Public Health Preparedness

Most Federal health centers are not integrated in their community's emergency preparedness plans

More than 15 million Americans receive care from 890 federally funded health centers across the United States. Despite their prevalence in both rural and urban areas and potential contributions in a disaster, these centers often do not have a designated role to play in community emergency response plans, a new study finds.

Jerod M. Loeb, Ph.D., of The Joint Commission, and colleagues mailed 60-item questionnaires to the health centers, covering experience with prior emergencies or disasters, community emergency preparedness planning, the health center's role in a community response, communication, surveillance, reporting and lab testing, and training and exercises. The research team focused the analysis on three items selected to best represent the health center's links to community preparedness efforts. These items included whether the center worked with community responders on a hazard vulnerability assessment (HVA), the center was included in the community emergency response plan, and the center participated in community exercises.

Of the 307 health centers that responded, just 25 (8.1 percent) answered positively to all three items. Those centers tended to be rural (and typically the only health care providers in a community), have past experience in responding to a disaster or public health emergency, perceived a threat of hazards, and were accredited by The Joint Commission.

Breaking down responses to the three items, 27 percent of the centers had completed an HVA, with rural centers more likely than urban centers to complete the assessment. Thirty percent said their centers were included in community emergency response plans. The 24 percent of centers that participated in exercises tended to have high patient volumes and past experience with emergencies or disasters.

Health centers offered several reasons why they were not incorporated in community disaster plans. They include staff and time limitations, insufficient funding for training and equipment, poor leadership and coordination, insufficient reimbursement for services, and lack of community understanding of the center's potential role.

This study was funded in part by the Agency for Healthcare Research and Quality (HS13728).

See "Assessing the integration of health center and community emergency preparedness and response planning," by Nicole V. Wineman, M.A., M.P.H., M.B.A., Barbara I. Braun, Ph.D., Joseph A. Barbera, M.D., and Dr. Loeb in the November 2007 Disaster Medicine and Health Preparedness 1(2), pp. 96-105.

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