Key Learnings from the DomPrep Action Plan
Written by RADM Craig Vanderwagen, M.D., Founding Assistant Secretary for Preparedness and Response, U.S. Public Health Service - Retired
The DomPrep Action Plan: Building Resilient Regions for a secure and Resilient Nation is an important report on the future of resilience as a critical component of response and recovery from disaster. The report is built from perspectives and opinions provided through a series of discussions, both in person, and online, held with regional leadership in preparedness and response who crossed the spectrum from public safety (fire and police leaders) to public health and academia. Private sector involvement was a critically important component as well in mapping a more effective “whole of community” approach.
These discussions were held over the past spring and summer and were initiated to assess the status of regional activity in light of budget reductions both from federal and state sources. Specific recommendations were sought with regards to strengthening and improving regional and local collaborative processes to maximize the use of surviving resources.
The discussions (which covered all regions of the country) were very lively and productive. Although there was some frustration expressed about changing federal policies and funding support, the main elements of the discussions were focused on how regional and local collaboratives had been built and their strengths and weaknesses. This willingness to address the issues with an eye towards clarifying the “lessons learned” over the last decade was very healthy and I believe led to some important insights. These insights first and foremost were focused on potential improvements in regional and local activity. But important policy directions for federal consideration were also articulated.
There was strong consensus that while federal funding is declining, it is most important for federal policy makers to act in unison to assure that remaining funding is well targeted to enhance regional and local performance through some standardization of threat and risk assessment methods and performance metrics and evaluation in planning and exercising as well as response and recovery activities. This more standardized approach would allow for more efficiencies in targeting remaining grants both federally and from state and local entities. Of course, how these standards are developed and implemented will be a challenging process since the jurisdictional sovereignty issues will require a most professional effort in all quarters, federally and regionally. It will require mature and effective team leadership throughout.
This was recognized as challenging by the participants and they strongly argued for a bottom up approach rather than a federally dictated top down process.
The preferred approach would involve collaboratives developing on an intra-state basis using processes and methods derived from their regional experience. These collaborative groups could then work jointly with federal entities to propose and test standard approaches to the elements noted above. It should be noted that some of this is already underway, particularly in the planning and exercising arena. I am most aware of this in the health (ESF-8) domain where the regional staff of ASPR has been working to jointly plan and assess efforts in most of the HHS regions in direct partnership with regional consortia of health entities both public and private. Standardized approaches to many challenges have been developed as a by-product of these joint activities (e.g, patient evacuation opera post Sandy reality in NYC). These standard approaches must be more formally and comprehensively developed to improve and make more efficient the preparednes/response/recovery enterprise.
Almost all of the discussants agreed that states can be more effective in their funding strategies if they invest in horizontal collaborative processes and entities. The collective impact where there is joint effort is increasingly clear and return on investment can be improved by further elaboration and strengthening of these consortia.
A corollary to this is for governments at all levels to increase the means for direct private sector involvement in these joint efforts. There is a clear but under appreciated role for private entities and means to provide them a greater role and incentive to participate not only in preparedness and response, but active recognition of their central role in recovery will greatly enhance the resiliency of regions and localities. Where the private sector has been given a clear role and support, the response and recovery processes have been significantly enhanced. The events around the tornado strike in Joplin, Missouri demonstrated this quite effectively.
In summary, I would encourage all in the preparedness/response/recovery arena to read this report. It is unique in that it approached the issues through the lens of regional efforts at joint planning and activities. It is powerful in providing clear and do-able recommendations for governmental activity, especially at the federal level in acting to support and improve the resiliency at the local and regional level. It is timely in that its importance is underscored by the impact of Hurricane Sandy and the transition to the next Administration no matter the outcome of the election. A good process and a good product that now demands action.
About the DomPrep Action Plan
The Action Plan, produced by Domestic Preparedness, presents key findings from thought leaders in government, non-government, and private sector organizations concerning the resiliency of the United States. The report presents findings from six regional workshops conducted across the nation from throughout 2012 wherein preparedness practitioners discussed current resilience efforts and outstanding needs. This is a must-read report about the security and safety of this nation, providing powerful, clear and actionable recommendations for improving resiliency at the local and regional levels. 
About Dr. Vanderwagen
From August 2006 until July 2009, Dr. Vanderwagen was the founding Assistant Secretary for  Preparedness and Response (ASPR), U.S. Department of Health and Human Services. In this role he was responsible for the leadership and development of a new organization whose mission was preparing the Nation for response and recovery from public health and other health disasters whether natural or manmade. The organization was initiated after hurricane Katrina and formalized after the passage of the Pandemic and All Hazards Preparedness Act.
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