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hpp: funding opportunity

 
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By the end of the project period, ASPR expects HPP awardees to strengthen and enhance the readiness of the health care system for activities that advance and document progress toward meeting the goals of the four capabilities detailed in the 2017-2022 Health Care Preparedness and Response Capabilities.

ASPR also expects awardees to document progress across five key domains in establishing or maintaining ready health care systems through strong health care coalitions.

HPP awardee strategies, activities, and related outputs indicated in the logic model will lead to achieving these response and program outcomes during the project period:

  • Timely assessment and earliest possible sharing of essential elements of information,
  • Earliest possible identification and investigation of an incident,
  • Earliest possible implementation of intervention and control measures,
  • Earliest possible communication of situational awareness and risk information,
  • Continuity of emergency operations management throughout the surge of an emergency or incident,
  • Timely and situationally appropriate coordination and support of response activities with partners, and
  • Continuous learning and improvements are systematic.

ASPR will monitor process outputs and performance measures to determine each awardees level of performance.

Important!  Remember, the cooperative agreement is a contract between ASPR and the Awardee, not between the Awardee and the healthcare coalition. HPP cooperative agreement requirements and recommendations only enforceable on the sub grantee – the healthcare coalition – if they are specifically stated in the coalition's sub grant.

But, if the term "the HCC Must" is stated within the cooperative agreement, the Awardee Must include the requirement within the coalition's sub grant.

2017-2018 hpp cooperative agreement domain one strategy

strengthen community resilience

Resilient communities develop, maintain, and leverage collaborative relationships among government, community organizations, and individual households that enable them to more effectively respond to and recover from disasters and emergencies. Awardees must conduct the following activities that sustain or expand community resilience. These activities must be actionable, realistic, and support the achievement of readiness outputs and intended outcomes.

  • Partner with stakeholders by developing and maturing health care coalitions
  • Characterize the probable risks to the jurisdiction and the HCC
  • Characterize populations at risk
  • Engage communities and health care systems
  • Operationalize response plans.

 

2017-2018 hpp cooperative agreement domain two strategy

strengthen incident management

HPP and PHEP awardees must conduct the following activities to strengthen emergency operations management throughout all phases of an incident.

  • Coordinate emergency operations
  • Standardize the incident command structure (ICS) for public health
  • Establish incident command structures for health care organizations and HCCs
  • Ensure HCC integration and collaboration with ESF-8
  • Expedite fiscal and administrative preparedness procedures

2017-2018 hpp cooperative agreement domain three strategy

strengthen information management

HPP and PHEP awardees must conduct the following activities to strengthen information sharing among public health and medical preparedness and response partners and enhance emergency public information and warning.

  • Share situational awareness across the health care and public health systems
  • Share emergency information and warnings across disciplines, jurisdictions, and HCCs and their members
  • Conduct external communication with the public.

2017-2018 hpp cooperative agreement domain four strategy

strengthen countermeasures and mitigation

HPP and PHEP awardees should conduct the following activities that strengthen access to and administration of medical and other countermeasures for pharmaceutical and non-pharmaceutical interventions and strengthen mitigation strategies.

  • Manage access to and administration of pharmaceutical and non-pharmaceutical interventions
  • Ensure safety and health of responders
  • Operationalize response plans.

2017-2018 hpp cooperative agreement domain five strategy

strengthen surge management

Following a public health incident, HPP and PHEP awardees should coordinate to assess the public health and medical needs of the affected community, with PHEP awardees focusing on public health surge needs and HPP awardees and their HCCs focusing on medical surge needs.

While the two programs may focus on different sectors within the community, HPP and PHEP awardees must coordinate these activities jointly.

The following four activities are used to manage public health surge:

  • Address mass care needs, such as shelter monitoring
  • Address surge needs, including family reunification
  • Coordinate volunteers
  • Prevent or mitigate injuries and fatalities.

Management of Public Health Surge | Joint Requirements

The following four activities are used to manage medical surge:

  • Conduct health care facility evacuation planning and execute evacuations
  • Address emergency department and inpatient surge
  • Develop alternate care systems
  • Address specialty surge, including pediatrics, chemical, radiation, burn, trauma, behavioral health, and highly infectious diseases.

Management of Medical Surge

2017-2018 funding restrictions

what awardees must not do, or may do only under specified conditions

phep/hpp overarching funding restrictions and conditions

Important!  Remember, the cooperative agreement is a contract between ASPR and the Awardee, not between the Awardee and the healthcare coalition. These funding restrictions and conditions only apply to the sub grantee – the healthcare coalition – if they are specifically stated in the coalition's sub grant.

hpp specific funding restrictions and conditions

Consistent with section 319C-2 of the PHS Act, HPP funds may only be used to support activities that prepare States for public health emergencies and to improve surge capacity . There are two situations when States (see definition) may use HPP funds during a State or locally declared emergency, disaster, or public health emergency (hereafter referred to as an “emergency”). These situations and related criteria are described below.

Situation 1: HPP Staff Conducting Activities Consistent with Approved Project Goals 

Awardees may use HPP funds to support positions performing preparedness-related activities consistent with the awardee’s project goals and may utilize those positions within any phase of the disaster cycle, provided that the staff members in those positions continue to do work within statutory limitations, the notice of award, and the approved spending plan. For example, an employee’s salary may be permissible for response activities if that employee is carrying out the same responsibilities he or she would carry out as part of his or her preparedness responsibilities.  

Situation 2: Using a Declared Emergency as a Training Exercise 

Under certain conditions, HPP funds may, on a limited, case-by-case basis, be reallocated to support response activities to the extent they are used for purposes provided for in Section 319C-2 of the PHS Act (the program’s authorizing statute), applicable cost principles, the funding opportunity announcement, and the awardee’s application (including the jurisdiction’s all-hazards plan). Awardees should contact their assigned HPP project officer and grants management specialists for guidance on the process to make such a change. ASPR encourages awardees to develop criteria such as costs versus benefits for determining when to request a “scope-of-work” change to use a real incident as a required exercise. 

The request to use an actual response as a required exercise and to pay salaries with HPP funds for up to seven days will be considered for approval under these conditions:

  • A state or local declaration of an emergency, disaster, or public health emergency is in effect.
  • No other funds are available for the cost.
  • The awardee agrees to submit within 60 days (of the conclusion of the disaster or public health emergency) an after-action report, a corrective action plan, and other documentation that supports the actual dollar amount spent.

Note: A change in the scope of work is required to use an actual event as an exercise whether or not funds are needed to support salaries. Also, regardless of the amount of money used in response to an event, the State is still required to meet all the requirements of the original award. 

HPP funding must primarily support strengthening health care system preparedness through the collaborative development of HCCs that prepare and respond as an entire regional health system, rather than individual health care organizations. HPP recognizes that, at the conclusion of the previous project period (2012-2017), some awardees only funded HCCs, some funded individual health care entities (with a requirement that they participate in regional preparedness efforts), and others funded a mixture of HCCs and individual health care entities.

During this project period (2017-2022), beginning in Budget Period 1, all awardees must allocate funding to HCCs. For Budget Period 1, ASPR still permits providing direct funding from the awardee to individual health care entities for regional preparedness efforts; however, ASPR expects that as the project period progresses, the awardee’s funding strategy will include allocating funding to HCCs in a graduated manner – such HCC funding should increase incrementally over the five-year project period.

As awardees allocate more funding to HCCs each year, individual health care entities can continue to receive HPP funding, through the HCC, to ensure regional coordination and collaboration. HCCs will determine the amount of funding for health care entities upon review of coalition projects, as well as health care entity projects, based on the funding priorities for each budget period. This process will ensure that HCC activities contribute to the overarching readiness, preparedness, and resilience of health care systems.

Awardees may retain direct costs for the management and monitoring of the HPP cooperative agreement during the 2017-2022 project period. Awardee-level direct costs are defined as personnel, fringe benefits, and travel. Because the goal is to support HCCs and their health care system partners, awardees must limit these direct costs to no more than 18 percent of the HPP cooperative agreement award.

By the end of Budget Period 5, awardees must limit these direct costs to no more than 15 percent of the HPP cooperative agreement award.

ASPR will consider requests for exemptions on a case-by-case basis. Requests for exemption must be submitted with the Budget Period 1 application. Requests for exemption will be strengthened by letters of support from the HCCs and the jurisdiction’s hospital association indicating these entities understand and agree with the amount the awardee is retaining for awardee-level direct costs. Please note that concurrence is not required, only recommended if an awardee is requesting an exemption.

Within the first 60 days of each budget period, all awardees must provide a detailed spend plan, including all budget line items, to all HCCs within their jurisdiction and any interested health care entity. This spend plan must also be sent to FPOs.

Awardees are not required to submit position descriptions for HPP funded-staff with the application. However, awardees may be required to submit this information to HPP if the roles and responsibilities of the employee(s), and how they support health care preparedness are not clear in the budget narrative section of the application.

HPP awardees and their subrecipients may provide funding to individual hospitals or other health care entities, as long as the funding is used for activities to advance regional, HCC, or health care system wide priorities, and are in line with ASPR’s four health care preparedness and response capabilities.

Funding to individual health care entities is not permitted to be used to meet Centers for Medicare and Medicaid Services (CMS) conditions of participation, including CMS-3178-F Medicare and Medicaid Programs: Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. CMS-3178-F requires providers and suppliers to the following conditions of participation.

  • Development of an emergency plan: Based on a risk assessment, develop an emergency plan using an all-hazards approach focusing on capacities and capabilities that are critical to preparedness for a full spectrum of emergencies or disasters specific to the location of a provider or supplier. HPP funding may not be provided to individual health care entities to meet this requirement; however, ASPR encourages HCCs to provide technical assistance to their individual members to assist them with the development of their emergency plans. HCCs are permitted to use HPP funding to develop the staffing capacity and technical expertise to assist their members with this requirement.
  • Develop policies and procedures: Develop and implement policies and procedures based on the plan and risk assessment. HPP funding may not be provided to individual health care entities to meet this requirement; however, ASPR encourages HCCs to provide technical assistance to their individual members to assist them with the development of policies and procedures. HCCs are permitted to use HPP funding to develop the staffing capacity and technical expertise to assist their members with this requirement.
  • Develop and maintain a communication plan: Develop and maintain a communication plan that complies with both Federal and State law. Patient care must be well-coordinated within the facility, across health care providers, and with State and local public health departments and emergency systems. HPP funding may not be provided to individual health care entities to meet this requirement; however, ASPR encourages HCCs to provide technical assistance to their individual members to assist them with the development a communication plan that integrates with the HCC’s communications policies and procedures. HCCs are permitted to use HPP funding for costs associated with adding new providers and suppliers to their HCC who are seeking to join coalitions to coordinate patient care across providers, public health departments, and emergency systems (e.g., hiring additional staff to coordinate with the new members, providing communications equipment and platforms to new members, conducting communications exercises, securing meeting spaces, etc.)
  • Develop and maintain a training and testing program: Develop and maintain training and testing programs, including initial and annual trainings, and conduct drills and exercises or participate in an actual incident that tests the plan. HPP funding may not be provided to individual health care entities for individual health care organizations’ trainings and exercises. HPP funding may be used to plan and conduct trainings and exercises at the regional or HCC level.

Hospital Preparedness Program: ASPR Proposed Funding FY 2018

State FY 2018 (CR) FY 2018 (Request) +/-$ +/-%
Alabama $3,316,320 $4,478,616 +$1,162,296 +11%
Alaska $951,914 $1,219,930 +$268,016 +11%
American Samoa $278,422 $0 -$278,422 -100%
Arizona $3,930,938 $0 -$3,930,938 -100%
Arkansas $2,002,932 $2,585,053 +$582,121 +11%
California $23,397,482 $20,175,928 -$3,221,554 +11%
Chicago $2,736,056 $2,048,099 -$687,957 +11%
Colorado $3,119,392 $0 -$3,119,392 -100%
Connecticut  $2,330,641 $0 -$2,330,641 -100%
Delaware $1,049,193 $0 -$1,049,193 -100%
Florida $11,882,752 $12,767,567 +$944,815 +11%
Georgia $5,973,258 $6,732,448 +$759,190 +11%
Guam $374,754 $0 -$374,754 +11%
Hawaii $1,261,124 $0 -$1,261,124 -100%
Idaho $1,247,694 $0 -$1,247,694 -100%
Illinois $8,772,659 $7,990,729 -$781,930 +11%
Indiana $3,934,926 $4,735,094 +$800,168 +11%
Iowa $2,130,401 $2,616,125 +$485,724 +11%
Kansas $2,117,146 $2,342,757 +$231,611 +11%
Kentucky $2,759,985 $3,970,833 +$1,210,848 +11%
Los Angeles County $9,263,958 $6,729,769 $-2,534,189 +11%
Louisiana $2,895,985 $4,412,533 +$1,516,548 +11%
Maine $1,065,567 $1,512,008 +$446,441 +11%
Marshall Islands $268,005 $0 -$268,005 +11%
Maryland $4,864,700 $4,240,380 -$624,320 +11%
Massachusetts $4,315,709 $3,684,602 -$631,107 +11%
Michigan $6,157,587 $4,221,454 -$1,936,133 +11%
Micronesia $276,806 $0 -$276,806 +11%
Minnesotta $3,518,356 $2,217,950 -$801,406 +11%
Mississippi $2,176,032 $2,861,356 +$2,685,324
Missouri $3,676,990 $5,186,585 +$1,509,595
Montana $920,601 $0 -$920,601 -100%
N. Mariana Islands $270,356 $0 -$270,356 -100%
Nebraska $1,373,309 $0 -$1,373,309 -100%
Nevada $1,911,347 $0 -$1,911,347 -100%
New Hampshire $1,089,878 $0 -$1,089,878 -100%
New Jersey $5,633,732 $5,186,585 -$535,388 +11%
New Mexico $1,527,031 $0 -$1,527,031 -100%
New York $9,639,512 $16,693,113 +$7,053,601 +11%
New York City $8,033,288 $13,455,551 +$5,514,224 +11%
North Carolina $5,908,241 $7,562,187 +$1,449,686 +11%
North Dakota $879,429 $0 -$879,429 -100%
Ohio $7,450,278 $6,202,189 +$248,089 +11%
Oklahoma $2,602,493 $2,758,110 +$155,617 +11%
Oregon $2,577,424 $0 -$2,577,424 -100%
Palau $255,373 $0 -$255,373 -100%
Pennsylvania $8,093,898 $7,851,839 -$242,059 +11%
Puerto Rico $2,576,010 $2,854,070 +$278,060 +11%
Rhode Island $940,547 $0 -$940,547 -100%
South Carolina $3,117,650 $3,929,521 +$811,871 +11%
South Dakota $848,108 $1,128,320 +$280,212 +11%
Tennessee $4,040,788 $3,659,664 -$381,124 +11%
Texas $16,176,634 $15,435,244 -$741,390 +11%
Utah $2,271,467 $0 -$2,271,467 -100%
Vermont $780,333 $0 -$780,333 -100%
Virgin Islands $305,611 $0 -$305,611 -100%
Virginia $6,075,317 $6,743,291 +$667,974 +11%
Washington $4,279,234 $0 -$4,279,234 -100%
Washington, DC $944,353 $1,814,895 +$870,542 +11%
West Virginia $1,405,606 $1,578,846 +$173,240 +11%
Wisconsin $3,634,631 $0 -$3,634,631 -100%
Wyoming $837,538 $0 -$837,538 -100%
Total $228,500,000 $204,500,000 -$24,000,000 +11%

Federal Fiscal Year vs. ASPR HPP Budget Year

hpp funding 2004–2018


2018-2019 (Requested), $204,500,000
 
2017-2018, $228,500,000
 
2016-2017, $228,500,000
 
2015-2016, $228,500,000
 
2014-2015, $228,500,000
 
2013-2014: $331,759,862
 
2012-2013: $351,644,731
 
2011-2012, $352,605,175
 
2010-2011: $390,500,000
 
2009-2010: $362,017,984
 
2008-2009, $398,095,000
 
2007-2008: $415,032,000
 
2006-2007: $450,396,032
 
2005-2006, $491,000,000
 
2004-2005: $498,000,000
 

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