Public Health Emergency - Leading a Nation Prepared
This section contains PMs that use data produced during the annual CST. These PMs are aligned to the requirements of the 2019 FOA. For a crosswalk of PMs to the
2017-2022 Health Care Preparedness and Response Capabilities, see
Appendix 3: Crosswalk of Performance Measures to 2017-2022 Health Care Preparedness and Response Capabilities.
The CST measures were waived for FY2019 (July 1, 2019 – June 30, 2020) due to COVID-19 response.
ASPR recognizes that HCCs are diverse, and their response capacities may vary. To gauge the full extent of HCC performance, ASPR selected eight PMs to assess the speed and extent to which HCCs can coordinate an evacuation exercise. The eight PMs assess participation and both time- and percent-based outcomes. In aggregate, these eight PMs should enable greater understanding of HCCs’ preparedness capacities.
The following table lists the data entity—the organizational level at which the data are captured (recipients or HCC)—and PM type for each PM:
The definitions for the PM types are:
The CST captures information on HCC performance that directly informs the PMs. The CST tests a coalition’s ability to work in a coordinated way, using their own systems and plans to find appropriate destinations for patients by using a simulated evacuation of inpatient facilities (that collectively represent at least 20 percent of a coalition’s staffed acute care bed capacity). The detailed
exercise manual and evaluation tools can be viewed online. In the event that an HCC has a real-world evacuation of at least 20 percent of a coalition’s total staffed acute care bed capacity during the reporting year, the HCC can use the data from the real-world evacuation to respond to each applicable PM. If a real-world evacuation occurs during the reporting year, the HCC must still submit an AAR/IP that specifically responds to each applicable PM.
The CST includes a low- to no-notice exercise. Low- to no-notice exercising is important for ensuring that HCCs can transition quickly and efficiently into “disaster mode” and providing a more realistic picture of readiness than pre-announced exercises. At least one month in advance, a trusted insider will identify the assessment team and inform HCC members of the two-week window in which the CST will occur. HCC members will not know the exact date and time, and they will not know whether they are playing the role of “evacuating” or “receiving” facility until 60 minutes before the start of the exercise.
The CST is designed to be challenging. Struggling with a challenging exercise may be more helpful in the long run than succeeding with an easier one. Within 90 minutes, an HCC should be able to identify the beds it can make available, determine the patient placements necessary, match patients to those beds, and identify transportation resources appropriate for each patient. While no patients will be moved during the exercise, the actual movement of patients during a real evacuation event may not happen within the 90 minutes of Phase 1 (during the CST, some HCCs may not be able to identify beds and transportation for all patients within 90 minutes).
The CST is intended to improve health care system response readiness. HCCs will select their own peer assessors who can provide exacting, but constructive, feedback to improve response.
The CST tests the overall health care system response. Although the exercise simulates a health facility evacuation, it can reveal preparedness capabilities needed for a number of different scenarios. These capabilities may include emergency operations coordination, information sharing, and medical surge capacity.
The entire CST takes approximately four hours to complete and includes the following phases:
ASPR will use measures within the CST to assess achievement of preparedness goals for the health care system. Pursuant to Section 319C-1(g)(5) of the Public Health Service Act, failure to achieve this benchmark for one of two consecutive years may result in withholding of 10% of funding amounts and increased withholding amounts in subsequent years that this benchmark is not met.
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