National Hospital Preparedness Program: Priorities, Progress & Future Direction

1. National Hospital Preparedness Program:Priorities, Progress & Future Direction Gregg Pane, MD, MPA, FACEP Director National Healthcare Preparedness Programs HHS/ASPR

2. Hospital Preparedness Program (HPP) Mission Statement: “To ready hospitals and supporting health care systems, in collaboration with other partners, to deliver coordinated and effective care, to victims of terrorism and other public health emergencies “

3. Pandemic and All Hazards Preparedness Act (PAHPA) • Signed into law December 2006 • Establishes the ASPR • Leadership • Personnel • Countermeasures • Coordination • Logistics • HRSA program ASPR • Title III: All Hazards Medical Surge Capacity • Transfers NDMS from DHS to HHS • Section 302: Enhancing Medical Surge Capacity • Section 305: Partnerships for State and Regional Hospital Preparedness to Improve Surge Capacity

4. FY02-FY08 HPP Funding History

5. Tiers of Response

6. FY08 HPP Funding Opportunity ($398M) • $398M in Cooperative Agreement Funds Released August 2008 • Overarching Requirements: • National Incident Management System (NIMS) • Education and Preparedness Training • Exercises, Evaluation and Corrective Actions • Needs of At-Risk Populations

7. FY08 HPP Funding Opportunity • Required Activities (Level One sub-capabilities) • Interoperable Communications Systems • ESAR VHP • Tracking of Bed Availability (HAvBED) • Fatality Management • Medical Evacuation / Shelter-in-Place • Partnership/Coalition Development • Once all the above are met in full States may propose a host of other activities: • PPE, Decon, Pharm Caches • ACS and Mobile Medical Assets • CIP • MRC

8. FY08 HPP Funding Opportunity • Significantly increased accountability in 2008 that will affect funding in 2009: • Meeting mid year and end-of-year targets for performance measures • Pan Flu plan submission and successful “grade” on medical surge and fatality management sections • Not exceeding established maximum carry-over limits • Maintenance of Effort for State funding

9. Performance Measures • State/Territory can report available beds for at least 75% of participating hospitals per HAvBED definitions • S/T can query ESAR-VHP system during drill/exercise/event and generate list of potential VHP, by discipline and credential level, within 2 hours of request • S/T can compile initial list of VHP within 12 hours, and report verified list of available VHP with 24 hours of a request • S/T conducts statewide and regional exercises that incorporate NIMS concepts and principles, and include hospitals • Proportion of hospitals that can report beds by HAvBED within 60 minutes • Hospitals demonstrate redundant communications capability; and two-way capability with local Operations Command or coalition partners • Hospitals have written plans for mass fatalities and medical evacuation • Incorporate NIMS concepts/principles; identify training needs and verify courses

10. Charting Progress: A Comparative Look at Hospital Preparedness FY02 to FY06 Source: FY03 GAO Study, April 2003 and FY06 End-of-Year Data

11. Charting Progress: A Comparative Look at Hospital Preparedness FY02 to FY06 Source: FY03 GAO Study, April 2003 and FY06 End-of-Year Data

12. Future Directions • Shared focus on required program performance metrics • Proactive approach to problem-solving; achieving goals • Broad, pre-decisional input on policy, guidance, measures • Adoption and spread of exemplary practices • Focus on health system preparedness and coordination • Medical surge and health system resiliency • Lessons and accomplishments from actual events • Longer planning cycle