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Goodbye HPP Capabilities, Hello...

Goodbye HPP Capabilities, Hello...

The Assistant Secretary for Preparedness and Response (ASPR) has released a Pre-Decisional Draft of the 2017 Health Care Preparedness and Response Capabilities (HCPR Capabilities) for public review and comment.

The comment period closes Friday, August 12th, so speak now or forever hold your peace. Keep reading to get a high level overview of the pre-decisional draft and learn how to download the document and ASPR's custom comment spreadsheet, as well as who at ASPR to send it to.

The HCPR Capabilities are intended to replace the Preparedness Capabilities: National Guidance for Healthcare System Preparedness, which is more often called the HPP Capabilities – the brethren of the Hospital Preparedness Program. But, as we will explain shortly, the Capabilities, either HPP or HCPR, are more like a cousin of HPP than a brother.

The HPP Capabilities were published in 2012 to dovetail with the Public Health Preparedness Capabilities: National Standards for State and Local Planning (PHEP Capabilities), under what was being marketed as program 'alignment.'

The PHEP Capabilities were published by the Centers for Disease Control and Prevention (CDC), Division of State and Local Readiness (DSLR) to drive national standards for local health department preparedness programs – in alignment with the efforts of the community's healthcare system.

four capabilities

Today's HPP Capabilities total eight, but the streamlined pre-decisional draft from ASPR currently proposes only four:

HCPR Capabilities Cover Image

  • Capability 1: The community has a sustainable Health Care Coalition (HCC) comprised of members with strong relationships—that can identify hazards and risks and prioritize and address gaps through planning, training, exercising, and acquiring resources.
  • Capability 2: Health care organizations, HCCs, and their jurisdictions collaborate to share and analyze information, manage resources, and coordinate strategies to deliver acute medical care to all populations during emergencies and planned events. Simultaneous response and recovery operations result in a return to normal or improved operations.
  • Capability 3: Health care organizations, with support from HCCs, provide uninterrupted medical care to all populations in the face of damaged or disabled health care infrastructure. Health care workers are well-trained, well-educated, and well-equipped to care for patients during emergencies.
  • Capability 4: Health care organizations—including hospitals, EMS, and out of hospital providers—deliver timely and efficient care to their patients even when the demand for health care services exceeds available supply. The HCC coordinates information and all available resources for its members to maintain conventional surge response. When an emergency overwhelms the HCC’s collective resources, the HCC facilitates the health care system transition to contingency and crisis surge response and its return to conventional standards of care.

Now, before you panic and go thinking, "I wouldn't have killed myself on the other four capabilities over the past four years had I knew ASPR would dump them," know that many of the changes are as much a reshuffling as they are a reinvention – an evolution, not a revolution. That said, more so than ever before, HCCs are engrained in everything the Capabilities are about.

emphasis on health care coalitions

Given the tight window to get comments into ASPR, I've forgone the time consuming deep rooted analysis and interjection of personality to this post. But, I do want to point out the extensive reference to the value of and necessity for HCCs. The following statements are verbatim from the draft:

  • HCCs play a critical role in developing health care delivery system preparedness and response capabilities.
  • HCCs serve as multi-agency coordinating groups that support and integrate with Emergency Support Function-8 (ESF-8) activities.
  • HCCs coordinate activities among health care organizations—such as hospitals and emergency medical services (EMS)—emergency management, public health, and other health care members and stakeholders.
  • HCC members actively contribute to HCC strategic planning, operational planning and response, information sharing, and resource coordination and management.
  • HCCs collaborate to ensure that each member has the necessary medical equipment and supplies, real-time information, communication systems, and trained health care personnel to respond to emergencies and planned events.

Yes, I intentionally bolded and italicized the terms "health care coalition" and HCC every time they were used. It looks like ASPR's driving a point home: engaged, collaborative, multi-discipline, multi-sector healthcare coalitions are the heart of their strategy for healthcare system preparedness. And for a provider, to meet the Capabilities without participating in their HCC would be overly burdensome and expensive.

the HPP Grant vs. the capabilities

Before closing out, let's take a moment to understand what the HPP/HPRC Capabilities are and what they are not.

Among most healthcare preparedness professionals I've spoken with, there is an overwhelming belief that the Capabilities are a mandatory check list that accompanies the HPP grant. That is, if your employer participates in the Hospital Preparedness Program and wants to continue to receive the grant, the capabilities are the required roadmap – that they must be achieved over the course of the five-year project period. They are not.

The only way that the Capabilities become a requirement – a deliverable – of the HPP grants delivered by a state, is if the state chooses to incorporate such a requirement into their sub-grants. You see, provided the states meet their requirements under the cooperative agreement with ASPR, they can dictate more stringent requirements for their sub grantees.

HCPR Capabilities Cover Image

Also, it's important to understand that no matter what the Capabilities are titled, the funding – unless the law is changed – will continue to come from the HPP Cooperative Agreement. This, despite the fact that the 'H' represents hospital and the HPP's direction and its associated Capabilities have clearly broadened to preparing the broader healthcare system through healthcare coalitions.

So, no, the Capabilities are not a grant requirement unless made to be so by a state. But, they are the recommended roadmap for preparing a community's healthcare system for disasters and public health emergencies – whether or not a healthcare provider participates in the HPP. And ASPR does not make this stuff up. They build the capabilities based on the outcomes of real-life catastrophes and emergencies. They pull information from disaster affected providers and their regional coordinators. And they are asking for your feedback before stamping them for publication.

Be sure to make your voice heard by reviewing the draft and submitting your thoughts – before August 12th.

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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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Karl Schmitt, Passionate Founder & CEO, bParati

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