1. New Jersey Preparedness Training Consortium Continuing Education for health care professionals “moduleNewJerseyv1” NJ Statewide Response to Health Threats

2. Public Health EmergencyManagement Healthcare Delivery System competency capability capacity The Health Emergency Preparedness and Response Triad

3. Components of New Jersey’s Response to Health Threats Detection - Health surveillance by clinical providers and laboratories –Notify Public Health (LINCS / NJDHSS) –Notify Emergency Management (first responders, law enforcement) Rapid Laboratory Diagnosis –Laboratory response network (LRN) Epidemiologic Investigation –Public health workers identify exposure risks Implementation of Control Measures Pharmaceutical Stockpile Medical Reserve Corps

4. DHSS Regionalization The division of the State into geographic sub-areas, and corresponding application of the Emergency Preparedness and Response Triad within these sub- areas through DHSS Regional Teams, in order to most effectively prepare for and respond to public health emergencies and disasters.

5. Local Information Network & Communications System (LINCS) Public Health Component of the Triad Backbone of Public Health System 22 LINCS Agencies Staff: Epi/Nurse/ Planner/Coordinator Health Alert Network (HAN) A tool for the State EOC A means for inter- and intra- regional coordination Public Health Response Teams

6. Region Team Public Health EmergencyManagement Healthcare Delivery System Region Team Public Health EmergencyManagement Healthcare Delivery System Region Team Public Health EmergencyManagement Healthcare Delivery System Region Team Public Health EmergencyManagement Healthcare Delivery System Region Team Public Health EmergencyManagement Healthcare Delivery System Regional Coordination Team Regional Coordinator Health System Liaison EMS Liaison PH Planner Exercise Coordinator OEM Liaison Lab Liaison County Epi Region Team Public Health EmergencyManagement Healthcare Delivery System

7. NJDHSS HECC Support HECC (NJHA,BENS,Associations,VA) Local/County EOC State EOC New Jersey Health Emergency Response Network State Regional Team Hospital FQHC Other Health Organizations Incident Commander MCC Regional Medical Coordination Center MCC

8. Medical Coordination Centers Healthcare Delivery Component of the Triad Backbone of the Health Response Network Mirror of DHSS ECC Augmented by HACC A tool for the State EOC A means for inter- and intra- regional coordination

9. The Laboratory Response Network (LRN) for BT Public and Private Labs Test According to Consensus Protocols Timely and Accurate Testing and Reporting Linked with Local, State, and Federal Agencies

10. Why is New Jersey’s State Public Health Laboratory (PHL) Involved? Mandate by Congress Experience with Biological Agents of Concern and Outbreak Investigations Link between Local Laboratory Level and CDC/Federal agencies

11. LRN Laboratory Levels LEVEL A: Clinical Labs LEVEL B: Public Health Labs LEVEL C: Typing Labs, Public Health Labs LEVEL D: CDC

12. Tasks by Capacity BT Level A - Rule-out or Refer BT Level B - Rule-In and Refer BT Level C - Rule-in and Refer BT Level D - Confirm, Validate, Archive

13. Questions to Answer Concerning Your Lab What is the BT level of my lab? Is my lab active in the LRN? Where is the nearest higher level lab? What guidelines should be followed to package and ship biological agents? Whom should I call?

14. Level A Procedures for Bioterrorism Event Properly collected specimens are to be referred to designated testing laboratories Prior to the shipment of any specimen, the designated laboratory must be notified and approved by the State Health Department

15. The Strategic National Stockpile (SNS) Program Mission To deliver pharmaceuticals and medical materiel to the site of a national emergency.

16. Readiness/Response How SNS Assets are Deployed Readiness/Response How SNS Assets are Deployed State Requests Federal Assistance Need for Drugs and Medical Supplies Exceeds Local & State Resources In Consultation with the Surgeon General, Secretary HHS, HHS Office of Emergency Preparedness (OEP), FEMA and the FBI Augments Local/State Medical Materiel Resources SNS CDC Director Deploys SNS Assets

17. Distribution Dispensing Point Dispensing Point Dispensing Point Dispensing Point RSS Security, Command & Communications Hospitals Military, Prisons, Industry

19. Oral Antibiotics IV Supplies Nerve Agent Antidotes Airway supplies Med/Surg Supplies (Clear)

20. Strategic National Stockpile & Strategic State Stockpile Purpose: Determine the State ’ s need for pharmaceutical and medical supplies in the event of a chemical, biological, radiological, nuclear, or explosive mass casualty event Activities: Planning for mass medication and/or mass vaccination acquisition and distribution Preparing to meet needs of pediatric and geriatric communities

21. State Stockpile Planning “ChemPack Program” State owned and managed assets 1. Potassium Iodide 2. State Owned Caches to be stored strategically in the State for deployment prior to the receipt of federal assets

22. Strategic National Stockpile NJ Receiving, Staging, Storage Private Partner Pharmaceutical Distributors will receive the federal push package, and use their resources to unpack and allocate (according to the DHSS’s orders) and ship out materials Private Partner repackaging companies will provide for all our repackaging needs.

23. Receiving, Staging, Storage Site Hospitals 22 Local Agencies (LINCS Agency Health Departments ) POD

24. Point of Dispensing (POD) Site Selection Considerations – accessibility, size, geography,familiarity to population Operational Considerations – flow, information/education, staffing Security Policies for Operations

25. Time Frames Request for SNS <12 hours later SNS arrives in NJ 12-24 Hours – SNS distributed to hospitals and counties 24-36 Hours – Pills in people

26. Site Considerations Do the math - protection from anthrax for 1,000,000 people in 48 hours –20,833 per hour –2,083 per hour for 10 sites –1,042 per hour for 20 sites – 521 per hour for 40 sites – 260 per hour for 80 sites – 130 per hour for 160 sites

27. NJ Medical Reserve Corps Purpose: Creating database of trained individuals to call upon in the event of a bioterrorism or mass medical crisis within the state of New Jersey Activities: Creating an electronic registry of volunteers Creating an operational manual for the implementation process of reserve corps units Establishing a baseline of recommended education and training requirements

29. www.NJMRC.state.gov To volunteer for New Jersey’s Medical Reserve Corps: