Defined Organizational Structure
ICS uses a clearly defined chain of command. The reporting channels are simple and clearly delineated, so that all participants know to whom they will report, and to whom they must convey received information (Figure 1). Under ICS, the emergency response plan is generally broken down into five key areas, including Command (with the Command Staff positions), and four key functional management sections: Planning/Intelligence, Operations, Logistics and Finance/Administration. Each of these areas will be explained below. It should be noted that, regardless of the size of the public health agency, several individuals need to be capable of fulfilling the roles of the Agency Incident Commander, other Command Staff positions, Section Chiefs, Unit Leaders and unit workers. Emergencies may require 24-hour activation of the department of health, requiring relief shifts, and no one individual can always be available to fulfill a particular emergency response functional role.
Figure 1: Organizational Structure & Chain of Command
* Note that Documentation Officer is not a standard ICS position. Because of the nature of public health agency operations, some agencies have found it a useful addition.
Command Positions
Under ICS there is one Agency Incident Commander (AIC) position and three Command Staff positions: Liaison Officer, Safety Officer, and Public Information Officer. The Incident Commander may have a deputy, and the Command Staff may have assistants.
- Incident Commander (IC)
- This person is in charge of the incident. The IC has ultimate responsibility for development of an Incident Action Plan, allocation of resources and assuring that the necessary sections are activated (or deactivated). Because there may be an Incident Commander at the inter-agency level, within PHICS the lead individual is called the Agency Incident Commander, or AIC. The AIC is provided with information (and advice and counsel) from his/her Command Staff and the Section Chiefs (for those sections that have been activated). The AIC oversees the development of the incident mission and key goals, and from this comes the development of an Incident Action Plan (IAP). The AIC is responsible for ensuring that the public health agency incident mission and goals are synchronous with those of the other responding agencies and jurisdictions. The AIC does not necessarily have to be the public health agency’s chief health official. The chief health official may delegate this responsibility to another capable public health employee, especially if he/she may be required to be away from the agency for long periods (e.g., the chief health official may be called to the office of the local or state elected official – mayor, county executive or governor). If this is the case and the chief health official designates someone else to serve as the AIC, the chief health official would surely be kept informed of all major activities. However, it is essential that whoever is designated as the AIC be given the authority to make decisions and execute the plan.
- Liaison Officer
- This position interfaces with and coordinates all activities with external agencies. The Liaison Officer assures that external agencies that are working with the department of health are provided with the resources that are required, as well as assure that agency policies, procedures and sovereignty are respected. The Liaison Officer may serve as a triage officer for information or inquiries from collaborating agencies by connecting the collaborating agency to the appropriate personnel within the department of health. The Liaison Officer needs to be knowledgeable enough to know what needs to be referred to the AIC, and what can be referred directly to a section or unit.
- Safety Officer
- This very important position is responsible for assuring the safety of the public health responders (both paid and volunteer). The Safety Officer assures scene safety, availability and appropriate use of personal protective equipment and basic human needs of the staff (including rest, nutrition and hydration). The person appointed to serve as the Safety Officer for a specific emergency or event should have a high level of knowledge about the hazards of the event (or know where to rapidly obtain appropriate consultation). For instance, in the event of a biological incident, the Safety Officer should have expertise in infectious diseases, while for a chemical event; the Safety Officer should have expertise in hazardous material incidents. In some public health agencies, one individual may possess expertise across several areas, while in others different individuals will serve as the Safety Officer, depending upon the nature of the event.
- Public Information Officer
- This individual is responsible for assuring that appropriate information is provided to the public, governmental officials and collaborating agencies. The Public Information Officer also assures that the required information is provided to the public health agency staff, so that the message of the agency is consistent, and in synchrony with other agencies. This information must be accurate, timely and consistent with that of other agencies. The Public Information Officer frequently serves as the official spokesperson for the public health agency, or may brief or assist the chief health official or AIC with preparing for a press conference or other major information session. During an emergency, all information that is provided to the public is first cleared through the Public Information Officer.
- Documentation Officer
- During complex emergencies, the AIC may decide that a Documentation Officer is required. The purpose of this role is to maintain (or oversee) a record of all activity that occurs in the agency Emergency Operations Center (EOC) as the Command Staff and Section Chiefs meet to report information or make decisions. Responsibilities may include assuring arrangements for Command Staff meetings, recording and maintaining meeting minutes, filing of correspondence, logging telephone calls and updating the situation status monitoring board.
- As you work with other agencies using ICS, be aware that Documentation Officer is not a standard ICS position. Because of the nature of public health agency operations, some agencies have found it a useful addition.
Sections
Each section in ICS provides a key management function for the emergency response. It should be remembered that only those sections required for the emergency response are activated. Sections can be activated and deactivated multiple times during an incident. The person who makes this decision regarding opening or closing sections is the AIC. Frequently, agencies use color-coding for sections to serve as visual aids for staff involved in the operation. Staff involved in the emergency response may wear a vest that is the color that corresponds to the traditional section color and is labeled with their emergency response functional role title. This allows all other personnel to immediately identify which section the worker is assigned to. The colors are:
Command Staff: White
Planning/Intelligence Section: Blue
Operations Section: Red
Logistics Section: Yellow
Finance/Administration Section: Green
While not all agencies do this, it does assist with easy recognition of personnel within each section.
- Planning / Intelligence
- The purpose of this section is to organize data, make projections and forecasts about the event and report the information to the AIC. Where required, this section may engage in intelligence activities – which for public health may be gathering, analyzing and sharing incident information (some of which may be sensitive) with other agencies. Examples of intelligence activities may include analysis and projections regarding epidemiological data about a bioterrorist event, risk assessments based on information reported by law enforcement or determination of toxic contamination levels in an environmental incident. Under NIMS, the ICS intelligence function can also be assigned to another functional management area within the ICS such as within the Command Staff or as a separate section entirely. This decision will be made by the AIC and based upon the nature and complexity of the event and the need for public health intelligence activities, or the needs of the jurisdiction-wide Incident Commander.
- The Planning/Intelligence Section Chief assists the AIC with establishment of an Incident Action Plan (IAP) and the information from Planning enables the AIC to make decisions about ramping up or contracting services. For example, during an influenza vaccination clinic, the Planning/Intelligence Section may monitor the number of citizens vaccinated each day and compare this to the targeted daily number of vaccinations. If the number exceeded the daily goal, this would be reported to the AIC, and the plan may be revised to operate the clinic for fewer days, or conversely, if the number of vaccinations was less than the goal, the number of public health vaccinators may be increased, the marketing or outreach strategy may be revised or the vaccination site relocated to increase accessibility. Therefore, the information and projections provided by the Planning/Intelligence Section is essential for development of the Incident Action Plan (IAP), monitoring the status of the event and making adjustments where needed.
- Operations
- The Operations Section carries out the specific tasks and objectives that the public health agency needs to do in order to accomplish the goals of the incident. In this section, the Incident Action Plan is actually executed. Examples of Operations activities include distribution of vaccines, water or soil sampling, delivery of risk communication messages to the public and case investigation, to name a few. In general, it can be said that the activities of the Logistics and Finance/Administration Sections support the activities of the Operations Section, and the Planning/Intelligence Section supports the Command Staff. For a public health agency, there are also essential day-to-day operations that will continue. The public health agency will need to determine which of its day-to-day services are essential and which can be either reduced or temporarily suspended. It is important that someone not directly involved in managing emergency response operations be made responsible for these ongoing essential services. This person will be assigned to a separate unit that will operate within the Operations Section.
- Logistics
- The Logistics Section provides the support to all other sections that have been activated in the public health agency so that the work can be accomplished. For public health, Logistics is usually responsible for acquiring space, supplies and equipment. For instance, Logistics may arrange for rental of space for a vaccination clinic, the delivery of supplies of vaccines and syringes to the vaccination clinic, or bottled water for the responders and blankets for shelters. Logistics may also provide drivers for case investigators or make arrangements for vehicle rental. Logistics acquires and sets up the things that are needed for Operations to get the job done.
- Finance/Administration
- The Finance/Administration Section has several key responsibilities. These include assuring that a contractual and financial process is in place for emergency procurement of supplies, equipment, space and personnel; interpretation of human resource policies; tracking of fiscal resources that are expended during the response (so that costs can be recovered by the agency during the recovery phase of the event) and in some cases, assurance of availability of resources to address the physiological and psychological needs of the paid and volunteer agency personnel who are engaged in the response. Diligent work done by the Finance / Administration Section during an emergency can serve to prevent a financial or human resource disaster after the event.