National%20Hospital%20Preparedness%20Program:%20Priorities,%20Progress%20

1
National Hospital Preparedness ProgramPriorities
, Progress Future Direction

• Gregg Pane, MD, MPA, FACEP
• Director
• National Healthcare Preparedness Programs
• HHS/ASPR

2
Hospital Preparedness Program (HPP)

• Mission Statement
• 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
Pandemic and All Hazards Preparedness Act (PAHPA)

• Signed into law December 2006
• Establishes the ASPR
• Leadership
• Personnel
• Countermeasures
• Coordination
• Logistics
• HRSA program ?ASPR
• Title III All Hazards Medical Surge Capacity
• Transfers NDMS from DHS to HHS
• Section 302 Enhancing Medical Surge Capacity
• Section 305 Partnerships for State and Regional
  Hospital Preparedness to Improve Surge Capacity

4
FY02-FY08 HPP Funding History
Fiscal Year (FY) Cooperative Agreements (millions) Healthcare Facility Partnerships (millions)
FY 2002 125 n/a
FY 2003 498 n/a
FY 2004 498 n/a
FY 2005 471 n/a
FY 2006 460 n/a
FY 2007 415 Facilities 18 E-care 25
FY 2008 398 n/a
5
Tiers of Response
6
FY08 HPP Funding Opportunity (398M)

• 398M in Cooperative Agreement Funds Released
  August 2008
• Overarching Requirements
• National Incident Management System (NIMS)
• Education and Preparedness Training
• Exercises, Evaluation and Corrective Actions
• Needs of At-Risk Populations

7
FY08 HPP Funding Opportunity

• Required Activities (Level One sub-capabilities)
• Interoperable Communications Systems
• ESAR VHP
• Tracking of Bed Availability (HAvBED)
• Fatality Management
• Medical Evacuation / Shelter-in-Place
• Partnership/Coalition Development
• Once all the above are met in full States may
  propose a host of other activities
• PPE, Decon, Pharm Caches
• ACS and Mobile Medical Assets
• CIP
• MRC

8
FY08 HPP Funding Opportunity

• Significantly increased accountability in 2008
  that will affect funding in 2009
• Meeting mid year and end-of-year targets for
  performance measures
• Pan Flu plan submission and successful grade on
  medical surge and fatality management sections
• Not exceeding established maximum carry-over
  limits
• Maintenance of Effort for State funding

9
Performance Measures

• State/Territory can report available beds for at
  least 75 of participating hospitals per HAvBED
  definitions
• S/T can query ESAR-VHP system during
  drill/exercise/event and generate list of
  potential VHP, by discipline and credential
  level, within 2 hours of request
• S/T can compile initial list of VHP within 12
  hours, and report verified list of available VHP
  with 24 hours of a request
• S/T conducts statewide and regional exercises
  that incorporate NIMS concepts and principles,
  and include hospitals
• Proportion of hospitals that can report beds by
  HAvBED within 60 minutes
• Hospitals demonstrate redundant communications
  capability and two-way capability with local
  Operations Command or coalition partners
• Hospitals have written plans for mass fatalities
  and medical evacuation
• Incorporate NIMS concepts/principles identify
  training needs and verify courses

10
Charting Progress A Comparative Look at Hospital
Preparedness FY02 to FY06
Preparedness Element 2002 2006
Federal Guidance Limited infrastructure for integrated and coordinated hospital preparedness activities among US hospitals 87 (5,067) of all US hospitals participate in HPP
Surge Bed Capacity No known surge bed capacity among US hospitals Participating hospitals report the ability to surge over 200,000 beds above the current daily bed staffed bed capacity within a 24-hour period.
Decontamination Two-thirds (66) of hospitals report the ability to handle less than nine patients an hour through a 5-minute decontamination shower per 100 staffed beds Over 400,000 persons could be decontaminated nationwide over a 3-hour period.
Personnel Training Seven out of ten hospitals trained their staff to diagnose biological-agent-related illnesses, with unknown extensiveness of the training 629,083 healthcare personnel nationwide were trained in competency-based programs in fiscal year 2006
Source FY03 GAO Study, April 2003 and FY06
End-of-Year Data
11
Charting Progress A Comparative Look at Hospital
Preparedness FY02 to FY06
Preparedness Element 2002 2006
Personal Protective Equipment Half of all hospitals reported having three or fewer PPE suits Nearly 80 (3995) of hospitals report having appropriate PPE for staff and volunteers
Isolation Capacity Half of all hospitals reported having fewer than four isolation beds per 100 staffed beds Over 79 of US hospitals (4,655) report the capacity to maintain at least one suspected infectious disease case in negative pressure isolation
Drills and Exercises About half of all hospitals had participated in drills or tabletop exercises focused on a biological attack during the past two years 9751 drills, 2914 tabletop exercises, and 4120 functional exercises completed. Nearly 80 of hospitals prepared After Action Reports within 60 days of the drill or exercise
Source FY03 GAO Study, April 2003 and FY06
End-of-Year Data
12
Future Directions

• Shared focus on required program performance
  metrics
• Proactive approach to problem-solving achieving
  goals
• Broad, pre-decisional input on policy, guidance,
  measures
• Adoption and spread of exemplary practices
• Focus on health system preparedness and
  coordination
• Medical surge and health system resiliency
• Lessons and accomplishments from actual events
• Longer planning cycle