President orders transformation of public health and medical preparedness

“The Secretary of HHS (SecHHS) shall establish an operational national epidemiologic surveillance system for human health…and create a networked system to allow for two-way information flow between and among Federal, State and local governmental public health authorities and clinical health care providers.”

SecHHS will establish within 180 days an “Epidemiologic Surveillance Federal Advisory Committee” with representatives from other Federal agencies as well as state and local public health and private sector health care.

Develop and share best practices regarding the rapid distribution of medical countermeasures in response to a catastrophic health event, and establish a formal system to measure and assess how well state and local jurisdictions are performing in this arena.

(1) SecHHS will publish within 270 days initial template(s) regarding minimum operational plans to enable community distribution & dispensing of countermeasures within 48 hours, establish standards and performance measures for States and locals, and establish a process to gather that performance data to assess readiness.

(2) SecHHS will begin using, within 180 days of completion of #1 above, said performance data and metrics as conditions for future public health preparedness grant funding.

(3) SecHHS will develop within 270 days Federal plans “to complement or supplement State and local government distribution capacity…if such entities’ resources are deemed insufficient to provide access to countermeasures in a timely manner in the event of a catastrophic health event.”

There are several additional metrics for which the reader is referred to the original document.

Develop a new way of re-orienting and coordinating existing medical capacity to “satisfy the needs of the population during a catastrophic health event.” This includes developing an operational concept which is “substantively distinct from and broader than” day-to-day medical activities in order to “transform the national approach to health care in the context of a catastrophic event.”

(1) SecHHS will engage a variety of partners to provide feedback on the review of the National Disaster Medical System and national medical surge capacity required by PAHPA.

(2) SecHHS will identify within 270 days after completion of #1 above high-priority gaps in mass casualty care capabilities and submit a concept plan to the White House that “identifies and coordinates all Federal, State, and local government and private sector public health and medical disaster response resources AND identifies options for addressing critical deficits.”

(3) SecHHS will within 120 days “identify any legal, regulatory or other barriers to public health preparedness and response…that can be eliminated by appropriate regulatory or legislative action.”

(4) SecHHS will within 180 days establish a Federal Advisory Committee for Disaster Mental Health. Within an additional 180 days, this committee will submit a report to SecHHS with “recommendations for protecting, preserving and restoring individual and community mental health in catastrophic health settings.”

There are several additional metrics for which the reader is referred to the original document.

Develop a plan to promote resilient communities, with emphasis on education about threats, “empowerment” to mitigate risks, opportunities to practice local response, development of stronger social networks, and greater familiarity with local public health and medical response systems.

SecHHS will within 270 days develop a plan to promote comprehensive community medical preparedness.

(1) Make a briefing available to mayors and senior county officials from the largest 50 MSAs regarding risk to public health posed by relevant threats and catastrophic health events (within 150 days).

NOTE: In PA, this includes Philadelphia-Camden-Wilmington (5) and Pittsburgh (23). Of note, Allentown-Bethlehem-Easton is 62nd in size and Pike County, PA is included in the New York –Northern New Jersey-Long Island MSA.

(2) Share up-to-date and specific public health threat information with relevant public health officials at the State and local government levels (within 180 days).

(1) Establish an academic Joint Program for Disaster Medicine and Public Health housed at a National Center for Disaster Medicine and Public Health at the Uniformed Services University of the Health Sciences (USUHS). The program will lead Federal efforts to develop and propagate core curricula, training and research related to medicine and public health in disasters (within 1 year).

(2) SecHHS and the Secretary of DHS shall develop and maintain processes for coordinating Federal grant programs for public health and medical preparedness (within 180 days).

(3) SecHHS will develop a mechanism to coordinate public health and medical disaster preparedness and response core curricula and training across executive departments and agencies (within 1 year).

(1) SecHHS will commission IOM to lead a forum to facilitate the development of national disaster public health and medicine doctrine and system design and to develop a strategy for long-term enhancement of disaster public health and medical capacity and the propagation of disaster public health and medicine education and training (within 180 days).

(2) Create financial incentives to enhance private sector health care facility preparedness (within 120 days).

(3) Establish an Office for Emergency Medical Care within HHS to lead a variety of projects (within 180 days).