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U.S. Department of Health and Human Services

Hospital Preparedness Program Overview

FY02 to Present and Beyond

The Hospital Preparedness Program (HPP) provides leadership and funding through grants and cooperative agreements to States, territories, and eligible municipalities to improve surge capacity and enhance community and hospital preparedness for public health emergencies.  This funding is used to support programs to help strengthen public health emergency preparedness in several ways:

Compass    Enhanced Planning:  HPP funding is used to enhance hospital and healthcare system planning and response at the State, local, and territorial levels.   
 Picture of medical symbol   Increasing Integration:  HPP facilitates the integration of public and private sector medical planning and assets to increase the preparedness, response, and surge capacity of hospitals and other healthcare facilities.
 Picture of responders with ambulance   Improving Infrastructure:   Awardees have used HPP Grants and Special Initiative Grant funding to improve the State, local, and territorial infrastructures that help hospitals and healthcare systems prepare for public health emergencies.


The program is managed the Office of the Assistant Secretary for Preparedness and Response, (ASPR) which provides programmatic oversight and works with its partners in State, territorial, and municipal government to ensure that the program’s goals are met or exceeded.


The National Bioterrorism Hospital Preparedness Program (NBHPP) was established by the U.S. Department of Health and Human Services (HHS) in 2002 to enhance hospitals’ ability to respond to a biological attack. The Health Resources and Services Administration (HRSA) originally administered the program and provided funding and guidance to hospitals.   NBHPP supported increases in stockpiles of equipment, supplies, and pharmaceuticals that would not have been purchased by financially strained institutions without the program.

In 2006, the Pandemic and all-Hazards Preparedness Act established the Assistant Secretary for Preparedness and Response.  ASPR’s mission areas cover  a wide array of preparedness and medical response capabilities, including the National Disaster Medical System (NDMS) its Disaster Medical Assistance Teams (DMATs),the Biomedical Advanced Research and Development Authority (BARDA), the National Health Security Strategy (NHSS), and the HPP.  In its new location, the HPP would be poised to ensure the healthcare system preparedness enterprise supports identified and newly emerging medical surge capacity and capability requirements at all levels of government, those identified during real-time medical and public health events, and through Federal and State/local/territorial and tribal (S/L/T/T) coordinated exercises. 

Since PAHPA implementation, the program made a major programmatic shift from bioterrorism and an emphasis on capacity building (e.g., quantities of surge beds, amount of PPE, etc.), to an all-hazards preparedness approach under PAHPA, emphasizing capabilities (e.g., use hospital staff, resources, training, etc.) to provide care in the event of a real or simulated event.

Building on Research

In an ASPR contracted study, Hospitals Rising to the Challenge:  The First Five Years of the U.S. Hospital Preparedness Program and Priorities Going Forward, the Center for Biosecurity of the University of Pittsburgh Medical Center (UPMC) provided UPMC’s preliminary recommendations for improving the state of U.S. hospital preparedness going forward.  This research found that HPP has improved the resilience of U.S. hospitals and communities and increased their capacity to respond to “common medical disasters.”

However, the report also stated that, “While much progress has been made in healthcare preparedness for common medical disasters, the U.S. healthcare system is ill-prepared for catastrophic health events”.  It recommended that “HPP should focus on building, strengthening, and linking Healthcare Coalitions to lay the foundation for a national disaster health and medical response system.”

Medical Surge Capacity and Capability (MSCC) Handbook

"The healthcare coalition organizes individual healthcare assets into a single functional unit.  Its goal is to maximize MSCC across the coalition through cooperative planning, information sharing, and management coordination.  The coalition ensures that health and medical assets have the information and data they need at a level of detail that will enable them to optimally provide MSCC.  In addition to hospitals, the coalition may include long-term care or alternative treatment facilities, private physician offices, clinics, and any other health or medical asset that may be brought to bear during major medical response.  Its reach may extend beyond the geographic area of the primary responding jurisdiction (Tier 3), especially in rural settings…”

-The MSCC Handbook  on the Role of Healthcare Coalitions


Picture of the MSCC Handbook Cover   The Medical Surge Capacity Handbook:  The MSCC Handbook provides a blueprint for a systematic approach to managing medical and public health responses to emergencies and disasters, through the use of a tiered response, from the Management of Individual Healthcare Assets (Tier 1) through the level of Federal Support to State, Tribal, and Jurisdiction Management (Tier 6).
Picture of MSCC Heathcare Coalition   Medical Surge Capacity and Capability:  The Healthcare Coalition in Emergency Response and Recovery:  Medical Surge Capacity and Capability:  The Healthcare Coalition in Emergency Response and Recovery serves as a companion handbook specifically expanding upon Tier 2 concepts and principles has also been developed through the ASPR.  This handbook is also available as a key resource and guide to assist with future awardee healthcare coalition development.


The Path Forward

Building on the recommendations of the UPMC report, and in concert with the MSCC, its Tier 2 framework, as well as a collection of formal lessons learned and useful practices obtained from awardees and other stakeholders, the HPP will maintain the momentum of the past year towards improving the quality of the program, and work to enable functional healthcare coalitions nationwide in FY12 and beyond.

  • This page last reviewed: November 20, 2013