1. Virginia Society of Healthcare Engineers Conference Hospital Preparedness Program Overview Williamsburg, VA May 18, 2012 Steven A. Harrison, MA, MEP

2. Topics Hospital Preparedness Program (HPP) History Funding Goals Capabilities Healthcare Coalitions Financials and Funding Resiliency

3. 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

4. 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

5. HPP History 2007 - 2011: Built on “all-hazards” capabilities Plans Communications Interoperability Information Sharing (e.g., VHASS) Equipment Exercises …and much more

6. 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.

7. 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

8. 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

9. Improving Infrastructure Capability-based approach Inclusive coalitions are key Regional benefit Primary HPP Funding Goals

10. 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

11. 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)

12. Healthcare Coalition

13. 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

14. Virginia Hospital Preparedness Program Funding Trend

15. HPP Funding Year/ Category 2009-20102010-20112011-2012 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…

16. 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

17. 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.

18. 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!”

19. 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.

20. Resiliency Continuity of services and reconstitution following a catastrophe...

21. 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

22. 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.

23. Virginia Resiliency Program Focus Evaluation – Facility Surveys Water Projects Electrical Enhancements Security Ventilation/Filtration, Isolation

24. 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

25. Viable Projects HVA-based Build surge capacity Add regional value Have consensus of coalition partners Element of long-term plan