Reviewing Health Care and Public Health Capabilities

Most in emergency management and homeland security are aware of the National Preparedness Goal’s 32 Core Capabilities, but are you aware of the Health Care and Public Health capabilities promulgated and published by the HHS/ASPR and the CDC?

Recently updated, the 2017-2022 Health Care Preparedness and Response Capabilities are assembled by the US Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR).  According to ASPR, these capabilities are intended to ‘describe what the health care delivery system must do to effectively prepare for and respond to emergencies that impact the public’s health’.  The health care delivery system includes health care coalitions (HCCs), hospitals, and EMS.  These consist of four capabilities:

  1. Foundation for Health Care and Medical Readiness
  2. Health Care and Medical Response Coordination
  3. Continuity of Health Care Service Delivery
  4. Medical Surge

The Centers for Disease Control and Prevention (CDC) (also part of HHS) publishes the Public Health Preparedness Capabilities.  The current version of the Public Health capabilities is dated 2011, with the CDC being anticipated to begin updating the document in late summer of 2017.  The CDC’s Public Health Preparedness Capabilities help to establish standards for state and local public health preparedness through 15 capabilities, which are:

  1. Community Preparedness
  2. Community Recovery
  3. Emergency Operations Coordination
  4. Emergency Public Information and Warning
  5. Fatality Management
  6. Information Sharing
  7. Mass Care
  8. Medical Countermeasure Dispensing
  9. Medical Material Management and Distribution
  10. Medical Surge
  11. Non-Pharmaceutical Interventions
  12. Public Health Laboratory Testing
  13. Public Health Surveillance and Epidemiological Investigation
  14. Responder Safety and Health
  15. Volunteer Management

Similar to the use of the Core Capabilities in emergency management and homeland security broadly, I see the ASPR and CDC sets of capabilities as providing an opportunity to identify capabilities which are functionally focused.  Aside from the three common Core Capabilities (Planning, Public Information and Warning, and Operational Coordination), there is only one public health/health care-specific Core Capability: Public Health, Health Care, and Emergency Medical Services.  It makes sense for these areas to need to further identify and refine their own capabilities.  It might be interesting to see other sub-sets of public safety, such as fire and law enforcement do the same relative to the Core Capabilities they each heavily participate in.  Or it might send us down a rabbit hole we don’t need to jump down…

That said, I always champion opportunities for synergy and streamlining of existing systems and doctrine, and I’m rather disappointed that has not been done.  There is clearly overlap between the ASPR and CDC capabilities as compared to the Core Capabilities; that being apparent in even the titles of some of these capabilities addressing topics such as operational coordination, mass care, and public information and warning.

Corresponding to the recent release of ASPR’s updated Health Care Preparedness and Response Capabilities, I sat through a webinar that reviewed the update.  The webinar gave an opportunity for me to ask if there was any consideration given to structuring these more similarly to the National Preparedness Goal’s Core Capabilities.  In response, ASPR representatives stated they are working with the Emergency Preparedness Grant Coordination Working Group, which consists of ASPR, CDC, Health Resources and Services Administration, DHS/FEMA, US DOT, and the National Highway Traffic Safety Administration.  This working group has developed an interim crosswalk, applicable to the current documents, and expected to be updated with the CDC’s update to the Public Health Preparedness Capabilities.  While a crosswalk helps, it still acknowledges that each are operating within their own silos instead of fully coordinating and aligning with the National Preparedness Goal.  The world of preparedness is dynamic and made even more complex when efforts aren’t aligned.

Regardless of the lack of alignment, these are great tools.  Even if you aren’t in public health and health care, you should become familiar with these documents, as they represent important standards in these fields.  Similar to the Core Capabilities, grants and preparedness activities are structured around them.  If you interface with public health and health care, you have even more reason to become familiar with these – as they are likely referenced in multi-agency discussions and you should be aware of the similarities and differences between these and the Core Capabilities.

© 2017 – Timothy Riecker, CEDP

Emergency Preparedness Solutions, LLC

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