Abstract
This dissertation in practice explored the various challenges the federal government faces with providing support to local governments and jurisdictions during a public health emergency. The federal government’s policies are expected to advance the public’s welfare and safety. A critical piece of these guidelines is preparing the nation for potential emergencies requiring federal assistance. The National Response Framework (NRF) is an essential document that offers guidance for offering a coordinated response during a national level emergency. Specifically, the NRF outlines how federal agencies collaborate with state, tribal, local, and territorial (STLT) agencies during crises requiring federal assistance. This qualitative comparative case study examines two separate public health emergencies requiring federal assistance. This methodical examination attempts to comprehend why the federal government (specifically the Department of Health and Human Services (HHS)) has difficulties with emergency preparation for local governments. Frequently, HHS’s vast resources and capabilities do not translate into effective public health and emergency preparedness. During the course of this study utilizing semi-structed interviews with public health professionals, three distinct themes emerged to why this gap in capabilities and capacities continues to be a challenge for public health emergency response. These three themes included the vast (1) Number of state, local and territorial requiring public health support, (2) Rigidity in federal plans and funding inhibiting the local health departments abilities to manage and use federal resources, and (3) Funding disparities and capacities at local health departments are unique challenges in providing effective federal support to state, tribal, local, and territorial agencies. Based on the data collected, there are three key opportunities to close this gap. First, enhancing federal collaboration between HHS and local governments to synchronize public health emergency preparedness priorities. Second, enhance public health emergency preparedness training opportunities at the local levels. Lastly, Confronting the rigidity of federal funding and planning requirements so local jurisdictions can tailor the federal assistance to their specific areas.