GNYHA, in coordination with its Emergency Preparedness Coordinating Council, has prepared a working draft of guidelines to assist providers with the measures they should consider taking as threat alert levels change under the Homeland Security Advisory System. The draft guidelines are the result of a collaboration among the Council, the NYS Department of Health, the NYS Office of Public Security, and the NYC Department of Health and Mental Hygiene, and have been sent by the NYS Department of Health in draft form to hospitals across the State. The guidelines were developed in response to questions as to what steps providers should take as threat alert levels change or as concerns about terrorist attacks increase. Providers in NYC, where the threat alert level has been orange (high) since the inception of the five-tiered color-coded system, have been concerned about measures to consider within the level orange, and as circumstances have caused an increase to what has been informally called "high" or "bright" orange. Providers outside NYC have been concerned about what measures to consider as the national and state levels increase from yellow (elevated) to orange.

Overview: The draft guidelines work within the five-tiered system, but they collapse the first two threat alert levels (green and blue) and treat them as basic planning levels during which providers would develop their emergency management plan, design their incident command system, and develop other protocols for responding to an emergency. The next two levels (yellow and orange) are treated as different levels of standing ready for an emergency, and the highest level (red) is treated as responding to an event (or standing ready for an imminent attack). Each level divides the steps into seven functional categories: basic emergency management program functions; communications with staff; monitoring and evaluating information sources; addressing staff availability and needs; communication systems; equipment, supplies, and services; and security. The guidelines are intended to be suggestions only, and providers should view them as a checklist for reviewing their own preparations. In addition, the guidelines indicate that the decision to take some of the measures will depend on whether a change in threat alert level affects a geographic area and on the directions that appropriate authorities might give.