BACKGROUND: During 2013–2016, Idaho worked towards implementing public health emergency responder health monitoring and surveillance (ERHMS) through the following incremental activities in subgrants with Public Health Districts (PHDs): review Public Health Emergency Preparedness Capability 14, Responder Safety and Health, complete training for monitoring staff and leadership, and pilot test ERHMS InfoManager. In October 2016, Idaho’s Preparedness Field Assignee from the Centers for Disease Control and Prevention (CDC) developed and facilitated a hands-on exercise to further ERHMS capabilities and share ERHMS plans among PHDs. Participants included representatives from state and local epidemiology and preparedness programs.
METHODS: The exercise scenario focused on a public health response during recovery from flooding, a top-ranked hazard in Idaho; the exercise was conducted over four 30-minute sessions. Participants identified potential health hazards, edited and deployed a pre-developed survey, analyzed responder data, developed risk communications, refined the survey to further identify hazards, and determined if executed prevention measures mitigated hazards. Participants were asked to self-evaluate their ability to complete these critical tasks during the exercise on a four-point scale: 4-fully successful, 3-some challenge, 2-major challenges, 1-unable to perform. They were also asked a free response question regarding PHD ERHMS implementation plans.
RESULTS: Among 19 participants, 15 (79 %) completed self-evaluations. Participants rated their abilities as either “4-fully successful” or “3-some challenges” in identifying potential health hazards, editing and deploying an existing survey, analyzing responder data, and developing risk communications. Participants rated their abilities as“2-major challenges” or “1-unable to perform” in refining the survey to further identify hazards and assessing if executed prevention measures mitigate hazards. Time constraints were identified as the primary barrier to completing these tasks. One of seven PHDs had current formal plans for conducting ERHMS; none had conducted ERHMS. Many participants stated that ERHMS does not significantly differ from routine surveillance duties and was achievable. Major reported barriers to ERHMS implementation included leadership buy-in and data privacy concerns.
CONCLUSIONS: A hands-on exercise with a plausible emergency scenario relevant to local public health agencies increased ERHMS awareness and skills among Idaho public health agency staff and improved knowledge of local public health ERHMS abilities and implementation plans. ERHMS implementation in Idaho could be advanced by development of operational ERHMS plans. State-specific training on data privacy laws related to ERHMS functions and encouraging leadership buy-in could further support EHRMS implementation. CDC Preparedness Field Assignees can be critical resources for ERHMS implementation by public health agencies.