Ensuring our nation’s health security presents a continual and complex challenge. Success requires integrating not only thousands of public health agencies at all government levels but also approximately 83,000 private sector health care entities and emergency management agencies nationwide.
As the only federal agency at the nexus of all three – public health, health care and emergency management – ASPR has made tremendous progress during its first 10 years. Yet much remains to be done so that every American community can bounce back from disaster with residents’ health intact. We need to build readiness into the core of American culture.
Beyond response readiness
ASPR coordinates across 20 operational and staff divisions of the U.S. Department of Health and Human Services and 16 other federal department and agencies to bring together all of the federal government’s public health and medical assets to serve communities in crises, including ASPR’s National Disaster Medical System teams and hospital network and our Medical Reserve Corps volunteers. We designed response processes and systems to deploy resources rapidly. During Hurricane Sandy, for example, ASPR had teams on the ground within just four hours of the state’s request.
Federal assets are useful when communities are overwhelmed but they are designed only to augment local and state resources. Ultimately, to better protect health and to build readiness into our culture, communities must find ways for people to remain at home and receive their regular health services in their normal location during an emergency.
Incentivizing health care readiness
ASPR took an important step to boost community readiness by collaborating with the Centers for Medicare and Medicaid Services on a CMS emergency preparedness rule issued in 2016. The rule established consistent emergency preparedness requirements for health care providers participating in Medicare and Medicaid to increase patient safety during emergencies and create a more coordinated response to natural and man-made disasters. Health care businesses covered by this rule can turn to ASPR’s TRACIE and join ASPR’s Health Care Coalitions to share tools, best practices, and participate in emergency drills to help meet requirements of the rule.
With funding and guidance from the Hospital Preparedness Program, almost 30,000 health care entities in nearly 500 coalitions across the country plan, drill, and respond together. The coalition approach has demonstrated value far beyond the early approach of funding individual hospitals to buy equipment. This approach drives competitive health care entities to work together. Now, they need to work toward specific capabilities. Even health care entities that don’t receive HPP funding would do well to work toward these capabilities. Building readiness into a business is as good for business as it is for patients.
emPOWERing community readiness
To build readiness into our culture, community organizations must get involved as well. ASPR also partnered with CMS to create a unique system called emPOWER to aid the 2.5 million people whose lives depend on electrically-powered medical equipment like oxygen concentrators.
Every hospital, first responder, electric company, and community organization can use emPOWER to find areas and populations at risk in power outages and work together to meet their needs. During a disaster, health authorities can request special emPOWER access to find and save the lives of these at-risk Americans.
In the first year alone, 43 states, 5 territories, and 3 large cities used emPOWER to support over 38 emergencies and planning activities – hurricanes, severe floods, tornadoes, wildfires, wide-spread power outages, and emergency drills.
Emergency medical products at the ready
We’re building readiness into our approach to developing drugs, vaccines, diagnostics, and medical devices needed in disasters and public health emergencies. Experts in ASPR uncovered private industry challenges in developing and manufacturing emergency medical products and found ways to overcome those hurdles. For efficiency and speed, ASPR sponsors development of products that have multiple uses not only in emergencies but also to fill unmet medical needs like antimicrobial resistant infections. When they are available on the commercial market when an emergency occurs, readiness is built into the system.
Ready by design
Communities also need to design health into infrastructure improvements, new buildings, and as they rebuild after disasters. Schools and college field houses often serve as shelters. Design and build them with that use in mind. As community planners rebuild after disasters, they can bring health experts to the table and discuss ways to rebuild infrastructure that promotes health, like walking and biking instead of driving. The healthier community members are day to day, the more likely they are to come through the next disaster with their health intact. Build and rebuild in ways that encourage social interaction; after all, people with strong social networks tend to be healthier and cope better with the stress that disasters bring.
Research ready
At ASPR, we’re also focused on building a culture of readiness in the scientific community. Decision makers need scientific evidence to make quick decisions during and immediately after disasters. Only in disasters can researchers conduct the studies necessary to support these decisions. Scientists must be ready with the appropriate procedures and rapid institutional reviews in place to act quickly so our society can learn from emergencies as they happen and make sound, informed decisions about how best to respond and recover.
Ready to respond at a moment’s notice
We may not know precisely when or where the next disaster will strike or the next disease emerge, but we can count on it happening. Readiness even needs to be built into health agency budgets. HHS, for example, has neither budget authorization nor appropriations for a public health emergency fund. Such a fund would cover immediate crisis needs while legislators work through longer term funding to respond and recover from the health effects of disasters. Budgeting for crises represents not only a culture of readiness but also a sound business practice.
Creating a culture of readiness is paramount if our nation is to survive emergencies and thrive despite them. There is no finish line for preparedness. Threats continue to emerge and evolve. Our nation’s health security requires constant vigilance.
