August 12, 2019 | Modern Healthcare 27
Federal hospital preparedness funding
weaker as requirements tighten
Emergency preparedness was once more
of an afterthought than a major priority among
healthcare providers. But much has changed since
the turn of the century when terrorist attacks on
New York and Washington, D.C., and a string of
natural disasters stretched hospitals beyond their
capacities and capabilities.
“It really came to a tipping point I think with
9/11 and Hurricane Katrina,” said Meg Femino,
senior director of emergency management at
Beth Israel Deaconess Medical Center in Boston.
Femino also oversees emergency management
for several other hospitals within the Beth Israel
Lahey Health system.
“We saw the fallout of what happens when you
are not prepared,” Femino said.
Indeed, the terrorist attacks on Sept. 11, 2001,
caused healthcare providers to bolster their focus
on emergency preparedness that included adding
more safeguards in the event of an extended
power loss.
Such focus was backed by the federal
government. In 2002, Congress passed the Public
Health Security and Bioterrorism Preparedness
and Response Act, creating the Hospital
Preparedness Program that provides grants to
healthcare providers specifically to fund their
readiness efforts.
At its height in 2003 and 2004, the preparedness
program provided hospitals with more thanDeGregorio said not every facility has enough capac-
ity in its emergency generators to provide continuous air
conditioning during an outage, since it is not considered
an essential system such as life-support devices. But ad-
dressing such issues has become increasingly important
as hospitals strive to achieve better patient satisfaction.
“Comfort is really critical for a lot of healthcare patients,”
DeGregorio said.
Setting priorities
Experts say how well a hospital performs during a power
outage ultimately has a lot to do with how much time and
resources it invested in planning.
During Hurricane Florence last September, Central Car-
olina Hospital, a 137-bed acute-care facility near Raleigh,
N.C., owned by LifePoint Health, experienced a series of roll-
ing brownouts that made its main power increasingly unre-
liable. So the hospital decided to switch to generator power to
ensure it had consistent power throughout the storm.
$500 million in grant awards, but over the years the
level of funding has steadily decreased. In 2019,
funding was set at $254.5 million.
But Femino said a lot has changed over the
past 10 years, with hospitals developing better
contingencies in the event of a blackout. She
said the number of emergency preparedness
standards for hospitals from federal and state
regulators as well as accrediting organizations
such as the Joint Commission and the National
Fire Protection Association has grown over the
past decade from just a few to more than 120
currently.
In 2017, the CMS finalized updates to its
Emergency Preparedness Rule to establish
national standards for how healthcare providers
handle natural disasters and terrorist threats.
Under the rule, hospitals are required to have
generators that can power critical care areas
where life support equipment is used and kick in
to supply power within 10 seconds after a power
outage occurs.
Following the CMS rule, the Joint Commission
also updated its own emergency management
standards, which include requiring hospitals
to perform regular testing of their emergency
generators every month for at least 30 continuous
minutes and store enough fuel on-site to keep
generators running for up to four days.
—Steven Ross JohnsonCentral Carolina CEO Spencer Thomas said a quick in-
ventory was conducted of what would be available and
what would be needed over the next several days while
the hospital was running on generators and found that the
refrigeration system was not being powered. The decision
was made to bring in another generator on a truck to have
on standby, which was ultimately used to power the entire
hospital for several days.
Thomas said such assessments play a critical part in
determining a hospital’s vulnerable areas during a power
outage. He said emergency planning involves evaluating
how the system performs both in routine testing and main-
tenance as well as during the actual emergency to under-
stand ways it can be improved.
“We’ve had situations where we had minor storms and
we lost power for an hour or two, and we have used those
opportunities to figure out if everything worked the way we
thought it would,” Thomas said. “Often we find some little
thing that we’re able to go back and correct.” l