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NIMS 3.0 | Healthcare Coalitions In Play

NIMS 3.0 | Healthcare Coalitions In Play

Note: This is Part 3 of a 3-Part Series. Read Part 1 Here...

NIMS 3.0 is the first new version in nearly a decade; it's the first version not drafted under duress, it's the first version signed by the FEMA Administrator and, as it should be, it's by far and away FEMA's best work. So why are leaders of healthcare coalitions– the sub grantees of the Hospital Preparedness Program (HPP) cooperative agreement– far less interested than emergency managers and public health preparedness pros? Maybe it's because a healthcare coalition has more in common with Walmart than with them.

Yes, the healthcare coalition has more in common with the Walmart Emergency Management Center than it does the local Emergency Operations Center. Really! Hold that thought. We'll get back to it.

In part one we explained that NIMS 1.0 was a mandate under Homeland Security Directive (HSPD) #5 and that it had to be drafted on the fast-track during one of the Nation's most chaotic periods. And in part two we learned that NIMS 2.0 was forced by the botched response to Hurricane Katrina and the Post-Katrina Emergency Management Reform Act. Yes, both documents were drafted under duress. Both had to be done in a hurry. 

So, you ask,  "what about NIMS 3.0, what happened to force the revision of NIMS 2.0?" Well, nothing. "Nothing?" you say "What about Hurricane Sandy?" Sounds like a rational argument, but from a federal and state perspective, the response to Hurricane Sandy was not a trainwreck. Clearly, there were some weak assumptions made in planning and too many mitigation oversights, but the 'response' was publicly acclaimed. In fact, unlike the Post-Katrina Emergency Management Reform Act, as its name implies, the Sandy Recovery Improvement Act was all about, well, recovery, not response.

So, I guess it's fair to say that the revision of NIMS 2.0 was a choice, not a mandate. Maybe that's why FEMA was able to work on it for five years, starting under one administration and publishing under the next? Maybe that's why they had time to release a draft and engage in a full public vetting process?

NIMS 3.0 & the MAC Group

So, what's different between, NIMS 2.0 and NIMS 3.0:

  • Fewer Sections: Dropped from 6 to 4
  • Fewer Pages: Dropped from 168 to 131
  • Added third NIMS principle, "Unity of Effort" (Joins Standardization and Flexibility).
  • Dropped Component I, Preparedness.
  • Dropped Component V, Ongoing Management and Maintenance.
  • Changed the Name of the  "Command & Management" section to "Command & Coordination."
  • Yada, yada, yada

Interesting list, but nothing earth-shattering, right? Well, as Lee Corso likes to say on ESPN College Gameday, "Not so fast my friend." You see, there are a few other changes that shake things up and bring organizations like healthcare coalitions and Walmart into the NIMS discussion. Let me introduce you to the MAC Group.

On page 40, under Command & Coordination, which was once Command and Management, NIMS 3.0 added a fourth NIMS functional group titled Multiagency Coordination Group (MAC Group). The MAC Group joins the Incident Command System (ICS), Emergency Operations Center (EOC), and Joint Information System (JIS) as a functional group.

Now, don't confuse the MAC Group with the Multiagency Coordination System (MACS). The MACS is not one of the functional groups but is instead an overarching structure that, when necessary, coordinates the four functional groups. Or as they put it in NIMS 3.0, the MACS is "[a]n overarching term for the NIMS Command and Coordination systems: ICS, EOCs, MAC Group/policy groups, and JISs."

Mac Groups are part of the off-site incident management structure of NIMS. They are, "sometimes called policy groups, typically consist of agency administrators or executives from organizations or their designees (emphasis added)," per NIMS 3.0. "MAC Groups provide policy guidance to incident personnel, support resource prioritization and allocation, and enable decision making among elected and appointed officials and senior executives in other organizations (emphasis added) as well as those directly responsible for incident management."

Note that on page 47 they've also replaced a subsection within Command & Coordination titled "Relationships Among Command and Management Elements" with "Interconnectivity of NIMS Command and Coordination Structures." Yes, those "structures" could be private coordinating structures like a healthcare coalition's catastrophic medical operations center or Walmart's regional EOC.

The interconnectivity section states that "[t]he interconnectivity of NIMS structures allows personnel in diverse geographic areas with differing roles and responsibilities and operating within various functions of ICS and/or EOCs to integrate their efforts through a common set of structures, terminology, and processes."

So, you ask, "Why are these subtle changes such a paradigm shift? I mean, they've only added a single functional group to the NIMS Structure."  Well, because by acknowledging that private organizations operating outside the traditional NIMS zone of interest have a position of consideration, the emergency management community can begin to understand their role, appreciate their value, and start to integrate them into their systems– but not under their systems.

These organizations, now considered MAC Groups in NIMS 3.0 (Regardless of what organizations title them), are often the EOCs of private companies and organizations that are critical to an effective response and timely recovery. But they do not fall under the command of emergency management. Think of them as bonus resources available during crisis,' and all you gotta do to get em' is get the power restored, the roads open, and get the !@C# out of the way.

Karl Schmitt, MPA

Karl Schmitt, MPA


Karl is the Passionate Founder & CEO of bParati. He is on a mission to build a national network of effective, sustainable healthcare coalitions. More...

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Karl Schmitt, Passionate Founder & CEO, bParati

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