In 2009 the Institute of Medicine (IOM) began to assess the need for better-defined medical and public health crisis standards of care (CSC) for catastrophic disasters and public health emergencies. Over the next 10 years, the IOM defined templates for those stakeholders responsible for integrated CSC planning and implementation; created a tool kit with guidance on indicators and triggers; provided a discussion kit for stakeholders to use with their own communities to establish appropriate indicators and triggers to guide their planning; disseminated the messages and key concepts of CSC; and built on the initial efforts to refine certain elements and address remaining gaps. This current Proceedings of a Workshop captures the discussions from a 2019 workshop reviewing the successes and gaps over the last 10 years of CSC work, in order to inform the next phases of planning and implementation. Table of Contents Front Matter 1 Introduction 2 Informing the Next Stage of Crisis Standards of Care 3 Ethical and Legal Considerations 4 Crisis Standards of Care Application Across Sectors 5 Implementing Crisis Standards of Care Across Sectors References Appendix A: Workshop Agenda Appendix B: Speaker Biographies

Crisis Standards of Care (CSC) inform decisions on medical care during a large-scale crisis such as a pandemic or natural disaster, eliminating the need to make these decisions at the bedside without protections or guidance. Numerous points throughout the COVID-19 pandemic have demonstrated the necessity of this type of crisis planning. The National Academies of Sciences, Engineering, and Medicine Forum on Medical and Public Health Preparedness for Disasters and Emergencies convened a series of public workshops to examine the experiences of healthcare providers during the COVID-19 pandemic and identify lessons that can inform current and future CSC planning and implementation. The workshops examined staffing and workforce needs, planning and implementation of CSC plans, and legal, ethical, and equity considerations of CSC planning. Topics of discussion included improving coordination between the bedside and boardroom, increasing buy-in from elected officials, expanding provider engagement, and addressing health equity issues. This publication summarizes the presentation and discussion of the workshops. Table of Contents Front Matter 1 Introduction 2 Reflections, Inflections, and the Future 3 Considerations for Staffing, Effects on the Workforce, and Future Trends 4 Crisis Standards of Care: From Plans to Reality 5 Legal, Ethical, and Equity Considerations for Crisis Standards of Care 6 Looking Forward References Appendix A: Workshop Agendas Appendix B: Speaker Biosketches

To explore issues related to the effects of disasters on children and youth and lessons learned from experiences during previous disasters, the virtual workshop From Hurricane Katrina to Paradise Wildfires, Exploring Themes in Disaster Human Services was convened on July 22 and 23, 2020, by the National Academies of Sciences, Engineering, and Medicine. The workshop was designed to focus on families engaged with federal, state or local supportive programs prior to disasters. Additional areas of focus were the coordination of disaster response efforts and the transition to reestablishing routine service delivery programs post-disaster by human services, social services, and public health agencies at the state, local, tribal, and territorial levels. The workshop was also intended to provide a platform for highlighting promising practices, ongoing challenges, and potential opportunities for coordinated delivery and restoration of social and human services programs. This publication summarizes the presentations and discussion of the workshop. Table of Contents Front Matter 1 Introduction 2 Exposure Outliers: Children Coming of Age in an Age of Environmental Extremes 3 Effect of Disasters on Critical Child Infrastructure 4 Exploring the Gaps in Evidence 5 Case Studies: Effect of Disasters on Specific Populations 6 Workshop Reflections References Appendix A: Workshop Statement of Task Appendix B: Workshop Agenda Appendix C: Speaker Biographies