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Opinion

We Need to Honor the Public’s Call for Preparedness

National polls demonstrate that natural disasters are the event Americans are most worried will impact their community, and by a wide margin. Americans are more concerned about natural disasters than terrorist events, pandemics and cyberattacks combined. With hurricane season here, this is an important consideration — and potential wake-up call — for public officials.

Indeed, hurricane season is even more significant for public officials as warmer weather also marks the beginning of Zika season. It is imperative that the agencies tasked with preparing for and responding to these events have not only adequate funding to carry out their life-saving missions, but also empowered leadership.

While it was encouraging to see Brock Long confirmed as FEMA administrator last month (albeit nearly five months after the president took office, and over three weeks into hurricane season), Brenda Fitzgerald appointed to director of the Centers for Disease Control and Prevention and Robert Kadlec nominated to assistant secretary for preparedness and response at the Department of Health and Human Services, such delayed confirmations and nominations come at a price. They cost these leaders time to craft and implement their agenda. They cost the agencies themselves — important preparedness programs and initiatives may be put on hold until leadership is in place to sign off on them. Prioritizing emergency preparedness and response in alignment with public opinion requires prioritizing the agencies in charge of it. A core tenet of the field is having resources and personnel in place before an event occurs, to include decision-makers.

As a nonprofit disaster response organization positioned between the public and private sector, Healthcare Ready both relies on and works with these agencies routinely. Our experience responding to over 65 events demonstrates the pressing need for these leaders to focus on preventive efforts. In the face of increasing extreme weather events, combined with aging infrastructure, FEMA and others must focus on strengthening critical infrastructure to a greater degree than ever before. Confronted by an increasing burden of chronic disease and emerging infectious diseases like Zika, among other threats, CDC and HHS leadership should continue to encourage preventive care. A prevention-based model not only improves health outcomes but also minimizes the impact of disasters on public health.

The administration’s prioritization of emergency preparedness and willingness to equip these leaders with the resources they require is additionally concerning when proposed funding for preparedness and response efforts is analyzed. The proposed budget for FY18 seeks to eliminate $667 million in FEMA grant funding for states, local governments and communities, including over 60 percent cut in funding for the agency’s Pre-Disaster Mitigation Grant Program, from $100 million in FY17 to $39 million in FY18. These grants are designed and intended to help communities reduce risks and be better prepared before a disaster. Accordingly, these grants have the dual benefit of protecting communities and saving money in the long-term.

The proposed budget also seeks to impose a 25 percent cost-sharing match for FEMA grants that do not currently have a match. Taken together, these could be successive hits to state and local governments. Not only will they receive less funding for mitigation activities, but they’ll be required to pay a greater share of costs incurred from disasters — costs that could likely be lower with pre-disaster mitigation efforts.

These proposed cuts and cost-sharing requirements are even more problematic in the context of funding for the Department of Homeland Security, the department under which FEMA falls. DHS was one of the few departments slated for on overall increase in funding, yet crucial preparedness programs under the Department are facing cuts. The cuts to FEMA grant programs referenced previously are coupled with cuts to training for security programs for first responders and reductions to public health preparedness and prevention efforts managed by the CDC.

Natural disasters and public health emergencies are multi-faceted events, impacting not just one sector, but many. The interdependencies that exist between sectors mean many decision-makers will be involved in a response. Similarly, these events typically impact people of all demographics and socioeconomic status in some way. This means much of the public will have a stake in the response and recovery.

The role and life-saving work of FEMA and other agencies dedicated to preparedness and response is only growing. It is vital that leadership at these organizations are prioritized and empowered, which include receiving adequate funding for the preparedness initiatives they oversee. When lives are on the line and the health of communities at stake, we must know we have the leaders in place to make important decisions and the budget in place to enact those decisions.

 

Sarah Baker is a program associate at Healthcare Ready.

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