Healthcare Preparedness Program (hpp) Needs Assessment Questionnaire

Form Approved
OMB No. 0990-0391
Exp. Date 05/31/2018

Purpose:
This assessment is meant for ASPR’s Hospital Preparedness Program (HPP)
awardees. The purpose of this assessment is to obtain feedback on HPP’s current
healthcare preparedness capabilities and how completely they cover the goals of the
program and the concepts of preparedness, response, mitigation, and recovery.
HPP appreciates your time and effort in completing this short assessment. Your input is
important as it will help inform HPP’s planning for the next project period (beginning in
2017). The information from this questionnaire will help optimize the data collection
related to program capabilities, which may result in the reduction of awardee reporting
burden. Specifically, we hope to collect information to help HPP:
1. Prioritize program capabilities;
2. Identify any gaps in the existing capabilities;
3. Identify any points to clarify in the next funding cycle;
4. Determine if additional capabilities are required; and
5. Determine if any capabilities require modification or are no longer relevant.
We ask that the person with the most knowledge of the HPP Capabilities (HPP
coordinator or someone with a longstanding involvement in the program) in your
jurisdiction or coalition submit the completed assessment. We request only one
response per awardee and one response per HCC; therefore, please do not forward
this questionnaire beyond the person in your jurisdiction or HCC who will complete it.
Your participation in this assessment is completely voluntary, and you may stop the
assessment at any time once you begin. The assessment will take approximately 10-30
minutes to complete. Your participation will help the Division of National Healthcare
Preparedness Programs (DNHPP) obtain important insights on the program design and
future directions of the program.
By clicking the button below, you confirm that you understand the above information
and are willing to take this assessment. We will be providing this questionnaire to all
awardees and select healthcare coalitions (HCCs).
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According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control
number. The valid OMB control number for this information collection is 0990-0391 . The time required to complete this information collection is estimated to
average _30__minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review
the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S.
Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports
Clearance Officer

Instructions
• Please answer all items by selecting the most appropriate response or providing
a written response.
• The following questions are to be answered from your viewpoint as an awardee
or HCC.
• If you have any questions regarding the assessment, please contact Suzanne
Berman ([email protected]), National Healthcare Preparedness
Programs (NHPP) contractor support.
General information
Please select your jurisdiction.
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Chicago
Colorado
Commonwealth of the Northern Mariana Islands
Connecticut
Delaware
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Los Angeles County
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada

New Hampshire
New Jersey
New Mexico
New York
New York City
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Republic of Palau
Republic of the Marshall Islands
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
U.S. Virgin Islands
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming

What role best describes your participation in your jurisdiction’s delivery of the
HPP Program?
HPP awardee (e.g., an HPP coordinator). (IF SELECTED SKIP NEXT
QUESTION)
Healthcare Coalition
Other [Please specify.] TEXT BOX
If you represent an HCC, please select all that apply to your HCC.
Urban
Suburban

Rural
Costal
Inland
Optional: Please specify your HCC name:______________________________

Please list your job position or title as it relates to your role in the HPP program.
TEXT BOX

HPP Capabilities
The following questions refer to the eight (8) Hospital Preparedness Capabilities
listed below.
Healthcare System Preparedness
Healthcare System Recovery
Emergency Operations Coordination
Fatality Management
Information Sharing
Medical Surge
Responder Safety and Health
Volunteer Management

Q1a. The Hospital Preparedness Program.
The ASPR, OEM, NHPP, Hospital Preparedness Program (HPP) provides Federal
leadership, guidelines, tools, and financial assistance through grants and cooperative
agreements to states, territories, and eligible municipalities to improve surge capacity
and enhance community and hospital preparedness for public health emergencies.
Funding is used to support awardee-based programs to improve public health
emergency preparedness in several ways:
Enhanced Planning: Enhanced Healthcare Coalition, hospital, and other healthcare
organization’s collective capability and system planning at the State, local, and territorial
levels.
Increased Integration: Increased coordination of public and private sector medical
strategies and assets for integrated preparedness, response, and surge capacity of
Healthcare Coalitions, hospitals, and other healthcare organizations.
Improving Infrastructure: HPP and Special Initiative Grant funding for improved the
State, local, and territorial infrastructure that help Healthcare Coalitions, hospitals and
other healthcare organizations prepare for public health emergencies.
This assessment builds upon the data HPP awardees have previously submitted in their
Capabilities Planning Guide. We would like to clarify the importance of capabilities to
the OVERALL HPP program, beyond the needs of your specific jurisdiction alone. The
capabilities are:



Healthcare System Preparedness



Healthcare System Recovery



Emergency Operations
Coordination



Fatality Management



Information Sharing



Responder Safety and Health



Medical Surge



Volunteer Management

Please consider the program definition above and rank the HPP capabilities in order of
importance.
Rank the capabilities with 1 being the most important and 8 being the least important
__ Healthcare System Preparedness
__ Healthcare System Recovery
__ Emergency Operations Coordination
__ Fatality Management
__ Information Sharing
__ Medical Surge
__ Responder Safety and Health
__ Volunteer Management

Q2a. Consider the capabilities that you ranked overall as 1, 2, and 3 above. For each,
please explain why you ranked that capability as high importance.
Why did you rank this capability as 1?

TEXT BOX

Why did you rank this capability as 2?

TEXT BOX

Why did you rank this capability as 3?

TEXT BOX

Q2b. Consider the capabilities that you ranked overall as 6, 7, and 8 above. For each,
please explain why you ranked that capability as low importance.
Why did you rank this capability as 6?

TEXT BOX

Why did you rank this capability as 7?

TEXT BOX

Why did you rank this capability as 8?

TEXT BOX

Q3. The eight (8) capabilities and their definitions are shown below. Please check all
those you think need improvement and/or clarification and provide any comments that
could explain your opinion or provide further guidance to us.

Needs
Recommendations/Comments
Improvement/Clarification
Healthcare System
Preparedness
Healthcare System
Recovery
Emergency Operations
Coordination
Fatality Management
Information Sharing
Medical Surge
Responder Safety and
Health
Volunteer Management

Q4a. Based on your knowledge and experience, are there any elements of the disaster
management cycle (preparedness, response, mitigation, and recovery) that are not
addressed in these 8 capabilities?

 Yes
 No (If NO, SKIP to Q6.)

Q4b. If YES, please describe in as much detail as possible what you believe is not
addressed and should be.

TEXT BOX

Q5. If you could make changes to the current eight capabilities, what would those
changes be?
Please provide as much detail as possible about what you would change and
why.
TEXT BOX
In the coming months, as we continue the next funding cycle (beginning in 2017), we
hope to engage awardees and HCC members in discussions around the capabilities
and the program measures. We are looking for awardees and HCC members interested
in participation in these discussions using internet webinars. If you are willing to
participate or would like more information about participating, click the link below to
please provide your email address and indicate which preferences you may have
around topics. By following the link, the information you provide will not be directly
linked to your responses in this assessment.

URL

Thank you for your participation.

(End of Assessment)

(URL DIRECTS TO NEW PAGE)

I am interested in participating or learning more about the discussions around the HPP
capabilities and program measures.
NAME: ______________________________________

EMAIL ADDRESS: _____________________________
Select all topics that you would be interested in contributing to ongoing discussions. You
will only be asked to participate in one.
 Capability discussions
 Measure discussions