31 January 2002

U.S. Health Agency Aids States in Bioterrorism Preparedness

Governors of the 50 U.S. states are receiving details about the federal financial help they are to receive to improve their capacity to cope with bioterror attacks. U.S. Secretary of Health and Human Services (HHS) Tommy G. Thompson sent letters to the governors January 31 explaining their share of aid to be drawn from the $2,900 million bioterrorism law signed by the president earlier in the month.

"These funds are just the start of our efforts to help states and communities build up their core public health capabilities," Thompson said in a January 31 HHS press release. "We must do everything we can to ensure that America's ability to deal with bioterrorism is as strong as possible."

The states are directed to use the funds to support public health emergency preparedness, to improve infectious disease surveillance and to create regional hospital plans to respond to a bioterror attack.

A table showing funding levels for U.S. states and territories is available at http://www.hhs.gov/news/press/2002pres/states.html

Following is the text of the press release:

HHS News
U.S. Department Of Health And Human Services
January 31, 2002
$1.1 Billion In Funding To States For Bioterrorism Preparedness

HHS Secretary Tommy G. Thompson today sent letters to governors detailing how much each state will receive of the $1.1 billion to help them strengthen their capacity to respond to bioterrorism and other public health emergencies resulting from terrorism. The money will allow states to begin planning and building the public health systems necessary to respond.

The funds will be used to develop comprehensive bioterrorism preparedness plans, upgrade infectious disease surveillance and investigation, enhance the readiness of hospital systems to deal with large numbers of casualties, expand public health laboratory and communications capacities, and improve connectivity between hospitals, and city, local and state health departments to enhance disease reporting. The funds come from the $2.9 billion bioterrorism appropriations bill that President Bush signed into law Jan. 10.

"We're putting money in the hands of states and local communities so they can start building strong public health systems for responding to a bioterrorism attack," Secretary Thompson said. "These funds are just the start of our efforts to help states and communities build up their core public health capabilities. We must do everything we can to ensure that America's ability to deal with bioterrorism is as strong as possible."

The funding to states and communities is divided into three parts. The first portion will be provided by the Centers for Disease Control and Prevention (CDC) and is targeted to supporting bioterrorism, infectious diseases, and public health emergency preparedness activities statewide. Each state's allocation will consist of a $5 million base award, supplemented by an additional amount based on its share of the total U.S. population.

The Health Resources and Services Administration will provide the second portion of funding, which will be used by states to create regional hospital plans to respond in the event of a bioterrorism attack. Hospitals play a critical role in both identifying and responding to any potential bioterrorism attack or disease outbreak. These funds will be allocated using a formula similar to that used by the CDC.

The third portion of the funds will be provided by the HHS Office of Emergency Preparedness and will support the Metropolitan Medical Response System (MMRS). The MMRS funding will add an additional 25 new cities to those which have already received funding in past years and will mean that 80 percent of the U.S. population will be covered by an MMRS plan. MMRS contracts are especially aimed at improving local jurisdictions' ability to respond to the possible release of a chemical or biological disease agent, but also serve to improve local response to any event involving mass casualties.

States will be permitted to begin immediately spending up to 20 percent of their allotments, so as to avoid delay in starting preparedness measures. The remaining 80 percent of the $1.1 billion in state funds will be released once complete plans have been received and approved.

State plans are due to HHS by March 15, 2002, and no later than April 15, 2002. HHS will complete its review of each plan within 30 days of receipt. Each statewide plan is to lay out how it will respond to a bioterrorism event and other outbreaks of infectious disease, but also how it will strengthen core public health capacities in all relevant areas. Each statewide plan is to be reviewed and endorsed by the governor prior to submission.

"Twenty-one days after the bill was signed HHS put together a comprehensive plan to distribute over $1 billion in funding. I commend the people who accomplished this task for their hard work, dedication and more importantly for their understanding of the importance of getting the funds in the hands of governors and state and local health officials so they can begin this important work," Secretary Thompson concluded.

A table showing state-by-state funding levels is available at: www.hhs.gov/news/press/2002pres/states.html

A table showing MMRS funding levels is available at: www.hhs.gov/news/press/2002pres/mmrs.html

The criteria for states to consider in developing their plans is below:

Critical Benchmarks for Bioterrorism Preparedness Planning

1. Designate a Senior Public Health Official within the State health department, to serve as Executive Director of the State Bioterrorism Preparedness and Response Program and a Coordinator for hospital preparedness planning.

2. Establish an advisory committee to include representatives from (included but not limited to):

• State and local health departments and government;
• Emergency Management Agencies;
• Emergency Medical Services;
• Office of Rural Health;
• Police, fire department and emergency rescue workers and occupational health workers;
• Other health care providers, including university, academic medical and public health;
• Community health centers;
• Red Cross and other voluntary organizations; and
• The hospital community (to include Veterans Affairs and military hospitals)
.

3. Prepare a time line for the development of a state-wide plan for preparedness and response for a bioterrorist event, infectious disease outbreak, or other public health emergency.

4. Prepare a time line for the development of regional plans for bio-preparedness and response for a bioterrorist event, infectious disease outbreak, or other public health emergency.

5. Prepare a time line for assessment of emergency preparedness and response capabilities related to bioterrorism, other outbreaks of infectious disease and other public health emergencies with a view to facilitating planning and setting implementation priorities.

6. Establish a hospital bio-preparedness planning committee, (affiliated with the state-wide bioterrorism advisory committee) whose composition includes representation from (but not limited to):

-- Emergency Medical Services -- Emergency Management Agencies; -- Office of Rural Health; -- State hospital associations; -- Veterans Affairs and military hospitals; -- Primary care associations.

7. Develop a time line for implementation of regional hospital plans that would accommodate in an emergency at least 500 patients.

8. Assess statutes, regulations, and ordinances within the state that provide for credentialing, licensure, and delegation of authority for executing emergency public health measures.

9. Develop a plan and identify personnel to be trained to receive and distribute critical stockpile items and manage a mass distribution of vaccine and/or antibiotics on a 24 hours a day, 7 days a week basis.

10. Develop a plan to receive and evaluate urgent disease reports from all parts of the jurisdiction on a 24-hour a day, 7 days a week basis.

11. Assess epidemiologic capacity with provision for at least one epidemiologist for each Metropolitan Statistical Area with a population greater than 500,000.

12. Develop a plan to improve working relationships and communication between Level A (clinical) laboratories and Level B/C laboratories, (i.e. Laboratory Response Network laboratories) as well as other public health officials.

13. Develop a plan that ensures that 90 percent of the population are covered by the Health Alert Network.

14. Develop a plan for communication systems that provides for a 24/7 flow of critical health information between hospital emergency departments, State and local health officials, and law enforcement.

15. Develop a plan to enhance risk communication and information dissemination to educate the public regarding exposure risks and effective public response.

16. Assess training needs with special emphasis on emergency department personnel, infectious disease specialists, public health staff, and other health care providers.