In the relatively young subspecialty of public health emergency preparedness, effective public health preparedness managers mustentify the essential elements of their roles and the skills or requirements necessary to be effective in their positions. Although there is no set recipe for success, diverse and field-related skills are a must.
In the October 2014 edition of the DomPrep Journal, Daryl Lee Spiewak published an article entitled, “The Professional Emergency Manager.” Similar questions can be raised about the essential elements for an effective public health preparedness manager:
Are there specific training programs, structured educational degrees, or even a blend of traits, training, education, and real-world operational experience that make for the optimal public health preparedness manager?
Is public health preparedness manager even the correct title? Or is public health emergency manager a better title?
Before answering these questions, a review of some of the background of Public Health Emergency Preparedness (PHEP) programs is in order.
Painting a Realistic Picture Although there were various emergency situations that could have utilized the services of those with expertise in public health emergency preparedness – such as the Aum Shinrikyo sarin attacks on the Tokyo subway system in 1995 – the subspecialty of public health emergency preparedness is relatively young, truly emerging only after the anthrax attacks in 2001. Before 2001, a lack of operational public health emergency preparedness experience combined with a crumbling health infrastructure (specifically with regard to the number of laboratories and adequately trained public health personnel) painted the picture for a less-than-prepared public health system.
Since the terrorist attacks of 9/11, considerable funding has been provided to local, state, and federal public health agencies and organizations to orient them toward the more comprehensive state of preparedness needed to cope with the changing and increasingly more dangerous realities of today’s world. These realities include the possibility of public health entities needing to plan for, and respond to, the full spectrum of threats from weapons of mass destruction (specifically chemical, biological, radiological, nuclear, and high-yield explosive threats) as well as from other threats such as pandemic influenza. Such funding must include the need for personnel with a unique blend of experiences and education in order to manage these programs and the personnel the programs require – for example, planners, trainers, budget analysts, and support staff.
Defining Public Health Emergency Preparedness There are various definitions for the field of public health emergency preparedness, including the following, which was published in 2007 in the American Journal of Public Health:
“Public health emergency preparedness (PHEP) is the capability of the public health and health care systems, communities, and individuals, to prevent, protect against, quickly respond to, and recover from health emergencies, particularly those whose scale, timing or unpredictability threatens to overwhelm routine capabilities.”
Additionally, key elements of public health preparedness now include regularly exercised plans, timely access to information, clear knowledge of individual and agency roles and responsibilities, reliable communications systems, and connectivity between and among responding agencies.
Yet, there currently is no definition for the public health emergency preparedness manager or a public health emergency manager. Possibly, the closest to a definition is a portion of the Center for Disease Control and Prevention’s (CDC) Preparedness Capabilities requirements (under skills and training for capability 1, function 2). These requirements define an individual’s ability to handle specific public health preparedness job requirements as “acquired from three sources: foundational public health competencies, generic health security or emergency core competencies, and position-specific or professional competencies.”
Many occupations defined as professions have their own set of requirements and methods of demonstrating compliance, and will employ various methodologies to ensure that practitioners can demonstrate said compliance. For example, many professions require a Bachelor of Science or Bachelor of Arts degree from an accredited college or university, but some also require: (a) a specific degree; (b) specialized advanced education such as graduate medical or law degrees; (c) a minimum amount of training, with required training subjects based on the specialized knowledge, skills, and abilities of the given profession; and (d) specialized examinations with varying topics and methods.
The PHEP profession is no different. Often, managers of local and state programs have baccalaureate and graduate-level degrees as well as various certifications including, but not limited to: Certified Emergency Manager (CEM®), Certified Healthcare Safety Professional, or Certified Business Continuity Professional. Additionally, relevant coursework such as various Incident Command System (ICS) and Homeland Security Exercise and Evaluation Program (HSEEP) es may be required. For many, an experiential component to employment as a public health preparedness manager includes having been employed as registered nurses, emergency medical service providers, or even firefighters.
Diverse Skills Required for Public Health Emergency Professionals PHEP managers must have a diverse skill set with expertise in at least the following areas in order to be most effective:
Mass vaccination and prophylaxis planning;
All-hazards preparedness training;
Implementation of National Incident Management System (NIMS) and ICS;
Enhancement of disease surveillance systems;
Hiring of new staff to work on preparedness planning;
Stockpiling of various personal protective equipment, vaccines, or antivirals;
Development of public health specific emergency plans; and
Administration of workforce training in emergency response.
It is clear that, in order to be an effective public health preparedness manager, there is no set recipe for success. A number of state and local managers have structured degrees in public health or public administration, whereas others have clinical experience as registered nurses, emergency medical service providers, or other degrees and/or additional credentials such as the CEM. However, certain skills are constant, including but not limited to: excellent communications skills, presentation skills, understanding of past events and incidents that have impacted public health, and an ability to research and develop plans in real-time to respond to emerging public health threats.
Time and again, public health agencies and organizations have been planning for, preparing for, and responding to various emergencies including environmental emergencies, foodborne and sanitation issues, and water supply safety. Emerging crises also may have an effect on public health such as SARS, H1N1, and even the recent Ebola outbreak. Other incidents, even if not directly related to public health – such as weather-related events or acts of terrorism – have the ability to significantly affect the public health system. Perhaps the next logical step in the progression of the subspecialty of public health emergency preparedness is the codification of a minimum list of education, experience, certifications, and necessary skills that a public health emergency manager should optimally possess for success.
Raphael M. Barishansky, MPH, MS, CPM is director of the Connecticut Department of Public Health’s Office of Emergency Medical Services (OEMS). Before establishing himself in this position, he served as chief of public health emergency preparedness for the Prince George’s County (Maryland) Health Department. A frequent contributor to the DomPrep Journal and other publications, he can be reached at firstname.lastname@example.org