DMBN:Tell us more about how the funding is broken down this year.

DM: 52 awardees in 50 states get the distribution of funding — this year the figure is over 300 million, and that funding gets dispersed to those awardees.


Funding is used to implement eight primary capabilities, which include health care coalitions, volunteer management, and fatality management — an unfortunate but necessary aspect of preparedness.

Under those capabilities are functions, and all those functions build to one capability and you can use your funds to execute those capabilities.

DMBN: Though preparedness funding held steady last year, this year we saw a $20 million dip in hospital funding. How can hospitals face this ongoing challenge?

DM: The challenge from a financial perspective is, you have a $2.8 trillion industry that's not geared toward disaster — it's largely a competitive market. All we can do is give our best attempt to put the right guidance while appreciating that funding will go up and down. So the question we ask is, regardless of funding, what is the best guidance out there?

DMBN: Any lessons to take away from the recent string of disasters such as Sandy, Boston, etc.?

DM: I guess I would say that you can't adjust to every different type of event. You need to have foundational processes that apply to all hazards. The concept of medical surge, part of our eight capabilities, applies just as well to Sandy as Boston. So health care recovery is critical to maximizing and optimizing disaster preparedness.

DMBN: Any other long-term measures on the horizon?

DM: It's important to think about metrics too — are we better as a result of these policies put out there? It's a challenge because there hasn't been a lot of science to define how good we are and track how effective our protocols are. Can we measure and track through time to confirm we are better prepared as a nation?

DMBN:Where do you see hospitals going in the future?

DM: We've identified eight foundational capabilities that hospitals should use as they develop their preparedness strategies. With the Affordable Care Act, we can better bridge between health care delivery and public health.

In public health, they use evidence-based documents to develop 15 capabilities that state and local health departments can use to better map out and develop their emergency plan.

We have eight that are right in line with our public health colleagues. Hospital preparedness is leading the charge on alignment between public health and health care.

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