Emergency and disaster preparedness are not new concepts in Florida. In fact, the Florida Department of Health (Department) has an entire division dedicated to emergency preparedness and community support. Through this Division, the Department shares recommendations for individual, community, environmental, and health care systems preparedness. This includes information on current hazards, how to make a plan for you and your family, children’s disaster preparedness, behavioral health, special needs sheltering, and how to “stop the bleed.” These tools are designed to help individuals and their families prepare for any disaster. Listed below is more information about different preparedness teams that that the MCH Section consults with in preparation for and response to emergencies:

• Individual preparedness includes tools and resources to help an individual and their family prepare for any disaster.  This includes information about current hazards and important information on what to do before, during, and after public health emergencies.
• Community preparedness relies on the ability to develop informed, empowered, and resilient health care systems and residents. With adequate information, resources, and tools, communities are better prepared to prevent, protect against, mitigate, respond, rebound, recover, and adapt to threats and all-hazards.
• Health care system preparedness ensures that there is capacity and capability for provision of critical public health and medical services in order to reduce the potential for adverse health outcomes during any event.

During emergencies, the preparedness team provides guidance to both Incident Command and county health departments regarding possible human health risks from environmental components. They also provide information to county health departments during responses that involve accidental spills, waste disposal, and water contamination. To maximize success, trainings and exercises are conducted with partners throughout the state.

One of the greatest challenges faced by the Department and county health departments during disasters is balancing emergency responsibility with continuing routine delivery of public health services for Florida citizens. One strategy the Department has implemented to mitigate this is through engagement with the Project Public Health Ready (PPHR). PPHR is a criteria-based training and recognition program that assesses local health department capacity and capability to plan for, respond to, and recover from public health emergencies. PPHR aims to protect the public's health and strengthen the public health infrastructure by equipping local health departments with sustainable tools to plan, train, and exercise using a continuous quality improvement model. PPHR is a partnership program comprised of the Department, the National Association of County and City Health Officials (NACCHO), and the Centers for Disease Control and Prevention (CDC) that recognizes effective county health department preparedness programs.

The PPHR criteria are nationally recognized standards for local public health preparedness. NACCHO regularly updates the criteria to align with recent federal initiatives, including the Centers for Disease Control and Prevention Public Health Emergency Preparedness (CDC PHEP) capabilities and Public Health Accreditation Board's (PHAB) Standards and Measures.

PPHR criteria are comprised of three goals:

• Goal 1: All-hazards Preparedness Planning
• Goal II: Workforce Capacity Development
• Goal III: Demonstration of Readiness through Exercise or Real Event

The MCH Section, Children and Youth with Special Health Care Needs (CYSHCN) program, and the Division of Emergency Preparedness and Community Support work together to ensure that the MCH and CYSHCN populations are considered when developing strategies to mitigate impacts on different populations. Consideration is made for our providers who provide direct services to the maternal and child health population. One example of this partnership was at the beginning of the COVID-19 pandemic. Florida's Healthy Start Coalitions were hearing that clients were not able to obtain diapers and wipes. This information was shared with emergency response teams and missions were completed to get these supplies to families. This not only included connecting community partners who had reserve supplies, but also communication with private entities (i.e. Wal-Mart, Publix, etc.) to know when items were restocked.

Additionally, during severe weather or a hurricane, a Special Needs Shelter (SpNS) may be activated. A SpNS is for "someone who during periods of evacuation or emergency, requires sheltering assistance, due to physical impairment, mental impairment, cognitive impairment or sensory disabilities.” Chapter 64-3, Florida Administrative Code. The Department’s Bureau of Preparedness and Response administers a statewide Special Needs Shelter Program to assist county health departments in addressing the special medical needs of people in their community.

SpNS are designed to meet the needs of people who require assistance that exceeds services provided at a general population shelter. A SpNS is a place to go when there is no other sheltering option. Shelters may be activated during an emergency event to provide mass care for people who cannot safely remain in their home. Often SpNS are intended to provide, to the extent possible under emergency conditions, an environment that can sustain an individual's level of health. SpNS are often setup in public facilities and have food and water available. Shelter staff offer basic medical assistance and monitoring. Clients and their caregivers will have a small sleeping area and they maintain back-up electricity for light and essential medical equipment.

The Department’s MCH Section coordinates with the WIC program during natural disasters and the pandemic. The WIC program provides breastfeeding supports to clients who were unable to attend face-to-face appointments due to the pandemic or a natural disaster (i.e., hurricanes) either by phone or virtually. Local WIC agencies educate and issue breast pumps to clients while following social distancing protocol. This includes demonstrating the use of a breast pump while behind a protective glass barrier or ensuring a distance of 6 feet between the staff and client. Local WIC agencies also promote the Breastfeeding Peer Counselor Program, including the availability of breastfeeding peer counselors, outside of normal office hours.