HHS releases $1.4 billion to states for public health preparedness

Robert Roos

Sep 4, 2003 (CIDRAP News) The US Department of Health and Human Services (HHS) said this week it is making $1.4 billion available to states and territories to improve their preparedness for terrorism and other public health emergencies.

The funds represent the appropriation for fiscal year 2003, which ends Sep 30. Their release follows completion by the states of their annual public health preparedness plans, according to HHS spokesman Marc Wolfson in Washington, DC. "We were waiting for all the plans to come in and be reviewed before the release of the funds," Wolfson told CIDRAP News.

The $1.4 billion includes $870 million administered by the Centers for Disease Control and Prevention (CDC) and $498 million administered by the Health Resources and Services Administration (HRSA).

The CDC funds are to be used to strengthen preparedness for bioterrorism, infectious disease outbreaks, and other public health emergencies, HHS said in a news release. Specific spending areas include disease surveillance and epidemiology, biological lab capacity, chemical lab capacity, communication technology, health information dissemination, education and training, and smallpox preparedness planning.

The HRSA funds are intended to help states "develop surge capacity to deal with mass casualty events," the statement said. "This includes the expansion of hospital beds, development of isolation capacity, identifying additional health care personnel, establishing hospital-based pharmaceutical caches, and providing mental health services, trauma and burn care, communications and personal protective equipment."

HHS announced last March that $1.4 billion would be provided this year and that states could receive 20% of their allocation early to help pay for the smallpox vaccination program, Wolfson noted. But he said none of the states asked for early release of the 20%. (About 38,000 health workers have received smallpox shots under the program, far fewer than the 500,000 originally expected.) The release said that states so far have spent only $563 million of the $1.1 billion allocated for public health preparedness in fiscal year 2002.

States and territories "are using some of the money to hire new staff for the public health departments and labs and such, so that kind of money isn't disbursed all at once," Wolfson said. "Their salary comes out a little bit at a time."

The CDC-administered funds include a $5 million base grant to each jurisdiction, with the rest based on population, according to Wolfson. The HRSA distributes a $1 million base grant to each jurisdiction and allocates the rest according to population.

A chart in the HHS release shows that the combined CDC and HRSA grants range from $94.4 million for California (excluding Los Angeles) to $7.4 million for Wyoming. Los Angeles County, New York City, and Chicago are receiving separate allocations of $40.1 million, $33.7 million, and $15.5 million, respectively. Wolfson said states don't receive their allocations all at once, but draw on the funds as they need them.

States have reported that about 75% of the fiscal 2002 funds are being passed directly to local governments and hospitals or being used for local and hospital infrastructure and support systems, the HHS statement said.

HHS said it is spending a total of about $3.5 billion for bioterrorism preparedness this year. That includes the funds for state and local preparedness and money for research on potential biological weapons and related treatments and vaccines.