PHEP Timeline

Please review some of the highlights of the Public Health Emergency Preparedness (PHEP) program since its establishment in 2022 when it was known as the Public Health Preparedness and Response for Bioterrorism Program.

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    • CDC activates its emergency operations center (EOC) in response to the Zika outbreak. In July, CDC awards $25 million in Public Health Preparedness and Response (PHPR) funding to 53 states, cities, and territories to support efforts to protect Americans from Zika virus infection and associated adverse health outcomes.
    • In December, CDC awards an additional $25 million in PHPR funding to 21 states, cities, and territories.
    • CDC expands its Preparedness Field Assignee (PFA) program with the development of its first senior PFA permanent position with increased responsibility. As of 2022, an additional six PFAs have transitioned into permanent positions.
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    • Thane Hancock, MD, MPH, a family physician and a native of Hawaii, becomes CDC’s first Pacific Islands CEFO. DSLR establishes the new regional CEFO program to help improve the public health preparedness capacity of the six U.S.-affiliated Pacific Islands to respond to emergency events, including infectious disease outbreaks and natural disasters.
    • In April, CDC awards $145 million in PHEP supplemental funding to support accelerated public health preparedness planning for Ebola within 62 state, local, territorial, and tribal public health systems. Additional funding supports the hiring and placement of 10 temporary epidemiology field assignees (TEFAs) for a period of up to two years. TEFAs support state and local jurisdictions with active monitoring contact, data collection, data analysis, and reporting; evaluation and management of persons under investigation; surveillance, contact tracing, and epidemiologic investigations; and health systems preparedness. The remaining supplemental funding supports CDC’s state and local response activities and grants management and evaluation activities related to the domestic Ebola response.
    • Beginning in July and ending in June 2016, DSLR and PHEP program recipients conduct the first national review of MCM operational readiness in 487 jurisdictions to identify key strengths and gaps using the new MCM ORR process.
    • CDC conducts a Pandemic Influenza Readiness Assessment (PIRA) of PHEP jurisdictions’ pandemic planning and vaccination campaign capacity. The agency also develops targeted technical assistance strategies to address identified gaps. Jurisdictions report strong epidemiology, laboratory, community mitigation, and medical care and countermeasures plans. Immunization workforce capacity is an area of concern due to staff retention issues and hiring delays.
    • CDC initiates the PHEP Impact Project to better quantify and effectively communicate the impact of CDC’s PHEP program on the development and sustainment of state and local public health emergency response systems activated during a response. The group develops six overarching PHEP Program accomplishments.
      • Since the events of 9/11, the PHEP program has:
        • Integrated public health in emergency responses and, in collaboration with partners, leads and coordinates the public health and healthcare sectors
        • Instituted public health emergency management structures in all 50 states and select local and territorial public health departments capable of leading or supporting public health responses.
        • Developed a nationwide system capable of rapidly distributing and dispensing lifesaving medications and emergency medical supplies to the public.
        • Developed nationwide laboratory and epidemiologic surveillance systems capable of faster detection and identification of public health threats.
        • Strengthened the ability of our nation’s communities to prepare for, withstand, and recover from public health threats.
        • Established state and local public health emergency management expertise capable of mitigating the health effects of public health threats.
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    • CDC introduces in July a new process for measuring MCM operational readiness using a standardized assessment tool. The tool is designed with extensive involvement and input from 19 PHEP recipient jurisdictions; national public health partners; and CDC subject matter experts. The Medical Countermeasure Operational Readiness Review (MCM ORR) is a rigorous assessment of MCM planning capabilities and operational capacity for a public health incident requiring the distribution and dispensing of MCMs. The MCM ORR is piloted by 36 PHEP recipient jurisdictions and 28 Cities Readiness Initiative (CRI) local planning jurisdictions. CDC conducts a formal evaluation of the ORR process in 2015 with nine PHEP recipients and 12 CRI local planning jurisdictions. CDC revises the ORR process and tool based on recipient feedback.
    • CDC activates its emergency operations center in August for the Ebola response. CDC determines that active monitoring of individuals potentially exposed to Ebola is critical to preventing an outbreak in the United States. In December, CDC awards $4.7 million to support development and implementation of active monitoring (AM) and direct active monitoring (DAM) of travelers who may have been exposed to Ebola. Funding was provided by the HHS Public Health and Social Services Emergency Fund (PHSSEF).
    • Congress appropriates supplemental funding to support state and local Ebola preparedness and response activities. CDC receives approximately $165 million of this supplemental funding.
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    • CDC’s CEFO Program transitions to DSLR effective October 1. The transition improves CDC’s efforts to support state, tribal, and local public health departments and jurisdictions’ abilities to successfully operationalize public health preparedness capabilities.
    • CDC establishes the Preparedness Field Assignee (PFA) program with 10 PHEP-funded positions that are filled by graduates of CDC’s Public Health Associate Program (PHAP). The PFAs are assigned to PHEP jurisdictions for two years to provide them with on-the-job training and skills in public health preparedness. The PFA program progresses over the years into a field service program that supports PHEP programs by building state and local capacity. CDC has recruited 66 PFAs since the beginning of the program.
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    • On July 1, HHS ASPR and CDC officially implement an administrative and programmatic alignment of their preparedness cooperative agreements. ASPR and CDC jointly restructure specific components of ASPR’s HPP and CDC’s PHEP cooperative agreements to establish the HPP-PHEP Cooperative Agreement CDC-RFA-TP12-1201.
    • On October 1, CDC transitions medical countermeasure (MCM) planning, training, technical assistance, and consultation to DSLR. The move better supports the PHEP program’s state, tribal, local, and territorial planning partners. DSLR reviews how best to advance MCM planning capabilities with internal and external partners. A key recommendation is to modify the current assessment process to better measure operational readiness, ensure consistency of approach, and include stakeholders in the design process.
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    • CDC releases “Public Health Preparedness Capabilities: National Standards for State and Local Public Health,” which creates national standards for public health preparedness capability-based planning. These national standards assist state and local planners in identifying gaps in preparedness, determining specific jurisdictional priorities, developing plans for building and sustaining capabilities, and prioritizing preparedness investments. CDC identifies 15 public health preparedness capabilities and groups them into six domains: biosurveillance, community resilience, incident management, information management, countermeasures and mitigation, and surge management.
    • CDC’s new five-year PHEP cooperative agreement begins in August with a new capabilities-based approach.
    • CDC awards $10 million in PHEP cooperative agreement funding to advance the development of innovative public health risk assessment models in 10 metropolitan statistical areas (MSAs) that encompassed 18 states. The one-year pilot project accelerates the development of strategies that could minimize the public health risks associated with higher population areas.
    • CDC’s Office of Public Health Preparedness and Response releases “A National Strategic Plan for Public Health Preparedness and Response.” This report was collaboratively developed by internal and external preparedness leaders as a guide for CDC, the public health system, and stakeholders to secure the health of the nation and attain the plan’s collective 2020 vision of “people’s health protected – public health secured.”