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Public Health Preparedness

What is DHEC's Role in Emergency Preparedness and Response?

Threats to public health are always present. Whether caused by natural, accidental, or intentional means, these threats can lead to the onset of public health incidents. Being prepared to prevent, respond to, and rapidly recover from public health threats is critical for protecting and securing our state's and our nation's public health. Regardless of the threat, an effective public health response begins with an effective public health system with robust systems in place to conduct routine public health activities.

Public health preparedness involves all areas of the Department of Health and Environmental Control (DHEC). South Carolina is unique among other states, in that DHEC is the state's public health agency and is also the state's environmental protection agency, hospital and health facility regulatory agency, and ocean and coastal resource management agency. There are diverse, complex functions that must be coordinated in order to respond rapidly and successfully to an act of bioterrorism, a serious epidemic, a hurricane or other public health emergency. Emergency management and response functions are integrated into each program and into each employee's job duties. These functions must be coordinated with the other state agencies and organizations involved in emergency preparedness and operations. This is done largely through joint planning and exercises carried out under the State Emergency Operations Plan.

What are DHEC's responsibilities in an emergency response?

Because of DHEC's varied infrastructure, we respond to many different public health threats. This infrastructure includes many different organizational units. To understand the agency's operations in an emergency response situation, it is important to understand how the critical functions are integrated into the organization. Overall authority for emergency management for all hazards rests in the Director's Office of Public Health Preparedness. Health Services manages the epidemiology and surveillance functions in the Division of Acute Disease Epidemiology of the Bureau of Disease Control. The Health Services Bureau of Disease Control has the responsibilities for emergency response to disease outbreaks and bioterrorism, as do the Bureau of Laboratories and the Bureau of Environmental Health. The Environmental Quality Control Division of Waste Assessment and Emergency Response has specific responsibilities for emergency management related to hazardous materials and radioactive materials. The Division of Emergency Medical Services and Health Licensing in the Health Regulations deputyship provide emergency support by coordinating emergency medical service and ambulance response to a disaster and by working with hospitals and nursing homes to assist them in managing medical surge and with evacuations, if needed.

How does DHEC operate during an emergency?

Under the State Emergency Operations Plan, DHEC has leadership responsibility for two critical emergency support functions (ESFs): ESF-8 Health and Medical Services and ESF-10 Hazardous Materials. In addition, DHEC plays an important support role in the emergency support functions of Public Works and Engineering; Information and Planning; Mass Care and Emergency Welfare Services; Search and Rescue; Animal Emergency Response and Specific Impact Hazards. Agency leadership and staff from all program and administrative areas are mobilized to staff the State and County Emergency Operations Centers, operate state and regional DHEC Emergency Operations Centers and participate in the emergency operations under the state plan. Many people participate in emergency operations, and they work in capacities that may have little to do with their regular duties in protecting health and environment.

DHEC Regional Health Directors, Regional Public Health Preparedness Directors, nursing, environmental health and key management staff coordinate local public health response through County Emergency Operations Centers. Local public health staff, regional surveillance and response coordinators and regional epidemiology teams conduct investigations during disease outbreaks and may assist first responders during bioterrorism threats.

The Role of Environmental Quality Control

Environmental Quality Control (EQC) staff provide an initial response to environmental emergencies. EQC program areas such as Drinking Water, Agricultural Wastewater, Waste Assessment and Emergency Response maintain an immediate response capability for hazardous material emergencies. EQC Disaster Coordination Team and Technical Assistance teams were created to respond to consequence management activities following an emergency. EQC provides technical expertise in the areas of hazardous materials identification and public safety/health assessment, hazardous materials containment, countermeasures for local responders and SLED, as well as decontamination of team members and equipment.

EQC provides staff to the State Emergency Operations Center for Emergency Support Function (ESF) 10 duties related to chemical or radiological events and staffs the DHEC emergency operations center.

The Nuclear Response and Environmental Surveillance Section coordinates the response to nuclear accidents or incidents at the four commercial nuclear power plant facilities located in South Carolina and another located adjacent to South Carolina in Georgia. More information is available at the EQC's Emergency Response website. The state has a radiological emergency response plan with detailed plans for each site, as required by the Nuclear Regulatory Commission. The section trains first responders in radiological hazards awareness. In the event of an emergency involving the release of radioactive materials from one of the nuclear power plant facilities, there are plans for evacuation, emergency medical response, and protection of food and water supplies.

The Nuclear Response and Environmental Surveillance Section would coordinate response to other potential radiological incidents, such as transportation-related radiological emergencies, or events associated with terrorism. The Office of Public Health Preparedness has developed a Wide Area Radiological Response Framework and is developing an annex to the Mass Casualty Plan (link ) to address the health-related responses to a radiological emergency.

The Environmental Health section of EQC assures the safety of consumable food and water by investigating dairy sanitation, on-site wastewater disposal, vector control and other sanitation issues that may arise in an emergency.

The Role of Health Services

The Division of Acute Disease Epidemiology (DADE) takes the lead in responding to bioterrorism threats, attacks or epidemic disease outbreaks. DADE conducts disease outbreak surveillance and investigations. It provides communications, technical assistance, consultation, training and other support functions during emergency response including food borne disease investigation. DHEC's Public Health and Emergency Preparedness cooperative agreement with the Centers for Disease Control and Prevention (CDC) supports full-time Regional Disease Surveillance and Response Coordinators assigned to disease surveillance, epidemiology and emergency preparedness duties. This grant also provides funding for the development and implementation of electronic disease surveillance systems in hospitals and healthcare providers' offices. More information .

Bureau of Laboratories

The Bureau of Laboratories (BOL) is a key partner in disease surveillance and epidemiology efforts. The BOL facility has a Level-3 biosafety capability for testing biological agents. Laboratory capacity for testing human tissue samples for chemical agents was added in an earlier grant year. A full range of testing services is available. Grant support provides for strengthening the public health laboratory's staffing, improving laboratory training capabilities, coordinating response activities with hospital laboratories, and purchasing needed equipment and supplies.

Health Alert Network/Communications and Information Technology

The Health Alert Network (HAN) provides capability for emergency communications, protection of data and information systems, and the secure electronic exchange of public health information.

The HAN is part of a nationwide communications and information system being developed by the Centers for Disease Control's (CDC) Public Health Emergency Preparedness and Response Program. The program builds public health capacity to respond to bioterrorism threats, emerging infections, and other health threats.

During an emergency response the HAN can provide high-speed, secure Internet connections to local health agencies to enable access to CDC's prevention recommendations, practice guidelines, and disease data. It can easily disseminate announcements released by local, state or federal public health authorities meant to inform the health and medical services of likely or imminent dangers to the health of the community. Its electronic system for disease surveillance and reporting between DHEC and health care providers assists the agency in quickly recognizing emerging diseases and health threats.

Risk Communication

The Division of Media Relations carries out public information functions for the Department, including the execution of the agency's crisis communications plan for public health emergencies. Public information spokespersons are available in each of the public health regions, as well as in the central office in Columbia. The Division of Media Relations provides crisis communications training for DHEC employees and other agencies employees, messages to assist the public in an emergency, and representatives of the Division staff Emergency Support Function (ESF) 15 in the State Emergency Operations Center during activation.

For additional information, contact:  (803) 898-3708