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Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us (2014)

Chapter: Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection

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Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
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Appendix E


Public- and Private-Sector Approaches
to Workforce Health Protection

The committee reviewed several relevant examples of public- (government) and private-sector approaches to workforce health protection during the course of the study. Those examples are discussed briefly in this appendix.

APPROACHES IN FEDERAL AGENCIES

Smithsonian Institution

The Smithsonian Institution is the world’s largest museum and research complex, comprising 19 museums and galleries; the National Zoological Park; 9 research facilities; 184 affiliate museums; and the Museum Support Center, which serves as a storage, research, and conservation facility. In 2005, to address the Secretary’s goal of a zero-injury workplace, and in accordance with the idea that “safe employees stay well and well employees stay safe,” safety and employee health programs were organizationally aligned under the Office of Safety, Health, and Environmental Management (OSHEM) (Duval, 2013). Museums and other entities belonging to the Smithsonian Institution do not have their own health and safety staff; therefore, OSHEM provides centralized services in addition to its role of establishing policies and standards (Duval, 2013). The director of OSHEM reports to the director of Facilities, Engineering and Operations, who serves as the Designated Agency Safety and Health Official (DASHO) and reports directly to the Undersecretary for Finance and Administration (Duval, 2013; Smithsonian Institution, 2006).

Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×

National Aeronautics and Space Administration

The National Aeronautics and Space Administration (NASA) conducts its work in four primary areas: aeronautics, human exploration and operations, science, and space technology. To ensure the health of its workforce, NASA aligned all health and medical activities, including aerospace medicine, occupational medicine, environmental health, health physics, physical fitness and health promotion, workers’ compensation, and employee assistance, under the Chief Health and Medical Officer (CHMO), who also serves as the DASHO (NASA, 2010b). Designated as NASA’s Health and Medical Technical Authority, the CHMO is independent of programs and projects, including the Mission Support Directorate under which Human Capital Management resides. This independence allows for “a check and balance to ensure all NASA programs and projects are developed and managed in a way that does not jeopardize the health and well being of NASA personnel,” and enables the CHMO to enforce standards that must be met by all programs and projects (NASA, 2010a). A second independent office, the Office of Safety and Mission Assurance, has responsibility for NASA’s occupational safety program (NASA, 2013). The two office chiefs report directly to the Chief of Staff and come together on the Agency Mission Support Council,1 which “serves as the executive board responsible for addressing the NASA occupational safety and health program” (NASA, 2012).

Department of the Interior

The Department of the Interior (DOI) comprises eight bureaus with a wide variety of responsibilities, including the management and conservation of most federal lands and natural resources. Within its ranks, DOI employs approximately 7,000 law enforcement officers and 15,000 wildland firefighters (Garbe, 2013). Organizationally, DOI has aligned most of its workforce health protection reporting structures at the departmental level, placing its Occupational Health and Medical Programs Division within the Office of Occupational Safety and Health. It was reported to the committee that integration of these functions has increased the emphasis on safety within the department’s medical programs (Garbe, 2013). The Office of Occupational Safety and Health sits organizationally alongside the Office of Civil Rights, the Office of Human Resources, and the Office of Strategic Employee and Organization Development, all of which fall under the direction of the Deputy Assistant Secretary for Human Capital and Diversity (DOI, 2013). Human Resources plays a supporting role by maintaining employee occupational health records and ensuring that

__________________

1Also referred to as the Operations Management Council.

Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×

appropriate workers’ compensation forms are completed and processed in coordination with the Office of Occupational Safety and Health (DOI, 2009). The Office of Occupational Safety and Health provides guidance to the component agencies through the Occupational Medicine Handbook, which covers all of the occupational health issues in which the department is involved, including safety, industrial hygiene, and medical clearance. The department-level program focuses on overarching policy concerns and program development. Program implementation is left to the bureaus within broad guidelines established by headquarters (Garbe, 2013).

To assist in coordination among the bureaus and vertically between headquarters and the bureaus, DOI created a number of councils and working groups. The DOI Safety and Occupational Health Council brings together bureau safety and health managers and serves as an advisory body to the DOI DASHO and the DASHO Council (DOI, 2012). The DASHO Council, comprising the departmental DASHO and bureau DASHOs, “provide[s] executive level bureau and office involvement in the formulation of policy and the management of the Departmental Safety and Health Program … [and] determine[s] collective action to achieve the Departmental Occupational Safety and Health Strategic Plan” (DOI, 1996). More information on DOI’s approach to workforce health protection is presented in the DOI case study in Chapter 3, Box 3-6.

Department of State

The Department of State (DoS) is responsible for U.S. foreign relations. Given its international mission, a large proportion of the workforce is stationed overseas. Health protection functions fall within the purview of the Office of Medical Services (OMS), Bureau of Administration, Bureau of Overseas Building Operations, and Bureau of Human Resources, all of which are organizationally aligned under the Under Secretary for Management. Led by the Medical Director, who also serves as the DASHO, OMS has as its primary function addressing the health needs of DoS employees stationed overseas, although health services also are made available to members of other federal agencies posted overseas, such as DHS and the Federal Bureau of Investigation (FBI) (Quillin, 2013). OMS’s overseas health units provide a wide variety of services to the workforce, including occupational health services, travel immunizations, routine care, direct primary care, and chronic health care. OMS also leads departmental emergency preparedness, operational medicine, and medical clearance programs. Safety and health functions are carried out domestically by the Domestic Environmental and Safety Division in the Bureau of Administration and overseas by the Office of Safety, Health and Environmental Management (OSHE) in the Bureau of Overseas Building Operations (DoS, 2012). Through the DASHO and

Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×

DASHO Operations Office, OMS works closely with both to coordinate departmental occupational safety and health efforts (DoS, 2012; Quillin, 2013). Whereas global health, medical, and occupational safety and health functions are aligned through OMS and the Medical Director, other health-related functions, including workers’ compensation and some wellness issues, fall under Human Resources.

Department of Defense

The Department of Defense (DoD) is the largest U.S. government agency, with more than 1.4 million active-duty service members and 718,000 civilian personnel (DoD, 2013a). The department is composed primarily of four military branches—the Army, Navy, Marine Corps, and Air Force—with the ability for a fifth, the U.S. Coast Guard, to operate under DoD during times of war. A number of additional defense agencies function under the Office of the Secretary of Defense.

Differing from civilian organizations, DoD is responsible for the complete health care of active-duty personnel, which is provided through its managed health care system, TRICARE, and in military treatment facilities (Cecchine et al., 2009). DoD also faces unique challenges, such as ensuring the safety and health of service members who are deployed, operating uniquely military equipment, facing mental and physical exposures not traditionally encountered during the course of employment, and often working outside of traditional work hours (Cecchine et al., 2009).

At the headquarters level, responsibilities for workforce health protection fall under two separate Under Secretaries of Defense: the Under Secretary of Defense for Acquisition, Technology and Logistics and the Under Secretary of Defense for Personnel and Readiness. The Office of the Under Secretary of Defense for Acquisition, Technology and Logistics is responsible primarily for occupational safety and health policy, focusing on a variety of areas including ergonomics, hearing conservation, industrial hygiene, fire and emergency medical services (EMS), and occupational medicine. The Office of the Under Secretary of Defense for Personnel and Readiness is responsible for DoD’s medical programs, including the budget and administration of the Defense Health Program (Cecchine et al., 2009). Under Personnel and Readiness, the Deputy Assistant Secretary of Defense for Clinical and Program Policy is responsible for occupational health programs outside of deployed theater, including standards and procedures that govern DoD clinical programs, clinical informatics, medical standards for accessions and separations, military public health, women’s health issues, quality management, DoD health and fitness promotion, medical ethics, mental health policy, patient advocacy, graduate medical education programs, and patient safety (Cecchine et al., 2009; DoD, 2014a). The

Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×

Deputy Assistant Secretary of Defense for Force Health Protection and Readiness is responsible for deployment medicine, force health protection, medical readiness, international health agreements, deployment-related health policy, theater information systems, humanitarian and health missions, and national disaster support (Cecchine et al., 2009; DoD, 2014b). These two offices are brought together by a number of working groups, including members from across the Office of the Secretary of Defense, the joint staff, and the branches. Chartered in 2003, the Defense Safety Oversight Council, chaired by the Under Secretary of Defense for Personnel and Readiness, helps integrate the offices and “provide[s] governance on DoDwide efforts to reduce preventable mishaps.” (DoD, 2013b)

APPROACHES IN PRIVATE INDUSTRY

General Electric Energy

General Electric (GE) is composed of three primary divisions: GE Energy, GE Technology Infrastructure, and GE Capital. GE Energy has a workforce of 110,000 employees operating in 140 countries, generating about half of the world’s energy, filtering 10-15 percent of the world’s water, and creating technologies for and providing services to the oil and gas industries. Employees take approximately 100,000 overseas business trips to 185 countries each year, many in remote and challenging work environments, such as Angola in Southwest Africa, Siberia, and the Amazon. To address its global operational scope, GE Energy created its traveler health program, aligning preproject planning, pretravel health assessment, wellness programs, eLearning tools, health incident planning, remote site medical services, and prevention activities. GE Energy spends significant time and resources on planning and assessment to ensure that it can protect the health and well-being of employees deployed to hazardous work environments. Before project bids are made, GE Energy engages in the Intent to Order process, examining the risks associated with a bid, including the level of access to medical care in the region, before determining whether a bid should be made and how it should be priced. Once a bid has been priced, during the postbid Order to Remittance process, risk assessments are conducted for each task on a variety of potential issues, including biological, chemical, radioactive, physical, and stress risks, to determine potential impacts. As part of the planning process, specific incidents also are planned for, including a variety of incidents that could require routine, minor acute, urgent, and chronic care. Every trip and employee also is assessed before deployment. Medical Services staff conduct pretravel employee health assessments and make occupational medical preparations that encompass vaccines, chemoprophylaxis, and diagnostic and treatment

Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×

kits. Individuals are assessed to ensure that they are not at risk and have access to whatever they need as a result of a medical condition before they deploy (Hoffman, 2013).

Through use of a centralized ticketing system, employees are not issued tickets for travel to non-Western countries until a health assessment has been conducted. GE has more than 100 on-site clinics that provide employees with medical services; these clinics must be able to handle minor acute, chronic, urgent, and emergency medical problems, including plans for evacuation. With work being conducted in many remote areas, however, it is also important to ensure access to medical care where an on-site clinic is not feasible. To this end, GE prequalifies providers and works with third-party providers such as International SOS, Europ Assistance, Advanced Medical, and Best Doctors to ensure that employees have access to quality medical care wherever they deploy. GE often engages in cooperative agreements with other companies with employees in the region for the provision or sharing of services. In recent years, telemedicine and cloud-based medical records have increasingly been used to support medical services in remote destinations (Hoffman, 2013).

Procter & Gamble

Procter & Gamble (P&G) is the largest nonfood consumer products business in the United States and the largest household and personal care business in developing markets, with more than 300 brands sold in 180 countries and a workforce consisting of 121,000 employees working in approximately 70 countries (P&G, 2013). Workforce health has been a concern for the company since 1919, when P&G hired its first full-time physician. Today, P&G provides health services to its employees through 180 clinics in 46 countries, employing 489 full- and part-time occupational health nurses, physicians, and administrative personnel in its Global Medical program. The P&G Global Employee Health & Wellness Policy ensures that a workforce health framework is in place, using an audit and report process and a global medical scorecard to ensure compliance with corporate standards for all sites, consistent procedures and training, and compliance with all health-related laws and regulations. Through the Vibrant Living program, Global Medical has consolidated all health and wellness activities into a single global program, instituting a health and wellness policy designed to ensure that all employees will have access to occupational health services locally, wherever they are located, either directly through P&G clinics or through a contracted provider. Global Medical also has created a steering team for Vibrant Living, bringing together leadership from both functional (human resources, manufacturing, research and development) and regional offices to help inform the direction of the program. Whereas

Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×

Global Medical is located within Human Resources, the Industrial Hygiene, Safety, and Environment program is housed separately under Manufacturing. However, systems and processes are in place to ensure timely information sharing between the two and coordination as necessary, including a shared oversight council. Global Medical also works closely with Global Security on travel medicine and executive protection (Christensen, 2013).

Superior Energy Services

Superior Energy Services provides a variety of specialized services to oil and gas operations, including those focused on responding to disasters and fires and mitigating risk. At the heart of Superior Energy is a team of 600 response employees, supported by 15,000 employees, which can quickly deploy to respond to disasters, assess sites, mitigate further risks, and provide operational support to private and government contractors. With operations in widely varying environments, Superior Energy saw a need to take an all-encompassing view of health for its team members operating in an international environment, who often travel directly from one international site to the next without returning home. Accordingly, the company consolidated functions related to occupational safety and health, fitness for duty, wellness, and return to work, and created standardized protocols and procedures company-wide. However, because of the international scope of its operations and the variety of regulations with which it must comply, Superior Energy has taken a hybrid approach. The standards it has created are not overly prescriptive, leaving sufficient flexibility to meet local needs. The company employs 24 physicians as part of its global medical direction cohort, operating in 17 global offices on 6 continents, with systems in place to ensure collaboration and coordination (Minson, 2013).

Johnson & Johnson

Johnson & Johnson (J&J) is the world’s sixth largest consumer health company, employing approximately 128,700 people worldwide. J&J consists of more than 275 operating companies, small and large, in 60 countries, each with its own leadership structures (J&J, 2013). Because of this decentralized nature, delivery of health services to employees is a challenge. Since 1995, J&J has taken a fully integrated approach to employee health and wellness services in the United States and Puerto Rico, centralizing occupational medicine, disability management, benefit plan design, mental well-being, and wellness activities under a single umbrella. With the success of this model, J&J currently is working to centralize all global medical services under the corporate umbrella as well. These services have been centralized under the Vice President of Global Health Services, who reports

Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×

through human resources, but occupational safety and health remains separate, reporting though supply chain operations. To ensure coordination between these functions, J&J created the Environmental Health and Safety Leadership Council, bringing leadership together to address high-level, cross-cutting issues related to the creation of organizational policies and standards. Similar teams operate at the local level, bringing together occupational health physicians and/or nurses; site safety managers; and wellness, employee assistance, and industrial hygiene professionals (Isaac, 2013). More information on the J&J approach to workforce health protection is presented in the J&J case study in Chapter 3, Box 3-7.

Johns Hopkins Institution

Johns Hopkins, a large, multicenter academic and medical institution, consists of The Johns Hopkins University and the Johns Hopkins Health System, employing more than 53,000 faculty and staff among the university, six academic and community hospitals, and four suburban health care and surgery centers (Johns Hopkins, 2011). In 1991, all activities related to occupational safety and health were consolidated into a single office, bringing together four independent entities—the Office of Workers’ Compensation, Occupational Health Services, the Office of Safety and Environmental Health, and the Employee Assistance Program—under a single office, Health, Safety and Environment (HSE). The activities of HSE are carried out by nine departments: Safety Management, Biosafety, Radiation Safety, Environmental Health Services, Workers’ Compensation Office, Workers’ Compensation Clinic, Faculty and Staff Assistance Program, and Occupational Health Services. The Director of HSE also chairs the Joint Committee for Health, Safety and Environment, reporting directly to the CEO of Johns Hopkins Medicine and the President of Johns Hopkins Health System. The objective of this joint structure is the management of risk in three primary areas: “(1) risk related to non-compliance with federal and state regulations, (2) risk related to workers’ compensation losses and; (3) risk related to working in a potentially hazardous environment” (Bernacki, 1999). Of particular note, the alignment of workers’ compensation with other health-related functions brought a philosophical change to claims management: “all individuals who were stakeholders (e.g., safety professionals, medical and nursing professionals, adjusters, and attorneys) were expected to add their expertise and became active participants in the claims process.… The program adopted a nonadversarial stance, encouraged early reporting, patient advocacy, facilitation of care, and preventive measures as primary strategies in managing claims” (Bernacki and Tsai, 2003, p. 510).

Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×

REFERENCES

Bernacki, E. J. 1999. The organization and management of a medical center’s occupational health, safety and environmental program. In Medical center occupational health and safety, edited by R. J. McCunney and C. S. Barbanel. Philadelphia, PA: Lippincott, Williams & Wilkins. Pp. 373-390.

Bernacki, E. J., and S. P. Tsai. 2003. Ten years’ experience using an integrated workers’ compensation management system to control workers’ compensation costs. Journal of Occupational and Environmental Medicine 45(5):508-516.

Cecchine, G., E. M. Sloss, C. Nelson, G. Fisher, P. R. Sama, A. Pathak, and D. M. Adamson. 2009. Foundation for integrating employee health activities for active duty personnel in the Department of Defense. Santa Monica, CA: RAND Corporation.

Christensen, C. 2013. Occupational medicine at P&G. Presentation at IOM Committee on DHS Occupational Health and Operational Medicine Infrastructure: Meeting 2, June 10-11, Washington, DC.

DoD (Department of Defense). 2013a. About the Department of Defense (DoD). http://www.defense.gov/about/ (accessed January 8, 2014).

DoD. 2013b. Initiatives: System safety. http://www.acq.osd.mil/se/initiatives/init_safety.html (accessed January 8, 2014).

DoD. 2014a. Clinical and program policy. http://www.health.mil/About-MHS/Organizational-Overview/Clinical-and-Program-Policy (accessed January 8, 2014).

DoD. 2014b. What is force health protection and readiness? http://home.fhpr.osd.mil/about/what-is-fhpr.aspx (accessed January 8, 2014).

DOI (Department of the Interior). 1996. Designated safety and health official council charter. In The departmental manual. Part 485: Safety and Occupational Health Program, safety management. Washington, DC: DOI. http://www.doi.gov/safetynet/information/councils/charters/dasho.html (accessed December 17, 2013).

DOI. 2009. Occupational medicine program handbook. Washington, DC: DOI.

DOI. 2012. Department safety and occupational health councils, committees, and working groups. In The departmental manual. Part 485: Safety and Occupational Health Program, safety management. Washington, DC: DOI. http://elips.doi.gov/ELIPS/DocView.aspx?id=1652&dbid=0 (accessed December 17, 2013).

DOI. 2013. Deputy assistant secretary—human capital and diversity. http://www.doi.gov/pmb/hcd/index.cfm (accessed December 17, 2013).

DoS (Department of State). 2012. 16 FAM 610: Administration of the DASHO program. In U.S. Department of State foreign affairs manual. Washington, DC: DoS.

Duval, J. 2013. Smithsonian Institution occupational health services. Presentation at IOM Committee on DHS Occupational Health and Operational Medicine Infrastructure: Meeting 2, June 10-11, Washington, DC.

Garbe, B. 2013. Department of the Interior medical clearance programs. Presentation at IOM Committee on DHS Occupational Health and Operational Medicine Infrastructure: Meeting 2, June 10-11, Washington, DC.

Hoffman, B. 2013. Global travel preparation at General Electric Energy. Presentation at IOM Committee on DHS Occupational Health and Operational Medicine Infrastructure: Meeting 2, June 10-11, Washington, DC.

Isaac, F. 2013. Work, health, and productivity: The Johnson & Johnson story. Presentation to IOM Committee on DHS Occupational Health and Operational Medicine Infrastructure: Meeting 2, June 10-11, Washington, DC.

J&J (Johnson & Johnson). 2013. About Johnson & Johnson. http://www.jnj.com/about-jnj (accessed November 12, 2013).

Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×

Johns Hopkins. 2011. The Impact of Johns Hopkins in Maryland. http://web.jhu.edu/administration/gcpa/EIR_PDFs/15358%20Maryland1PgSumPrinterProof.pdf (accessed January 9, 2014).

Minson, M. 2013. Occupational health at Superior Energy Services. Presentation at IOM Committee on DHS Occupational Health and Operational Medicine Infrastructure: Meeting 2, June 10-11, Washington, DC.

NASA (National Aeronautics and Space Administration). 2010a. OCHMO technical authority. http://www.nasa.gov/offices/ochmo/techauth/index.html#.UswT2_uFdhA (accessed December 17, 2013).

NASA. 2010b. Policy directive: NASA occupational health program. NPD 1800.2C. Washington, DC: NASA.

NASA. 2012. NASA occupational safety and health programs. NPR 8715.1A. Washington, DC: NASA.

NASA. 2013. Office of safety and mission assurance. http://www.hq.nasa.gov/office/codeq (accessed December 17, 2013).

P&G (Procter & Gamble). 2013. Annual report. Cincinnati, OH: The Procter & Gamble Company.

Quillin, W. 2013. Occupational health at the Department of State. Presentation at IOM Committee on DHS Occupational Health and Operational Medicine Infrastructure: Meeting 2, June 10-11, Washington, DC.

Smithsonian Institution. 2006. Smithsonian Institution safety and health program. Directive 419. Washington, DC: Smithsonian Institution.

Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×
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Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×
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Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×
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Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×
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Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×
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Suggested Citation:"Appendix E: Public- and Private-Sector Approaches to Workforce Health Protection." Institute of Medicine. 2014. Advancing Workforce Health at the Department of Homeland Security: Protecting Those Who Protect Us. Washington, DC: The National Academies Press. doi: 10.17226/18574.
×
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×
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×
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×
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×
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The more than 200,000 men and women that make up the Department of Homeland Security (DHS) workforce have been entrusted with the ultimate responsibility - ensuring that the homeland is safe, secure, and resilient against terrorism and other hazards. Every day, these dedicated individuals take on the critical and often dangerous challenges of the DHS mission: countering terrorism and enhancing national security, securing and managing the nation's borders, enforcing and administering U.S. immigration laws, protecting cyber networks and critical infrastructure, and ensuring resilience in the face of disasters. In return, DHS is responsible for protecting the health, safety, and resilience of those on whom it relies to achieve this mission, as well as ensuring effective management of the medical needs of persons who, in the course of mission execution, come into DHS care or custody.

Since its creation in 2002, DHS has been aggressively addressing the management challenges of integrating seven core operating component agencies and 18 supporting offices and directorates. One of those challenges is creating and sustaining a coordinated health protection infrastructure. Advancing Workforce Health at the Department of Homeland Security examines how to strengthen mission readiness while better meeting the health needs of the DHS workforce. This report reviews and assesses the agency's current occupational health and operational medicine infrastructure and, based on models and best practices from within and outside DHS, provides recommendations for achieving an integrated, DHS-wide health protection infrastructure with the necessary centralized oversight authority.

Protecting the homeland is physically and mentally demanding and entails many inherent risks, necessitating a DHS workforce that is mission ready. Among other things, mission readiness depends on (1) a workforce that is medically ready (free of health-related conditions that impede the ability to participate fully in operations and achieve mission goals), and (2) the capability, through an operational medicine program, to provide medical support for the workforce and others who come under the protection or control of DHS during routine, planned, and contingency operations. The recommendations of this report will assist DHS in meeting these two requirements through implementation an overarching workforce health protection strategy encompassing occupational health and operational medicine functions that serve to promote, protect, and restore the physical and mental well-being of the workforce.

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