National Health Security Strategy
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The National Health Security Strategy (NHSS) is a strategic plan for 2010 developed by the United States Department of Health and Human Services to help minimize the consequences associated with significant health incidents. The purpose of the plan is to provide coordination between separate organisations in order to reduce the social and economic cost in the case of a significant health incident. The strategy covers coordination of preparation and contingency planning, incident identification and recovery strategies relevant to each stakeholder in the event of a national health incident.
The aim of the document is that when a health incident occurs, all appropriate organisations will coordinate and minimise the effect of the incident on the nation. In addition to this the strategy includes a framework for the accountability and assessment of implementation including eventual assessment criteria.
The document was initially developed by the United States Department of Health and Human Services in consultation with stakeholder organisations as required by the Pandemic and All Hazards Preparedness Act. These include local, state, territorial, tribal and federal governments; community focus groups, private sector firms and academic advisers.
The National Health Security Strategy was first published in 2009 with an implementation schedule extending until 2014. In addition to this an interim implementation guide was published in 2010 and then every two years in order to provide additional guidance as the project matures.
The National Health Security Strategy
The National Health Security Strategy (NHSS) was developed to improve coordination and response of stakeholders in the event of a health incident, and thereby minimise the consequences of that incident. The strategy provides a framework for improvement within the scope of the Pandemic and All Hazards Preparedness Act, which aims to improve the preparedness and response of the nation to emergencies.
In preparing the strategy, its developers consulted with a range of independent stakeholders, reflecting the wide scope of organisations which would be involved in the strategy. In particular, developers consulted all levels of medical organisations and government from local to federal grades. The developers also consulted with community organisations, private-sector firms and academia.
The principle of health security defined in the NHSS is built on the principle of community resilience. This means that in an emergency healthy individuals, families, and communities with access to health care, and with the knowledge and resources to know what to do to care for themselves and others would work together in both routine and emergency situations.
The NHSS was developed with the understanding that achieving improved health security at the national level is a long term proposition. The improvement of the nation's ability to prepare for, respond to, and recover from a major health incident by coordinating many stakeholders will take significant commitment by all parties to improvement, accountability and engagement.
Interim Implementation Guide
In order to properly realise the strategic objectives of the NHSS, an implementation guide was produced which aids stakeholder organisations in how to comply with the strategy. The comprehensive implementation guide is produced biennially from 2010, so that it can include amendments based on the initial implementation of the strategy. In order to provide implementation guidance in the first few months, an initial interim implementation plan was also produced and released accompanying the original strategy in 2009.
The interim implementation guide describes initial implementation activities, and provides the foundation for a more complete biennial implementation planning process.
Biennial Implementation Plan
To help the Nation achieve national health security and to implement the first quadrennial National Health Security Strategy (NHSS) of the United States of America (2009), the U.S. Government produced and published NHSS Biennial Implementation Plan (BIP).
To help stakeholders improve national health security and to effectively implement the quadrennial National Health Security Strategy (NHSS) 2009, the U.S. Government produce and publish biennial implementation plans. These provide comprehensive guidance on implementation of the strategy for participating organisations. The first Biennial Implementation Plan was published in July 2010, six months after the strategy first began, this means the Biennial includes guidance augmented by several months of implementation.
The Pandemic and All Hazards Preparedness Act (PAHPA) was enacted in 2006 to improve the nation’s ability to detect, prepare for, and respond to a variety of public health emergencies. Among other things, PAHPA directs the Secretary of the Department of Health and Human Services (HHS) to develop a National Health Security Strategy, presented to Congress in December 2009 and to be subsequently revised every four years afterwards. The statutory authority and requirements for the NHSS are provided under section 2802 of the Public Health Service Act.
The Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (H.R. 307; 113th Congress) was enacted in 2013 to reauthorize and improve many of the programs established by the Pandemic and All Hazards Preparedness Act. Section 101 of the bill amends the Public Health Service Act to require the Secretary of Health and Human Services (HHS) to submit the National Health Security Strategy to the relevant congressional committees in 2014. The bill revises the Strategy's preparedness goals, particularly to require that regular preparedness drills also include drills and exercises to ensure medical surge capacity for events without notice.
Section 101 of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 also requires that the National Health Security Strategy include:
- (1) provisions for increasing the preparedness, response capabilities, and surge capacity of ambulatory care facilities, dental health facilities, and critical care service systems;
- (2) plans for optimizing a coordinated and flexible approach to the medical surge capacity of hospitals, other health care facilities, critical care, and trauma care and emergency medical systems;
- (3) provisions taking into account the unique needs of individuals with disabilities in a public health emergency; and
- (4) strategic initiatives to advance countermeasures to diagnose, mitigate, prevent, or treat harm from any biological agent or toxin or any chemical, radiological, or nuclear agent or agents, whether naturally occurring, unintentional, or deliberate.