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Tools to Improve Special Pathogens Readiness [presentation]
From the Presentation: "ASPR [Assistant Secretary for Preparedness and Response] TRACIE [Technical Resources, Assistance Center, and Information Exchange] was developed as a healthcare emergency preparedness information gateway to address the need for: [1] Enhanced technical assistance; [2] A comprehensive, one-stop, national knowledge center for healthcare system preparedness; [3] Multiple ways to efficiently share and receive information between various entities, including peer-to-peer; [4] A way to leverage and better integrate support (force multiplier)[.]"
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
Brannman, Shayne; Madad, Syra; Bennett, Mary Ellen . . .
2019-03-27
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Hospital Surge Evaluation Tool: User Manual for Controllers and Evaluators
From the Introduction: "The Surge Test is a user-friendly peer assessment tool that helps hospitals identify gaps in their surge planning through a no-notice drill. This training module provides a brief overview of the Surge Test, including its objectives, key features, and staff and resource requirements. Planning checklists at the end of the document can be used to track progress in completing needed tasks before the drill."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2014-12
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The Exchange, Issue 10, 2020
From the Document: "In this issue of 'The Exchange', we discuss lessons learned from recent wildfires, evacuating and receiving patients, and preparing for planned power outages. ASPR [Assistant Secretary for Preparedness and Response] TRACIE [Technical Resources, Assistance Center, and Information Exchange] interviewed a variety of subject matter experts from emergency medicine, emergency management, and the federal government to learn more about the effects of these incidents on local hospitals and communities at large."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2020
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ASPR TRACIE Training and Technical Assistance: Considerations for Homecare Actions in Infectious Disease Outbreaks
From the Response: "ASPR [Assistant Secretary for Preparedness and Response] TRACIE [Technical Resources, Assistance Center, and Information Exchange] reviewed existing resources and gathered best and promising practices and compiled them into a series of considerations below. These considerations were reviewed by ASPR TRACIE home-based healthcare subject matter experts and have been broken into the following headings: [1] Emergency Planning Communication; [2] Staff Infrastructure Consumables/Supply Chain; [3] Infection Control/Patient Care; [4] Lab; [5] Behavioral Health; [6] Additional Resources[.]"
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2020-03-13
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Hospital 2009 H1N1 Pandemic Influenza Readiness Review Checklist
"Hospitals have planned for an influenza pandemic for several years, but thus far the characteristics of the 2009 H1N1 pandemic are different than the high-severity pandemic that had been anticipated. The Centers for Disease Control and Prevention (CDC) and The Office of the Assistant Secretary for Preparedness and Response (ASPR) have developed this Readiness Review Checklist as a supplement to existing hospital emergency management plans. This list focuses on information hospitals can use in response to a surge in H1N1 and seasonal flu patients rather than the basic planning and regulatory considerations included in earlier checklists."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2009
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Report of the Interagency Workgroup on Pandemic Influenza and At-Risk Individuals
"This report is an introduction to planning for at-risk individuals during pandemic influenza. Limited explicit information is available to prepare emergency planners, public health agencies, and human services providers for the impact that pandemic influenza will have on the medical, behavioral health, and human services networks that provide needed functional support for at-risk individuals. Using the functional definition of at-risk (special needs) individuals in the National Response Framework (NRF); at-risk individuals may constitute as much as 62% of the U.S. population. Historically, these individuals have not been well integrated into the emergency planning process and their needs and concerns have only recently begun to be more comprehensively addressed in State and local emergency planning. The U.S. Department of Health and Human Services (HHS) Interagency Workgroup on At-Risk Individuals and Pandemic Influenza was tasked to make recommendations for integrating the needs and concerns of at-risk individuals into pandemic influenza emergency planning. This report presents these recommendations. It is intended as a resource for service providers and emergency planners. The report serves as an introduction to planning for at-risk individuals during pandemic influenza. It begins with a review of the needs and concerns of at-risk individuals, moves to key concepts and planning assumptions, and provides specific recommendations and resources for integration of at-risk individual needs into Federal, State, and local pandemic influenza response plans."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2009-08
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Listening Session on At-Risk Individuals in Pandemic Influenza and Other Scenarios: After Action Report
"On August 14, 2009 the Office for At-Risk Individuals, Behavioral Health, and Human Services Coordination (ABC) in the Office of the Assistant Secretary for Preparedness and Response (ASPR) held a Listening Session on 'At-Risk Individuals in Pandemic Influenza and Other Scenarios.' The Listening Session was designed and conducted as a 'facilitated discussion' to engage stakeholder participants in a robust open dialogue. The Listening Session brought together a diverse group of more than 35 experts and practitioners representing public health non-governmental organizations, health care providers and federal agencies involved in public health preparedness and planning, emergency response, and at-risk individuals. The group was brought together to engage and promote dialogue about the challenges and solutions needed to effectively address the needs of at-risk individuals during pandemic influenza and other emergencies in five main areas: 1) Locating and identifying at-risk individuals; 2) Unique concerns of at-risk individuals in accessing public health and medical services; 3) Best Practices in public health and medical service delivery for at-risk individuals; 4) Successful program implementation at the state, tribal and local level, and: 5) Gaps and Barriers to accessing public health and medical services for at-risk individuals."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2009-08-14
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Human Trafficking: What Disaster Responders Need to Know
From the Document: "As a disaster responder and/or a healthcare provider, the likelihood that you will come in contact with a human trafficking victim is very high! Remember that anyone can be trafficked--men and boys, women and girls."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2017-09?
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Hospital Preparedness Program (HPP)
"The Hospital Preparedness Program (HPP) provides leadership and funding through grants and cooperative agreements to States, territories, and eligible municipalities to improve surge capacity and enhance community and hospital preparedness for public health emergencies. In July 2010, states, territories, and large metropolitan areas received HPP grants totaling $390.5 million to help hospitals and other health care organizations strengthen the medical surge capability across the nation. HPP Program funding supports: [1] Enhanced Planning: HPP funding is used to enhance hospital and healthcare system planning and response at the State, local, and territorial levels. [2] Increasing Integration: HPP facilitates the integration of public and private sector medical planning and assets to increase the preparedness, response, and surge capacity of hospitals and other healthcare facilities. [3] Improving Infrastructure: Awardees have used HPP Grants and Special Initiative Grant funding to improve the State, local, and territorial infrastructures that help hospitals and healthcare systems prepare for public health emergencies. The program is managed the Office of the Assistant Secretary for Preparedness and Response, (ASPR) which provides programmatic oversight and works with its partners in State, territorial, and municipal government to ensure that the program's goals are met or exceeded."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
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Considerations for the Use of Temporary Surge Sites for All-Hazards Incidents
From the Document: "This ASPR [Office of the Assistant Secretary for Preparedness and Response] TRACIE [Technical Resources, Assistance Center, and Information Exchange] tip sheet describes the major considerations healthcare facility emergency planners should account for when developing patient surge management solutions. For the purposes of this document, the term 'hospital' is used to describe acute care hospitals with emergency departments and critical access hospitals with emergency management capability. The term 'temporary surge site' is used to describe a range of solutions, including the use of non-patient care areas (e.g., waiting rooms), tents, and mobile facilities to triage and/or treat patients. Please contact your state licensing agency and Centers for Medicare & Medicaid Services (CMS) Regional Office for information about your specific licensing and certification requirements for such temporary surge sites."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2020-02
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EMS Infectious Disease Playbook
"This document was created using official or best practice information taken from multiple organizations that was vetted and assembled by subject matter experts working for the Technical Resources, Assistance Center, and Information Exchange (TRACIE) at the request of the U.S. Department of Health and Human Services (HHS)/Office of the Assistant Secretary for Preparedness and Response (ASPR). The aim was not to develop novel guidance for emergency medical services (EMS) agencies, but to unify multiple sources of information in a single planning document addressing the full spectrum of infectious agents to create a concise reference resource for EMS agencies developing their service policies. This document does not represent official policy of HHS/ASPR or other federal or private agencies."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2017-06?
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Challenges in the Use of Anthrax Vaccine Adsorbed (AVA) in the Pediatric Population as a Component of Post-Exposure Prophylaxis (PEP): A Report of the National Biodefense Science Board
"In the event that Bacillus anthracis (B. anthracis) spores are released in the United States, the current plan of the U.S. Department of Health and Human Services (HHS) is to ensure that anthrax vaccine adsorbed (AVA) is made available to adults and children. In this emergency scenario, AVA would be offered in conjunction with antibiotics to prevent the development of infection and illness following exposure to anthrax spores, a form of therapy termed 'post-exposure prophylaxis' (PEP). The NBSB [National Biodefense Science Board] is a federal advisory committee authorized in December 2006 by the Pandemic and All-Hazards Preparedness Act (PAHPA). The NBSB provides expert advice and guidance to the Secretary of HHS, on scientific, technical, and other matters of special interest to HHS regarding current and future chemical, biological, radiological, and nuclear agents, whether naturally occurring, or accidentally or deliberately released. The NBSB also provides advice on issues related to public health emergency preparedness and response."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2011-10
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Medical Operations Coordination Cells Toolkit, First Edition
From the Purpose and Scope: "This Medical Operations Coordination Cells (MOCCs) Toolkit offers flexible and modifiable guidance, developed by the United States (U.S.) government, aimed to assist regional, state, local, tribal and territorial (SLTT) governments to ensure load-balancing across healthcare facilities and systems so that the highest possible level of care can be provided to each patient during the coronavirus disease 2019 (COVID-19) pandemic caused by the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Medical and other subject-matter experts from the U.S. government developed this Toolkit as a best-practices reference to support SLTT governments in establishing and operationalizing MOCCs."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2020-04-24
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Coronavirus Disease 2019 (COVID-19) Fatality Management Tabletop Exercise [presentation]
This presentation contains details on COVID-19 fatality management for government, private sector, and nonprofit groups. This document is organized as follows: "[1] Exercise Objectives and Outcomes; [2] Scenario Overview: [A] Confirmed COVID-19 Cases [B] Hospitalizations and Deaths; [3] Facilitated Discussion[.]"
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2020-03-26?
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Private Sector Exercise in a Box Materials
From the Document: "This pandemic tabletop exercise was based on the Crimson Contagion Exercise Series and intended to support private sector pandemic preparedness and to enhance ongoing COVID-19 [coronavirus disease 2019] response operations. The following products can be easily customized and are geared towards owners/operators, company legal counsel, communications teams, human resources, and other private sector leaders."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2020?
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ASPR TRACIE Technical Assistance: Infectious Disease/COVID-19 Drive-Through Testing
From the Document: "ASPR TRACIE [Assistant Secretary for Preparedness and Response Technical Resources, Assistance Center, and Information Exchange] compiled and synthesized information from the Centers for Disease Control and Prevention (CDC), local and state health departments, and other open sources. This response highlights resources for healthcare system emergency preparedness planners to use while preparing for and responding to infectious disease outbreaks with drive-through clinic models. Considerations and lessons learned from these materials are also gathered and provided as points for consideration. ASPR TRACIE reached out to members of its Subject Matter Expert Cadre for information and will update this document with additional operational resources and guidance documents as they become available."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2020-03-16
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Crisis Standards of Care and Civil Rights Laws
From the Purpose: "The purpose of this document is to highlight language from the National Academies of Science, Engineering and Medicine (NASEM), the Department of Health and Human Services Office of Civil Rights (DHS OCR), the Federal Emergency Management Agency (FEMA), and relevant law which support the adherence to civil rights laws and disability rights laws in the application of Crisis Standards of Care during resource-constrained emergencies, such as the COVID-19 [coronavirus disease 2019] pandemic."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
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COVID-19 Hospital Resource Package
From the Document: "This document lists key COVID-19 [coronavirus disease 2019] guidance and resources for hospital administrators, hospital emergency planners, and infection control practitioners in the following topical areas: hospital surge, crisis standards of care, staffing surge and resilience, workforce protection, regulatory relief, equipment supply surge, and telemedicine. Each section contains links to Federal and non-Federal guidance to help hospitals prepare for and respond to a COVID-19 outbreak. These sections are then broken down into sub-sections with guidance that can be used during a crisis/actual patient surge, or when a hospital is in the planning phase for the crisis/patient surge. All guidance in this document is accessible to the public, and disclaimers are included for non-Federal resources."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
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Federal Healthcare Resilience Task Force Alternate Care Site Toolkit: Second Edition
From the Purpose: "This Toolkit is guidance and was developed to help state, local, tribal, and territorial (SLTT) entities address potential capacity and capability gaps in healthcare systems during the 2020 SARS-CoV2 [severe acute respiratory syndrome coronavirus 2] virus (COVID-19) pandemic. It is intended to provide guidance and technical assistance to SLTT entities in establishing and operationalizing Alternate Care Sites (ACS) used to care for COVID-19-positive or presumed positive patients. If an ACS is used to treat non-COVID-19 patients, additional considerations will apply."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2020-04-21
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North American Plan for Animal and Pandemic Influenza
"Pandemic (H1N1) 2009 was the first public health emergency of international concern (PHEIC) declared under the International Health Regulations (2005) [IHR (2005)] and the first influenza pandemic in more than 40 years. Canada, Mexico, and the United States recognize that the risk of another pandemic has not diminished and that the world faces an ongoing threat posed by the emergence and spread of influenza viruses with the potential to cause a human influenza pandemic. The three countries continue to work together to strengthen their preparedness in anticipation of a highly contagious influenza virus or other pandemic either originating in or spread to this continent. […] The 'North American Plan for Animal and Pandemic Influenza' (NAPAPI) retains the key elements of the 2007 version, while incorporating the lessons learned from the North American response to Pandemic (H1N1) 2009, including recognizing that a pandemic influenza virus may emerge in our region and expanding the focus on animal influenza viruses to incorporate both avian and non-avian species. The NAPAPI outlines how the three countries intend to strengthen their emergency response capacities as well as our trilateral and cross-sectoral collaborations and capabilities in order to assist each other and ensure a faster and more coordinated response to future outbreaks of animal influenza or an influenza pandemic. [… ] In brief, the NAPAPI is a comprehensive cross-sectoral regional health security framework developed mainly with the input of the health, agriculture, security, and foreign affairs sectors to protect against, control and provide a public health response to animal and pandemic influenza in North America, while avoiding unnecessary interference with international travel and trade."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2012-04-02
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Going with No Flow: Coping with Hospital Water Supply Issues
"On the evening of July 12th, 2018, staff at the MedStar Washington (DC) Hospital Center noticed a significant drop in water pressure. While this loss of water was remedied by the District of Columbia Water and Sewer Authority (DC Water) within hours, residents and facilities across much of the city were urged to boil water before drinking or cooking with it. Dr. John Hick (ASPR TRACIE's Senior Editor) interviewed Craig DeAtley (PA-C, Director, Institute for Public Health Emergency Readiness, MedStar Washington Hospital Center) to discuss this incident, lessons learned, and planning considerations healthcare facilities can incorporate to improve preparedness and response to similar incidents."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
Hick, John L.; DeAtley, Craig A.
2018?
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Federal Patient Movement: NDMS Definitive Care Program Fact Sheet
"When a state requests Federal support to move patients, the U.S.
Department of Health and Human Services (HHS), as the lead federal
agency, will implement the patient movement system, which is
comprised of five functions: patient evacuation (to include patient
reception and management), medical regulating, en-route medical
care, patient tracking, and re-entry. [...] Definitive care is provided by a network of approximately 1800 to 2000 civilian hospitals nationwide
that have signed agreements with the National Disaster Medical System (NDMS) to accept patients
during a disaster or public health emergency."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response; United States. Department of Health and Human Services
2016-10-27
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Federal Patient Movement Overview Fact Sheet
"When a state requests federal support to move patients, the U.S.
Department of Health and Human Services (HHS), as the lead
federal agency for Emergency Support Function #8, Public Health
and Medical Services, will implement the patient movement
system, which is comprised of five functions: patient evacuation
(to include patient reception and management), medical
regulating, en-route medical care, patient tracking, and re-entry."
United States. Department of Health and Human Services; United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2016-10-27
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2016 Public Health Emergency Medical Countermeasures Enterprise Stakeholders Workshop Report
"The Department of Health and Human Services (HHS) established the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) in July 2006, as a coordinated, interagency organization to define and prioritize requirements for public health emergency medical countermeasures (MCMs); to integrate and coordinate research, early- and late-stage product development, and procurement activities addressing the requirements; and to set deployment and use strategies for MCMs held in the Strategic National Stockpile (SNS). The Pandemic and All-Hazards Preparedness Act (PAHPA), enacted in December 2006, established the Office of the Assistant Secretary for Preparedness and Response (ASPR), under which the PHEMCE is managed and through which it operates. [...] The goal of the 2016 PHEMCE Stakeholders Workshop was to provide a forum within which a broad spectrum of stakeholders in the PHEMCE mission of effective provision of emergency medical countermeasures could learn about PHEMCE activities, interact, and provide input to PHEMCE partners about their interests, issues, concerns, and priorities."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response; HHS Public Health Emergency Medical Countermeasures Enterprise (U.S.)
2016-01
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Patient Moving and Tracking Topic Collection
"In the event of a mass casualty incident, local emergency responders will be faced with the challenge of identifying, categorizing, triaging, and tracking large numbers of patients. As the scale of the event increases, so does the need for expanded assistance-from the local, state, regional, and federal levels, including health care coalitions and other health systems. Organizing appropriate transport and matching appropriate patients to the transportation can be challenging. Patient tracking takes a coordinated effort with all involved to identify a system that works in specific jurisdictions. This Topic Collection includes resources on patient movement from area healthcare facilities and tracking that can help emergency planners and responders learn more about various levels of assistance available, how to request it, how it is activated, and lessons learned from recent events."
United States. Department of Health and Human Services; United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response
2017-03-08
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Hospital (and Transplant Program) Requirements: CMS Emergency Preparedness Final Rule
From the Document: "The Centers for Medicare & Medicaid Services (CMS) issued the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule to establish consistent emergency preparedness requirements for healthcare providers participating in Medicare and Medicaid, increase patient safety during emergencies, and establish a more coordinated response to natural and human-caused disasters. The U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response (ASPR) worked closely with CMS in the development of the rule. This document combines excerpts from the Final Rule, the Interpretive Guidelines and revisions (New 3.6.19) from CMS to provide a consolidated overview document for the Hospital and Transplant Program Requirements."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response; United States. Technical Resources, Assistance Center and Information Exchange
2019-11-29
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Long Term Care Requirements: CMS Emergency Preparedness Final Rule
From the Document: "The Centers for Medicare & Medicaid Services (CMS) issued the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule to establish consistent emergency preparedness requirements for healthcare providers participating in Medicare and Medicaid, increase patient safety during emergencies, and establish a more coordinated response to natural and human-caused disasters. The U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response (ASPR) worked closely with CMS in the development of the rule. This document combines excerpts from the Final Rule, the Interpretive Guidelines, and revisions (New 3.6.19) from CMS to provide a consolidated overview document for the Long Term Care (LTC) Requirements."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response; United States. Technical Resources, Assistance Center and Information Exchange
2019-11-29
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Clinics, Rehabilitation Agencies, and Public Health Agency Requirements: CMS Emergency Preparedness Final Rule
From the Document: "The Centers for Medicare & Medicaid Services (CMS) issued the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule to establish consistent emergency preparedness requirements for healthcare providers participating in Medicare and Medicaid, increase patient safety during emergencies, and establish a more coordinated response to natural and human-caused disasters. The U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response (ASPR) worked closely with CMS in the development of the rule. This document combines excerpts from the Final Rule, the Interpretive Guidelines, and revisions (New 3.6.19) from CMS to provide a consolidated overview document for the Clinics, Rehabilitation Agencies, and Public Health Agencies as providers of Outpatient Physical Therapy and Speech-Language Pathology Services Requirements."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response; United States. Technical Resources, Assistance Center and Information Exchange
2019-11-29
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Primary Response Incident Scene Management: PRISM Guidance, Volume 1, Second Edition
From the Executive Summary: "This document (PRISM [Primary Response Incident Scene Management] Volume 1) provides a detailed summary of the scientific evidence which supports revisions to mass patient decontamination protocols and practical guidance for their implementation. The majority of the underpinning research was derived from a six-year program of laboratory, human volunteer and field trials funded by the Biomedical Advanced Research and Development Authority (BARDA). The document also draws on best practices identified from contemporaneous or prior research and so represents a collation of technical knowledge acquired over the past decade. In particular, this document presents new evidence which identifies hair as a potential hazard due to the relative ineffectiveness of aqueous-based decontamination strategies for oil-soluble contaminants."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response; United States. Office of the Biomedical Advanced Research and Development Authority
Chilcott, Robert P.; Larner, Joanne; Matar, Hazem
2018
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Medical Surge and the Role of Home Health and Hospice Agencies
From the Overview: "Millions of patients across the country receive care through Medicare-certified home health agencies and hospices each year. Mostly comprised of older adults who frequently have multiple medical conditions and often have lower household incomes, home health and hospice patients are among the most vulnerable populations in the U.S. Unlike other recipients of healthcare services, the care is delivered to the home health or hospice patient; the patient does not travel to receive care. Emergency planning for home health and hospice agencies must account for a continually changing patient population and care setting; unique situations encountered in each care setting; the routes staff must travel to safely and efficiently reach their patients; and the business continuity of their administrative offices. [...] This study does not provide conclusive statements on emergency management that are generalizable to all Medicare-certified home health and hospice agencies. Rather, the project team used this exploratory study to learn more about the role of home health and hospice agencies in emergency response and to inform future efforts from ASPR [Assistant Secretary for Preparedness and Response] TRACIE [Technical Resources, Assistance Center and Information Exchange]. These findings and recommendations are a first step toward greater emergency management awareness and engagement, particularly among home health and hospice agencies and their community partners, including hospitals, public health, emergency management, emergency medical services, and other healthcare providers and settings."
United States. Department of Health and Human Services. Office of the Assistant Secretary for Preparedness and Response; United States. Technical Resources, Assistance Center and Information Exchange
2019-06
