Ready or Not? Protecting the Public’s Health from

Diseases, Disasters, and Bioterrorism

Jeff Levi, PhD

Executive Director

Trust for America’s Health

Chief Findings

General Progress has been made – average state scores are higher.

Progress is threatened by decreased federal funding and recession.

Issue is losing focus at federal level. Opportunity in health reform to rethink

healthy system related preparedness issues.

2008 Report State Indicators Mass Distribution –

Strategic National Stockpile

Mass Distribution – Antivirals

Public Health Labs – Pickup and Delivery

Public Health Labs – Pandemic Planning

Biosurveillance

Healthcare Volunteer Liability Protection

Entity Liability Protection

Medical Reserve Corps Food Safety –

Detection & Diagnosis Funding Commitment

State Results Areas of progress:

Lab capacity; pandemic and all-hazards plans; plans for distributing countermeasures; workforce; emergency communications.

Areas of vulnerability: Surge capacity (liability protections and Medical Reserve

Corps coordination); 24 hour lab response; antiviral stockpiling; food safety capacity varies widely; cuts in public health funding.

Progress at Risk State budget crises combined with federal cuts

threatens tremendous progress since 2001. In the coming year, according to the Center on

Budget and Policy and Priorities, 33 states are facing shortfalls in their 2009 budgets and 16 states are already projecting shortfalls to their 2010 budgets.

More than 11,000 state and local public health jobs have already been cut, and another 10,000 may be cut, according to surveys conducted by state and local health departments.

Loss of Focus at Federal Level Federal funding declined. Failure to see through investment on BARDA

and pandemic R&D. Plans need to be evergreen. States and local health depts. need more

explicit guidance so all are equally prepared and do not waste resources duplicating efforts.

Federal and Congressional Action

Pandemic Preparedness Funding Build Preparedness into Health Reform Research and Development Legal Preparedness Federal Food Safety Reforms

Pandemic Preparedness A severe pandemic flu outbreak could result in 90

million Americans becoming sick, 2.2 million deaths, and a drop in the U.S. Gross Domestic Product of more than 5.5 percent, leading to an estimated $683 billion loss. National Strategy should be evergreen document. Congress should continue to fund pandemic preparedness:

For FY10, TFAH recommends $870M in no-year funding, $350M for states.

Congress should ensure oversight of PAHPA.

Pandemic Funding - Inconsistent2006 2007 2008 2009

Omnibus

State & Local$600M (no year)

$0 $0 $0

No Year

(Vaccines, antivirals, etc.)

$5B $0 $0 $507M

CDC $400M $70M $155M $156M

Office of the Secretary

$78M $0 $75M $78M

Funding Fully fund and stabilize funding for state and local

capacity, hospital preparedness, pandemic influenza, BARDA. Fund PHEP grants at $1B (Omnibus was $746M) Fund hospital preparedness at $596M (Omnibus was

$387M) Fund pandemic flu at $870M, and $350M for states

(Omnibus was $507M with no money for states) Fund BARDA at $500M over multiple years (Omnibus

was $250M) Funding should be accountable, transparent, with

outcomes-based measures.

Federal Funding Decline

Preparedness & Health Reform Assure stable funding for strong public health

infrastructure. Build hospital preparedness and surge

capacity funding into reimbursement mechanisms. The federal government should lead surge planning.

Modernize disease surveillance and incorporate preparedness into development of health IT.

Emergency Health Benefit No federal mechanism exists for reimbursing

providers during a public health emergency for treatment of uninsured/underinsured. Senator Durbin (D-IL) and Rep. Lois Capps (D-

CA) introduced Public Health Emergency Response Act in 110th to enable HHS to offer temporary emergency health coverage for uninsured during a health disaster.

Legal Preparedness Congress should amend Public Health Service

Act to provide Federal Tort Claims Act protection to ESAR-VHP volunteers.

Congress should explore liability protection for organizations that participate in emergency response

Federal Food Safety Reforms

Increase resources for food functions at FDA, but pair that with long-term strategic planning and transparency from Agency.

Immediately: HHS should elevate and unify food safety functions within HHS. Should be line authority for food safety official at FDA.

Short-term: Congress should enact legislation to unify food safety functions of HHS (such as H.R. 875) and to strengthen prevention, enforcement, and surveillance capacity at FDA (multiple bills).

Questions?

Please contact: Jeff Levi, Executive Director

jlevi@tfah.org Rich Hamburg, Director of Government

Relationsrhamburg@tfah.org