ASPR Takes Control of the SNS

ASPR Takes Control of the SNS

The transfer of oversight and operational control of the Strategic National Stockpile (SNS) from the Centers for Disease Control and Prevention (CDC) to the Assistant Secretary for Preparedness and Response (ASPR) is seen by some as a power play that demotes the CDC and its Public Health Emergency Preparedness Program (PHEP). Others worry that it will lead to healthcare coalitions being tasked with mass prophylaxis responsibilities currently managed by local health departments. It is neither. It is a long overdue shift that aligns with ASPR's broad Emergency Support Function (ESF) 8 mission.


Per the CDC, the SNS is "the nation’s largest supply of potentially life-saving pharmaceuticals and medical supplies for use in a public health emergency severe enough to cause local supplies to run out." Yes, the SNS is strategically located warehouses stocked full of pharmaceuticals and medical supplies and equipment that can be loaded onto aircraft and quickly dispatched to states in a matter of hours. After delivery, stockpile items become assets of the states and are rapidly delivered to local health departments and medical facilities utilizing detailed plans.

Put simply, the SNS is a logistics mission. 

The program was established in 1999 as the National Pharmaceutical Stockpile with a mission "to assemble large quantities of essential medical supplies that could be delivered to states and communities during an emergency within 12 hours of the federal decision to use the stockpile." It was renamed the Strategic National Stockpile in 2003 and, after a few years of oversight and control by the Department of Homeland Security, it was moved to the CDC and placed in its own division, the Division of Strategic National Stockpile.

Why the CDC? Maybe that's because ASPR did not yet exist.

In addition to "12-hour push packs" and managed inventory, the SNS has Federal Medical Stations in its arsenal. Per the CDC, a Federal Medical Station is, "a non-emergency medical center set up during a natural disaster to care for displaced persons with special health needs—including those with chronic health conditions, limited mobility, or common mental health issues—that cannot be met in a shelter for the general population during an incident." Keep in mind that a Federal Medical Station is requested through the CDC, and does not include the staff.

So who staffs it? Most likely a Disaster Medical Assistance Team (DMAT) requested by the states through ASPR.

The Transfer

"The recently released President's Budget announced the Secretary's decision to transfer oversight and operational control of the Strategic National Stockpile from the CDC to ASPR," stated Dr. Robert Kadlec in a February email to ASPR Colleagues. "At ASPR, the SNS will continue to be a fundamental preparedness and response capability in the nation's arsenal to protect the health of Americans from 21st century threats."

Unlike other strategic shifts recently announced by ASPR, transfer of the SNS does not require Congressional action. The change can be made at the sole discretion of the Secretary of the Department of Health and Human Services. So, it's a done deal. And it's not big deal for healthcare coalitions or local health departments. 

In explaining the rationale for the transfer to colleagues, Dr. Kadlec wrote, "[t]his new arrangement will allow the work to be coordinated more directly with the work of ASPR and our response function under Emergency Response Function (ESF) 8."

And that's where the departure from the CDC makes sense. You see, ASPR is far bigger than just the Hospital Preparedness Program (HPP), and moving the SNS does not make it an HPP function. The agency has a legislative mandate to serve as the Nation's ESF 8 lead, which includes oversight and operational control of the National Disaster Medical System (NDMS). Per ASPR, the NDMS is "a federally coordinated system that supports communities that have been impacted by a disaster by providing various medical services."

So, the NDMS puts boots-on-the-ground to support state and local officials in providing medical services during disasters. And providing such services requires tightly coordinated logistics operations. Which is why ASPR's Office of Emergency Management, Division of Logistics "manages and provides the critical logistical supporting components for NDMS and other HHS public health and medical teams to respond, and ensures that the right equipment is where it is needed to provide an effective response." Yes, ASPR has a Logistics Division that handles logistics for NDMS, but, until now, not the SNS.

The transfer of the SNS is about nothing more than streamlining logistics and aligning systems and programs with a modern, maturing ASPR. And it has little impact on the CDC Division of State and Local Readiness (DSLR) or its mission.
The anticipated transition date is October 1, 2018. And it's not a big deal.

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Karl Schmitt, Passionate Founder & CEO, bParati

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