August 12, 2016- A few weeks ago, the Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) released the draft 2017 Health Care Preparedness and Response Capabilities for the Hospital Preparedness Program (HPP) funding for public comment. HPP is the federal funding program for hospital preparedness in states and healthcare coalitions.
To fully appreciate why the capabilities prescribed in the document and the release of the capabilities are important, it’s important to first understand what a healthcare coalition is. Coalitions are partnerships between healthcare, public health and emergency management. The grant funds they receive are meant to do a number of things, but at their core, they’re aimed at getting to get diverse healthcare companies – who are often competitors – to sit at the same table and work to ensure they are ready to respond to any disaster, even if that means acting against their own self-interest. It’s a uniquely non-competitive space to plan, exercise, and coordinate. The proposed capabilities are what will be used to create performance measures and grant application requirements, making them a big deal to coalitions.
Healthcare Ready is a member of the HPP Partner group which is brought in quarterly to provide feedback and expertise on HPP, the capabilities and performance measures, and on the coalitions. And overall, I’ve been impressed with the draft capabilities. They are short(er), flexible for different coalition needs (especially differences based on urban vs. rural communities), and responsive to previous concerns raised by the previous capabilities. The proposed capabilities also connect to the Public Health Emergency Preparedness (PHEP) grants (which are the main way state and local public health preparedness are funded), without making the programs – HPP and PHEP – appear to be the same to outsiders and appropriators, which has been a challenge in the past. The proposed capabilities are trying to be adaptable to unique coalition needs and reflect important considerations like the supply chain and newer issues like cyber security.
Accomplishing all the things the document sets out to do is a difficult task for a variety of reasons. First, the capabilities are more than any one coalition can accomplish. This is intentional as the goal of the document is to state what all of healthcare and emergency services, not just coalitions, need to be prepared. Hopefully this will be clearly stated in both the grant guidelines and the performance measures or it may feel hopelessly unattainable with current HPP funding. Another challenge is that there are only four proposed required groups to make a coalition;
Other proposed members (groups like dialysis centers, nursing centers, and community health centers) are left optional. Intended to allow flexibility, this provision may wind up inadvertently removing any incentive to bring other groups to the table.
Healthcare and public health are complex enough spaces during day to day operations. This reality makes emergency preparedness not only that much more important, but also that much more complex. Developing guidance and metrics on how to achieve this is an incredibly tricky task, but ASPR’s routine refresh and updating of the capabilities signals a genuine commitment to helping ensure resources are being allocated efficiently.
Anyone wishing to comment on the capabilities can submit via TRACIE.
In the meantime, HPP focus now will shift to developing performance measures that can meet the needs of not only grantees, but also ASPR/HPP, and those government affairs folks who are on the Hill trying to ensure the funding continues into the future.