At ASPR, we’re excited about the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 (PAHPAIA), which the president signed last night. The new law strengthens public health and healthcare readiness, bolsters response and recovery programs, and increases transparency. What do the changes mean for our non-federal partners? We see some key provisions that can significantly improve preparedness and response for our partners.

Improving preparedness

PAHPAIA authorized a funding increase for the Hospital Preparedness Program from $374.4 million to $385 million which would continue to pass through state and territory health departments to healthcare coalitions. Congress must appropriate specific funding levels as part of the annual appropriations process, including any increase.

ASPR, the Director of National Intelligence, and the Department of Homeland Security are directed to coordinate regularly on threat assessments, including potential emergency health security threats. By coordinating more closely, ASPR will have the critical information to guide decisions about which medical countermeasures should take priority in development and acquisition for the Strategic National Stockpile and the National Pre-Pandemic Influenza Vaccine Stockpile.

Strengthening response

The law reauthorizes the authority giving states and territories the ability to reassign federally funded personnel temporarily in public health emergencies to support the response. When the HHS Secretary declares a public health emergency, states may request temporarily deployment of state personnel whose salaries are funded by HHS in whole or in part under Public Health Service Act programs. Under PAHPAIA, the National Disaster Medical System (NDMS) received direct hire authority which streamlines the federal hiring process for NDMS, making it easier and faster to hire new personnel. The law also authorizes benefits under the Public Safety Officers Benefit program for NDMS personnel which addresses a concern of NDMS personnel. NDMS personnel have jobs in the private sector and are called into federal service during disasters, and these provisions are expected to improve NDMS recruitment, which in turn increases the number of NDMS personnel available to support state and local healthcare emergency operations.

The Hospital Preparedness Program received enhanced authority under the reauthorized law. Coalitions funded under this program now can use the funding for response activities, and work with state health departments and other healthcare coalition members on greater accountability; with the new authorization, ASPR has two years to work with grantees and sub-grantees on coalition success rates; ASPR now could withhold a percentage of program funds from awardees that fail to meet required benchmarks.

PAHPAIA also authorizes ASPR to establish guidelines for the Regional Disaster Health Response System. Under the provisions, ASPR is authorized to use HPP funds to support demonstration projects related to the development and implementation of these guidelines. The Government Accountability Office is required to assess the program within three years and provide Congress with specific findings on success, limitations, and challenges.

Improving medical countermeasure development for emergency preparedness and response

Project BioShield received an increase in its authorized funding levels with appropriations authorized for 10-years. This longer timeframe means Congress can provide funding for a decade rather than on an annual basis. Given that a single medical product can take 10 years or longer to develop, long-term funding like this gives biotech and pharmaceutical companies an incentive to work with our Biomedical Advanced Research and Development Authority (BARDA) on advanced development, manufacturing and acquisition of medical countermeasures.

Programs to develop medical countermeasures for pandemic influenza and other emerging infectious diseases now are authorized to receive annual funding from Congress. In the past, funding to develop medical countermeasures for pandemic influenza and emerging infectious diseases came largely from supplemental appropriations after public health emergencies occurred, such as the H5N1 pandemic in 2009 and the Ebola responses in 2014. Having a standard budget line allows federal and private partners to undertake research, development and manufacturing before a disease spreads. Not waiting having to wait on supplemental budget funding is important because developing medical products takes years and to save lives in public health emergencies every moment counts.

These are exciting changes, and we look forward to working with our partners under the new and reauthorized authorities to protect the American people from modern health threats.