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When it comes to preventing, detecting and responding to outbreaks, Pennsylvania is prepared, but not as much as it could be.

A new report released by Trust for America’s Health finds that states throughout the nation are often caught off guard when a new public health emergency pops up.  
According to the report, overall trends show an improvement in emergency operations and communications and major upgrades in public health laboratories, but a cycle of major cuts over time have left the federal government and states scrambling for emergency funding. Most recently, money to combat the Zika virus took up to 10 months to reach states that needed it most.

“While it’s nearly impossible to be 100 percent prepared for all emergency, there are core responses experts agree can be done to achieve better outcomes and results and better protect Americans from ongoing threats,” said Rich Hamburg, interim president and CEO for the health policy nonprofit, during a teleconference Tuesday.

Having a strong public health emergency fund, improving federal leadership before, during and after a disaster, and training the “next generation public health workforce” to use technology and work within the community could help those outcomes, he said.

States received one point each for meeting each of 10 key indicators of public health preparedness examined. Twenty-six states and Washington, D.C., scored a six or below, including Pennsylvania, which scored a six.  Massachusetts did the best, scoring a 10 out of 10, North Carolina and Washington came in second with nines, and Alaska and Idaho made the bottom of the list with a three out of 10.

Pennsylvania met benchmarks for increasing public health funding, national health security, public health department accreditation, climate-change readiness, food safety and reducing health care-associated infections.

Hamburg said public health efforts across the nation have struggled from post-recession cuts in federal funding. Between 2002 and 2016, the federal government cut one-third of funding to states for health security and half of the funding for health care system preparedness, according to the report.

Federal preparedness funding grants for Pennsylvania decreased by 30.4 percent. During the same time period, the federal government went from allocating $37.3 million to Pennsylvania to just over $26 million in public health emergency preparedness and hospital preparedness program grants.

Hamburg said this leaves states scrambling to find the money to pay for efforts against new outbreaks such as Zika or Ebola.
Pennsylvania increased public health funding by one-tenth of a percent from fiscal year 2014 -2015 to fiscal year 2015-2016, spending $14.72 per Pennsylvanian.
However, the dollar amount spent per person didn’t necessarily correspond with how much a state was doing to respond to public health threats. The lowest scoring states — Alaska and Idaho — spent more per capita, $120.14 and $90.45 per capita respectively, than top-scoring Massachusetts, which spent $51.19 per capita.

Just 10 states, not including Pennsylvania, vaccinated at least half of their population against the seasonal flu during the 2015-16 flu season.  Dedicated state public health laboratory training and staffing cost the state two points. The commonwealth also missed the mark on having a formal plan for getting private-sector medical staff and supplies into restricted areas during a disaster, although there are county and city level programs.

“While it’s nearly impossible to be 100 percent prepared for all emergency, there are core responses experts agree can be done to achieve better outcomes and results and better protect Americans from ongoing threats,” Hamburg said.

Those include having a strong public health emergency fund, improving federal leadership before, during and after a disaster, reconsidering health system preparedness and training the “next generation public health workforce” to use technology and work within the community could help those outcomes.

Dr. Bryan Wexler, medical director for Disaster Preparedness and Response at WellSpan Health, said WellSpan York Hospital coordinates at the local and county level to prepare for the worst. In April, the hospital’s employees participated in a joint active-shooter training with local law enforcement.

Employees also were trained in what to do to respond if Ebola came to Pennsylvania in 2015.

“Even if the threat remained low, it’s really on us to make sure we are as prepared as possible,” Wexler said. “You can’t prepare for everything, but it’s really on us to do our due diligence. If it’s not Ebola, it could very well be something else.”

Each year, the hospital puts together a hazard vulnerability analysis, breaking down scenarios that are most likely to occur that year, but it also coordinates with the South Central Task Force and the York Adams Metropolitan Response System. Through those partnerships, Wexler said WellSpan’s employees can be better prepared to respond.

“The old days of practicing in a silo by yourself are thankfully long gone,” Wexler said.

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