| Identify agents | IDENTIFY nuclear, biological or chemical agents from signs and clinical history, autopsy and other evidence. |
| Generate bioterrorism response plan | GENERATE a public health bioterrorism (BT) response plan for epidemiology and surveillance (OR Environmental Health OR Public Health Laboratory OR Medical Examiner’s Office OR Public Health Information Office) that is integrated with the emergency response plan for the agency by applying the following competencies: |
| Establish communications roles | ESTABLISH emergency communications roles and responsibilities for bioterrorism response. |
| Maintain resource directory | MAINTAIN a directory of materials and resources on bioterrorism. |
| Prepare for crime scenes | PREPARE public health personnel responding to a bioterrorism event regarding procedures of crime scene preservation, proper handling, transportation and storage of criminal evidence. |
| Identify response resources | IDENTIFY specific resources needed for response to critical biologic agents (Category A, B, C). |
| Specify safety measures | SPECIFY safety measures to be taken by public health responders in a bioterrorism event, including use of personal protective equipment. |
| Ensure laboratory capacity | ENSURE Level A laboratories can conduct "rule-out" testing, specimen packaging and handling, and referral of suspected biological threat agents to a higher level laboratory and that Level B and Level C laboratories have the capacity and proficiency to identify and confirm biological threat agents and can refer specimens to higher level laboratories for further characterization. |
| Delineate environmental protocols | DELINEATE protocols for patient decontamination, and environmental remediation, including populations with special needs. |
| Generate risk assessment plans | GENERATE plans to conduct risk assessments in public health emergencies. |
| Integrate response plans | INTEGRATE the agency's bioterrorism response plan into the Incident Command or Unified Command System used by other responders (Fire, Police, Etc.) in the jurisdiction. |
| Maintain partner agreements | MAINTAIN agreements with partners from within the jurisdiction and from other jurisdictions to allow the public health agency to secure assistance and other resources. |
| Describe chain of command. | DESCRIBE the chain of command and management system (“incident command system” or similar protocol) for emergency response in the jurisdiction. |
| Ensure communication messages | ENSURE development and delivery of accurate event-specific, science-based communication messages to the public, to health care providers, to the media, and to the response community during a bioterrorism event |
| Establish data collection | ESTABLISH data collection protocols that systematically monitor community health indicators (e.g., aberrations in utilization trends or syndromic surveillance). |
| Determine roles through risk assessments | USE risk assessment of potential biologic, chemical or radiological hazards in the community to determine roles and responsibilities of those involved in public health bioterrorism response. |
| Apply epidemiological investigations | APPLY algorithms that trigger further epidemiological investigation. |
| Define further investigation needs | DEFINE algorithms that trigger further epidemiological investigation. |
| Manage psychological impact | RECOGNIZE and TREAT the psychological impact of bioterrorism event on victims and health care professionals. |
| Ensure psychological support | ENSURE ongoing support for the psychological impact of a Weapons of Mass Destruction (WMD) event on the families of victims. |
| Handle human remains | HANDLE human remains appropriately, addressing safety, psycho-social, and forensic needs. |
| Address training gaps | ENSURE that knowledge/skill gaps identified through emergency response evaluation are filled. |
| Evaluate event response | EVALUATE every emergency response to identify needed internal/external improvements. |
| Apply recovery measures | APPLY appropriate science-based public health measures to ensure continued population protection appropriate to the biological threat involved, including follow up of those exposed, vaccinated, or quarantined. |