Health Care Coalitions Response

Today’s blog comes to us from Arizona Hospital and Healthcare Association (AzHHA) Program Director, Emergency Preparedness and Community Health Laura Dix. Ms. Dix is responding to a recent story on new research at Arizona State University on hospital coalitions. Once you have had a chance to read our position, we hope you will take a minute to let us know what you think. Driving important conversations around the health issues affecting our state is another way we are working toward our long-term goal of one day making Arizona the Healthiest State in the Nation!

ASU Now’s January 22nd newsletter featured an article titled “Government Funding of Hospital Coalitions a Good Deal, ASU Research Finds.” The article is a report on the efficacy of the nation’s 500+ health care coalitions (HCCs), which are groups of health care organizations and their partners (ranging from emergency management to public health) working in a unified manner to prepare the region for a large-scale disaster or emergency. HCCs are primarily funded through the U.S. Department of Health and Human Services, Assistant Secretary for Preparedness and Response (ASPR).

ASU’s findings were that

  1. government funding of HCCs that share information have better patient outcomes; and
  2. HCCs are “significantly more valuable than they thought themselves to be or the government thought they would be,” particularly with smaller scale disasters.

The article paints HCCs in a very positive light, which they should be. Federally funded coalitions not only benefit us by saving lives and mitigating damage, but they also build relationships within and across organizations that might not otherwise be inclined to cooperate with each other. Professor Jonathan Helm notes that “hospitals are competitors and typically would never share … information.” My experience as a coalition administrator in Central Arizona has led me to believe that emergency managers are some of the most dedicated community builders. They see across proprietary boundaries into a world of communication and cooperation that exceeds expectations, and they do it all for the sake of inter-facility and inter-organizational emergency preparedness.

There is, however, one statement in the article with which I must disagree. Professor Helm states,

“Government funding for disaster preparedness doesn’t come with many rules on what the health-care coalitions should do.”

This is, unfortunately, an erroneous assertion. As a grant administrator, I know full well the implications of not adhering to the governments reporting requirements and funding restrictions. There are, in fact, many rules on what health care coalitions can and should do. For example, prior to receiving any funding, a coalition must submit a detailed work plan that outlines activities in accordance with five Domains, or Strategies:

  1. Strengthen Community Resilience;
  2. Strengthen Incident Management;
  3. Strengthen Information Management;
  4. Strengthen Countermeasures and Mitigation; and
  5. Strengthen Surge Management.

In addition, activities must align with one or more of the four Capabilities: (1) Foundation for Health Care and Medical Readiness; (2) Health Care and Medical Response Coordination; (3) Continuity of Health Care Service Delivery; and (4) Medical Surge.

Furthermore, all activities must support a line-item budget request that clearly defines scopes of work, contractor services, and more. The work plan and budget are just the first steps to obtaining funds for the coalition. There are then mid-year and end-of-year reports that describe measurable and meaningful progress toward meeting ASPR’s goals and strategies.

Federal funding seldom, if ever, is provided without rules. That, however, is not a challenge. The challenge occurs when the rules inhibit a program’s ability to perform as intended, i.e., when they “get in the way.” This is not the case with ASPR’s HCC funding. As previously stated, and as shown in the evidence found by Professor Helm at ASU, HCC funding builds and fortifies bridges across the healthcare and emergency management spectrum so that when the worst day happens, we are as prepared as we can possibly be.

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