Emergency preparedness is a critical national, state, and local issue crucial to all citizens, including Title V populations. Preparedness is a complex process that involves many federal and state agencies and private partners. Serving Title V populations requires the infrastructure to serve all Guam residents affected by a disaster during a disaster.

Guam Department of Public Health and Social Services “Incident Command System Positions Chart” (available upon request) depicts key DPHSS positions and lines of authority to implement response to disasters. During the implementation of such responses, the lines of authority depicted in the chart supersede lines shown in other DPHSS organizational charts.

The Department’s primary role during weather-related disasters is to provide medical needs to shelters. These shelters are intended to provide care that could be provided at home in the absence of a disaster. As a result, the medical needs shelters are not designed to serve as hospitals. The Department coordinates its response to disasters through the Office of Civil Defense.

All DPHSS staff are expected to respond to emergency and disaster assignments when called to duty. However, some employees—particularly nurses, social workers, and certain administrative personnel—are required to or have volunteered to be members of disaster response teams. Nurses and social workers have been assigned to “Medical Needs Teams,” and other volunteer personnel posted to “Administrative Teams.” Persons on these teams undergo special training concerning tasks that they may be called upon to perform during a disaster. At the medical needs shelters, the primary role of nurses is to provide direct nursing care and, if appropriate, enabling services. The primary function of social workers is to provide enabling services. The role of the Administrative Teams is mainly to observe the operation of shelters, converse with shelter staff and residents, communicate needs to DPHSS Director’s Office, and provide administrative support. Some Administrative Teams are to serve in the Department’s medical needs shelters.

Emergency preparedness for Title V populations is part of overall emergency preparedness, not an isolated entity. Accordingly, the Bureau of Family Health and Nursing Services (participates in the Department’s planning and implementation of emergency preparedness.

The State Emergency Operation Center (EOC) functions under the State Emergency Operations Plan to help healthcare in Guam coordinate and create emergency operations plans (EOPs) specific for their organization and encompass all Guam agencies. The department’s Public Health Emergency Preparedness Coordinator represents DPHSS within the EOP along with two other liaisons. The three liaisons are expected to alternate-working around the clock to collect information and make informed decisions on behalf of the department in an emergency response. The Strategic National Stockpile Coordinator is responsible for Point of Dispensing (POD) sites to ensure dispensing supplies.

Guam DPHSS was awarded CDC funding for an Epidemiology and Laboratory Capacity (ELC) grant to enable enhanced detection. The ELC scope of work assists in contact tracing efforts;, assisting with the surveillance of vulnerable populations;, implementing prevention strategies with vulnerable, diverse populations;, and providing alternative testing and vaccine sites for COVID-19.

As we continue to have limited information from published scientific reports regarding pregnant women and their risks with COVID-19, Guam DPHSS is monitoring pregnant women who test positive for COVID-19 through the end of their pregnancy as well as monitoring birth outcomes of their infant(s), By collecting information on these mothers and infants, we will be able to characterize the spectrum of health effects associated with COVID-19 infection during pregnancy to inform clinical guidance, programs, and services.

Through this initiative, the data may be used to monitor and improve the health of pregnant women and infants; link families to medical and social services to get recommended care; strengthen laboratory and clinical testing to find emerging health threats quickly; and ensure public health is ready and prepared to meet the needs of pregnant women and infants during emergencies.

Guam DPHSS views emergency preparedness as a journey rather than a destination that has been reached. However, Guam has made tremendous progress on this journey. This progress has come through a challenging experience, thorough planning based on that experience, and the Guam Emergency Response Plan development. We remain committed to assuring that their respective agencies and the residents of Alabama are well prepared to meet special health-related and health care system-related needs that may arise during future disasters that may strike the island.