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Appendix D: Health

Children’s Environmental Health Post-Disaster Assessment Toolkit 2.0
 
 

Health facilities may face environmental health hazards such as utility failures, air or water contamination, or damage to medical infrastructure, which can interrupt care for children and increase health risks during critical periods. These disruptions can be especially dangerous for medically fragile children, those with behavioral health needs, and communities relying on specialized pediatric services during and after a disaster.

Types & Definitions

  • Facilities with advanced/critical care with pediatric capability provide specialized care for critically ill or injured children, often in ICUs or emergency departments, with advanced medical technologies and pediatric specialists.

  • Health centers and clinics (including Federally Qualified Health Centers and Rural Health Centers) offer primary care and pediatric services to underserved populations, with a focus on accessibility and affordability.

  • Maternal & child health programs deliver services to improve the health of mothers, infants, and children, including prenatal care, immunizations, and developmental screenings.

  • Pediatric Disaster Networks are coordinated networks of pediatric healthcare providers ensuring access to medical care for children during disasters and public health emergencies.

  • A pediatric hospital is a healthcare facility dedicated to diagnosing and treating children, offering specialized care and services from newborns to adolescents.

  • Specialty care providers are healthcare professionals who focus on specific pediatric conditions, such as pediatric cardiologists or neurologists, providing specialized diagnostic and treatment services.

  • Suicide prevention & crisis intervention facilities offer immediate care for children and young adults facing mental health crises, including suicidal ideation, and connect them to ongoing mental health support.

  • Youth and young adult behavioral health or substance use disorder facilities provide treatment for behavioral health challenges or substance use disorders in children and young adults, offering therapy and counseling services.

Partners

State, Tribal, Territorial, or Local Partners

  • State, Tribal, Territorial Departments of Health

  • Maternal and Child Health (MCH) Programs

  • Behavioral Health Authorities

  • Local Health Departments

  • Hospital and Healthcare Coalitions

  • State or Local Suicide Prevention Coalitions

Federal Partners

  • Administration for Strategic Preparedness & Response (ASPR)

  • Office of the Assistant Secretary for Health (OASH)

  • Centers for Disease Control and Prevention (CDC)

  • Centers for Medicare & Medicaid Services (CMS)

  • Health Resources & Services Administration (HRSA)

  • Indian Health Service (IHS)

  • Environmental Protection Agency (EPA)

Non-Governmental Partners

Methods of Engagement

  • Coordinate Through Local and Regional Health Systems: Engage hospital systems, healthcare coalitions, and local health departments as conveners. They can help connect to pediatric units, critical care teams, and specialty providers across facilities.

  • Conduct Focus Groups by Provider Type: Host small, tailored focus groups to surface concerns specific to each health provider type (e.g., pediatric behavioral health vs. maternal & child health programs), allowing for deeper discussion of environmental health impacts on children.

  • Offer One-on-One Listening Sessions: For overburdened or high-priority facilities, offer short, private interviews to gather candid input, especially from providers like crisis intervention programs, rural clinics, or environmental health specialty units.

  • Collaborate with State Title V and MCH Programs: These maternal and child health leaders have statewide oversight and relationships with a range of pediatric services, making them excellent partners in identifying and coordinating engagement with relevant providers.

  • Engage Providers via Pediatric Emergency Preparedness Channels: Many pediatric hospitals and specialty networks participate in emergency preparedness coalitions. Pre-existing relationships can simplify engagement to gather input on environmental health threats post-disaster.

  • Conduct Environmental Walkthroughs or Technical Assessments: Offer voluntary facility walkthroughs (virtually or in-person) to identify environmental health risks such as mold, ventilation issues, or contamination and jointly prioritize recovery actions.

  • Partner with Behavioral Health Agencies and Youth-Serving Systems: Work through youth behavioral health systems, school-linked mental health programs, and substance use treatment centers to ensure their unique environmental concerns (e.g., quiet space, air quality, safety) are included.

Considerations

  • Many pediatric-serving health facilities are already overwhelmed post-disaster with increased medical needs and may have limited staff time to participate in non-clinical assessments.

  • Federally Qualified Health Centers (FQHCs) and Rural Health Centers often serve medically underserved populations and are required to meet federal reporting standards, making them important partners for identifying health disparities in environmental exposures.

  • Behavioral health and substance use disorder providers may observe early signs of environmental trauma but might not frame them in environmental health terms. Engagement should bridge clinical and environmental health language.

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