Aerosolized Anthrax Pre-Scripted Statements of Work (PSSW)

Emergency Support Function #8 (ESF #8) Biological Attack – Aerosolized Anthrax

Under the National Response Plan (NRP), The Department of Health and Human Services (HHS) is the lead Federal agency for ESF #8 (Public Health and Medical Services), which confers upon HHS coordination responsibilities during an anthrax attack response.  Because of the nature of the HHS mission and its lead role in the public health and medical response during most major disasters, a number of Federal agencies and departments would be supporting ESF #8 mission assignments related to an anthrax response.

DOD
OSG
CDC
SAMHSA
FEMA/DHS
USDA
DoD
DHS
DOJ
DOL
DOS
DOT
VA
EPA
USPS
ARC

The following is a listing of the ESF #8 mission assignments and sub-taskings most likely to be used during an anthrax response.

ESF #8 Pre-Scripted Statements of Work (PSSWs):

1. Provide Public Health and Medical Staffing Support
   1. Provide public health and medical staffing to support disaster response operations as directed by FEMA in the Tribe, Territory or State of _________ affected by _________.  This staffing may include, but is not limited to, physicians, mid-level practitioners, nurses, pharmacists, behavioral health specialists, veterinarians and the required administrative support staff.  All activities will be coordinated with the appropriate tribal, territory, state and local officials as well as other federal agencies.  All personnel requirements must be coordinated with and authorized by FEMA in conjunction with ESF #8 and the affected tribe, territory or state(s).  Specific tasks under this mission assignment will be requested by Mission Assignment Task Orders.
2. Provide medical supplies, pharmaceuticals, and equipment.
   1. Provide medical supplies, pharmaceuticals, and equipment as directed by FEMA to support disaster response operations in the Region, Tribe, Territory or State of _______________ affected by _________. All activities will be coordinated with the appropriate tribe, territory, state and local officials as well as other federal agencies.  All medical supply, pharmaceutical, and equipment requirements must be coordinated with and authorized by FEMA in conjunction with ESF #8 and the affected tribe, territory or state.  Specific tasks under this mission assignment will be requested by Mission Assignment Task Orders. All property purchases must be coordinated with FEMA Operations and Logistics and a copy of the invoice or receiving report for purchased property provided to the Accountable Property Officer for FEMA within 30 days of receipt of the property. All accountable property purchased under this mission assignment must be returned to FEMA to be eligible for reimbursement.
3. Provide pharmaceuticals, and medical equipment
   1. All activities will be coordinated with the appropriate tribe, territory or state and local officials as well as other federal agencies. All pharmaceutical and medical equipment requirements must be coordinated with and authorized by FEMA in conjunction with ESF #8 and the affected tribe, territory or state.
   2. Specific tasks under this mission assignment will be requested by Mission Assignment Task Orders. All property purchases must be coordinated with FEMA Operations and Logistics and a copy of the invoice or receiving report for purchased property provided to the Accountable Property Officer for FEMA within 30 days of receipt of the property. All accountability property purchased under this mission assignment must be returned to FEMA to be eligible for reimbursement.

HHS Subtaskings

The three HHS PSSWs are further divided into and delegated to responsible agencies and departments. 

NDMS now under HHS control must perform the following functions:

1. Deploy and track available DHS mass fatality response assets.
2. Deploy available personnel to provide technical assistance and/or medical support, to workers in the highest priority critical infrastructure/key resources that must be maintained to protect the integrity and continuity of the nation.
3. Deploy available personnel to provide augmentation support for hospitals.
4. Deploy available public health and medical personnel to support highest priority declared critical Federal health care infrastructure areas.

Department of Defense (DOD)

1. Deploy available personnel to provide technical assistance and/or medical support, including home health care, to workers in the highest priority critical Federal health care infrastructure/key resources that must be maintained to protect the integrity and continuity of the nation.
2. Deploy available personnel to provide augmentation support for hospitals and PODS.
3. Deploy available public health and medical personnel to support highest priority declared critical Federal health care infrastructure areas.

HHS Office of the Surgeon General (OSG)

1. Deploy available PHS Commission Corps (CC)  to staff the Emergency Management Group (EMG) and Incident Response Coordination Teams.
2. Deploy available PHS CC to staff ESF #8 positions in the directed regional Joint Field Office(s) (JFOs) and other multi-agency coordination elements (e.g. NRCC).
3. Deploy available Rapid Assessment Team to determine epidemiological situation and assess local capabilities and resources.
4. Deploy available Rapid Response Public Health and Medical assets to support response efforts.
5. Deploy available PHS CC to support highest priority declared critical Federal health care infrastructure areas.
6. Deployment available assets to provide staffing for FMS.
7. Deploy available PHS CC to provide technical assistance and/or medical support, to workers in the highest priority critical Federal health care infrastructure/key resources that must be maintained to protect the integrity and continuity of the nation.
8. Deploy available PHS CC to provide augmentation support for hospitals.

HHS Centers for Disease Control and Prevention (CDC)

1. Deploy ESF #8 Advance Elements in Support of Federal (FEMA) and State Rapid Assessments efforts. Also, at the request of local and state, federal and tribal partners CDC will provide additional resources to conduct more comprehensive and detailed public health assessments including Rapid Public Health Community Rapid Needs Assessments and evaluation of  the capacity of the affected jurisdictions to conduct basic public health operations/services
2. Deploy Rapid Response Public Health and Medical assets to support containment efforts.
3. Deploy FMS caches.
4. Deploy medical material and pharmaceuticals from SNS.

HHS Substance Abuse & Mental Health Services Administration (SAMHSA)

Provide psychosocial support to responders and affected communities through institutionalization of psychosocial support services and development of workforce resiliency program.

DHS Federal Emergency Management Agency (FEMA)

1. Provide [Base/Location Name] as a FEMA MOB center to support forward distribution of supplies / equipment to affected area. Provide billeting (barracks facilities are acceptable) and life support, to include meals and hygiene facilities, for  [Number]  personnel; marshalling area for up to  [Number]  trucks and trailers;  [Number]  sq. feet of covered storage; office and desks space for  [Number]  personnel; and  Materiel Handling Equipment (MHE)/lift capability to offload (type of supplies/equipment) from (type vehicles/aircraft).
2. Provide (base name) as an Operational Staging Area to support forward distribution of supplies / equipment to affected area. Provide marshalling area for up to [Number] trucks and trailers; [Number]  sq. feet of covered storage; and Materiel Handling Equipment (MHE)/lift capability to offload [type of supplies/equipment] from [type vehicles/aircraft].
3. Provide capability to conduct retail fuel distribution operations at [Number] different points.  Each point must provide the capacity to issue [Number] gallons of diesel fuel and/or [Number] gallons of unleaded gasoline. Fuel points must have appropriate nozzles to provide retail re-supply to first responders and commercial ground vehicles. Points must be operational [date/time] at [Location Name].
4. Provide, all non-medical logistic and base operating support for deployed medical personnel and support personnel to include food, shelter, fuel, ground transportation, and line item resupply for (location) from ( Start Date) to (End Date).
5. Provide site preparations if required for deployed Federal Medical Station at (location).  Each site will be cleared and leveled to allow construction of the FMS

Department of Agriculture (USDA)

1. Provides appropriate personnel, equipment, and supplies, coordinated through ESF #4 – Firefighting or the Branch Chief, Disaster and EmergencyOperations, Fire and Aviation Management Office in Washington, DC. This support is primarily for communications aircraft and the establishment of base camps for deployed Federal health and medical teams.
2. USDA also supports a multiagency response to a domestic incident through:
   • Provision of nutrition assistance;
   • Control and eradication of an outbreak of a highly contagious or an economically devastating animal disease;
   • Assurance of food safety, and security, in coordination with other responsible Federal agencies, or any combination of these requirements;
   • Provision of appropriate personnel, equipment, and supplies, coordinated through the Animal and Plant Health Inspection Service Emergency Management Operations Center. Support is primarily for coordination of animal issues such as disposal of animal carcasses, protection of livestock health, and zoonotic diseases associated with livestock.

Department of Defense (DoD)

• Alerts DOD NDMS Federal Coordinating Centers (FCCs) (Army, Navy, Air Force) and provides specific reporting/regulating instructions to support incident relief efforts.
• Alerts DOD NDMS FCCs to activate NDMS patient reception plans in a phased, regional approach, and when appropriate, in a national approach.
• At the request of HHS, DOD coordinates with ESF #1 to provide support for the evacuation of seriously ill or injured patients to locations where hospital care or outpatient services are available.
• Using available DOD transportation resources, in coordination with the NDMS Medical Interagency Coordination Group (MIACG), evacuates and manages victims/patients from the patient collection point in or near the incident site to NDMS patient reception areas.
• Provides available logistical support to health/medical response operations.
• Provides available medical personnel for casualty clearing/staging and other missions as needed including aero-medical evacuation and medical treatment. Mobilizes and deploys available Reserve and National Guard medical units, when authorized and necessary to provide support.
• Coordinates patient reception, tracking, and management to nearby NDMS non-Federal hospitals, VA hospitals, and DOD military treatment facilities that are available and can provide appropriate care.
• Provides available military medical personnel to assist HHS in the protection of public health (such as food, water, wastewater, solid waste disposal, vectors, hygiene, and other environmental conditions).
• Provides available DOD medical supplies for distribution to mass care centers and medical care locations being operated for incident victims with reimbursement to DOD.
• Provides available emergency medical support to assist Region, Tribe, Territory, State, local governments within the disaster area and the surrounding vicinity. Such services may include triage, medical treatment, mental health support, and the use of surviving DOD medical facilities within or near the incident area.
• Provides assistance in managing human remains, including victim identification and mortuary affairs.
• Provides evaluation and risk management support through use of Defense Coordinating Officers, Emergency Preparedness Liaison Officers, and Joint Regional Medical Planners.
• Provides available blood products in coordination with HHS.
• Provides DOD confirmatory laboratory testing support in coordination with HHS.

Department of Homeland Security (DHS)

• Provides communications support in coordination with ESF #2 – Communications.
• Provides logistics support as appropriate.
• Through ESF #1, identifies and arranges for use of U.S. Coast Guard aircraft and other assets in providing urgent airlift and other transportation support.
• The Interagency Modeling and Atmospheric Assessment Center (IMAAC) provides predictions of hazards associated with atmospheric releases for use in emergency response. The IMAAC provides a single point for the coordination and dissemination of Federal dispersion modeling and hazard prediction products that represent the Federal position during an Incident of National Significance.

Department of Justice (DOJ)

• Provide 24 hour security in support of Federal Medical Stations and medical base operating camps at (location) from (Start date) to (End Date).
• Assists in victim identification, coordinated through the Federal Bureau of Investigation (FBI).
• Provides Tribal, Territory, State, local governments with legal advice concerning identification of the dead.
• Provides HHS with relevant information of any credible threat or other situation that could potentially threaten public health. This support is coordinated through FBI Headquarters.
• Provides communication, transportation, and other logistical support to the extent possible. This support is provided through the FBI.
• Provides security for the SNS and quarantine enforcement assistance, if required.

Department of Labor (DOL)

• Request monitoring of occupational health effects to ensure the safety of federal responders providing are or otherwise rendering assistance at (Location) from (Start Date) to (End Date).
• Coordinates the safety and health assets of cooperating agencies and the private sector to provide technical assistance and conduct worker exposure assessment and responder and worker risk management within the Incident Command System. This assistance may include 24/7 site safety monitoring; worker exposure monitoring; health monitoring; sampling and analysis; development and oversight of the site-specific safety and health plan; and personal protective equipment selection, distribution, training, and respirator fit-testing.
• Provides personnel and management support related to worker safety and health in field operations during ESF #8 deployments.

Department of State (DOS)

• Coordinates international activities related to chemical, biological, radiological, and nuclear incidents and events that pose trans-border threats. Assists in communicating real-time actions taken by the United States and U.S. projections of the international consequence of the event (e.g., disease spread, quarantine, isolation, travel restrictions, pharmaceutical supply and distribution, and displaced persons).
• Assists with coordination with foreign states concerning offers of support, gifts, offerings, donations, or other aid. This includes establishing coordination with partner nations to identify the U.S.-validated immediate support in response to an Incident of National Significance.

Department of Transportation (DOT)

• Department of Transportation to provide on demand transportation to support federal teams and resources as directed by FEMA Region [Number] for [Name]. Any tasks will include duration and cost estimate and POCs, and will be on a FEMA task order form.
• In collaboration with DOD, GSA, and other transportation-providing agencies, assists in identifying and arranging for all types of transportation, such as air, rail, marine, and motor vehicle.
• At the request of HHS, provides patient movement assistance from DOT resources subject to DOT statutory requirements.
• Coordinates with the Federal Aviation Administration for air traffic control support for priority missions.

Department of Veterans Affairs (VA)

• Request VA staff and operate a Federal Medical Station level, to include the following quantities and types of medical personnel: (X#) of (specify types of physicians), (X#) of (specify types of registered nurses), (X#) of LPNs, and (X#) of (specify types of other ancillary or support personnel) to support patient care at [Location Name] from (Start date) to End Date).  Request that VA identify available personnel within 24 hours, and coordinate transportation so ensure that these personnel arrive at [Location Name] within 48 hours.
• Request VA provides assistance in the interment of 5,000 human remains.
• Deploy available personnel to provide technical assistance and/or medical support, including home health care, to workers in the highest priority critical infrastructure/key resources that must be maintained to protect the integrity and continuity of the nation.
• Deploy available PHS CC to provide augmentation support for hospitals.
• Subject to the availability of resources and funding, and consistent with the VA mission to provide priority services to veterans, when requested, VA:
• Coordinates with participating non-Federal NDMS hospitals to provide incident-related medical care to authorized NDMS beneficiaries affected by a major disaster or emergency.
• Furnishes available VA hospital care and medical services to individuals responding to, involved in, or otherwise affected by a major disaster or emergency, including members of the Armed Forces on active duty.
• Designates and deploys available medical, surgical, mental health, and other health service support assets.

Environmental Protection Agency (EPA)

• Provides technical assistance and environmental information for the assessment of the health/medical aspects of situations involving hazardous materials, including technical and policy assistance in matters involving drinking water supplies.
• Assists in identifying alternate water supplies for critical care facilities.

General Services Administration (GSA)

• Provides facilities, equipment, supplies, and other logistical support, including contracting for private-sector ground and air transportation.

U.S. Postal Service (USPS)

• Assists in the distribution and transportation of medicine and pharmaceuticals and medical information to the general public affected by a major disaster or emergency as needed.

American Red Cross (ARC)

• Provides emergency first aid, consisting of basic first aid and referral to appropriate medical personnel and facilities, supportive counseling, and health care for minor illnesses and injuries to incident victims in mass care shelters, the JFO, selected incident cleanup areas, and other sites deemed necessary by the primary agency.
• Assists community health personnel subject to staff availability.
• Provides supportive counseling for the family members of the dead, injured, and others affected by the incident.
• Provides available personnel to assist in temporary infirmaries, immunization clinics, morgues, hospitals, and nursing homes. Assistance consists of administrative support, logistical support, or health services support within clearly defined boundaries.
• Acquaints families with available health resources and services, and makes appropriate referrals.
• Provides coordination for uploading appropriate casualty/patient information from ESF #8 into the Disaster Welfare Information system.
• Refers all concerns regarding animal health care, safety, or welfare to American Veterinary Medical Association contact(s) in the disaster area, as appropriate. These contact people are veterinarians affiliated with national, Tribal, Territory, State, county, or local veterinary associations.

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