Virginia Society of Healthcare Engineers Conference Hospital Preparedness Program Overview

Virginia Society of Healthcare Engineers Conference

Hospital Preparedness Program Overview

Williamsburg, VA May 18, 2012

Steven A. Harrison, MA, MEP

Topics

• Hospital Preparedness Program (HPP) History

• Funding Goals• Capabilities• Healthcare Coalitions• Financials and Funding• Resiliency

HPP History

• 9/11 Response• Anthrax• 2002- National Bioterrorism Hospital

Preparedness Program created:• 125 million appropriated to provide

States with funding directed toward addressing gaps in hospital preparedness.

• Focused on building capacity

HPP History

• 2004: • Emphasis shifted from bioterrorism to an

all hazards approach.

• 2006 - 2007: • Office of the Assistant Secretary for

Preparedness and Response (ASPR) created

HPP History

• 2007 - 2011: • Built on “all-hazards” capabilities

• Plans• Communications Interoperability• Information Sharing (e.g., VHASS)• Equipment• Exercises• …and much more

HPP – Present Day

• 2011:• The mission of the HPP is to enhance the

resiliency of healthcare systems to deliver coordinated and effective care during public health emergencies and mass casualty events by improving surge capacity and enhancing community and hospital preparedness.

• Consistent with national preparedness strategies

• Capabilities-based planning and implementation

• Provides national guidance with a “whole of community” and “all of nation” approach

• Serve as the foundation for the 2012 HPP-PHEP cooperative agreements

HPP – Present Day

Public Health Emergency Preparedness

Hospital Preparedness Program

Department of Homeland Security

Emphasis on strengthening community resilience

✔ ✔ ✔

“All-of-nation”/whole community approach

✔ ✔ ✔

Capabilities-based approach

✔ ✔ ✔

Identification of “gaps” ✔ ✔ ✔

Requirement for risk assessment

✔ ✔ ✔

Need for demonstration of ROI

✔ ✔ ✔

Inter-disciplinary Crosswalk

• Improving Infrastructure

• Capability-based approach    • Inclusive coalitions are key

• Regional benefit

Primary HPP Funding Goals

Healthcare Preparedness Capabilities

• Eight (8) HPP capabilities: • Healthcare System Preparedness (Coalitions)• Recovery • Responder Safety and Health • Emergency Operations Coordination • Medical Surge • Fatality Management• Information Sharing• Volunteer Management

Healthcare Coalition Partnerships• Hospitals and other

healthcare providers• Emergency management• Public health • Emergency medical

services• Public safety • Long-term care providers • Mental/behavioral health

providers • Private entities associated

with healthcare (e.g., Hospital associations)

• Private/public labs

• Specialty service providers (e.g., dialysis, pediatrics, woman’s health, stand alone surgery, urgent care)

• Support service providers (e.g., laboratories, pharmacies, blood banks, poison control)

• Community health centers • Primary care providers • Federal entities (e.g.,

NDMS, VA hospitals, IHS facilities, Department of Defense facilities)

Healthcare Coalition

Healthcare & Preparedness Financials

• National health expenses grew to $2.5 trillion in 2009, or $8,086 per person, and accounted for 17.6% of Gross Domestic Product (GDP).

• 2010: Hospital expenditures were $814 Billion (CMS)

• Average Hospital Expenditures= approx. $141 million

• The Hospital Preparedness Program 2012 budget is $347 million (.01% of overall NHE)

• $60,305 per hospital• .0455% of overall budget

Virginia Hospital Preparedness Program Funding Trend

FY00 FY01 FY02 FY03 FY04 FY05 FY06 FY07 FY08 FY09 FY10 FY11 FY12 FY13$0

$2,000,000

$4,000,000

$6,000,000

$8,000,000

$10,000,000

$12,000,000

$14,000,000

HPP

HPP

HPP Funding

Year/ Category

2009-2010 2010-2011 2011-2012 2012-2013

HPP $8,857,019 $9,572,306 $9,421,624 $8,739,318

Match HPP $442,285 $957,230 $942,162 $873,931

2013 – 2014 – Not looking so good…

Funding Restrictions

• Must be reasonable, allocable, necessary and consistent (2CFR225)

• Include use and relationship to specific HPP objectives

• May NOT be used for:• Fund-raising, lobbying• Research• Major renovation (e.g., modified footprint)• Clinical care• Vehicle purchases

Resiliency

Hospital Preparedness Program’s (HPP) definition:

The ability of an asset, system, network or function, to maintain its capabilities and function during and

in the aftermath of an all-hazards incident.

Resiliency• How do you define, measure and evaluate

resiliency?

Timex - It takes a licking…and

keeps on ticking!

Energizer – Just keeps going and

going and going…

“Git ‘er done!”

Resiliency

• Ties directly to Critical Infrastructure and Community Resources:

The assets, systems, networks, and functions, whether physical or organizational, whose

destruction or incapacity would have a debilitating impact on the Nation’s security, public health and

safety, and/or economic vitality.

Resiliency

• Continuity of services and reconstitution following a catastrophe...

Resiliency

Regional Approach:

HHS recognizes that healthcare entity level needs will likely be high for these kinds of activities but

still urges awardees to consider activities and purchases that support REGIONAL approaches to planning and response due to limited funding and

competing demands

Resiliency

Regional Approach:

States may propose projects and fund facility upgrades that relate directly to resilience

and protection of critical healthcare entities and services…based on a need identified in

regional HVAs.

Virginia Resiliency Program Focus

• Evaluation – Facility Surveys• Water Projects• Electrical Enhancements• Security• Ventilation/Filtration, Isolation

Other Examples

• Enhance regional hospital radio system• Hospital reporting of HAvBED compliant

information• Add morgue holding capacity• Portable power units for HCCs• Vents• Trailers• Decontamination equipment, tents and

showers• STIPs

Viable Projects

• HVA-based• Build surge capacity• Add regional value• Have consensus of coalition partners • Element of long-term plan