National Health Preparedness and Response Centers: Revisiting the Increasingly Critical Need to Expand Cooperative Emergency Response Capabilities in the United States.

In 1999, a robust National Health Preparedness and Response Center was conceptualized and piloted, but never fully operationalized. This study revisits the expansive, coordinated efforts invested in this concept, considered an overdue remedy for persistent shortfalls in medical Chemical, Biological, Radiological, Nuclear, and High Yield Explosives training, proficiency, and preparation. The concept defined a robust mission for longstanding, proven programs for prepositioning equipment and associated training of personnel. This study explores the reasons that ended military and governmental support, attendant funding, and operations of the created Joint/Interagency Civil Support Center, which ceased on September 30, 2006. Unfortunately, the concept remains relevant. Major gaps in disaster medical response capabilities have been recognized for decades. Experts from the Institute of Medicine, United States Northern Command, and multiple academic centers and professional organizations have identified these shortcomings, but the national response posture remains disjointed, under-resourced, and based upon obsolete planning premises. Given increasing threats, the authors recommend revisiting the collaboration of military, civilian, academic, and governmental resources that once established the Joint/Interagency Civil Support Center as a multidisciplinary and trans-disciplinary model for a new National Health Preparedness and Response Center coordinated framework for enhanced resilience and operational response capabilities on a national level.

The road less taken: modularization and waterways as a domestic disaster response mechanism.

Preparedness scenarios project the need for significant healthcare surge capacity. Current planning draws heavily from the military model, leveraging deployable infrastructure to augment or replace extant capabilities. This approach would likely prove inadequate in a catastrophic disaster, as the military model relies on forewarning and an extended deployment cycle. Local equipping for surge capacity is prohibitively costly while movement of equipment can be subject to a single point of failure. Translational application of maritime logistical techniques and an ancient mode of transportation can provide a robust and customizable approach to disaster relief for greater than 90 percent of the American population.

The Health Assessment Longitudinal File imperative: foundation for improving the health of the force.

A smaller active duty force and an increased operational tempo have made the Reserve components (RC) essential elements in the accomplishment of the mission of the U.S. Army. One critical factor in meeting mission is maintaining the optimal health of each soldier. Baseline health data about the RC is currently not being collected, even though increasing numbers of reserve soldiers are being activated. The Annual Health Certification and Survey is being developed as a way to meet the RCs' statutory requirement for annual certification of health while at the same time generating and tracking baseline data on each reservist in a longitudinal health file, the Health Assessment Longitudinal File. This article discusses the Annual Health Certification Questionnaire/Health Assessment Longitudinal File, which will greatly enhance the Army's ability to accurately certify the health status of the RC and track health in relation to training, mission activities, and deployment.