Post 9/11, 2001 a group of seasoned (old) like-minded healthcare professionals met to discuss how we could make some meaningful contribution to the nation’s strategy for Homeland Security protection. Our first task centered on finding the answer to the question “Is the non-federal hospital and healthcare industry prepared to meet its expected roles and responsibilities as full partner in this effort?â€

A nine month self-funded research study revealed that the industry was ill prepared to deal with known threats posed by this new hostile environment and had little appetite to make the changes necessary to achieve a meaningful level of voluntary compliance.

The overarching challenge is that the non-federal healthcare industry owns or operates up to ninety-percent (90%) of the nation’s healthcare delivery capacity. Successfully responding to the healthcare needs associated with Weapons of Mass Destruction (WMD) events would place a heavy reliance on the nation’s private sector resources.

Weak Congressional oversight of the Healthcare Industry, poor stewardship within Department of Health and Human Services (DHHS) Center for Medicare and Medicaid Services (CMS) and confusion over the Department of Homeland Security’s Federal Emergency Management Agent (DHS-FEMA) operational authority for the Public Health and Healthcare Sector handicaps the formation of an effective response effort.

Our “boots on the ground†experiences with all-hazards assessment of hospitals across the nation convinced us that the weakest link in the Healthcare readiness posture is found within the DHHS/CMS and DHS/FEMA nexus. Both have oversight responsibilities for the Public Health and Healthcare Sector and both depended on a system which relies on self-reporting from States and CMS contracted entities tasked with detailed external evaluation assessments for healthcare quality, safety and security.

Congressional concern over the lack of guidance for implementation of a number of the 9/11 Commission Recommendations on private sector preparedness surfaced in the form of Public Law 110-53, “Implementing Recommendations of the 9/11  Commission Act of 2007â€. In part, it required the Department of Homeland Security to establish a common set of criteria for private sector preparedness in disaster management, emergency management and business continuity.

This brings us to the point:

The department published a notice in the Federal Register seeking public comment on its proposed pan for implementing separate classifications and methods of certification under PS-Prep. Comments would be submitted to FEMA-POLICY @dhs.gov in Docket ID FEMA-2008-0017.  We made a goodwill effort to contribute to this “open†process of review by submitting this set of comments.

Thus started one of the most bizarre events in my long and tumultuous career. The usual timely notification of receipt did not materialize. Follow-on calls indicated that it had not been received and was asked to forward another copy of the comments. The following day I receive an e-mail informing me that both had been rejected- “this e-mail has violated the Racial Discrimination Quarantine entire message has been taken offâ€. We sent the comments to professional colleagues within and outside of government to identify what could have been identified as a racial slur. None was identified including those sent to American National Standards Institute (ANSI).

We contacted the National Accreditation Board (ANAB) our final stop was with the ANAB IT Director. Asked how this could happen, he said that a message could be blocked for obscene or offensive remarks. Asked for an example of a racially offensive word or phrase he replied “cotton pickingâ€, numbed by the experience, I ended the conversation. Not only did the words “cotton†or “picking†not appear in the text, peer review by several colleagues including those mentioned above found nothing that could be construed to be either racial or offensive. To date there has never been any official answer as to the offending content.

The reality that a formally submitted comment, on a time-sensitive review in the Federal Register could fall victim to a Content Filtering Device is outrageous and contrary to the whole process of requesting input. We would also pose the question that if it is happening at DHS without ability to escalate to a final answer, where else is the citizen’s voice being summarily dismissed?

We invite your thoughts on this issue…Jim