Delivering Essential Healthcare Services

A severe influenza pandemic or wide-scale public health disaster would severely affect how communities provide healthcare services. Communities need to consider methods for delivering healthcare in spite of large-scale disruptions or challenges. Communities would need to define and prioritize which of their healthcare services would be essential to maintain during such an event. They would also need to consider the ethical consequences of delaying or canceling other healthcare services.

In 2007-2008, nine states and local communities received grants to begin to address the challenges of delivering essential healthcare services. The Pandemic Influenza Guidance Supplement to the 2006 Public Health Emergency Preparedness Cooperative Agreement was the source of this funding. Communities that received the grants had to achieve several intended outcomes. Each community had to develop its ability to coordinate various unrelated healthcare delivery resources such as staff, supplies, and medicines. Each community also had to determine how it would maintain delivery of essential healthcare services while providing care for large numbers of influenza patients during a pandemic. In addition, the communities developed plans, guidelines, and tools to assist with these activities (e.g., staffing plans, triage and care plans, supply and resource lists).

The following products are available online to share with other planners.


Oregon HPP Region 1 addressed care in the multi-county region centered in the Portland metropolitan area. The project looked at care for influenza, as well as other essential health services. The Project Evaluation Report describes how the project group assembled a health and medical collaboration group. The collaboration group considered the system of care, healthcare demands during a “normal” flu season, healthcare demands during a severe influenza pandemic, and the resources available for care. The team used modeling data and a Multi-Agency Coordination (MAC) Group to create an effective tool for making decisions. They designed the decision-making tool to integrate with the Incident Command System. The tool also includes practical local health response strategies and tools for urban communities.

The evaluation report includes the following resources:

  • Access to Influenza Care System Description and Report
  • Community Focus Groups Final Report
  • Ethical Framework
  • Ethical Framework PowerPoint
  • Hospital Discharge Data Analysis and Summary
  • MAC Group Handbook


The Virginia project expanded the Virginia Department of Health’s existing Critical Resource Shortages Planning Guide. This toolkit helps hospitals plan for the continuation of essential services. It provides a systematic approach for allocating scarce resources during emergencies and disasters.

Elements of the Critical Resource Shortage Planning Guide Toolkit include the following:

  • Critical Resource Shortages Planning Guide
  • Critical Resource Shortages Planning Guide – Hospital Implementation Guide
  • Critical Resource Shortages Planning Guide – Implementation Aids
  • Sample Critical Resource Shortages Response Plan
  • Critical Resource Shortages Planning Guide – Implementation Presentations
    • Implementation Toolkit Power Point Navigation Guide
    • Chapter 1: Planning Infrastructure
    • Chapter 2: Critical Resource Vulnerability Analysis
    • Chapter 3: Ethical Framework
    • Chapter 4: Operational Infrastructure
    • Chapter 5: Protocol Development
    • Chapter 6: Ad Hoc Infrastructure
    • Chapter 7: Coordination with Health and Medical Delivery Organizations
    • Chapter 10: Communication Plans