The Impacts of the Affordable Care Act on Preparedness Resources and Programs Workshop Summary (2014) / Chapter Skim
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1 Introduction
1 Introduction
Pages 1-14
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There is a commonly held notion that preparedness is separate and distinct from everyday operations and that it only affects emergency departments. But time and time again, he said, catastrophic events challenge the entire health care system, from acute care and emergency medical services down to the public health and community clinic level, and the lack of preparedness of one part of the system places preventable stress on other components.
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How do investments in preparedness and national health security improve everyday health care? We have the opportunity to bridge two worlds, Margolis said, and bring the health care policy and emergency preparedness communities together to think about how to achieve Berwick's Triple Aim3 of higher-quality care, better population health across the country, and lower cost, with an added focus on making our nation more prepared.
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Public Health Service Corps volunteer members who can be available on short notice to assist in emergency or routine public health missions. Section 4304 establishes an epidemiologylaboratory capacity grant program to award funding to states and local and tribal jurisdictions to improve surveillance and threat detection and build laboratory capacity.
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D tribal jurisdictions to improve local levels for threat Laboratory (4304) surveillance and threat detec- detection and bio Capacity Grants tion and build laboratory surveillance.4 capacity.
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C Ready Reserve crises and to fill critical pub- deployed to assist in any (5210) Corps lic health positions left vacant public health emergency by members of the Regular and augment response.6 Corps who have been called to duty elsewhere.
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(1) By including mental Individuals can have health and substance use better coverage for daily disorder benefits in the Essen- mental health and sub tial Health Benefits; (2)
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. 1 9 Speakers: Lisa Tofil Nicole Lurie 2 10 Norman Miller Gus Birkhead 3 11 Gregg Margolis Nathaniel Hupert 4 12 Georges Benjamin Brandon Dean 5 13 Charles Cairns Kevin Larsen 6 14 Ellen Embrey Roland Gamache 7 15 Karen DeSalvo Connie Chan 8 16 Justin Barnes Xiaoyi Huang 17 Jack Ebeler In a keynote address to open the workshop, Assistant Secretary for Preparedness and Response, Nicole Lurie, shared her perspective that health care delivery system reform will have tremendous benefits for preparedness, response, and recovery.
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by including mental health and substance use disorder benefits in the Essential Health Benefits; (2) by applying federal parity protections to mental health and substance use disorder benefits in the individual and small-group markets; and (3)
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This is an opportunity for coalitions to further integrate and connect hospitals with public health departments. Provisions in the ACA can be leveraged to integrate preparedness into daily health care and to help create stronger routine and emergency health care delivery systems that can surge to respond to disasters (Lurie et al., 2013)
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Many participants pointed out that the imp lementation of the ACA provides the opportunity to incorporate preparedness into all aspects of the health care system. Pro visions in the ACA can be leveraged to integrate preparedness into daily health care and to help create stronger routine and emergency health care delivery systems that can surge in response to disasters.
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For example, health information exchange platforms provide a real community benefit, both directly, to the individuals whose data are housed in them, and at a population level, to public health and health care systems for preparedness. 8 Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; laboratory services; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; pediatric services, including oral and vision care; prescription drugs; preventive and wellness services and chronic disease management; and rehabilitative and habilitative services and devices.
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Many collaborations that already exist for routine care could, for example, enhance public health capacity in threat assessment, immunization tracking, and medical countermeasures disp ensing. Additionally, mission-critical vendor agreements could provide for the vendor's assistance in planning for and resp onding to an emergency.
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Participants also discussed a model of a social-health information exchange, which includes community-based service organizations, enabling providers to focus on the whole person during a disaster response and addressing acute medical needs as well as housing, shelter, and other needs that impact health. Also noted is that there is an ongoing struggle to sustain health information exchanges and that identifying sustainable revenue streams is critical.
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Although the ACA provides opportunities and incentives for health systems to prepare, several participants stressed that it cannot ensure that entire communities are prepared, and there is still a strong role for coordinating and collaborating across the entire spectrum of medical and public health preparedness programs.
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