Law enforcement typically maintains public order and exists to “serve and protect”; this mission must be understood within the context of society, politics, governance, and the criminal justice system. Despite incidents that demonstrate the importance of collaboration, law enforcement agencies rarely work closely with public health agencies on public health issues, and the same can be said regarding public health practitioners working with law enforcement. These two separate disciplines evolved based on differing motivations, lending them differing priorities and cultures. This has created a social distance between the two disciplines, which engage in occasional ad hoc collaboration with “mutual hostility.” However, these two disciplines have a common mission in the homeland security enterprise: to protect individuals from “ill-health, injury and unnatural or untimely death.”
During a large-scale public health emergency, law enforcement and public health practitioners will undoubtedly exhaust their resources rapidly. While the demands of the job will continually be there during the response, officers and public health practitioners must make contingency plans for when their staff members become ill, refuse to respond, or succumb to illness and pass away. The ability to properly respond to these types of emergencies relies heavily on planning and collaboration between law enforcement and public health agencies; by forming professional relationships, the two disciplines can bolster their response capabilities.
Terrorist groups continue to strengthen their forces, increasing the need for U.S. preparedness. A weapon of mass destruction (WMD) or homegrown violent extremist attack involves response efforts from both public health and law enforcement responders. While it is clear that investigation of terrorism is within the domain of law enforcement, public health officials can provide important information about the nature of biological and radiological agents during the investigation and response.
Fusion centers were created to house representatives from the array of homeland security enterprise agencies, with the sole purpose of gathering, analyzing, and then sharing potential threat intelligence with law enforcement agencies. Another method of formal intelligence gathering is the 104 Joint Terrorism Task Forces (JTTFs) that focus primarily on terrorism and “other criminal matters related to various aspects of the counterterrorism mission.” Fusion centers and JTTFs work together “to safeguard our homeland and prevent criminal and terrorist activities.”
Historically, public health practitioners have had difficulty receiving key information for response efforts, often because of information silos. In 2007, James Morrissey surveyed 22 fusion centers, 12 of which had established collaborations with the public health sector. However, the public health positions offered in these 12 fusion centers were mostly “minimal,” with only one full-time position. Today, roughly 10 years after Morrissey’s research, it is unknown how often, and to what extent, public health practitioners are involved in fusion centers nationally. A formal system is needed to ensure that the proper public health practitioners are receiving relevant threat information. The lack of a current system does not mean that those in public health do not seek information. Public health agents do seek information; but without a system in place, this information usually comes from informal intelligence sources (news media or social media) rather than formal sources (fusion centers, local law enforcement, and federal law enforcement).
Notably, the benefits of improving collaboration between the public health sector and fusion centers and JTTFs are not one-sided. Public health practitioners can act as subject-matter experts in fusion centers, especially for WMD threats such as chemical, biological, and radiological events. The research conducted for this thesis aimed to determine the current level of integration between public health and law enforcement by measuring the integration of public health considerations in fusion centers and JTTFs. Three distinct, but closely related, surveys were sent to fusion centers, JTTFs, and public health departments. The fusion center survey was sent to all 77 fusion centers across the country with a response rate of 29.87 percent. The public health survey was sent to 24 public health departments, with a response rate of 66.67 percent (16 responses). The JTTF survey was sent to 15 of the country’s 104 JTTFs, with a response rate of 20 percent (three responses).
Of the 23 responding fusion centers, four indicated they have public health representatives. However, based on the responses, it is questionable if three of these centers have a true public health component. Of the 16 responding public health departments, nine represented local departments and seven represented state departments; none of the local departments had representatives on the JTTF or in the fusion center, and seven state health departments indicated that they have a representative in the fusion center. Of those seven, however, only one representative holds a security clearance, so it is unclear the extent of the relationship between the remaining six state health departments and their respective fusion centers. Two state health departments indicated that they have representatives on their local JTTF, but responses later in the survey made their involvement questionable. While all three responding JTTFs value public health, none have a public health subject-matter expert serving on the task force.
The survey data indicate that fusion centers and JTTFs want to collaborate with the public health sector. However, there is less collaboration occurring between public health agencies and the other branches of the homeland security enterprise when compared to Morrissey’s 2007 research. The surveys indicate common issues inhibiting collaboration, including a lack of personnel, funding, and reciprocal awareness between the disciplines. Several of the public health respondents had difficulty differentiating fusion centers from JTTFs, while those in law enforcement continually equated public health with medicine. The surveys also revealed that it is difficult to integrate public health practitioners in JTTFs and some fusion centers because they are not sworn law enforcement officers.
Additionally, Department of Justice (DOJ) guidance has recommended including various disciplines in the homeland security enterprise. Although the DOJ published guidance to facilitate fusion center and public health integration in 2008, the surveys revealed that the majority of fusion centers have not implemented the DOJ capabilities.
This thesis proposes several policy recommendations to enable integration: removing the sworn law enforcement officer requirement for fusion center and JTTF staff, utilizing pre-existing positions to act as regional liaisons, establishing full-time public health positions in fusion centers, and reinstating the original grant amounts of the Public Health Emergency Preparedness grant program and the Homeland Security Grant Program. Notably, the recommendations to utilize pre-existing positions as regional liaisons and establish full-time public health positions are dependent on increased grant funding.
The public health issues over the past 15 years serve as a reminder to the homeland security enterprise. Ebola, Zika, Chikungunya, H1N1, seasonal influenza, the anthrax letters, and the emerging discipline of gene editing are all public health factors that affect homeland security. Improving information sharing through collaborative efforts is the first step in improving situational awareness and decision-making processes for public health leadership. The health implications of WMDs are catastrophic; the faster public health is aware of an issue, the quicker practitioners can respond to mitigate its impact.
 van Dijk and Crofts, 261.
 van Dijk and Crofts, 261.
 Brienne Lenart et al., “Integrating Public Health and Medical Intelligence Gathering into Homeland Security Fusion Centres,” Journal of Business Continuity & Emergency Planning 6, no. 2 (Winter 2012–Autumn 2013): 175.
 “Fusion Centers and Joint Terrorism Take Forces,” Department of Homeland Security, July 29, 2016, https://www.dhs.gov/fusion-centers-and-joint-terrorism-task-forces.
 Department of Homeland Security, “Fusion Centers and Joint Terrorism Task Forces.”
 Joe Eyerman and Kevin Strom, “A Cross-national Comparison of Interagency Coordination between Law Enforcement and Public Health,” RTI Project Number 08914 (research report, NC: RTI International, 2005), vii, https://www.ncjrs.gov/pdffiles1/nij/grants/212868.pdf.
 James F. Morrissey, “Strategies for the Integration of Medical and Health Representation within Law Enforcement Intelligence Fusion Centers” (master’s thesis, Naval Postgraduate School, 2007), 27, https://www.hsdl.org/?abstract&did=471887.
 Morrissey, 27.
 Adam Bulava, “Fusion Centers & Public Health Agencies: Unlikely or Natural Partners?” Domestic Preparedness, August 26, 2009, https://www.domesticpreparedness.com/preparedness/fusion-centers-public-health-agencies-unlikely-or-natural-partners/.
 Morrissey, “Integration of Medical and Health Representation.”