Q&A about the Cities Readiness Initiative (CRI)
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What is the Cities Readiness Initiative?
The Cities Readiness Initiative is a federally funded effort to prepare major U.S. cities and metropolitan areas to effectively respond to a large scale bioterrorist event by dispensing antibiotics to their entire identified population within 48 hours of the decision to do so.
Why is CRI necessary?
CRI is needed to enhance preparedness at all levels of government and to provide a consistent nationwide approach to prepare for, respond to, and recover from a large-scale public health emergency.
What are the specific risks for the citizens in my city?
Past events have taught us that the risk of terrorism—including bioterrorism—being perpetrated against Americans, is real. The ability to quickly deliver countermeasures to a large population is a central component of public health preparedness.
How is CRI funded?
Since 2004, the Centers for Disease Control and Prevention (CDC) has provided funding for CRI through the Public Health Emergency Preparedness Cooperative Agreement to enhance the mass dispensing capabilities of the CRI cities. Funds are provided to the states for further distribution to the local level, except for Washington DC, Chicago, New York City, and Los Angeles, which are directly funded cities.
What are PODs?
Points of Dispensing (PODs) are designated dispensing locations for persons who are currently healthy but may have been "exposed" and need prophylactic medication. PODs are the traditional method of providing prophylaxis in CRI.
Are there any other plans for dispensing during a public health emergency?
The Department of Health and Human Services (HHS) has identified several other dispensing modalities in order to help guide state and local planners. Alternate modalities include:
- Postal Plan: Home delivery of antibiotics by the United States Postal Service (USPS). The Postal Plan was conceptualized as a way of reducing the population surge at PODs. With this modality, mail carriers will deliver antibiotics to the homes in selected zip codes. The USPS option is entirely voluntary for the employees of the USPS and only available to the jurisdictions with an approved USPS Dispensing Plan.
- Pre-deployment of community-based caches of medications. Pre-deployment of antibiotics to community-based caches might include churches, schools, large employers, or fraternal organizations.
- Pre-event dispensing to first responders. Pre-event dispensing to first responders could mean that critical personnel and/or volunteers would be issued antibiotics upon being identified and trained.
- Pre-event placement of medications in households. A pilot study is currently underway to test the feasibility of pre-event placement of caches of antibiotics in households that are to be reserved for use during a declared public health emergency. The study will demonstrate the extent to which household members follow instructions on proper storage, maintenance, and the use of antibiotics only in a declared emergency. The results of the study will be reported in 2007.
What assistance does CDC provide in CRI?
CDC's Coordination Office for Terrorism Preparedness and Emergency Response (COTPER), Division of Strategic National Stockpile (DSNS), provides technical assistance on the planning process by helping to identify resources and training opportunities for participating cities. The DSNS utilizes a number of venues including educational web casts, guidebooks, and training classes to share information and lessons learned from federal, state and local perspectives. In addition, CRI cities are evaluated regularly by DSNS program consultants during a CRI assessment process.
Page last reviewed July 5, 2007