For the first time since it began examining the nation's level of emergency preparedness after Sept. 11, the Trust for America's Health has analyzed the hospital industry's efforts in laying the groundwork for dealing with major disasters.
The verdict isn't good.
While the federal government rates a sorry D-plus for its overall public-health emergency preparedness, the hospital industry has not been much more effective in planning for the expected surge in patient volume following a major disaster. In fact, the report found that nearly one-third of states and the District of Columbia have failed to prepare for disasters by identifying nearby community centers, sports arenas or hotels that can be used to care for a sudden increase of patients in the wake of a terrorist attack, natural disaster or a large-scale medical emergency.
The state of affairs is no surprise to a cash-strapped industry that has received insufficient help from the federal government, said Shelley Hearne, executive director of the Trust for America's Health, a not-for-profit, nonpartisan Washington group formed after Sept. 11 to help strengthen the public health system.
"The results are not going to be a shock to the hospital world, where over the past few years there has been budget cutting, fiscal belt-tightening and a wide range of needs," Hearne said. "The bottom line is that hospitals in the end received a drop in the bucket from the federal government to strengthen the nation's front-line health defenses."
Jim Bentley, senior vice president of strategic policy planning at the American Hospital Association, said the report echoed his organization's mantra that "increased federal funding is necessary for hospitals and communities to improve their state of preparedness." Experts like Bentley say hospitals need federal funds for preparedness because margins are so tight they often need to focus their spending on immediate concerns such as indigent care and technology upgrades.
The report, Ready or Not: Protecting the Public Health From Diseases, Disasters and Bioterrorism, calls for the Health Resources and Services Administration, a division of HHS, to more than double its readiness grants to about $1 billion per year. The HRSA and the Centers for Disease Control and Prevention provided about $1.3 billion in funding for bioterrorism preparedness in 2005, a slight drop from the previous year. In the nation's capital, funding from those two agencies fell more than 7%. The study blasts current funding across the nation as "woefully inadequate to make any broad impact."
Indeed, many of those experts have pushed for more funding and public awareness recently, partly as a result of the problems resulting from Hurricane Katrina. While some progress has been made in recent years, experts say much more needs to be done, especially in anticipating the overflow of patients by locating "surge facilities" (Sept. 26, p. 6).
Now in its third year, the two-part report from the watchdog group included one section in which 20 leading public health experts judged the federal government's overall standing since Sept. 11 based on a dozen aspects of emergency preparedness. The overall grade was D-plus, with more than half of the states receiving scores of five or less out of 10 possible points for key indicators of preparedness. The second section rated hospitals, without providing an overall grade, on five of 10 key indicators, including surge capacity and how effective they have been in providing incentives or encouragement to employees to show up in case of a major infectious disease outbreak. Only Rhode Island and South Dakota have met those standards, the report said. Also, hospitals in nearly one-third of the states lack sufficient capabilities to "consistently and rapidly" consult with infection-control experts about possible or suspected disease outbreaks.