Preparedness Policy Statement

State and territorial health agencies are vital to our nation’s ability to respond to public health emergencies and threats. Principally, they ensure the public health of their jurisdictions through their inherent authorities to protect and promote the health, safety and general welfare of their populations. However, all levels of government in partnership with individuals, communities and the private sector, must concertedly participate in public health preparedness to ensure the public health of our nation.

A collaborative effort in preparedness is critical and requires the clear delineation of roles and responsibilities for federal, state, local, territorial and tribal agencies in public health preparedness. Within this effort, the federal government ensures the protection of the general welfare and national security. As the national nonprofit organization representing the state and territorial public health agencies of the United States, its territories, and the District of Columbia, the Association of State and Territorial Health Officials (ASTHO) recognizes the need for strong federal support for state and territorial public health preparedness. Federal support for preparedness must be facilitated through grant policies and business practices that foster coordinated planning and response.

1. SUSTAINED FUNDING FOR ALL-HAZARDS PREPAREDNESS

Public health preparedness requires the long-term development of continuously improving public health systems that can be used to respond to all hazards. These systems are built only through flexible, sustained federal support. Maintaining these systems require a public health workforce of highly skilled personnel who can respond to all hazards and routine public health needs. The strongest response systems integrate into and build upon existing structures and programs, while incorporating dedicated personnel to advance and coordinate this effort. Therefore, state and territorial health agencies require federal support to develop and maintain highly skilled and well-trained staff through continued training and workforce development. Furthermore, they require sufficient resources to conduct exercises, develop corrective action plans and implement improvements. When new preparedness responsibilities arise, the resources to address them must be integrated into the existing public health system to guarantee an infrastructure that can respond to all hazards.

2. INTEGRATED PLANNING

All levels of government must participate in the planning, coordination and implementation of preparedness and response activities. Coordination and collaboration must occur among different levels of government and across agencies. States seek to ensure that assets are allocated appropriately within their jurisdictions; and federal, state, local, territorial and tribal health agencies and other partners are responsible for identifying and securing adequate and sustained resources through prior intrastate and interstate planning. ASTHO strongly supports regional initiatives that call for a sharing of resources, personnel and volunteers among states and territories during public health emergencies. ASTHO recognizes that such regional coordination efforts require integrated planning with the federal government and supports a continued federal commitment to and support of integrated planning in preparedness through the Emergency Management Assistance Compact (EMAC).¹   Furthermore, ASTHO recognizes the critical importance and value of strategic planning at the national level. ASTHO supports the National Health Security Strategy and the aggressive and timely implementation plan as required by the Pandemic and All Hazards Preparedness Act through a structured participatory process involving key stakeholders and partners such as state and territorial public health officials.

3. PROTECTION OF PRIORITY POPULATIONS

A competent response to a public health emergency requires planning for all populations, including those at greatest risk. Each state and territory needs to identify and address priority populations based on their own demographics, needs and available resources. ASTHO strongly supports the commitment of state and territorial health agencies to addressing the unique needs of priority populations in public health preparedness planning such as the incorporation of culturally and linguistically appropriate public health information, behavioral health information and exercises with priority populations into state and territorial plans.

4. QUALITY IMPROVEMENT SYSTEMS

Public health preparedness must be measured through a set of flexible, valid, and meaningful performance indicators. Leadership is needed to guide the collaborative development and implementation of appropriate and consistent standards that state and territorial health agencies may use to assess their progress and state of readiness and to provide accountability to the populations they serve. ASTHO strongly supports the transparent use and development of comprehensive performance measures accompanied by a system that identifies and shares innovative approaches, lessons learned and best practices to further ensure a strong quality improvement process that correlates individual benchmarks to national public health preparedness goals. The development and implementation of the CDC Public Health Emergency Preparedness capabilities is an important development in this area and should be fully implemented and updated as new evidence and practice emerges.

Approval History:

Preparedness Policy Committee Review and Approval on
Board of Directors’ Review and Approval on July 20, 2011.
Ratified by the ASTHO Membership on October 20, 2011.
Policy Expires on October 19, 2014.

ASTHO policies are broad statements of enduring principles related to particular policy areas that are used to guide ASTHO’s actions and external communications.

Related ASTHO Documents:

Workforce Development Policy Statement
Emergency Response
TBD–surge capacity, vulnerable populations, incident management, environmental surveillance program

1. The Emergency Management Assistance Compact was approved by Congress in 1996 as Public Law 104-321.