May 17, 2012 (CIDRAP News) – The federal agency tasked with shoring up the nation's preparedness against a host of public health emergencies released a plan yesterday to help it and other partners focus and coordinate steps to meet national preparedness objectives.
The plan, authored by the US Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR), is a detailed roadmap for implementing the National Health Security Strategy (NHSS), which was released in December 2009 and required in the 2006 Pandemic and All Hazards Preparedness Act.
ASPR said the NHSS is an overarching vision of national health security that contains two main goals: building community resilience and strengthening and sustaining health and emergency response systems. The strategy describes 10 key objectives for meeting the goals:
- Foster informed and empowered individuals and communities
- Develop and maintain the workforce needed for national health security
- Ensure situational awareness
- Foster integrated, scalable healthcare delivery systems
- Ensure timely and effective communications
- Promote effective countermeasures
- Ensure prevention or mitigation of environmental and other emerging health threats
- Incorporate post-incident health recovery into planning and response
- Work with cross-border and global partners to enhance national, regional, and global health security
- Ensure that all systems are based on the best available science, evaluation, and quality improvement methods
ASPR emphasized in background materials on its Web site that the implementation plan is a national one that incorporates input from stakeholders outside of federal government, including academia, private industry, and community organizations. "While many of the actions in the plan are federal and will be led by federal agencies, these actions are meant to serve as models and catalysts for action in communities across the country," it said.
Many of the actions are under way, and all will have started by the end of 2014, according to ASPR.
In the introduction to the plan, ASPR recognized that the goals must be reached amid widespread budgeting challenges. "The activities in this plan are priorities intended to be executed with existing resources," it said. "It is assumed that there will be no significant additional public funds available for national health security for several years."
It added that the plan helps groups identify high-priority activities during times of limited resources.
The 134-page implementation plan includes a chapter for each of the 10 objectives that includes the rationale and broad planning steps, then focuses on 4-year outcomes and detailed steps for achieving them.
For example, under the objective that address national health security workforce issues, one of the action steps is for ASPR and the Office of the Assistant Secretary of Health to identify the nature and scope of concerns that workers have in serving during an emergency and to develop a plan to address their concerns.
ASPR said federal agencies will develop progress indicators for the implementation steps and will report to ASPR the headway they're making 12 months after the report is approved. It said the information will help guide a quadrennial review and the development of the next versions of the NHSS and its implementation plan.
In the objective addressing situational awareness, ASPR said it would work with a broad range of partners to establish a model that conforms to privacy rules, along with legal and policy issues that would be barriers to a common approach to sharing information in public health emergencies.
Under the objective of fostering integrated scalable health systems, the report said one strategy would be to form healthcare coalitions to help coordinate preparedness and response and involve organizations such as outpatient clinics and home healthcare agencies that aren't typically involved in national health security activities.
In addition, regional emergency planning alliances could help foster partnerships between the healthcare coalitions and could be a platform to ensure effective training of paid and volunteer medical and emergency response workers. The alliances could also facilitate emergency plan exercises, the report said.
For several of the objectives, the plan suggests working with partners to develop best practices and lessons learned resources to help streamline and improve preparedness activities.
The chapter addressing the medical countermeasure objective focuses on the need for innovative solutions that increase the capability to distribute and dispense drugs, vaccines, and other supplies. For example, one step urges the Department of Defense and HHS to work with their partners to develop countermeasures that are simple to administer or use and have a longer shelf life.
In the objective about science-based planning and evaluation, the report recommends that federal health agencies and their partners establish a Public Health Emergency Research Review Board to facilitate ethical research components, streamline the review of research protocols, and provide oversight for the development of effective clinical and public health interventions in the context of incidents.