Toolkit: Insights for Communities From OIG's Historical Work on Emergency Response

See also:

• Toolkit: Insights for Health Care Facilities From OIG's Historical Work on Emergency Response
• Video: Insights for Communities

Last Updated: 03-28-2023

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This toolkit contains key insights and lessons learned from Office of Inspector General (OIG) reports published from 2004 to 2020 about community emergency preparedness and response. These reports address State and local actions during outbreaks of emerging infectious diseases (such as Ebola and H1N1 pandemic influenza) and natural disasters (such as Hurricane Katrina and Superstorm Sandy), as well as bioterrorism preparedness and response. OIG conducted these audits and evaluations prior to the COVID-19 pandemic. We provide this information to assist communities in responding to the current pandemic and to other emergencies as they arise.

For reports referenced in this document, OIG conducted audits in accordance with the Generally Accepted Government Auditing Standards issued by the U.S. Government Accountability Office and conducted evaluations in accordance with the Quality Standards for Inspection and Evaluation issued by the Council of the Inspectors General on Integrity and Efficiency.

Funding

Clear guidance, flexibility, and appropriate oversight are important when distributing emergency funds to local entities

• Managing response and recovery funds. Local entities benefit from clear guidance regarding how funds may be used, when funding sources expire, and which documents or other evidence must be maintained for program integrity purposes. (OEI-09-15-00200, OEI-04-14-00410, A-05-05-00031, A-05-04-00027)
• Flexible use of funds. Allowing local entities flexibility in the use of funds for emergency response and recovery helps them address community-specific needs. (OEI-09-15-00200)
• Internal controls. Effective Federal and State oversight of funds for emergency response and recovery includes ensuring that recipients:
  • use funds timely;
  • submit required financial status reports;
  • do not draw down cash advances in excess of immediate needs; and
  • do not claim expenditures that were reimbursed by other sources. (A-02-15-02009, A-02-15-02005, A-02-14-02010, OEI-09-15-00200, A-02-14-02013, A-05-05-00031, A-05-04-00027)

Training

Training of community organizations, staff, and volunteers helps enable effective emergency planning and response

• Hands-on training for volunteers. When possible, supplementing computer-based training with hands-on training better prepares emergency response volunteers or others who assist in response efforts. (OEI-09-06-00030)
• Timely training of volunteers. Training emergency response volunteers or others who assist in response efforts before they are deployed or as soon as they are deployed will increase overall response effectiveness. (OEI-04-13-00350, OEI-09-06-00030)
• Training according to community needs. Community training and technical assistance on emergency preparedness and response is most effective when based on an assessment of local challenges and needs. (OEI-04-08-00260)
• Community-wide participation in emergency training. Regular participation of local entities (including childcare facilities and nonhospital facilities such as nursing homes) in community emergency exercises and drills can help ensure collaboration with local emergency management agencies when an emergency occurs. (OEI-04-14-00410, OEI-06-09-00270, OEI-04-08-00260)

Laboratory Testing

Coordination and communication among public and private labs are essential for rapidly expanding the capacity to test for infectious diseases; ongoing oversight is essential to maintain quality testing

• Coordinating among laboratories. Private clinical laboratories and State public health laboratories can coordinate to decrease the time needed to detect and report outbreaks. (OEI-04-07-00670)
• Information-sharing with health care professionals. Timely sharing of information about test results (from State public health laboratories to health care professionals) helps to support effective community response. (OEI-04-07-00750)
• Sharing clear expectations for public health reporting. Clear communication from State public health laboratories helps to ensure that hospitals and health care systems report information to the appropriate partners for public health and emergency response. (OEI-04-07-00670)
• Augmenting laboratory testing capacity. Developing and implementing operational plans and preparedness exercises helps to augment laboratory capacity to meet increased testing needs during a pandemic. (OEI-04-07-00670)
• Oversight of laboratories. Regular reviews of diagnostic testing proficiency among State public health laboratories and private clinical laboratories, and adherence to safety protocols, helps to ensure laboratory readiness for outbreaks. (OEI-04-07-00670)
• Safety of laboratory staff. Surveillance for illness among laboratory personnel working with viruses can help track and mitigate the spread of a disease. (OEI-04-07-00670)
• Proficiency of laboratory staff. To detect a disease outbreak and help slow its spread, it is essential that frontline clinicians and laboratory personnel are knowledgeable and competent with respect to safe specimen collection, testing, reporting potential cases of diseases, and submitting specimens to referral laboratories. (OEI-04-07-00670)

Vaccination Programs

Developing strategies to adequately staff and manage community vaccination programs is needed in advance of vaccine availability

• Plans for community distribution and dispensing of vaccines. These plans should be outlined in detailed, formal agreements with partnering agencies that identify:
  • the organizations or individuals responsible for carrying out specific actions;
  • facilities to serve as dispensing sites;
  • the sources that will be necessary to hire and support distribution and dispensation staff;
  • individuals who should be authorized to receive medication shipments; and
  • specific plans to dispense vaccines to vulnerable populations and priority groups. (OEI-04-08-00260)
• Exercises to test vaccine dispensing. Effective community response plans include conducting exercises for vaccine distribution and dispensing. Exercises are most beneficial when followed by after-action reports, development of improvement plans, and testing of proposed solutions. (OEI-04-08-00260)
• Sufficient vaccination staff. When deploying staff skilled to administer vaccines, a sufficient number and distribution of staff are needed to help meet community and site needs. (OEI-04-10-00020)
• Vaccination storage. Using CDC-recommended containers, and monitoring and recording storage temperatures, helps to ensure safe vaccine storage. (OEI-04-10-00020)
• Educating the public about vaccines. Providing clear and consistent information to the public about vaccines, including the dosage needed and any potential adverse reactions, helps ensure the success of community vaccination programs. (OEI-04-10-00020)

Emergency Planning

Community emergency preparedness plans should incorporate a wide range of health and human service needs

• Health Care Coalitions. Community Health Care Coalitions can better plan a whole-community emergency response when they ensure that their members include diverse types of entities (such as long-term care facilities, outpatient clinics, and home health agencies in addition to hospitals, public health agencies, emergency medical services, and emergency management). (OEI-04-18-00080)
  • Communities that do not yet have Health Care Coalitions should also involve a wide array of health care providers in emergency response planning. (OEI-06-09-00270, OEI-02-08-00210)
• Managing medical equipment and supplies. Community planning for managing and distributing medical equipment and supplies should include identifying sufficient storage space; maintaining and replacing equipment; and determining the logistics of transporting the equipment when needed. (OEI-02-08-00210)
• Alternate care sites. Effective community emergency plans should:
  • identify alternate care sites (such as temporary hospitals) to use during a pandemic;
  • determine the scope of care to be provided at these sites; and
  • decide how the sites would be managed, staffed, and supplied. (OEI-02-08-00210)
• Childcare services to support essential workers. Emergency plans specific to keeping and restoring childcare services are important to help essential workers who rely on those services to work. (OEI-04-14-00410)
• Emergency preparedness checklists. Regular use of emergency preparedness checklists can help ensure that community emergency plans are complete and updated. (OEI-06-09-00270)