Executive summary 8 I. Introduction 26 II. State government capability 28


NORTH CAROLINA DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES



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NORTH CAROLINA DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES

This Section describes a few of the programs carried out by the Division of Public Health and the Division of Mental Health, Development Disabilities, and Substance Abuse Services as they pertain to hazards mitigation.



Division of Public Health

The Division of Public Health within the Department of Public Health and Human Services carries out many responsibilities that pertain to natural hazards mitigation as it relates to the public health of our citizens. Branches of the Division of Public Health that are described here include the Epidemiology Branch, the Office of Public Health Preparedness and Response, and the Communicable Disease Control Branch.



Division of Public Health Epidemiology Branch


Epidemiology is the branch of Public Health that works to understand the causes and effects of disease in communities. The branch looks for ways to prevent or control those diseases and their negative effects on people and society. Epidemiologists study the factors and relationships that determine the presence, numbers, trends and distribution of diseases in communities and certain populations.
Epidemiological services offered by the State include:


  • Information on disease and injury prevention and control

  • Consultations on community health problems

  • Surveillance and prevention activities

  • Identification of environmental or occupational threats to health from asbestos, lead, chemicals, dusty trades, intensive livestock operations, harmful algal blooms, mold and other environmental factors

  • Investigation, intervention strategies and education on disease outbreaks and prevention



Division of Public Health Office of Public Health Preparedness and Response


The first steps toward establishing an office specifically designed to address biological attacks began in November 2001 when more than $3 million form the State’s “Rainy Day Fund” was made available to public health officials. In addition to bioterrorism preparedness, the Division of Public Health was tasked with revitalizing the Department’s disease prevention and detection infrastructure.
The effort gained more momentum in the spring of 2002 when federal grant money became available and the concept of creating a dedicated “Office of Public Health Preparedness and Response” (PHPPR) was formally embraced. With the federal grant, a large portion of the state funds were reimbursed or not spent, resulting in a state expenditure of less than $500,000. Having access to the state funds, however, had given North Carolina a jump-start over most other states and gave our preparedness efforts momentum that carries on today.

To make efficient and effective use of the funds, the PHP&R Office created seven Public Health Regional Surveillance Teams (HRSTs) to provide support to local health agencies serving all 100 counties. The host counties for these regional offices are Buncombe, Mecklenburg, Guilford, Durham, Cumberland, Pitt, and New Hanover. Each team includes an epidemiologist, an industrial hygienist, a nurse consultant, and an administrative specialist.


A vital link in the State’s ability to detect and respond to a disease threat is laboratory capacity. In that regard, the North Carolina State Laboratory of Public Health has expanded its capacity and is working with the local health departments in Buncombe, Pitt, and Mecklenburg counties to develop regional bioterrorism laboratory testing capabilities.
Another key component to the effort is communications. The Division of Public Health deployed its first version of the North Carolina Health Alert Network (HAN) in October 2002. This secure, internet-based alerting system provides 24/7 flow of critical health information among North Carolina’s state and local health departments, hospital emergency departments, and law enforcement officials. The NCHAN database system provides secure, tiered health alerts to key personnel through simultaneous use of phone, fax, email, and pagers to communicate urgent health information.
The Division of Public Health also increased and updated its technology capacity to facilitate electronic disease reporting. Coordinated by the CDC through a program titled National Electronic Disease Surveillance System (NEDSS), this effort fosters the ready exchange of health data among and between federal, state and local health agencies. North Carolina was the third state selected for inclusion in the system.
Tying all of these components together is the NCHAB Web site, used both as a conduit for exchanging information and as a resource for accessing an almost limitless collection of information on disease control and bioterrorism issues.
Inter-governmental Collaboration

The Division collaborates with other state and local agencies in order to carry out its mission of disease preparedness and response.


The Division assists in planning, drafting, and reviewing county Bioterrorism Plans.
The Division works with the North Carolina Department of Agriculture and Consumer Services to strengthen the bonds between animal and human health surveillance and disease investigation.
The Division also collaborates with the North Carolina Division of Emergency Management and the SBI to coordinate response activities and plans. The Division has written the North Carolina Public Health Bioterrorism Addendum to the North Carolina Emergency Operations Plan. Two representatives from the Division of Public Health served on the State Hazard Mitigation Advisory Group (SHMAG), and contributed their knowledge and expertise to the development of the State Hazard Mitigation Plan. Their participation in the SHMAG opened new channels of communication between NCDEM and the Division of Public Health to address the critical issues of communicable disease and bioterrorism, despite the fact these issues are not generally considered under the umbrella of “natural hazards.”

Division of Public Health Communicable Disease Control Branch


The General Communicable Disease Control Branch has four main objectives:


  • To promptly investigate disease outbreaks and unusual situations and to implement control measures to minimize further transmission of diseases

  • To monitor disease-reporting by physicians and laboratories in order to detect trends and to assess the public health impact of diseases

  • To provide a channel of communication between public health agencies, private physicians, and hospital and occupational infection control personnel, as an essential part of disease control efforts

  • To explain pubic health inventories and disseminate health education messages to the community and the media in order to encourage disease control efforts.



Division of Mental Health, Developmental Disabilities and Substance Abuse Services

Disaster Preparedness Program

As part of public services in our state, the Division and the local programs that make up the Mental Health, Developmental Disabilities and Substance Abuse Services system provide help during and after disasters. Whether it is providing shelter in state facilities, seeing that consumers get needed needed medications, or deploying people in stricken communities, staff and programs are available to help with people’s emotional needs.
In the past, this help has usually centered around natural disasters such as floods, hurricanes, and other damaging storms. Now the system is also ready to assist with the effects of coping with man-made disasters, such as terrorism and bioterrorism. These situations create different kinds of problems for people. People may experience stress over long periods of time just from the threat of something happening.

Hope After Program

The Hope After Program serves the mental health needs of communities following a disaster. The Hope After Floyd Program involved outreach workers, sponsored by the Division and federal grants, helping people to recover from Hurricane Floyd. Public health specialists visited the scenes of flooding, and worked with victims to pinpoint their immediate challenges, and to help them find available resources and practical solutions.



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