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  • the cip report

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    cr it ical infrastructure protect ion program volume 7 number 2



    Sector Overview ...........................2

    Sector-Specifi c Metrics .................4

    Research & Development .............5

    Mass Fatalities Management .........7

    Role of NVHA .............................8

    Medical Materials Supply Chain. 10

    NACCHO .................................12

    Legal Insights .............................14

    Editorial Staff

    Editors Morgan Allen Olivia Pacheco

    Staff Writers Tim Clancy Maeve Dion

    JMU Coordinators Ken Newbold

    John Noftsinger

    Publishing Zeichner Risk Analytics

    Contact: 703.993.4840

    Click here to subscribe. Visit us online for this and other issues at

    In this month’s issue of The CIP Report we highlight the Healthcare and Public Health (HPH) Sector. We present an overview of the sector from the Department of Health and Human Services (HHS) as well as two tables illustrating the size of the sector and its interdependencies, respectively. Contributions are presented from the MITRE Corporation, one from the Sector- Specific Metrics Workgroup and another from the HPH Sector Joint Advisory Workgroup (JAWG). We also take a look at the different aspects that make up the HPH Sector and offer an article about one of its sub-councils, Mass Fatalities Management Services (MFM).

    Hospitals are another important part of the HPH Sector and we present an article on how some of our local hospitals are working together through the Northern Virginia Hospital Alliance (NVHA). The Medical Materials Coordinating Group (MMCG) is another of the HPH Sector’s sub-councils and we look at why disaster preparedness is important within the medical materials supply chain. The National Association of County and City Health Officials (NACCHO) provides an article on the work that they do as a nonprofit organization representing local health departments. Lastly, Legal Insights discusses information sharing.

    On a personal note, it is a great pleasure and honor to join this very dedicated team at George Mason University School of Law’s Critical Infrastructure Protection (CIP) Program. It is our goal to help further develop and continue to grow the capability of this program, so that we can better assist all those engaged in protecting the critical infrastructures of this Nation.

    Mick Kicklighter Director, CIP Program George Mason University, School of Law

  • The CIP Report August 2008


    If one were to ask the general public what “critical infrastructure” meant to them, the most likely responses would include roads and bridges, nuclear power plants, dams, water treatment plants, and similar physical structures. If the same people were asked about critical infrastructure within the Healthcare and Public Health (HPH) Sector, the responses would likely point to hospitals, pharma- cies, and traditional healthcare delivery facilities. In fact, neither depiction captures the breadth of this diverse sector which reaches far beyond physical structures to networks, systems, and key domes- tic and international dependencies and beyond healthcare delivery systems to medical manufacturing, medical distribution, research and diagnostic laboratories, and other vital capabilities that form the fun- damental building blocks operating behind the scenes upon which the healthcare delivery component is wholly dependent.

    Homeland Security Presidential Directive 7 (HSPD-7) initiated the development of a national critical infrastructure protection strategy and divided the nation into 18 sectors. Each sector has been assigned to a Sector-Specifi c (Fed- eral) Agency (SSA) for day-to-day management and execution of the requirements set forth in HSPD-7 and the National Infrastructure

    Protection Plan (NIPP). Working toward these critical infrastructure protection goals for the HPH Sector is the responsibility of the Offi ce of the Assistant Secretary for Preparedness and Response within the Department of Health and Human Services (HHS).

    Th e HPH Sector is a vital com- ponent of our Nation’s stability and longevity and is comprised of interconnecting operations, information-systems, activities, processes, and resources. Taken in- dependently, public health has one of the most singularly diverse and essential roles across all healthcare capabilities, from food and water protection to emergency planning, management, and policy develop- ment. Healthcare and public health have the vision of achieving overall resiliency against all hazards — natural and manmade — in order to prevent or minimize damage to, or destruction of, the Nation’s healthcare and public health infrastructure; and to preserve the ability to mount timely and eff ec- tive responses to both routine and emergency situations, while provid- ing continuity of services in non- impacted areas. Looking across the sector, we strive to identify, analyze, and develop approaches to ensure continuity of mission through preparedness and response, with a focus on “consequence reduction” across the sector.

    Th e HPH Sector constitutes approximately 15 percent of the Gross National Product (GNP)1, equal to $1.86 trillion, and has an important impact on the U.S. economy. Privately owned and operated organizations comprise a vast majority of the sector and iden- tify themselves with the delivery of healthcare goods and services. Th e public health component is composed largely of government agencies at the Federal, State, local, and tribal community levels. Th e public health component is not as large as the private component and performs a somewhat diff erent array of functions, concentrating largely on preventive measures. Th e sector is highly diverse in its com- position and relationships with its many systems, networks, services, facilities, functions, and roles, both public and private, needed to prevent disease and disability, treat patients, foster public health, and respond to incidents requiring medical and public health services.

    Th e sector provides a full array of goods and services for acute hospital and ambulatory healthcare, public health, public health infor- mation, mental health, substance abuse treatment, environmental and occupational health, long-term care, tele-health, pharmaceuticals, mortuary services, medical supplies,

    The Healthcare and Public Health Sector Overview

    by Nitin Natarajan, Department of Health and Human Services Offi ce of the Assistant Secretary for Preparedness and Response

    1 According to U.S. National Economic Accounts, the U.S. Gross Domestic Product was $12.456 trillion in 2005. Th e Healthcare and Public Health Sector was estimated to be approximately 15 percent of that total or $1.868 trillion.

    (Continued on Page 3)

  • The CIP Report August 2008


    and others. Private sector as well as Federal, State, and local agen- cies provide healthcare and public health services, and participate in ongoing surveillance and detection of potentially devastating thre