By Chris LaPage
July 2011

There are all kinds of disasters that require emergency response. Some of them occur naturally like pandemic influenza and hurricanes. Others are man-made disasters such as exploding bombs and other terrorist attacks. No matter the cause, health care providers play an essential role in the aftermath of these events, caring for the sick and wounded. In addition, health care entities play a major role in preventing certain catastrophes like the spread of infectious diseases. States and other regulatory agencies require hospitals and other health care organizations to be prepared for and able to respond to such emergencies.

However, as if often the case with government mandates, they often times are not funded. For instance, hospitals must have bed tracking software that enables them to secure real time data on availability during crises. Health care entities must be able to communicate with first responders to ensure they are in position to respond to an influx of patients resulting from a disaster. Health care entities must ensure staff are properly trained for dealing with such crises, including proper response protocol. There are supplies to purchase for command centers as well as personal protective equipment for providers in the field. While health care organizations do budget for these items, thin operating margins means that a funding gap typically exists.
The good news is that the federal government does make money available for these efforts.

However, health care facilities may not be aware of how to access the money or how funds can be spent. The Department of Health and Human Services (HHS) recently announced $352 million in Hospital Preparedness Program (HPP) funds that is being distributed across the United States. HPP is formula-based funding that is passed along to states based on population statistics as well as the likelihood of natural and man-made disasters.

The issue is that each state utilizes its own mechanism for passing through the funding to health care providers. While some states administer the funds directly through their state department of health, others allows hospital associations or similar entities to manage the funding. In addition, once it is at state level, the money is typically passed through as "emergency preparedness" or "disaster recovery" funding so it becomes very hard to track. Many states pass the funds through to regional health care providers that are responsible for coordinating efforts for all providers in a specified area. If you are not receiving any emergency preparedness funding from your state, you need to contact your state department of health as a starting point. Sometimes you have to advocate for your patient base and demand a piece of the funding pie.

You may find out that the local department of health in your area receives the funding and you simply need to engage them for support. You have to pay close attention for pass through deadlines as many states will still require health care providers to formally apply to them to receive an allocation. If you are receiving state dollars, then it becomes a question of what is being purchased with the dollars. Unfortunately, many providers are unaware of the flexibility of these funding streams that originate with HPP. A provider may choose to update its command center every year not knowing they can spend the funds on bed tracking software and
communications upgrades. You may not receive enough HPP money to fund all your emergency preparedness activities, but it is an essential source to supplement your budget in this important area.

In addition to HPP funds, you can coordinate with your local public health department on certain emergency preparedness efforts. Local public health departments have access to a similar stream of funding known as Public Health Emergency Preparedness (PHEP) funding. As part of their plans, they may be able to support certain activities carried out by private health care providers. Finally if you are in an high density urban area, you may be able to explore additional emergency preparedness dollars through the "Urban Areas Security Initiative (UASI): Nonprofit Security Grant Program (NSGP)" or "Metropolitan Medical Response System (MMRS)." These are two federal programs offered through the Department of Homeland Security but are administered at the state and local level. Your first point of contact will be the State Administrative Agency (SAA) for these funding sources, which typically is the department of public safety or emergency management agency. However, you will ultimately need to work through the local working group for UASI and municipal officials for MMRS.

There are two lessons here when it comes to emergency preparedness funding for health providers... make sure you advocate for your fair share and spend it wisely. This is true whether you are exploring HPP funding or directly with municipal officials in major urban areas.