• The purpose of the National Health Care Preparedness and Response Capabilities (the Capabilities) is to provide the attributes required for health care to save lives and continue to function in advance of, during, and after a response.

• The Capabilities are a national vision of the critical functions to support this mission, not a step-by-step checklist of how to achieve these outcomes.

• There are eight capabilities:

  • Incident Management and Coordination

  • Information Management

  • Patient Movement and Distribution

  • Workforce

  • Resources

  • Operational Continuity

  • Specialty Care

  • Community Integration

• ASPR intends for audiences^[1] to use the Capabilities as a reference to:

  • Understand what is needed to improve health care readiness

  • Guide development of plans, training, and exercises

  • Connect partners to resources and toolkits

• ASPR expects audiences across the spectrum of health care delivery to use the Capabilities. For example:

  • A health care workforce audience (clinical or non-clinical, inclusive of Emergency Medical Services (EMS)) can use the Capabilities to prepare for their role in response and as a reference to advocate for the needs of the workforce during response

  • Health care facility and health care system leaders can use the Capabilities as a reference in emergency management planning and exercises, and to inform policy development and partnerships

  • While state, tribal, local, or territorial (STLT) government and public health agency leaders are not health care providers, they can use the Capabilities to understand the needs of health care during a disaster and the ways in which government agency, executive, and regulatory resources and powers may contribute to supporting the health care response.

  • ASPR and its federal and SLTT partners can use the Capabilities to inform future priorities and programming.

  • Health care coordinating entities such as Health Care Coalitions (HCCs), Regional Disaster Health Response System (RDHRS) sites, and Pediatric Centers of Excellence (COEs) can use the Capabilities to inform patient coordination and movement, areas of focus for community and specialty care partnerships, and surge prevention, mitigation, and response.

• The Capabilities do not represent federal requirements or cooperative agreement guidance.

The updated Capabilities include an increased or new focus on the following topics based on ASPR's understanding of current challenges: 
 

• Patient care coordination across the health care delivery system.^[2]

• Surge prevention to save lives given the recent study suggesting that 1 in 4 COVID-19 deaths was potentially attributed to hospitals with surging caseloads.^[3] The Capabilities look at surge through the lens of patient movement in particular, because of how critical patient movement can be to effectively manage strain across the care continuum.

• Medical considerations integrated into the Incident Command Structure (ICS) and facility-based ICS to support the prioritization of patient transfers and suggested coordination constructs like Medical Operations Coordination Centers (MOCCs) for patient movement solutions.

• Actions the health care delivery system can take to support the health care workforce and ensure resilience given burnout, moral distress, and workplace safety concerns among the health care workforce. The Capabilities provide objectives to augment health care workforce numbers to ensure adequate staffing across the spectrum of health care delivery; this is crucial to resilience of the workforce and continuity of patient care during a response.

• Prioritization of equity in all activities, with the goal of ensuring access to consistent levels of care, particularly in underserved and historically marginalized communities given structural inequities and the disproportionate impact experienced by communities of color and individuals with access and functional needs.

• Integration of community-based health care, public health, and social services into preparedness, response, and recovery activities to reduce burden on acute care, address equity, and ensure access to at-risk individuals and those with access and functional needs.

• Actions to address how to operate in the face of personal protective equipment (PPE), medication, and resource constraints, particularly in rural and frontier areas, given the intense strain on facilities across the nation due to supply chain difficulties and widespread shortages.

• As compared to the 2017-2022 release, these updated Capabilities provide more specificity around what the entire health care delivery system can do to save lives and continue to function in advance of, during, and after a response, and they incorporate lessons learned from COVID-19 and other recent responses.

• A key focus of the 2017-2022 Capabilities was defining the role of health care coalitions (HCCs) during response. The updated Capabilities take a step further, defining what organizations that make up HCCs (e.g., the core members of hospitals, EMS, emergency management organizations, public health agencies, etc.) will need to do to build a truly ready health care delivery system. HCCs will be a key entity, among others, to achieving these Capabilities in many jurisdictions. However, actions by health care (including EMS), public health, emergency management, and community partners as well as coordination entities at the community, state, regional, and national level are all required to achieve a successful response and recovery.

• No. The updated Capabilities will complement the 2017-2022 Capabilities document, which is available as a guide for foundational capabilities of HCCs.

• The updated Capabilities are a living document, which will be revised as needed to adapt to developments in preparedness and response. It does not have a fixed update cycle like the previous Capabilities.

• ASPR's approach to updating the Capabilities prioritizes input of the health care workforce and organizational partners across health care.

• ASPR requested input from diverse groups and their respective individual members within health care throughout each phase of the process.

  • These groups included frontline health care providers, EMS, health care leaders, state and local government agencies with preparedness and response functions, coordinating entities supported by ASPR (e.g., HCCs, RDHRS sites, Pediatric COEs), ASPR programs and leadership, federal interagency partners, health care and disaster professional associations and nongovernmental partners, and other audiences with roles in preparedness and response.

• ASPR's approach to updating the Capabilities includes the following phases:

  • Phase 1: Updated Document Outline and Listening Sessions

    • Identified priorities for the document based on challenges and lessons from recent responses experienced by the health care workforce across the spectrum of care

    • Hosted 15+ listening sessions to collect feedback on list of proposed topics for the updated document

  • Phase 2: Draft Development and Focus Groups

    • Developed initial draft of the updated Capabilities

    • Held eight focus groups with subject matter experts to discuss the relevance and scope of each capability's desired outcome and objectives at a high level

    • Revised content based on focus group input

  • Phase 3: Detailed Review and Draft Revision

    • Shared the draft Capabilities for a review with 65 individuals with relevant and diverse knowledge and expertise

    • Revised the draft based on input

    • Revised format for readability and ease of use

  • Phase 4: Pre-decisional Review (current stage)

    • Sharing the draft Capabilities with a broad group of partners for feedback on critical updates

    • Revising and finalizing draft for release based on feedback

• ASPR requests reviewers provide a recommended change if they identify: 
   

1. There is a missing element that is critical to saving lives and ensuring health care continues to function

2. Something in the Capabilities is factually incorrect and needs to be removed or updated

3. An additional link to a publicly available resource to support implementation of the corresponding activity