Public Health Emergency Management Within the DoD

By Rob Anastasio
FHP&R Staff Writer

January 27, 2010 - A new DoD Instruction will “establish DoD guidance to protect installations and personnel by mitigating the impacts of publish health emergencies,” according to USPHS Capt. D.W. Chen, Office of the Assistant Secretary of Defense for Health Affairs, who spoke at the At the 2010 MHS Conference Jan 26. Chen said that, additionally, the policy will clarify roles and responsibilities of military treatment facility (MTF) commanders and emergency managers, as well as public health emergency officers (PHEOs).

The DoD Instruction (DoDI), number 6200.03, is titled “Public Health Emergency Management Within the Department of Defense” and was signed Jan. 14 by Gail McGinn, deputy undersecretary of defense (plans) performing the duties of the undersecretary of defense for personnel and readiness.

The DoDI takes a holistic approach to public health emergency management moving DoD toward an “all-hazards” focus and away from the chemical, biological, radiological, nuclear, and high yield explosive (CBRNE) focus of the past.

Other significant provisions of the DoDI include: public health emergency notification routing requirements; authorization for DoD laboratories to participate in the Laboratory Response Network (LRN); update of guidance on quarantine and restriction of movement; authorization for military installations to serve as close points of distribution and receipt, staging, storage sites for strategic national stockpile assets; guidelines surrounding situational standards of care; establishment of military treatment facility emergency managers (MEMs); enumeration of roles and responsibilities of military public health emergency officers (PHEOs) and MEMs and attendant training/education requirements; the use of ESSENCE as the DoD syndromic surveillance tool.

The Assistant Secretary of Defense for Health Affairs has a major responsibility with the policy. “The ASD(HA) will serve as the primary advisor to the Secretary of Defense regarding PHEs, will be the point of contact for interagency coordination,” said Chen. “The individual services will ensure commanders work with state and local government authorities, and ensure that public health emergency management (PHEM) resources are identified and developed.”

In addition to the added responsibilities of the services, geographic combatant command, military commander, and the MTF commander, there are a set of general procedures that military commanders must follow during a PHE.

“Making timely decisions is very important,” said Chen. “The emergency should be immediately reported through the proper channels, and the PHEOs have the responsibility of examining facilities that may endanger public health, share the information with civilian public health officials, and declare a public health emergency.”

PHEOs are also responsible for assisting with risk communication efforts and maintaining situational awareness of the public health emergency, said Chen.

The new DoDI also incorporates guidance from and brings the Department of Defense into compliance with several key documents that have emerged over the past several years, including the updated International Health Regulations, updated Centers for Disease Control and Prevention (CDC) quarantine regulations, the Pandemic and All-Hazards Preparedness Act, and the Model State Emergency Health Powers Act. While it was written specifically in coordination within the Department of Defense, this DoDI was also coordinated extensively within the federal interagency with offices from the Departments of Health and Human Services, State, and Veterans Affairs.