Future Directions for the
Preparedness Programs
Office of Public Health Preparedness
South Carolina Department of Health and Environmental Control
August 28, 2012
Overview
• New directions for emergency management, public
health preparedness and healthcare system
preparedness
• Program alignment
• Healthcare system capabilities
• Performance Measures
• Emphasis on broad community coalitions
Changes in National Directions for
Emergency Management
• Presidential Policy Directive 8 was issued
March 30, 2011 to facilitate “an integrated,
all-of-Nation, capabilities-based approach to
preparedness”
• Replaces HSPD-8 (2003)
• Provides guidance for National Preparedness
Goal, National Preparedness System, National
Preparedness Report
PPD-8 Implementation Plan
• National Preparedness Goal – September 25, 2011
• National Preparedness System - November 24, 2011
•
•
•
•
•
National Incident Management System
National Planning System
National Training and Education System
National Exercise Program
Remedial Action Management Program
• National Preparedness Report – March 30, 2012
• National Planning Frameworks – June 30, 2012
• Interagency Operational Plans – September 25, 2012
National Preparedness Goal
• A secure and resilient Nation with the
capabilities required across the whole
community to prevent, protect against,
mitigate, respond to, and recover from
the threats and hazards that pose the
greatest risk
National Preparedness Goal
• Five Mission Areas
•
•
•
•
•
Prevention (of Terrorism)
Protection
Mitigation
Response
Recovery
National Preparedness System
• National Preparedness System description
released November 24, 2011
• Components:
•
•
•
•
•
•
Identifying and assessing risks
Estimating capability requirements
Building and sustaining capabilities
Planning to deliver capabilities
Validating capabilities
Reviewing and updating
National Preparedness System
• Identifying and Assessing Risks
• Threat and Hazard Identification and Risk
Assessment (THIRA) guidance currently
under development
• Strategic National Risk Assessment
identifies major risks for the nation
• Estimating capability requirements
• Setting target levels for core capabilities in each
community
National Preparedness System
• Building and sustaining capabilities
• Identifying and prioritizing gaps
• Leveraging community resources
• Planning to deliver capabilities
• A whole community approach
• Federal guidance in National Frameworks
• Validating capabilities
• Exercises and training
• Reviewing and updating
• Senior level reviews of national preparedness
National Disaster Recovery
Framework
•
•
•
•
Defines core recovery principles
Roles and responsibilities
Coordinating structure
Guidance for pre- and post-disaster recovery
planning
• Describes process for community rebuilding
• Recovery Support Functions – core recovery
capabilities
Core Principles
•
•
•
•
•
•
•
•
•
Individual and family empowerment
Leadership and local primacy
Pre-disaster recovery planning
Partnerships and inclusivity
Public information
Unity of effort
Timeliness and flexibility
Resilience and sustainability
Psychological and emotional recovery
National Preparedness Report,
March 2012
•
Overall, the National Preparedness Report found
that the Nation has increased its collective
preparedness not only for the countless threats
posed by those who wish to harm America’s
homeland, but also for the many natural and
technological hazards that face the Nation’s
communities. Areas of national strength include
planning, operational coordination, intelligence and
information sharing, and other response-related
capabilities.
Public Health Emergency Preparedness
• Alignment of CDC Public Health Preparedness
Program and Hospital Preparedness Program
• One application
• Financial administration by CDC Program Grants
Office
• Two separate budgets
• Two sets of requirements, capabilities and reports
• Two Project Officers
Aligned Capabilities
•
•
•
•
•
•
•
1. PHEP - Community Preparedness
1. HPP – Healthcare System Preparedness
2. PHEP - Community Recovery
2. HPP – Healthcare System Recovery
3. PHEP - Emergency Operations Coordination
3. HPP – Emergency Operations Coordination
4. PHEP - Emergency Public Information and
Warning
• 5. PHEP - Fatality Management
• 5. HPP – Fatality Management
Aligned Capabilities
•
•
•
•
•
•
•
•
6. PHEP - Information Sharing
7. PHEP - Mass Care
8. PHEP - Medical Countermeasure Dispensing
9. PHEP - Medical Materiel Management and
Distribution
10. PHEP - Medical Surge
10. HPP - Medical Surge
11. PHEP - Non-Pharmaceutical Intervention
12. PHEP - Public Health Laboratory Testing
Aligned Capabilities
• 13. PHEP - Public Health Surveillance and
Epidemiological Investigation
• 14. PHEP - Responder Health and Safety
• 14. HPP - Responder Health and Safety
• 15. PHEP - Volunteer Management
• 15. HPP - Volunteer Management
Each Capability Has Multiple Functions, Tasks
and Resource Elements
• PHEP: 15 capabilities, 65 functions, 237
tasks, 425 resource elements
• HPP: 8 capabilities, 29 functions, 62
tasks, 111 resource elements
• We must assess status of all these
capabilities, functions and resource elements
each year
• We must address all functions and resource
elements over the 5 year grant period
PHEP and HPP Requirements
• Assessment, planning and implementation of the 15 PHEP
capabilities and the 8 HPP capabilities
• Assessment at state and local (regional) levels
• Documented achievement of resource elements, functions
for each capability
• Required performance measures and reports
• Budgeting by capability and function
• Detailed accountability requirements include exercises,
training, performance measures, expenditure reporting
SC Preparedness Funding FY 2012-13






SC PHEP FY 2012-13 Funding
Total Funding: $9,759,429
Base: $8,587,829
Cities Readiness Initiative: $284,781
Level 1 Chemical Lab: $886,849
SC HPP FY 2012-13 Funding: $5,263,121
CDC Public Health Emergency Preparedness
Funding Including All Categories
PHEP Base Funding
HPP Funding
Funding Issues
• Outlook for future funding is not good: anticipate further reductions in
both PHEP and HPP.
• Do not expect a Federal budget for FFY 2013 to be passed before the
election (or the end of the year)
• A six-month Continuing Resolution is expected to fund the Federal
programs from October 1, 2012 to March 30, 2013. This would mean
that the 2013 PHEP and HPP application budgets would be ”planning
figures” subject to reduction.
• If sequestration begins January 2013, it would not affect current FY
2012 budgets (through June 30, 2013). Projected impact is about 8%
reduction in FY 2013.
• President Obama’s FY 2013 budget request in February 2012 asked
for 30% cut in HPP and roughly level funding for PHEP. [It was DOA
in Congress.]
Regional Healthcare Coalitions
• New HPP vision - Greater emphasis on regional
coalitions and planning:
• “Federal leadership and grant funding to move from
preparedness at the facility level to healthcare preparedness
at the community level.”
• National Health Security Strategy’s two strategic
goals:
• Build Community Resilience
• Strengthen and sustain health and emergency response
systems
1. HPP - Healthcare System Preparedness
•
•
•
•
•
•
Healthcare system preparedness is the ability of a community’s healthcare
system to prepare, respond, and recover from incidents that have a public
health and medical impact in the short and long term. The healthcare system
role in community preparedness involves coordination with emergency
management, public health, mental/behavioral health providers, community and
faith-based partners, state, local, and territorial governments to do the
following:
..Provide and sustain a tiered, scalable, and flexible approach to attain needed
disaster response and recovery capabilities while not jeopardizing services to
individuals in the community
..Provide timely monitoring and management of resources
..Coordinate the allocation of emergency medical care resources
..Provide timely and relevant information on the status of the incident and
healthcare system to key stakeholders
Healthcare system preparedness is achieved through a continuous cycle of
planning, organizing and equipping, training, exercises, evaluations and
corrective actions.
1. HPP Healthcare System Preparedness
• Function 1: Develop, refine, or sustain Healthcare Coalitions
• Function 2: Coordinate healthcare planning to prepare the
healthcare system for a disaster
• Function 3: Identify and prioritize essential healthcare assets
and services
• Function 4: Determine gaps in the healthcare preparedness and
identify resources for mitigation of these gaps
• Function 5: Coordinate training to assist healthcare responders
to develop the necessary skills in order to respond
• Function 6: Improve healthcare response capabilities through
coordinated exercise and evaluation
• Function 7: Coordinate with planning for at-risk individuals and
those with special medical needs
Function 1
•
Develop, refine, or sustain Healthcare Coalitions consisting of a
collaborative network of healthcare organizations and their respective
public and private sector response partners within a defined region.
Healthcare Coalitions serve as a multi-agency coordinating group that
assists Emergency Management and Emergency Support Function
(ESF) #8 with preparedness, response, recovery, and mitigation
activities related to healthcare organization disaster operations. The
primary function of the Healthcare Coalition includes sub-state regional,
healthcare system emergency preparedness activities involving the
member organizations. Healthcare Coalitions also may provide multiagency coordination to interface with the appropriate level of
emergency operations in order to assist with the provision of situational
awareness and the coordination of resources for healthcare
organizations during a response.
Coalition Members
•
•
•
•
•
•
•
The State and Healthcare Coalition member organizations encourage the
development of essential partner memberships from the community’s healthcare
organizations and response partners. These memberships are essential for
ensuring the coordination of preparedness, response, and recovery activities.
Memberships may be dependent on the area, participant availability, and
relevance to the Healthcare Coalition. Prospective partners to engage (assuming
they are not already members):
..Hospitals and other healthcare providers
..EMS providers
..Emergency Management/Public Safety
..Long-term care providers
..Mental/behavioral health providers
..Private entities associated with healthcare (e.g., Hospital associations)
Coalition Members
•
•
•
•
•
•
•
•
..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)
..Primary care providers
..Community Health Centers
..Public health
..Tribal Healthcare
..Federal entities (e.g., NDMS, VA hospitals, IHS facilities, Department of
Defense facilities)
Note: Active membership from these constituencies are evidenced by written
documents such as MOUs, MAAs, IAAs, letters of agreement, charters, or other
supporting evidence documents
Coalition Members
•
•
•
•
•
•
•
•
•
•
•
•
P4. Additional Healthcare Coalition partnerships/memberships
The State and Healthcare Coalition member organizations network with subject
matter experts (SMEs) for improved coordination of preparedness, response, and
recovery activities. These memberships may be dependent on the area, participant
availability, and the Healthcare Coalition’s unique needs. Examples of organizations
that may be considered include but are not limited to:
..Local and state law enforcement and fire services
..Public Works
..Private organizations
..Non-governmental organizations
..Non-profit organizations
..Volunteer Organizations Active in Disaster (VOAD)
..Faith-based Organizations (FBOs)
..Community-based Organizations (CBOs)
..Volunteer medical organizations (e.g., American Red Cross)
..Others partnerships as relevant
Thank You
South Carolina is fortunate to have committed
leadership in our hospitals, community
organizations, and professional associations
and the support of knowledgeable and
dedicated emergency management
professionals like yourselves.
Thank you for all you have done and for all you
will do to prepare for the next disaster.