistance
• NRP uses the term incidents to include
  credible threats

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Incidents of National Significance

• Definition based on 4 criteria from HSPD-5

• A Federal department or agency, responding under
  its own authorities, requests DHS assistance
• Resources of State/local authorities overwhelmed
• Stafford Act major disasters or emergencies
• Other catastrophic incidents
• More than 1 Federal department /agency involved
• Credible threats or indications of imminent
  terrorist attack
• Threats/incidents related to high-profile, large
  scale events
• The President directs DHS to assume
  responsibility for incident management

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The National Response Plan

• Concept of Operations

• NRP provides a single national framework
  describing the roles/responsibilities of
• State, Local, and Tribal Responders
• DHS and other Federal Departments
• Nongovernmental Organizations
• Private Sector and Citizen Groups
• Incidents handled at lowest possible level
• DHS receives notification of incidents, assesses
  regional or national implications, and determines
  need for DHS involvement
• DHS operational and/or resource coordination for
  Incidents of National Significance

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EMERGENCY SUPPORT FUNCTION 8Health Medical
Services Annex

• provides coordinated Federal assistance to
  supplement State and local resources in response
  to public health and medical care needs.
• Assistance is directed by the Department of
  Health and Human Services (HHS)
• Resources furnished when State and local
  resources are overwhelmed and public health
  and/or medical assistance is requested from the
  Federal Government.

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EMERGENCY SUPPORT FUNCTION 8

• Assessment of health/medical needs
• Health surveillance
• Medical care personnel
• Health/medical equipment and supplies
• Patient evacuation
• In-hospital care
• Food/drug/medical device safety
• Worker health/safety
• Radiological/chemical/biological hazards
  consultation
• Mental health care
• Public health information
• Vector control
• Potable water/wastewater and solid waste disposal
• Victim identification/mortuary services
• Veterinary services

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ESF 8 Support Agencies

• Department of Agriculture, Forest Service
• Department of Defense
• Department of Energy
• Department of Homeland Security
• Department of Justice
• Department of Transportation
• Department of Veterans Affairs
• American Red Cross
• Environmental Protection Agency
• General Services Administration
• U.S. Postal Service

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EMERGENCY SUPPORT FUNCTION 6Mass Care

• Primary Agency American Red Cross

• ESF 6 Mass Care coordinates Federal assistance
  in support of State and local efforts to meet the
  mass care needs of victims of a disaster. This
  Federal assistance will
• Support the delivery of mass care services of
  shelter, feeding, and emergency first aid to
  disaster victims
• Establishment of systems to provide bulk
  distribution of emergency relief supplies to
  disaster victims
• The collection of information to operate a
  Disaster Welfare Information (DWI) system to
  report victim status and assist in family
  reunification.

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EMERGENCY SUPPORT FUNCTION 6

• Shelter
• Feeding
• Emergency First Aid
• Disaster Welfare Information
• Bulk Distribution of Emergency Relief Items
• ESF 6 does not include recovery activities.

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National Preparedness System

• Universal Task List
• (UTL)

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Always comb your hair...
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Universal Task List (UTL)

• Definition
• Common tasks are those tasks that cut across the
  mission areas. They must be performed to achieve
  more than one or all of the missions.
• Preparedness
• Resource Management
• Communications and Information Management
• Supporting technology

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Universal Task List (UTL)

• Purpose
• list what tasks need to be performed
• flexibility to determine
• who should perform them
• how to perform them
• No single jurisdiction or agency is expected to
  perform every task.
• Individual jurisdictions will need to assess and
  select the tasks based on
• specific roles
• missions
• functions

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Universal Task List (UTL)

• Describes
• What tasks need to be performed.
• Federal, State, local, and tribal entities
  reserve the flexibility to determine
• who needs to perform them
• how to perform them.
• A reference to help plan, organize, equip, train,
  exercise, and evaluate personnel.
• A reference tool (menu of tasks)

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Universal Task List

• Identifies tasks that must be performed
• Defines task interdependence and
  interrelationship
• Does NOT address how or who performs task
• Provides common language and reference
• Approximately 4,800 tasks

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National Preparedness System

• Target Capabilities List
• (TCL)

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Avoid bad habits...
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Target Capabilities List

• Defines preparedness
• Defines capabilities required to achieve homeland
  security missions
• Provides the basis for assessing preparedness
• Provides the basis to improve decisions related
  to investments and strategies
• Defines capabilities and national targets
• Assumes shared responsibility across local,
  tribal, State, and Federal agencies,
  nongovernmental organizations, the private
  sector, and citizens

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Target Capabilities List

• Provides guidance on the specific capabilities
  and levels of capability that Federal, State,
  local, and tribal entities will be expected to
  develop and maintain.
• Every entity will not be expected to develop and
  maintain every capability to the same level.
• The capabilities and levels of capability will
  vary based upon the risk and needs of different
  types of entities
• 36 capabilities

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Target Capabilities

• Animal Health Emergency Support
• CBRNE Detection
• Citizen Preparedness and Participation
• Citizen Protection Evacuation and/or In-Place
  Protection
• Critical Infrastructure Protection
• Critical Resource Logistics and Distribution
• Economic and Community Recovery
• Emergency Operations Center Management
• Emergency Public Information and Warning
• Environmental Health and Vector Control
• Explosive Device Response Operations
• Fatality Management
• Firefighting Operations/Support
• Food and Agriculture Safety and Defense

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Target Capabilities (continued)

• Information Collection and Threat recognition
• Information Sharing and Collaboration
• Intelligence Fusion and Analysis
• Interoperable Communications
• Isolation and Quarantine
• Mass Care (Sheltering, Feeding, and Related
  Services)
• Mass Prophylaxis
• Medical Supplies Management and Distribution
• Medical Surge
• On-Site Incident Management
• Planning

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Target Capabilities (continued)

• Public Health Epidemiological Investigation and
  Laboratory Testing
• Public Safety and Security Response
• Restoration of Lifelines
• Risk Analysis
• Search and Rescue
• Structural Damage Assessment and Mitigation
• Terrorism Investigation and Intervention
• Triage and Pre-Hospital Treatment
• Volunteer Management and Donations
• WMD/Hazardous Materials Response and
  Decontamination
• Worker Health and Safety

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Capabilities Planning Process and Tools
PROCESS
Readiness Assessment
Threat Analysis
Mission Area Analysis
Task Analysis
Capabilities Development
Needs Identified
Strategy Development
National Planning Scenarios
Task Taxonomy
Universal Task List
Target Capabilities List
Information System
Exercise other Assessments
TOOLS
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Elements of Capability

• Personnel
• Planning
• Organization and Leadership
• Equipment and Systems
• Training
• Exercises, Evaluations, and Corrective Actions

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Target Capabilities

• Identifies capability measures to assess whether
  the capacity is in place to perform the critical
  tasks associated with the capability.
• Includes performance measures, both qualitative
  and quantitative, to assess the demonstration of
  the capability through performance of the
  critical tasks during operations, training, and
  exercises.
• Full capabilities may take years to develop and
  maintain.
• National preparedness requires every entity to do
  their part to develop and maintain the
  appropriate capabilities and levels of
  capability.

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Capability Summaries

• Capability Summaries Include
• Definition
• Outcome
• Relationship to NRP Emergency Support
  Function/Annex
• Major Activities
• Critical Tasks
• Conditions
• Preparedness Measures and Metrics
• Performance Measures and Metrics
• Capability Elements (Resources)
• Planning Assumptions
• Planning Factors
• National Target Levels
• Assignment of Responsibility
• Linked Capabilities
• References

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TCL Version 2.0

• Phase I Capabilities enhanced to address
  recommendations from Hurricane Katrina Reports
  with emphasis on
• Planning with focus on preparing for catastrophic
  events
• Formal pre-incident agreements and identification
  of resources
• Identification and provision of assistance to
  affected person with specific needs (e.g.,
  transportation, medical assistance)
• Redundancy and diversity of systems
• Prioritization of resources to address most
  critical needs
• Capability Working Groups continue work to
• Assist with NIMS typing and credentialing
• Refine or expand several capabilities (e.g.,
  sheltering of person with medical needs,
  restoration of lifelines)

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Always be alert and then wait. Perhaps what
you're looking for, will find you...
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Phase II of TCL Development

• Phase II will develop new capabilities for
  functions in the homeland security taxonomy not
  addressed in the initial phase
• Prevent functions such as border control,
  screening, inspection of materials, and
  disruption of sources
• Protect functions related to critical
  infrastructure protection, countermeasures, and
  mitigation
• Long-term recovery
• Many of the Phase II capabilities are primarily a
  Federal
• Responsibility.
• Capabilities will continue to be developed by
  stakeholders from all levels of government and
  the private sector.

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Target Capabilities

• Provide the means to achieve measurable
  outcomes..
• through the performance of critical tasks
• under specified conditions
• to target levels of performance

A capability may be delivered with any
combination of properly planned, organized,
equipped, trained and exercised personnel that
achieves the desired outcome
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Don't stop yourself from learning...
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Thank you !

• Any Questions?

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Contact information

• Michael W. Proctor, MD

• The University of Texas Health Science
  Center-Houston
• Center for Biosecurity and Public Health
  Preparedness
• 1200 Herman Pressler Drive RASW334
• Houston, Texas 77030
• Office 713-500-9421
• Cell 256-310-5212
• Email Michael.W.Proctor_at_uth.tmc.edu
• www.texasbiosecurity.org