Epidemiology and Laboratory Capacity (ELC) HAI/AR Program Funded Activities

American Rescue Plan

American Rescue Plan funding through the ELC HAI/AR program is intended to strengthen and equip state, local, and territorial public health departments and other partner organizations with the resources needed to better prevent and fight infections in U.S. healthcare facilities, including COVID-19 and other known and emerging infectious diseases.

From 2021-2024, CDC will issue $1.25 billion to 64 state, local, and territorial health departments to support this work. Initial awards totaling $885 million were made in October 2021, with an additional approximately $300 million awarded in future years to continue portions of this work.

CDC will use the majority of the initial funding, $500 million pdf icon[PDF – 12 pages], to strengthen and sustain capacity to fight COVID-19 and protect our most vulnerable and disproportionately affected population in nursing homes and long-term care facilities via:

  • State-based nursing home and long-term care strike team and infrastructure. This funding from CDC will further equip health departments to assist nursing homes and other long-term care facilities to prevent and respond to infectious diseases and emerging pathogens, including SARS-CoV-2. The strike team and infrastructure support allows jurisdictions to increase surge capacity for clinical services; to retain, support, and expand existing staff to help prevent shortages; and to strengthen baseline infection prevention and control in long-term care facilities, including uptake of vaccines.

The remaining $385 million pdf icon[PDF – 22 pages] in initial funding was awarded in October 2021 under the ‘Strengthening HAI/AR Program Capacity’ (SHARP) supplement to support state, local, and territorial health departments with several critical project areas:

  • HAI/AR Program Response and Prevention Network aims to strengthen and expand public health capacity to prevent, detect, and respond to the threat of SARS-CoV-2/COVID-19 transmission in healthcare settings nationwide. Activities under this project will strengthen existing HAI/AR Program infrastructure, enhance multidrug-resistant organism (MDRO) prevention activities, support the HAI/AR response workforce, and implement targeted HAI/AR prevention projects.
  • Antibiotic Resistance Laboratory Network (AR Lab Network) aims to use the existing structure of the AR Lab Network to expand laboratory capacity for early detection of antibiotic-resistant pathogens and public health infrastructure for rapid response to stop transmission, which are critical components of effective strategies for preventing the spread of AR in the context of COVID-19.
  • Antibiotic Stewardship aims to support healthcare settings with the following activities in the context of COVID-19: implementing CDC Core Elements for Antibiotic Stewardship, tracking and reporting antibiotic use (AU), establishing and supporting antibiotic stewardship collaboratives and implementing stewardship activities to improve prescribing practices.
  • Enhancing States’ Use of the National Healthcare Safety Network (NHSN) aims to bolster HAI/AR Programs’ use of NHSN to identify areas of improvement in patient safety and healthcare quality for emerging and enduring health threats including HAIs, AR infections, SARS-CoV-2, and others. Funding will be available for HAI/AR Programs to incentivize and support healthcare facilities with implementing antibiotic use and resistance reporting and/or leveraging electronic health record systems (EHRs) to automate reporting to NHSN.
  • Project Firstline aims to increase the capacity of health departments to effectively engage, educate and train their healthcare workforce about infectious disease threats that spread in healthcare settings.

HAI/AR Programs funded through ELC Program, including CARES and Enhancing Detection ELC Supplements

  • Rapid Response, Containment, and Prevention Capacity– Coordination and implementation of HAI/AR prevention and response activities across the state/city/territory. Activities focus on promoting proven prevention practices, detecting and responding to HAI/AR outbreaks, and increasing the use of CDC’s NHSN to track and prevent HAIs and transmission of AR pathogens in healthcare settings.
    • Expanded Infection Prevention and Control (IPC) Capacity – With significant additional funding provided via the CARES and Enhancing Detection ELC supplements as part of the COVID-19 pandemic response, recipients will increase capacity to identify infections and IPC breaches, conduct IPC assessments, and mitigate IPC gaps in healthcare settings across the provider spectrum.
  • Educational Efforts to Promote Appropriate Antibiotic Use – Assists state and local agencies in implementing health communication programs and behavioral interventions to promote appropriate antibiotic use. These programs aim to improve the knowledge, attitudes, and behaviors of the general public and healthcare providers, contributing to a reduction in inappropriate prescribing, and antibiotic resistance.
  • Coordinated Prevention and Stewardship – Support for state and local health departments to improve tracking of antibiotic use and resistance and expanding coordinated prevention and stewardship activities across healthcare.
  • External Data Validation – Build and sustain health department programs’ ability to ensure the quality of healthcare-associated infection data reported to NHSN.
  • Antibiotic Resistance Laboratory Network – Support the AR Lab Network to detect, confirm, and characterize AR pathogens and novel resistance mechanisms. This increased capacity will improve response to outbreaks and containment of AR threats in healthcare such as CRE, carbapenem-resistant Pseudomonas aeruginosa (CRPA), and C. auris. The AR Lab Network includes labs in 50 states, several cities, and Puerto Rico, including seven regional labs and the National Tuberculosis Molecular Surveillance Center (National TB Center). It supports nationwide lab capacity to rapidly detect antibiotic resistance in healthcare, food, and the community, and inform local responses to prevent spread and protect people. The AR Lab Network also identifies germs that could be used to support researchers in developing new diagnostics and more treatment options through the CDC AR Isolate Bank. Learn more about the AR Lab Network and AR investments in your state.
  • Project Firstline IPC Training – Supported by COVID-19 resources and as part of CDC’s Project Firstline Collaborative, recipients will assist in providing innovative IPC training to front-line healthcare personnel while also creating IPC training expertise in the public health workforce. Recipients will help build a foundation of IPC knowledge and a culture of IPC expertise in the healthcare and public health communities, in order to keep healthcare workers, patients, and the healthcare environment safe from COVID-19 and other infectious disease threats.

Learn more about HAI prevention activities in your state.

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