CHAPTER 3: Public <strong>Health</strong> Promotion <strong>and</strong> Protection, Disease Prevention,<strong>and</strong> Emergency Preparednessstorage, deployment, <strong>and</strong> utilization <strong>of</strong> medicalcountermeasures. NIH leads the effort for medicalcountermeasure basic research, early stage productdevelopment, <strong>and</strong> clinical research. FDA is committedto facilitating the development <strong>and</strong> availability <strong>of</strong> safe<strong>and</strong> effective medical countermeasures. CDC hasresponsibilities including disease monitoring throughits infectious disease surveillance program <strong>and</strong> medicalcountermeasure storage <strong>and</strong> deployment throughits Strategic National Stockpile (SNS) program. TheSNS procures <strong>and</strong> stores large quantities <strong>of</strong> medicine<strong>and</strong> medical supplies to protect the Americanpublic if there is an emergency (e.g., terrorist attack,influenza p<strong>and</strong>emic, or earthquake) severe enoughto cause local supplies to run out. HHS will continueto invest in research <strong>and</strong> development <strong>of</strong> medicalcountermeasures, procure safe <strong>and</strong> effective materialsfor the SNS, <strong>and</strong> work with States to ensure thatthey are prepared to request, receive, <strong>and</strong> utilize SNSmaterials in the case <strong>of</strong> a public health emergency.P<strong>and</strong>emic InfluenzaHHS p<strong>and</strong>emic influenza implementation activitiessupport the larger National Strategy for P<strong>and</strong>emicInfluenza, <strong>and</strong> many are conducted in concert with orin support <strong>of</strong> other Federal departments <strong>and</strong> agencies.The key strategies for p<strong>and</strong>emic influenza preparednessfocus on international activities; domestic surveillance;public health interventions; medical response; vaccines,antivirals, diagnostics, <strong>and</strong> personal protective equipment;passive <strong>and</strong> active surveillance for vaccine safety;communication; <strong>and</strong> support for State, local, <strong>and</strong> tribalpreparedness. HHS, primarily through ASPR, CDC, FDA,NIH, <strong>and</strong> OPHS, will continue to support the NationalStrategy by completing actions in these strategy areas.One major area <strong>of</strong> focus will be building the prep<strong>and</strong>emic<strong>and</strong> p<strong>and</strong>emic influenza vaccine production capacity <strong>and</strong>vaccine supply. In April 2007, FDA approved the first U.S.vaccine for humans against the H5N1 influenza virus. FDAwill continue to facilitate advanced product development<strong>of</strong> both seasonal <strong>and</strong> p<strong>and</strong>emic influenza medicalcountermeasures, including novel vaccines, antivirals,<strong>and</strong> rapid diagnostics. This will be accomplished byproviding assistance to industry partners on domesticmanufacturing capabilities, accelerating the reviews <strong>of</strong>seasonal <strong>and</strong> p<strong>and</strong>emic influenza related products, <strong>and</strong>issuing guidance to external stakeholders on variousregulatory subjects, including clinical requirements forlicensure <strong>of</strong> seasonal <strong>and</strong> p<strong>and</strong>emic influenza vaccines.HHS agencies also will work closely with other Federalagencies <strong>and</strong> international partners, such as WHO <strong>and</strong> theministries <strong>of</strong> health in target countries. HHS has forwarddeployeda quantity <strong>of</strong> Tamiflu in Asia for the purposes<strong>of</strong> mounting a containment operation to attempt tohalt a potential influenza p<strong>and</strong>emic. In addition, HHSis engaged in a number <strong>of</strong> international p<strong>and</strong>emicpreparedness activities, through the InternationalPartnerships on Avian <strong>and</strong> P<strong>and</strong>emic Influenza, the Security<strong>and</strong> Prosperity Partnership <strong>of</strong> North America, <strong>and</strong> theGlobal <strong>Health</strong> Security Initiative.People With DisabilitiesUnder Executive Order 13347, all Federal emergencypreparedness efforts must address the needs <strong>of</strong>individuals with disabilities <strong>and</strong> other vulnerablepopulations. HHS has taken a leadership role inengaging the disability community <strong>and</strong> providingguidance to partners to address the unique healthneeds <strong>of</strong> individuals with disabilities <strong>and</strong> othervulnerable populations, including children <strong>and</strong> youthwith special health care needs. In 2006, HHS <strong>and</strong> theU.S. <strong>Department</strong> <strong>of</strong> Homel<strong>and</strong> Security cosponsored aworking conference for State emergency preparedness,public health, aging, <strong>and</strong> disability agencies to facilitatedialog <strong>and</strong> collaboration among these organizationstoward the common goal embodied in the ExecutiveOrder. The result has been a living laboratory for State<strong>and</strong> Federal cooperation <strong>and</strong> shared learning aroundthe issue <strong>of</strong> emergency preparedness for vulnerablepopulations. OD <strong>and</strong> ASPR will implement <strong>and</strong>monitor the use <strong>of</strong> the disability-based preparednesstoolkit <strong>and</strong> public health staff training modules—developed by a broad-based HHS workgroup—toensure that the needs <strong>of</strong> children, youth, <strong>and</strong> adultswith disabilities <strong>and</strong> chronic conditions are fullyunderstood by first responders <strong>and</strong> other emergencyresponse providers at the Federal, tribal, State, <strong>and</strong>local levels during all emergency situations.78 HHS Strategic Plan FY 2007-2012
CHAPTER 3: Public <strong>Health</strong> Promotion <strong>and</strong> Protection, Disease Prevention,<strong>and</strong> Emergency PreparednessASPR, OD, <strong>and</strong> OCR are working with the AmericanRed Cross to develop an intake <strong>and</strong> assessment toolthat will be used at shelters to evaluate the functionalneeds <strong>of</strong> all individuals, including individuals withdisabilities. This tool will help ensure that individualswith disabilities have equal access to shelter services<strong>and</strong> are served in the most integrated settingappropriate. On the local level, OCR’s 10 regional<strong>of</strong>fices are working with other <strong>of</strong>fices in HHS <strong>and</strong> Statesto provide technical assistance <strong>and</strong> resources to planfor <strong>and</strong> respond to needs <strong>of</strong> individuals with disabilitiesin the event <strong>of</strong> an emergency.Protected <strong>Health</strong> Information. In its review <strong>of</strong> State<strong>and</strong> local emergency plans issued in the summer <strong>of</strong> 2006,the U.S. <strong>Department</strong> <strong>of</strong> Homel<strong>and</strong> Security identifiedmisunderst<strong>and</strong>ing <strong>and</strong> confusion surrounding theapplication <strong>of</strong> the HIPAA Privacy Rule protections toinformation sought for emergency response planningpurposes. OCR has implemented a new Web-basedinteractive decision tool designed to assist emergencypreparedness <strong>and</strong> recovery planners in determininghow to access <strong>and</strong> use health information consistentwith the HIPAA Privacy Rule. The tool guides emergencypreparedness <strong>and</strong> recovery planners through a series<strong>of</strong> questions regarding how to apply the HIPAA PrivacyRule. The tool is available on OCR’s Web site alongwith bulletins containing information for emergencyproviders on the disclosure <strong>of</strong> protected healthinformation to assist with disaster relief efforts.Equal AccessOCR has taken steps, consistent with a FederalGovernmentwide effort, to help ensure that individualswith Limited English Pr<strong>of</strong>iciency (LEP) have equal accessto information, shelters, <strong>and</strong> other evacuation <strong>and</strong> reliefefforts. For example, OCR is working with ASPR <strong>and</strong> theAmerican Red Cross to develop an intake <strong>and</strong> assessmenttool that will be used at shelters to identify <strong>and</strong> addresscommunication needs <strong>of</strong> individuals with LEP. On thelocal level, OCR’s regional <strong>of</strong>fices are working with HHSpartners <strong>and</strong> States to provide technical assistance<strong>and</strong> resources to plan for <strong>and</strong> respond to the needs <strong>of</strong>individuals with LEP in the event <strong>of</strong> an emergency.Information Technology SupportHHS will be developing a deployable, interoperable firstresponder electronic health record system. The electronichealth record system for disasters will maintain thesecurity <strong>and</strong> confidentiality <strong>of</strong> health information. Theintention is to field test possible platforms during the 2007hurricane season to gain insight into their benefits <strong>and</strong>limitations. There are few existing systems <strong>and</strong> st<strong>and</strong>ardsin the broader health environment to interact with at thistime, so the expected benefits are to ensure quality <strong>of</strong> care<strong>and</strong> continuity <strong>of</strong> information sharing during a publichealth emergency <strong>and</strong> its aftermath. Wider health sectorst<strong>and</strong>ards development <strong>and</strong> endorsement by the <strong>Health</strong>Information Technology St<strong>and</strong>ards Panel <strong>and</strong> the Secretarywill be completed to capitalize on the desired benefits <strong>of</strong>this approach toward continuity <strong>and</strong> quality <strong>of</strong> care.HHS Strategic Plan FY 2007-201279