Using Preparedness Exercise Tools to Train Public Health Teams to Address Access and Functional Needs During Emergencies in Rural Appalachia.

Local public health agencies are a critical component of communities' ability to respond to and manage emergencies. This article outlines one public health agency's process for developing an all-inclusive, all-hazards public health plan to guide preparedness activities. The plan is interactive and searchable to enable it to be applied practically during an emergency. The new plan was developed using a collective action approach and is consistent with the whole community framework. It represents the perspectives of people with access and functional needs and better prepares local emergency management and response teams to anticipate these needs during emergencies. We created both a tabletop exercise and a full-scale exercise to train public health practitioners on the plan contents, as well as an exercise planning and implementation workbook that includes agendas, sample exercises, sample slides, and supporting documentation. These materials provide specific suggestions for supporting people with access and functional needs during emergency mitigation, preparedness, response, and recovery. In October 2017, more than 110 people participated in the tabletop exercise as part of the annual staff training at our local health department. One year later, we delivered a full-scale exercise. Nearly all relevant staff (95%) participated in both exercises, and 98% of participants reported that they had greater knowledge and resilience in mitigating and responding to public health emergencies as a result of their participation. We aim to include additional community members in future exercises to assure the plan meets everyone's needs. The current plan has increased the confidence level of local public health practitioners in responding to emergencies.