Public Health Emergency - Leading a Nation Prepared
Hurricane Sandy, the 2009 H1N1 influenza outbreak, mass shootings, chemical spills, and the 2014 Ebola outbreak: these large-scale and highly-publicized emergencies required coordinated preparedness and timely responses from health care system partners across our nation.
For more than a decade, ASPR has strengthened our nation’s health care system through the Hospital Preparedness Program (HPP), bringing partners together and helping the health care system prepare for and respond to the medical effects of disasters. HPP is the only source of federal funding that supports regional health care system preparedness.
HPP initiatives improve patient outcomes, minimize the need for state and federal agencies to send temporary personnel and equipment during emergencies, and enable rapid recovery. As a result of improvements made through HPP, our nation is more prepared than ever to address emergencies that threaten the public’s health, and health care systems across the nation are better equipped to respond at a local level, minimizing the need for state and federal support.
When HPP began, the program focused on building hospitals’ capacity to respond to bioterrorism. The program has evolved rapidly, adapting its strategy from hospital preparedness to creating stronger, more resilient health care systems that can respond to all hazards.
HPP shifted its focus to building health care coalitions, which incentivize diverse and often competitive health care organizations with differing priorities to work together so that each member has the necessary medical equipment and supplies, real-time information, communication systems, and trained personnel to respond to emergencies. Health care coalitions promote information sharing and relationship building within communities and among health care and public health partners that rely heavily on each other during emergencies.
With almost 30,000 members nationwide, health care coalitions continue to grow and reflect the diversity of the communities they serve and enable health care systems to save lives during incidents that exceed the day-to-day capacity of health and emergency response systems.
In addition to supporting the nation’s health care system, HPP aligned with the Centers for Disease Control and Prevention’s Public Health Emergency Preparedness (PHEP) program in 2012, which funds state, local, tribal, and territorial public health departments so they are prepared to prevent and respond to public health threats.
Since alignment with PHEP, the largely private sector health care system and the primarily public sector public health system are working more closely than ever before to meet the nation’s public health and medical needs before, during, and after emergencies.
In recent years, HPP built on the success of health care coalitions and focused on enhancing health care systems' capabilities to perform core functions common to all emergency responses with flexibility and efficiency. As captured in HPP success stories, health care coalitions are engaged during every stage of disasters, from preventing health consequences to supporting communities in as they recover.
During the Ebola epidemic in West Africa, HPP took a collaborative approach to prepare the United States for potential cases of Ebola. The program created a network of health care facilities that now stands ready to respond to highly infectious diseases like Ebola. The network features over 200 assessment hospitals, more than 75 treatment hospitals and 10 regional special pathogen treatment centers.
Health care coalitions provide critical support organizing and leading preparedness efforts, such as a joint exercise held in 2015 by the Arizona Pediatric Disaster health care coalition. This exercise evaluated how schools and hospitals interact during an emergency. Exercise outcomes played a direct role in improving relationships between hospitals and schools and highlighted the need for health care coalitions and their members to have family reunification procedures.
Health care coalitions are instrumental in preparing for major community events. The Southeast Pennsylvania health care coalition readied the Philadelphia-area medical community for the Papal visit in 2015; the coalition coordinated health care responsibilities and resources across the city, with the state health department, and with federal agencies, and participated in the U.S. Secret Service’s planning committee.
In addition to strengthening preparedness efforts, health care coalitions respond together. When an Amtrak train crashed on May 12, 2015, the Philadelphia Department of Health immediately activated an HPP-funded system to track and triage patients and to assist with the distribution of patients to various health care facilities to avoid overburdening hospitals.
A New York City health care coalition also successfully responded to a confirmed Ebola patient and, with the help of HPP funding, built a quarantine and isolation unit in 2012—long before anyone seriously considered Ebola as a likely threat to our nation.
Health care coalitions also provided long-term behavioral health support for communities. After a shooting at Umpqua Community College in Oregon, the health care coalition responded to the community’s need for a safe outlet to process the incident.
The local coalition coordinated with the Federal Bureau of Investigation’s Victim Assistance to support victims’ families in the immediate aftermath. Coalition members worked with a local mental health program to provide additional behavioral health support for 16 weeks. The coalition stood up a wellness center and staffed it with volunteers who saw 56 clients and provided more than 1,700 hours of clinical behavioral health support, including crucial support for first responders.
To encourage health care facilities and health care service providers to prepare for emergencies, the Centers for Medicare and Medicaid Services issued an emergency preparedness rule in 2016. The rule affects 17 types of health care facilities and services. Newly affected groups can leverage the experience and expertise of health care coalition members to create the plans and drills required under the new rule.
HPP has become a critical component of the nation’s readiness. Looking ahead to 2017 and beyond, the program will continue to focus on operationalizing health care coalitions for effective and agile response. HPP’s new 2017-2022 Health Care Preparedness and Response Capabilities provides an overview of the activities the nation’s health care delivery system should undertake to prepare for, respond to, and recover from emergencies. Equipped with this guidance, communities will continue to enhance their preparedness through health care coalitions, creating a nation and health care system that is prepared and response-ready.
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