Health Care Coalitions Frequently Asked Questions

A preparedness plan is never in its finality, it is constantly changing/evolving based on real-time emergency events, new membership type, and the required activities and deliverables for all budget periods of the HPP. There is a Preparedness Plan template on the HCC Webpage under National Resources, that shows short and long term objective examples.

Yes, you could use and upload the same drill template used by the LPHA, or you could just include a list of participants, date, time and type of redundant communications used. The goal is to see how members within your regional HCC are able to receive shared communications, what was the means they received the information, and how many members actually participated in the redundant drill.

If so, will the funding distribution be similar to the All-Hazards Advisory Committee disbursements? Yes, the proposed plan is  based on the All-Hazards Regions. CDPHE-OEPR will use a funding formula; however, this formula is not the same formula used by the All-Hazards Advisory Committee.  We believe our recommended funding distribution is the most equitable for our healthcare communities within the restrictions set forth by our federal grantors.

We agree all incidents start and end locally that is why HCCs MUST coordinate with all ESF-8 lead agencies.  HCCs serve as multiagency coordination groups that should support and integrate with ESF-8 activities.  Coordinating regionally among partners is a key element of a successful response.  Using the HCC Regional Model, will ensure you have sufficient “like” partners to strategically plan, identify gaps and mitigation strategies, develop operational planning and response, share information and coordinate resources to support each other during an event.

In cases where there are multiple entities of a Regional HCC, there may be subcommittee structures (sub-HCCs) that establish a lead entity (governance) to communicate common interests to the Regional HCC and vis-versa.  We suggest the Regional HCC governance be made up of representatives from the subcommittees (sub-HCCs).

The new regional coalition can use existing leadership or elect new leaders.  Determining who will lead the Regional HCC will be up to the existing HCCs to establish.  CDPHE and our partner organizations are willing to assist any Regional HCC with the initial coordinating meetings.

According to the FOA, a governance must be in place by the end of Budget Period 1.  However, our goal is to have this established within the first quarter of the new budget period which would be by September 1, 2017.  This will ensure the new HCC has ample time to coordinate with partners and still meet other required deliverables by the end of BP1.

No each regional HCC will not receive the same amount of funding, we anticipate breaking down funding allotments by  four impacts: base amount (same for each coalition), number of hospitals, square miles of coalition, and population.

OEPR Admin/Finance is researching opportunities to allocate funds by a fixed price agreement to the Regional HCCs on a quarterly basis rather than on a reimbursement basis for every expenditure of funds.  However, these requirements are driven by procurement processes and may be beyond our control.  Either way funds are allocated to the Regional HCCs, OEPR will provide a standardized reporting process.  It will be the responsibility of each fiscal agent to control, track and report on expenditures for their respective Regional HCC. The regional HCC will be responsible for allocating funding authorizations based on the needs of the coalition members and specific deliverables that will be set by the CDPHE, which will follow the HPP guidelines. The money should be disbursed by need and how best to meet the gaps of the HCC. We do not recommend to merely disbursing funding to the previously funded agencies.

CDPHE-OEPR hopes that the regions would see a benefit on having federal resources to assist their communities. We can provide further guidance to this region.

There will be a work plan with deliverables that need to be met by the Regional HCC. These are currently being compiled by CDPHE-OEPR and should be available soon.

Surge would be dependent on the regional makeup and specific to incidents and is difficult to quantify what that amount would be.

CDPHE-OEPR is in the process of establishing the deliverables for public health and will work to align as many deliverables with the HCCs as possible. Since we do not fund Hospitals, EMS or EM we will be sharing these deliverables with our state and department partners for awareness.

We do not encourage this, however this decision would be left up to the regional HCC. If giving them funding will assist the regional HCC on accomplishing their required deliverables then this could be considered.  All Regional HCC partner organizations may benefit from Regional HCC procured training or exercises.

While it may be possible to obtain a waiver for some funding to be rolled over into the next budget year, this is highly discouraged. As a general rule, all funding must be spent by the end of budget period of that year (June).

Since capabilities change over time, funding will not be tied to specific deliverables for the HCCs and it would be up to the regional HCC to ensure the completion of these deliverables.

Due to the population in these counties, CDPHE-OEPR feel this is being considered as is the hospitals in these regions.

The capabilities are not tied to population impact and each regional HCC is required to complete the deliverables associated with the capabilities. As a regional HCC, you will have all the core members; hospitals, emergency medical services, emergency management organization, and a local public health agency, these agencies working together can ensure the deliverables are met even when the population is smaller.

The proposed model suggests sub-area HCCs within the regional HCC. It will be up to the regional HCC governance and those elected to officer positions, to ensure that all capabilities are met through completion of the capabilities within their region. It may be ideal that the governance board have members from the sub-areas to collaborate on planning, training, communications, and all required exercises, this would make it easier to share all deliverables.

The regional HCC governance will determine how best to allocate funding to meet the grant deliverables.  If the HCC governance determines fund the hospitals is the best way to meet the requirements, they will decide how much they want to give hospitals.

This was not intended to be funding directed to hospitals. This is simply a way to help ensure funds were not simply allocated based upon population. How each regional HCC decides to distribute funds in order to meet contract requirements, is up to the governance of each HCC.

Funding for hospitals will be at the discretion of the regional HCC, they will either fund the hospital's or not. FQHCs have never received funds from the HPP. Funding should support the accomplishment of the activities and deliverables outlined in the HCC work plan.

Hospitals that participated received $10,000, BH Agencies: $15,000-$17,000 depending on their deliverables and FQHCs have not received any direct funding.

Behavioral health facilities under the CMS Rule are required to meet four core elements: 1.) Risk Assessment and Emergency Planning 2.) Policies and Procedures for Emergency Preparedness Planning 3.) Have a Emergency Communications Plan 4.) Must train and exercise their emergency preparedness plan. HPP grantees and their sub-recipients may provide funding to individual hospitals or other healthcare entities, as long as the funding is used for activities to advance regional, HCC, or health care system-wide priorities, and are in line with ASPR’s four health care preparedness and response capabilities. However, though coalitions should support other preparedness efforts, funding to individual health care entities is not permitted to be used to meet CMS CoPs, including for the CMS EP Rule.

 CHA and CCHN have supported HCCs by attending local HCC meetings and having their members attend these meetings. For future work plans, this will be spelled out in detail on how these two organizations will be directly impacting these regional HCCs.

HCCs must have a minimum of two acute care hospitals within their region to qualify for HPP funding, the proposed 9 regional HCCs do comply with this core requirement.

This would be up to the discretion of the regional HCC and we would hope that any education in emergency preparedness would be provided to all the members of the HCC and not just a few agencies.

Under the CMS Rule hospitals must meet 4 core elements 1.) Risk Assessment and Emergency Planning 2.) Policies and Procedures for Emergency Preparedness Planning 3.) Have a Emergency Communications Plan 4.) Must train and exercise their emergency preparedness plan.  Meeting these requirements would be difficult if you are not working with your regional HCC. It would be up to the hospital.

The HPP is more focused on healthcare and believe by filtering the monies through HCCs the hospitals will benefit from the community-based collaboration. PHEP and our public health agencies will be required to continue to support their HCCs. Local public health agencies will have several deliverables in the their upcoming work plan to support and assist their regional HCCs. Currently there are no changes to the PHEP funding due to the changes to HPP.

PHEP recipients will be able to request funds as part of the regional HCC. Awarding them funding will be at the discretion of the regional HCC governance. Keeping in mind that PHEP recipients (local public health agencies) receive Public Health Emergency Preparedness funds and you cannot supplant federal funding.

Regional HCCs may provide funding to individual hospitals or other healthcare entities, as long as the funding is used for activities to advance regional, HCC, or healthcare system wide priorities and aligned with HPP response capabilities. Again, funding is not permitted to by used to meet CMS Emergency Preparedness requirements.

Regional HCC governance should have appointed officers which means there would be opportunities to “take turns” in attending official meetings or conferences as long as clear communications lines were set up to share the information learned from attending a meeting with other officers and HCC members. It is not necessary that all regional HCC officers attend the same meeting.

The State of Colorado mileage reimburement rate is established by the State Controller.

The Regional HCC must define and implement a governance structure and necessary processes to execute activities.  Information about using HPP funds to establish a HCC legal entity can be found in ASPR Grant Directive 02(A). Use of Grant Funds for Setting up a HCC as a Separate Legal Entity is available in the HPP-PHEP Supplemental Guidelines.  More information about establishing HCC governance can be found in Capability 1, Objective 1, Activity 3 of the 2017-2022 Health Care Preparedness and Response Capabilities. The state is generally only able to contract with the following entities: governmental and nonprofit entities. It is the decision of the Regional HCC governance to choose what entity to use as a fiscal agent. The fiscal agent will be the legal authority of the HCC. The state recommends that not be more than 10% of the total award be allocated for administrative costs for a fiscal agent.

Your chosen fiscal agent would have that authority.

There are resources available on ASPR TRACIE. South Central HCC is a great resource for these governance requirements as well as the Funding Opportunity Announcement and the 2017-2022 Healthcare Capabilities.

This amount was based upon previous contracts with CDPHE and these numbers could go down which would mean more funding to the regional HCCs. EmSystems is utilized by virtually all partners in the state.

While RETACs typically deal with First Responder Coordination, HCCs expand to hospitals, Public Health, Behavioral Health, Coroner etc.  The purpose is not to supplant RETAC planning to but to ensure integration with some of the less traditional planning partners and those serving in a complimentary capacity in planning and response.  RETAC is specific to Emergency Medical and Trauma Care.  The HCCs expand beyond those considerations.  Each participating agency and discipline will maintain discipline-specific associations, but within the HCC, they can work to coordinate their special resources and capabilities within the wider health and medical community.

How each regional HCC decides to distribute funds in order to meet contract requirements is up to the governance of each HCC. Funds may be used to procure HCC-wide activities or directed to individual agencies. Caution! Funding can not be directed to specific agencies to fund them to meet CMS requirements. If they are accomplishing contract requirements and it also meets CMS requirements, then there is no issue. If giving funding to specific agencies for equipment is what the regional HCC decides to do, the activities and deliverables will still have to be accomplished.

Provided that the regional HCC maintains the oversight to ensure all deliverables are met, some deliverables can be completed at the sub-coalition level.

As it says on page 6 of the 2017-2022 Health Care Preparedness and Response Capabilities document, "...capabilities may not be achieved solely with the funding provided to HPP awardees and sub-awardees (including HCCs and health care organizations) through the HPP Cooperative Agreement."  So for many of our partner organizations, they need to think of EPR responsibilities the same way as paying to keep the lights on...it's a cost of doing business.  We realize that to some extent the State's BH efforts are out in front of the Federal requirements for BH activities--that's why other states call our state BH folks when they have an incident.  Since we do not want to see a degradation in our state-wide BH preparedness activities, we are working on some state specific deliverables that will ensure the HCCs maintain some level of focus on these areas. We would also hope that each Regional HCC would ensure including these local behavioral health agencies in mind when accessing gaps and funding specific agencies.

HCCs may use funding to employ staff.  That decision ultimately resides with the HCC governance. OEPR will require the PHEP funded regional staff provide subject matter expertise to the HCCs. We highly encourage the collaboration of our regional staff, as they have already been doing these HCC deliverables.

As stated within the FOA, Domain 1, Activity 2, Page 19, the OEM THIRA would be acceptable as long as the THIRA contains coordinated health and medical vulnerability considerations.

The Homeland Security Information Network (HSIN) can be accessed via https://www.dhs.gov/how-join-hsin.