Issue Category: Public Health Preparedness

TFAH Applauds Passage of Critical Preparedness Legislation

Adopting the Pandemic and All-Hazards Preparedness and Advancing Innovation Act Supports the  Nation’s Health Security

(Washington, DC) – John Auerbach, president and CEO, of Trust for America’s Health (TFAH) today made the following statement regarding the congressional passage of the Pandemic and All-Hazards Preparedness and Advancing Innovation (PAHPAI) Act.

“Trust for America’s Health applauds Congress for working in a bipartisan manner to pass important legislation to advance our nation’s health security. The Pandemic and All-Hazards Preparedness and Advancing Innovation Act shows that we are learning the lessons from recent disasters and disease outbreaks and addressing ongoing challenges. Passage of this legislation, was a top recommendation in TFAH’s recent report, Ready or Not: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism.

During the Zika outbreak, it took about nine months to approve emergency supplemental funding. And recent severe weather showed that we are still not prepared for a worst-case scenario event. In this legislation, lawmakers try to address some of the gaps that these events exposed. The bill makes it easier to get money out more efficiently to address a public health emergency. It codifies the roles of federal agencies in managing important preparedness programs and ensures we are consistently improving the performance of awardees. It supports outbreak detection through workforce and strategy enhancements. It reauthorizes programs for research, development and stockpiling of medical countermeasures and seeks to speed the capability to deploy those products.

Public health and health care are at the frontlines in responding to health crises large and small.  The fact that Congress passed this bill is acknowledgement that health security is national security.

Now, we call on Congress to give this legislation the teeth it needs by providing adequate funding for these critical public health programs.”

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.  www.tfah.org. Twitter: @healthyamerica1

 

Nearly 70 Organizations Call on Congress to Advance the Pandemic and All-Hazards Preparedness & Advancing Innovation Act

March 22, 2019

The Honorable Mitch McConnell Majority Leader U.S. Senate
The Honorable Charles Schumer Minority Leader U.S. Senate
The Honorable Nancy Pelosi Speaker U.S. House of Representatives
The Honorable Kevin McCarthy Minority Leader U.S. House of Representatives

On behalf of the undersigned organizations, representing public health, healthcare providers, emergency managers, environmental health, biotechnology innovators, and researchers, we are again writing to encourage you to advance the Pandemic and All-Hazards Preparedness & Advancing Innovation Act (PAHPAI, H.R. 269), which overwhelmingly passed the House of Representatives in January. A similar version passed the Senate Health Education, Labor & Pensions (HELP) Committee last year. The HELP and Energy & Commerce Committees have made tremendous, bipartisan progress on this important legislation, and it would be a setback for our national health security to further delay reauthorization. The disaster relief package being considered by Congress would be a logical vehicle for PAHPAI.

The recent wildfires, hurricanes and measles outbreaks have demonstrated that all sectors – public health, healthcare and private sector – play a critical role in saving lives during disasters and outbreaks. PAHPA is the backbone of our nation’s health security, providing the U.S. Department of Health and Human Services (HHS) with authorities for preparing the healthcare and public health systems for disasters and strengthening the medical countermeasures enterprise. The legislation addresses gaps we have seen in recent responses, such as the speed of funding for public health emergencies, development and deployment of medical countermeasures for significant threats and preparedness for children in disasters.

The time is now to move this legislation. We are particularly concerned that several authorities have expired as of 2018, including temporary reassignment of state and local personnel, the National Advisory Committee on Children and Disasters, limited antitrust exemption and other provisions critical to HHS contracting. We believe that time is of the essence in reauthorizing these important authorities.

We commend the work of the committed Senators, Representatives and their staff who have devoted considerable thought to this legislation. Our organizations are committed to our nation’s health security, and we remain ready to assist in order to see this legislation enacted into law as soon as possible.

Sincerely,

AABB (formerly known as American Association of Blood Banks)
AFSCME
Alliance for Biosecurity
American Academy of Pediatrics
American Association of Poison Control Centers
American Association on Health and Disability
American Hospital Association
American Public Health Association
American Society for Microbiology
America’s Blood Centers
Asian & Pacific Islander American Health Forum
Association for Professionals in Infection Control and Epidemiology
Association of American Medical Colleges
Association of American Veterinary Medical Colleges
Association of Maternal & Child Health Programs
Association of Public Health Laboratories
Association of Schools and Programs of Public Health
Association of State and Territorial Health Officials
Barnesville Hospital
Berger Health System
Big Cities Health Coalition
Biotechnology Innovation Organization (BIO)
California Life Sciences Association
Central Ohio Trauma System
Child Care Aware of America
Colorado Association of Local Public Health Officials
Commissioned Officers Association of the U.S. Public Health Service, Inc. (COA)
Coshocton Regional Medical Center
Council of State and Territorial Epidemiologists
Entomological Society of America
Fayette County Memorial Hospital
Federation of American Hospitals
Future of Life Institute
Genesis Community Ambulance
Global Health Technologies Coalition
Health Industry Distributors Association
Health Resources in Action
Healthcare Distribution Alliance
Healthcare Leadership Council
Healthcare Ready
Hogg Foundation for Mental Health
Hospital Council of Northwest Ohio
Infectious Diseases Society of America
International Association of Emergency Managers
Johns Hopkins Center for Health Security
Los Angeles County Department of Public Health
Louisiana Public Health Institute
March of Dimes
Mount Carmel Health System
National Association of Counties
National Association of County and City Health Officials
National Association of Federal Veterinarians
National Association of Pediatric Nurse Practitioners
National Association of State Emergency Medical Services Officials
National Center for Disaster Preparedness, Columbia University
National Emergency Management Association National Network of Public Health Institutes
NEHA
Oklahoma City-County Health Department
One Health Commission
One Health Initiative Autonomous pro bono Team
Suburban Hospital Alliance of New York State
The Antimicrobials Working Group (Amplyx Pharmaceuticals, Aridis Pharmaceuticals, Cidara Therapeutics Inc., ContraFect Corporation, Entasis Therapeutics Inc., Iterum Therapeutics Ltd., Melinta Therapeutics Inc., Motif Bio plc, Nabriva Therapeutics US Inc., Paratek Pharmaceuticals Inc., Qpex Biopharma Inc., SCYNEXIS Inc., Summit Therapeutics plc andVenatoRx Pharmaceuticals Inc.)
The Society for Healthcare Epidemiology of America
Trauma Center Association of America
Trust for America’s Health
UCSF Benioff Children’s Hospitals
Virginia Hospital & Healthcare Association

New Report Finds Nation’s Public Health Emergencies Are Increasing While State Emergency Preparedness Levels Are Mixed

17 States Score in Top Readiness Tier, 20 States and DC in Middle Tier, 13 States in Lower Tier

Report provides action steps for states to improve emergency preparedness; progress will require action by public health agencies, elected officials and state residents

(Washington, DC – February 12, 2019) – Seventeen states place in the top tier of a three-tiered measure of performance on 10 indicators of public health and emergency readiness, according to a new report Ready or Not: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism, released today by the Trust for America’s Health (TFAH). Twenty states and the District of Columbia score in the middle tier and 13 states score in the lower tier.

State public health preparedness, by scoring tier:

 Performance Tier States Number of States
Top Tier AL, CO, CT, FL, ID, KS, MA, MD, MO, MS, NC, NE, NJ, RI, VA, WA, WI 17 states
Middle Tier CA, DC, GA, HI, IA, IL, LA, ME, MI, MN, MT, ND, NH, NM, NV, OK, OR, SC, TX, VT, WV 20 states and DC
Lower Tier AK, AR, AZ, DE, IN, KY, NY, OH, PA, SD, TN, UT, WY 13 states

The report takes an annual snapshot of states’ public health and emergency readiness.  Authored by TFAH since 2003, it documents that all states have made progress in preparedness since 9/11, but, also highlights pressing needs for additional action particularly as weather-related and other public health emergencies become more frequent.

The report, although not a comprehensive evaluation of any state’s overall emergency readiness or response, focuses on key indicators of states’ level of emergency preparedness. It identifies specific action-steps that if taken would improve the jurisdiction’s overall level of emergency preparedness, including dedicated funding for health security initiatives, modernizing and supporting technologies and innovations within public health programs, and building multisectoral collaboration and leadership.

The report’s 10 key indicators of state public health preparedness are:

Indicators
1 Incident Management: Adoption of the Nurse Licensure Compact.

 

 6 Water Security: Percentage of the population who used a community water system that failed to meet all applicable health-based standards.
2 Cross-Sector Community Collaboration: Percentage of hospitals participating in healthcare coalitions. 7 Workforce Resiliency and Infection Control: Percentage of employed population with paid time off.
3 Institutional Quality: Accreditation by the Public Health Accreditation Board. 8 Countermeasure Utilization: Percentage of people ages 6 months or older who received a seasonal flu vaccination.
4 Institutional Quality: Accreditation by the Emergency Management Accreditation Program. 9 Patient Safety: Percentage of hospitals with a top-quality ranking (Grade A) on the Leapfrog Hospital Safety Grade.
5 Institutional Quality: Size of the state public health budget, compared with the past year. 10 Health Security Surveillance: The public health laboratory has a plan for a six- to eight-week surge in testing capacity.

Key report findings include:

  • A majority of states (31) have made preparations to expand public health and healthcare capabilities in an emergency, often through inter-state collaboration and compacts.
  • A strong majority of Americans (96%) who access water from a community water system, have access to water that meets all applicable health-based standards. Ninety percent of all Americans get their water from a community water system.
  • Most states are accredited in the areas of public health and emergency management, many in both. These accreditations are one measure of a state’s capacity to effectively respond to health threats.

However, areas of concern include:

  • Seasonal flu vaccination rates, already below 50 percent, fell last year. The flu vaccination rate for Americans ages 6 months and older dropped from 47 percent in the 2016 – 2017 season to 42 percent during the 2017- 2018 season.
  • In 2018, 45 percent of employed state residents did not have access to paid time-off, meaning they were more likely to go to work if ill, increasing the potential for infections to spread.
  • Only 28 percent of U.S. hospitals, on average, earned top-quality patient safety grades. Hospital safety scores measure performance on such issues as infection control, intensive-care capacity, nursing staff volume and an overall culture of error prevention.

“Preparedness is key to preventing harm when public health emergencies and natural disasters occur, but, being prepared requires dedicated funding and multi-sector planning and collaboration,” said John Auerbach, President and CEO of the Trust for America’s Health.   “The risks to America’s health security are very real, and in the headlines – from wildfires to floods to food borne illnesses.  These events are wake-up calls.  To stay safe, we need to devote more time and money to emergency preparedness.”

TFAH’s report also includes a number of recommendations across 11 high priority areas.  Among the top priorities:

  • Congress should fund public health and health system preparedness and response as well as global health security.
  • Congress should pass the Pandemic and All-Hazards Preparedness and Advancing Innovation Act.
  • Investment in disease surveillance and data infrastructure needs to be significantly increased.
  • The “last mile” of medical countermeasure distribution, meaning ensuring that important medications or other needed supplies get to the right person at the right time, needs to be strengthen.

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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.  www.tfah.org

TFAH Applauds Passage of Senate Farm Bill

(Washington, D.C., June 29, 2018) – John Auerbach, president and CEO, of Trust for America’s Health (TFAH) today made the following statement regarding Senate passage of “Farm Bill” legislation (the Agriculture Improvement Act – Senate amendment to H.R. 2) to reauthorize key federal agricultural and nutrition programs.

“The Trust for America’s Health is pleased the U.S. Senate has completed work on Farm Bill legislation that will support and promote good nutrition and improved health outcomes. By rejecting the approach taken by the House, the Senate bill largely protects and strengthens the Supplemental Nutrition Assistance Program (SNAP), which serves as a critical lifeline to millions of American children and families that otherwise lack the means to access adequate nourishment and make healthy food choices.

In addition to increases in funding to the Food Insecurity Nutrition Incentive Pilot, the Senate bill includes a Harvesting Health pilot that would help to further promote linkages between health care providers and anti-hunger and nutrition improvement activities.

According to TFAH’s State of Obesity report, roughly two out of every three adults or one out of every three children is either obese or overweight. Obesity remains both a significant public health crisis and a national security issue-being overweight or obese is the leading cause of medical disqualifications for military service, with nearly one-quarter of applicants being rejected for exceeding the weight or body fat standards. Additionally, obesity translates to higher health care costs and poor quality of life.

Many efforts are underway that encourage SNAP recipients to make healthy food choices; for example, incentive programs to use SNAP benefits at farmers’ markets. Such efforts, combined with other prevention programs and policies, have been shown to be effective. We must now continue to invest in and scale such approaches to help Americans eat healthier. SNAP and other Farm Bill programs will be critical to turning the tide against this longstanding health problem.

TFAH looks forward to continuing to work with Congress through the conference process as it develops a final Farm Bill that will lead us in the right direction, towards improving the health and prosperity of all Americans.”

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Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

New Report: Funding for Public Health Has Declined Significantly since the Great Recession

Core Federal Emergency Preparedness Funding has been cut by More than One-Third Since FY 2002

Washington, D.C., March 1, 2018 – A new Trust for America’s Health (TFAH) analysis—A Funding Crisis for Public Health and Safety: State-by-State and Federal Public Health Funding Facts and Recommendations—finds spending on public health is insufficient.

“A healthy United States is a strong United States. A prepared nation is a safe nation. But persistent underfunding of the country’s public health system has left the nation vulnerable,” said John Auerbach, president and CEO, of TFAH. “The country needs a long-term commitment to rebuild the nation’s public health capabilities – not just to plug some of the more dangerous gaps but to make sure each community will be prepared, responsive and resilient when the unexpected occurs.”

Flat Federal Funding

In Fiscal Year (FY) 2017, the U.S. Centers for Disease Control and Prevention’s (CDC) budget was $7.1504 billion ($21.95 per person). Adjusting for inflation, CDC’s core budget—not including the Prevention and Public Health Fund—has been essentially flat for the last decade.

Because much of CDC’s budget is distributed to states and localities, the impact of budget cuts is experienced directly at the state and local level. Of the roughly 75 percent of CDC funds that go to states and local communities, support ranges from a low of $5.74 per person in Missouri to a high of $114.38 per person in Alaska.

In addition, 12 percent of CDC’s budget consists of the Prevention and Public Health Fund, with about $625 million a year of that directed to state and local efforts. From FY 2013 through FY 2027, the Prevention Fund will receive nearly $12 billion less than the law intended.

Within CDC, the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Program is the only federal program that supports the work of state and local health departments to prepare for and respond to emergencies. Except for one- time, short-term funding to contain the Ebola and Zika viruses, core emergency preparedness funding has been cut by more than one-third (from $940 million in FY 2002 to $667 million in FY 2017) since the program was established.

State Public Health Funding Declining

Spending for public health by states has been declining.  Based on a TFAH analysis (adjusted for inflation), 31 states made cuts to their public health budgets from FY 2015-2016 to FY 2016-2017.  Only 19 states and Washington, D.C. maintained or increased their budgets, making it hard for states to compensate for reduced federal funding.

According to the report, state public health spending is actually lower in 2016-2017 than it was in 2008-2009, as some of the funding cuts that occurred during the Great Recession have not been fully restored—and federal funding has been essentially flat (almost half of state public health spending comes from federal funds).

Local Public Health Funding Decreasing

Since 2008, local health departments (LHDs) have lost 55,590 staff due to layoffs or attrition. In addition, about 25 percent of LHDs reported a lower FY 2016 budget than the previous year, with fewer LHDs reporting an increase in their budget for the current year as compared to the previous.

Recommendations

“Each year, we issue this report to examine the amount of public health funding each state receives and provide an independent analysis of how communities protect the public’s health. With life expectancy declining in the U.S. for the second year in a row—something unheard of in recent memory—policymakers must take the public’s health seriously and allocate the funds needed to improve well-being and prevent illness and injury,” said Auerbach.

The report includes eight key recommendations:

  1. Increase Funding for Public Health – at the Federal, State and Local Levels
  2. Preserve the Prevention and Public Health Fund
  3. Prepare for Public Health Emergencies and Pandemics
  4. Establish a Standing Public Health Emergency Response Fund
  5. Build a National Resilience Strategy to Combat Deaths of Despair
  6. Prevent and Reduce Chronic Disease
  7. Support Better Health and Top Local Priorities in Every Community
  8. Expand the Use of Evidence-Based, High-Impact Strategies to Improve Health in Every Community

The brief was supported by a grant from the Robert Wood Johnson Foundation (RWJF).

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

 

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