Public Health Disaster Preparedness Bolstered By HHS Grants, Agency Says; Applauded By Public Health Advocacy Group

July 3, 2012
by Anthony Kimery
Homeland Security Today

As wildfires rage in the West and a rare hurricane-force storm swept across the eastern United States killing more than a dozen people, destroying untold hundreds of homes and leaving millions without power, preparedness for catastrophic disasters once again has been forced into the public's awareness.

It comes on the heels of a comprehensive survey that took an in-depth look at Americans' attitudes and concerns with regard to emergency preparedness and response that “stresses how important it is for Americans to have an emergency plan in place that enables them to act quickly when their safety is threatened."

More than $971 million in grants will be awarded by the Department of Health and Human Services (HSS) to "continue improving preparedness and health outcomes for a wide range of public health threats within every state, eight US territories and four of the nation’s largest metropolitan areas," HHS announced Monday.

“Health care and public health systems that are prepared to respond successfully to emergencies and recover quickly from all hazards are also able to deliver services more effectively and efficiently every day,” said HHS Assistant Secretary for Preparedness and Response Nicole Lurie. “Having systems in place to provide better treatment for disaster survivors and improved public health for our communities also leads to better health outcomes on a day-to-day basis.”

According to HHS, the funding awards included a total of about $352 million for the Hospital Preparedness Program (HPP) cooperative agreement and more than $619 million for the Public Health Emergency Preparedness (PHEP) cooperative agreement.

Administered by the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR), HPP funding supports preparedness for health care systems, health care coalitions and health care organizations. HHS’ Centers for Disease Control and Prevention (CDC) administer PHEP funding to support the preparedness of state, local and territorial public health systems.

HPP and PHEP funding helps recipients build and sustain public health and health care preparedness capabilities outlined in ASPR’s document, Healthcare Preparedness Capabilities: National Guidance for Healthcare System Preparedness and in CDC's Public Health Preparedness Capabilities: National Standards for State and Local Planning.

Both documents establish standards for protecting human health and national health security.

"For the first time, the HPP and PHEP funds are being awarded jointly, encouraging cooperation between the nation’s health care and public health systems," HSS said, noting that, "this change follows a year-long effort by ASPR and CDC to align the two federal preparedness programs. These programs represent critical sources of funding and support for public health and health care preparedness systems."

Continuing, HHS said, "improved coordination among federal emergency preparedness programs is a high priority of HHS and other federal entities, as well as for HPP and PHEP awardees. In December 2010, ASPR, CDC, and other federal partners began developing strategies to better align grants with public health and health care preparedness components."

“State and local agencies have made tremendous progress over the past decade in building and sustaining public health and health care preparedness capabilities,” Lurie said. "The integration fostered by HPP and PHEP alignment is important in streamlining and strengthening the day-to-day relationships and cross-sector cooperation that are critical to achieving a resilient health system ready to face any health hazard and capable of providing the affordable, high-quality daily care that all Americans deserve.”

With aligned HPP and PHEP cooperative agreement programs, HHS said states and communities can more easily, efficiently and effectively conduct joint planning, exercises and program operations.

"These activities are vital in preparing communities to respond and recover from emergencies and help communities manage health care and public health on a daily basis," HHS said.

Lurie noted that as access to health care increases, more Americans are likely to seek care from primary care providers and health clinics to address these day-to-day health issues rather than visiting emergency departments. And with fewer people seeking basic care in emergency rooms, hospitals can care for a greater number of patients during emergencies, HHS said.

HHS said, "ASPR and CDC aligned HPP and PHEP cooperative agreements to advance all-hazards preparedness and national health security, promote responsible stewardship of federal funds, and reduce the administrative burden for grant recipients. The programs support complementary preparedness capabilities and performance measures, use the same processes for grants administration, technical assistance and data management, use common reporting requirements, and have compatible IT systems."

While closely aligned in many aspects, HPP and PHEP will continue to remain individual programs in accordance with authorizing legislation. HPP and PHEP budgets also will remain separate to ensure accountability for the statutory requirements of each separate funding stream, HHS assured.

"This alignment has resulted in several key changes for the 2012 HPP-PHEP grant cycle," the department said, adding that "among the changes are a single HPP-PHEP funding opportunity announcement, funding application and grant award, as well as a single grants administration agency, CDC’s Procurement and Grants Office. An aligned grant cycle is also being implemented, with the annual HPP-PHEP grant cycle beginning July 1 and ending June 30."

The Washington, DC-based Trust for America's Health (TFAH) applauded HHS for releasing the first joint awards of the PHEP and HPP programs.

“This is a great step toward improving the efficiency of the country’s public health preparedness system," said Jeff Levi, executive director of TFAH. "These two grants have been the backbone of supporting state and local preparedness efforts for a decade. Without them, state and local health departments would not have the training, staff or other resources to prepare for and respond to health emergencies. But, since their inception, neither program has reached its full potential."

Levi said in a statement that "aligning the grants is common sense: bringing PHEP – which is administered by CDC to state and local public health systems for preparedness activities – and HPP – which is managed by ASPR and improves surge capacity and community and hospital preparedness for public health emergencies – together should create synergies and make it easier for public health officials to do their jobs."

"Until this announcement," Levi continued, "the grant processes have been separate, leading to confusion and inefficiencies for grantees and the federal government. As an independent watchdog, TFAH has been supportive of the alignment process – both through our annual Ready or Not? report and in congressional testimony – as a way to simplify the process, reduce inefficiencies and better leverage the funds."=

"The next step," Levi concluded, "is making sure the grant alignment actually meets the intended goals of reducing burdens on grantees, improving federal efficiencies, and increasing programmatic benefits to state and local preparedness programs.”

To learn more about HPP and PHEP including grant awards to individual states, territories or localities, visit http://www.cdc.gov/about/organization/ophpr.htm.

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