3The health system includes all parts of the health care delivery system (e.g., primary and hospital care, disaster
medicine, and behavioral health care) and the public health system. The emergency services system includes police,
fire, emergency medical services, and emergency management.
4 As defined in section 2802(b)(4)(B) of the PHS Act, at-risk individuals include “children, pregnant women, senior
citizens and other individuals who have special needs in the event of a public health emergency, as determined by
the Secretary.” For purposes of this document, the category of at-risk individuals also includes individuals who may
need additional response assistance during an emergency, such as persons who have disabilities, live in
institutionalized settings, are from diverse cultures, have limited English proficiency or are non-English speaking,
are transportation disadvantaged, have chronic medical disorders, or have pharmacological dependency. See also
the definition in Appendix C Glossary of Key Terms.
5Section 319C-1(g)(1), of the Public Health Service (PHS) Act (42 U.S.C. 247d-3a(g)(1)), as amended by section
201 of the Pandemic and All-Hazards Preparedness Act (PAHPA), Public Law No. 109-417, requires that standards
be developed to measure levels of preparedness with respect to activities carried out by recipients of the Centers of
Disease Control and Prevention’s Public Health Emergency Preparedness (PHEP) grants and the Assistant Secretary
for Preparedness and Response’s Hospital Preparedness Program (HPP) grants. “Not later than 180 days after the
date of enactment of the Pandemic and All-Hazards Act, the Secretary shall develop or where appropriate adopt, and
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which the Nation is prepared for the types of health incidents that we have experienced in the
past and may have to confront in the future.
A Vision