Trends and Impacts in National Health and Medical Preparedness Funding

Background
The primary funding streams for hospital and public health preparedness post 9/11 have come from the Hospital
Preparedness Program (HPP) and the Public Health Emergency Preparedness (PHEP) Cooperative Agreements. Both
grants are funded through the US Department of Health and Human Services, with HPP administered by the Assistant
Secretary for Preparedness and Response (ASPR) and the PHEP funds distributed by the US Centers for Disease Control
and Prevention (CDC). These funding sources have provided vital funding to allow for the development and refinement
of health and medical response systems to disasters.
Funding Trends
Overall funding for HPP has been reduced by more than 50% since its peak in 2003. Funding for HPP has been reduced
by nearly 30% just in the past year. PHEP funding has also seen significant decline, with funding at less than 70% of levels
in 2003 (See Exhibit I for a more detailed analysis and data tables). This is consistent with decreases in other sources of
preparedness funding from the Department of Homeland Security, as well as reductions in traditional funding for broad-
based public health and medical funding. This includes over $1 billion in cuts to federal CDC funding from 2005-2013, of
which approximately 75% are distributed as grants to state and local health departments
1
.
Impact of Reduced Funds
As a result of reduced funding, many advances in national health and medial preparedness are being rolled back as jobs
are lost and programs are cut. The Trust for Americas Health annual Ready or Not? report cites numerous programs
threatened for reduction or elimination. A few of the many issues highlighted are:
Reduced capacity and capability for mass vaccine and antibiotic distribution
Loss of top-level laboratory capabilities, necessary for timely detection and characterization of outbreaks
Loss of key epidemiologists to detect and investigate suspicious disease outbreaks
Cuts to resources for environmental health programs needed to mount a comprehensive response to nuclear,
radiologic, and chemical threats
Between 2008 and 2012, budget cuts have led to over 45,700 job losses at state and local health departments
Reduction in preparedness funding, coupled with a recession and significant cuts to baseline health and medical funding,
has left the nations response infrastructure in a dangerous state. Hospitals and health departments across the country
struggle with cuts to funding; they are faced with impossible choices between providing essential services or scaling
back disaster readiness.
The Solution
For national health and medical preparedness to become a reality, a stable and dedicated stream of funding to build and
sustain our response infrastructure is necessary. This funding is also needed to promote partnerships with academia and
other stakeholders to ensure that the best science is available to guide response and recovery efforts, as well as future
investments in preparedness.

1
From: Trust for Americas Health, Investing in Americas Health: A State-by-state Look at Public Health Funding and Key Health Facts

2 | P a g e
Exhibit 1 Hospital and Public Health Emergency Preparedness Funding 2001-2005 (in millions)
2









2
Data is from UPMC analysis of funding trends. Methodology includes analysis of funding from official agency announcements, and
estimates based on the Presidents requested budget for 2015. Source for year 01-09: Crystal Franco and Tara Kirk Sell. Biosecurity
and Bioterrorism: Biodefense Strategy, Practice, and Science. June 2011, 9(2): 117-137. Source for years 10-15: BoddieCrystal,
SellTara Kirk, and WatsonMatthew. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. July/August 2014,
$-
$100
$200
$300
$400
$500
$600
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
(est)
2015
(bud)
Hospital Preparedness Funding
0
100
200
300
400
500
600
700
800
900
1000
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
(est)
2015
(bud)
Public Health Emergency Preparedness Funding
(including supplements)
Fiscal Year 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
2014
(est)
2015
(bud)
HPP $ - $135 $515 $515 $487 $474 $474 $423 $394 $417 $375 $375 $358 $255 $255
PHEP $ 67 $940 $939 $918 $919 $823 $767 $746 $747 $761 $664 $657 $620 $653 $607