DEPARTMENT OF HUMAN RESOURCES
DIVISION OF PUBLIC HEALTH
EMERGENCY OPERATIONS PLAN:
EMERGENCY PREPAREDNESS COORDINATOR
ALERT AND NOTIFICATION
STANDARD OPERATING PROCEDURE
SUPPORT ANNEX A1
11 Dec 2007
I. PURPOSE
This Standard Operating Procedure (SOP) provides guidance for the alert and notification of
the Georgia Division of Public Health (DPH) Emergency Preparedness Coordinators (EC) at the
State and District levels. This SOP will assist the Department of Human Resources (DHR)
Emergency Manager, Public Health Leadership, and Public Health District Director’s staff to
contact and notify the appropriate level ECs of situations or events that have the potential to be
of Public Health significance.
II. SITUATION
All incidents occur locally and are handled by the local jurisdiction, as stated in the National
Incident Management System (NIMS) guidance, as well as through Department of Homeland
Security-Federal Emergency Management Agency (DHS-FEMA) and Georgia Emergency
Management Agency (GEMA). As incidents mature, assistance may be requested from other
agencies, including DHR and/or Public Health.
To coordinate intra-state/inter-state/federal assistance/support, Division and District Public
Health personnel need to know how to contact the appropriate personnel at all levels and notify
them of the situation. The On-Call Representative (OCR) is a generic term that will be used
throughout this SOP describing the representative member of the Public Health Emergency
Preparedness Staff at all levels that will receive an initial alert. Division OCR signifies the
representative at the State level and District OCR signifies the representative at the District level.
The OCR can be found by visiting the Division of Public Health State Electronic Notifiable
Disease Syndromic Surveillance (SendSS) web site, http://sendss.state.ga.us and searching the
On Call Calendar.
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To assist with the myriad of responsibilities, there are Annexes and Attachments to refer to:
-Responsibilities Of On-Call Representative Standard Operating Plan: Attach I: pg 11
-Suggested Responsibilities Of On-Call Emergency Coordinator: Attach II: pg 12
-ESF8 Response in an Emergency, A Public Health Primer Support: Attach III: pg 14
-Suggested “go-bag” Contents: Attach IV: pg 17
-ESF8 (Public Health) Responsibilities, Emergency Operations Center: Attach V: pg 18
-DHR EOC MACC Structure: Attach VI: pg 22
-Threat Level Actions (State, Hospital, Public Health): Attach VII: pg 23
-1-866 PUB-HLTH SOP; Annex A1, Appendix I: pg 43
-1-866-PUB-HLTH SOP: Hotlines Manual; Support Annex A1, Appendix 1, Attachment I:
pg 46
-Call-Down Exercise Program Standard Operating Plan: Support Annex A1, Appendix II:
pg 112
-Call-Down Feedback Form Support: Annex A1, Appendix II, Attach 1: pg 118
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III. ASSUMPTIONS
The affected District is aware of its Public Health and non-Public Health capabilities and
resources, as related to the primary role of Emergency Support Function (ESF) 8 and support of
Emergency Support Function 6. During an event, the affected District will not only use its
available resources, but will request and coordinate assistance from adjacent Districts through
official and unofficial Memorandum of Understandings (MOUs) or Memorandum of Agreement
(MOAs).
The District OCR is the “local Public Health” point of contact for any event, emergency or
request of Public Health significance. (Note: While the District Emergency Coordinator is
expected to be the initial contact during business hours at the District level, identifying the
District OCR as the initial contact in this SOP ensures that the representative “on-call” at the
time an alert is given is prepared to follow the procedures outlined below.)
It is the responsibility of the District OCR to contact and coordinate response activities with
other available District resources. As this coordination is occurring, the District OCR will notify
the Division OCR, briefing that individual on the situation, including potential requirements.
The Division OCR may be aware of events throughout the State, due to alerts/notifications
from GEMA, other partners and the media. Therefore, the Division OCR is expected to contact
the respective District OCR(s), briefing them of the situation and requesting periodic feed back
from the District EC staff.
The Division OCR is the conduit to State level resources, including DHR, DPH and GEMA.
The Division EC is the conduit to regional/federal resources, including various out of state
resources, Disaster Medical Assistant Teams (DMAT), Disaster Mortuary Operational Response
Teams DMORT), Strategic National Stockpile (SNS) resources, Assistant Secretary of
Preparedness and Response (ASPR) resources, to name a few. Therefore, the District OCR will
contact the Division OCR for assistance requesting any out of District resources not previously
covered under an MOU or MOA.
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IV. ALERT AND NOTIFICATION HIERARCHY
Consideration must be given to which hierarchy is appropriate under any given incident. The
hierarchies listed below can be followed individually or in conjunction with each other. During
normal duty hours, alerts should be conducted based on the department’s structure. The
department’s lead will make the determination which hierarchy is appropriate. After normal
duty hours, the individual reporting an incident must notify the OCR. The OCR will then make
the determination which hierarchy is appropriate.
A. Intra-Division/Intra-District
Alerts requiring responses from key responders within the Division of Public Health
will be initiated by the Division Emergency Coordinator or OCR; which ever is
available/appropriate. This will be referred to as an Intra-Division alert. Districts will use a
similar system where the District Emergency Coordinator/OCR will ensure alerts are given to
key responders within the district. This alert will be referred to as an Intra-District alert.
B. Division to District, District to District, District to Division
Alerts that require notification of key responders outside of the Division/District will
fall into three categories: Division to District, District to District, and District to Division.
Division to District and District to Division alerts will be the most common. These alerts will be
initiated by the department which is the first to become aware of an incident requiring
notification of key responders outside of their department. There may also be times which will
require a District to alert another District of an immediate, imminent threat. Under any of these
three categories, the lead Emergency Coordinator or OCR will determine the appropriate
individual/office to contact outside of their department.
C. Division to State/Regional/Federal
The Division Emergency Coordinator or representative will determine when to contact
an agency/department which sits outside of and higher than the Division of Public Health.
Districts who need to contact an agency outside of their district (other than another district) and
is outside of DPH, must contact the Division Emergency Coordinator to request assistance in
contacting that agency/department.
V. PUBLIC HEALTH EMERGENCY RESPONDERS
The following is a list of offices, agencies, teams, partners, or individuals who have a role
within Public Health to respond to and/or coordinate an incident covered under either ESF 6 or
ESF 8. This list may not include all potential responders, but should be used as a guide in
developing an alert and notification roster.

Division Health Emergency Assistance and Resource Team (DHEART), District Health
Emergency Assistance and Resource Team (DHEART), County Health Emergency
Assistance and Resource Team (CHEART), Regional Coordinating Hospitals (RCH),
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Other Hospitals, Emergency Preparedness Staff, Emergency Medical Services (EMS),
Nurse Managers, Environmental Health Managers, Strategic National Stockpile Staff, PH
Directors, Medical Reserve Corps, Emergency Management Agencies (EMA), Public
Information Officer, Fire, School System Liaisons, Pharmacists, Immunization
Managers, Epidemiologists, Information Technology Manager.
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VI. CONCEPT OF OPERATIONS:
This SOG supports the PH EOP’s 3 phases of emergency management:
Phase I: Preparedness and Prevention
Phase II: Detection and Response
Phase III: Recovery and Mitigation
Phase I: PREPAREDNESS/PREVENTION
This phase includes preparation for an event of public health significance and prevention of
circumstances leading to emergencies.
All Districts must be aware of their ESF 6 and 8 capabilities and resources. The District
Health Director’s staff should also be aware of the local Emergency Medical Services (EMS),
hospital capabilities, Emergency Management Agency (EMA), local Red Cross chapter, Division
of Family and Children Services (DFCS), nursing home and other resources and capabilities
within their District. This awareness will assist the District Health Director’s staff to know when
to request resources from outside the district. The District staff needs to be aware that the DPH
staff is available to assist them during an event. Being aware of the procedure to request the
appropriate DPH assistance is critical to acquiring that aid quickly.
The Division EC works with additional state resource emergency coordinators, including, but
not limited to the Assistant Secretary of Preparedness and Response (ASPR) Coordinators, the
Strategic National Stockpile (SNS) Coordinator, Chempack Coordinator, the Public Health
Exercise Coordinator, Public Health Laboratory, Public Health Chemical-Radiological
Emergency Coordinator, Environmental Health, Epidemiology, Division of Mental
Health/Developmental Disabilities and Addictive Diseases (MHDDAD), DHR Emergency
Management, Nursing, Pharmacy and many others.
The Division EC works with and coordinates asset requests with state, regional and federal
partners within GEMA, Health and Human Services (HHS) Region IV, DHS-FEMA Region IV,
Federal Coordinating Center in Atlanta, Federal Bureau of Investigation (Atlanta Office),
Centers For Disease Control and Prevention, and many other partners. The Division Emergency
Preparedness staff is responsible to contacting the requested resource coordinators as well as
additional DPH and DHR staff to assist in a response. As of December 2006, the Senior Planner
within the Division Emergency Preparedness Staff is responsible for all Division on call related
duties and is usually the primary normal duty hour Division OCR, with back up from other
Division level staff.
A) The DHR Emergency Manager, applicable Division of Public Health office and
branch leadership, Division Emergency Preparedness Staff, and District ECs contact
information is available on SendSS. All OCRs and applicable Division and District staff
members are responsible for registering on SendSS and maintaining current contact
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information. This includes after hours contact information. The on-call calendar needs to be
accurately filled in for the current and following month.
B) The Division and Districts must identify an OCR for 24/7/365 availability. The OCR
will ensure their radio(s), cell phone(s), pager(s) and other electronic contact resources (as
stated on the SendSS Contact list) are in good working condition.
C) During normal duty hours, the primary means of communication/alert will be the duty
phone/work phone. If a District or other contact does not respond within 10 minutes of the
initial alert, then other means of contact (as identified in SendSS) will be used until that
contact has been alerted.
D) The OCR will be immediately available for emergency calls via one of their contact
devices and be available to physically respond within a reasonable time to the requested
location. If the Primary OCR does not respond to calls or pages, the Back-up OCR will be
contacted. If neither responds and it is urgent the Division needs to be notified, the Director
of the Office of Emergency Preparedness or the Director of Planning will be contacted.
Reasonableness is defined below, unless otherwise stated.
1. Alert and Response – Within 15 minutes
2. Physically respond to designated EOC or other location – Within 90 minutes
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Phase II: DETECTION/RESPONSE
This phase includes the detection of and response to an event of public health significance.
Depending upon the nature of the incident, the appropriate response will be determined and acted
upon using appropriate annexes, Standard Operating Procedures (SOP) and Standard Operating
Guides (SOG).
The OCR will make brief notes of the calls and responses, enabling a record log to be
maintained for potential legal reasons. The notes will be entered onto WebEOC, under
“Significant Events”. Refer to the WebEOC Manual and the PH Emergency Operations Plan
Annex A-9 for further guidance to open a new District specific or Statewide Incident. The nature
of the event, personnel and/or agencies notified, outcome and any other pertinent information
related will be entered into the note. Separate entries by the same reporting individual do not
need to me made; the original entry will be updated and saved. If there are entries made by
additional personnel, those will be entered as new entries. The log can also be used as a training
tool for new on call personnel.
At their earliest convenience, the affected District Health Director’s staff will notify the
Division EC that an event is occurring in their District. The Division EC will ensure appropriate
State, regional and/or federal personnel are notified per protocol or based on the event. As a
minimum, the Division EC may notify other members of the PH Emergency Preparedness Team,
the Division’s Health Assistance and Resource Team, DHR Emergency Manager and OHSGEMA SOC.
As an event matures, the Division EC is responsible to coordinate resource needs for the
affected district(s). Most responses can be coordinated while at their work station. As the event
becomes more complex, the Division EC may require additional PH and DHR personnel to assist
in the response. As those personnel are contacted, the Division EC will coordinate with the DHR
Emergency Manager, opening the DHR EOC. The Division EC and DHR Emergency Manager
will coordinate with appropriate DHR and DPH management personnel to staff the OHS-GEMA
SOC.
The Division EC will coordinate with the DHR Emergency Manager, establishing the DHR
EOC Incident Command structure, ensuring it is posted on WebEOC and in the DHR EOC. The
Division EC and DHR Emergency Manager will establish DHR EOC operational periods with
appropriate manning. Appropriate contact numbers within the DHR EOC and OHS-GEMA
SOC (PH and DHR only), will be appropriately posted on WebEOC.
If there is a National Disaster Medical System (NDMS) response occurring in Atlanta, Augusta
or other areas of the state, a personnel support plan will need to be developed. For other
extensive and extended operations, such as SNS deployment, large scale evacuations, mass
casualties, administration assistance teams may be deployed from DHR to the affected areas.
The Division EC and DHR Emergency Manager will coordinate with the deploying team
leader(s), assisting as required.
The DHR, Division EC and support staff assigned to the OHS-GEMA SOC will notify the
Division EC verbally and through WebEOC, that they are on site and available to assist and
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coordinate activities as requested and required by either the DHR EOC and/or the OHS-GEMA
SOC action officers and/or Emergency Support Function staff. Staff assigned to the OHSGEMA SOC will monitor the virtual EOC management system used in the OHS-GEMA SOC, as
well as the WebEOC.
The Public Health Districts will notify the DHR EOC of all requests for information (RFI),
requests for assistance (RFA), mission taskings, and significant event notifications through the
WebEOC. During events requiring activation and staffing of the DHR EOC and the OHSGEMA SOC, there is heightened activity, limiting radio/phone access. It is best to use WebEOC
as the primary method of communicating these types of messages.
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Phase III: RECOVERY/MITIGATION
Recovery is the transition to normal operations. Short-term recovery actions are taken to assess
damage and return vital life-support systems to minimum operating standards. Long-term
recovery may go on for years and involve the development, coordination, and execution of
services.
Mitigation minimizes the adverse impact of an emergency and reduces vulnerability to future
emergencies. Mitigation measures may be implemented at any time.
The DPH Exercise Coordinator will conduct monthly and quarterly Call-Downs in order to test
the State and District Public Health Staffs’ ability to rapidly respond to a significant event or
public health incident. The Call-Down exercise program and schedule is located at Appendix 2
to Support Annex A1. After action reviews will be conducted quarterly to determine the
strengths and weaknesses of the alert and notification process. These reviews will help shape
this SOP, drive how Call-Downs are conducted, and focus on those areas that need improvement.
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DEPARTMENT OF HUMAN RESOURCES
Division Of Public Health
Emergency Operations Plan
Responsibilities Of On-Call Representative
Standard Operating Plan
Support Annex A1, Attachment I
As a disclaimer, it is recognized this list is not all inclusive. It serves as a guide of suggested
activities of the On-Call Representative. This list is arbitrary and no ranking should be assumed.
 Be available for the assigned period, unless otherwise stated
 Be accessible by more than one means of communication devices and have all available
devices listed, including unlisted home/cell numbers on SendSS
 current statewide radio (Southern LINC) will be mass voice notification of choice
 maintain good battery charge of all communication devices
 keep all assigned radios on the designated channel
 If somebody else takes your call, ensure they notify the caller of your current status
 Caller should then notify an alternate (if necessary) or another key individual (if
available). Another key individual could include, but is not limited to: peer staff
member or higher emergency responder or manager.
 As a minimum, maintain easy access to an alert roster of all essential personnel and
teams, at the State and District level
 Have easy access to all essential operations plans and contact numbers of essential
partners
 Notify fellow staff, appropriate PH management team members and DHR Emergency
Manager of incidents in a timely manner:
 includes, but not limited to bomb threats of PH property, evacuation of a PH office
for any reason, power outages or computer server crashes, unusual or increase in
disease presentations to local hospitals or clinics as related by District staff, any
unusual occurrences that may be of PH significance, and powder/suspicious package
incidents requiring a law enforcement, HAZMAT, medical, EMA response
 Limit use of alcohol during On Call period
 Contact and change On Call status with alternate, notifying appropriate personnel, if you
become physically or mentally impaired.
 Be familiar with the roles and responsibilities of the Emergency Support Function 8
 Be familiar with the roles and responsibilities supporting Emergency Support Function 6
 Be familiar with the OHS-GEMA Georgia Emergency Operations Plan and how it
supports the National Response Plan
 Be familiar with the DHR Emergency Management Plan and how it supports the Division
of Public Health Emergency Operations Plan
 Be familiar with Division of Public Health Emergency Operations Plan and various
Support Annexes, Incident Annexes and Appendices
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Suggested Responsibilities Of On-Call Emergency Coordinator
Support Annex A1, Attachment II
As a disclaimer, it is recognized this list is not all inclusive. It serves as a guide of suggested
activities of the on-call Emergency Coordinator. The ranking is arbitrary.
-ensure contact information is up to date in the SendSS “On Call Calendar”
-be available for the stated/assigned 24 hour period, unless otherwise stated
-be accessible by more than one means of communication devices and have all available devices
listed, including unlisted home/cell numbers
---maintain good battery charge of all communication devices
---keep the SouthernLinc radio on the predesignated channel (determined by your protocol)
-if you are on call and have somebody else take your call, make appropriate changes in SendSS
“On Call Calendar” and notify all pertinent individuals
---pertinent individuals (minimum) include, but are not limited to: fellow staff, District Health
Director, District Administrator, District Epi on call, District PIO, designated OEMS/BT staff
member, others as determined by your SOP
-as a minimum, maintain easy access to SendSS “On Call Calendar”of all essential personnel and
teams, at both the District and State level
-have easy access to District SOP and all essential operations plans, including hospital 24 hour
points of contacts and numbers, EMA’s, other essential partners
-notify appropriate OEMS/BT staff of incidents occurring in your District, in a timely manner:
---includes, but not limited to bomb threats of PH property, evacuation of a PH office for any
reason, power outages or computer server crashes, unusual or increase in disease presentations to
local hospitals or clinics as determined by the DHD or Epi, any unusual occurrence you were
informed of that may be of interest at the state level, powder incidents requiring a law
enforcement, HAZMAT, medical, EMA response
---if event does not evolve into a large response or has no untoward outcome, complete an entry
on WebEOC, in the “Significant Event” Board. Include type of event, whom contacted and the
outcome.
---upon resolution of event or every 24 hours, complete and submit a SITREP/STATUS
REPORT to the OEMS/BT Section. Minimal information includes that as found on the
distributed SITREP TEMPLATE
-limit use of alcohol during on call period
---contact and change on call statue with alternate, notifying appropriate personnel
-if taking medications that may alter mental status
--- contact and change on call statue with alternate, notifying appropriate personnel
-have authority and responsibility to contact senior District personnel
-know location of and have authority and responsibility to open Emergency Operations Center
and initiate call down of essential personnel (or respond per procedure as outlined in the District
SOP)
-be familiar with the roles and responsibilities of the Emergency Support Function 8
-be familiar with the roles and responsibilities supporting Emergency Support Function 6
-be familiar with the GEMA Operations Plan and how it supports the National Response Plan
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-be familiar with the DHR Emergency Management Plan and how it supports the Division of
Public Health Emergency Response Plan
-be familiar with the District SNS Plan
---maintain authority and responsibility to call down and activate initial personnel for staffing the
RSS as soon as a decision is made to do so
---during a heightened alert situation, if the decision is made not to activate the District SNS
Plan, review the plan with essential personnel ASAP, in the event you will need to activate the
plan
--be familiar with the various SOPs and SOGs, including the “Advice for first Responders
Dealing with Suspicious Substances”, as found under the PH EOP IA4.
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ESF8 Response in an Emergency
A Public Health Primer
Support Annex A1, Attachment III
This is not intended to be an all encompassing review of the Public Health Response to
Presidentially Declared Disaster. Its primary intent is to familiarize state and District Public
Health personnel with the possible response of the state and federal government.
The scenario is one that has created or has the potential to create an overwhelming number of
casualties or overwhelm the medical resources in a given location.
LOCAL AND STATE EMERGENCY:
-a situation has occurred in a given location, either creating or has the potential to create a large
number of casualties or overwhelm the medical resources
-the District Health Director, in consultation with the Local/County Emergency Manager and
local hospital(s), determines their resources will either deplete soon or are depleted
-the District Health Director requests mutual aid with surrounding District Health Directors
-the Public Health mutual aid will not suffice
-the District Health Director consults with the Medical Director of the Office of Emergency
Preparedness (or representative)
- Medical Director of the Office of Emergency Preparedness (or representative) Director of
Public Health, updating the situation
-based on the information received, the Director of Public Health deploys available unaffected
Public Health resources to the affected area
STATE RESPONSE:
-the Director of the Office of Emergency Preparedness designee contacts and briefs the
Department of Human Resources Emergency Management and the Division’s Health Emergency
Assistance and Resource Team. If the event is resource intensive (cannot be handled at the work
station), the DHR Emergency Operations Center will be opened
-the DHR Emergency Management or member of the Office of Emergency Preparedness will
contact Georgia Emergency Management Agency, updating of the situation, requesting
assistance
-a member of the Office of Emergency Preparedness may courtesy call the Health and Human
Services Region IV Response Emergency Coordinator
-the Director of Public Health and Director of the Office of Emergency Preparedness (or
designee), based on consultation with the affected area’s District Health Director and Georgia
Emergency Management Agency, will contact the Governor, requesting a Public Health
Emergency be declared
-the Governor’s Office will consult Georgia Emergency Management Agency, being updated on
the situation
-based on the information received, the Governor requests a declaration of a Federal Emergency
through the Department of Homeland Security Office of Emergency Response/Federal
Emergency Management Agency, Washington, DC
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-based on the information received at the Federal level and from the State authorities, the
President does designate a Presidentially Declared Disaster, authorizing the implementation of
the National Response Plan, deploying Federal assets to the state and the affected area
-Georgia Emergency Management Agency’s State Operations Center is “activated” and the
Emergency Support Function representatives and representatives of other vital agencies are
contacted to report to the State Operations Center
FEDERAL RESPONSE (initial):
-the Department of Homeland Security Office of Emergency Response/Federal Emergency
Management Agency Regional Operations Center, Federal Emergency Management Agency
Region IV, Atlanta, GA is contacted by its Headquarters in Washington, DC and is “activated”
-the National Management Response Team, stationed in Thomasville, GA is alerted and all of its
equipment and personnel are prepared for deployment to the affected area
-the Regional Response Coordination Center is prepared for the arrival of response personnel
-response personnel include all of the Emergency Support Functions (1-12), Department of
Homeland Security Emergency Coordinators, Federal Department of Defense Regional
Emergency Preparedness Liaison Officers, Health and Human Services Region IV Response
Emergency Coordinator, Federal Department of Defense US Northern Command’s Joint
Regional Medical Planning Officers (upon request of the Regional Emergency Preparedness
Liaison Officers and/or the Emergency Coordinators)
-response of additional State resources is coordinated through Georgia Emergency Management
Agency’s State Operations Center
-representatives coordinated the initial Federal response through the State Operations Center,
continually assessing the situation and needs
FEDERAL RESPONSE (maturing):
-in concert with the State Operations Center, a Federal Department of Homeland Security
Emergency Response/Federal Emergency Management Agency’s Field Office will be
established near the disaster site, becoming the focal point for coordinating the Federal response
(near is relative; could be 10’s of miles from the scene)
-from the White House, a Federal Coordinating Officer will be appointed, the highest ranking
federal official on scene, reporting directly to the President of the United States
-all Requests for Information and Requests for Assistance will be assigned a number through the
Operations Section
-National Management Response Team will be assigned to this location
-representatives from the various Emergency Support Functions, including the Federal
Department of Homeland Security’s Emergency Coordinators, US Northern Command’s Joint
Regional Medical Planning Office, Federal Department of Defense Regional Emergency
Preparedness Liaison Officer, and others as requested will be deployed
-the Federal Department of Defense deploys a Defense Coordinating Officer with the Defense
Coordinating Element to coordinate the Federal and State Department of Defense response.
They will closely coordinate with other agencies located at the Field Office. The Defense
Coordinating Officer is responsible for ALL State and Federal Department of Defense personnel
and equipment deploying the site
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-as this is occurring, other Federal Agencies and Department of Defense are establishing their
respective Emergency Operations Centers
-all requests received by the Field Office for medical supplies and personnel, are coordinated by
the Department of Homeland Security’s Emergency Coordinators
-those requests requiring Department of Defense medical assets, will be coordinated through US
Northern Command’s Joint Regional Medical Planners
-as the situation unfolds, if it appears it might be a chemical/biological event, US Northern
Command may deploy its Joint Task Force-Civil Support command team. The Joint Task forceCivil Support will assist coordinating the deployment of the Federal Department of Defense
assists with the Defense Coordinating Element, ensuring the appropriate integration into the
response force
-the Health and Human Services Region IV Response Emergency Coordinators will coordinate
the response and integration into the response theater of Federal medical assets, such as the
Disaster Medical Assistance Teams, Disaster Mortuary Operational Response Teams, Veterinary
Medical Assistance Teams and other civilian relief teams and/or organizations attempting to
assist
Mature Response:
-for both the State Operations Center and the Federal Field Office, planning for a coordinated
drawdown will occur as suggested by the observations of senior staff
-this drawdown will occur as it appears the civilians will be capable of handling the situation
-it is understood the drawdown may not actually begin for several weeks or even months after
their deployment
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Suggested “go bags” for EOC activation
Support Annex A1, Attachment IV
The below is a suggested content listing for an unannounced EOC activation. The intent is for
the individual to be able to work in a sustained operational environment for up to three days.
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
14)
Sweater/long sleeve shirt/similar item (DHR EOC can be cold)
Bottled water/tea/other drinks as desired (not requiring refrigeration)
Some snack food (high protein/low fat, as an example)
Personal care items, e.g., tooth brush, tooth paste, baby wipes (assist with cleaning if
showers not available), deodorant, additional hygiene items
Any medications you are taking
ID badge
Comfortable shoes
Cash, small bills/change (snack bar, ordering food, etc). Suggest NMT $50 to start.
Change of clothes/underwear/socks for 3 days (suggest comfortable-no dress
clothes)
Book/magazines/journals to read during down times
Sleep wear (sweat clothes, etc) appropriate to sleep in the DHR EOC Conference
Room; mixed company
Sleeping bag or similar and pillow; suggest rubber mat or similar to sleep on (no
cots/bedding provided)
Flash light with extra batteries/bulb
Appropriate personal and professional communication devices (cell phones, radios,
pagers, etc)
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ESF8 (Public Health) Responsibilities:
Emergency Operations Center
Support Annex A1, Attachment V
This is not meant to be all inclusive, but to provide guidance for those Public Health (PH)
personnel who will assigned to the Emergency Support Functions (ESF) 8 desk (Health and
Medical Services) in an Emergency Operations Center (EOC). It is understood each District is
different, therefore the response has to be modified according to the District and local EMA
agreements.
Some of the areas listed below are strictly State functions and cannot be accomplished by the
District or County. It is up to the District/County to refine this document to reflect their roles
and responsibilities.
As this is a suggested guide, it may be best utilized as a reference document for a check list.
Per the Georgia Department of Human Resources (DHR) DPH Emergency Operations Plan
(EOP), PH has both primary and support responsibilities. Their Primary role is the Health and
Medical Services and the Secondary role is support of the Mass Care and Shelter process.
The three (3) primary areas of responsibility, as described in the Georgia Emergency
Operations Plan (GEOP) are:
(1) Medical Care:
 Emergency Medical Services (EMS): may need to assist with simultaneous response of
multiple vehicles,
 specialized medical and dental care (may need to provide at the District clinic or
coordinate through the existing or responding medical community);
 pharmaceutical acquisition and distribution:
including, coordinating and distributing medical supplies and personnel, to include
licensed health care providers, nurses, medical technicians, equipment, immunizations,
hospitals, first aid clinics, facilities, Strategic National Stockpile and other medically related
services.
 Medically related services could include assisting with patient redistribution
within a county or PH District or coordinate the redistribution across PH District
boundaries;
 assisting the medical on-scene commander and EOC staff understand
the PH implications of the situation; coordinate with other agencies that have a
medically related mission.
 Enforce laws and regulations to protect public health and safety
 Assist the hospital community with decisions facing potential/actual surge capacity
issues; may include redistribution of patients to other facilities or to alternate care settings
as established by District/State Public Health
 Mobilize and coordinate the volunteer public health workforce
 Be aware of and coordinate the Public Health response in accordance to the appropriate
Federal and Georgia Homeland Security Threat Levels
 Coordinate integration of Regional and Federal response assets into the local response
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

Provide and/or coordinate representation to designated Special Needs Population Shelters
and other alternate care facilities.
Coordinate public information releases related to health care concerns with the PH PIO
and the EOC Information and Planning (ESF5).
Coordinate through your EMA, debris removal in/near medical treatment facilities and
private property that may create health and safety hazards (obtain as much information
as possible, including type of debris, location, how its interfering with operations).
Ensure you keep in touch with the medical agency until mission is complete
Mobilize and coordinate partners to identify and solve health problems
Coordinate Epidemiological response to the incident area, as well as affected citizens and
local receiving hospitals. Assist hospital community with infection control questions and
issues.
Coordinate the Epidemiological response: ensure the appropriate level infectious
disease epidemiology and environmental epidemiological investigations are
instituted,
Coordinate with Epidemiology (District and/or State), Emergency Management, Public
Safety and other officials/agencies if it is decided to recommend/institute
isolation/quarantine conditions
Coordinate transportation of appropriately contained laboratory samples,
including environmental samples, body fluid samples and other samples as
approved by the Georgia Division of Public Health Laboratory;
Need to coordinate and/or inform the DHR Emergency Operations Center of the medical
activities and other pertinent activities within the EOC;
The District Health Director (DHD) will be kept abreast of all requests and actions, as the
ESF8 representative is acting on behalf of the DHD;
(2) Environmental Health:
Staffing, supplies and equipment essential to:
Prevent communicable diseases and contamination of food and water and
Develop and monitor health information, inspection and control of sanitation
measures, disease vector and epidemic control;
Laboratory testing, facility and daily shelter inspections;
Assist as requested with private water testing;
Assist with potable water testing;
Assist with decision making concerning best locations for feeding stations, types of foods
to be served and food inspections during a disaster situation
Assist Department of Natural Resources and Department of Agriculture with disposal of
contaminated animal remains (as requested);
Assist GBI with human remains disposal (including contaminated remains guidance);
(3) Crisis Counseling, Grief Assistance and Rehabilitation Services:
Professional personnel; services and facilities to relieve mental health problems of
victims caused or aggravated by an emergency or disaster or the aftermath; and
rehabilitation services, including accessibility determinations of shelter facilities.
Page 19 of 125
AS A RESOURCE, THE PUBLIC HEALTH FUNCTIONS ARE PROVIDED:
In the Georgia Division of Public Health (DPH), the ESF 8 Health and Medical Services
representative is responsible to integrate the following into their response (as defined in the
Public Health Emergency operations Plan, October 2005:
Core Functions:
-Assessment of the health of the community
-Assurance of necessary services through regulation and provision of these services
-Policy development to establish the framework for healthy individuals and
communities
Essential Functions:
-Conducting community diagnosis
-Preventing and controlling disease and injury
-Ensuring a safe, healthy environment
-Measuring performance, effectiveness and outcomes of health services
-Promoting healthy lifestyles
-Laboratory testing
-Providing personal health services
-Assuring public health capacity and infrastructure and ensuring rules and
Regulations
EMERGENCY OPERATIONS CENTER OVERVIEW
The ESF 8 representative will establish and operate their Emergency Operations Center (EOC)
within the National Incident Management System (NIMS) compliant Incident Command System
(ICS) structure that is unique for the incident/event, including Type 1-5. It is beyond the scope
of this document to provide an overview of NIMS, therefore, please refer to
http://www.fema.gov/emergency/nims/nims_training. Additionally, the various standard and
applicable emergency management tools and principles can be further researched at
www.training.fema.gov/EMIWeb/IS/crslist.asp (IS 100, 200, 235, 701 and ICS 300 and 400,
along with other incident command related units).
Within the EOC, the ESF8 representative’s primary duty is to coordinate all health and medical
Requests for Information (RFI) and Requests for Action (RFA), keeping the applicable
Emergency Management Agency informed. Affected Districts will keep the Division abreast of
events. This includes ensuring other appropriate ESFs are included as necessary. An example
would be the request for medical supplies. The ESF 8 would work with the requester,
determining the actual need, coordinating that request with the DHR EOC; and coordinating the
transportation related issues with their local Emergency Management Agency’s Department of
Transportation ESF 1 representative.
The ESF 8 representative will use all of the available tools at hand, including, but not limited to
WebEOC, LiveProcess, SendSS On Call Calendar, GroupWise and other systems that are
available. The primary event management tool is WebEOC.
Page 20 of 125
A tool providing management of the event is the internet based system, WebEOC. WebEOC is
paid for and maintained by the Division of Public Health, maintained by the DHR Office of
Information Technology and based on a separate server. The WebEOC manual is located on the
website, as well as in the PH EOP Annex A9, “Communications (Equipment, Services,
Information Technology). Users are approved by the Division’s Office of Emergency
Preparedness that have a direct supporting role with Public Health.
The management of the event is expandable and contractable. This is determined by many
factors, including, but not limited to the type of event, number of citizens involved, responding
agencies and involvement of Public Health (Division and District). Public Health recognizes and
will incorporate as needed, the roles of the Command and General Staff. However, it is not
imperative to operationalize all segments of either, nor is it imperative to actually open their
respective EOC (if manageable off site, i.e, home). An important factor, as stated in the “Public
Health Exercise Design and Evaluation Guide” and emails to the Emergency Preparedness staff,
document the process of the management of the event through WebEOC.
It is the intent of the Office of Emergency Preparedness to not mandate that all of the
Command and General Staff functional roles be activated and staffed during an event. However,
it is imperative that functional roles be spelled out, including the names of personnel in those
positions. As applicable, an After Action Report will be completed after the event. If the event
is less than one operational period (generally 12 hours), the notes in the WebEOC “Significant
Events Board” are sufficient. If the event exceeds one operational period, a Situation Report
(SITREP) will be accomplished (located on WebEOC dash board).
Page 21 of 125
DEPARTMENT OF HUMAN RESOURCES
DIVISION OF PUBLIC HEALTH
EMERGENCY OPERATIONS PLAN:
DEPARTMENT OF HUMAN RESOURCES
EMERGENCY OPERATIONS CENTER ACTIVATION/DEACTIVATION
STANDARD OPERATING PROCEDURE
SUPPORT ANNEX A1, ATTACHMENT VI
(Primary Location is inSUPPORT ANNEX A14, APPENDIX I, ATTACHMENT II)
DHR EOC MACC STRUCTURE, PROPOSED, 16 Nov 07
DHR MACC
(DHR EM and PH EP)
PIO/RC
Liaisons:
Affected District,
SOC, PHLn
Safety
Legal
OPS
EP Coord
LOG
Pharm
PLAN
EP Coord
Med Intel
EP or EPI
GHA
EH
EH
VolunteersMRC/ESARVP
ORS
Epi
Epi
EMS
HCO Surge
OTWD
OIT
Nursing
Nursing
Augusta
Vaccines
PHL
Epi
Chem-Rad
SNS
SNPS
Shelters
CISM
ARC
RSS
Team
Vital Records
EOC Staffing
Atlanta
NDMS
Fin/Admin
Admin Coord
Communications
Officer
PODs
CHEMPACKS
Page 22 of 125
Threat Level Actions (State, Hospital, Public Health):
Support Annex A1, Attachment VII
Georgia Office of Homeland Security: Threat Levels
LOW
• Ensure that existing security measures and communications equipment are in place and functioning.
• Make sure that contact lists, phone numbers, contingency and business continuity plans are current.
• Distribute security awareness bulletins, prepared by GOHS or designee, throughout State agencies.
• Report the presence of unknown personnel, unidentified vehicles, vehicles operating out of the ordinary, abandoned
parcels or packages, and other suspicious activities.
• Assure that all facilities are regularly assessed for vulnerabilities.
• Develop procedures for shutting down and evacuating the facility.
• Survey surrounding areas to determine activities that might increase potential risks to the facility.
GUARDED
• Maintain close coordination with GOHS, GEMA, and law enforcement to share information.
• Require all employees and visitors to display proper ID while on State property.
• Review facility operation plans, security plans and procedures to include bomb threat, chemical, biological
or radiological, and evacuation.
• Designate employees to make regular sweeps of the facility to look for suspicious items or activities.
• Require each visitor to check in and verify his or her identification.
• Be familiar with vendors who service the facility and investigate changes in vendor personnel.
• Inspect emergency supplies to ensure equipment is in good working order.
ELEVATED
• Review all appropriate plans with personnel. Review notification/recall lists.
• Ensure that vital personnel are informed and on-call.
• Prepare specialized units for activation.
• Escort all unknown visitors in the facility.
• Heighten the mail examination process.
• Reduce the number of access points for vehicles and personnel to minimum levels.
• Coordinate emergency plans as appropriate with nearby jurisdictions.
• Inspect the interior/exterior of buildings for suspicious items at the beginning and end of each workday and at random
intervals.
• Check all deliveries to facility and loading docks.
• Ensure security of vehicles at the facility by locking all vehicles.
• Inform GEMA and GOHS Public Information Officer of events as they occur.
• Coordinate the release of information with GOHS PIO.
HIGH
• All employees should remain in close contact with their supervisor for pertinent instructions regarding work activities and
scheduling.
• Make preparations for changes in tours of duty (extended hours, cancellation of off days and/or leave).
• Put all employees on high alert for suspicious persons, items, or activities and instruct them to report any such findings
immediately.
• Inspect all mail and packages coming into a facility, but do not open suspicious packages (review the USPS "Suspicious
Mail Alert"
and the "Bombs by Mail" publications with all personnel involved in receiving mail and packages).
• Establish Command Center(s). Prepare to execute contingency procedures.
• Implement Emergency Operations Plans and form contingency plans in all agencies, as conditions require.
• Keep all personnel responsible for implementing antiterrorist plans on call.
• Restrict access to all non-public areas of State facilities to properly identified employees and escorted guests.
• Curtail certain functions or close State facilities at discretion of the Governor or his designee.
• Close and lock gates and barriers except those needed for immediate ingress and egress. Inspect perimeter fences
regularly.
• Consult with local authorities about control of public roads and accesses that make the building more vulnerable.
• Move cars and objects (e.g., crates, trash containers) at least 25 meters from buildings (consider centralized parking).
• Take additional precautions at public events and consider alternative venues or cancellations.
Page 23 of 125
SEVERE
• Release non-essential employees from duty at the discretion of the Governor or designee.
• Set all employees on the highest alert for suspicious persons, items or activities.
• Increase or redirect personnel to address critical emergency needs.
• Assign emergency response personnel; pre-position and mobilize specially trained teams or resources.
• Implement emergency and continuity plans as appropriate.
• Restrict access and implement positive identification of all personnel; minimize administrative journeys and visits.
• Search all suitcases, briefcases, packages, etc. brought into the facility.
• Search all vehicles and their contents before allowing entrance to facility.
• Cancel or delay all non-vital facility work conducted by contractors, or continuously monitor their work.
• Reduce restricted area access points to an operational minimum.
• Coordinate the possible closing of public roads and facilities with local authorities.
• Coordinate the sharing of media information with Governor’s Office via State PIO.
State of Georgia:
General Response to Georgia Office of Homeland Security (GOHS)
Threat Conditions
In some instances, emergency conditions may be declared based on information
gathered by State or Federal intelligence agencies, law enforcement activities or
Homeland Security. Conditions involving potential terrorist threats require increased
vigilance on the part of State employees, supervisors, and law enforcement/security
personnel.
In order to ensure a systematic, measured response to emergencies or potential
emergency conditions for the protection of State of Georgia citizens, employees and
State property, a system of “Threat Conditions” has been established to define levels of
risk and appropriate levels of response. Each State department/agency head can
evaluate agency operations and, at their discretion, establish procedures and
responsibilities applicable to each threat level in order to provide for the safety of its
employees and the public at large.
Purpose:
To establish general security procedures and define Threat Condition Levels for the
State
of Georgia.
Policy:
The protection of State of Georgia citizens, employees and property is the primary
mission of the Georgia Office of Homeland Security. To enhance this mission, Threat
Condition definitions and procedures will be used to help determine staffing, deployment
and assignment of State and other assets. It will be the responsibility of the Director of
Georgia’s Office of Homeland Security to advise the Governor in designating the current
Threat Level.
Definitions:
Threat Condition—Alert level, based on the potential of threat against citizens,
employees, and property.
Threat Condition Levels—Levels of risk posed against State interests on a scale of
normal, or no known risks, to an actual terrorist or large impact criminal event.
Threat Condition GREEN—No known threat against State interests exists. Only
normal, everyday security precautions are to be in effect.
Threat Condition BLUE—A general risk or threat of possible terrorist or large impact
criminal activity (riot, civil unrest, major demonstrations, local or national emergency)
against State interests exists, though the nature and extent do not warrant actions
Page 24 of 125
beyond normal liaison notifications or placing assets or resources on a heightened alert
(agencies are operating under normal day-to-day conditions).
Threat Condition YELLOW—Intelligence or an articulated threat indicates a potential
for a terrorist incident or large-scale criminal act. However, this threat has not yet been
assessed as credible.
Threat Condition ORANGE—An attack or incident has not taken place on State or
Nation, but a threat assessment indicates that the potential threat is credible, and
confirms the involvement of a high risk of terrorist attack or large impact criminal action.
Threat Condition RED—This is the highest level of threat condition. An attack or
incident has occurred or is in progress against State and/or national interests. This
requires implementation of an immediate process already in place to identify, acquire,
and plan the use of State resources to augment state and local authorities in response
to limited or major consequences of terrorist use of or employment of Weapons of Mass
Destruction (WMD).
It is anticipated that actions listed under this threat level will be initiated and sustained
for a relatively short period of time, based on guidance from federal and state
governments, due to significant personnel and economic considerations.
General Security Measures:
Each employee must aid in the effort to maintain proper security. To increase the
security consciousness of the entire organization, it is important for administrators to
share security information with their staffs. The purpose is to help employees recognize
and appropriately report unusual activity.
1. Familiarize employees with existing security procedures and emergency numbers
for appropriate local law enforcement agencies.
2. Familiarize employees with the locations of and activation procedures for
emergency and fire alarm systems.
3. Instruct employees that when every small area is secure, the entire facility is
secure. All security deficiencies or hazards that are reported will be checked and
corrected.
4. All employees are to be alert to strangers loitering or lingering in or around the
premises and to suspicious vehicles parked near the building. In such situations, the
employee will document a description of any person(s) observed and/or the license
plate(s), color and make of the vehicle and any other points that could be significant.
Information should be immediately reported to security or supervision.
5. Familiarize all employees with the facility’s routine operational procedures relating
to deliveries, vendors, frequent visitors, new hires, terminations, and changes in
workspace or common areas.
6. Review evacuation procedures included in employee orientation packages
periodically. Hold drills periodically.
7. Assign staff members to regularly check specific areas. Close and lock desks and
door locks. Note and report inoperable, damaged, or inadequate hardware to the
proper supervisor.
8. Appoint, train, and equip a supervisor or mid-management person to function as
the building security coordinator.
9. Establish a building-wide alert system to inform all employees in the event of an
emergency.
Page 25 of 125
10. Institute a positive identification process and access control system.
11. Establish a mail/package inspection procedure.
12. Unnecessary information about the facility or fellow employees will not be given
out. Report anything questionable to supervisors or security, including:
• Threats or harassment
• Persons who ask unusual questions or show unnatural interest in the
organization or an employee, such as building layout or design, security
measures, staffing, or institutional procedures, or anyone tampering with
building equipment or fixtures
• Any deviation in delivery procedures
• Unattended packages
13. Develop and distribute lists to appropriate personnel of names and telephone
numbers of management and key personnel to contact in an emergency. Review
and update such lists and procedures periodically.
14. Georgia’s Office of Homeland Security (GOHS) will ensure that all steps are taken
to successfully mitigate and respond to the incident or attack, and the Georgia
Emergency Management Agency (GEMA) will ensure recovery operations are
initiated at the earliest opportunity.
Procedures and Responsibilities-Elevated Threat Levels:
� Threat Condition Green
Personnel
1. Ensure that personnel receive proper training on the Homeland Security Advisory
System and specific pre-planned department or agency protective measures.
2. Develop terrorist and security awareness; provide information and educate
employees on security standards and procedures. Caution employees not to talk
with outsiders concerning their facility or related issues.
3. Establish contact information for state and local public safety, and public health
officials.
4. Distribute security awareness bulletins prepared by GOHS or designee, and upon
discretion of the Director of GOHS, distribute throughout the State agencies.
5. Advise all personnel to report the presence of unknown personnel, unidentified
vehicles, vehicles operated out of the ordinary, abandoned parcels or packages,
and other suspicious activities.
Facilities/Equipment
1. Develop a process assuring that all facilities are regularly assessed for vulnerability
to terrorist attacks and all reasonable measures are taken to mitigate those
vulnerabilities.
2. Ensure existing security measures are in place and functioning, such as fencing,
locks, camera surveillance, intruder alarms, and lighting.
3. Develop and implement hardware, software, and communications security for
computer-based operational systems.
4. Ensure contingency and business continuity plans are current and include a
response to terrorist threats.
5. Require all contractors and visitors to check in and out of designated facilities or
areas that are considered key command, control, or communications centers.
Page 26 of 125
6. Develop procedures for shutting down and evacuating the facility. Vigilant security
measures will be observed for facilities located near critical community assets.
7. Survey surrounding areas to determine activities that may increase security risks
for the facility, e.g., airports, government buildings, industrial facilities, pipelines,
etc.
� Threat Condition BLUE- Includes procedures in Threat GREEN plus:
Personnel
1. Management will maintain a close local liaison with operational and intelligence
units of State law enforcement.
2. Sustain close coordination with GOHS and GEMA to share information
3. Alert all State Agency Communications personnel of heightened alert status.
4. Require all employees and visitors to display proper ID while on State property.
5. Review facility security plans and procedures including bomb threat, chemical,
biological or radiological threat, and evacuation procedures.
6. Review personnel details, logistics requirements, and all operations plans including
emergency operations plans and business continuity plans that pertain to
implementing a change in Threat levels.
7. Remind all personnel, at regular intervals, to be suspicious and inquisitive about
strangers, particularly those carrying suitcases or other containers.
8. Be especially alert to repeat visitors or outsiders with no apparent business at the
facility that are seeking information about the facility or related issues including
personnel.
Facilities/Equipment
1. Designate employees to make regular sweeps of the facilities for suspicious items
or activities.
2. Watch for unidentified vehicles in or near the facilities. Watch for unusual activity,
abandoned parcels, or suitcases.
3. Increase checks of vent and fan rooms, emergency exits, and electrical and control
room doors.
4. Inspect perimeter fencing routinely and repair all fence breakdowns. Review all
outstanding maintenance and capital project work that might affect security of
facilities.
5. Require each visitor to check in at designated facilities or areas that are
considered key command and control or communications centers, and verify their
identification.
6. Be familiar with vendors and packages. Investigate changes in vendor personnel.
7. Inspect emergency supplies, and ensure emergency equipment is in good working
order.
8. Inspect all CCTV/Video Camera/VCR equipment and intercom systems to ensure
equipment is operational.
� Threat Condition YELLOW-Includes procedures in Threat BLUE plus:
Personnel
1. Review with all facility employees the operation plans, personnel safety, security
details, and logistics requirements that pertain to implementing increased security
Page 27 of 125
levels. Review notification/recall lists. Reinforce awareness of responsibilities with
employees.
2. Inform all agency employees with an operational need to know of the specifics of the
increased threat.
3. Make staff aware of the general situation in order to prevent unnecessary alarm and
stop rumors.
4. Ensure that personnel with access to building plans and area evacuation plans be
available at all times. Personnel will be capable of sealing off an area immediately.
5. Keep key personnel on call that are involved in implementing contingency plans.
6. Prepare specialized units for activation.
7. Limit visitor access to key security areas and confirm that the visitor has a need to
be there and is expected. All unknown visitors will be escorted.
8. Interface with vendors and contractors to heighten awareness and report suspicious
activity.
9. Coordinate emergency plans as appropriate with nearby jurisdictions.
10. Confirm availability of security resources that may assist 24/7 coverage.
11. Examine mail (above the regular examination process) for letter or parcel bombs.
12. At the discretion of the GEMA Director, GEMA State Operations Center (SOC) may
increase activation of normal 24-hour operation. State agencies and other
organizations may be asked to provide a liaison to the SOC.
Facilities/Equipment
1. Reduce the number of access points for vehicles and personnel to minimum levels.
Be alert to vehicles parked for an unusual length of time in or near a facility.
2. Periodically spot check vehicles and persons entering facilities.
3. Secure and regularly inspect all interior and exterior buildings and storage areas at
frequent intervals.
4. Check designated unmanned and remote sites at more frequent intervals for signs
of unauthorized entry, suspicious packages, or unusual activities.
5. Interface with vendors and contractors to heighten awareness and report
suspicious activity.
6. Check to ensure all emergency telephone, radio, intercom, television, and satellite
communication devices are in place and are operational.
7. Ensure all personal, company, and contractor vehicles at the facilities are secured
by locking the vehicles.
Media
1. Monitor national and local events and keep GEMA and GOHS Public Information
Officer (PIO) informed of events as they occur.
2. Coordinate the release of information with GOHS PIO.
� Threat Condition ORANGE- Includes procedures in Threat YELLOW plus:
Personnel
1. Instruct all employees to remain in close contact with their supervisor for pertinent
instructions regarding work activities and scheduling.
2. Make preparations for possible extended tours of duty, cancellation of off days and
or/leave.
3. Prepare to release non-essential employees from duty at the discretion of the
Page 28 of 125
Governor or his designee.
4. Curtail or suspend certain services at the discretion of the Governor or his
designee.
5. Put all employees on high alert for suspicious persons, items, or activities and
instruct them to immediately report any findings to law enforcement or supervision.
6. Inspect all mail and packages coming into the facility. Do not open suspicious
packages. Review the US Postal Service’s "Suspicious Mail Alert" and the "Bombs
by Mail" publications with all appropriate personnel.
7. Review procedures and make necessary preparations to establish Command
Center(s) where applicable. Dispatch Mobile Command Centers in an actual
emergency, and initiate an incident command system or similar incident
management structure for organizing emergency responses. Prepare to execute
contingency procedures, such as moving to an alternate site or dispersing the
workforce.
8. Implement Emergency Operations and contingency plans in all agencies, as
conditions require.
9. Keep all personnel responsible for implementing contingency plans on call.
10. Restrict access of all non-public areas of State facilities to properly identified
employees and escorted guests.
11. Limit access of designated facilities to personnel with a legitimate and verifiable
need to enter. Implement positive identification of all personnel with no exceptions.
12. Physically inspect visitors and inspect their suitcases, parcels, and other
containers.
Facilities/Equipment
1. Curtail certain functions or close State facilities at the discretion of the Governor or
his designee.
2. Close and lock gates and barriers except those needed for immediate ingress and
egress. Reduce facility access points to the absolute minimum necessary for
continued operation. Restrict threatened facility access to essential personnel only.
Inspect perimeter fences on a regular basis.
� Threat Condition ORANGE (continued)
3. Strictly enforce control of entry. Inspect all vehicles entering key areas/facilities
including the vehicle's cargo areas, undercarriage, glove boxes, and other areas
where dangerous items might be concealed.
4. Erect barriers and obstacles to control direction of traffic flow and protect key areas
from an attack by a parked or moving vehicle. Implement centralized parking and
shuttle bus service where feasible.
5. Identify the owner of all vehicles parked at key command, control, or
communications areas or other critical areas/facilities and have all unidentified
vehicles removed.
6. Move cars and objects (e.g., crates, trash containers) at least 25 meters from
buildings—particularly highly populated, mission-related, or high profile buildings.
Identify areas where explosive devices could be hidden.
7. Consult with local authorities about control of public roads and accesses that might
make the building more vulnerable to terrorist attack if they remain open. Take
Page 29 of 125
additional precautions at public events and consider alternative venues or
cancellation.
8. Check all security systems routinely to ensure they are functioning properly. Install
additional, temporary lighting if necessary.
9. Disable all baggage lockers where applicable.
10. Implement frequent inspection of key areas or facilities including the exterior and
roof of all buildings and parking areas. Increase patrolling and ensure all
vulnerable critical points are fully illuminated and secure.
� Threat Condition RED- Includes procedures in Threat ORANGE plus:
Personnel
1. Release non-essential employees from duty at the discretion of the Governor or
designee.
2. Put all employees on the highest alert for suspicious persons, items or activities
and instruct them to immediately report findings to law enforcement/supervision.
3. Instruct all employees to remain in close contact with their supervision for pertinent
instructions regarding work activities and scheduling.
4. Increase or redirect personnel to address critical emergency needs.
5. Assign emergency response personnel, and pre-position and mobilize specially
trained teams or resources.
6. Implement emergency and continuity plans as appropriate.
7. Restrict access and implement positive identification of all personnel.
8. Minimize all administrative journeys and visits.
9. Search all suitcases, briefcases, packages, etc., brought into the facility.
10. Recognize that an incident of this type will affect the duty performance of
employees and prepare to handle signs of fear, anxiety, and apprehension with
compassion and discretion. Utilize professionals to assist as needed.
Management must ensure that business continuity measures are being adequately
employed.
Facilities/Equipment
1. Curtail services and close facilities at the discretion of the Governor.
2. Reduce restricted area access points to an operational minimum.
3. Search all vehicles and their contents before allowing entrance to facilities.
4. Check building exteriors and parking areas frequently.
5. Cancel or delay all non-vital facility work conducted by contractors, or monitor their
work continuously with facility personnel.
6. Coordinate the possible closing of public roads and facilities with local authorities.
Media
1. Coordinate the release of information with Governor’s Office/State PIO.
April 17, 2003
Page 30 of 125
State of Georgia Homeland
Security Threat Hospital Alert System
Recommended Actions
Level
GREEN
Emergency
Department
Provide training
or refresher
courses for all
hospital staff on
threat colorcoding system.
Review
implications, roles
and
responsibilities for
each individual
and each
department.
Perform monthly
assessment/
inventory of
decontamination
area/supplies/
personal
protection
equipment (PPE).
Be alert for trends
in patient
symptoms.
Ensure telephone
numbers for local
and state health
departments AND
resource hospital
are readily
available and
current.
Maintain in-house
calling tree.
Develop staffing
modification
plans, including
rest cycles and
Laboratory
Pharmacy
Identify level
capabilities of
laboratory (Level
A, B, C, or D)
Maintain calling
tree.
Maintain calling
tree.
Maintain calling
tree.
Develop staffing
modification
plans, including
rest cycles and
provision of
family member
care.
Develop staffing
modification
plans, including
rest cycles and
provision of
family member
care.
Develop staffing
modification plans,
including rest
cycles and
provision of family
member care.
Develop and
maintain plans
for assisting with
community
pharmacy
support
requirements.
Continue
common sense
practices in daily
security routines.
Arrange for
contracted
laboratory to
provide
specimen testing
beyond facility
capabilities.
Arrange for
transport of
specimens and
for education of
transporters on
safe transport of
specimens.
Maintain calling
tree.
Develop staffing
modification
plans, including
rest cycles and
provision for
family member
care.
Be alert for
trends in
culture/test
ordering. Identify
appropriate
personnel for
notification.
Report concerns
to appropriate
personnel.
Page 31 of 125
Public Safety
Security
Report suspicious
circumstances
and/or individuals
to appropriate
person (director
of public
safety/law
enforcement).
Administration
Review hospital,
local community,
and state disaster
plans.
Have public
relations or public
safety staff monitor
news information
stations for change
in Threat Con.
Have a "basic"
unified public
information (PI)
message available
to in an "all –
hazards" form.
Provide Public
Information
seminars to key
personnel within
the institution.
provision for
family member
care.
Perform and
document weekly
radio checks.
BLUE
Continue all
measures
outlined in
GREEN Threat
Alert.
Continue all
measures
outlined in
GREEN Threat
Alert.
Continue all
measures
outlined in
GREEN Threat
Alert.
Continue all
measures
outlined in
GREEN Threat
Alert.
Alert staff in all
departments
(Administration,
Laboratory,
Pharmacy, Public
Safety/Security,
Nursing Directors,
EMS Coordinator,
Infection Control)
to heightened
Threat Con.
Alert appropriate
staff concerning
the heightened
Threat Alert.
Alert appropriate
staff to
heightened
Threat Alert.
Alert appropriate
staff to
heightened
Threat Alert.
Alert appropriate
staff, including
medical staff, to
heightened Threat
Alert.
Review disaster
preparedness
protocols specific
to department.
Review disaster
preparedness
protocols specific
to department.
Review disaster
preparedness
protocols specific
to department.
Review disaster
preparedness
protocols specific to
department.
Ensure that the
laboratory is
secure.
Ensure that
pharmacy is
secure.
Ensure that the
department is
secure.
Review call tree
and staff
modification
plan.
Review call tree
and staff
modification
plan.
Implement
security plans
appropriate to the
facility (e.g.,
monitoring of
entrances/exits,
including those in
professional
office buildings).
Be alert for
trends in patient
culture/testing
patterns. Inform
appropriate
personnel if
suspicious
patterns noted.
Inventory
antidotes/
medications
levels. Note
expiration dates.
Include
information in
shift reports.
Review disaster
preparedness
protocols for
department.
Review calling
tree and staff
modification plan.
Assign staff
person to watch
for faxes/E-mails/
correspondence
from GDPH, the
GHA, the Health
District and the
Health Alert
Network (HAN).
Check all
equipment for
operational
readiness.
Prohibit casual
access by
unauthorized
personnel.
Ensure all
vehicles are
secured.
Check all
communications
equipment for
operational
readiness.
Inventory
emergency
disaster medical
bags. Check
expiration dates
Be alert for
suspicious
activity and report
it to the
appropriate
Page 32 of 125
Continue all
measures outlined
in GREEN Threat
Alert.
Review call tree
and staff
modification plan.
Check all
communication
equipment for
operational
readiness.
Test group page
capabilities with
Threat Alert status.
Have public
relations and public
safety/security staff
monitor news
information stations
(CNN, FOX,
MSNBC) for
change in Threat
Alert.
Refresh key
personnel on media
and
completeness of
bags.
persons (director
of public safety,
law enforcement).
Check that all
disaster related
paper work is
available.
Duplicate as
necessary
protocols. Provide
media training for
all key personnel
(e.g., ED
physicians, charge
nurses, EMS
coordinator, nursing
supervisor).
Conduct tabletop
exercises for key
personnel.
Assess
communications
readiness
(telemetry radios,
walkie-talkies and
other redundant
communication
systems).
Inventory
decontamination
area supplies and
equipment,
including PPE.
Be alert for trends
in patient
symptoms.
YELLOW Continue all
measures
outlined in Green
and Blue Threat
Alert.
Alert staff in all
departments
(Administration,
Laboratory,
Pharmacy, Public
Safety, Nursing
Directors, EMS
Coordinator,
Infection Control)
to heightened
Threat Alert.
Assign staff
person to watch
for faxes/E-mails/
correspondence
from GDPH, the
GHA, the Health
District and the
Continue all
measures
outlined in Green
and Blue and
Threat Alert.
Continue all
measures
outlined in Green
and Blue Threat
Alert.
Continue all
measures
outlined in Green
and Blue Threat
Alert.
Ensure that all
staff is alerted to
the heightened
Threat Alert.
Ensure that all
staff is alerted to
the heightened
Threat Alert.
Ensure that all
staff is alerted to
the heightened
Threat Alert.
Review
emergency plans
for this alert level
with all shifts.
Review
emergency plans
for this alert level
with all shifts.
Review
emergency plans
for this alert level
with all shifts.
Ensure security
of laboratory.
Ensure security
of pharmacy.
Ensure call tree
is available and
current.
Ensure call tree
is available and
current.
Consider
Consider
Remind all
hospital staff to
be suspicious
and inquisitive
and to maintain
heightened
awareness of
people, vehicles
Page 33 of 125
Continue all
measures outlined
in Green and Blue
Threat Alert.
Ensure that all staff
is alerted to the
heightened Threat
Alert.
Review emergency
plans for this alert
level with all shifts.
Ensure security of
department.
Ensure call tree is
available and
current.
Consider
alternative work
schedules to
Health Alert
Network (HAN).
Ensure security of
emergency
department.
Ensure call tree is
available and
current.
alternative work
schedules to
implement for
operational staff
if threat alert
escalates.
Check all
equipment for
operational
readiness.
Consider
alternative work
schedules to
implement for
staff if threat alert
escalates.
Check inventory
of critical
supplies; reorder
if necessary.
Perform and
document radio
tests daily.
Be alert for
suspicious
activities and
report to
appropriate
person.
Perform and
document
telemetry radio
tests (if
applicable) daily.
alternative work
schedules to
implement for
operational staff
if threat alert
escalates.
Check inventory
of critical
antidotes/
medications;
reorder if
necessary.
and activities.
Ensure call tree is
available and
current.
Consider
alternative work
schedules to
implement for
operational staff if
threat alert
escalates.
Increase spot
checks of specific
high-risk
entrances/exits
(e.g., loading
docks,
professional
office buildings).
Document
security checks.
Do not leave
vehicles
unattended and
unlocked.
Monitor diversion
incidents within
EMS region.
Move vehicles
and objects (trash
containers, etc.)
away from the
building.
Review hospital
and state disaster
plans with all
shifts.
Lock and
regularly inspect
all buildings,
rooms and
storage areas not
in regular use.
Inventory
available internal
resources (beds,
pharmacy stock,
laboratory
supplies, ancillary
services) daily.
At the beginning
and end of each
shift, as well as at
other regular and
frequent intervals,
inspect the
interior and
exterior of
buildings for
suspicious
packages or
Perform disaster
call tree drill,
including threat
alert in call.
Review disaster
related
paperwork.
Page 34 of 125
implement for
operational staff if
threat alert
escalates.
Review hospital,
local community
and state disaster
plans.
Review incident
command structure
and command
center operations.
Ensure
communications
equipment and
information,
including telephone
numbers of
governmental
agencies, is
available and
operational. Instruct
telecommunications
staff to complete a
group page with
color alert system
and document
response times.
Inventory available
internal resources
(beds, pharmacy
supplies, laboratory
capabilities,
ancillary services).
Evaluate elective
admissions and
determine need to
cancel elective
admissions.
Review media
protocols and have
public relations staff
monitor news
information stations
continuously for
change in Threat
Con. Be aware of
large-scale
Ensure it is
readily
accessible.
activities.
Be alert for
suspicious
activities and
report to
appropriate
person.
Consult with law
enforcement
officials/emergency
medicine/GDPH on
message to be
disseminated.
Ensure that all key
personnel have
same message
(cue cards, talking
points, etc.).
Ensure
decontamination
area is
operational.
Assign person on
each shift to be
media
representative.
Ensure that the
emergency
medical disaster
bags are readily
available.
ORANGE Continue all
measures as
outlined in Green,
Blue and Yellow
Threat Alerts.
At each shift
change alert staff
in all departments
(Administration,
Laboratory,
Pharmacy, Public
Safety, Nursing
Directors, EMS
Coordinator,
Infection Control)
to heightened
Threat Alert.
Assign staff
person to watch
for faxes/E-mails/
correspondence
from GDPH, the
GHA, the Health
District and the
Health Alert and
share with each
on-coming shift
supervisor.
Ready
decontamination
community events
(sporting events,
concerts, etc.).
Continue all
measures as
outlined in
Green, Blue and
Yellow Threat
Alerts.
Continue all
measures as
outlined in
Green, Blue and
Yellow Threat
Alerts.
Ensure that all
staff is alerted to
heightened
Threat Alert.
Ensure that all
staff is alerted to
heightened
Threat Alert.
Ensure security
of laboratory.
Ensure security
of pharmacy.
Activate call tree;
place staff on
alert status.
Activate call tree;
place staff on
alert status.
Advise staff of
shift
modifications if
threat escalates.
Advise staff of
shift
modifications if
threat escalates.
Ensure that PPE
and specialized
response
equipment and
supplies are
checked and
readily available.
Check inventory
of critical
antidotes/
medications;
reorder if
necessary.
Page 35 of 125
Continue all
measures as
outlined in Green,
Blue and Yellow
Threat Alerts.
Continue all
measures as
outlined in Green,
Blue and Yellow
Threat Alerts.
Ensure that all
staff is alerted to
heightened
Threat Alert.
Ensure that all staff
is alerted to
heightened Threat
Alert.
Activate call tree;
place staff on
alert status.
Ensure security of
department.
Advise staff of
shift modifications
if threat
escalates.
At the beginning
and end of each
shift, as well as at
other regular and
frequent intervals,
inspect the
interior and
exterior of
buildings for
suspicious
packages.
Consider activation
of facility disaster
preparedness plan.
Have Incident
Command sheets
available
Assess readiness
of the command
center
Activate call tree;
place staff on alert
status.
Advise staff of shift
modifications if
area equipment
and supplies.
Ensure PPE is
available for all
staff.
Inventory
categories on
disaster form
(bed/ blood
availability,
availability of
medical
teams/bags).
Audit internal
resource
availability (e.g.,
beds/monitored
beds, blood
supply,
antibiotic/IV
supply, ventilator
supply, linen
supply,
food/water
supply).
Check inventory
of critical
supplies; reorder
as necessary.
Be alert for
trends in patient
testing. Notify
appropriate
person if trends
noted.
Check all
equipment for
operational
readiness.
Limit access
points to the
absolute
minimum and
strictly enforce
entry control
procedures.
Enforce parking
of vehicles away
from main
hospital buildings.
Identify and
protect all
designated
vulnerable points.
If unavailable to
perform certain
tests, contact
contracted
laboratories.
Ensure security of
emergency
department.
Activate call tree;
place staff on
alert status.
Advise staff of
shift modifications
if threat
escalates.
Check equipment
and supplies at
patient
care/treatment
locations as
outlined in facility
internal disaster
plan (professional
office buildings,
outpatient
departments,
etc.).
Page 36 of 125
threat escalates.
Check all
telecommunications
equipment for
operational
readiness. Review
transfer
agreements in
anticipation of
patient transfer to
other appropriate
facilities.
Lock all exterior
doors except the
main facility
entrance(s).
Have public
relations staff
monitor news
information stations
(MSNBC, CNN)
continuously for
change in Threat
Alert.
Check
identification of all
visitors. Require
a sign-in log with
information from
each visitor's
identification.
Inform private
providers of the
Threat Alert for
possible rapid
evacuation of
patients to other
facilities.
Increase
defensive
perimeters
around key
structures.
Test all internal
communications
and warning
systems. Alert CFO
to begin collecting
expense data
(personnel,
equipment,
supplies, transfer
costs) related to
Threat Alert.
Be alert for trends
in patient
symptoms. Notify
appropriate
person if trends
noted. Be alert for
increase in
ambulance
transport times.
Check inventory
of critical
supplies; restock
if necessary.
RED
Continue all
measures as
outlined in Green,
Blue, Yellow and
Orange Threat
Alerts.
Alert staff in all
departments
(Administration,
Laboratory,
Pharmacy, Public
Safety, Nursing
Directors, EMS
Coordinator,
Infection Control)
to heightened
Threat Alert.
At each shift
change report
current status of
each department.
Ensure
emergency
department is
secure.
Activate full ED
command center
if applicable.
Assign staff
person to watch
for faxes/E-mails/
correspondence
from GDPH, the
GHA, the Health
District and the
Continue all
measures as
outlined in
Green, Blue,
Yellow and
Orange Threat
Alerts.
Continue all
measures as
outlined in
Green, Blue,
Yellow and
Orange Threat
Alerts.
Ensure that all
staff is alerted to
the heightened
Threat Alert.
Ensure that all
staff is alerted to
the heightened
Threat Alert.
Ensure
laboratory is
secure.
Ensure
pharmacy is
secure.
Activate call tree.
Secure as many
additional staff
as necessary.
Advise staff of
schedule
modifications.
Activate call tree.
Secure as many
additional staff
as necessary.
Advise staff of
schedule
modifications.
Maintain
communication
with hospital
command post.
Maintain
communication
with hospital
command post.
Ensure critical
supplies are
available.
Ensure critical
antidotes/
medications are
available for staff
and patients.
Ensure that PPE
and specialized
response
equipment and
supplies are
Page 37 of 125
Continue all
measures as
outlined in Green,
Blue, Yellow and
Orange Threat
Alerts.
Continue all
measures as
outlined in Green,
Blue, Yellow and
Orange Threat
Alerts.
Ensure that all
staff is alerted to
the heightened
Threat Alert.
Ensure that all staff
is alerted to the
heightened Threat
Alert.
Implement
parking
restrictions and
park vehicles
away from facility.
Activate facility
disaster
preparedness plan.
Place traffic and
pedestrian
barriers in place.
Put up signage
indicating patient
treatment areas,
information area,
family area, etc.
Control access
and implement
positive
identification of all
persons - no
exceptions.
Search all
suitcases, brief
cases, packages,
etc., brought into
Open the hospital
incident command
center.
Ensure department
is secure.
Activate call tree.
Secure as many
additional staff as
necessary.
Advise staff of
schedule
modifications.
Have public
relations staff
monitor news
information stations
(FOX, MSNBC,
CNN) for change in
Health Alert and
share with each
on-coming shift
supervisor.
Activate call tree.
Secure as many
additional staff as
necessary.
Advise staff of
schedule
modifications.
Maintain
communication
with hospital
command post.
available.
the facility.
Threat Alert.
Check all
equipment for
operational
readiness.
Secure all doors.
Maintain a
security presence
at a single point
of access to each
building and
check
identification of all
visitors. Maintain
a sign-in log.
Check all bags,
suitcases, brief
cases and
packages at the
security point.
Provide for day
care/child care
facilities for staff
responding to
Threat Alert Red.
Alert any
contracted labs
of Threat Alert
Red and the
possibility that
specimens may
be sent to them.
Increase
defensive
perimeters
around facility.
Make frequent
checks of the
exterior.
Deliveries should
not be accepted
unless approved
by supervisory
staff. All
deliveries are to
be opened
outside the facility
and minimal
numbers of
personnel should
be in the
immediate area
when deliveries
are opened.
Maintain
communication
with support
hospitals.
Have disaster
paperwork in
order.
Assure availability
of the SNS
request forms.
Activate
decontamination
area, including
supplies and
PPE.
Screen all arrivals
for possible
contaminants.
Contact Resource
hospital in EMS
region for
additional
instructions
and/or
information.
Have medical
bags ready for
deployment.
Page 38 of 125
Arrange for food
service to provide
meals to staff.
Alert CFO to begin
collecting expense
data (personnel,
equipment,
supplies, transfer
costs) related to
Threat Con Alert.
GEORGIA HOMELAND SECURITY ADVISORY SYSTEM
THREAT LEVELS & RECOMMENDED
PUBLIC HEALTH ACTIONS
RED
Severe risk of terrorist attacks. DHR Emergency Response Center (ERC) may be
activated. Individual hospital emergency operation centers and Public Health District
emergency operations centers may be activated.
In addition to the previously outlined protective measures, the following steps may be taken:
Establish functions according to internal operating procedures, responding appropriately
for the current threat information.
Convene emergency response personnel at each DPH location - conduct situation
briefing. 
Poll hospitals to assess capabilities and resource availability. 
Poll District and DPH facilities to assess capabilities and resource availability. 
Coordinate health-related activities with other local, state, and federal public and private
response agencies/groups. 
Increase or redirect personnel to address critical emergency needs. 
Review the authorities of the State and District Health Officer and advise accordingly. 
Begin active epidemiology activities as appropriate. 
Review available threat information and assess impact upon daily activities to determine
employee protection activities in response to possible attack. 
Director DPH will determine and implement limitation of non-critical programs as
appropriate. 
Initiate activities to provide for needs of essential staff in order to maintain critical
staffing levels.
Page 39 of 125
ORANGE
High risk of terrorist attacks. This condition may or may not activate the DHR
Emergency Response Center (ERC), depending on the state and local assessments.
In addition to the previously outlined protective measures, the following steps may and taken:
Implement, as appropriate, DHR contingency and emergency response plans 
Coordinate security efforts with Georgia Homeland Security.
Collaborate with other public and private healthcare provider state level representatives. 
Inform Districts of threat level increase. 
Use all available means to alert hospitals of threat level increase. 
Alert emergency response and special communications teams. 
Coordinate response efforts with districts, CDC, and PHS Emergency Coordinators, and
MMRS. 
Evaluate availability of alternate sites, multi-agencies/jurisdiction as needed. 
Restrict access to allow essential and authorized personnel only. 
Review and ensure the implementation of security measures for mission critical assets. 
Ensure service and supplies procurement procedures and vendor lists are current for
continuity of service and emergency operations needs 
Review appropriate security and emergency preparedness policies and procedures. 
Assist in establishing public health surveillance for potential toxic exposures following
an emergency/disaster situation. 
Review operations for general or mass emergency immunizations/pharmaceuticals or
quarantine/isolation procedures.
Page 40 of 125
YELLOW
Significant risk of terrorist attacks. This condition may or may not call for the activation of the
DHR Emergency Response Center (ERC), depending on the state and local assessment.
In addition to the previously outlined protective measures, the following steps may be taken:
Review emergency/contingency plans for DPH. 
Review/update emergency contact directory and personnel notification procedures. 
Assess further enhancement of preventive, protective measures, and efforts to
ameliorate public concern within the context of the current threat information. 
Increase human/veterinary/ environmental epidemiological surveillance at critical
locations. This includes surveillance and epidemiological issues related to toxic
exposures. 
Review laboratory services for confirmatory testing for possible agents and ensure that
alternate facilities are identified and available.
BLUE
General risk of terrorist attacks. DHR Emergency Response Center (ERC) activation
level is inactive.
In addition to the previously outlined protective measures in GREEN, the following steps may
be taken:
Check communications with designated emergency response personnel, including the
Public Health facilities. 
Review and update emergency/disaster assessment response/recovery procedures. 
In association with the Georgia Homeland Security Taskforce, provide the public with
appropriate information, via the DHR Communication Office, Public Health's Web site,
and other appropriate vehicles. 

Increase training of response personnel and other private healthcare facilities within the
context of the current threat information.
GREEN
Low risk of terrorist attacks. DHR Emergency Operations Center (ERC) activation level
is inactive.
The following protective measures may be applied:
Refine and exercise planned preventive and protective measures pertaining to
chemical, biological, radiological, nuclear, and explosive incidents. 
Page 41 of 125
Ensure personnel receive training about the Homeland Security Advisory System, DPH
and departmental preventive and protective measures. 
Assess Hospital community, Emergency Medical Services providers, and Public
Health's infrastructure vulnerabilities and adopt measures to mitigate accordingly. 
Ensure policies and procedures are in place to provide for needs of essential personnel
during crisis situations, to enhance maintenance of critical staffing levels when required.
Page 42 of 125
DEPARTMENT OF HUMAN RESOURCES
Division of Public Health
Emergency Operations Plan:
1-866-PUB-HLTH Standard Operating Plan
Support Annex A1, Appendix 1
(As an Epi Primary Document, this document stands alone in Support Annex A 10,
Appendix 1)
I. INTRODUCTION
This Standard Operating Plan provides guidance regarding the use of the statewide public
health emergency hotline 1-866-PUB-HLTH (1-866-782-4584) for the alert and notification of
the Georgia Division of Public Health (DPH) Emergency Preparedness Coordinators (EC) at the
State and District levels.
1-866-PUB-HLTH operates under the legal authority of OCGA §31-12-2, which requires
notifiable disease reporting, including those diseases that may result from “bioterrorism,
epidemic or pandemic disease, or novel and highly fatal infectious agents or toxins and that may
pose a substantial risk of a public health emergency”. OCGA §31-12-2 also requires DPH to
report “any case of an unusual illness, health condition, or death, or an unusual cluster of such
events, or any other suspicious health related event that it reasonably believes has the potential to
be caused by bioterrorism” to the Department of Public Safety including state and federal
partners.
II. PURPOSE
The purpose of 1-866-PUB-HLTH is to allow time-sensitive communication among DPH
personnel at the State and District levels, as well as among healthcare providers and emergency
response partners at all levels of government. 1-866-PUB-HLTH is for the reporting of
immediately notifiable diseases, including those that could result from a bioterrorism event, and
public health emergencies. 1-866-PUB-HLTH is one easy-to-remember number that should be
distributed to all local, state, and federal partners for use in a public health emergency.
III. SITUATION AND ASSUMPTIONS
1-866-PUB-HLTH is housed at the Georgia Poison Center (GPC) and staffed by Public Health
Specialists (PHS) who respond to calls according to protocols developed by DPH. Calls to 1866-PUB-HLTH are made by local, state, and federal emergency responders as well as
healthcare providers, laboratorians, coroners, medical examiners, and other partners. Calls are
triaged by the PHS according to DPH protocols, and those that require immediate notification of
public health are passed to the On-Call Representative (OCR) at the District level for response.
If state or federal assistance is needed, the District OCR responds as stated in the Emergency
Preparedness Coordinator Alert and Notification SOP.
Page 43 of 125
IV. ROLES AND RESPONSIBILITIES
It is the responsibility of DPH to provide GPC with the training and resources necessary to
make decisions regarding triage of incoming 1-866-PUB-HLTH calls.
It is the responsibility of GPC to staff the hotline with trained PHS 24 hours a day, 7 days a
week. It is the responsibility of PHS to follow established protocols regarding triage of incoming
1-866-PUB-HLTH calls.
The role of the District OCR is to serve as a first responder to a call from 1-866-PUB-HLTH.
The responsibilities of responding to a 1-866-PUB-HLTH call are the same as responding to any
other type of notification and are as stated in the Emergency Preparedness Coordinator Alert and
Notification SOP. The District OCR should be aware of its Public Health and non-Public Health
capabilities and resources, as related to the primary role of Emergency Support Function 8 and
support of Emergency Support Function 6. It is the responsibility of the District OCR to contact
and coordinate response activities with other available District resources. As this coordination is
occurring, the District OCR will notify the Division OCR, briefing that individual on the
situation, including potential requirements.
The District EC Calendar Administrator is responsible for ensuring that the EC Calendar in
SendSS is up to date with current OCR contact information.
The Division OCR is the conduit to State level resources, including DHR, DPH and GEMA.
The Division EC is the conduit to regional/federal resources, including various out of state
resources, Disaster Medical Assistant Teams (DMAT), Disaster Mortuary Operational Response
Teams (DMORT), Strategic National Stockpile (SNS) resources, Assistant Secretary of
Preparedness and Response (ASPR) resources, to name a few. Therefore, the District OCR will
contact the Division OCR for assistance requesting any out of District resources not previously
covered under an MOU or MOA.
V. CONCEPT OF OPERATIONS
1-866-PUB-HLTH is available 24 hours a day, 7 days a week for use by public health partners
in the reporting of notifiable diseases and public health emergencies. A public health partner
will use the hotline to report an event of public health significance. A PHS at the GPC will
answer the call, record basic event information, and respond according to established protocols
(see Attachment I). If the event is of immediate importance, the PHS will call the District OCR.
The District OCR will call the initial reporter and gather additional information needed for
response. The District OCR will respond to the situation as stated in Roles and Responsibilities.
The District OCR will contact the Division OCR as needed to brief the Division on the event and
to request state resources as needed.
Page 44 of 125
VI. ADMINISTRATION AND LOGISTICS
1-866-PUB-HLTH is administered by the DPH Epidemiology Branch through a contract with
GPC.
VII. PLAN DEVELOPMENT AND MAINTENANCE
This 1-866-PUB-HLTH SOP will be updated annually. The 1-866-PUB-HLTH Manual (PH
EOP Annex A-10) is updated as needed (at least annually) to correspond with changing public
health needs.
VIII. AUTHORITIES AND REFERENCES
The Official Code of Georgia §31-12-2.
Page 45 of 125
DEPARTMENT OF HUMAN RESOURCES
Division Of Public Health
Emergency Operations Plan:
1-866-PUB-HLTH Standard Operating Plan
Support Annex A1, Appendix 1, Attachment I
(As an Epi Primary Document, this document stands alone in Support Annex A 10,
Appendix 1)
GEORGIA’S PUBLIC HEALTH EMERGENCY AND
DISEASE REPORTING HOTLINES
MANUAL
1-866-PUB-HLTH (1-866-782-4584)
&
1-866-752-3442
Georgia Department of Human Resources
Division of Public Health
Georgia Poison Center
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TABLE OF CONTENTS
Introduction, Background, & Purpose
4
Introduction
Purpose
Notifiable Disease Reporting
Authority & Confidentiality
5
5
6
6
Procedures, Guidelines, & Flow Charts
8
1-866-PUB-HLTH VS. 1-866-752-3442
General Flow Chart for Calls from Public Health Partners
General Flow Chart for Calls from the General Public
9
10
11
Bioterrorism / Mass Casualty
Detailed Procedure for Bioterrorism / Mass Casualty Calls
from Public Health Partners
Blood / Body Fluid Exposures
Dead Bird Calls (WNV)
Dead Bird Calls (Avian Influenza)
Insert: How to Handle Dead Birds or Dead Bird Inquiries
Financial Assistance Requests
Health Department Routine Services
Immunization Availability Questions
Infectious Disease
Detailed Procedure for Infectious Disease Calls from
Public Health Partners
Infectious Disease: Smallpox / Smallpox Vaccine / Vaccinia
Disease List
Insects Crawling In / On A Person
Mold
Mosquito Complaints
Other
School / Daycare Issue
Swimming Pool Fecal Incident
Fecal Incident Chart
Records Requests
Referral to Advice Nurse
Restaurant Complaint
Sewage Complaints
Unhygienic Tourist Accommodations
12
13
15
16
17
18
19
20
21
22
24
25
31
33
34
35
36
37
38
39
40
41
42
43
Common Mistakes and How to Avoid Them
44
Additional Resources
46
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Alphabetical Listing of Georgia Counties and the Districts in which
They Belong
Insert: Public Health Districts in Georgia Map
County & District Hours of Operation
Insert: Disease Fact Sheets
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47
51
INTRODUCTION, BACKGROUND, AND PURPOSE
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I. INTRODUCTION
The Georgia Department of Human Resources, Division of Public Health (GDPH) provides two
hotlines for reporting public health emergencies and notifiable diseases. 1-866-PUB-HLTH (1866-782-4584) is for use by public health partners, and 1-866-752-3442 is for use by the general
public. The hotlines are housed at and staffed by the Georgia Poison Center (GPC), and are
available for use 24 hours a day, 7 days a week. The hotlines are made possible by federal
bioterrorism grant funding and a contract between GDPH and GPC, which is renewed annually.
II. PURPOSE
Georgia’s Public Health Emergency and Disease Reporting Hotlines combine the resources of
GDPH at the State and District levels with those of GPC.
1. 1-866-PUB-HLTH
The purpose of 1-866-PUB-HLTH is to allow time-sensitive communication among
GDPH personnel at the State and District levels, as well as among healthcare providers
and emergency response partners at all levels of government. 1-866-PUB-HLTH is for
the reporting of immediately notifiable diseases, including those that could result from a
bioterrorism event, and public health emergencies. 1-866-PUB-HLTH is one easy-toremember number that should be distributed to all local, state, and federal partners for use
in a public health emergency as well as to healthcare providers and other disease
reporters to report notifiable diseases.
Examples of public health partners that might use 1-866-PUB-HLTH include but are not
limited to:
 Healthcare providers
 Metro Medical Response
System (MMRS)
 Laboratorians

Georgia Management
 Coroners
Agency (GEMA)
 Medical Examiners

Seaports
 Pharmacists
 Local police/fire/EMS/911
 Veterinarians
operators
 Airport Quarantine Stations

Federal Bureau of
 American Red Cross
Investigation (FBI)
 United States Postal Service

Centers for Disease Control
 Disaster Medical Assistance
and Prevention (CDC)
Teams (DMAT)
Members of the general public should not use 1-866-PUB-HLTH.
2. 1-866-752-3442
The purpose of 1-866-752-3442 is to provide the general public with a way to contact
public health in an emergency after normal business hours. The hotline provides for
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better customer service and may aid in detecting and managing a bioterrorism event, as
some districts currently have no other way of accepting calls from the general public at
nights or on weekends. The general public hotline began as a pilot involving four
volunteer health districts: Gainesville, Columbus, Valdosta, and Waycross. Currently,
hotline use has expanded to eight health districts, including the original four plus Fulton,
LaGrange, Dalton, and Coastal.
III. NOTIFIABLE DISEASE REPORTING
The purpose of notifiable disease surveillance is to:
1. identify in a timely way any diseases or conditions that may require immediate public
health intervention and follow up;
2. detect changing trends or patterns in disease occurrence;
3. identify areas or communities that require special public health response as a result of
changes in disease patterns; and
4. assess and evaluate control and prevention interventions.
In Georgia, public health surveillance is conducted on more than 40 diseases and conditions. The
data are collected by GDPH at the State and District levels in order to analyze, interpret, and
disseminate the information for administrative, program planning, and decision making
purposes.
The diseases are reported by County Health Departments, District Health Offices, hospitals,
clinical and state laboratories, physicians and other healthcare providers, as well as public and
private clinics to the Epidemiology Branch in the Division of Public Health. The reports are
made electronically, by telephone, by letter, or by mailing weekly reporting forms provided by
the Department. Callers to 1-866-PUB-HLTH are reporting a disease by dialing 1-866-PUBHLTH. Although 1-866-PUB-HLTH is marketed towards public health partners for after hours
use to report immediately notifiable diseases and public health emergencies, there is some use of
the hotline during the day and for diseases that are not emergencies. The Disease List therefore
lists other diseases that are not emergencies and do not require a phone call to the district health
department after hours. These reports are faxed and the district will receive them the next
business day (see instructions for more details about the disease list and when to call).
IV. AUTHORITY AND CONFIDENTIALITY
The hotlines operate under the legal authority of OCGA §31-12-2, which requires notifiable
disease reporting, including those diseases that may result from “bioterrorism, epidemic or
pandemic disease, or novel and highly fatal infectious agents or toxins and that may pose a
substantial risk of a public health emergency”. OCGA §31-12-2 also requires GDPH to report
“any case of an unusual illness, health condition, or death, or an unusual cluster of such events,
or any other suspicious health related event that it reasonably believes has the potential to be
caused by bioterrorism” to the Department of Public Safety including state and federal partners.
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OFFICIAL CODE OF GEORGIA: 31-12-2 (a)
All Georgia physicians, laboratories and other health care providers are required to report patients with certain
conditions to their County Health Department or District Health Office. Reporting enables appropriate public health
follow-up for your patients, helps identify outbreaks, and provides a better understanding of disease trends in
Georgia.
THE HIPPA PRIVACY RULE: 45 CFR 164.512 (b)(1)(i)
A covered entity may disclose protected health information…to…a public health authority that is
authorized by law to collect or receive such information for the purpose of preventing or
controlling disease, injury, or disability, including, but not limited to, the reporting of disease,
injury, vital events such as birth or death, and the conduct of public health surveillance, public
health investigations, and public health interventions.
PATIENT CONFIDENTIALITY
Georgia Rule 290-5-3-03: Case reports submitted to county boards of health or to the
Department shall be deemed confidential and shall not be subject to public inspection.
Georgia Code 31-12-2(b): Any person, including but not limited to practitioners of the healing
arts, submitting in good faith reports or data to the Department or county boards of health in
compliance with the provisions of this Code section shall not be liable for any civil damages
therefore.
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PROCEDURES, GUIDELINES, AND FLOWCHARTS
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1-866-PUB-HLTH VS. 1-866-752-3442
Hotline calls come from two different groups of people.
When answering a call, it is important to find out who is calling. Is it a Public Health Partner, or the General Public?
Greeting: “Georgia Public Health Hotline, how may I help you?”
1-866-PUBHLTH
Caller is a public health partner*
Caller
wants to
report a
notifiable
disease.
Caller wants
to report a
public health
emergency.
1-866-7523442
Caller is a member of the general public
Caller wants to
speak to someone in
public health
immediately for any
reason.
Caller
wants to
report a
notifiable
disease.
Caller wants
to report a
public health
emergency.
Caller wants
advice on a
non-emergency
issue.
*Public Health Partners may include but are not limited to: healthcare providers, laboratorians, public health, coroners,
medical examiners, pharmacists, veterinarians, airport quarantine stations, American Red Cross, United States Postal Service,
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Disaster Medical Assistance Teams (DMAT), Metro Medical Response System (MMRS), Georgia Management Agency (GEMA),
seaports, local police/fire/EMS/911 operators, Federal Bureau of Investigation (FBI), Centers for Disease Control and Prevention
(CDC).
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GENERAL FLOW CHART FOR CALLS FROM PUBLIC HEALTH PARTNERS
Greeting: Georgia Public Health Hotline. How may I help you?
Verify caller is a Public Health Partner (healthcare provider,
laboratorian, public health, emergency responder, etc.)
To report case(s) of disease
Purpose of call?
Patient’s county of residence?
To contact public health
immediately for reason other than
to report a case of disease
Caller’s county of employment?
Complete an Information Request including the
Infectious Disease tab. Find disease on disease list.
(See detailed instructions).
Does caller want a call back from Public Health?
If yes (and call is received during non-business
hours), ask if the next business day is OK for the
return call.
Complete Information Request
End call.
Contact the District Epi On-Call by
phone or pager to relay the message.
(This will be the District Epi On-Call,
unless the caller specifically requests
to speak to another On-Call
Representative like the EC On-Call or
the State).
End call.
Use Alphabetical List of
GA Counties to find the
health district in which the
county belongs.
If the disease reported is “EC” or “EPI”,
or the caller requested a same-day
return call, CALL the District EC or EPI
(depending on disease—check Disease
List) On-Call Representative.
If the disease reported is “FAX” (and the
caller did NOT request a same-day
return call), FAX the report to the District
EPI On-Call Representative. (If caller
wanted a return call the next business
day, be sure to fax this information to the
District Epi On-Call as well).
If you are unable to locate the disease
on the list, CONSULT with your
supervisor and/or call the State Epi OnCall.
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GENERAL FLOW CHART FOR CALLS RECEIVED
FROM THE GENERAL PUBLIC
Greeting: “Georgia Public Health Hotline, how may I help you?”
Caller is calling to report an emergency or non-emergency situation related to public health,
or to ask a question.
Complete an Information Request Form.
Tips:
 The type of call (emergency or non-emergency) may require a judgment call after asking
appropriate questions of the caller and assessing the situation.
 For situations described as food poisonings, infectious diseases, or dead birds a
supplemental form will pop up and ask for additional information.
Use flow charts/guidelines for common public health inquiries to answer the caller’s
questions. If additional information is needed about a specific disease, answer the caller’s
questions using the disease fact sheets.
Contact or fax the report to the appropriate District Health Department as instructed on the
flow chart/guidelines. If the instructions are not clear, consult with your supervisor.
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BIOTERRORISM / MASS CASUALTY
Calls involving chemical exposures or illnesses that the caller reports might be the result of an
intentional exposure, criminal act, or terrorist attack. Mass casualty (or the potential for such)
including but not limited to the following: large numbers of people ill, accidental exposures, train
derailments, tanker truck spills, meth lab explosions, etc.
Fill out an Information
Request Form.
Advise the caller to hang up and dial 911 to
report the incident and to request medical help.
If it is a chemical exposure or other area of GPC
expertise, give them the number for GPC (404616-9000 or 800-222-1222) for more
information.
Call the State EC On-Call immediately. Tell the
State EC On-Call that you will ALSO be calling
the District EC On-Call. Give the State EC OnCall the name and phone number for the Primary
District EC On-Call.
Call the District EC On-Call for the district
where the event took place. Tell the District
contact that you also called the State EC OnCall, and give the District contact the name
and phone number of the State EC On-Call
with whom you spoke.
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DETAILED PROCEDURE FOR BIOTERRORISM/MASS CASUALTY CALLS
FROM PUBLIC HEALTH PARTNERS
1. If the caller does not identify himself right away, verify that he is a Public Health
Partner (healthcare provider, laboratorian, public health, emergency responder,
etc).
2. If the caller is calling to report a single case of disease that is not suspected to be the
result of an intentional exposure, criminal act, or terrorist attack, follow the instructions
“DETAILED PROCEDURE FOR INFECTIOUS DISEASE CALLS FROM
PUBLIC HEALTH PARTNERS”.
3. Request the name of the county where the event took place (event county). If the caller
does not know the event county, request the county the caller is calling from (caller
county).
4. Complete an Information Request Form to document the call.
5. End the call.
6. Use the Alphabetical Listing of GA Counties to find the health district in which the
county belongs.
7. Bioterrorism/Mass Casualty calls from Public Health Partners are ALWAYS an
emergency situation! Contact the District EC On-Call Representative AND the State
EC On-Call Representative immediately by phone or pager.
1. Log onto SendSS and locate the contact numbers for the Primary State EC OnCall Representative (see SendSS instructions).
2. For pager notifications, wait 10 minutes for the On-Call Representative to
respond. If there is no response, go to the next number listed for the Primary OnCall Representative. If no response after attempted contact of the Primary OnCall Representative, call the Backup On-Call Representative(s) in the order listed
until a contact is made.
3. Tell the State EC On-Call Representative that you will ALSO be calling the
District EC On-Call Representative. Give the State EC On-Call the name and
phone number for the Primary District EC On-Call.
4. Call the District EC On-Call Representative for the district where the event
took place (event county). Tell the District EC On-Call that you also called the
State EC On-Call, and give the District contact the name and phone number of the
State EC On-Call with whom you spoke.
8. For chemical exposures of any type or any illness that the caller reports might be the
result of an intentional exposure, criminal act, or terrorist attack – Notify the
District AND State EC On-Call Representatives immediately!
9. For reports of anthrax, smallpox, or botulism (suspect or confirmed) contact the
District AND State On-Call Representatives immediately! Use the Disease List to
see if the disease is “EC” or “EPI”.
10. Notify the District EPI On-Call Representative immediately by phone of any
reported cluster of ANY illness.
1. Use these guidelines to decide if it’s a cluster (either in this call or among a few
calls received in the time span of a few hours):
1. For GI illness or rash illness, 3 or more cases not in the same household.
2. For hospitalized respiratory illness, 2 or more not in the same household.
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For non-hospitalized respiratory illness and all other illnesses, greater than
10 cases.
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BLOOD / BODY FLUID EXPOSURES
Is the caller the person exposed,
or is the caller a person from
employee health wanting a
public health consult?
Person exposed
or other member
of the public
Is the caller employed as a
healthcare worker, laboratory
worker, EMS worker, or other
occupational exposure?
Employee
health
NO
Can the caller see his/her doctor
that same day?
YES
Complete an Information
Request Form. Call or page
the District Epi On-Call (use
the district of the exposed
person’s residence). If
exposed residence is
unknown, use the district of
the institution.
Tell caller to
report the incident
to employee health
immediately and
follow their
procedures for
occupational blood
exposures.
YES
NO
Instruct caller to
visit his/her
doctor that same
day.
Instruct
caller to
visit the
emergency
department
within 24
hrs.
Complete an Information Request Form. FAX to
the District Epi On-Call (use district of the
exposed person’s residence).
Blood / Body Fluid Exposure Information for Public Health Specialists (note: this
information may be used to answer questions if the caller specifically asks for more information)
What diseases can be transmitted by what body fluids?
HIV
Hepatitis A
Hepatitis B
Hepatitis C
Blood or other body
fluids containing blood
yes
no*1
yes
yes
Saliva
Urine
Feces
no
no
no
no
no
no
no
no
no
yes
no
no
Semen / Vaginal
Fluid
yes
yes
yes
yes*2
*1 On rare occasions, hepatitis A virus has been transmitted by transfusion of blood or blood
products.
*2 Sexual transmission of hepatitis C virus appears to occur, but the virus is inefficiently spread
in this manner.
Additional resource for clinicians only:
 National Clinicians’ Postexposure Prophylaxis Hotline (PEPline)—Run by University of California-San
Francisco / San Francisco General Hospital staff; supported by the Health Resources and Services
Administration Ryan White CARE Act, HIV/AIDS Bureau, AIDS Education and Training Centers, and
CDC. 1-888-448-4911
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DEAD BIRD CALLS (WNV) (revised 11/9/2006)
USE THIS FLOW CHART FOR BIRDS OF PREY (E.G. FALCONS, HAWKS, EAGLES), SONGBIRDS, AND SIMILAR
SPECIES ONLY (E.G. PIGEONS, CARDINALS, CROWS, WRENS, BLUE JAYS, ETC.)
Complete an Information Request
Form AND Supplemental Dead Bird
Call Form.
Does the bird have
visible decomposition?
Advise the caller to safely dispose of the dead bird by double
bagging it in sealed plastic bags and placing it in the trash or
burying it. Do not handle the bird with bare hands.
YES
NO
Pet bird
What kind of bird is it?
Wild songbird or similar
species (i.e. pigeon,
cardinal, wren, blue jay,
crow, etc.) or UNKNOWN
Tell caller to consult
their veterinarian.
Did the call come
in on a weekend?
YES
Will the caller double bag the
bird in sealed plastic bags and
place in the refrigerator (do not
freeze) for the weekend?
NO
Wild bird of prey (i.e.
falcon, hawk, eagle, etc.)
YES
NO
FAX completed form to the caller’s
District ENV On-Call Rep. If they
have additional questions, tell them to
contact their county environ. health
office during regular business hours.
Educate the
caller using
“How to
Handle
Dead Birds
or Dead
Bird
Inquiries”.
Tell the caller that it is the district health department’s decision to make
(during normal business hours) whether or not the bird will be submitted
for testing (i.e. saving it in the refrigerator does not guarantee that it will
be tested). See p. 10 in “How to Handle Dead Birds or Dead Bird
Inquiries” for reasons why a bird might not be submitted for testing.
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Bird MIGHT be tested for
WNV or Avian Flu. Tell
caller to call their regional
Georgia Department of
Natural Resources (DNR)
Game Management Specialist
during office hours (look up
phone # by county for the
caller using p. 7 of “How to
Handle Dead Birds or Dead
Bird Inquiries”). DNR will
decide if/what to test the bird
for. If bird not too large,
caller should double bag it
and store it in a refrigerator or
in an iced cooler. If cooler is
used, replace ice as needed to
keep bird cold. Do not handle
with bare hands.
DEAD BIRD CALLS (Avian Influenza) (updated 11/9/2006)
USE THIS FLOW CHART FOR DEAD WATERFOWL, SHORE BIRDS, CHICKENS, AND OTHER POULTRY.
Complete an Information Request
Form AND Supplemental Dead Bird
Call Form.
Does the bird have
visible decomposition?
YES
Advise the caller to safely dispose of the dead bird by double
bagging it in sealed plastic bags and placing it in the trash or
burying it. Do not handle the bird with bare hands.
NO
Canada goose
What kind of bird is it?
If <5 sick/dead, use
procedure for WNV
testing from the Dead
Bird Call Flow Chart
(WNV). Canada geese
are not migratory and
will not be tested for
avian influenza unless
there is a large die-off.
Waterfowl, shore bird (i.e.
duck, goose, seagull, etc.)
EXCEPT Canada goose
If <5 sick/dead, tell caller to call their
regional Georgia Department of
Natural Resources (DNR) Game
Management Specialist during office
hours (look up phone # by county for
the caller using p. 7 of “How to Handle
Dead Birds or Dead Bird Inquiries”. If
bird not too large, caller should double
bag it and store it in a refrigerator or in
an iced cooler. If cooler is used,
replace ice as needed to keep bird cold.
Do not handle with bare hands.
If ≥5 sick/dead,
tell caller to call
DNR Game
Management
Specialist (1800-TRYGEMA)
Other wild bird, songbird, or
pet bird (i.e. pigeon, blue
jay, crow, pet cockatiel, pet
canary, etc.)
Chicken or other
poultry (i.e. quail,
turkey, gamefowl)
If <4 or <10% of
flock sick/dead
If ≥4 or ≥
10% of
flock
sick/dead
Stop. Use the other
Dead Bird Call Flow
Chart (WNV).
Tell caller to call the
State Veterinarian’s
Office (1-800-TRYGEMA) or the USDA
Area Veterinarian’s
Office (770-922-7860)
immediately, 24/7.
Tell caller to call the closest Georgia Poultry Lab during normal business
hrs (look up phone # on p. 8 of “How to Handle Dead Birds or Dead Bird
Inquiries”). Meanwhile, double bag bird(s) and place in an iced cooler or
in a refrigerator. If cooler is used, replace ice as needed to keep bird
cold. Do not handle with bare hands.
Educate the caller using p. 9-11 of “How to
Handle Dead Birds or Dead Bird
Inquiries”.
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FAX the completed form to the GA
Division of Public Health at 404-6577517 ATTN: Dana Cole.
FINANCIAL ASSISTANCE REQUESTS
“I need help paying my medical bills.”
Fill out an Information
Request Form.
Instruct the caller to call the
Health Department during
normal business hours. There is
no need to fax a form to the
district health department.
Remind the caller that this
phone number is for public
health EMERGENCIES.
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HEALTH DEPARTMENT ROUTINE SERVICES
“I need to schedule an appointment at the health clinic.”
Fill out an Information
Request Form
Instruct the caller to call the Health
Department during normal business
hours. There is no need to fax a
form to the district health
department. Remind the caller that
this phone number is for public
health EMERGENCIES.
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IMMUNIZATIONS AVAILABILITY QUESTIONS
“Where can I get a flu shot?”
Fill out an Information
Request Form.
What kind of vaccine(s) are
you seeking?
Flu Shots
--County health departments offer flu shots,
but people should call ahead (during normal
business hours) to confirm the county has
vaccine and the hours/days it is being
offered. At
http://www.immunizeadultga.org/search.asp
you can search by zip code for the nearest
county health department clinic and
information about flu shots at that location.
--Sometimes people don't want to go to the
county health department or it's easier to go
to a Publix, Kroger, CVS, Walgreens, etc.
The following websites list locations of flu
clinics in their neighborhood by zip code:
http://www.findaflushot.com/ and
http://www.flucliniclocator.org/.
--If the person doesn't have internet access,
you can do the searches for them over the
phone.
Page 66 of 125
Travel, school,
and all other
immunizations
Tell the caller to call the
Health Department during
normal business hours.
There is no need to fax the
Information Request to the
Health Department.
INFECTIOUS DISEASE (for smallpox-related calls, see “Infectious Disease: smallpox / smallpox
vaccine / vaccinia” flowchart)
Caller is calling to report a case of known or suspected
infectious disease in him/herself or in another person.
Complete an Information Request Form with Infectious
Disease Supplemental Form.
Is the caller a Public Health Partner
(healthcare provider, laboratorian,
medical examiner, public health
worker, etc.)?
YES
YES
NO or
unknown
NO
Advise the patient to seek
medical attention. If it is an
emergency, send the patient to
the emergency department.
YES
Did the doctor diagnose this
patient with this condition?
Locate the disease on the
Disease List. Determine if the
disease is “EC” (Emergency
Coordinator), “EPI”
(Epidemiology/Immediately
Reportable), or “FAX” (other
reportable diseases). Follow
detailed instructions next
page. Always ask if the
physician would like a call
back from public health.
NO
FAX report to the District
EPI On-Call of the patient’s
residence. If patient’s
residence is unknown, use
caller’s residence.
Tell the patient to return to the
doctor if he/she does not get
better, or seek a 2nd opinion.
If FAX disease or not on
the Disease List
If “EC” or “EPI”
disease
Contact the District EC or
EPI immediately by phone
or pager. Use the district of
the patient’s residence. If
the patient’s residence is
unknown, use the district of
the physician’s institution
(office or hospital).
Has the patient seen a doctor for
this condition?
YES
Could this be a cluster or
outbreak of disease? To decide,
use these guidelines (either in
this call or among a few calls
received in the time span of a
few hours):
For GI illness or rash illness, 3
or more cases not in the same
household.
For hospitalized respiratory
illness, 2 or more not in the
same household.
For non-hospitalized respiratory
illness and all other illnesses,
greater than 10 cases.
Page 67 of 125
NO
FAX report to the District
EPI On-Call of the
patient’s residence. If
patient’s residence is
unknown, use the district
of the physician’s
institution (office or
hospital).
If callers need more information:
Georgia Division of Public Health
website www.health.state.ga.us.
DETAILED PROCEDURE FOR INFECTIOUS DISEASE CALLS
FROM PUBLIC HEALTH PARTNERS
1. If the caller does not identify himself right away, verify that he is a Public Health
Partner (healthcare provider, laboratorian, public health, emergency responder,
etc). If he is a member of the general public, use the instructions for calls from the
General Public (see Infectious Disease flowchart).
2. Request the patient’s county of residence. If the caller does not know the patient’s
county of residence, ask for the county of the facility (office or hospital) where the
patient was seen. If the caller is not calling about a single specific patient but still needs
to contact Public Health, ask for the caller’s county of employment.
3. Complete the Information Request Form including the Infectious Disease tab. (Do this
for any disease that the caller is reporting, whether or not you are able to locate it on the
Disease List).
a. Locate the disease being reported on the Disease List.
b. If you cannot find the disease on the list, ask the caller if the disease has another
name. If you find something on the list that is similar but not exactly the same as
what the caller said, ask the caller if that is the same thing.
c. If there is no other name or you cannot find any of the names the caller gives on
the list, you should still fill out the Infectious Disease tab using whatever disease
name the caller gives you.
4. If the caller does not wish to report a case of disease, but only wants to contact Public
Health, still complete an Information Request Form to document the call.
5. Ask the caller, “Do you wish to receive a call back from public health?” If the caller
says yes, and the call is not received during regular working hours, ask whether the
caller needs a response back before the next business day. Public Health Partners
may request to speak with Public Health immediately for any reason.
6. End the call.
7. Use the Alphabetical Listing of GA Counties to find the health district in which the
county belongs.
8. Locate the disease on the Disease List and report to the District as follows:
a. If the disease is under “EC” (Emergency Coordinator), contact the District EC
On-Call Representative immediately by phone or pager.
i. Log onto SendSS and locate the contact numbers for the Primary District
EC On-Call Representative (see SendSS instructions).
ii. For pager notifications, wait 15 minutes for the EC On-Call
Representative to respond. If there is no response, go to the next number
listed for that person. If no response after attempted contact of the
Primary On-Call Representative, call the Backup On-Call
Representative(s) in the order listed until a contact is made.
iii. If attempts to contact the District are unsuccessful, contact the State EC
On-Call Representative (listed at the bottom of the District EC On-Call
tab).
b. If the disease is under “EPI” (Epidemiology), contact the District EPI On-Call
Representative immediately by phone or pager.
Page 68 of 125
i. Log onto SendSS and locate the contact numbers for the Primary District
EPI On-Call Representative (see SendSS instructions).
ii. For pager notifications, wait 15 minutes for the EPI On-Call
Representative to respond. If there is no response, go to the next number
listed for the Primary On-Call Representative. If no response after
attempted contact of the Primary On-Call Representative, call the Backup
On-Call Representative(s) in the order listed until a contact is made.
iii. If attempts to contact the District are unsuccessful, contact the State EPI
On-Call Representative (404-657-2588 during normal working hours,
770-578-4104 after hours).
c. If the disease reported is under “FAX” (Other Reportable Diseases / NonEmergency), fax the completed Information Request to the appropriate
District Health Department.
i. Log onto SendSS and locate the FAX number for the Primary EPI OnCall Representative (see SendSS instructions).
d. If you are unable to locate the disease reported anywhere on any of the lists,
consult with your supervisor if available, and then contact the State EPI On-Call
Representative immediately by phone (404 657-2588 during normal working
hours, 770 578-4104 after hours) if there is still a question regarding how to
handle the report.
9. If the caller did not want to report a disease but just wanted to contact Public Health
immediately, contact the District EPI On-Call Representative by phone or pager in the
same manner used for EPI diseases (see “8.b.” above), and give the message and caller’s
contact information to the responding official. NOTE: If the call is regarding suspect
Bioterrorism, Mass Casualty, or similar, use the instructions “DETAILED
PROCEDURE FOR BIOTERRORISM/MASS CASUALTY CALLS FROM
PUBLIC HEALTH PARTNERS”.
a. Regardless of the reason for the call, if the caller (confirmed to be a Public Health
Partner) requested a call back from Public Health, be sure to notify the District
EPI On-Call Representative and give them the caller’s contact information. (If the
caller stated that a return call on the next business day would be adequate, fax the
message and request for a return call, along with the caller’s contact information,
to the District EPI On-Call Representative).
10. For chemical exposures of any type or any illness that the caller reports might be the
result of an intentional exposure, criminal act, or terrorist attack – Notify the
District AND State EC On-Call Representatives immediately!
11. For reports of anthrax, smallpox, or botulism (suspect or confirmed) contact the
District AND State On-Call Representatives immediately!
12. Notify the District EPI On-Call Representative immediately by phone of any
reported cluster of ANY illness.
a. Use these guidelines to decide if it’s a cluster (either in this call or among a few
calls received in the time span of a few hours):
i. For GI illness or rash illness, 3 or more cases not in the same household.
ii. For hospitalized respiratory illness, 2 or more not in the same household.
iii. For non-hospitalized respiratory illness and all other illnesses, greater than
10 cases.
Page 69 of 125
INFECTIOUS DISEASE: SMALLPOX / SMALLPOX VACCINE / VACCINIA
Caller is calling to
report a case of (or
suspect case of )
smallpox, smallpox
vaccine reaction, or
vaccinia.
Complete an
Information Request
Form with Infectious
Disease
Supplemental Form.
Is the caller a Public Health
Partner (healthcare provider,
laboratorian, medical examiner,
public health worker, etc.)?
NO
YES
Have you recently received the smallpox
vaccine, or are you a close contact of
someone who has received the vaccine?
Do you want to consult about
a patient?
YES
Contact the
District EPI OnCall immediately
by phone or pager.
Use the district of
the patient’s
residence. If the
patient’s residence
is unknown, use
the district of the
physician’s
institution (office
or hospital).
Also contact the
State EPI On-Call
immediately. Tell
the State EPI on call
the name and phone
number of the
District EPI On-Call
with whom you
spoke.
NO
YES
FAX the
Information
Request Form to
the District EPI
of the patient’s
residence. If
there is no
patient, use the
caller’s county.
Provide
telephone
number to
District Office
for information
during regular
business hours.
NO
Do you have any of the
following symptoms:
Chest pain?
Shortness of breath?
Extreme weakness?
Severe headache?
Confusion?
Stiff neck?
YES
Advise caller to
get immediate
medical attention
at the emergency
room and to
inform the
doctor about the
smallpox
vaccination.
Page 70 of 125
Provide telephone
number to District
Health Director’s
office for
smallpox
information
during regular
business hours.
NO
Do you have fever,
any concerns about
the vaccination site,
or a rash or sore?
YES
NO
DISEASE LIST
Red = “EC” (Emergency Coordinator)  Report immediately by phone to District EC OnCall Representative.
Blue = “EPI” (Epidemiology / Immediately Reportable Diseases)  Report immediately by
phone to District EPI On-Call Representative.
Green = “FAX” (Other Reportable Diseases)  Report by FAX to District EPI On-Call.
*** = Report immediately by phone to BOTH the District AND the State On-Call Rep.
0157:H7 E. coli - EPI
0157:H7 Escherichia coli - EPI
AIDS - FAX
Animal Rabies – FAX
Animal Bites – FAX
Anthrax (any type) – EC***
Arboviral Illness - FAX
Argentinian Hemorrhagic Fever - EPI
Aseptic Meningitis - EPI
Avian Influenza - EPI
Bacillus anthracis – EC***
Bacterial Meningitis - EPI
Bird Flu - EPI
Birth Defects – FAX
Bites, Animal – FAX
Bolivian Hemorrhagic Fever - EPI
Bordetella pertussis - EPI
Botulism (foodborne type or unspecified type) – EPI***
Botulism (infant, intestinal, wound) – EPI***
Brazilian Hemorrhagic Fever - EPI
Brucella - EPI
Brucellosis - EPI
Bubonic Plague - EPI
Campylobacteriosis - FAX
Cancer (any type) - FAX
Chancroid- FAX
Chemical Exposure (any type) – EC
Chicken pox - FAX
Chlamydia - FAX
Cholera - EPI
CJD [Creutzfeld-Jakob Disease] - FAX
Clostridium botulinum – EPI***
Cluster (more than one case) of any illness - EPI
Corynebacterium diphtheriae - EPI
Coxiella burnetti - EPI
Creutzfeld-Jakob Disease - FAX
Crimean-Congo Fever - EPI
Cryptosporidiosis - FAX
Cutaneous Anthrax – EC***
Page 71 of 125
DISEASE LIST
Red = “EC” (Emergency Coordinator)  Report immediately by phone to District EC OnCall Representative.
Blue = “EPI” (Epidemiology / Immediately Reportable Diseases)  Report immediately by
phone to District EPI On-Call Representative.
Green = “FAX” (Other Reportable Diseases)  Report by FAX to District EPI On-Call.
*** = Report immediately by phone to BOTH the District AND the State On-Call Rep.
Cyclosporiasis - FAX
Diphtheria - EPI
Eastern Equine Encephalitis - FAX
Ebola Hemorrhagic Fever / Ebola - EPI
E. coli 0157:H7 - EPI
E. coli (Enterohemorrhagic, Shiga Toxin-Producing, Verotoxin-Producing) - EPI
Ehrlichia - FAX
Ehrlichiosis – FAX
Elevated Blood Lead Level - FAX
Encephalitis (any type) - FAX
Enterohemorrhagic E. coli - EPI
Enterohemorrhagic Escherichia coli - EPI
Escherichia coli 0157:H7 - EPI
Escherichia coli (Enterohemorrhagic, Shiga Toxin-Producing,
Verotoxin-Producing) - EPI
Flu (suspected avian flu OR hospitalized with international travel) – EPI
Flu (seasonal flu) – FAX
Flu-associated pediatric death - FAX
Foodborne Botulism – EPI***
Francisella tularensis - EPI
Gastrointestinal Anthrax – EC***
Giardia - FAX
Giardiasis - FAX
Gonorrhea - FAX
Group A Strep Disease - FAX
Group A Streptococcal Disease - FAX
Group B Strep Disease - FAX
Group B Streptococcal Disease - FAX
Haemophilus influenzae Disease - EPI
Haemophilus influenzae Meningitis - EPI
Haemophilus Meningitis - EPI
Hantaviral Infection / Hantaviral Disease - EPI
Hantavirus - EPI
Hantavirus Pulmonary Syndrome - EPI
Hearing Impairment - FAX
Hemolytic Uremic Syndrome - EPI
Hemorrhagic Fever - EPI
Hemorrhagic Fever with Renal Syndrome - EPI
Hepatitis A – EPI
Hepatitis B – FAX
Page 72 of 125
DISEASE LIST
Red = “EC” (Emergency Coordinator)  Report immediately by phone to District EC OnCall Representative.
Blue = “EPI” (Epidemiology / Immediately Reportable Diseases)  Report immediately by
phone to District EPI On-Call Representative.
Green = “FAX” (Other Reportable Diseases)  Report by FAX to District EPI On-Call.
*** = Report immediately by phone to BOTH the District AND the State On-Call Rep.
Hepatitis C – FAX
H. flu Disease - EPI
H. flu Meningitis - EPI
Hib Diseases – EPI
Hib Meningitis - EPI
HIV - FAX
Human Rabies - EPI
Infant Botulism – EPI***
Infectious Hepatitis (Report Type A immediately. Report other types by fax) - EPI
Infectious Hepatitis (other than Type A – report Type A immediately) - FAX
Influenza (suspected avian flu OR hospitalized with international travel) – EPI
Influenza (seasonal flu) – FAX
Influenza-associated pediatric death -- FAX
Inhalational Anthrax – EC***
Intestinal Anthrax – EC***
Intestinal Botulism – EPI***
Invasive Group A Strep Disease - FAX
Invasive Group A Streptococcal Disease - FAX
Invasive Group B Strep Disease - FAX
Invasive Group B Streptococcal Disease - FAX
Invasive Haemophilus influenzae Disease - EPI
Invasive H. flu Disease - EPI
Invasive Hib Disease - EPI
Invasive Meningococcal Disease - EPI
LaCrosse Encephalitis - FAX
Lassa Hemorrhagic Fever / Lassa - EPI
Lead Blood Level greater than or equal to 10 micrograms per deciliter - FAX
Legionella - FAX
Legionellosis - FAX
Legionnaires’ Disease - FAX
Leptospirosis - FAX
LGV [Lymphogranuloma venereum] - FAX
Listeria - FAX
Listeriosis - FAX
Lyme Disease - FAX
Lymphogranuloma venereum - FAX
Malaria - FAX
Marburg Hemorrhagic Fever / Marburg - EPI
Measles - EPI
Meningitis (any type) - EPI
Page 73 of 125
DISEASE LIST
Red = “EC” (Emergency Coordinator)  Report immediately by phone to District EC OnCall Representative.
Blue = “EPI” (Epidemiology / Immediately Reportable Diseases)  Report immediately by
phone to District EPI On-Call Representative.
Green = “FAX” (Other Reportable Diseases)  Report by FAX to District EPI On-Call.
*** = Report immediately by phone to BOTH the District AND the State On-Call Rep.
Meningococcal Disease - EPI
Meningococcal Meningitis - EPI
Meningococcal Sepsis - EPI
Meningococcemia – EPI
Meningoencephalitis – EPI
Methicillin-resistant Staph aureus – FAX
Methicillin-resistant Staphylococcus aureus - FAX
Monkeypox – EPI
MRSA - FAX
Mumps - EPI
Neisseria meningitides - EPI
Non H1 or H3 Flu - EPI
Non H1 or H3 Influenza - EPI
Non-Typable Flu - EPI
Non-Typable Influenza – EPI
Pediatric Influenza Death - FAX
Pertussis - EPI
Plague (any type) - EPI
Pneumococcal Infection / Disease - FAX
Pneumonia in someone who traveled recently - EPI
Pneumonic Plague - EPI
Polio - EPI
Poliomyelitis - EPI
Psittacosis - FAX
Purpura fulminans - EPI
Q Fever - EPI
Rabies (in a human) - EPI
Rabies (in an animal) - FAX
Respiratory Disease in someone who traveled recently - EPI
Rift Valley Fever - EPI
Rocky Mountain Spotted Fever - FAX
Saint Louis Encephalitis - FAX
Salmonella - FAX
Salmonellosis - FAX
SARS - EPI
Severe Acute Respiratory Syndrome - EPI
Shiga Toxin Positive Test - EPI
Shiga Toxin-Producing E. coli - EPI
Shiga Toxin-Producing Escherichia coli – EPI
Shigella - FAX
Page 74 of 125
DISEASE LIST
Red = “EC” (Emergency Coordinator)  Report immediately by phone to District EC OnCall Representative.
Blue = “EPI” (Epidemiology / Immediately Reportable Diseases)  Report immediately by
phone to District EPI On-Call Representative.
Green = “FAX” (Other Reportable Diseases)  Report by FAX to District EPI On-Call.
*** = Report immediately by phone to BOTH the District AND the State On-Call Rep.
Shigellosis - FAX
South American Hemorrhagic Fever - EPI
Smallpox – EPI*** (See Smallpox instructions)
Staph aureus resistant to methicillin / with methicillin resistance - FAX
Staph aureus resistant to vancomycin / with vancomycin resistance – EPI
Staphylococcus aureus resistant to methicillin / with methicillin resistance - FAX
Staphylococcus aureus resistant to vancomycin / with vancomycin resistance - EPI
Staph aureus with elevated vancomycin MIC [minimum inhibitory concentration] - EPI
Staphylococcus aureus with elevated vancomycin MIC [minimum inhibitory concentration] EPI
Strep A – FAX
Strep B - FAX
Strep pneumo – FAX
Streptococcal Disease (Group A or B) - FAX
Streptococcus pneumoniae - FAX
Syphilis - FAX
TB - FAX
Tetanus - FAX
Toxic Shock Syndrome - FAX
Toxoplasmosis - FAX
Tuberculosis - FAX
Tularemia - EPI
Typhoid - FAX
Unexplained Pneumonia in a Traveler - EPI
Unexplained Respiratory Disease in a Traveler - EPI
Vancomycin-Intermediately Susceptible Staph aureus - EPI
Vancomycin-Intermediately Susceptible Staphylococcus aureus - EPI
Vancomycin-Resistant Staph aureus - EPI
Vancomycin-Resistant Staphylococcus aureus - EPI
Venezuelan Hemorrhagic Fever - EPI
Verotoxin-Producing E. coli - EPI
Verotoxin-Producing Escherichia coli - EPI
Vibrio cholerae - EPI
Vibrio Infection - EPI
Viral Hemorrhagic Fever (any type) - EPI
Viral Hepatitis (Report Type A immediately. Report other types by fax.) - EPI
Viral Hepatitis (other than Type A – report Type A immediately) - FAX
Viral Meningitis - EPI
VISA [pronounced like the credit card] - EPI
VRSA [pronounced “versa” or “V-R-S-A”] - EPI
Page 75 of 125
DISEASE LIST
Red = “EC” (Emergency Coordinator)  Report immediately by phone to District EC OnCall Representative.
Blue = “EPI” (Epidemiology / Immediately Reportable Diseases)  Report immediately by
phone to District EPI On-Call Representative.
Green = “FAX” (Other Reportable Diseases)  Report by FAX to District EPI On-Call.
*** = Report immediately by phone to BOTH the District AND the State On-Call Rep.
West Nile Virus - FAX
Whooping Cough - EPI
Wound Botulism – EPI***
Yellow Fever in someone WITH international travel history - FAX
Yellow Fever in someone WITHOUT international travel history - EPI
Yersinia pestis - EPI
Yersinia (Exception: Report Yersinia pestis immediately as Section A Bioterrorism) - FAX
Yersiniosis - FAX
Page 76 of 125
INSECTS CRAWLING IN / ON A PERSON (always a non-emergency situation)
“I have bugs, worms, fibers, or mites crawling out of my skin”
Fill out an Information
Request Form
Answer the person’s
questions using the
talking points below.
Advise the caller to visit their primary care
physician. If the caller does not have insurance,
tell him to visit the county health department.
FAX the form to the
District EPI On-Call of
the caller’s residence.
Information for GPC staff:
The caller may have delusory parasitosis. Delusory parasitosis is a mental health condition
commonly caused by one of many physical health conditions. There are a few things in common
to sufferers of delusory parasitosis:
 They feel like bugs, worms, fibers, or mites are biting, crawling, or burrowing
into, under, or out of their skin.
 They can feel them and see them, even if no one else can. If someone else can see
them, it is never a physician.
 They think their home or furniture is infested.
 They may tell you that no one seems to believe the "bugs" or "fibers" exist except
themselves, or maybe a friend, who is “also infested”.
 They may have seen many doctors, who either refuse to listen, refuse to see them,
or refer them to someone else.
 They have tried lots of different remedies, none of which worked at all or for
long.
 They will offer to show/send you the "bugs" or "fibers".
 They will often say that the problem is spreading to family, family pets, and
friends.
 They will say they saw whatever is causing their problem on the internet.
Suggestions for dealing with the caller:
 Ask the person if they have contacted their health care provider and discussed the issue.
Be prepared for a diatribe against physicians.
 Remind them that this is a medical condition, and must be dealt with by a physician (do
this repeatedly). If they are taking any medications, they should ask their physicians
about drug reactions. Emphasize that they should continue taking their medications until
their physicians tells them to stop.
 Tell them to visit their primary care physician, or county health department if they have
no insurance.
Page 77 of 125






If they talk about bugs living under their skin or fibers coming out from their skin,
emphasize that insects and parasites do not behave in the manner they are describing.
Suggest the use of oils, lotions, or oatmeal soaks to help with itching or dry skin.
Emphasize that they should never self-medicate or use other chemicals on their skin
without a physician's express order. Tell them this will just aggravate the problem.
If they are concerned about fleas on pets, tell them to take their pet to the veterinarian.
Other things to consider:
o Stress
o Drug/alcohol abuse
o Allergic sensitivity to nonliving substances in the environment
o Dry skin
Most of the time, if you listen sympathetically, emphasize eliminating behaviors that will
cause harm (over-application of pesticides, digging the "bugs" out of the skin, use of
harsh chemicals, etc), suggest the use of oatmeal soaks and skin lotions to reduce itching,
and remind them (repeatedly) to see a physician, the caller will be satisfied. It does no
good to tell these callers that they are imagining things. To their minds, the itching and
infestation is very real.
Page 78 of 125
MOLD
Complete an
Information
Request Form.
Answer the caller’s
questions using the talking
points below. If the
person is sick, tell them to
seek medical attention.
FAX the completed
Information Request to the
District ENV On-Call
Representative of the caller’s
residence.
Mold Talking Points:








Mold frequently grows in homes, schools, and other buildings when humid warm
conditions and/or where leaks are present indoors.
Many different mold species can be found indoors. No particular species has been
demonstrated to pose a higher risk to the general public than any other.
People with allergies to mold can suffer adverse effects, but the ability of mold to cause
other human illness is controversial and not well established. Allergy symptoms may
include stuffy or runny nose, difficulty breathing, worsening of asthma, chest tightness,
headache, altered sense of smell or seeming to smell unusual odors, or feeling tired. If
you develop these or other symptoms, you should see your doctor.
The two main strategies for managing mold are removing the sources of moisture and
cleaning up the mold.
If there is a lot of mold present (an area greater than 3 feet by 3 feet), you may need to
hire someone experienced in removing mold rather than attempting it yourself.
Whether or not the mold is the cause of health problems, there is clearly no benefit to
having the mold present. The best approach to mold can be summarized in the phrase,
“Clean up the mold and dry out the building.”
Tips for cleaning up mold:
o Wear gloves, a filter mask (N-95), and goggles. These items can be purchased at
home improvement stores.
o First fix any water leaks or obvious sources of moisture.
o Damp wipe or scrub thoroughly all contaminated surfaces with warm water and
non-ammonia soap / detergent.
o Rinse and thoroughly dry the cleaned surface of water and moisture.
o If desired, you can use a bleach solution to disinfect the area after cleaning. This
does not prevent the re-growth of mold. Do not mix bleach with products
containing ammonia as a toxic gas will form. Wearing gloves, mix ½ cup bleach
with one gallon of water and apply to the surface using a sponge, mop, or spray
bottle. Be sure to ventilate the area. Remove excess bleach solution and allow
the area to dry.
For more information about landlord issues, call the Georgia Landlord-Tenant Hotline at
404-463-1596 or 800-369-4706.
Page 79 of 125
MOSQUITO COMPLAINTS (always a non-emergency situation)
Complete an Information Request Form and FAX to the District ENV On-Call Representative.
Enter the following information in the comments section:
 Address/location of the problem if not the same as the caller’s address
 Time of day mosquitoes are biting (middle of the day vs. dusk and dawn)
Educate the caller using the following talking points:
1.) Mosquito control is done at the city or county level. To find out if your city or county has
a mosquito control program, contact your public works office.
2.) Not all mosquitoes carry West Nile virus. The ones that do carry West Nile virus breed in
water holding containers and polluted waters and do not fly more than half a mile from where
they breed. This means that you and your neighbors should act together to find the breeding sites
and eliminate them.
3.) Tips for reducing mosquito breeding sites:
 Dump the water out once a week: bird baths, ornamental ponds, swimming pool covers,
boat covers, boats, rain barrels, trash cans, buckets, toys, etc.
 Eliminate from your yard: tires (or drill holes in tire swings), trash along the roadway,
flower pot saucers, leaf litter, and low spots or ditches that hold water for several days
 Clean and properly maintain: clogged gutters, swimming pools, and window screens
4.) For retention ponds and other bodies of standing water that cannot be drained, use larvacides
that kill mosquito larvae before they become biting adults. Larvacides (for example Bti,
mosquito dunks, and others) can be purchased at home improvement stores. Alternatively,
mosquito-eating fish can be put into the water.
5.) Wear an insect repellent containing DEET (for example Off, Cutter, and others) when
outside if mosquitoes are biting. Do not use more than 30% DEET on children. Do not use
DEET on infants under 2 months of age (keep them inside or place a mosquito net over the baby
carriage). Follow label directions.
6.) Spraying to kill adult mosquitoes is the least effective means of controlling mosquito
populations, and should not be relied upon completely for control. Reducing breeding sites and
larvaciding is essential for a complete mosquito control program.
Page 80 of 125
OTHER
There is no flow chart or guidelines sheet for the situation at hand.
Is there an immediate threat to
someone’s life?
YES
Tell the caller to hang up
and dial 911 or go to the
emergency department.
NO
Fill out an Information Request Form. Consult
with your supervisor regarding whether or not to
contact the District EC, EPI, or ENV On-Call
Representative immediately, or whether to fax the
report. If needed, the State EPI On-Call can
provide guidance (404-657-2588 during working
hours, 770-578-4104 after hours). Use good
judgment—if the issue is one of public safety or
environmental hazard, call public health!
Page 81 of 125
SCHOOL / DAYCARE ISSUE
“When can a child return to school or daycare after having an illness?”
Fill out an Information Request
Form and supplemental Infectious
Disease Form.
Consult Common Infectious
Illnesses poster to answer the
caller’s questions.
Follow Infectious Disease flow
chart for how to report to public
health (whether to call or fax
report).
Page 82 of 125
SWIMMING POOL FECAL INCIDENT
Fill out an Information
Request Form.
Ask: Is it a public or private pool?
Private
Public
FAX the Information Request
Form to the District ENV OnCall Representative.
Ask: Is it diarrhea or unknown type?
Yes
Call the District ENV On-Call
Representative for the district
where the pool is located.
Follow Fecal Incident Chart to answer questions about cleaning the pool.
Page 83 of 125
No
FAX the
Information Request
Form to the District
ENV On-Call
Representative.
FECAL INCIDENT
Log Fecal Incident by recording date, time, observations and chlorine level at time of
event. Document actions taken and applicable chemical parameters used.
CLOSE POOL
NO
YES
DIARRHEA?
CLOSE POOL,
CALL HEALTH
DEPARTMENT
or unknown type
YES
REMOVE ALL VISIBLE
FECAL MATTER
CHECK CHLORINE
LEVELS
*CHLORINE LEVEL
2 PPM OR HIGHER?
REMOVE ALL VISIBLE FECAL
MATTER FROM POOL
DRAIN POOL
YES
RUN SYSTEM
FOR 30 MINUTES
HOURS
CLEAN SKIMMERS,
GUTTERS AND
STRAINERS
BACKWASH OR
CLEAN FILTERS
NO
REMOVE ALL VISIBLE
FECAL MATTER
NO
RAISE CHLORINE LEVEL
TO 2 PPM OR HIGHER
RUN SYSTEM FOR
30 MINUTES MINIMUM
BRUSH POOL SURFACE'S
WITH 100 PPM CHLORINE
SANITIZING SOLUTION
RINSE AND THEN
FILL POOL
ADJUST TOTAL ALKALINITY,
CORRECT pH, 7.2 - 7.5,
*INCREASE CHLORINE TO
2 PPM
RUN SYSTEM FOR 30 MINUTES
OPEN POOL
BACKWASH, CLEAN
OR REPLACE FILTERS
Georgia
Environmental Health
(2004)
POOL DRAINABLE?
(SPA or WADING)
RAISE CHLORINE TO 20
PPM MINIMUM
BRUSH SIDES, BOTTOM, AND
DECK IF CONTAMINATED,
WITH 100 PPM CHLORINE
RUN SYSTEM 8 HOURS AND
UNTIL CHLORINE HAS
REACHED ALLOWABLE LEVELS
CLEAN SKIMMERS, GUTTERS
AND STRAINERS
BACKWASH, CLEAN
OR REPLACE FILTERS
OPEN POOL
Note: Maintain pH, between 7.2- 7.5. *If stablizer is used raise chlorine level to 3 ppm.
Page 84 of 125
OPEN POOL
RECORDS REQUESTS
“I need a copy of a birth or death certificate, or a copy of my immunization record.”
Fill out an Information
Request Form.
What records is the caller
requesting?
Birth or Death
Certificate
Immunization
Records
Birth certificates must be requested from
the state Vital Records Office by mail,
online, phone, or in person. OR they can be
requested from the county vital records
office. All the information about ordering
birth certificates can be found at
http://www.health.state.ga.us/programs/vita
lrecords/birth.asp, including a link to the
county vital records office listing with
addresses and phone numbers of county
offices. If someone calls to request a birth
certificate, please give him/her this link. If
they do not have internet access, use this
website to answer their questions and look
up the phone number for the vital records
office in their county. Do NOT just refer
them to their county health department, as
in most cases it's not the health department
that deals with issuing birth certificates.
Death certificate information is at
http://www.health.state.ga.us/programs/vital
records/death.asp and the same guidelines
apply.
There are several options you may
choose from in searching for your
record: (1) There may be a record of
your immunizations in GRITS, the
Georgia Registry of Immunization
Transactions and Services. The registry
is not all-inclusive or comprehensive
but may be helpful. To request this
information, call 1-888-223-8644; FAX
your request to 404-657-7496; or send
an email to immreg@dhr.state.ga.us.
(2) Contact the health care provider
who administered your last
immunizations and request your record
from them. (3) Call the last school you
attended to see if they still have your
immunization certificate on file. (4) If
you had your immunizations
administered in a public health clinic in
Georgia, contact the County Health
Department in the county the clinic was
located in during normal business
hours.
NOTE: For other immunization
FAQs, visit:
http://health.state.ga.us/programs/i
mmunization/faq.asp.
It is not necessary to fax these Information Requests to the Health District.
Page 85 of 125
REFERRAL TO ADVICE NURSE
“I have a question about some symptoms I’m having and need some advice.”
Fill out an Information Request
Form.
Are the symptoms severe
or life-threatening?
YES
NO
Instruct the caller to call 911
or go to the emergency room
immediately.
Advise caller to call the
Health Department during
business hours or call the
Advice Nurse at
FAX report to District
EPI On-Call
Representative. Use the
district of the patient’s
residence.
It is not necessary to fax
the Information Request
Form to the District.
Page 86 of 125
RESTAURANT COMPLAINTS
Fill out an Information
Request Form
Anything having to do with
power outages, floods, sewage
failures, water outages, or fires
Any other complaint
FAX to the District ENV
On-Call Representative.
Use the county where the
restaurant is located.
Contact the District ENV On-Call
Representative immediately. Use
the county where the restaurant is
located.
Page 87 of 125
SEWAGE COMPLAINTS
Fill out an Information
Request Form
Any other sewage
complaint, including
sewage on the ground
or running into
a creek
Sewage backing up
into a restaurant
Contact the District ENV On-Call
Representative immediately. Use
the county where the restaurant is
located.
What is the SOURCE of the
sewage discharge?
Public sewer
line discharge
Contact the Georgia
Environmental Protection
Division emergency
hotline at 404-656-4863
or 1-800-241-4113
(24 hours a day, 7 days a
week).
Septic tank discharge
or unknown source of
discharge
FAX the notification to the
District ENV On-Call
Representative. Use the county
where the property is located.
Page 88 of 125
UNHYGIENIC TOURIST ACCOMMODATIONS
“The hotel I stayed in last night was filthy and had rats and roaches.”
Fill out an Information Request
Form.
FAX to the District ENV
On-Call Representative.
Use the county where the
reported unhygienic
accommodation is located.
Page 89 of 125
COMMON MISTAKES AND HOW TO AVOID THEM

NEVER tell a healthcare provider/1-866-PUB-HLTH caller to call the health
department in the morning to report the disease/situation. It’s YOUR job to do the
reporting. You do this by either calling the district, or by faxing the report to the district,
depending on the disease.

Do NOT fax anything to Laurel Garrison for follow up. Faxes should always go to the
District. If there is a particular case that went wrong that you want to draw my attention to,
fax or e-mail me, but his is not a reliable way to get a message to a doctor or someone at the
state or district office. These should only be in reference to procedural issues. For example,
you should NOT e-mail me to let me know that Dr. Fixit is trying to get in touch with
someone at the District Health Department. If Dr. Fixit is trying to get in touch with
someone at the Health Department, you should CALL the District EPI On-Call
Representative. An example of something you SHOULD e-mail me about is if you don’t
have a flow chart for something and would like to have one in the future, or if you would like
clarification on how to handle something (non-urgent).

The District On-Call Representative is your first person to contact. If you are unsure of
whether to call him/her, consult with your supervisor. If your supervisor is unsure, contact
the STATE EPI On-Call to ask if you need to contact the district. You should never call the
State On-Call Representative without also calling the District (for example, a
bioterrorism situation).

For pager notifications, wait 15 minutes for a response. If no response, go to the next phone
number listed on the contact list. Don’t forget you’ve paged the person! If they don’t call
you back you haven’t made your notification. Try another number or another person
until you talk to a LIVE person.

NEVER leave a message when you are making a notification. If you get an answering
machine, hang up and try the next number or next person on the list.

NEVER give the phone number of the public health (either State or District) employee
to the caller directly. It’s YOUR job to make the notification for them. EXCEPTION:
when someone in public health is calling to get a phone number (ex: a District Epi is calling
to get the number for another District Epi or the State Epi is calling to get the number for a
District Epi).

Always fax a report to the district for anything concerning follow up the district needs
to do (ex: caller reports mold in home). Examples of calls you do NOT need to fax a report
on include: making appointments, seeking monetary assistance, birth certificates, and
immunization records. These are not emergencies and people need to call the health
department on their own during normal business hours.

For EC or EPI Infectious Diseases, you should ALSO fax the report after you contact
someone and talk to a LIVE person.
Page 90 of 125

Not all animal bite calls should be referred to the Poison Center. In all cases, take a
report. If the caller has questions regarding testing the animal, putting the person on
prophylaxis, etc. then you can transfer them to the Poison Center.

Human rabies is NOT equal to animal rabies and animal bite calls. Human rabies (suspect
or confirmed) is an EMERGENCY. Even if you get calls regarding specimen coordination
with the lab, treat human rabies testing, suspect, or confirmed cases as an IMMEDIATE
notification of the district.

For calls that come in during normal business hours, document these well. Make sure to
write down enough information so that the District can understand that the call came in when
the health department was supposed to be open. FAX the report to the district, so they
know that they are missing these calls during the day. The district NEEDS TO KNOW if
people aren’t able to reach them during the day. Example: “Caller wants to make an
appointment. She tried calling the Hart county health department a few minutes ago (about
10:15am) and got a recording with our number on it so she called us. I told her that the HD
should be open right now according to their hours of operation and to try back in a few
minutes.”

Use “1-866-PUB-HLTH” to refer ONLY to healthcare provider, lab, public health,
emergency responder, etc. General public calls should not have this phrase anywhere in the
record. This is a signal to me about what kind of call it is and these are treated differently
than those from the general public.
Page 91 of 125
ADDITIONAL RESOURCES
Page 92 of 125
Alphabetical Listing of Georgia Counties and the Districts in which they belong
COUNTY
HEALTH DISTRICT
DISTRICT NUMBER
Appling
Waycross--Southeast HD
9-2
Atkinson
Waycross--Southeast HD
9-2
Bacon
Waycross--Southeast HD
9-2
Baker
Albany--Southwest HD
8-2
Baldwin
Macon--North Central HD
5-2
Banks
Gainesville--North HD
2-0
Barrow
Athens--Northeast HD
10-0
Bartow
Rome--Northwest HD
1-1
Ben Hill
Valdosta--South HD
8-1
Berrien
Valdosta--South HD
8-1
Bibb
Macon--North Central HD
5-2
Bleckley
Dublin--South Central HD
5-1
Brantley
Waycross--Southeast HD
9-2
Brooks
Valdosta--South HD
8-1
Bryan
Coastal HD
9-1
Bulloch
Waycross--Southeast HD
9-2
Burke
Augusta--East Central HD
6-0
Butts
LaGrange--LaGrange HD
4-0
Calhoun
Albany--Southwest HD
8-2
Camden
Coastal HD
9-1
Candler
Waycross--Southeast HD
9-2
Carroll
LaGrange--LaGrange HD
4-0
Catoosa
Rome--Northwest HD
1-1
Charlton
Waycross--Southeast HD
9-2
Chatham
Coastal HD
9-1
Chattahoochee Columbus--West Central HD
7-0
Chattooga
Rome--Northwest HD
1-1
Cherokee
Dalton--North Georgia HD
1-2
Clarke
Athens--Northeast HD
10-0
Clay
Columbus--West Central HD
7-0
Clayton
Morrow -- Clayton County HD
3-3
Clinch
Waycross--Southeast HD
9-2
Cobb
Marietta--Cobb/Douglas HD
3-1
Coffee
Waycross--Southeast HD
9-2
Colquitt
Albany--Southwest HD
8-2
Columbia
Augusta--East Central HD
6-0
Cook
Valdosta--South HD
8-1
Coweta
LaGrange--LaGrange HD
4-0
Crawford
Macon--North Central HD
5-2
Crisp
Columbus--West Central HD
7-0
Dade
Rome--Northwest HD
1-1
Page 93 of 125
Dawson
Decatur
DeKalb
Dodge
Dooly
Dougherty
Douglas
Early
Echols
Effingham
Elbert
Emanuel
Evans
Fannin
Fayette
Floyd
Forsyth
Franklin
Fulton
Gilmer
Glascock
Glynn
Gordon
Grady
Greene
Gwinnett
Habersham
Hall
Hancock
Haralson
Harris
Hart
Heard
Henry
Houston
Irwin
Jackson
Jasper
Jeff Davis
Jefferson
Jenkins
Johnson
Jones
Gainesville--North HD
Albany--Southwest HD
Decatur--DeKalb HD
Dublin--South Central HD
Columbus--West Central HD
Albany--Southwest HD
Marietta--Cobb/Douglas HD
Albany--Southwest HD
Valdosta--South HD
Coastal HD
Athens--Northeast HD
Augusta--East Central HD
Waycross--Southeast HD
Dalton--North Georgia HD
LaGrange--LaGrange HD
Rome--Northwest HD
Gainesville--North HD
Gainesville--North HD
Atlanta--Fulton HD
Dalton--North Georgia HD
Augusta--East Central HD
Coastal HD
Rome--Northwest HD
Albany--Southwest HD
Athens--Northeast HD
Lawrenceville--East Metro HD
Gainesville--North HD
Gainesville--North HD
Macon--North Central HD
Rome--Northwest HD
Columbus--West Central HD
Gainesville--North HD
LaGrange--LaGrange HD
LaGrange--LaGrange HD
Macon--North Central HD
Valdosta--South HD
Athens--Northeast HD
Macon--North Central HD
Waycross--Southeast HD
Augusta--East Central HD
Augusta--East Central HD
Dublin--South Central HD
Macon--North Central HD
Page 94 of 125
2-0
8-2
3-5
5-1
7-0
8-2
3-1
8-2
8-1
9-1
10-0
6-0
9-2
1-2
4-0
1-1
2-0
2-0
3-2
1-2
6-0
9-1
1-1
8-2
10-0
3-4
2-0
2-0
5-2
1-1
7-0
2-0
4-0
4-0
5-2
8-1
10-0
5-2
9-2
6-0
6-0
5-1
5-2
Lamar
Lanier
Laurens
Lee
Liberty
Lincoln
Long
Lowndes
Lumpkin
Macon
Madison
Marion
McDuffie
McIntosh
Meriwether
Miller
Mitchell
Monroe
Montgomery
Morgan
Murray
Muscogee
Newton
Oconee
Oglethorpe
Paulding
Peach
Pickens
Pierce
Pike
Polk
Pulaski
Putnam
Quitman
Rabun
Randolph
Richmond
Rockdale
Schley
Screven
Seminole
Spalding
Stephens
LaGrange--LaGrange HD
Valdosta--South HD
Dublin--South Central HD
Albany--Southwest HD
Coastal HD
Augusta--East Central HD
Coastal HD
Valdosta--South HD
Gainesville--North HD
Columbus--West Central HD
Athens--Northeast HD
Columbus--West Central HD
Augusta--East Central HD
Coastal HD
LaGrange--LaGrange HD
Albany--Southwest HD
Albany--Southwest HD
Macon--North Central HD
Dublin--South Central HD
Athens--Northeast HD
Dalton--North Georgia HD
Columbus--West Central HD
Lawrenceville--East Metro HD
Athens--Northeast HD
Athens--Northeast HD
Rome--Northwest HD
Macon--North Central HD
Dalton--North Georgia HD
Waycross--Southeast HD
LaGrange--LaGrange HD
Rome--Northwest HD
Dublin--South Central HD
Macon--North Central HD
Columbus--West Central HD
Gainesville--North HD
Columbus--West Central HD
Augusta--East Central HD
Lawrenceville--East Metro HD
Columbus--West Central HD
Augusta--East Central HD
Albany--Southwest HD
LaGrange--LaGrange HD
Gainesville--North HD
Page 95 of 125
4-0
8-1
5-1
8-2
9-1
6-0
9-1
8-1
2-0
7-0
10-0
7-0
6-0
9-1
4-0
8-2
8-2
5-2
5-1
10-0
1-2
7-0
3-4
10-0
10-0
1-1
5-2
1-2
9-2
4-0
1-1
5-1
5-2
7-0
2-0
7-0
6-0
3-4
7-0
6-0
8-2
4-0
2-0
Stewart
Sumter
Talbot
Taliaferro
Tattnall
Taylor
Telfair
Terrell
Thomas
Tift
Toombs
Towns
Treutlen
Troup
Turner
Twiggs
Union
Upson
Walker
Walton
Ware
Warren
Washington
Wayne
Webster
Wheeler
White
Whitfield
Wilcox
Wilkes
Wilkinson
Worth
Columbus--West Central HD
Columbus--West Central HD
Columbus--West Central HD
Augusta--East Central HD
Waycross--Southeast HD
Columbus--West Central HD
Dublin--South Central HD
Albany--Southwest HD
Albany--Southwest HD
Valdosta--South HD
Waycross--Southeast HD
Gainesville--North HD
Dublin--South Central HD
LaGrange--LaGrange HD
Valdosta--South HD
Macon--North Central HD
Gainesville--North HD
LaGrange--LaGrange HD
Rome--Northwest HD
Athens--Northeast HD
Waycross--Southeast HD
Augusta--East Central HD
Macon--North Central HD
Waycross--Southeast HD
Columbus--West Central HD
Dublin--South Central HD
Gainesville--North HD
Dalton--North Georgia HD
Dublin--South Central HD
Augusta--East Central HD
Macon--North Central HD
Albany--Southwest HD
Page 96 of 125
7-0
7-0
7-0
6-0
9-2
7-0
5-1
8-2
8-2
8-1
9-2
2-0
5-1
4-0
8-1
5-2
2-0
4-0
1-1
10-0
9-2
6-0
5-2
9-2
7-0
5-1
2-0
1-2
5-1
6-0
5-2
8-2
County & District Hours of Operation (created March 2006)
County
Facility
Appling
Appling County HD
Atkinson
Atkinson County HD
Bacon
Bacon County HD
Baker
Baker County HD
Baldwin
Baldwin County HD
Banks
Banks County HD
Barrow
Barrow County HD
Bartow
Bartow County HD
Ben Hill
Ben Hill County HD
Berrien
Berrien County HD
Bibb
Bibb County HD
Bibb
Department of Family & Children
Services Clinic
Bibb
Felton Homes Clinic
Bibb
Teen Parent Center Clinic
Bleckley
Bleckley County HD
A-1-97
Phone
Number
(912) 3674601
(912) 4223332
(912) 6324712
(229) 7345226
(478) 4454264
(706) 6772296
(770) 3073011
(770) 3821920
(229) 4265288
(229) 6865411
(478) 7450411
(478) 7451333
(478) 7435893
(478) 7521887
(478) 9346590
Hours of Operation
M-F: 8-5
M-F: 8-5
M-F: 8-5
M-F: 8-5
M, W, Th, F: 8-4:30, Tu: 8-6
M-F: 8-5, closed 12-1
M: 8-7, Tu, W, Th: 8-5, F: 8-2
M-W: 7:30-5, Th: 8-7, F: 8-2
M-F: 8-5
M-F: 8-5
M-F: 8-4:30
M-F: 8-4:30
M-F: 8-4:30
M-W: 8-5, Th: 8-6:30, F: 8-12:30
Brantley
Brantley County HD
Brooks
Brooks County HD
Bryan
Bryan County HD
Bryan
Richmond Hill Clinic
Bulloch
Bulloch County HD
Burke
Burke County HD
Burke
Burke County HD (Sardis)
Butts
Butts County HD
Calhoun
Calhoun County HD
Camden
Camden County HD (Kingsland)
Camden
Camden County HD (St. Mary's)
Camden
Camden County HD (Woodbine)
Candler
Candler County HD
Carroll
Carroll County HD (Carrollton)
Carroll
Carroll County HD (Villa Rica)
Catoosa
Catoosa County HD
Charlton
Charlton County HD
Chatham
Chatham County HD
Chattahoochee Chattahoochee County HD
Chattooga
Chattooga County HD
Cherokee
Cherokee County HD (Canton)
Cherokee
Cherokee County HD (Woodstock)
Clarke
Clarke County HD
A-1-98
(912) 4626165
(229) 2637585
(912) 6534331
(912) 7562611
(912) 7643800
(706) 5543456
(478) 5694949
(770) 5042230
(229) 8492515
(912) 7294554
(912) 8828515
(912) 5763040
(912) 6855765
(770) 8366667
(770) 4590031
(706) 9352366
(912) 4962561
(912) 3562441
(706) 9893663
(706) 8573471
(770) 3457371
(770) 9280133
(706) 542-
M-F: 8-5
M-F: 8-5
M, W, Th: 8-5, Tu: 8-6, F: 8-4
M, W, Th: 8-5, Tu: 8-6, F: 8-4, so
M-F: 8-5
M-F: 8-4:30, closed 12-1
Only open 2x a month
M-F: 8-5
M-F: 8-5
M-F: 8-5
M-F: 8-5
Closed Temporarily
M-F: 8-5
M-F: 8-5
Tu & W: 8-4:15, F: 8-11:15, M&T
M-W: 8-5, Th: 8-7, F: 8-2
M-F: 8-5
M-F: 8-5
M-F: 8-4:30
M-W: 7:30-5, Th: 8-6:30, F: 8-2
M-F: 8-5
M-F: 8-5
M, W, Th: 8-5, Tu: 8-7, F: 8-2
Clarke
East Athens Clinic
Clarke
Teen Matters
Clay
Clay County HD
Clayton
Clayton County HD
Clayton
Forest Park Health Center
Clayton
Jonesboro Health Center
Clayton
Tara Health Center
Clinch
Clinch County HD
Cobb
Acworth Public Health Center
A-1-99
8600
(706) 3695816
(706) 3695670
(229) 7682355
(678) 6107199
(404) 3666231
(770) 4718635
(770) 4736024
(912) 4872199
(770) 9743330
M, W, Th: 8:30-5, Tu: 8:30-7, F: 8
M, W, Th: 8:30-5:30, Tu: 8:30-7:3
M-F: 8-4:30
M-F: 8:30-5 Location moved to 1
Jonesboro
Location closed: Moved to Clay
Battle Creek Rd, Jonesboro Ph#
M, Th: 9:30-6, T, W, F: 8:30-5
Location closed: Moved to Clay
Battle Creek Rd, Jonesboro Ph#
M-F: 8-5
M-F: 8-5
Cobb
Cobb
Cobb
Cobb
Cobb
Coffee
Colquitt
Columbia
Columbia
Columbia
Cook
Coweta
Crawford
Crisp
Dade
Dawson
Decatur
DeKalb
Dodge
Dooly
Dougherty
Douglas
Early
(770) 5142300
(678) 784East Cobb Public Health Center
2180
(770) 919Roosevelt Circle
0025
(770) 438Smyrna Public Health Center
5105
(678) 385South Cobb
1362
(912) 389Coffee County HD
4450
(229) 891Colquitt County HD
7100
(706) 541Columbia County HD
1318
(706) 556Columbia County HD (Grovetown Clinic)
3727
Columbia County HD (Martinez-Evans
(706) 868Clinic)
3330
(229) 896Cook County HD
3030
(770) 254Coweta County HD
7400
(478) 836Crawford County HD
3167
(229) 276Crisp County HD
2680
(706) 657Dade County HD
4213
(706)-265Dawson County HD
2611
(229) 248Decatur County HD
3055
(404) 294DeKalb County HD
3700
(478) 374Dodge County HD
5576
(229) 268Dooly County HD
4725
(229) 430Dougherty County HD
6200
(770) 949Douglas County HD
1970
Early County HD
(229) 723Cobb County HD
A-1-100
M-F: 8-5
M-F: 8-4
M-Th: 8-5, F: 8-12, closed Th 1-2
M-F: 8-5
M-F: 8-4
M-F: 8-5
M-Th: 7:30-6, F: 8-4:30
M-F: 8-5
M-F: 8-5
M-F: 8-5
M-F: 8-5
M-F: 8-4:30
M-F: 8-4:30
M-F: 8-5
M-W: 8-5, Th: 8-6:30, F: 8-2
M-F: 8-5, closed 12-1
M-F: 7:30-6
M-F: 8:15-5
M, W, Th: 8-5, Tu: 8-7, F: 8-12
M-F: 7:30-6:00, closed Thursday
M-F: 8-5
M-F: 8-4:30
M-F: 8-5
Echols
Echols County HD
Effingham
Effingham County HD
Elbert
Elbert County HD
Emanuel
Adrian Clinic
Emanuel
Emanuel County HD
Emanuel
Twin City Clinic
Evans
Evans County HD
Fannin
Fannin County HD
Fayette
Fayette County HD
3707
(229) 5595103
(912) 7546484
(706) 2833775
(478) 6683436
(478) 2377501
(478) 7633452
(912) 7392088
(706) 6323023
(770) 4611178
A-1-101
M-F: 8-5
M-F: 8-5
M: 8-6:30, Tu, W, Th: 8-4, F: 8-1
W: 8:30-4, closed M, Tu, Th, F ex
8:30-4
M, W, Th: 8-4:30, Tu: 8-6:30, F: 8
M, W, Th: 8-4:30, Tu: 8-6:30, F: 8
M-F: 8-5
M-F: 8-5, closed 12-1
M-F: 8:30-5
Floyd
Floyd County HD
Floyd
Floyd County HD Satellite Office
Floyd
Floyd County Teen Resource Center
Forsyth
Forsyth County HD
Franklin
Franklin County HD
Fulton
Adamsville Health Center
Fulton
Aldredge Health Center
Fulton
Center Hill Health Center
Fulton
Fairburn Health Center WIC Office
Fulton
Hapeville Health Center WIC Office
Fulton
Infant WIC Program
Fulton
Lakewood Health Center
Fulton
Lindbergh Women’s & Children’s Health
Center
Fulton
Maternal WIC Program
Fulton
Neighborhood Union Health Center Main
Desk
(706) 2956123
(706) 8025409
(706) 8025372
(770) 7816900
A-1-102
(706) 3845575
(404) 6994204
(404) 7301448
(404) 6996370
(770) 3063119
(404) 7624027
(404) 6165190
(404) 6240628
(404) 6166999
(404) 6164621
(404) 7304665
M-W: 8-5, Th: 8-6:30, F: 8-2
M-W: 8-5, Th: 8-6:30, F: 8-2, clos
M, W, Th: 9-6, Tu: 9-5, F: 9-4, Sat
M-F: 8-4, closed 11-1, Exception:
month clinic closes at 7pm. Exce
month, clinic closes at noon.
M-F: 8-5, closed 12-1, 1st Thursd
until 7 pm. Friday following 1st
M-F: 8-5
M: 8-7, Tu-F: 8-5
M-F: 8:30-5
M-F: 8:30-5
M-F: 8:30-5
M-F: 8-4:30
M-F: 8-5
M-F: 8-5
M-F: 8-4:30
M-F: 8:30-4
Fulton
Neighborhood Union Health Center WIC
Office
Fulton
North Fulton Health Center (dental care)
Fulton
Northeast Health Center Main Number
Fulton
Pediatric WIC Program
Fulton
Ponce Medical Center WIC Office
Fulton
Roy McGee Health Clinic
Fulton
Sandy Springs Health Center
Fulton
South Fulton Health Center WIC Office
Fulton
Southside Healthcare, Inc
Fulton
West End Medical Center (Bowen
Homes)
Fulton
West Lake Medical Center
Fulton
Willie J. Freeman College Park Regional
Health Center
Gilmer
Gilmer County HD
Glascock
Glascock County HD
Glynn
Glynn County HD
A-1-103
(404) 7308314
(770) 7402403
(404) 7305835
(404) 6168549
(404) 6169836
(404) 7528753
(404) 3036162
(404) 7305408
(404) 6881350
(404) 7990851
(404) 7521400
(404) 7654146
(706) 6354363
(706) 5982061
(912) 2643961
M-F: 8:30-5
M, Tu, W, F: 9-5, Th: 9-7
M-F: 8:30-5, 2nd Tuesday of eac
M-F: 7:30-4
M-F: 8-4:30, this number is for p
referred to the WIC Office by Gr
any other services.
Temporarily Closed but there m
Neighborhood Union Health Cen
M-F: 8:30-5
M-F: 8:30-5
M: 8am-8:30pm, Tu-F: 8-5
M-Th: 8-5, F: 8-12
M-F: 8-5
M, W, F: 8-5, Tu, Th: 8-7, Open 2
M-F: 8-5, closed 12-1
M-F: 8-5
M-W & F: 8-5, Th: 8-7
Gordon
Gordon County HD
Grady
Grady County HD
Greene
Greene County HD
Gwinnett
Buford Health Center
Gwinnett
Lawrenceville Health Center
Gwinnett
Norcross Health Center
Habersham
Habersham County HD
Hall
Hall County HD
Hancock
Hancock County HD
Haralson
Haralson County HD
Harris
Harris County HD
Hart
Hart County HD
Heard
Heard County HD
Henry
Henry County HD (McDonough)
Henry
Henry County HD (Stockbridge)
(706) 6241444
(229) 3772992
(706) 4537561
(770) 6142401
(770) 3394283
(770) 6385700
(706) 7787156
(770) 5315600
(706) 4446616
(770) 6465541
(706) 6285037
(706) 3765117
A-1-104
(706) 6753456
(770) 9542250
(770) 3897887
M-W: 8-5, Th: 8-6:30, F: 8-2
M-F: 8-5
M, Tu, Th: 8-4, W: 8-6:30, F: 8-1
M-F: 8-5, Sat: 8-12
M-F: 8-4:15, Sat: 8-11:15
M-F: 8-5, Sat: 8-12
M, W, Th: 8-5, Tu: 8-7, F: 8-3, clo
M, W, Th: 8-5, Tu: 8-7, F: 8-3, clo
Wednesday of each month open
M-F: 8-4:30
M-W: 8-5, Th: 8-7, F: 8-2
M: 7-6. Tu-Th: 8-5, F: 8-3
M-F: 8-5, closed 12-1, 1st Tuesda
closes at 7pm. Friday after the 1
3 pm.
M-F: 8-5, closed 12-1
M-F: 8-5
M-F: 8-5, closed 12-1
Houston
Houston County HD (Perry)
Houston
Houston County HD (Warner Robins)
Irwin
Irwin County HD
Jackson
Jackson County HD (Commerce)
Jackson
Jackson County HD (Jefferson)
Jasper
Jasper County HD
Jeff Davis
Jeff Davis County HD
Jefferson
Jefferson County HD
Jenkins
Jenkins County HD
Johnson
Johnson County HD
Lamar
Lamar County HD
Laurens
Laurens County HD
Lee
Lee County HD
Liberty
Liberty County HD
Lincoln
Lincoln County HD
Long
Long County HD
Lowndes
Hahira Clinic
Lowndes
Lowndes County HD
Lowndes
Lake Park
Lowndes
Teen Clinic
Lumpkin
Lumpkin County HD
Macon
Macon County HD
Madison
Madison County HD
A-1-105
(478) 9871717
(478) 2182000
(229) 4685003
(706) 3353895
(706) 3675204
(706) 4686850
(912) 3752425
(478) 6253716
(478) 9822811
(478) 8643542
(770) 3581483
(478) 2722051
(229) 7593014
(912) 8762173
(706) 3593154
(912) 5452107
(229) 7942665
(229) 3335257
(229) 5596470
(229) 2457274
(706) 8672727
(478) 4728121
(706) 795-
M-F: 8-4, closed 12-12:30
M-F: 8:30-3:30
M-F: 8-4
M, W, Th: 8-4, Tu: 8-6:30, F: 8-1
M, W, Th: 8-4:30, T: 8-7, F: 8-1:30
M-F: 8-4:30
M-F: 8-5
M, Tu, Th: 8-4:30, W: 8-6:30, F: 8
M-F: 8-5
M: 8-7, Tu-Th: 8-5, F: 8-12
M-F: 8:30-5, closed 12-1
M, W, Th: 8:15-5, Tu: 8:15-7, F: 8
M: 9-5, Tu-F: 8-5
M, Tu, F: 8-5, W: 9:30-5, Th: 8-3
M-F: 8-4:30
M-F: 8-5
M-F: 8-4:30
M, Tu, W, F: 8-5, Th: 8am-8pm
M-F: 8-4:30, closed 12-12:30
M-F: 8-6:30, sometimes closed 1M-F: 8-5, closed 12-1, Thursday
clinic opens at 10am.
M-F: 8-4:30
M: 8-6:30, Tu, W, Th: 8-4, F: 8-1
Marion
Marion County HD
McDuffie
McDuffie County HD
McIntosh
McIntosh County HD
Meriwether
Meriwether County HD (Greenville)
Meriwether
Meriwether County HD (Manchester)
Miller
Miller County HD
Mitchell
Mitchell County HD
Monroe
Monroe County HD
Montgomery
Montgomery County HD
A-1-106
2131
(229) 6495664
(706) 5951740
(912) 4374561
(706) 6724974
(706) 8463353
(229) 7583344
(229) 3362055
(478) 9925083
(912) 5834602
M-F: 8-5
M-F: 8-5
M-F: 8-5
M-F: 8-5
M-Th: 8:30-5, closed 12-1 daily an
M-F: 8-5
M-F: 8-5
M-F: 8:30-3:30
M, W, Th: 8-5, Tu: 8-7, F: 8-12
Morgan
Morgan County HD
Murray
Murray County HD
Muscogee
Muscogee County HD
Muscogee
SHAPP/Hypertension
Muscogee
STD Clinic
Muscogee
Teen Health Services
Muscogee
Tuberculosis Clinic
Muscogee
WIC Services: Columbus
Muscogee
WIC Services: Fort Benning
Muscogee
Women's Health Services
Newton
Newton County HD
Oconee
Oconee County HD
Oglethorpe
Oglethorpe County HD
Paulding
Paulding County HD
Peach
Peach County HD (Byron Clinic)
Peach
Peach County HD (Fort Valley)
Pickens
Pickens County HD
Pierce
Pierce County HD
Pike
Pike County HD
Polk
Rockmart HD
Polk
Polk County HD
Pulaski
Pulaski County HD
Putnam
Putnam County HD
A-1-107
(706) 7521266
(706) 6954585
(706) 3216300
(706) 3216241
(706) 3216240
(706) 3210619
(706) –3216636
(706) 3216205
(706) 6826280
(706) 3216225
(770) 7869086
(706) 7693983
(706) 7438181
(770) 4437881
(478) 9567679
(478) 8256939
(706) 2532821
(912) 4492032
(770) 5678972
(770) 6841385
(770) 7492270
(478) 7831361
(706) 485-
M, W, Th: 8:30-5, Tu: 8:30-7, F: 8
M&W: 8-5, Tu&Th: 8-7, F: 8-12
M-F: 8-5
M-F: 8-4
M-F: 8-4
M-F: 8-6
M-F: 8-4:30
M-F 8-5
M-F: 8-5
M-F: 8-5
M, Th: 8-7, Tu, W, F: 8-5
M, W, Th: 8-4:30, T: 8-6:30, F: 8-1
M: 8-6:30, Tu, W, Th: 8-4, F: 8-1
M-W: 8-5, Th: 8-7, F: 8-2
Tu-F: 8-4:30, closed Monday
M-F: 8-4:30
M-F: 8-5
M-Th: 7:30-6:30, F: 8-5
M-F: 8-5, closed 12-1
M-W: 8-4:30, Th: 8-6:30, F: 8-2
M-W: 8-5, Th: 8-6:30, F: 8-2
M, W, Th: 7-5:30, Tu: 7-6:30, F: 7
M-F: 8-4:30
Quitman
Quitman County HD
Rabun
Rabun County HD
Randolph
Randolph County HD
Richmond
Fort Gordon WIC Clinic
Richmond
Richmond County HD
Richmond
South Augusta Clinic
Rockdale
Rockdale County HD
Schley
Schley County HD
Screven
Screven County HD
8591
(229) 3343697
(706) 2120289
(229) 7322414
(706) 7215800
(706) 7215800
(706) 7900661
(770) 7855936
(229) 9372208
(912) 5642190
A-1-108
M-F: 8-5, closed 12-1
M, W, Th: 8-5, Tu: 8-7, F: 8-3, clo
M-F: 8-4, closed 12-1
Located at the main Richmond C
M-F: 8-5
M-W: 8-5, Th: 8-7:30, F: 8-12:30
M, W, F: 8-5, Tu, Th: 8-7
M-F: 8-5, closed 12-1
M-F: 8-4
(229) 5242577
(770) 4674740
Seminole
Seminole County HD
Spalding
Spalding County HD
Stephens
Stephens County HD
Stewart
Stewart County HD
Sumter
Sumter County HD
Talbot
Talbot County HD
Taliaferro
Taliaferro County HD
Tattnall
Tattnall County HD (Glennville)
Tattnall
Tattnall County HD (Reidsville)
Taylor
Taylor County HD
Telfair
Telfair County HD
Terrell
Terrell County HD
Thomas
Thomas County HD
Tift
Tift County HD
Toombs
Toombs County HD
(706) 2824507
A-1-109
(229) 8384859
(229) 9243637
(706) 6658561
(706) 4562316
(912) 6545290
(912) 5577850
(478) 8625628
(229) 8687404
(229) 9958435
(229) 2264241
(229) 3868373
(912) 5268108
M-F: 8-5
M-F: 8:30-4:30
M-Th: 8-5, F: 8-3, closed 12-1. 1
close at 7 pm. Friday following 1
pm.
M-F: 8-5
M, Tu, Th: 7-5:30, W: 7-3:30, F: 8
M-F: 8-5
M-F: 8-4:30
M-F: 8-5
M-F: 8-5
M-F: 8-4:30, closed 12-12:30
M, Tu, W: 8-5, Th: 8-6:30, F: 8-12
M-F: 8-5
M-Th: 7:30-5, F: 7:30-4:30
M-F: 8-5
M-F: 8-5
Towns
Towns County HD
Treutlen
Treutlen County HD
Troup
Hogansville Health Center
Troup
Troup County HD
Troup
West Point Health Center
Turner
Turner County HD
Twiggs
Twiggs County HD
Union
Union County HD
Upson
Upson County HD
Walker
Walker County HD (Lafayette)
Walker
Walker County HD (Rock Springs)
Walton
Adolescent Center for Education and
Services
Walton
Walton County HD
Walton
West Walton County HD
Ware
Ware County HD
Warren
Warren County HD
Washington
Washington County HD
Wayne
Wayne County HD
Webster
Webster County HD
Wheeler
Wheeler County HD
White
White County HD
Whitfield
Whitfield County HD Children's Health
Whitfield
Whitfield County HD Medical Access
A-1-110
(706) 8962265
(912) 5294217
(706) 6374834
(706) 8454085
(706) 6431111
(229)5674357
(478) 9453351
(706) 7456292
(706) 6477149
(706) 6385577
(706) 3750775
(770) 2074151
(770) 2074125
(770) 4661789
(912) 2831875
(706) 4652252
(478) 5523210
(912) 4272042
(229) 8283225
(912) 5687161
(706) 8652191
(706) 2262621
(706)-226-
M, W, Th: 8-5, Tu: 8-7, F: 8-3, clo
M, W, Th: 8-5, Tu: 8-7, F: 8-1
T: 8-5, W: 8-4, F: sometimes
M-F: 8-4:30
M, Tu, Th:8-5, closed 12-1, closed
M-F: 8-5
M-F: 8-4:30
M-F: 7:30-6, closed 12-12:30
M-F: 8-5
M-W, 7:30-4, Th: 8-5:30, F:8-1
M: 8-2, Tu-Th: 8-3, closed Friday
M-Th: 8-5, F: 8-2, closed 11:30-12
M: 8-6:30, Tu, W, Th: 8-4:30, F: 8
M-Th: 8:30-7, closed Friday
M-F: 8-5
M, Th: 8-4:30. Tu, 8-6:30, W:8-5,
M-F: 8-5
M, Tu, Th, F: 8-5, W: 9-5
M-F: 8-5, closed 12-1
M, Tu, Th: 8-5, W: 8-7, F: 8-12
M-W: 8-5, Th: 8-7, F: 8-3, closed 1
M&W: 8-4, Tu&Th: 8-6, F: 8-1
M&W: 8-5, Tu&Th: 8-7, F: 8-2
Clinic
Whitfield
Whitfield County HD Women's Clinic
Wilcox
Wilcox County HD
Wilkes
Wilkes County HD
Wilkinson
Wilkinson County HD (Gordon)
Wilkinson
Wilkinson County HD (Irwinton)
Worth
Worth County HD
A-1-111
5446
(706)-2812259
(229) 3652310
(706) 6782622
(478) 6285353
(478) 9462226
(229) 7772150
M&W: 8-5, Tu&Th: 8-7, F: 8-2
M, Tu, W: 8-5, Th: 8-6:30, F: 8-12
M, W, Th: 8-4:30, Tu: 8-6:30, F: 8
M-F: 8-4:30
M-F: 8-4:30
M-F: 8-5
DEPARTMENT OF HUMAN RESOURCES
Division Of Public Health
Emergency Operations Plan
Call-Down Exercise Program
Standard Operating Plan
Support Annex A1, Appendix II
I. PURPOSE
The purpose of the Call Down Exercise Program is to demonstrate our ability to contact
our Division Staff, District Coordinators, and Community Partners when a situation requires a
rapid response by public health emergency responders across the State of Georgia.
NOTE: For the purpose of continuity and brevity, PHERs will be used throughout this
Appendix to signify personnel within the public health community with an emergency response
role.
II. SCOPE
This exercise program will target PHERs at the State, District, and County levels.
Exercises should test both horizontal and vertical integration with response partners at the state,
district and local levels. Methods used to conduct this exercise will be limited only by the
technologies currently available. This exercise program is intended to remain flexible and allow
for input from all public health partners. Initially this will be a very simple process of contacting
PHERs at the State and District level via one of the communication devices that are recognized
in the Communications Plan (pending publication). The program will eventually scale up the
complexity of these drills to tests the Division’s ability to respond to any given incident.
III. GOAL
The end goal is to provide the State Public Health Director with a method of assessing,
exercising, and improving the ability of the Division of Public Health to rapidly contact PHERS
at all levels upon the happening of a significant event requiring actions by the State’s Public
Health Community.
IV. OBJECTIVES
1. Test the Viability of the Public Health’s Alert and Notification SOP and
Database (SendSS).
The Division has developed an Alert and Notification SOP contained within the
State of Georgia’s Department of Human Resources Emergency Operations Plan under Support
Annex A1. This Support Annex outlines the process for alerting the Division of Public Health
A-1-112
Emergency Preparedness Coordinators at the State and District levels. Additionally, DPH has a
web based system that contains the contact information for all PHERs. This system allows key
personnel to identify who the “On-Call Representative” (OCR) will be on any given day. In the
event of a Call-Down drill or a “Real-World” event, the OCR will be the first individual notified
and will be responsible for conducting further alerts and notifications based on that
office’s/agency’s standard operating procedures and as outline in Support Annex 1.
To measure this objective, in terms of the ability to contact the OCRs, a ratio will
be determined based on the number of first time contacts divided by the total number of contacts
attempted. The expected ratio should be at least 90%.
2. Test the Operability of the Various Communication Assets Throughout the State.
The Division uses a wide array of systems to contact PHERs throughout the state.
These multiple systems are necessary in that they provide redundant methods, each using a
different architecture, in the event one or multiple systems are made or become inoperable. This
exercise program gives users at all levels a tool to test each system, allows an assessment to be
made of the effectiveness of the system(s), and seek ways to improve the use of current systems
or seek new systems which better meet their needs.
To measure this objective, a ratio will be determined based on the number of
systems that functioned as expected without issue divided by the total number of systems
employed during the drill. The expected ratio should be at least 90%.
3. Measure the Division’s Response Times to an Alert.
The key objective of this exercise program is to assess the Division’s ability to
rapidly respond to a public health emergency. Assuming that SendSS is up to date with the
contact information of all PHERs and the systems available to conduct the alert are available and
working properly, the Division should be able to respond to any public health related emergency
in a short time period.
To measure this objective, the time a response is obtained is subtracted from the
time at which the alert was initiated. The expected response time is 15 minutes or less. Times
will be recorded as follows:
(a) 0:01 to 15:00 minutes
(b) 15:01 to 30:00 minutes
(c) 30:01 or more minutes
4. Exercise the Use of WebEOC.
While WebEOC is not a method used to alert key personnel, it is used to track an
event (it gives a recorded history of an event). Each individual who has a requirement to access
WebEOC must first obtain a password. If there is a requirement to log onto WebEOC during a
A-1-113
Call Down, the State Emergency Coordinator (Planning) will make that determination and will
establish a link for the specified event.
To measure this objective, the number of those who log onto WebEOC will be
divided by the total number of those who were expected to access WebEOC. The expected ratio
should be at least 90%.
V. RESPONSIBILITIES
All PHERs must ensure their contact information is updated on the SendSS database.
Each department, division, or district lead must also ensure that their OCR is identified daily and
updated on SendSS. SendSS will be used to determine who will be alerted during a Call Down
exercise or a “Real-World” event. The following is a list of participants which are contacted
either monthly or quarterly: (This is not an exhaustive list.)

DHEART, CHEART, Regional Coordinating Hospitals, Acute Care Hospitals,
Community Health Centers, Other Participating Hospitals, Emergency Preparedness
Staff, Emergency Medical Services, Nurse Managers, Environmental Health Managers,
SNS Staff, District Health Directors, Medical Reserve Corps, Emergency Management
Agencies, Public Information Officer, Fire, School System Liaisons, Pharmacists,
Immunization Managers, Epidemiologists, IT Manager
The OCR for each agency must be available to answer a call 24 hours a day, 7 days a
week, and all reports of public health emergencies must be evaluated and acted on, including
initiating coordination between the State, District, County and other local public health partners.
The OCR is expected to begin this coordination effort, start recording all communications, and
exercising a reporting system within 15 minutes of an alert.
The Division’s Office of Emergency Preparedness will establish a calendar of Call Down
drills and publish the schedule in conjunction with the Multi-Year Exercise Plan. This Office
will also initiate the Call Down drill, unless otherwise stated or a “Real World” event has
triggered an alert from outside of the Division. Which would mean that the initiating agency
should track the alert and notification process and prepare an after action report for submission to
the Division within 10 working days at the end of the event.
District ECs will develop their own Call Down calendar and SOP for their respective
districts. Their Call Down list should include all PHERs within their district. In addition, they
should include all Acute Care Hospitals located within their District boundaries. These calendars
should mirror the Division’s calendar to minimize confusion, provide for synchronization during
Quarterly Call Downs, and establish continuity of reporting.
The exercise planning team will develop the drill schedule for the State as well as the
scenarios and systems to be tested. The exercise planning team will consist of the following, at a
minimum:

State EP Exercise Coordinator
A-1-114




State EP Planning Coordinator
State EP ASPR Liaison, Training and Exercise Coordinator
State EP Communications Officer
State EP Field Exercise Coordinator
VI. CONCEPT OF THE EXERCISE PROGRAM
The Call Down Exercise Program is designed to provide a systematic means of testing,
evaluating and improving our alert and notification system within the public health community
throughout Georgia. This SOP will prescribe the number of exercises per year, the systems to be
tested, objectives of each exercise, and expected deliverables. These exercises will also vary in
their degree of complexity based on assessments of past exercises and the anticipated
requirements of our public health responders as we move forward.
The design of these exercises will range from simply calling a limited number of key
PHERs during duty hours on a scheduled basis to notifying all PHERs after hours and requiring
the DHR EOC to stand up. A pinnacle exercise will include a statewide alert with an expectation
that key personnel will stand up their respective EOCs. This exercise will not occur before 2008
and will be scheduled on a cyclical basis with the frequency to be determined at a later date.
NOTE: If an event requires the use of the alert and notification process and an EOC to
stand up, then an AAR will be completed to give exercise credit for this requirement.
Performance measures as previously indicated will be recorded and then reported to the
Office of Emergency Preparedness within 5 days of the drill or event. Feedback forms and
AARs will be used to capture agency and systems specific issues. Feedback forms are required
to report any issues identified during a drill. AARs will be used only when requested by the
Office of Emergency Preparedness but will always be used at the completion of an actual event.
1. Drill Types
a. Announced: An announced drill will be listed on the Multi-Year Exercise
Plan indicating the Month, day, and time of the initial alert. These will normally be conducted
during regular duty hours.
b. Unannounced: An unannounced drill will be listed on the Multi-Year
Exercise Plan indicating the Month which the drill will be conducted but will not indicate the day
or time of the initial alert. At least one unannounced drill will be conducted during a weekend
and one during the week after regular duty hours.
2. Exercise Scenario: An exercise scenario will be published no later than 60 days prior
to the conduct of the scheduled Call Down drill. Scenarios will vary, but will normally mirror
the scheduled exercises outline in the Multi-Year Exercise Plan. Call Down participants may be
required to submit reports via WebEOC based on these scenarios. Any required report will also
be described and a format published no later than 60 days prior to the drill.
A-1-115
3. Initial Alert: An initial alert will be given via one of the communication means listed
in the Communications Plan of the EOP. Currently, Southern LINC will be the primary means
of initiating an alert, but other systems will also be exercised. The system to be exercised will be
published no later than 60 days prior to the exercise in conjunction with the exercise scenario.
4. Follow Up Alert: A follow up alert will be conducted when an initial alert fails to
generate a response within 5 minutes. Alternate systems, which an agency or emergency
responder has listed on SendSS as a means to contact them, will then be used until a response has
been received. If the primary contact cannot be reached within 10 minutes, then an alert will be
sent to any of the alternates listed on SendSS.
5. WebEOC: WebEOC, while not the system used for an initial alert, will be used to
record exercise participation. WebEOC is also the primary means of reporting and recording
data during actual events. Incorporating WebEOC in Call Down drills will help to build fluency
and efficiency throughout the State. If WebEOC will be used, this too will be identified 60 days
prior to the drill.
6. Communication Systems: The current primary means of initiating an alert is using
the State Group on Southern LINC. A State wide alert and notification (PCA) system in being
negotiated during the drafting of this SOP. Once this system is in place, it will become the
primary means of alerting the public health community due to its capability to reach users
regardless of vendor and is wireless carrier agnostic. Southern LINC will then become
secondary. The tertiary system that will be used is phone, either wireless or landline.
NOTE: In the event a key responder is not able to be reached within 30 minutes of an
actual “Real World” event, coordination between agencies will be made to physically locate the
responder.
7. Frequency of Drills: Drills will be conducted monthly and quarterly. Monthly drills
will focus primarily on key Division staff, District Emergency Coordinators, the Georgia
Hospital Association, and Regional Coordinating Hospitals. Each District will be required to
conduct a monthly Call Down drill and record the average response times as described in this
SOP.
Quarterly drills will extend beyond the alert list for the Monthly drills and will include all
PHERs within the state. This will require each District to conduct a Call Down to all PHERs
within their respective districts.
The following is the expected frequency of Monthly and Quarterly drills:
Monthly drills will be conducted January, February, April, May, July, August,
October and November each year. The Multi-Year Exercise Plan will have these months
annotated as so, with the months of April and October being designated as an unannounced Call
Down.
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Quarterly drills will be conducted March, June, September, and December each
year. The Multi-Year Exercise Plan will have these months annotated as so, with the months of
June and December being designated as an unannounced Call Down.
8. Feedback: In order to improve the State’s ability to effectively and efficiently
conduct an alert and notification, it is critical to receive feedback from participants. Responses
to the following questions will greatly assist in the improvement process:






Was the appropriate responder contacted?
How long did it take to receive a response?
Were there any troubles with the communication system employed?
Were there any problems with accessing WebEOC or SendSS?
What other issues occurred during the drill?
Recommendations on how to improve the process or systems used during an alert and
notification drill or event.
See: Attachment 1 to Appendix 2 to Support Annex 1 – Call Down Feedback Form
VII. REPORTING
The Office of Emergency Preparedness and each District will be responsible for reporting
the results of each Call Down drill or “Real World” event. The information gathered in these
reports will be available for reporting to the CDC on a semi-annual basis. This information will
also be used to identify strengths to maintain and areas to improve; as well as to develop
corrective actions as appropriate. The following reports are attached to this Appendix:
1.
2.
3.
4.
5.
6.
7.
Exercise Events Summary – See: Attachment 2 to Appendix 2 to Support Annex 1
District Response Times – See: Attachment 3 to Appendix 2 to Support Annex 1
Hospital Response Times – See: Attachment 4 to Appendix 2 to Support Annex 1
Other Contacts Response Times – See: Attachment 5 to Appendix 2 to Spt Annex 1
Average Response Times – See: Attachment 6 to Appendix 2 to Support Annex 1
SendSS Ratio – See: Attachment 7 to Appendix 2 to Support Annex 1
Systems Ratio – See: Attachment 8 to Appendix 2 to Support Annex 1
VIII. SUMMARY
This SOP is intended to provide guidance on the conduct of regularly scheduled Call
Down drills that enable agencies at all levels within the public health community to test, assess,
and improve upon the alert and notification processes and systems currently in use. These drills
will also enable the public health community to rapidly respond to any public health emergency
regardless of the size or timing of the event. This SOP is intended to remain flexible and should
be revised at least yearly to reflect the input from all those who participate under the guidance of
this SOP. This SOP should be revised immediately if it is determined that a procedure outline
within would lead to a detrimental outcome for the citizens of Georgia.
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Georgia Department of Human Resources
Division of Public Health
Office of Emergency Preparedness
Call Down Feedback Form
Support Annex A1, Appendix I
Attachment 1
Please complete one form for EACH method of communication tested:
Participant Name:
Title:
Agency:
Date of Call-Down:
Time of Call-Down:
Communications System:
800 Megahertz radios
Cell phone
Nextel
WebEOC
Live Process
Southern LINC
DataFM
HAM/Amateur radio
1.
Were you able to successfully participate in the call down? If not, please describe:
YES
2.
NO
Did you have any access problems or issues? If so, please describe:
YES
NO
3.
Did you have any equipment problems or issues? If so, please describe:
YES
NO
4.
Please describe any other problems or issues:
5.
Suggestions/Comments:
PLEASE COMPLETE AND SEND TO: EPExercise@dhr.state.ga.us
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Attachment 2: Exercise Events Summary
Date
Time
Scenario Event,
Simulated Player
Inject, Player Action
Event/Action
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Attachment 6: Average Response Times – In Minutes
Date of Exercise:
Communication Type:
AVG Response Times
0:00 - 15:00
15:01 - 30:00
30:01 - 45:00
45:01 - 60:00
60:01 +
EOC Operational
Response Times
0:00 - 30:00
30:01 - 60:00
60:01 - 90:00
90:01 - 120:00
120:01 +
Districts
RCHs
PH
Districts
Others
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Attachment 7: SendSS Ratio
Date of Exercise:
Communication Type:
Total Number To Be
Contacted
0
Number Reached
Using SendSS
Data
0
SendSS
Ratio
#DIV/0!
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Attachment 8: Systems Ratio
Date of Exercise:
Communication Type:
Total Number Systems
Used
0
Number Of
Systems
Operational
0
Systems
Ratio
#DIV/0!
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