Debora Cartagena

Position Description: Development of numerous emergency preparedness plans to ensure accuracy and compliance with current processes and procedural regulations as mandated by The Centers for Disease Control and Prevention (CDC), Public Health Emergency Preparedness (PHEP), and Hospital Preparedness Program (HPP) Cooperative Grant Agreements.

Achievements and responsibilities:

• Provide expertise and technical interpretation of plans by facilitating recommendations for strengthening the county's all-hazard preparedness/response and bioterrorism mitigation capabilities. Ensure plans are written in accordance with federal, state, and local, regulations and reflective of current scientific literature.
• Oversee the development and writing of County policies, procedures/protocols, and emergency management/response plans to mitigate identified public health risks during public health emergencies, medical disasters, or potential bioterrorism events. Plans developed and updated: Pandemic Preparedness and Response, Infectious Diseases – Ebola, Smallpox, Isolation and Quarantine at San Diego Ports of Entries, First Responders Prophylaxis, and ChemPack.
• Ensure plans complies with CDC and California Department of Public Health (CDPH) Fiscal Year (FY) PHEP/HPP domain grant deliverables. First all-hazards plans to be approved County Public Health Officer for PHPR branch.
• Response plans developed in collaboration with County Epidemiology and Immunization Services Branch (EISB) staff: COVID-19 Consumer Response Plan, Shigellosis in Persons Experiencing Homelessness, MPOX Outbreak, and Respiratory Diseases (COVID-19, Influenza, and Respiratory Syncytial Virus) in Skilled Nursing Facilities Response Plan. Plans addressed coordinated efforts to preserve and protect the health and wellbeing of at-risk populations.
• Provide previous CDC expertise and acquired knowledge as it relates to the technical review of County of San Diego key stakeholder preparedness plans (e.g., SD International Airport Multiagency Airport Communicable Disease Plan).
• Collaborate with Public Health Officer and County Epidemiologists in the revision of numerous scientific public health briefs (e.g., African American Infant Mortality, CA Children’s Health Gross Motor Functional Classification System, Sexually Transmitted Diseases, and Tuberculosis & Homelessness) by incorporating the Five Lenses of Health. Coordinated development of PHPR’s first Health Equity White Paper titled: Addressing Health Equity During Public Health Emergency Response. White Paper abstract submitted to NACCHO for 2025 annual conference and approved for presentation – primary authorship.
• Support PHPR’s Exercise and Response Team - Emergency Management Specialists (EMS), Medical Health Operational Area Coordinator (MHOAC), Office of Emergency Services (OES), and Emergency Medical Services (EMS/LEMSA) in the preparation and all-hazard planning of numerous Countywide trainings, outreach, tabletop exercises (TTX), full-scale exercises (FSE), and medical response and surge exercises (MRSE).
• Trainings include Measles Disease, ICS Overview & Outbreaks, Planning Chief/Deputy Section Duties, and MOC Responder Overview. TTX/FSE/MRSE’s conducted: Summer 2022 Medical & Health Facility Evacuation Preparation - Earthquake, February 2023 Regional OES - FSE, May 2023 Wildfire Evacuation FSE, and October 2024 Pediatric Surge Mass Casualty Incident - FSE. Active role in TTX/FSE/MRSE’s (e.g., Planning Section Chief.). Only PHPR staff member to be fully proficient in ICS Planning section duties. Exercises facilitated in adherence and alignment with County of San Diego - Emergency Operations Plans (EOP’s). Utilization of WebEOC, Essential Forms, Geographic Information System (GIS) mapping, and PowerBI/LEMSIS allowed for communication with external partners
• Facilitate the implementation of emPOWER initiative with HPP Project Manager. Partnered with OES and 2-1-1 San Diego to promote resources, educational materials, and services available to vulnerable populations during emergencies.
• Contributed to the development/updating of SD Healthcare Disaster Coalition (SDHDC) and County Public Health Services - Continuity of Operations (COOP) plans as well as PHPR’s Operational Manual. Collaboratively worked with SD healthcare systems in creation of HPP’s Radiation and Pediatric Surge Annexes which provides guidance to support a coordinated healthcare response to radiation and pediatric surge emergencies.
• Participate in numerous points of dispensing (PODS), flu vaccine, and MPOX community vaccination events. Addressed equitable distribution of vaccines to target populations. Provided logistical and event planning assistance as warranted. Educational materials distributed to impact health behaviours. PODS increased overall vaccination rates of general public by 20-30%.
• Spearheaded the development of several Medical Reserve Corps (MRC) policies (3 in total) for implementation during medical surges. Policies resulted in addressing gaps and liability issues encountered during public health emergencies.

Position Description: Executing daily incident command system, emergency management/preparedness operational activities. Collecting, managing, and assessing all incident-relevant operational data and response intelligence for development of the Incident Action Plan (IAP) and San Diego Healthcare Disaster Coalition (SDHDC) - MOC Briefing Reports. Perform analytical assessments, maintenance, and archived response documentation per Incident Command Structure (ICS) and National Incident Management System (NIMS) standards. Aid in the preparation of demobilization plans, after-action reporting, Situation, Background, Assessment, Recommendation (SBAR) communication tool, and hot wash briefings. On-call rotations as part of COVID-19 Incident Management Team.

Achievements and Responsibilities:

• Managed the Planning cycle and facilitated the development of the IAP with input from the appropriate ICS sections chiefs: Operations, Logistics, Planning/Intelligence, and Finance/Administration. Total of 405 IAP’s produced over 3-year response span. County IAP’s received high commendations by State EOC personnel. Supervised 15+ staff members throughout 3-year response. Positions held within Planning Section: Situation Unit Leader, Deputy Planning Section Chief, and Planning Section Chief.
• Oversee the capture of COVID-19 response activities via the COVID-19 Timeline and designated SharePoint site. Over 2,400+ activities captured. Timeline utilized by Policy Team for situational awareness, provide update to County Executives, Board of Supervisors, and development of COVID-19 After-Action Report.
• Responsible for evaluating, displaying information, and preparing consolidated data reports (e.g., Personal Protective Equipment (PPE) Trigger Supply and ICU bed availability among others). Perform specialized statistical analysis of PPE and ICU hospital capacity data for use in “Triggers for Modifying Health Officer Order” dashboard. Data analysis resulted in dissemination of public health guidance to San Diego population by county Public Health Officer.
• Collaborate with County Health Equity specialists in development of health equity strategic plans and one-pager documents (e.g., COVID-19 Health Equity Strategy Plan, COVID-19 Targeted Equity Investment Plan, and public health intervention/health equity one pagers) to document policies, systems, and process improvements set in place to address health inequities. Measures received recognition by CDPH.
• Review and update of COVID-19 COOP plans and other response related guidance documentation. Support Public Health Officer in the development County outbreak notifications to stakeholders, healthcare administration, and community sectors. Facilities Letters include recommendations, mitigation efforts, and address health behaviours of at-risk communities.
• Facilitate daily virtual MOC briefings and tactical meetings for situational awareness. Only section within MOC-ICS structure to facilitate 100+ briefings and tactical meetings.
• Active member of SDHDC & Advisory Committee meetings to provide public health and emergency management updates to coalition members.
• Responsible for the development and dissemination of MOC COVID-19 Briefing Reports for critical stakeholder such as SDHDC and long-term care facilities. Collaboration with other ICS response sections on acquiring critical updates for report. Overarching goal of report was to provide hospital emergency managers insight of County response efforts. Over 100+ reports produced and disseminated 2 times a week.
• Development of SBAR for COVID-19 as part of end of local public health emergency declaration. Reviewed by Public Health Officer. SBAR template developed used as goal standard in subsequent SBAR’s.

Other MOC Planning Section Chief Response Activations and Duties:

• Shigellosis Outbreak in Persons Experiencing Homelessness (October 2021 – December 2021)
• Monkeypox Outbreak (June 2022 – December 2022)
• Hepatitis A Response (January 2023 – September 2023)
• Tuberculosis Bone Graph FDA Recall - ViBone | CDC & CDPH Response (July 2023 – December 2023)
• CDC Community Assessment for Public Health Emergency Response (CASPER) – South Region Tijuana River Valley Sewage Crisis (September 2024 – October 2024)
• Facilitated numerous cross-trainings and training materials for CoSD – PHS branches on ICS Planning Section Chief/Deputy fundamentals. Branches include: EISB, TB Control and Refugee Health Branch (TBCRH), and HIV, STD, and Hepatitis Branch (HSHB), resulting in a 20% increase of staff proficiency on ICS principals.

• Positions Description: Oversee the transfer of biological select agent(s) and toxin(s) by screening and evaluating all incoming transfer documentation request submitted to the CDC via the Federal Select Agent Program (FSAP) secure electronic database. Ensure applications meet all regulatory requirements prior to providing legal authorization to transfer select agent(s) and toxins(s) as required by federal regulations. In addition, perform onsite inspections of entities that possess, use, or transfer select agents and toxins to ensure regulatory compliance

Achievements and responsibilities:

• Managed regulatory approval of all select agent(s) and toxin(s) Form 2 submissions. Oversee the movement of select agent(s) or toxin(s) during transport in coordination with federal partners (e.g., Department of Transportation) as mandated by 42 CFR part 73 and Executive Order 13546. Total of 200-500 requests approved and shipments monitored per year. Approved all submissions within 1-2 business day resulting in 90-100% approval rating.
• Increased oversight/monitoring of infectious substance shipments while in route to ensure the public’s biosafety, biosecurity, and mitigation of bioterrorism threats. Collaborated with DOT and Weapons of Mass Destruction (WMD) Coordinators to provided advance notification when delivery exceptions occurred.
• Performed on-site safety regulatory inspections to certify entities compliance with federal regulations and guidelines (e.g., 42 CFR Part 73, Foreign Quarantine: Etiologic Agent, Host, and Vector; 42 CFR Part 71.54; and Biosafety in Microbiology and Biomedical Laboratories). Over 25 regulatory on-site inspections/assessments of biosafety levels 1-3, federal, state, private, and international laboratories executed.
• Served as the Import Permit Program (IPP) Coordinator from 2007 through 2009 and technical reviewer from 2010 through 2011. Reviewed all incoming IPP applications for technical accuracy and provided regulatory approval for the import of infectious materials into the United States as governed by 42 CFR Part 71 Foreign Quarantine Act 71.54. Over 2,000+ applications reviewed per year. Streamed lined review process from 15 to 1-3 business days.
• Supervised contracting data entry staff for Form 2 and IPP processes to ensure integrity of applicant information entered into secure regulatory application approval program. Delegated tasks among contracting staff to increase overall productivity by 25%
• Collaborated with policy team in amending 42 CFR 71.54 policy through Notice of Proposed Rulemaking and public comment for permitting IPP to conduct regulatory inspections prior to issuance of import permit
• Identify compliance risks as they relate to importation of infectious materials and transfers of select agent(s) and toxin(s). Imposed compliance enforcement actions on entities that did not comply with 42 CFR 71.54 & 42 CFR Part 73.16 via various mechanisms. Serious departures referred to DSAT Policy Officer and the U.S. Office of Inspector General (OIG).
• Aided in the review and processing of entity personnel select agent Security Risk Assessments (SRA) in collaboration with FBI’s Criminal Justice Information Services (CJIS) Division in accordance with USA Patriot Act of 2001 and the Public Health Security and Bioterrorism Preparedness and Response Act of 2002.
• Managed government quality assurance protocols on all completed transfers prior to forwarding documents to the National Achieve Records Administration (500+ reviews per calendar year).
• Coordinated with DSAT emergency management specialist in divisional all-hazards emergency drills/TTX exercises and identifying potential weather hazards which required emergency CDC evacuation assistance for select agent registered entities. Provided recommendations on enhancing internal divisional plans and evacuation protocols.

2014-2016 West Africa Ebola Response | Deployment Liaison | Deployment Risk Mitigation Unit | January 2015 – May 2015

• Participated in CDC’s 2014-2016, West Africa Ebola EOC response as the Deployment Liaison (LNO) for the Deployment Risk Mitigation Unit (DRMU). Provided programmatic support to CDC responders and family members by enhancing the health, safety, and well-being of deployed staff via various mechanisms. Primary tasks include managing the DRMU Liaison mailbox, identifying and contacting future responders via the Ebola Deployment Pipeline. Worked in partnership with other EOC taskforce to gather relevant pre-and post-deployment information.

• Collaborated with the Ebola Response after-action and hot-wash teams in conducting assessments of the pre-deployment briefings and training materials to enhancement of responder pre-deployment process. Streamlined numerous processes to ensure the quality and effectiveness of all the information received by CDC responders prior to deployment was consistent with ICS standards.
• Addressed daily issues and concerns from CDC Ebola responders by developing guidance documents, educational trainings, and communication materials. Identified gaps in public health knowledge for responder family members.
• Collaborate with other CDC and EOC public health teams including Joint Information Center (JIC), Communication Services, Logistics/Equipment, Occupational Health Clinic, International Task Force, and Travel/Passport office personnel on joint projects to augment responder deployment efforts thus leading to a significant improvement in responder satisfaction.

CDC EOC Response | Unintentional DoD shipment of Anthrax | May 2015 – December 2015

• Participated in CDC’s EOC; Department of Defense (DOD) 2015 Anthrax response by overseeing the expedited approval process of all Form 2 transfers of select agents and toxins submissions.
• Collaborated with registered/non-registered entities to ensure all samples involved in the investigation were securely transferred to CDC/ Laboratory Response Network (LRN) laboratories for further testing per MOU.
• Managed the tracking of all FedEx Custom Critical/ White Glove packages as a means of safeguarding the biosecurity of select agents and toxins while in route. Worked closely with WMD Coordinators during response.

• Position Description: Analyzed and granted approval to all pharmaceutical change requests associated with existing products and manufacturing processes. Documents assessed: Standard Operational Procedures (SOP’s), production records, validation documents, manufacturing protocols, and internal Quality Assurance/Quality Control policies.

Achievements and Responsibilities:

• Maintained and control the revision level of documented processes
• Ensured compliance with pharmaceutical Corrective and Preventive Action (CAPA) procedures
• Managed large volumes of documentation change requests during transfer of product start-ups (e.g., 30-50 in total) as mandated by corporate headquarters. Consistently exceeded number of approved change requests by 10-20%
• Monitored flow of change requests through Abbott Diagnostics computer-based document control system and facilitated routing of documentation review for all affected departments
• Cultivated working relationships with federal stakeholders (e.g., Food and Drug Administration) to discuss the processing of all documentation change requests impacted by validation equipment processes, test method, facility updates or resulting from a product start-up, transfers/launch. Ensured compliance with the Federal Food, Drug, and Cosmetic Act 21 U.S Code Chapter 9
• Contributed to the implementation of new Abbott documentation control system by performing QA/QC user test cases. Provided recommendations for streamlining quality reporting processes and reducing data entry errors by 50%.

• Conducted pharmaceutical and microbiological testing within manufacturing and production facilities (e.g., Sterilization Studies, Bioburden, HIAC, and Pyrogen). Adhered to microbiological aseptic techniques, microbial control, and environmental monitoring protocols per manufacturing industry standards
• Identified as one of the few laboratory technicians that possessed the training and skill set to perform all microbiological testing as outlined by Baxter internal procedures
• Cross trained on all microbiological testing protocols ensured coverage for all testing upon absence of laboratory personnel
• Responsible for executing specialized microbiological tasks such as environmental testing of water systems, air, and contact surfaces. Samples were obtained throughout the manufacturing facilities. Ensure adequate inventory records of all samples taken (e.g., 1,000+ samples)
• Sample areas carefully tested to ensure quality systems performed as programmed in reducing contamination of manufactured product
• Ensured final products were rendered free of microbial contaminants before release. Testing performed in clean rooms (classification 100,000) as required by industry standards such as International Organization for Standardization (ISO), resulting in reduction of product defects and improvement of product reliability
• Conducted internal inventory quality control audits to ensure inventory samples were labeled and stored as mandated by internal SOPs
• Maintained comprehensive quality records of laboratories culture collections to provide accountability of samples, resulting in a 20% reduction in audit findings
• Earned fast-track promotion from Laboratory Technologist II (contracting position) to Computer Operator (permanent position) within a 3-month period
• Validated the BioControl Laboratory Automatic System (version 3.1) for the Environmental laboratory and commenced validation of the Infinity QS Software. Validation completed 6 months ahead of schedule
• Provide technical writing support for microbial control documents including SOPs, validation and qualification documents such as: Installation Qualification (IQ), Operational Qualification (OQ), and Performance Qualification (PQ).