Emergency preparedness training framework: A model for local health departments

To meet the emergency preparedness needs of such a large and diverse population as Los Angeles County's 10.1 million residents, the county's nearly 3800 public health employees must be trained in specific response systems, such as the Incident Command System (ICS) and the National Incident Management System (NIMS). Because such systems were not originated within public health and, in some ways differ from traditional public health strategies, staff preparedness training efforts and workplace preparedness initiatives present unique challenges. To address these challenges, the Los Angeles County Department of Public Health created a three-tiered training framework that is connected to readiness competencies, is amenable to funding requirements, and can be rolled out over time, to allow for increased organizational training and exercise opportunities over a three-year period. This infrastructure includes in each training tier distinct core courses, elective courses, and exercises; complete with specific competencies and tangible outcomes (e.g. assembling an evacuation communication plan). In it, all staff receive baseline training in the first tier and staff identified as having ICS roles receive more intensive training in the higher tiers. Our goal in implementing a structured format for delivering trainings and defining workplace preparedness measures is to ensure our staff are personally and professionally prepared for emergencies, willing to report for duty, and that the department as a whole will be well-suited to handle such emergencies. Our belief is that this infrastructure is a useful means to initiate change and that it can be successfully duplicated in other local health departments.