ASPR Makes First Playbook Available
By Ann Norwood, M.D., March 28, 2008
The Department of Health and Human Services (HHS), Office of the Assistant Secretary for Preparedness and Response (ASPR) has posted online its Hurricane Playbook (ESF-8 Hurricane Response), the first in a series designed to “outline key options and recommended actions to support the HHS Secretary (or designee) in directing and coordinating the HHS Emergency Support Function (ESF) #8, Public Health and Medical Services, response to disasters and other large scale emergencies.”1
As described on the HHS website, the playbooks are “written at a strategic level to highlight key decision points, actions, capabilities and assets that may be required to support an incident response . . . [and they] contain a concept of operations that outlines the phases of the response and identifies specific action steps for each phase.” 1 The playbooks are organized into five sections: scenario, concept of operations (CONOPS), action steps/issues, pre-scripted mission assignment sub tasks, and essential element of information (EEI). There is a further delineation by phases of the response, e.g., alert, activation, deployment, and deactivation/demobilization of federal ESF #8 assets.
The Department of Veterans Affairs, the Department of Defense, and other federal ESF #8 partners specified in the National Response Framework (NRF) participated in the playbook's development in an attempt to ensure that the federal capabilities are accurately described and synchronized. It is hoped that state and local planners will use the playbooks to gain an understanding of the ways in which federal resources can be used in support of ESF #8 activities.
The playbooks are intended to be “living” documents and will be updated periodically to reflect lessons learned, organizational changes, and other refinements. The Hurricane Playbook exemplifies this flexibility. Rather than using the same scenario presented in the National Planning Scenarios (NPS), the playbook employs a scenario that is based on the 2006 and 2007 Atlantic hurricane seasons and reflects consequences of and lessons learned from Hurricanes Katrina and Rita.
More Playbooks to Come
ASPR is developing strategic planning documents for each of the 15 NPS to enhance medical and public health preparedness and response. The NPS constitute one of the four elements of the National Preparedness Guidelines; the three others are the National Preparedness Vision, the Target Capabilities List, and the Universal Task List. The NPS are based on high consequence threats, including terrorist attacks, natural disasters, and other emergencies. As shown in the table below, several scenarios involve biological agents.
|National Planning Scenarios|
|Improvised Nuclear Device||Major Earthquake|
|Aerosol Anthrax||Major Hurricane|
|Pandemic Influenza||Radiological Dispersal Device|
|Plague||Improvised Explosive Device|
|Blister Agent||Food Contamination|
|Toxic Industrial Chemicals||Foreign Animal Disease|
|Nerve Agent||Cyber Attack|
|Chlorine Tank Explosion|
Key Federal Documents on Preparedness
The playbooks are the newest addition to a collection of key federal documents that now serve as the cornerstone of preparedness. ESF #8, which provides for federal assistance to state, tribal, and local governments specifically during public health and medical disasters, is just one of 15 emergency support functions described in the NRF, which recently replaced the National Response Plan. The Department of Homeland Security (DHS) has created an NRF Resource Center, which is a “one-stop shop” for key federal documents on preparedness. The website contains the NRF and its Emergency Support Function Annexes, Support Annexes, and Incident Annexes, as well as other documents (most of which are named with frequently encountered acronyms). Also on the website is FEMA’s draft document on the National Incident Management System (NIMS). The “Additional Resources” section contains several documents that may be of interest to clinicians involved in preparedness and response:
Federal Strategy May Have Implications for Hospitals
As the playbooks are published, clinicians involved in emergency preparedness may wish to peruse them to learn about the federal government’s strategy for public health and medical responses to disasters. Increasingly, hospitals and other healthcare institutions will be expected to organize their preparedness and response activities in compliance with these principles. Readers interested in biosecurity specifically may wish to check the playbook site again soon; the ASPR website indicates that the playbooks on pandemic influenza and biological attack-aerosol anthrax will be posted shortly. The playbooks for the remaining NPS are in development and are to be added upon completion.
U.S. Department of Health and Human Services Website: http://www.hhs.gov/disasters/discussion/planners/playbook