Ebola spot­lights emer­gency-preparedness cuts

Modern Healthcare - - NEWS - By Paul Demko

Congress en­acted ma­jor leg­is­la­tion after 9/11 to help lo­cal of­fi­cials bet­ter pre­pare for health emer­gen­cies such as bioter­ror­ism or in­fec­tious dis­ease out­breaks. In 2003, HHS dis­trib­uted more than $1.5 bil­lion to bol­ster re­sponses by lo­cal health of­fi­cials.

But emer­gency preparedness fund­ing for the na­tion’s pub­lic health and health­care sys­tems has fallen vic­tim to the over­all cli­mate of fis­cal aus­ter­ity in Wash­ing­ton, with the bud­get se­ques­tra­tion cuts tak­ing a chunk out of both pro­grams. Those cuts have been sup­ported both by the Obama ad­min­is­tra­tion and con­gres­sional Repub­li­cans.

But that may change with the cur­rent Ebola scare. The cases in Texas, which have raised ques­tions about whether fed­eral, lo­cal and hos­pi­tal of­fi­cials were ready to treat and con­tain the virus, could heighten pres­sure to boost fund­ing.

In the years since those na­tional emer­gen­cies in the early 2000s, fund­ing for the pro­grams has steadily eroded. Fund­ing for HHS’ hos­pi­tal preparedness pro­gram in fis­cal 2014 was $255 mil­lion, about half of what it was a decade ear­lier. Fund­ing for the Cen­ters for Dis­ease Con­trol and Preven­tion’s State and Lo­cal Preparedness and Re­sponse Ca­pa­bil­ity Pro­gram has dropped to $655 mil­lion, more than one-third be­low peak ap­pro­pri­a­tions.

The re­cent lower fund­ing lev­els trans­late into re­duced train­ing pro­grams and fewer pub­lic health work­ers, ex­perts say. Lo­cal health de­part­ments have lost 44,000 jobs since 2008, ac­cord­ing to the Na­tional As­so­ci­a­tion of County and City Health Of­fi­cials.

“It’s been very trau­matic in terms of im­pact­ing the abil­ity of what can be done,” said Jeff Sch­legelmilch, a man­ag­ing di­rec­tor at the Columbia Univer­sity Na­tional Cen­ter for Dis­as­ter Preparedness.

Last week, Sen. Robert Casey (D-Pa.) sent a let­ter to the lead­ers of the Se­nate Ap­pro­pri­a­tions Com­mit­tee call­ing for ad­di­tional spend­ing on the hos­pi­tal preparedness pro­gram. “With­out an on­go­ing com­mit­ment to pre­par­ing for th­ese events … we can­not ad­e­quately en­sure that our health sys­tem is ready for Ebola or any other emer­gency,” he wrote.

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