Systems capabilities on ISHM (Integrated System Health Management)and autonomy have traditionally been addressed separately. This means that ISHM functions, such as anomaly detection, diagnostics, prognostics, and comprehensive system awareness have not been considered traditionally in the context of autonomy functions such as planning, scheduling, and mission execution. One key reason is that although they address systems capabilities, both ISHM and autonomy have traditionally individually been approached as independent strategies and models for analysis. Additionally, to some degree, a unified paradigm for ISHM and autonomy has been difficult to implement due to limitations of hardware and software. This paper explores a unified treatment of ISHM and autonomy in the context of distributed hierarchical autonomous operations.