HHS Seeks Emergency Powers to Speed Future Outbreak Responses

HHS wants new emergency powers to surge up staffing and expedite contracting the way FEMA and the Department of Defense already can.

The pursuit of new authorities aims to apply the lessons from Covid-19 and arm the nation better against the next pandemic, said Dawn O’Connell, assistant secretary for preparedness and response (ASPR) in the Department of Health and Human Services.

“We are not the same organization we were three years ago at the start of this pandemic, nor should we be,” she said Thursday at Axios’s event on improving public health preparedness. “So how do I account for that? How do I make sure that our authorities have kept up with our responsibilities?

Lawmakers have taken initial steps to reauthorize the Pandemic and All-Hazards Preparedness Act (Public Law 116-22). First passed in 2006, the law established ASPR. The current authority expires Sept. 30.

As the US faced supply chain shortages and worked to expand the domestic capacity to provide medical equipment diagnostics and accelerate Covid vaccines and new treatments, ASPR had to enter into a memorandum of understanding with Defense to acquire new supplies quickly because the health agency couldn’t do that on its own, O’Connell said.

“We didn’t have a fast twitch acquisitions ability,” O’Connell said.

But that MOU expires at the end of the fiscal year. “I would like to get some of the authorities that DoD currently has so we can do our own contracts quickly.”

ASPR is building an acquisitions workforce to take this work forward, but O’Connell said she’ll need Congress to provide the authorities to go with it. “Given the vast and challenging geopolitical landscape we’re currently in right now, let’s let DoD do DoD things and have HHS do the HHS things.”

FEMA Surge Capabilities

The Covid response also necessitated a staffing surge, and O’Connell said staff from the Federal Emergency Management Agency came in early to help bolster the work HHS needed to do.

“FEMA of course, is designed for surge staffing. They’re designed to respond very quickly to be able to ramp up,” she said. “They have some authorities and pay flexibilities that I think HHS could benefit from, and I’ll be seeking those too.”

Those FEMA-like authorities will be critically important in cases that don’t trigger a response at the level of the Stafford Act—which provides state and local disaster relief—but are “critically important to our health care system.”

O’Connell said she’s already been speaking with lawmakers about these new authorities and “we’re well positioned, I think, to have a good conversation” with members of Congress as they seek PAHPA reauthorization.

But the law’s reauthorization process already has fallen behind with a new Congress that took longer to organize at the beginning of the year coupled with last year’s retirement of Sen. Richard Burr (R-N.C.), who led all of those bills, Asha M. George, executive director of the Bipartisan Commission on Biodefense, said at an earlier panel.

Bipartisan lawmakers in both the House and Senate issued requests for information on reauthorizing PAHPA. Reps. Anna G. Eshoo (D-Calif.) and Richard Hudson (R-NC)'s RFI closed March 13; the one from Sens. Bernie Sanders (I-Vt.), Bill Cassidy, (R-La.), Mitt Romney (R-Utah), and Bob Casey (D-Pa.) closes March 29.

“That was more of a later start than we would have liked,” George said. “But they do seem to be moving as quickly as they possibly can. So we’ll see.”

The last PAHPA reauthorization lapsed about eight months between its Sept. 30, 2018, expiration date and the June 2019 law. It’s not technically a must-pass bill the way the Farm Bill or the National Defense Authorization Act are, George said.

“We as a community, in the health care and public health, and in the biodefense arena for that matter, I think need to be pushing to get the Pandemic and All-Hazards Preparedness Act to be must-pass,” George said. “How does it make sense that defense authorization has to go forward and agricultural stuff has to go forward, but the human health stuff does not? It doesn’t comport.”