Public Health Emergency Preparedness and Response Capabilities

2018 Update Initiative—What Changed?

In 2011, the Centers for Disease Control and Prevention (CDC) established 15 capabilities that serve as national standards for public health preparedness planning. Since then, these capability standards have served as a vital framework for state, local, tribal, and territorial preparedness programs as they plan, operationalize, and evaluate their ability to prepare for, respond to, and recover from public health emergencies.

Over the years, feedback from subject matter experts (SMEs) across CDC, state and local health departments, and national partner organizations highlighted specific opportunities to revise and modernize the capabilities. In 2017, CDC began updating the capabilities in response to lessons learned from public health emergency responses, updates to public health preparedness science, revised guidance and resources, findings from internal reviews and assessments, SME feedback from the practice community, and input from allied federal agencies. In addition, representatives from professional associations, including the Association of Public Health Laboratories (APHL), the Association of State and Territorial Health Officials (ASTHO), the Council of State and Territorial Epidemiologists (CSTE), the National Association of County and City Health Officials (NACCHO), and the National Emergency Management Association (NEMA) provided input on the updated content.

The capabilities update focused on streamlining language and aligning content with new national standards, updated science, and current public health priorities and strategies. The capabilities also support topics such as pandemic influenza, environmental health, at-risk populations, and tribal populations.

Download Fact Sheet [PDF – 708 KB]

The 2018 Public Health Emergency Preparedness and Response Capabilities maintains the 15 capabilities structure, with minor revisions to capability definitions, modest revisions to function structure and definitions, and significant revisions throughout most tasks and resource elements.

Unlike the 2011 version, this 2018 update does not include programmatic performance measures. However, jurisdictional public health agencies are encouraged to use the updated content to foster their own evaluation strategies.

CDC incorporated revisions based on specific criteria that determined whether the suggested feedback

Reflected the growth and evolution of public health preparedness and response;
Supported the continued advancement of state and local preparedness programs;
Drew upon the best available evidence and updated national resources;
Avoided specific implementation guidance like what will be included in CDC’s Public Health Emergency Preparedness cooperative agreement requirements or evaluation criteria, such as performance measures; and
Was applicable to diverse state, local, tribal, and territorial public health systems (avoiding unique topic areas and jurisdiction-specific approaches).

Detailed Summary of Changes by Capability

Defines at-risk individuals as people with access and functional needs that may disproportionately impacted by an incident, and provides parameters to identify those populations
Highlights Americans with Disabilities Act (ADA) requirements in jurisdictional public health preparedness and response plans
Accentuates the importance of community partnerships, including tribes and native-serving organizations in public health preparedness and response activities
Promotes integration of community partners to support restoration of community networks and social connectedness to improve community resilience

Highlights the need to define the jurisdictional public health agency recovery lead and support role
Supports the National Disaster Recovery Framework (NDRF)
Promotes integration of community partners to support community recovery and restoration
Emphasizes engagement of community partners to access hard-to-reach populations to ensure inclusive communications that meet the needs of the whole community

Distinguishes the need to identify and clarify the jurisdictional Emergency Support Function #8 (ESF #8) response role based on incident type and characteristics
Incorporates the National Health Security Strategy and Crisis Standards of Care for public health activation
Emphasizes the importance of supporting development of mission ready-packages for mutual aid and understanding the Emergency Management Assistance Compact

Promotes the need to leverage social media platforms for issuing emergency public information and warnings
Clarifies conditions for establishing a virtual Joint Information Center and Joint Information System
Includes content to identify and reach populations at risk to be disproportionately impacted by incidents and those with limited access to public information messages

Clarifies importance of identifying the public health agency role in fatality management and describes potential fatality management lead, advisory, and support roles
Aligns the fatality management definition to the existing federal definition as recommended by the U.S. Department of Health and Human Services’ (HHS), Disaster Mortuary Operational Response Team
Updates resources to improve coordination, accuracy, and timeliness of electronic mortality reporting

Increases alignment to public health surveillance and data strategies
Emphasizes the need to implement data security and cybersecurity
Emphasizes the need to decrease reporting time and increase collaboration by expanding use of electronic information systems, such as electronic death registration, electronic laboratory reporting , and syndromic surveillance systems

Incorporates content for accommodating individuals with functional and access needs within general population shelters
Includes considerations for registration of individuals requiring decontamination or medical tracking in the event of an environmental health incident
Coordinated content with HHS Assistant Secretary for Preparedness and Response’s (ASPR) Health Care Preparedness and Response Capabilities

Revises the Capability 8 title, definition, and content to account for both the dispensing and the administration of medical countermeasures, such as vaccines, antidotes, and antitoxins
Adds content and resources to account for potential radiological or nuclear exposure
Broadens the network of dispensing and administration sites to include pharmacies and other locations

Broadens the cold chain management guidance to include all aspects of storage and handling
Expands recovery activities to incorporate proper handling and disposal of infectious, hazardous, or contaminated materiel and waste
Accounts for security and inventory management tasks that occur throughout the entire distribution process

Emphasizes the need to define public health agency lead and support roles within medical surge operations
Eliminates use of the term “HAvBED” because the term is no longer promoted by the Hospital Preparedness Program and focuses instead on “situational awareness” and “health care systems tracking” as an overarching theme
Emphasizes the need to identify and clarify the jurisdictional ESF #8 response role in medical surge operations based on jurisdictional role and incident characteristics

Focuses on collaboration by expanding suggested partners for implementing nonpharmaceutical interventions
Supports establishment of community reception center processes to enhance ability to respond to radiological and nuclear threats
Highlights management of mass gatherings (delay and cancel) based on all-hazards scenarios

Updates Laboratory Response Network (LRN) requirements
Incorporates LRN-chemical requirements
Prioritizes cooperation, coordination, and information sharing with LRN laboratories, other public laboratories, and jurisdictional sentinel laboratories

Increases alignment with public health surveillance and data strategies
Strengthens surveillance systems for persons in isolation or quarantine and persons placed under monitoring and movement protocols
Emphasizes syndromic surveillance and data collection to improve situation awareness and responsiveness to hazardous events and disease outbreaks, for example, participation in the CDC’s National Syndromic Surveillance Program BioSense Platform

Incorporates the need to securely manage responder data
Improves responder on-site management, tracking, in-processing, and out-processing
Reprioritizes hierarchy of control and promotes the alignment of responder safety and health control measures, for example, personal protective equipment, with jurisdictional risk assessment findings

Addresses the need to monitor volunteer safety, risks, and actions during and after an incident
Strengthens and clarifies volunteer eligibility considerations, such as medical, physical, and emotional health, during the volunteer selection process
Promotes use of Emergency Responder Health Monitoring and Surveillance^TM