Overview
The Hospital Preparedness Program (HPP) is a cooperative agreement initiative led by the Administration for Strategic Preparedness and Response (ASPR), within the Office of Preparedness. The program strengthens the health care delivery system's ability to save lives during emergencies that overwhelm routine health care and emergency response capabilities. As the primary federal funding source for health care system preparedness and response, HPP supports the development of Health Care Coalitions (HCCs) collaborative networks of health care, public health, and emergency management organizations. These public-private partnerships enhance coordination and readiness across communities. ASPR requires HPP recipients to prioritize investments in HCCs, establishing a strong foundation for national health care preparedness.
HPP primarily focuses on building and strengthening Health Care Coalitions (HCCs). These coalitions are structured partnerships between healthcare organizations and both public and private sector entities. Coalitions are formed to enhance preparedness, response, and recovery during emergencies, mass casualty incidents, or large-scale disasters. Operating within a specific geographic region, most commonly within a specific state, HCCs unite key healthcare and emergency response organizations such as hospitals, EMS providers, emergency management, and public health agencies. Some HCCs have sub-coalitions, leadership councils or governing board including representation from types of members (acute care representation, long term care, ambulatory care etc.). Health Care Coalitions develop shared preparedness plans, conduct exercises and coordinate equipment and supply needs. Each HCC must have a Readiness and Response Coordinator that serves as the HCC’s administrative and programmatic point of contact. The RRC oversees planning activities, including coordinating training, facilitating exercises, ensuring financial sustainability, and developing budgets. They are responsible for ensuring that the HCC meets all HPP performance measures and benchmarks.
As part of this initiative, 62 awards spanning 10 regions across the country are distributed annually to states, with the expectation funds will be passed through to health care coalitions (HCC) within those states. the Hospital Preparedness Program supports a network of over 300 Healthcare Coalitions (HCCs) and over 47,000 health care coalition members. The program ensures that vital resources reach those on the front lines of healthcare emergencies aimed at building resilience and enhancing the capacity of healthcare systems to respond to a wide range of public health threats and planning for specific scenarios like burn, trauma, mass casualty events and communicable diseases.
Who can apply to HPP NOFO?
The HPP program opens a notice of funding opportunity and a call for applications annually with the expectation 62 awards will be granted. Applicants from all 50 states, the District of Columbia, the nation’s largest three municipalities (New York, Chicago, and Los Angeles County and the Commonwealths of Puerto Rico and Northern Mariana Islands are eligible to apply.. The HPP cooperative agreement receives funding through federal appropriations. Congress appropriates the total funding for HPP. After funds are appropriated, Office of Healthcare Readiness (OHCR) uses a statutorily required funding formula to determine funding award amounts which will vary by recipient. The FY2024 funding total was $240 million.
History
HPP established in 2002 in response to the attacks to the World Trade Center and Washington D.C. on 9/11/2001and other extreme events in the early 2000’s. The program is in its third decade and remains the primary source for federal funding for health care preparedness. HPP guides the development of “Health Care Coalitions” that are partnerships of public and private healthcare entities designed to respond to large scale emergencies. HPP is evolving and builds on previous years objectives and progress and the shifting threat landscape. States and HCC(s) work together to identify and meet community needs, foster connections among members, and strengthen the health care delivery system’s ability to continue to provide care during a disaster or emergency. Every awardee and their Health Care Coalitions are given the autonomy to identify needs and strengthen the healthcare delivery system ability to meet those needs.
In 2023 the program realigned the Administration for Strategic Preparedness and Response (ASPR) priorities to new and evolving threats to ensure the program stayed relevant in a changing landscape of healthcare delivery and emergencies.
The current period of performance 2024-2028 incorporates changes informed by feedback from the FY 2019–2023 cycle and industry insights in emergency response. Notably, in response to needs identified around patient transfer and extended downtime (e.g., cyber incidents), ASPR has introduced a Patient Movement Plan requirement, alongside new mandates for cybersecurity assessments, extended downtime evaluations, planning, and exercises.
A CLOSER LOOK AT DIVERSE STATES
ALABAMA
Funding for the Hospital Preparedness Program (HPP) experienced a significant drop in 2013. Since then, funding levels have remained steady, with the state currently receiving a total of $3,309,964 annually. This funding is distributed across nine Health Care Coalitions (HCCs), each receiving approximately $260,000. These coalitions cover regions ranging from five to eleven counties, with one lead county coordinating efforts within each HCC.
The program is administered by the Alabama Department of Public Health’s Center for Emergency Preparedness. The HCCs play a crucial role in strengthening Alabama’s health care system by focusing on critical areas such as hospital staffing, bed capacity, and establishing alternative care sites. Coalitions actively collaborate with hospitals, emergency services, public health agencies, and emergency management organizations to build strong mutual aid agreements and ensure a unified response during crises.
Each HCC is responsible for developing comprehensive emergency plans and clinical protocols to guide health care responses in the face of disasters. Their primary goals are to treat patients efficiently, save as many lives as possible, and help prevent the further spread of disease during public health emergencies.
Alabama has achieved strong engagement from core coalition partners. All (100%) of the state’s acute care hospitals participate in HCC activities. Public health agencies are involved at an 80% rate, and 99% of emergency management agencies are also engaged. However, participation from emergency medical services (EMS) remains low, at just 26%, highlighting a key area for improvement.
To streamline communication and support new partners, Alabama HCCs offers a unified response form that connects potential applicants directly with their district’s HCC coordinator. The form can be submitted online, and contact information is readily accessible, making it easier for health care entities across the state to engage in preparedness efforts and strengthen Alabama’s emergency response system.
OHIO
In Ohio, the Hospital Preparedness Program (HPP) plays a central role in strengthening the state’s health care system readiness, receiving a total of $7,060,825 in federal funding annually. This support is coordinated through the Ohio Department of Health and distributed across eight regional Health Care Coalitions (HCCs), which serve as the backbone of the state's health emergency preparedness efforts.
Ohio’s HPP initiatives encompass a wide range of critical activities designed to bolster preparedness and response capabilities. These include guiding the development and operation of HCCs, overseeing contracts for the state’s Ebola Assessment Hospital (EAH) and specialized Ebola Coalitions, and coordinating with other Midwestern states through the Great Lakes Healthcare Partnership. This regional collaboration brings together Ohio, Indiana, Wisconsin, Minnesota, Illinois, Michigan, and the city of Chicago to share resources and strengthen collective response strategies.
The state also plays a key role in facilitating Ohio’s Burn Surge Planning Committee, which works to prepare the health care system for mass burn casualty incidents. Additionally, the HPP manages two essential tracking systems—EMResource for monitoring bed availability, and EMTrack for tracking patient movement during emergencies. These systems provide real-time data that is vital for effective coordination during disaster response.
Core member participation across Ohio’s HCCs is strong in most sectors, with 95% of acute care hospitals, 96% of public health agencies, and 96% of emergency management agencies actively engaged. However, emergency medical services (EMS) participation remains significantly lower, at just 3%, highlighting a critical gap in coalition integration and a key area for potential outreach and improvement.
Overall, Ohio’s HPP efforts reflect a comprehensive and collaborative approach to emergency preparedness, ensuring that health care entities are equipped to respond effectively to both routine and large-scale public health emergencies.
PENNSYLVANIA
In Pennsylvania, the Hospital Preparedness Program (HPP) serves as a cornerstone for statewide health care emergency readiness, supported by $7,761,310 in federal funding. The state’s preparedness efforts are organized through six regional Health Care Coalitions (HCCs), each uniquely structured to meet local needs while contributing to a coordinated statewide response system.
Membership in Pennsylvania’s HCCs is inclusive and flexible. While each coalition sets its own criteria, any organization involved in the medical care delivery system with a role or interest in emergency preparedness is encouraged to participate. Entities willing to serve as a resource during large-scale public health emergencies gain access to training, exercises, technical guidance, and readiness materials to help meet federal compliance requirements. Coalition contact information is publicly available, making it easy for interested organizations to get involved.
Participation among core coalition members is exceptionally strong: 97% of acute care hospitals, 98% of EMS providers, 89% of public health agencies, and 95% of emergency management agencies are actively involved in HCC activities. These high levels of engagement reflect the state’s commitment to an integrated, all-hazards approach to emergency response.
With deep ties to fire departments, law enforcement, EMS, county health departments, and other local resources, Pennsylvania’s HCCs form a comprehensive network. Together, they enhance the state’s ability to respond effectively to public health crises, protect communities, and maintain continuity of care when disaster strikes.
TEXAS
Texas stands as a national leader in health care emergency preparedness, supported by substantial federal funding through the Hospital Preparedness Program (HPP). For Fiscal Year 2024, the state received a total of $23,277,698, administered through Texas Health and Human Services. This funding is critical in supporting the state’s 40 Health Care Coalitions (HCCs), which work across a broad and diverse landscape to enhance readiness and response capacity for public health emergencies.
Each of Texas’s HCCs operates under the leadership of a designated organization selected through a competitive request for proposals process. Eligible lead organizations include hospitals, EMS providers, emergency management agencies, local public health departments, regional offices of the Texas Department of State Health Services (DSHS), dialysis centers, long-term care facilities, and nursing homes. These coalitions are tasked with coordinating preparedness activities, strengthening health system partnerships, and ensuring rapid deployment of medical assets during disasters.
To qualify for HPP funding, applicants must meet the following requirements, they must be a public or private entity legally operating in Texas, submit a complete application by the designated deadline, and provide official documentation affirming their commitment to deploy resources during emergencies. This includes a formal letter from a governing body such as a Board of Directors or County Judge and confirming their willingness to support mutual aid and deploy HPP and EMTF assets during mass casualty incidents, regional crises, statewide disasters, or pandemics.
Participation among Texas’s HCC core members reflects a strong statewide effort, with 93% of acute care hospitals involved, along with 84% of EMS agencies and 88% of public health agencies. However, participation among emergency management organizations is lower, at 67%, pointing to an opportunity for deeper collaboration at the local and regional levels.
Texas’s extensive network of coalitions and its commitment to structured, inclusive planning positions the state to respond effectively to a wide range of emergencies—ensuring that health care systems remain resilient and responsive in times of crisis.
In conclusion, the Hospital Preparedness Program (HPP) is dedicated to strengthening healthcare preparedness so that, during large-scale emergencies and disasters, patient outcomes improve, reliance on federal and supplemental state resources is reduced, and the healthcare system can recover quickly. To fulfill this mission, HPP empowers health care coalitions to proactively plan, coordinate, train, and deliver lifesaving care under threat conditions. The path to participation in a coalition may vary by state, however those entities interested in coordinated emergency response are encouraged to contact their local coalition to get involved.