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U.S. Department of Health and Human Services

Goal 2: Strengthen Leadership and Capabilities within Public Health and Medical Emergency Management to Include Prevention, Preparedness, Mitigation, Response, and Recovery

ASPR leads the nation’s public health preparedness and medical response to emergencies under its own authorities and with Emergency Support Function 8 (ESF8) of the National Response Framework, leading a federal response in support of state partners during a disaster. ASPR also supports communities’ recovery by coordinating federal health and social services efforts under the National Disaster Recovery Framework. Through a robust exercise system and lessons-learned process, as well as through careful stewardship of resources, the federal infrastructure for preparedness, response, and recovery has steadily improved. Additional work remains to make it a nimbler, more modern system ready to serve an increasingly diverse population with evolving needs.
Through this goal, ASPR promotes efforts to develop a strong, well trained workforce ready to provide an effective response to disasters and emergencies. ASPR is helping the public understand how they can care for themselves during an emergency and ensuring resources are invested where they are most needed. ASPR is also working to improve communications across all sectors, from government emergency response to private sector and community-based organizations.
In addition, the increasingly interconnected health, economic, security, and diplomatic ties in today's world mean that local disasters and disease outbreaks can have a global impact. Thus, strengthening domestic preparedness and response capabilities requires the ability to rapidly share information and coordinate emergency response with international partners, including strengthening international mechanisms for emergency communications, information-sharing, risk assessment, response coordination, and mutual assistance.


  • Define, prioritize, and integrate national, regional, and state response and recovery frameworks for health security, ensuring that the public health and medical components are integrated. Proposed activities:
    • Improve unity of effort in building a national program for planning engagement of HHS regional offices to systematically integrate regional and state response activities with catastrophic events [OEM, OPP];
    • Develop a reference document that describes the capability of each ESF8 functional area and supporting resources for integration with regional and state capabilities [OEM];
    • Utilize the development of the web-based, interactive All Hazard Plan to better define, synchronize, and integrate public health and medical functions, tasks, and capabilities [OEM];
    • Better define ESF8 functional areas and coordinate national and regional preparedness, response, and recovery supporting tasks to build a coordinated and efficient unified whole of community response system [OEM, OPP].
Outcome: Private and nonprofit sectors, and all levels of government supporting the public health and medical functionalities, fully integrate planning to increase the efficiency of responses to and recovery from catastrophic events.
  • Improve the nimbleness and effectiveness of response. Proposed activities:
    • Develop a process that uses identification requirements, and uses the results from the local/state/regional Threat and Hazard Identification and Risk Assessment (THIRA) and hazard vulnerability analysis, to conduct ongoing gap analysis between current resources, tools, processes, and best practices in order to provide solutions more effectively and efficiently—including building an acquisition strategy to meet these requirements.  [OEM, AMCG];
    • Develop regional immediate response plans and state profiles to improve responder effectiveness [OEM];
    • Improve responder recruiting, management, and training to result in adaptable and effective ESF8 and National Disaster Medical System teams [OEM];
    • Leverage emerging technologies and innovative concepts of operations to improve levels of preparedness and target response operations to meet identified needs [OEM];
    • Assist partners in building public health emergency preparedness and response capacity internationally [OEM, OPP];
    • Establish a balanced process for defining the requirements for preparedness, response, and recovery personnel, teams, and equipment that are deployed through ASPR to assist communities [OEM].
Outcome: Adaptable ESF8 and National Disaster Medical System teams able to respond to all-hazards and all patient populations, and flexible and effective response resource capabilities to maximize efficiency, and support state and local preparedness and response needs. 
  • Improve preparedness coordination among the federal interagency, homeland security, public health, and health care system grants. Proposed activities:
    • In coordination with The Centers for Disease Control and Prevention (CDC), develop a comprehensive, modern Information Technology (IT) system that will better track and monitor federal investments capable of integrating ASPR and CDC programs, evaluation, grants, and project management, and further consolidate awardee information [OEM, OPP];
    • Create a standing interagency body to identify and discuss alignment of homeland security, public health, and healthcare system preparedness grants on topics such as policy development, grant management, performance metrics, and reporting requirements to ensure all grant programs are coordinated and the participating agencies fully support national strategies [OEM, OPP];
    • In collaboration with the Department of Homeland Security (DHS) and the CDC, ASPR will work to utilize federal grant funds to increase and measure collaboration between the disciplines of public health, healthcare, and emergency medicine to enhance interdisciplinary planning, joint capability development, and shared budget strategies to optimize preparedness and response activities. As a result, HHS and DHS will have common Funding Opportunity Announcement language that describes administrative preparedness [OEM, OPP];
    • In collaboration with DHS, ASPR will include Homeland Security Exercise and Evaluation Program (HSEEP) doctrine in HHS Funding Opportunity Announcements and will create exercise evaluation guides for HPP / Public Health Emergency Preparedness cooperative agreement (PHEP) capabilities that support consistent evaluation of exercises [OEM, OPP];
    • ASPR and CDC will update the public health and healthcare preparedness capabilities. The HPP and PHEP programs will engage critical stakeholders (awardees, National Association of County and City Health Officials (NACCHO), and others) to review the capabilities and to consider tiering priorities and functions to help awardees manage scarce resources [OEM, OPP]. 
Outcome: The coordination of federal emergency preparedness grant programs will enhance interdisciplinary planning, joint capability development, and shared budget strategies to optimize preparedness and response activities.
  • Enhance regional coordination on preparedness. Proposed activities:
    • Focus headquarters activities in collaboration with the entire HHS enterprise to support regional preparedness, response, and recovery efforts [OEM, OPP];
    • Develop a regional structure that fosters the ‘One-ASPR’ team, improving internal and external collaboration [OEM, COO];
    • Use the Regional Advisory Committee to provide guidance on regional preparedness, response, and recovery policy; and provide ideas for pooling regional resources [OEM];
    • Develop and regularly use a consistent national framework based on regional coordination of preparedness, response, and recovery activities [OEM].
Outcome: Regional coordination on all public health, medical preparedness, and response recovery activities is measurably improved.
  • Coordinate with international partners to prepare for and respond to public health or medical emergencies to strengthen mechanisms for international emergency communications, information-sharing, risk assessment, response coordination, and mutual assistance. Proposed activities:
    • Establish collaborative relationships internal and external to ASPR and HHS that will improve situational awareness among international partners related to international crises, repatriation, refugees, and disaster response missions [OEM];
    • Leverage information awareness tools, both classified and unclassified, to build a rapid common operating picture [OEM];
    • Develop policies and procedures for requesting and deploying HHS personnel in support of an international emergency [OEM];
    • Train and equip HHS personnel (e.g. technical experts, Incident Response Coordination Team (IRCT), National Disaster Medical System (NDMS), and U.S. Public Health Service (USPHS) commissioned corps) to respond to international emergencies [OEM];
    • Develop and train ASPR staff on ways to better identify and monitor HHS personnel who are working overseas during an international crisis, including collaborating effectively with Operating Divisions outside the Office of the Secretary [OEM].
Outcome: A coordinated response to international public health emergencies that may influence U.S. health security, and domestic public health emergencies with potential international impact.
  • Promote broad situational awareness for national health security, and work toward a real time awareness of evolving health incidents and availability of health care system resources. Proposed activities:
    • Use the SOC as the focal point for information sharing, and promote a common operating picture amongst HHS, ASPR, and interagency partners, as appropriate [OEM];
    • Finalize an Information Management Framework policy document to enhance information sharing and coordination [OEM];
    • Incorporate non-traditional partners into the Secretary’s Operation Center during both normal and response operations (e.g. Association of State and Territorial Health Officials (ASTHO) [OEM];
    • Use Centers for Medicare and Medicaid (CMS) data to provide State and local health officials with situational awareness of medically vulnerable populations in their communities—including individuals who rely on electrically-powered DME—to achieve resilient populations prepared for emergencies, and to assist local responders and community groups with targeted wellness checks [OEM, OPP].
Outcome: A common national approach to situational awareness for National Security with real-time awareness of evolving incidents having potentially negative health consequences. Additionally, an effective situational awareness program that provides both scalability and multi-directional communication from local to national levels, public and private sectors, along with domestic and international partners.
  • Incorporate post-incident health recovery into planning and response by leading federal health and social services recovery efforts, promoting pre-disaster health and social services recovery planning, and promote systematic improvements in public health emergency and disaster recovery planning and operations. Proposed activities:
    • Complete the Health and Social Services (HSS) Recovery Support Function (RSF) concept of operations [OEM];
    • Train HHS and federal interagency partners on the roles and responsibilities of the HSS RSF—including roles for non-deployed program staff, to expand and improve capabilities [OEM];
    • Provide technical assistance to the Healthcare Systems division regarding the implementation of the healthcare systems capability [OEM];
    • Continue to build relationships with strategic partners to leverage opportunities and advance the recovery mission [OEM].
Outcome: Immediate: The recovery mission is fully integrated into the preparedness and response continuum. Longer term: Communities recover quicker from an incident.
  • Identify and implement effective and empirically-supported behavioral health practices in disaster preparedness, response, and recovery. Proposed activity:
    •  Implement and revise the HHS Disaster Behavioral Health Concepts of Operation and monitor effectiveness to improve coordination of behavioral health activities for disaster survivors and responders [OPP, OEM].
Outcome: Effective coordination of federal disaster behavioral health activities and consistent use of empirically-supported behavioral health practices by federal, state, and local responders in order to foster recovery, facilitate policy formation and planning, and to promote community and responder resilience.
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  • This page last reviewed: February 18, 2014