HHS to give states $430 million for hospital preparedness

Jul 11, 2007 (CIDRAP News) – This year's round of federal grants to states to help healthcare facilities prepare for public health emergencies totals $430 million, down from $450 million last year, the US Department of Health and Human Services (HHS) announced recently.

The grants are intended to help hospitals and other healthcare facilities cope with emergencies that could cause mass casualties, including bioterrorist attacks, infectious disease outbreaks, and natural disasters, according to a Jun 28 HHS news release.

Congress began supplying the states with sizable grants for healthcare facility preparedness, as well as general public health preparedness, after the Sep 11 and anthrax letter attacks in 2001. In 2002, HHS awarded $125 million to the states for hospital preparedness. This was increased to $498 million in 2003 and 2004, but was pared to $471 million in 2005 and to $450 million last year.

HHS said this year's funds are to be used to develop or improve four activities: interoperable communications, systems to track available hospital beds, advance registration of volunteer health professionals, and planning for "fatality management and hospital evacuation."

That list differs somewhat from the one listed in last year's round of funding. The objectives mentioned then included increasing hospital beds, providing more isolation rooms, finding more healthcare workers, and setting up hospital-based medication caches, among other things.

The grants will go to territories and four major metropolitan areas—Chicago, Washington, Los Angeles County, and New York—as well as the states. For the states, amounts range from $1.15 million for Wyoming to $34.1 million for California.

Each state is allotted a base grant of $500,000 plus an additional amount based on population, according to Marc Wolfson, spokesman for the HHS Office of the Assistant Secretary for Preparedness and Response. The various jurisdictions are required to file their annual applications for the funds by Aug 6, and the grants are expected to be awarded in September, he said.

The funds are intended not only for hospitals, but also for medical clinics, long-term care facilities, and emergency medical services, according to Patricia Tomett, supervisor of the Healthcare System Preparedness Unit at the Minnesota Department of Health.

HHS said this year's funding includes $15 million for the new Healthcare Facilities Partnership Program, which is designed to foster regional partnerships to enhance community and hospital preparedness. The agency will use a competitive process to award between 6 and 30 cooperative agreement awards ranging from $500,000 to $2.5 million.

"The goal of the new program is to develop innovative and creative projects that can be replicated across the country," said Rear Adm. Craig Vanderwagen, MD, HHS assistant secretary for preparedness and response. "These partnerships will require close coordination among health officials from state, local and private sectors."

Oversight of the hospital preparedness grants was transferred from the Health Resources and Services Administration (HRSA) to Vanderwagen's office this year, HHS reported in the news release. Congress ordered the change when it passed the Pandemic and All-Hazards Preparedness Act (PAHPA) last December.

Relatively little information has been available so far on the results of the hospital preparedness program. However, Wolfson said plans are in the works to increase monitoring and evaluation.

"The guidance for this year's program includes new performance measures, one of which requires the submission of timely and complete data from grantees," he commented by e-mail. He said the PAHPA directed HHS to improve its performance measures for hospital readiness.

In addition, Wolfson said, "There is an ambitious evaluation plan for this year that includes a number of studies and reports." One of these will be a book of state preparedness profiles, including data on hospital preparedness and other dimensions, such as hazards and vulnerability.

Plans call for developing and updating the profiles every 1 to 2 years, but no target date has been set for completing the first issue, he said.

Trust for America's Health (TFAH), a nonprofit public health advocacy group based in Washington, DC, has examined hospital preparedness in a series of annual reports called "Ready or Not? Protecting the Public's Health from Diseases, Disasters, and Bioterrorism." Last year's report looked at hospital surge capacity, a key measure of preparedness, and found it lacking.

TFAH estimated that 25 states would run out of hospital beds within 2 weeks after the start of a "moderate" influenza pandemic, defined as one in which 2 million Americans would need hospitalization. Further, in a severe, 1918-like pandemic, 47 states would run out of beds in 2 weeks.

Laura Segal, a TFAH spokeswoman, said there has not been much examination of the hospital preparedness grants program by Congress or other groups outside HHS. "It's definitely an area where there's not a lot of transparency," she said.

In past years HHS usually has announced the state allocations for hospital preparedness and for general public health preparedness at the same time. The general public health preparedness grants are administered by the Centers for Disease Control and Prevention (CDC). This year the information about the CDC grants wasn't ready yet, according to Wolfson. "I expect the CDC announcement will come out in the next couple weeks," he said.

See also:

Jun 28 HHS news release with list of grants by jurisdiction
http://www.hhs.gov/news/press/2007pres/06/20070628a.html

Dec 11, 2006, CIDRAP News story "CDC rates hospital bioterrorism preparedness"

TFAH's 2006 "Ready or Not" report and links to previous reports in the series
http://healthyamericans.org/reports/bioterror06/

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