CDC continually evaluates its Emergency Management Program (EMP) activities, including Incident Management System (IMS) activations, use of EMP functions (referred to as EMP utilizations), and exercises, to ensure that the agency is ready to respond to infectious disease outbreaks, disasters (human-made or natural), and security events. Such evaluation not only documents baseline preparedness and response activities during a selected analytical period, but also highlights significant EMP actions that can guide and inform future emergency operations. To characterize EMP activities that occurred during January 1, 2013-December 31, 2018, CDC conducted a retrospective analysis of operational activity logs. The results showed 253 domestic (U.S. states and territories) and international EMP activities, including 12 IMS activations, 147 EMP utilizations, and 94 exercises. Infectious diseases were the most common threat among both IMS activations (58%) and EMP utilizations (52%). CDC responded to the 2014 Ebola epidemic and the 2016 Zika outbreak; each response lasted approximately 2 years and required extended collaboration with domestic and international partners. Understanding the trends in EMP activities, including knowing the most common threats, aids CDC in allocating resources and focusing preparedness efforts. In 2013, CDC became the first federal agency to receive full agency-wide accreditation by the Emergency Management Accreditation Program (EMAP) in recognition of CDC's commitment to preparedness and its ability to respond to domestic and global public health threats. CDC received EMAP reaccreditation in December 2018 (1,2).

The current hyper-volatile, -uncertain, -complex, and -ambiguous (VUCA) threat environment demands a more cohesive support structure for crisis leaders who may be faced with crises of increasing magnitude and frequency and, in some instances, multiple crisis events simultaneously. The project team investigates the perceptions of crisis leaders regarding establishing a crisis leader advisor position for crisis leaders to benefit from their experience while prosecuting crisis response activities. The team linked hyper-VUCA crises, crisis response frameworks, meta-leadership, crisis leader attributes, and advisor attributes. The overall goal of the project is to increase the ability of the crisis leaders to more effectively and efficiently navigate crisis events resulting in more efficient and effective response and recovery. Three research questions were developed to assess the following: thoughts of integrating a crisis leader advisor position; development of a crisis leader advisor certification program; and attributes of crisis leader advisors. A qualitative research methodology using a phenomenological approach was employed. Forty-one participants were purposefully selected and administered a short, on-line survey consisting of 11 questions. Data were analyzed using percentage analysis,weighted sums, and inductive thematic analysis. The project team found an overwhelming support for the crisis leader advisor position and the crisis leader advisor certification program. Additionally, experience and trustworthiness ranked among the top sought after attributes of a crisis leader advisor. The team recommendations included (1) implement a crisis leaders advisor guide/framework; (2) create a formal crisis leader advisor position in national incident management system; (3) implement a crisis leader advisor certification framework; (4) benchmark established advisor programs; and (5) implement a framework to match leaders and advisors.