Public Health Incident Command System

As a requirement of federal funding, implementation of the Incident Command System is now required for many public sector agencies. Local health departments working to implement the ICS during the past few years, however, often struggle to apply the principles in public health settings. The training curriculum and examples used by ICS instructors frequently focuses on responses to fires and natural disasters making it difficult to envision the use of ICS during public health events. The Kane County Health Department implemented its Incident Command team on 4/25/09 in response to the first cases of a new type of H1N1 influenza. This team continued to meet throughout the pandemic and swelled to include many different partner agencies. Throughout the H1N1 response, the health department and county Office of Emergency Management shared responsibility for the Incident Commander and Deputy Incident Commander roles. An organization structure was developed for the various ICS modules needed based on the current situation and was frequently revised as the situation unfolded. For the first time formally, the IC team utilized the “Planning P” to frame a weeklong operational period. An Incident Action Plan was developed and then utilized to assure the work done was focused on that operational period's objectives. On 10/26/09, the county established three large-scale vaccination clinics and served over 11,000 individuals. Agencies involved included public health, fire, police, emergency management, schools and more. This required the utilization of Area Command, a concept not regularly practiced in the county and much less by the health department. A hot-wash survey completed by all of mass vaccination clinic staff revealed striking deficits in span of control, chain-of-command and resource management. Drastic improvements were completed prior to the next mass vaccination clinic and a post event survey completed by all clinic staff overwhelming showed a vast improvement.