Report: 51 U.S. Cities Risk Losing Emergency Readiness Funds

By Stew Magnuson
After years of progress preparing for public health emergencies caused by bioterrorist attacks, pandemics or natural disasters, the economic downturn and federal fiscal crisis are forcing cities and states to scale back their efforts, an annual report on public health concluded.
“Ready or Not? Protecting the Public’s Health From Diseases, Disasters and Bioterrorism 2011,” produced by the Trust for America’s Health, said the years between the 9/11 attacks and when the economic crisis struck saw an upward trajectory in preparedness. Since then the progress has been eroding.
“We were leaps and bounds beyond where we were” prior to 9/11, Jeffrey Levi, executive director of Trust for America’s Health said in a conference call. The nation was finally moving away from knee-jerk reactions to disasters.
“If we don’t maintain our core capacity, that is going to be a poor investment,” Levi said.
In the past year, 40 states and Washington, D.C., have cut funds to public health. Some 50,000 state and local public health department jobs have been lost to layoffs or attrition. Federal funds for state and local preparedness declined 38 percent from fiscal year 2005 to 2011. Additional cuts are expected under budget sequestration, the report added.
Past reports have taken an “all-hazards” approach to mass casualty events that could overwhelm hospitals, whether an incident is caused by natural disasters, a pandemic or a terrorist attack. In all these cases, hospitals, many of which are in private hands, may not be able to care for all the injured or sick who will arrive seeking care. Most for-profit hospitals do not have a financial incentive for stockpiling drugs.
All 50 states and Washington, D.C., saw federal grants to the Hospital Preparedness Program cut in 2011 and 41 states saw reductions in Public Health Emergency and Preparedness grants.    
One program, the Cities Readiness Initiative, which is administered by the Centers for Disease Control, sought to address some of these concerns, but 51 of the 72 participating municipalities are at risk of losing their federal funding. The program provides alternative means for rapidly distributing vaccinations and medicines to the public during emergencies.
The 10 states with top-level chemical threat testing laboratories are also at risk of losing their funding id proposed budget cuts go through, the report said. That would leave the nation with only one federal lab in Atlanta capable of full chemical testing capabilities, the report said.
“States across the U.S. are facing the same challenges,” said Mel Kohn, Oregon’s state health officer and public health director. Nine of his department 60 employees have been laid off. The state funds all of its preparedness and response program though federal grants.
“Americans expect the public health system to have the capability to competently protect their health during emergencies,” Kohn said. “This is not really an optional service. This is not something we can just decide we can’t afford right now. It has life and death consequences.”
The 51 cities at risk for elimination from the Cities Readiness Initiative include:  Albany and Buffalo, N.Y.; Albuquerque, N.M.; Anchorage, Alaska, Baltimore; Baton Rouge and New Orleans, La.; Billings, Mont.; Birmingham, Ala.; Boise, Idaho; Burlington, Vt.; Charleston, W.V.; Charlotte, N.C.; Cheyenne, Wyo.; Cincinnati and Columbus, Ohio; Columbia S.C.; Des Moines, Iowa: Dover, Del.; Fargo, N.D.; Fresno, Riverside, Sacramento and San Jose, Calif.; Hartford and New Haven, Conn.; Honolulu; Indianapolis; Jackson, Miss.; Kansas City, Mo.: Little Rock, Ark.; Louisville, Ky.; Manchester, N.H.; Memphis and Nashville, Tenn.; Milwaukee; Oklahoma City; Omaha, Neb.: Orlando and Tampa, Fla.; Peoria, Ill.; Portland, Maine; Portland, Ore; Providence, R.I.; Richmond and Virginia Beach, Va.; Salt Lake City; San Antonio, Texas; Sioux Falls, S.D.; Trenton, N.J.; and Wichita, Kan.

Topics: Homeland Security, Disaster Response

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