September 30, 2011
Preparedness Brief
Leading the Way to Prepared and Resilient Communities
In This Issue
APC Program and Quality Improvement
APC Program and Quality Improvement: A Brief Overview
APC Regional Workshop Tour Recap
Marketing the MRC
Creative and Strategic Outreach Opportunities for the MRC
Transit Rail Preparedness
Personal Preparedness and Transit Rail Preparedness
PHEP Capabilities
PHEP and PPHR: Making Sense of Alphabet Soup
Kansas City Health Department Receives Model Practice Awards for Closed Federal PODs
Closed PODs for the Federal Workforce—A Collaborative Practice
SNS STOCKbox is Looking for a Few Good Tools!
Social Media
Social Media for Preparedness and Response
Pandemic Influenza Preparedness
Nurse Triage Line
News, Reports, and Journal Articles
A Brief History of the Medical Reserve Corps
No News Wasn't Good News
Report Released—Review of Pandemic Influenza Community Mitigation Strategies
Refugee Health from the Local Health Department Perspective
2010 National Profile Report Is Now Available
Tools and Resources
Doxycycline Emergency Use Authorization
Release of the Food Related Emergency Exercise Boxed Set
Hurricane Resources for Your Community
New Technical Assistance Review Tool for State and Local Health Department
Public Health Preparedness: 2011 State-by-State Update on Laboratory Capabilities and Response Readiness Planning
Emergency Response and Multnomah County's "Just-in-Time Training" Toolkit
Upcoming Events
Register Today for the 2012 PHP Summit
Attend the 2012 Integrated Training Summit
Newsletter Tools
Search Past Issues
Print-Friendly Article
Print-Friendly Issue
Forward to a Friend
Subscribe to This Newsletter
Subscribe via RSS
Jack Herrmann, MSEd., NCC, LMHC, Senior Advisor & Chief, Public Health Preparedness at NACCHO


Lead Editor
Megan Skupien, Communications Specialist, Public Health Preparedness at NACCHO


Subscribe to the Preparedness Brief
The Preparedness Brief, NACCHO's bi-monthly public health preparedness e-newsletter, features announcements, events, resources, and stories from the field, relevant to today's public health preparedness professional.


Sign up today by clicking here; go to Login and then "My subscriptions" on the right-hand side of screen. Click "more" and then check the Preparedness Brief box to subscribe. If you don't have an account, sign up for free!

Social Media
Follow NACCHO on Facebook, and LinkedIn!


Follow NACCHO on Twitter: @NACCHOalerts



PHEP Capabilities
PHEP and PPHR: Making Sense of Alphabet Soup
Scott Fisher, MPH, Director, Preparedness at NACCHO and Resham Patel, MPH, Senior Analyst at NACCHO

With increased budget constraints and limited resources directed toward public health preparedness, the demands on local health departments (LHDs) to meet mandatory and voluntary requirements may seem more daunting than ever before.  At the same time, there is increased pressure to demonstrate overall agency capacity and public health preparedness capability. While both capacity and capability remain imperative to overall success, there has been an intentional shift from the focus on the former to the latter. Instead of simply counting the number of staff or points of dispensing locations, there is now an increased emphasis on assessing an agency’s ability to respond.

The shift toward capability is one that looks to whether training and exercises have been useful or important, rather than how many have occurred. This also represents a rising interest in understanding whether the investment in public health preparedness has made an impact on an agency’s ability to prepare for, respond to, and recover from public health emergencies. With decreased federal funding, the demands to demonstrate this effectiveness to external decision-makers and stakeholders are increasing nationwide. Since the early 2000’s, Project Public Health Ready (PPHR) and the Centers for Disease Control and Prevention (CDC) Public Health Emergency Preparedness Program, have maintained a specific focus and relevance on building public health preparedness capacity and capability at the state and local level.

About Project Public Health Ready
Administered by the National Association of County and City Health Officials (NACCHO), PPHR is a competency-based training and recognition program that prepares LHDs to respond to emergencies. The program builds preparedness capacity and capability through a continuous quality improvement model by assessing LHDs in three project goals areas—all-hazards preparedness planning, workforce capacity development and demonstration of readiness through exercises or real events. Since 2004, LHDs in 27 states have implemented PPHR with over 200 of those agencies receiving recognition.[i]

About Public Health Preparedness Capabilities: National Standards for State and Local Planning
Since 2002, the CDC has provided technical assistance and approximately $700 million annually for state, local, and territorial public health departments to build and strengthen their abilities to respond to public health incidents through the Public Health Emergency Preparedness cooperative agreement.
[ii] Recently, the CDC implemented a systematic process for defining a set of public health preparedness capabilities to assist state and LHDs with their strategic planning. This year, they released the Public Health Preparedness Capabilities: National Standards for State and Local Planning, also known as the public health emergency preparedness (PHEP) capabilities. These national standards for public health preparedness are designed to assist state and local planners in identifying gaps in preparedness, determining the specific jurisdictional priorities, and developing plans for building and sustaining capabilities.[iii]

Both PPHR and PHEP initially targeted agency capacities, and have also incorporated a stronger emphasis on a capability-based view with an eye toward demonstration of planning. While both PPHR and PHEP provide the state and local structure for public health preparedness, each tackles unique aspects of the equation. PPHR has taken the lead on detailed preparedness planning with a local focus, while PHEP has maintained a strategic, state-focused approach to preparedness priorities and resources. As both programs continue to serve their unique and critical purposes, NACCHO and the CDC have recently increased efforts to collaborate and inform one another, and now both programs are more closely aligned.

PPHR and PHEP Linkages
NACCHO reviews and updates the PPHR criteria annually to incorporate the most recent federal preparedness initiatives, including the National incident Management System (NIMS), Homeland Security Exercise and Evaluation Program (HSEEP), and the PHEP guidance.[iv]  NACCHO has used the annual updates to the PHEP guidance in revising the PPHR criteria because PHEP is one of the primary programs that guides LHDs in building preparedness capacity and capability to respond to emergencies.

In particular, NACCHO has refined the PPHR criteria in areas such as mass prophylaxis and medical countermeasure dispensing, risk communication, and addressing the needs of vulnerable and at-risk populations during emergencies based on updates to the PHEP guidance over the past several years. NACCHO has developed a comparison document to assist LHDs in identifying commonalities between the PPHR criteria and existing federal guidance, including PHEP.[v] NACCHO, similarly to the PHEP Program, is making a concerted effort to place greater emphasis on LHD capability, particularly through the demonstration of the readiness component within PPHR.  

In addition, PPHR contributed to the development of the CDC’s new Public Health Preparedness Capabilities: National Standards for State and Local Planning, creating strong synergies between the two programs. During the fall and winter of 2010, CDC solicited feedback on the 15 public health preparedness capabilities, which are the foundation of the PHEP program. The CDC sought input from state and LHD representatives, identified by NACCHO and the Association of State and Territorial Health Officials (ASTHO) on the capability definitions. NACCHO identified several members from its PPHR Workgroup, a group of LHD representatives charged with providing guidance to the organization on program-related items, to participate in the review. The CDC incorporated the feedback obtained during this review into developing the final version of the Public Health Preparedness Capabilities: National Standards for State and Local Planning. Furthermore, the CDC used the 2011 version of the PPHR criteria as a reference in developing the Public Health Preparedness Capabilities: National Standards for State and Local Planning.  In fact, PPHR is cited over 100 times throughout the PHEP capabilities, predominantly within the planning resource elements.[vi]

The alignment between PPHR and PHEP allows for a more streamlined approach to addressing state and local public health preparedness, and meeting relevant requirements with limited resources. Particularly, participating in PPHR can be used to inform a strategy for meeting PHEP requirements. Together, these programs help to demonstrate the impact of state and local public health preparedness funding and initiatives in a measureable manner. 

[i] NACCHO. Project Public Health Ready Webpage. Available at

[ii] CDC. 2010 Report: Public Health Preparedness Funding Supporting Public Health Preparedness and Response Webpage. Available at

[iii] CDC. (July 2011). Public Health Preparedness Capabilities: National Standards for State and Local Planning. Available at

[iv] NACCHO. Project Public Health Ready Webpage. Available at

[v] NACCHO. 2011 Comparison of Project Public Health Ready Criteria and Federal Guidance. Available at

[vi] CDC. (July 2011). Public Health Preparedness Capabilities: National Standards for State and Local Planning. Available at

Previous Article
Next Article
Post a CommentView Comments
 Rate This Article
Share LinkedIn Twitter Facebook