Ready or Not? Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism

1. Ready or Not? Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism Jeffrey Levi, PhD Congressional Briefing February 3, 2012

2. Who We Are • Trust for America’s Health (TFAH) is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

3. Overview • Progress in public health preparedness over past decade • Economic crisis and federal budget cuts leave us less prepared than a few years ago • Basic capabilities are eroding • Policy opportunities • PAHPA reauthorization • FY 13 budget and sequestration (risks and opportunities)

4. 9th Annual Ready or Not? report • Goals: • Demonstrate progress, challenges in preparing nation for disaster • Illustrate role of public health • Supported by Robert Wood Johnson Foundation

5. A Decade of Progress • 10 years ago, health departments responded to 9/11 with little preparation. Since then: • PHEP and HPP Grants established • All states and localities have tested their plans to receive and distribute medical supplies • Developing domestic vaccine and other medical countermeasure capacity • Growth in lab capacity • Passage of PAHPA, FSMA

6. Federal, State & Local Cuts • Federal funds for state & local preparedness cut by 38% since FY05 (adjusted) • $72M cut to PHEP grants from FY10-12 • 40 States & DC cut public health funding • 49,000 lost state & local public health jobs • More prepared than a decade ago…but may be less prepared than even a few years ago

7. Programs at Risk from FY 11&12 Cuts and Potential Sequestration • 51 of 72 cities in Cities Readiness Initiative • Level 1 Chemical Testing Labs in 10 states • Field epi program in 24 states • Research and training centers at 18 different universities • Comprehensive nuclear, radiological, chemical response support from CDC

8. Recommendations • Assuring dedicated funding and strengthening the public health preparedness core capabilities • Improving biosurveillance to rapidly detect and track outbreaks or attacks • Improving research, development and manufacturing of vaccines and medications

9. Recommendations • Enhancing the ability to provide care for a mass influx of patients during emergencies • Providing better support to help communities cope with and recover from disasters • Coordinating food safety with other preparedness efforts through the strategic implementation of the FDA Food Safety Modernization Act of 2011.

10. Pandemic and All-Hazards Preparedness Act (PAHPA) • Originally passed in 2006 to specifically address public health preparation and response for disasters • Created Assistant Secretary for Prep & Response at HHS (ASPR) • Created BARDA to spur development of pipeline of vaccines, drugs, devices (MCM) • Created National Health Security Strategy • New focus on at-risk individuals

11. PAHPA Reauthorization (H.R. 2405/S. 1855) • Key Provisions Include: • Flexibility for states to surge public health staff during disaster (House) • Limited carryover of unspent preparedness funds (Senate) • MCM implementation plan and 5-year budget • Review of need to replenish SNS

12. PAHPA Reauthorization (cont.) • Key provisions: • MCM Strategic Investor to leverage venture capital and technical expertise (Senate) • Plan to improve coordination among biosurveillance plans. Senate bill includes coordination with HIT • Separate Senate medical surge capacity bill to allow 1135 waivers for evacuation areas

13. PAHPA Reauthorization • Principal Area of Concern • Spending capped at lowest level in several programs’ history, including state & local preparedness grants

14. Questions? • Please contact TFAH: • Dara Lieberman, Senior Government Relations Manager – dlieberman@tfah.org or 202-223-9870 ext. 20. • www.healthyamericans.org