Post-Incident
Recovery Considerations
of the Health Care Service
Delivery Infrastructure

Workshop Summary


Theresa Wizemann and Bruce M. Altevogt,
Rapporteurs


Forum on Medical and Public Health Preparedness for
Catastrophic Events

Board on Health Sciences Policy

INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu



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Post-Incident Recovery Considerations of the Health Care Service Delivery Infrastructure Workshop Summary Theresa Wizemann and Bruce M. Altevogt, Rapporteurs Forum on Medical and Public Health Preparedness for Catastrophic Events Board on Health Sciences Policy

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THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, NW • Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Insti- tute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by contracts between the National Academy of Sciences and the American College of Emergency Physicians; American Hospital Association; Ameri- can Medical Association; American Nurses Association; Association of State and Territo- rial Health Officials; Centers for Disease Control and Prevention (Contract No. 200- 2005-13434 TO #6); Department of the Army (Contract No. W81XWH-08-P-0934); Department of Health and Human Services’ National Institutes of Health (Contract No. N01-OD-4-2139 TO #198 and TO #244); Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (Contract Nos. HHSP233200900680P, HHS P23320042509X1); Department of Homeland Security’s Federal Emergency Management Agency (Contract No. HSFEHQ-08-P-1800); Depart- ment of Homeland Security’s Office of Health Affairs (Contract No. HSHQDC-07-C- 00097); Department of Transportation’s National Highway Traffic Safety Administration (Contract No. DTNH22-10-H-00287); Department of Veterans Affairs (Contract No. V101(93)P-2136 TO #10); Emergency Nurses Association; National Association of Chain Drug Stores; National Association of County and City Health Officials; National Association of Emergency Medical Technicians; Pharmaceutical Research and Manufac- turers of America; Robert Wood Johnson Foundation; and United Health Foundation. The views presented in this publication do not necessarily reflect the views of the organi- zations or agencies that provided support for the project. International Standard Book Number-13: 978-0-309-26060-2 International Standard Book Number-10: 0-309-26060-4 Additional copies of this report are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334- 3313; http://www.nap.edu/. For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu. Copyright 2012 by the National Academy of Sciences. All rights reserved. Printed in the United States of America The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin. Suggested citation: IOM (Institute of Medicine). 2012. Post-incident recovery considera- tions of the health care service delivery infrastructure: Workshop summary. Washington, DC: The National Academies Press.

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The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal gov- ernment on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of out- standing engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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PLANNING COMMITTEE ON LONG-TERM RECOVERY OF THE HEALTH CARE SERVICE DELIVERY INFRASTRUCTURE1 JACK HERRMANN (Co-Chair), National Association of County and City Health Officials, Washington, DC LYNNE KIDDER (Co-Chair), Bipartisan WMD Terrorism Research Center, Washington, DC Project Staff BRUCE M. ALTEVOGT, Preparedness Forum Director KRISTIN VISWANATHAN, Research Associate (until June 2012) ALEX REPACE, Senior Program Assistant ANDREW M. POPE, Director, Board on Health Sciences Policy 1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution. v

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FORUM ON MEDICAL AND PUBLIC HEALTH PREPAREDNESS FOR CATASTROPHIC EVENTS1 ROBERT KADLEC (Co-Chair), PRTM Management Consultants, Washington, DC LYNNE KIDDER (Co-Chair), Bipartisan WMD Terrorism Research Center, Washington, DC ALEX ADAMS, National Association of Chain Drug Stores Foundation, Alexandria, VA GEORGES BENJAMIN, American Public Health Association, Washington, DC D. W. CHEN, Office of Assistant Secretary of Defense for Health Affairs, Department of Defense, Washington, DC (since June 2012) BROOKE COURTNEY, Food and Drug Administration, Silver Spring, MD JEFFREY DUCHIN, Seattle & King County and University of Washington ALEXANDER GARZA, Department of Homeland Security, Washington, DC JULIE GERBERDING, Merck Vaccines, West Point, PA LEWIS GOLDFRANK, New York University Medical Center, NY DAN HANFLING, Inova Health System, Falls Church, VA JACK HERRMANN, National Association of County and City Health Officials, Washington, DC JAMES JAMES, American Medical Association, Chicago, IL PAUL JARRIS, Association of State and Territorial Health Officials, Arlington, VA JERRY JOHNSTON, National Association of Emergency Medical Technicians, Mt. Pleasant, IA (until January 2012) BRIAN KAMOIE, The White House, Washington, DC LISA KAPLOWITZ, Department of Health and Human Sciences Office of the Assistant Secretary for Preparedness and Response, Washington, DC ALI KHAN, Centers for Disease Control and Prevention, Atlanta, GA MICHAEL KURILLA, National Institute of Allergy and Infectious Diseases, Bethesda, MD JAYNE LUX, National Business Group on Health, Washington, DC 1 Institute of Medicine forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution. vii

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ANTHONY MACINTYRE, American College of Emergency Physicians, Washington, DC NICOLE MCKOIN, Target Corporation, Minneapolis, MN (from April 2012) MARGARET MCMAHON, Emergency Nurses Association, Williamstown, NJ MATTHEW MINSON, Texas A&M University, College Station ERIN MULLEN, Pharmaceutical Research and Manufacturers of America, Washington, DC CHERYL PETERSON, American Nurses Association, Silver Spring, MD STEVEN PHILLIPS, National Library of Medicine, Bethesda, MD LEWIS RADONOVICH, Veterans Health Administration, Washington, DC JOSHUA RIFF, Target Corporation, Minneapolis, MN (until April 2012) KENNETH SCHOR, Uniformed Services University of the Health Sciences, Bethesda, MD (from April 2012) ROSLYNE SCHULMAN, American Hospital Association, Washington, DC SARAH SEILER, Carolinas Medical Center, Charlotte, NC RICHARD SERINO, Federal Emergency Management Agency, Washington, DC MICHAEL SKIDMORE, U.S. Department of Defense, Washington, DC (until May 2012) SHARON STANLEY, American Red Cross, Washington, DC ERIC TONER, University of Pittsburgh Medical Center, PA REED TUCKSON, UnitedHealth Group, Minneapolis, MN MARGARET VANAMRINGE, The Joint Commission, Washington, DC GAMUNU WIEJETUNGE, National Highway Traffic Safety Administration, Washington, DC IOM Staff BRUCE ALTEVOGT, Project Director KRISTIN VISWANATHAN, Research Associate (until June 2012) ALEX REPACE, Senior Program Assistant ANDREW M. POPE, Director, Board on Health Sciences Policy viii

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Reviewers This workshop summary has been reviewed in draft form by individ- uals chosen for their diverse perspectives and technical expertise, in ac- cordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published summary as sound as possible and to ensure that the summary meets institutional standards for objectivity, evidence, and re- sponsiveness to the study charge. The review comments and draft manu- script remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this summary: James Craig, Mississippi State Department of Health Onora Lien, King County Healthcare Coalition Rev. Kevin Massey, Advocate Lutheran General Hospital Linda Williams, Montana State University, Chouteau County Extension Although the reviewers listed above have provided many construc- tive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this summary was overseen by Kristine M. Gebbie, Flinders University School of Nursing and Midwifery. Appointed by the Institute of Medicine, she was respon- sible for making certain that an independent examination of this work- shop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Re- sponsibility for the final content of this summary rests entirely with the workshop rapporteurs and the institution. ix

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Contents INTRODUCTION 1 THE FEDERAL GOVERNMENT: COORDINATOR AND FACILITATOR 3 The National Disaster Recovery Framework, 3 Office of the Assistant Secretary for Preparedness and Response—Portal to the Full Spectrum of Department of Health and Human Services (HHS) Resources, 5 THE PRIVATE SECTOR: BUILDING RESILIENT COMMUNITIES 7 Sharing Our Strengths, 7 The Power of Planning Together, 8 NONGOVERNMENTAL ORGANIZATIONS: PROVIDING SUPPORT AND RELIEF 10 The American Red Cross, 10 LOCAL AND STATE ROLES: THE COMMUNITY AS THE LEAD 12 Planning for the Unexpected, 13 Depth and Breadth of Local Recovery Planning and Priority Setting, 14 BARRIERS AND CHALLENGES TO RECOVERY 15 FINAL REMARKS 17 xi

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xii CONTENTS REFERENCE 17 APPENDIXES A Workshop Statement of Task 19 B Agenda 21 C Speaker Biographies 23