1. National Bioterrorism Hospital Preparedness Program (NBHPP) Surge Capacity LCDR Sumner L. Bossler Jr. Senior Public Health Analyst Department of Health and Human Services Health Resources and Services Administration Special Programs Bureau Division of Health Care Emergency Preparedness Nation Bioterrorism Hospital Preparedness Branch

2. Overview Program initiated in 2002 Program initiated in 2002 $135 Million in 2002 $135 Million in 2002 $498 Million in 2003 $498 Million in 2003 62 Awardees 62 Awardees 50 States, Washington, DC and Puerto Rico 50 States, Washington, DC and Puerto Rico Cities of Chicago, Los Angeles and New York Cities of Chicago, Los Angeles and New York Virgin Islands Virgin Islands Pacific Territories and Freely Associated Nations Pacific Territories and Freely Associated Nations

3. Priority Areas Administration Administration Regional Surge Capacity Regional Surge Capacity Emergency Medical Services Emergency Medical Services Linkages to Public Health Departments Linkages to Public Health Departments Education and Preparedness Training Education and Preparedness Training Terrorism Preparedness Exercises Terrorism Preparedness Exercises

4. Critical Benchmarks 16 Total Critical Benchmarks 16 Total Critical Benchmarks Evidence based Evidence based Sentinel Indicators Sentinel Indicators

5. Minimal Levels of Readiness Developed for each benchmark Developed for each benchmark Serve, in some cases, as a phased-in approach to achieving the overall benchmark Serve, in some cases, as a phased-in approach to achieving the overall benchmark Some minimal levels are benchmarks themselves Some minimal levels are benchmarks themselves

6. Sentinel Indicators Developed for each benchmark Developed for each benchmark Will serve as a baseline for quantitative data Will serve as a baseline for quantitative data Asking for retrospective report with applications and yearly updates from then on Asking for retrospective report with applications and yearly updates from then on

7. Critical Benchmarks: Surge Capacity 2.1: Beds 2.1: Beds 2.2: Isolation Capacity 2.2: Isolation Capacity 2.3: Health Care Personnel 2.3: Health Care Personnel 2.4: Advanced Registration System 2.4: Advanced Registration System 2.5: Pharmaceutical Caches 2.5: Pharmaceutical Caches 2.6: Personal Protective Equipment 2.6: Personal Protective Equipment 2.7: Decontamination 2.7: Decontamination 2.8: Behavioral Health 2.8: Behavioral Health 2.9: Trauma and Burn Care 2.9: Trauma and Burn Care 2.10: Communications and Information Technology 2.10: Communications and Information Technology

8. Critical Benchmarks Surge Capacity 2.1: Beds 2.1: Beds 2.3: Health Care Personnel 2.3: Health Care Personnel 2.6: Personal Protective Equipment 2.6: Personal Protective Equipment 2.7: Decontamination 2.7: Decontamination

9. Critical Benchmark #2.1: Beds Establish a system that allows the triage, treatment and initial stabilization of 500 adult and pediatric patients per 1,000,000 awardee jurisdiction (1:2000), above the current daily staffed bed capacity, with acute illnesses or trauma requiring hospitalization from a chemical, biological, radiological, nuclear or explosive (CBRN&E) incident.

10. Critical Benchmark #2.3: Health Care Personnel Establish a response system that allows the immediate deployment of additional health care personnel in support of surge bed capacity noted in Critical Benchmark # 2-1. The number of health care personnel must be linked to already established patient care ratios noted by the awardees Patient Care Practice Acts based on 24 hours operations This benchmark must describe how these personnel are recruited, received, processed and managed through the incident in accordance with the awardee system noted in CB #2.1.

11. Critical Benchmark #2.6: Personal Protective Equipment Each awardee must ensure adequate personal protective equipment (PPE) per awardee defined region, to protect current and additional health care personnel, during a chemical, biological, radiological or nuclear incident. This benchmark is tied directly to number of health care personnel the awardee must provide (CBM # 2.3) to support surge capacity for beds (CBM # 2.1).

12. Critical Benchmark #2.7: Decontamination Ensure that adequate portable or fixed decontamination systems exist for managing adult and pediatric patients as well as health care personnel, who have been exposed during a chemical, biological, radiological, nuclear or explosive incident in accordance with the numbers associated with CBM # 2.1 & # 2.3. All decontamination assets must be based on how many patients/providers can be decontaminated on an hourly basis. The awardee should plan to be able to decontaminate all patients and providers within 3 hours from the onset of the event.

13. Contact Information Sumner L. Bossler Jr. Lieutenant Commander, United States Public Health Service Division of Health Care Emergency Preparedness Special Programs Bureau Health Resources and Services Administration Office: 301-443-1095 Fax: 301-480-0334 Email: sbossler@hrsa.gov sbossler@hrsa.gov Website: www.hrsa.gov/bioterrorism/index.htm www.hrsa.gov/bioterrorism/index.htm