The first National Health Security Strategy (NHSS), intended to minimize health consequences of major disasters by galvanizing a broad range of stakeholders, has been released by the Department of Health and Human Services, the agency charged with developing policy in this area in the 2006 Pandemic and All-Hazards Preparedness Act.
The strategy has two goals: to build community resilience and strengthen and sustain health and emergency response systems. The document is the framework for how the nation will seek to achieve national health security for the next four years. This includes relying on a broad range of stakeholders, from individuals and communities to governments, to build the capabilities that will enable them to achieve the goals and strategic objectives outlined in the document, which range from informed and empowered individuals to post-incident health recovery in planning and response.
The vision portrayed in the NHSS is one of communities that have created a culture of preparedness in which bystander response to emergencies is not the exception but the norm, and where individuals, families and communities have the knowledge and resources to care for themselves and others in both routine and emergency situations. The NHSS, at hhs.gov/aspr/opsp/nhss/nhss0912.pdf, calls for the development of an evidence base for national health security and for lessons learned to be widely disseminated and incorporated into practice.
The companion document, Interim Implementation Guide for the NHSS, at hhs.gov/aspr/opsp/nhss/nhss_iig0912.pdf, identifies eight initial activities to support the NHSS’s implementation. By September 2010, a more detailed implementation plan, which defines more fully the roles and responsibilities of all stakeholders, will be released with a revised target capabilities list.
Medical countermeasure dispensing by the U.S. Postal Service was established under an executive order signed by President Obama in the final days of 2009.
The order establishes a U.S. postal model for cities by requiring the Health and Human Services and Homeland Securities secretaries, in coordination with the secretary of defense, to develop a concept of operations and establish requirements for a federal rapid response to dispense medical countermeasures to an affected population following a large-scale biological attack. The secretaries must work with the USPS to establish by June 2010 a plan for postal workers to dispense the medical countermeasures, with anthrax as the primary threat consideration.
An accompanying plan, also due by June, developed in coordination with the attorney general and local emergency management and law enforcement officials, must be formulated for any necessary supplementation of local law enforcement personnel to escort the postal workers who will deliver the medical countermeasures. A plan will also be developed to provide medications to federal personnel so mission-essential functions of the executive branch departments and agencies would continue following an attack.
The Kids Wish II Act, a House bill introduced in January, would amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to address the needs of children and families who are the victims of a major disaster.
Under the bill, the president would encourage states and localities to include services and facilities for children in all phases of disaster planning, training and exercises. Children’s services and facilities are defined in the bill broadly, including health, mental health, education, child care, early education, child welfare, residential treatment centers and juvenile corrections and court services. Children’s needs would be included within all national planning activities, such as the National Response Framework and the National Disaster Recovery Framework, and a single federal disaster case management program would be established with an emphasis on achieving positive outcomes for children and families. The bill would also require agencies to develop a standardized evacuee tracking and family reunification system to ensure the safety and well-being of children, among other similar provisions.
The bill, which does not have a Senate companion, was referred to the Committee on Transportation and Infrastructure.
With health care reform uncertain due to the election of Scott Brown, a Republican, to former Sen. Ted Kennedy’s Democratic seat in Massachusetts, breaking the filibuster-proof 60-seat majority of the reform supporters, ambulance agencies must likely look elsewhere for a vehicle for ambulance relief extensions. The House health care reform bill extended the existing 2 percent urban and 3 percent rural ambulance relief adjustments for two years. The Senate legislation extended this relief for one year as well as the existing 22.6 percent super rural relief adjustment.
Due to uncertainty over the future of the existing health care reform bills, ambulance relief proponents, such as the American Ambulance Association, are reconsidering their strategy for seeking these relief extensions, which must be made retroactive to Jan. 1, 2010, when they expired.
