Memorandum

May 26, 2006


TO:	Hospital Administrators, State and Local Emergency Managers and Public Health Directors:  

FR:	Albert H Fluman, Acting Director, NIMS Integration Center, DHS/FEMA
	CDR Melissa Sanders, Branch Chief, Bioterrorism Hospital Preparedness, HRSA, HHS	

We recognize that there has been growing confusion over the NIMS compliance requirements placed 
upon hospitals and other healthcare facilities. This was unintended and we are writing now to try 
providing definitive clarification on the issue.  
   
We applaud local and state government efforts to be compliant with the original 2004 NIMS 
compliance guidance by the September 2006 deadline. That guidance and the deadline are not being 
altered. It is important to note that hospitals and healthcare facilities are not government agencies and 
were not included in the original compliance expectation. However, because hospitals are partners in 
planning for and responding to emergency situations, compliance guidance is appropriate and 
necessary to insure optimum integration and preparedness.  
   
To date, compliance requirements for hospitals and other healthcare facilities have not yet been 
promulgated by the NIMS Integration Center. A draft NIMS Compliance Expectations for Hospitals 
has been devised and is in the final stages of approval. Once approved over the next 45 days, the new 
NIMS Compliance for Hospital Guidance will be widely disseminated via several strategies including 
publication in the FY 2006 HRSA Guidance. The information will also be emailed to appropriate 
national organizations such as the American Hospital Association, the Joint Commission for 
Healthcare Organizations, the International Association of Emergency Managers, the National 
Association of City and County Health Officials and the Association of State and Territorial Health 
Officials. It will also be posted on the NIC web page.      
   
We recognize that clear, concise and cost-effective federal guidance on this matter is imperative for the 
hospitals, emergency managers and public health officials. It is anticipated the pending guidance will 
provide needed direction that will advance individual hospital and healthcare preparedness while at the 
same time better insure these efforts are effectively integrated into the overall community planning 
effort. 

NIMS compliance activities for hospitals will be phased in over the next 2 years; compliance with the 
first set of activities outlined in the HRSA National Bioterrorism Hospital Preparedness Program 
guidance will be September 30, 2007. 
 
It is our intention that this information and the pending guidance about to be released will alleviate the 
misinformation and misunderstandings that have regretfully arisen. We also hope that rather than each 
state imposing their own NIMS compliance requirements on the hospital and health care community 
the new guidance should be reviewed and used as a means of establishing a nationwide template to 
enable Federal, State, local, and tribal governments and private-sector and nongovernmental 
organizations to work together effectively and efficiently to prepare for, prevent, respond to, and 
recover from domestic incidents, regardless of cause, size, or complexity.  
 
We thank you for your understanding and look forward to our continued work together on these issues.

Sincerely,



Albert H Fluman					CDR Melissa Sanders
Acting Director					Branch Chief			
NIMS Integration Center				Bioterrorism Hospital Preparedness 
Federal Emergency Management Agency		HRSA
Department of Homeland Security			Department of Health and Human Services


					 


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