ASPR aims to better identify and address gaps in coordinated patient care during disasters through the establishment and maturation of a Regional Disaster Health Response System (RDHRS).

The primary objectives of the RDHRS are to:
1.

Improve bidirectional communication and

credit:

situational awareness of the medical needs and issues of the response between healthcare organizations and local, state, regional, and federal partners; 2.

Leverage, build, or augment the highly specialized clinical capabilities critical to unusual hazards or catastrophic events; and 3.

Augment the horizontal (whole of community) integration of key stakeholders that comprise healthcare coalitions with readily accessible and clinical capabilities that are largely missing from the current configuration of such coalitions.

The RDHRS structure is conceptualized as a tiered system that builds upon the existing Medical Surge Capacity and Capability (MSCC) , foundation for local medical response (e.g.

trauma systems and HCCs) by enhancing coordination mechanisms and incorporating discrete clinical and administrative capabilities at the state and regional levels.

The RDHRS is not intended to alter or displace current local patient referral patterns, but is instead intended to define the delivery of clinical care when the existing referral patterns and health care delivery capacity and capabilities are exceeded by catastrophic events (requiring either redistribution of patients, importation of resources, or resource utilization guidelines).

At all levels of RDHRS, activities aim to optimize clinical surge capacity, provide clinical expertise to support healthcare surge planning, and ensure that appropriate clinical expertise is involved and empowered as a partner in emergency planning and response.

At the state level, RDHRS specifically aims to establish more robust situational awareness of healthcare system capability and capacity, coordination and prioritization mechanisms for patient transfers, process and policy for resource management, and access to clinical specialists in areas such as pediatrics, trauma and burn care, and infectious disease.

The maturation of these capabilities will better enable states to respond to healthcare crises within their geographic boundaries and increase their ability to support resource requests from other states.

At the regional (e.g.

multi-state) level, the RDHRS will cultivate and establish mechanisms for sharing the clinical expertise necessary to respond to low-probability, high-risk threats (e.g.

chemical, biological, radiological, and nuclear (CBRN) threats) and provide a mechanism to coordinate patient care and movement across jurisdictional boundaries.

RDHRS will also integrate with and leverage the expertise and resources of existing response systems for biologic (e.g.

National Emerging Special Pathogens Training and Education Center ) radiologic (e.g.

Radiation Injury Treatment Network), and trauma- based (trauma systems) disasters.

This Notice of Funding Opportunity (NOFO) does not aim to establish the RDHRS in its entirety, but instead seeks to fund a demonstration site that will advance the vision for a nationwide, regional response system, and that will help identify issues, develop best practices, and demonstrate the potential effectiveness and viability of this concept.

The new award will focus primarily on building and maturing the partnerships that are required to effectively prepare for and respond to the management of patients in disasters, including those that facilitate rapid expansion of medical surge capacity of the existing healthcare system, coordination of patient and resource movement to support the response, and the swift involvement of specific clinical specialists, building on lessons learned from the two active demonstration sites established in 201 8.

The intent of this effort is to enhance response capabilities for both small- and large-scale emergencies and disasters.

Whereas the healthcare coalition effort has successfully promoted horizontal integration of key stakeholders in the emergency response system, including healthcare entities and organizations, this effort will bolster such efforts by simultaneously promoting vertical integration of key expert resources such as trauma centers, pediatric centers, and poison control centers.

ASPR will fund one (1) Partnership that will serve as demonstration site for implementation of the RDHRS concept.

The Partnership will bring together required members as described in the Eligibility Criteria section and as required by section 319C-2(b)(1)(A) of the Public Health Service Act (42U.S.C.

247d-3b(b)(1)(A)), as amended.

Successful applicants will propose a governance structure that is capable of coordinating healthcare assets across the recipient’s state and is also poised to share information and medical assets with other states in their HHS region.

ASPR designed the capabilities included in this NOFO to be complementary to the Health Care Preparedness and Response capabilities but emphasize the clinical coordination aspects of disaster response.