NYC DOHMH Public Health Crisis Response - New York City has responded to numerous recent significant public health threats, including emerging infectious diseases, such as Zika virus, Ebola virus, and COVID-19, as well as more routine disease outbreaks, including Legionnaires disease, Hepatitis A, avian influenza H7N2 and measles/mumps. These outbreak responses have underscored the importance of effective public health preparedness and response capabilities required to respond to an emerging infectious disease outbreak - including those with multiple routes of transmission, a high attack and mortality rate, and either a countermeasure and/or pharmaceutical and/or vector control and/or an oral prophylaxes component. DOHMH has a robust Incident Command System (ICS) structure, including an on-call roster with pre-identified staff to fill leadership and general ICS roles in support of emergency preparedness and response activities. Several real-world responses, regular trainings, exercises and drills ensure staff can perform emergency response roles. This assures a steady state of readiness for notification, situational awareness, staff deployment and other response operations. As new threats, including novel infectious diseases, emerge, DOHMH must continue to ensure the NYC public health and health care systems are able to rapidly mobilize and respond in order to prevent or reduce morbidity and mortality from incidents. By the end of the project period, DOHMH expects to achieve the following public health response-related outcomes: • Earliest possible activation and management of emergency operations • Earliest possible identification and investigation of an incident/index case • Timely implementation of intervention and control measures • Timely communication of risk and essential elements of information by partners • Timely coordination and support of response activities with healthcare and other partners DOHMH will achieve these outcomes by ensuring internal collaboration between its laboratory, surveillance and epidemiology leads, maternal-child health program, environmental health/vector control programs, healthcare system readiness program and emergency management program. DOHMH will also work closely with NYC Emergency Management (NYCEM) to facilitate the inclusion of public health concerns and expertise into the citywide response, as well as an array of private and public agencies who are key stakeholders in healthcare preparedness, response and recovery. During a response, DOHMH will support the needs of any community impacted by a public health emergency and ensure that the public health system is ready and capable of keeping NYC communities safe and mitigating the impacts of any public health emergency. In addition, DOHMH will ensure the health of at-risk and underserved populations and that plans and processes are in place during an event to address the unique needs of these populations, including underserved populations. Finally, given the expediency with which DOHMH needs to receive and expend preparedness funds, DOHMH will utilize a fiscal agent, Public Health Solutions, to receive, obligate and liquidate preparedness and response grant funds on DOHMH’s behalf. The relationship between DOHMH and Public Health Solutions for management of preparedness funds has resulted in significant efficiencies in the procurement of goods and services, including rapid and complete spend-down of preparedness and response awards.