Cara Christ: Keeping Arizona Prepared

June 21, 2018|9:23 a.m.| ASTHO Staff

This year, when CDC’s Office of Public Health Preparedness and Response released its annual 2018 National Snapshot, Arizona received high marks for public health preparedness, including top scores for emergency operations coordination and public health laboratory testing. ASTHO spoke with Cara Christ, MD, director of the Arizona Department of Health Services (ADHS), about the department’s preparedness priorities, last year’s opioid and wildfire response, as well as collaborations with local health departments to help address these issues and improve preparedness around the state.

What are ADHS’s top preparedness priorities?

ADHS is focused on whole community preparedness planning for Arizona. In addition to ensuring we are well prepared to respond to emerging infectious disease threats, outbreaks, and natural disasters, we have prioritized strengthening our relationships with local, tribal, and healthcare coalition partners, as well as non-traditional partners, to augment our public health responses. For example, we maintain engagement throughout the year—during both exercises and real-world events—with partners working with access and functional needs populations, schools, and behavioral health organizations to facilitate information sharing and needs assessments.

Overall, our priorities center around maintaining and strengthening statewide capacity to support traditional and non-traditional public health emergencies (such as the opioid epidemic), as well as improving our ability to obtain situational awareness and share information with partners and the public.

In terms of activating key emergency operations centers, what did you learn from the measles response (2016) that helped informed the wildfire and opioid response activities (2017)?

One of the key things we learned from the measles response that we have been able to carry forward into subsequent activations was the importance of thinking broadly about mechanisms for getting information out to partners and the public beyond press releases and our health alert network. During the measles response, we were able to use Women, Infants, and Children (WIC) clinics to distribute messages to the public about areas of potential exposure. This was a mechanism that we have continued to use in future responses as a complementary mechanism for public messaging.

When activating an emergency operations center, it is critical to take time at the outset of an event to consider the potential objectives and considerations that may arise throughout the course of response. It is helpful to engage the executive leadership team across the department, not just from areas that would traditionally respond, in order to ensure an interdisciplinary approach to a response and engage key staff as early as possible. Our opioid response involved an incredibly broad group of staff from across the department, including injury prevention, medical facilities licensing, EMS, epidemiology, laboratory, public health preparedness, vital statistics, and chronic disease. Similarly, our wildfire responses include representation of areas beyond public health emergency response, environmental health, and epidemiology. We also routinely engage our licensing group, vital records, WIC, immunizations, and EMS.

Extreme heat, infectious disease outbreaks, and power outages are Arizona’s most frequent public health emergencies. How is the health department collaborating with local partners and other entities (e.g., first responders, healthcare providers) to address these issues?

We’ve used a variety of mechanisms to engage with local partners and other entities to address Arizona’s most frequent public health threats. For example, there are active healthcare coalitions in Arizona with which we exercise to prepare for real world events. In addition, we convene stakeholder meetings when necessary to support information sharing and gather feedback, such as during our roll out of an enhanced surveillance advisory in support of Arizona’s public health emergency declaration for opioids, or through our facilitation of the Council on Infectious Disease Preparedness and Response convened during the Ebola response, which has continued to advise ADHS on Zika preparedness from the perspective of partners from healthcare facilities, first responders, law enforcement, local and tribal health departments, and state agencies.

What activities or initiatives are currently underway to help Arizona continue to grow and improve its already resilient preparedness and response infrastructure?

ADHS is currently partnering with Arizona Gov. Doug Ducey’s office, legislators, as well as key Arizona state agencies on a National Governor’s Association project to create a playbook, or quick reference guide, to facilitate timely declaration of a public health emergency. This work will allow us to centralize documentation related to the legal authorities and responsibilities of public health in support of large-scale emergency responses and streamline our ability to activate and coordinate resources across Arizona to more efficiently respond to public health situations.

We’ve also capitalized on our health emergency operations center (HEOC) activation for opioid response, which will allow us to support a more scalable infrastructure for public health emergency response in order to adapt to lengthy or complex responses in the future.