Hospitals told a major Senate panel that a $385 million bucket of annual emergency preparedness funding up for reauthorization should “be at least doubled” if the country’s healthcare system is to be ready for another public health threat.
On July 3, the Committee on Health, Education, Labor and Pensions (HELP) released a bipartisan discussion draft on legislation to reauthorize the Pandemic and All-Hazards Preparedness Act (PAHPA). The oft-extended act was first passed in 2006 and is currently set to expire with the end of the government’s current fiscal year Sept. 30.
Chief among the discussion draft’s proposals (PDF) was reauthorizing $385 million in annual funding for PAHPA’s Hospital Preparedness Program (HPP) for fiscal years 2024 through 2028. This would be the same amount Congress authorized for the HPP for fiscal years 2019 through 2023.
Writing Monday in a letter (PDF) to the Senate HELP Committee’s leading members, the American Hospital Association (AHA) told lawmakers that a greater investment is necessary to “help prepare and equip our nationwide healthcare system in advance of the growing number and scope of future disasters and public health emergencies.”
AHA noted that funding for the HPP has slipped over the two decades since its inception, falling from a high of $520 million in fiscal year 2023 to the current $385 million. The program and its funds have been “critical” toward helping health systems collaborate with state, territory and city health departments during health emergencies, the AHA wrote.
The lobby group also reiterated comments it passed along to lawmakers back in March advocating that HPP include additional, dedicated direct-to-hospital funding “to help rebuild the program after years of underfunding;” allow for hospitals and hospital associations to compete with each other over what organization gets to serve as the HPP recipient of their jurisdiction; and permit HPP funding to span across state lines of better multiregion response planning.
Beyond HPP funding, the AHA noted in the letter that the PAHPA reauthorization discussion draft did not include any increased authorities for the Food and Drug Administration (FDA) to tackle “the cascading impact” of drug and devices shortages. These shortages “can adversely affect patient care by causing delays in treatment, increasing the risk of medication errors and requiring the use of less effective alternative treatments,” the group wrote.
With this in mind, AHA said that it “continues to strongly recommend” that congressional leaders expand the medical device manufacturer notification authorities granted to the FDA under the CARES Act. That pandemic legislation gave FDA the authority only during an official public health emergency, which the AHA wrote “limits the FDA’s ability to respond to any early signs of supply constraints or a potential shortage situation.”
AHA also said Congress could stand to better incentivize drug and device manufacturers to target product quality and resilience under stronger FDA requirements, which would help lessen the impact of shortages.
Meanwhile, the AHA took a favorable tone on updates to the PAHPA discussion draft related to all-hazards emergency preparedness and response. The hospital lobby called out greater consideration of active pharmaceutical ingredients, key starting materials and “other critical components within the National Security Priority.” It also hailed the new inclusions of “relevant industry, academia, professional societies and other stakeholders” among those involved in preparation exercises—though noted that the language could be revised to specifically include “hospital associations” among the list of groups.
“This will help avoid the confusion that arose during the COVID-19 pandemic when federally purchased and state-distributed countermeasures and other supplies were distributed to hospitals without proper information included and sometimes without any notice,” the AHA wrote in the letter. “These situations might have been avoided had hospitals and health systems been included in the planning and exercises conducted around the distribution of countermeasures.”
Comments on the HELP Committee’s PAHPA discussion draft closed Monday. Lawmakers had sought feedback on policies requiring certain products be sold to the U.S. government or commercial market at lower prices compared to other G7 countries and on policy to incentivize medical countermeasure development by extending PAHPA’s Priority Review Voucher program.