Issue Category: Public Health Preparedness

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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Public Health Preparedness

Examples of the need to protect the public’s health from disease, disasters, and bioterrorism abound. The COVID-19 pandemic is a stark example. In addition, during 2023 the U.S. experienced 25 weather-related events that each caused over $1 billion dollars in damages in addition to tragic loss of lives. During August of 2023, an estimated 57 million people were living under an excessive heat warning putting them at risk of heat-related illnesses.

As a nation, we need to do more to ensure that we are adequately prepared to protect the public’s health during emergencies including providing increased and sustained public health funding and fostering multi and cross sector planning and collaboration.

TFAH Releases Special Issue Brief: Racial Healing and Achieving Health Equity in the United States

TFAH Calls for Increased Focus on Addressing Health Inequities and Releases Priority Recommendations to Achieve this Goal

Washington, D.C., January 16, 2018 – Today, Trust for America’s Health (TFAH) released Racial Healing and Achieving Health Equity in the United States, which highlights and acknowledges health inequities, the factors that influences them and highlights policy recommendations that can help the nation achieve health equity.

TFAH issued the brief in conjunction with The Truth, Racial Healing & Transformation’s second annual National Day of Racial Healing, which is intended to identify key steps that will help take collective action to promote positive and lasting change across issues.

“As we mark the annual Martin Luther King Day, we are reminded he said that ‘of all the forms of inequality, injustice in health care is the most shocking and inhumane’,” said John Auerbach, president and CEO, TFAH. “TFAH is proud to be joining the National Day of Racial Healing to acknowledge health inequities in the country and to focus on building a pathway forward toward an equitable and socially just future.”

TFAH has issued the following set of recommendation to help the nation to achieve health equity:

  • Create strategies to optimize the health of all Americans, regardless of race, ethnicity, income or where they live.  All levels of government must invest in analyzing needs and increasing effective policies and programs to address the systematic inequities that exist and the factors that contribute to these differences, including poverty, income, racism and environmental factors. Solutions should feature community-driven tactics, including using place-based approaches to target programs, policies and support effectively.
  • Expand cross-sector collaborations.  Improving equity in health will require supporting and expanding cross-sector efforts to make communities healthy and safe.  Efforts should engage a wide range of partners, such as schools and businesses, to focus on improving health through better access to high-quality education, jobs, housing, transportation and economic opportunities.
  • Fully fund and implement health equity, health promotion and prevention programs in communities. And, partner with a diverse range of community members to develop and implement health improvement strategies.  Federal, state, local and tribal governments must engage communities in efforts to address both ongoing and critical health threats.  The views, concerns and needs of community stakeholders, such as volunteer organizations, religious organizations and schools and universities, must be taken into account in this process.  Proven, effective programs, such as the U.S. Centers for Disease Control and Prevention’s REACH (Racial and Ethnic Approaches to Community Health) program should be fully-funded and expanded.
  • Collect data on health and related equity factors – including social determinants of health – by neighborhood.  There should be a priority on improving data collection at a very local level to understand connections between health status and the factors that impact health to help identify concerns and inform the development of strategies to address them.
  • Support Medicaid coverage and reimbursement of clinical-community programs to connect people to services that can help improve health.  Medicaid should reimburse efforts that support improved health beyond the doctor’s office – for example asthma and diabetes prevention programs and other community-based initiatives can help address the root causes that contribute to inequities.
  • Communicate effectively with diverse community groups.  Federal, state, local and tribal officials must design culturally competent, inclusive and linguistically appropriate communication campaigns that use respected, trusted and culturally competent messengers to communicate their message. Communication channels should reflect the media habits of the target audience.
  • Prioritize resiliency in health emergency preparedness efforts.  Federal, state, local and tribal government officials must work with communities and make a concerted effort to address the needs of low-income, minority and other vulnerable groups during health emergencies. Public health leaders must develop and sustain relationships with trusted organizations and stakeholders in diverse communities on an ongoing basis—including working to improve the underlying health of at-risk individuals, sub-population groups and communities, so these relationships are in place before a disaster strikes.  Communication and community engagement must be ongoing to understand the needs of various populations.
  • Eliminate racial and ethnic bias in healthcare.  Policies should incentivize equity and penalize unequal treatment in healthcare, and there should be increased support for programs to increase diversity in and across health professions.  In addition, efforts should be increased to train more healthcare professionals from under-represented populations so that the workforce reflects the diversity of the patient population.
  • Incorporate strategies that foster community agency—or a community’s collective ability and opportunity to make purposeful choices—into the design, implementation and governance of multi-sector collaborations. Building community agency can contribute to improved community health by yielding a deeper understanding of the challenges and opportunities influencing a community, and relies on an asset-based approach to leverage existing community strengths and resources. Multi-sector collaborations should include dedicated resources for fostering and measuring community agency. Efforts should maximize and bolster community voice and power as a means to influencing larger policy- and systems-level changes (including those within and outside of the traditional health sector).

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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.  Twitter: @HealthyAmerica1

Half of States Scored 5 or Lower Out of 10 Indicators in Report on Health Emergency Preparedness

Report Finds Funding to Support Base Level of Preparedness Cut More than Half Since 2002

 

Washington, D.C., December 19, 2017 – In Ready or Not? Protecting the Public’s Health from Diseases, Disasters and Bioterrorism, 25 states scored a 5 or lower on 10 key indicators of public health preparedness. Alaska scored lowest at 2 out of 10, and Massachusetts and Rhode Island scored the highest at 9 out of 10.

The report, issued today by the Trust for America’s Health (TFAH), found the country does not invest enough to maintain strong, basic core capabilities for health security readiness and, instead, is in a continued state of inefficiently reacting with federal emergency supplemental funding packages each time a disaster strikes.

According to Ready or Not?, federal funding to support the base level of preparedness has been cut by more than half since 2002, which has eroded advancements and reduced the country’s capabilities.

“While we’ve seen great public health preparedness advances, often at the state and community level, progress is continually stilted, halted and uneven,” said John Auerbach, president and CEO of TFAH.  “As a nation, we—year after year—fail to fully support public health and preparedness. If we don’t improve our baseline funding and capabilities, we’ll continue to be caught completely off-guard when hurricanes, wildfires and infectious disease outbreaks hit.”

Ready or Not? features six expert commentaries from public health officials who share perspectives on and experiences from the historic hurricanes, wildfires and other events of 2017, including from California, Florida, Louisiana and Texas.

The report also examines the nation’s ability to respond to public health emergencies, tracks progress and vulnerabilities, and includes a review of state and federal public health preparedness policies. Some key findings include:

  • Just 19 states and Washington, D.C. increased or maintained funding for public health from Fiscal Year (FY) 2015-2016 to FY 2016-2017.
  • The primary source for state and local preparedness for health emergencies has been cut by about one-third (from $940 million in FY 2002 to $667 million in FY 2017) and hospital emergency preparedness funds have been cut in half ($514 million in FY 2003 to $254 million in FY 2017).
  • In 20 states and Washington, D.C. 70 percent or more of hospitals reported meeting Antibiotic Stewardship Program core elements in 2016.
  • Just 20 states vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2016 to Spring 2017—and no state was above 56 percent.
  • 47 state labs and Washington, D.C. provided biosafety training and/or provided information about biosafety training courses (July 1, 2016 to June 30, 2017).

The Ready or Not? report provides a series of recommendations that address many of the major gaps in emergency health preparedness, including:

  • Communities should maintain a key set of foundational capabilities and focus on performance outcomes in exchange for increased flexibility and reduced bureaucracy.
  • Ensuring stable, sufficient health emergency preparedness funding to maintain a standing set of core capabilities so they are ready when needed. In addition, a complementary Public Health Emergency Fund is needed to provide immediate surge funding for specific action for major emerging threats.
  • Strengthening and maintaining consistent support for global health security as an effective strategy for preventing and controlling health crises. Germs know no borders.
  • Innovating and modernizing infrastructure needs – including a more focused investment strategy to support science and technology upgrades that leverage recent breakthroughs and hold the promise of transforming the nation’s ability to promptly detect and contain disease outbreaks and respond to other health emergencies.
  • Recruiting and training a next generation public health workforce with expert scientific abilities to harness and use technological advances along with critical thinking and management skills to serve as Chief Health Strategist for a community.
  • Reconsidering health system preparedness for new threats and mass outbreaks.  Develop stronger coalitions and partnerships among providers, hospitals and healthcare facilities, insurance providers, pharmaceutical and health equipment businesses, emergency management and public health agencies.
  • Preventing the negative health consequences of climate change and weather-related threats. It is essential to build the capacity to anticipate, plan for and respond to climate-related events.
  • Prioritizing efforts to address one of the most serious threats to human health by expanding efforts to stop superbugs and antibiotic resistance. 
  • Improving rates of vaccinations for children and adults – which are one of the most effective public health tools against many infectious diseases.
  • Supporting a culture of resilience so all communities are better prepared to cope with and recover from emergencies, particularly focusing on those who are most vulnerable.   Sometimes the aftermath of an emergency situation may be more harmful than the initial event.  This must also include support for local organizations and small businesses to prepare for and to respond to emergencies.

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

Score Summary: 

A full list of all of the indicators and scores and the full report are available on TFAH’s website.  For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator.  Zero is the lowest possible overall score, 10 is the highest.  The data for the indicators are from publicly available sources or were provided from public officials.

9 out of 10: Massachusetts and Rhode Island

8 out of 10: Delaware, North Carolina and Virginia

7 out of 10: Arizona, Colorado, Connecticut, Hawaii, Minnesota, New York, Oregon and Washington

6 out of 10: California, District of Columbia, Florida, Illinois, Maryland, Nebraska, New Jersey, North Dakota, South Carolina, South Dakota, Utah, Vermont and West Virginia

5 out of 10: Georgia, Idaho, Maine, Mississippi, Montana and Tennessee

4 out of 10: Alabama, Arkansas, Iowa, Louisiana, Missouri, New Hampshire, Oklahoma and Pennsylvania

3 out of 10: Indiana, Kansas, Kentucky, Michigan, Nevada, New Mexico, Ohio, Texas, Wisconsin and Wyoming

2 out of 10: Alaska

 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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Mental Health is Vital to Preparedness and Response

By Dr. Octavio N. Martinez, Jr., MD, MPH, MBA, FAPA, Executive Director, the Hogg Foundation for Mental Health at The University of Texas at Austin

This story was published in Ready or Not: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism.

The health effects from a public health emergency go way beyond the physical, taking an enormous mental toll in the immediate aftermath and the years following—and often can harm our children the most.

We must do more to know how to ensure mental health and physical health go hand-in-hand in response planning and efforts. We must also do a far better job of increasing our mental health workforce and ensuring and increasing access to mental health services both during and after an emergency.

Using Data to Plan for Maintaining Access to Mental Health Services

To prepare for any type of emergency, communities must be aware of vulnerable populations—typically children, the elderly and those who have an underlying medical condition or are mentally ill. We have gotten better at identifying where groups of these populations live.

And, we should also be able to access databases to predict what portion of a certain population might have substance use disorders, for example—and then understand what kind of continued treatment and medication are needed and where they might best be distributed.

Paired with this, we should be able to identify geographically which communities will have the hardest time bouncing back from an emergency and will need more resources.

While some neighborhoods might have good infrastructure and better access to transportation and physical and mental health services, others will struggle. The neighborhoods that will struggle should be identified in advance and plans created to help them. And, we can create plans based on any number of scenarios: fires, floods, wind damage, loss of power, etc. If you combine all the knowledge and data together, you can then coordinate resources and everyone has a chance to be healthy.

Long-term Strategies to Improve Responses to Emergencies

We also must acknowledge that human connections are incredibly important. In-between disasters, preparedness work should focus on strengthening families and communities so they are resilient enough to weather an emergency.

For example, after Hurricane Katrina, New Orleans developed community leaders specifically focused on mental wellness, resilience and recovery. The gains in improved access to care and lessened stigma were noticeable—and these should help ensure responders and communities can work together to forge a better response during the next emergency.

While this is by no means a quick fix, taking a long-term approach to emergency preparedness and community health will pay dividends in improved health of the entire population. We should bring this research to other cities and communities that will likely face similar events.

Additionally, psychological effects can take years to manifest and get under control—especially if there isn’t access to mental health services. We learned from Hurricanes Katrina and Sandy that PTSD and suicidal ideation increased dramatically after these events. However, if we were able to step in earlier and connect individuals with mental health professionals, it’s likely these issues and potentially other health issues (substance use disorders, increased anxiety, depression, etc.) could have been prevented or lessened.

Further, while we are getting better at recognizing that mental health is a key component to physical health, the workforce in this area is inadequate—and we’ve known this for a while, especially as the opioid epidemic has continued. By increasing our workforce and ensure they have the right skill sets; we could help tackle the opioid epidemic and better prepare our communities to bounce back from a disaster.

Additional Research is Needed

The devil is often in the details and coordination among the various federal, state and local agencies, organizations and others must be improved. To do so, the nation has to prioritize funding into research and assessments post emergencies—so we can truly understand how these events affect the mental health and stability of a community at a population level.

While the National Institutes of Health has a Disaster Research Response Project, it needs to better include measures on mental health and substance use disorders. We must take each disaster as a learning opportunity that can prepare us for the next one and enable us to save more lives. Increasing research would also help build a network of behavioral health disaster experts.

First Responders

Our first responders and volunteers must be trained to identify and assist people who exhibit psychiatric symptoms, i.e., in “psychological first aid.” And, going beyond this training, we know that mental health must be better integrated with the traditional health services.

Responders and volunteers must also be cared for—they are at risk for suffering secondary psychiatric distress themselves. We need better ways to monitor them during but also after the crisis to ensure they are receiving the appropriate interventions and care.

Part of the solution is increased mental health providers, which would serve many roles: keeping our first responders in good shape, filling gaps in mental health services and, by increasing access to care, hopefully preventing someone from developing a serious and chronic mental health illness.

Quite simply, if we intentionally make mental health part of our preparedness and response systems it will have untold benefits for communities before, during and after an emergency—we will build resiliency and improve well-being.

Local Public Health Preparedness and Response to Hurricanes and Other Emergencies: High Tech and High Touch

By Umair Shah, MD, MPH, Executive Director and Local Health Authority for Harris County Public Health

This story was published in Ready or Not? 2017.

Harris County, Texas, is a large and rapidly growing community. We are the third largest county in the United States with 4.5 million residents spread over 1,700 square miles.

We are diverse in every sense of the word, making it vital to communicate in culturally competent ways. Additionally, since we are growing and people come from all over, they might not have experience with mosquito or hurricane seasons. We cannot assume our constituents, year after year, are the same. So we must continue to reach out to our community and educate.

That means we need adequate capacity within the department and a diverse team with a broad array of skills and experiences who continual drill and train.

To ensure we reach all our constituents, we are mobile—we take public health to the public. We’ve built health villages with large RV units—that focus on all aspects of health from mosquito abatement to dental services to immunizations.

We didn’t stop there – we knew to be a trusted source during an emergency we must foster a real intimate sense of community.

I mention this because, day-to-day, we rely both on high tech and high touch. We must remember the importance of both. As much as we talk about technology, social media and sophisticated surveillance systems, we cannot lose the high touch of knocking on a door or stopping to share a story, laugh or cry. At the end of the day, the high tech gets the visibility, but it’s the high touch that allows the high tech to succeed.

This is the backdrop that all our preparedness activities take.

Being Prepared

Even preceding Hurricane Katrina, we made sure that every single Harris County Public Health employee had up-to-date Incident Command Systems (ICS) training—and new staffers get this training as part of initiation.

And, every year, we practice—drills, exercises, call down lists, etc.—making sure we can perform all the tasks we’ll need to do during a response.

So, in reality, our response to Hurricane Harvey started more than a decade before the hurricane ever made landfall.

Hurricane Harvey

Before Harvey even hit, our preparedness director alerted staff and the executive team that a major response would be necessary. With this advanced warning, we put all assets in place before landfall.

We set up communications pathways and communicated to all staff, ensuring they were aware of what was coming and their roles and responsibilities.

Once we were in place, we turned to the community. Our communications team sent out messages before the storm about how to be prepared: get your kits ready; what will you do without power; what if you’re displaced; how will you care for the elderly, children and pets; and many more.

Aside from those messages, we needed to make sure people avoided flood water—there could be any number of dangers from power lines to insects to animals to sewage to toxins.

I highlight talking to the public because we’re all in this together. We can respond great from a systems perspective, but if, for instance, people lose access to medications or begin to eat unsafe foods, we could see infectious disease outbreaks or worsened chronic conditions.

In addition to communicating, building and leveraging partnerships is key to a good response.

For example, we worked with state public health and federal partners (the U.S. Air Force) to continue ground and aerial spraying for mosquitos to ensure there wouldn’t be increased levels of Zika or dengue or chikungunya. All levels of government coordinated to ensure we maintained adequate control over mosquitos and other infectious diseases.

Harris County also sheltered a number of people. Our epidemiologists relied on outside experts and volunteers to help them go cot-to-cot to make sure there wasn’t an infectious disease outbreak and that people maintained access to medicines—a high touch strategy.

This is just a small sample of all the activities we did to keep people safe. At the end of the day, a good response involves working across systems to ensure strong partnerships are in place.

Going Forward

I’m always struck by the fact that everyone talks about the importance of health during an emergency, but, when the emergency goes away, we often forget that we need to adequately resource public health agencies so they have the tools and resources to take on the next emergency.

It’s about capacity.

I worry, one day, there will be an emergency that we haven’t trained for enough and don’t have adequate resources in place. Public health can’t all of a sudden be ready to respond to a major emergency – we need to drill and train and have access to infrastructure and technology.

To better prepare for and respond to emergencies, we also must improve technology solutions, electronic surveillance activities, and infrastructure support. We need more epidemiologists and environmental toxicology experts. And, we need more social workers and community health workers to fan into the community and link folks with vital social services.

The best response features a combination of high tech and high touch. This is where our department shines day in and day out. We’ve never let one overtake the other.

Nationally, though, we can’t rest on our laurels—the next storm could be different and we need to be ready and prepared.

The Private Sector’s Role in Preparing for and Responding to Public Health Emergencies

By Nicolette A. Louissaint, Ph.D., Executive Director, Healthcare Ready

This story was published in Ready or Not? 2017.

The private sector can often respond to rapidly changing circumstances nimbly and usually knows the communities they serve incredibly well. As such, amidst an emergency, there is opportunity for private organizations to step in and fill any response gaps.

The public sector takes on an enormous burden and works tirelessly to respond to emergencies, and the private sector sees its role, especially when it operates in affected regions, to surge alongside the public sector, pivot nimbly and augment public efforts—thereby enhancing the public system’s response efforts.

Often to take advantage of public and private sector expertise, there just needs to be a connection between the two.

For example, during the Hepatitis A outbreak in San Diego, public officials reached out to the private sector for help locating a significant amount of vaccines—since one of the solutions was to do a mass vaccination campaign.

Instead of suggesting they import or special order something (possibly at an extremely high cost), Healthcare Ready (HcR), my organization, checked the levels of vaccines in pharmacies in the area. We found the private sector had enough in stock to supply what was needed. Sometimes you just need to know how and who to ask.

As evidenced by this example, one important aspect of coordinating emergency response is sharing critical information. HcR is designated by the Department of Homeland Security as an information sharing and analysis center (ISAC). So, the private sector knows they can trust us with their proprietary information—and we won’t share with any outside parties inappropriately.

This designation also gives us a fuller view of the resources in a community during an emergency. For example, during a flood, we can know where emerging challenges in the medical pipeline might be because roads are not accessible. We can inform the public sector and work on a solution to ensure vital supplies make it to the public workers who are saving lives.

The public sector knows we can provide them with accurate status of response supplies and what is or isn’t happening along the supply chain. It’s absolutely vital for the public sector to know what kind of relief they’ll be getting and when and what might be missing so they can adjust on the fly.

What we’ve learned from 2017’s Hurricanes

After this hurricane season, we realized that the private sector can do a lot fast and rapidly fill gaps to supplement public sector efforts by getting around bureaucracy.

When faced with an emergency response, we initially focus on resuming supply chain operation and work to support any patients who might be falling through the gaps that naturally occur. The public sector can rely on us to gain insight into what the private sector sees—with us being a central hub coordinating private sector information.

One recent example:  There was a small group of patients on St. Thomas who needed a specific drug that could only be prescribed every 30 days. The public sector folks asked us to look for ways to get the drug from Puerto Rico and onto a plane that was making routine trips between the islands after the hurricane.

As we looked into that, we also were able to reach out to the pharmacies on St. Thomas that we knew had re-opened. And we asked them to speak with their distributors who supply them with medicine. We actually found that one pharmacy had the necessary medicine and it was already on the island. We just had to connect the dots.

While this sounds easy written down, there are many competing priorities and everything is in flux during an emergency response. With the public sector relying on the private sector for these kinds of responsibilities it can free them up to handle other vital activities.

How we can better use the private sector?

While there many examples of public and private sectors working well together, too often the private sector is only looked at a supplier, notably of money and medicine, which is frustrating because clearly the private sector wants to and can help in other ways.

This might seem like a minor problem—but if the public sector is only engaging with the private sector amidst a crisis or when money is needed, the relationships aren’t developed that are necessary to work alongside one another during an emergency. A lot of emergency preparedness and response is about knowing the right organization or person to contact to obtain the life saving measure/supply you need.

Currently, in most places, states have just one Emergency Management Coordinator for the entire private sector—encompassing industries like transportation, healthcare, agriculture, food, etc. It really isn’t feasible for the level of coordination that needs to happen to go through a single node.

As such, there should be a coordinator for each industry, setup in advance with regular meetings to fold private sector emergency capabilities into the public sector’s response plans—so when a hurricane makes landfall we all know what to do.