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PHEP Zika Cut Likely To Hit HPP & Healthcare Coalitions

PHEP Zika Cut Likely To Hit HPP & Healthcare Coalitions

When is a Public Health Emergency Preparedness (PHEP) program funding cut a Hospital Preparedness Program (HPP) funding cut? When states' preparedness offices spilt funding between PHEP and HPP for staff, training programs, and technology licenses, such as alerting, resources management, and interoperable communications systems.

Yes, the efficiencies that came with grant and program alignment in 2012 are partially responsible for today's indirect funding cut to HPP – let's call it collateral damage. And understand that the phenomenon can cut both ways, as future cuts to HPP are very likely to cause pain for local health departments.

That is unless states can absorb the cuts within their own budgets.

To their credit, some state directors I've spoken with have held funding at last year's levels for their PHEP and HPP sub grantees through various strategies, including reallocating carryover, holding vacant positions, and cancelling projects.

I suspect such strategies will not fully offset the cuts for most, but there is hope. When reached out to for data on states that expect to cut funding to their HPP sub grantee, sources at the Office of the Assistant Secretary for Preparedness and Response (ASPR) stated that no such data was available.

the political problem

To date, the problem before us is that the House, Senate, and White House cannot agree on the true value of averting a public health emergency.

  • February 22: President requests $1.9 billion Zika appropriations from congress.
  • March 16: CDC announces a shift of $44.2 million from the current fiscal year state and local base PHEP grants to pay for the Zika response.
  • May 17: Senate approves a $1.1 billion Zika appropriations bill.
  • May 18: House of Representatives approves a $622.1 million Zika funding.

As for the President's request, instead of acting, leaders 'recommended' the administration use unspent Ebola dollars to fight Zika. The administration did transfer $589 million into the Zika effort, but they intend to restore it should their full request be approved.

Aside from the Ebola funding shift, the administration authorized the CDC to redirect $44.2 million from state and local base PHEP grants. And that is the crux of today's story – the very reason that state and local health departments are up in arms; the very reason HPP sub grantees should be concerned.

public health's unified voice

And it is the very reason public health stakeholders have raised their collective voices to advocate for the President's proposal. Yes, the National Association of City and County Health Officials (NACCHO), the Association of State and Territorial Health Officials (ASTHO), the Association of Public Health Laboratories (APHL), and the Council of State and Territorial Epidemiologists (CSTE) are in lockstep.

These organizations banded together to publish an excellent report, Impact of the Redirection of Public Health Emergency Preparedness (PHEP) Funding from State and Local Health Departments to Support National Zika Response. And introduced it with a well-written Press Release to ensure the media had the information they needed to cover the story.

And this great report clearly laid out how the cuts to PHEP would likely cause indirect cuts to HPP and therefore healthcare coalitions, right? Nope, not a word. As we've written before, pubic health ain't healthcare, and understanding and advocating for HPP is not the responsibility of or a priority for NACCHO, ASTHO, APHL, or CSTE.

healthcare preparedness, a mute

But fortunately, not to be outdone, healthcare coalitions and their member hospitals, long-term care centers, community health centers, dialysis clinics, and home health agencies have banded with their national associations to deliver – nothing.

Huh! It's almost as if healthcare preparedness has no national voice. Other than ASPR, which as a government agency must remain tight lipped, is there anyone fighting for HPP, for healthcare system preparedness, for healthcare coalitions?

Next week, I will compare and contrast the 'national uproar' over Congress’ decision to cut $103,259,862 from HPP in 2013 and the furious response to CDC's recent decision to redirect $44,200,000 from state and local PHEP grants. When it comes to advocacy, one of these programs is not like the other.

So, why is it that PHEP is defended like Fort Knox while HPP gets little more attention than Fort DeSoto? And who will emerge as the national voice for healthcare preparedness?

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Karl Schmitt, MPA

Karl Schmitt, MPA


Karl is the Passionate Founder & CEO of bParati. He is on a mission to build a national network of effective, sustainable healthcare coalitions. More...

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In all we do, we seek to reduce human suffering and loss of life caused by disasters.

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Karl Schmitt, Passionate Founder & CEO, bParati

Karl SchmittPassionate Founder & CEO

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