The Pandemic and All-Hazards Preparedness Act (PAHPA)

1
The Pandemic and All-Hazards Preparedness Act
(PAHPA)

• Changes in Federal Programs for Healthcare
  Preparedness

2
Hospital Preparedness Mission

• 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
Healthcare Preparedness to Date

• FY 2002 FY 2005 Capacity Building
• Responding to increased numbers of patients
• ?Beds ?Personnel
• ?Isolation ?Decontamination
• ?Pharmaceuticals ?Exercises
• ?Trauma / Burn ?EMS
• ?Hospital Labs ?Surveillance
• ?Personal Protective Equipment
• ?Interoperable Communications
• ?Mental Health Needs

4
Healthcare Preparedness to Date

• Bioterrorism focus
• Other Public Health Emergencies
• Intrastate Regional Plans
• Hazard Vulnerability Assessments (HVA)
• Aligned with
• National Preparedness Goal (NPG)
• Target Capabilities (TCL)
• National Incident Management Systems (NIMS)

5
FY 2006 Hospital Preparedness Guidance

• FY 2006 Building Capability
• Responding to the unique needs of victims
• Focus on
• Tiered Medical Response Framework (MSCC)
• Pandemic Influenza Scenario
• Explosive Event Scenario
• Other Hazards and Vulnerabilities as identified
  by the state

6
The Pandemic and All-Hazards Preparedness Act
(PAHPA) 2007

• Identifies the Secretary of Health and Human
  Services (HHS) as the lead official for all
  Federal public health and medical responses for
  public health emergencies
• Establishes the position of Assistant Secretary
  for Preparedness and Response (ASPR)
• Consolidates Federal public health and medical
  response programs under the Assistant Secretary
  for Preparedness and Response

7
Six Preparedness GoalsOutlined in PAHPA

• At-Risk Individuals
• Coordination
• Continuity of Operations

• Integration
• Public Health
• Medical

Medical must include developing plans for
Strengthening public health emergency medical
management and treatment capabilities. Medical
evacuation and fatality management. Rapid
distribution and administration of medical
countermeasures Effective utilization of any
available public and private mobile medical
assets and integration of other Federal
assets. Protecting health care workers and health
care first responders from workplace exposures
during a public health emergency.
8
Pandemic and All-Hazards Preparedness Act (PAHPA)
2007

• Hospital Preparedness Program moves from HRSA to
  the ASPR
• Office of Preparedness Emergency Operations
  (OPEO)
• Authorizes new competitive awards
• New eligible funding entities in addition to
  States
• Assurances from State, Territory or Local PH
  Agency
• New Funding Preferences
• Regional Coordination
• Include one or more National Disaster Medical
  System (NDMS) hospitals
• Located in a geographic area that faces a high
  degree of risk
• Have significant need for funds to achieve the
  medical preparedness goals

9
FY2007 Healthcare Programs

• Hospital Preparedness Program (HPP)
  415,032,000
• Non-competitive, funding by base population
• All applications reviewed (August 8th)
• Notice of Grant Awards (NGAs) are being
  processed through OPHS
• Pandemic Influenza Supplement 75million
• One time supplement to the Hospital
  Preparedness Program awardees
• Applications due October 9th
• Awards to be made in late October

10
FY2007 Healthcare Programs

• Healthcare Facilities Partnerships
  (HFP) 15million
• Reviewed 40 Partnership applications
• Eleven Facilities partnerships to be funded
• Awards to be announced on or about September 19
• Emergency Care Partnerships (ECP) 25million
• Reviewed 35 Emergency Care Partnerships
  applications
• 3 Emergency Care partnerships to be funded
• Awards to be announced by September 30

11
FY2007 Hospital Preparedness Program Activities

• Level One sub-capabilities mandated in the
  guidance
• Interoperable communication system Bed tracking
  system
• ESAR-VHP System Fatality
  Management Plan
• Hospital evacuation plans
• Secondary Activities
• Alternate Care Sites (ACS) Personal Protective
  Equipment
• Pharmaceutical Caches Mobile Medical Assets
• Decontamination
• One functional exercise must be conducted ( of
  Level One capabilities)

12
Supplemental Funding for Pandemic Influenza
Preparedness

• One time funding of 75,000,000
• A. Equipment/Supplies
• Ventilators, Ancillary Supplies and Oxygen
• Personal Protective Equipment (PPE) and Infection
  Control Supplies
• B. Alternate Care Sites (ACS)
• Purchase of Equipment/Supplies (i.e., IV bags,
  tubing and pumps)
• Staffing plans
• Training/Exercises
• Supply/Re-supply considerations
• Development of operational plans
• Defining how these facilities will interface and
  coordinate with State, jurisdiction and Federal
  assets

B. Alternate Care Sites (ACS)
Ventilators, Ancillary Supplies and Oxygen
Ventilators, Ancillary Supplies and Oxygen
B. Altern
Ventilators, Ancillary Supplies and Oxygen
13
Pandemic Influenza Supplement Activities
(continued)

• C. Mortuary Services/Supplies
• Development or enhancement of mass
  fatality plans
• Purchase of equipment supplies to such as face
  shields, protective covering,
• gloves, and disaster body bags
• D. Exercises
• Awardees are required to conduct at
  least one pandemic influenza exercise
• specifically targeting medical
  surge.

14
Healthcare Facilities Partnerships (HFP)

• Mission
• To improve surge capacity and enhance community
  and hospital
• preparedness for public health emergencies in
  defined geographic areas
• Activities
• Enhanced situational awareness of capabilities
  and assets of partnerships
• Advanced planning and exercising of plans that
  address common risks and vulnerabilities and
  consequences in a defined geographic area.
• Fostering the development of Medical Mutual Aid
  agreements
• Developing and strengthening relationships
  between and among partnership entities,
  traditional first response agencies, public
  health and other response partners prior to
  disasters and emergencies

15
Healthcare Facilities Partnership Overview

• Competitive
• 15,000,000
• Range 500,000 - 2,500,000
• Budget cycle 11 months and 1 week
• Eligible Applicants
• one or more hospitals, at least one of which
  shall be a designated trauma center
• one or more other local health care facilities,
  including clinics, health centers, primary care
  facilities, mental health centers, mobile medical
  assets, or nursing homes and
• one or more political subdivisions
• one or more States or
• one or more States and one or more political
  subdivisions.

16
Emergency Care Partnership Program (ECP)

• Mission
• To improve hospital emergency department (ED)
  surge capacity, the emergency care
• system, and to enhance community and hospital
  preparedness for public health
• emergencies in defined geographic areas.
• Activities
• Enhancing situational awareness of hospital ED
  surge capacity and emergency care system
• Planning and exercising of plans that address
  common risks and vulnerabilities and
• consequences in a defined geographic area
• Fostering the development of Medical Mutual Aid
  agreements among partnership entities around the
  provision of emergency care
• Developing and strengthening relationships
  between and among partnership entities engaged in
  the provision of emergency care

17
Emergency Care Partnership Overview

• Competitive
• 25,000,000
• Budget cycle May include up to three
  successive, annualized budget/project periods
• Eligible Applicants
• one or more hospitals, at least one of which
  shall be a designated trauma center
• one or more other local health care facilities,
  including clinics, health centers, primary care
  facilities, mental health centers, mobile medical
  assets, or nursing homes and
• one or more political subdivisions
• one or more States or
• one or more States and one or more political
  subdivisions.

18
FY 2008 and Beyond Issues

• Readjustment of Grant cycle to June start date
• More closely aligned with State budget cycle
• More closely aligned with DHS
• Maintenance of Funding (all awards)
• Must maintain expenditures for healthcare
  preparedness at a level that is not less than the
  average of such expenditures maintained for the
  preceding 2 years
• Achievement of evidence based benchmarks and
  objective standards
• Withholding of funds for failure to meet those
  benchmarks and standards
• Secretary must compile data on programs and make
  it publicly available

19
Robert Scott Dugas, MPHOffice of Preparedness
Emergency Operations330 C Street, Room 5625,
SWWashington, DC 20201(202) 205-8648Robert.Duga
s_at_hhs.gov