DEPARTMENT of HEALTH and HUMAN SERVICES Fiscal Year 2021 Public Health and Social Services Emergency Fund Justification of Estimates for Appropriations Committee Public Health and Social Services Emergency Fund TABLE OF CONTENTS ORGANIZATION CHARTS ..................................................................................................................................... 9 Assistant Secretary for Preparedness and Response ................................................................................ 9 Cybersecurity .......................................................................................................................................... 10 Office of National Security ...................................................................................................................... 11 INTRODUCTION AND MISSION........................................................................................................................... 12 OVERVIEW OF BUDGET REQUEST ...................................................................................................................... 14 OVERVIEW OF PERFORMANCE .......................................................................................................................... 16 ALL PURPOSE TABLE ........................................................................................................................................ 21 APPROPRIATIONS LANGUAGE ........................................................................................................................... 22 AMOUNTS AVAILABLE FOR OBLIGATION ............................................................................................................ 24 SUMMARY OF CHANGES................................................................................................................................... 25 BUDGET AUTHORITY BY ACTIVITY ...................................................................................................................... 26 AUTHORIZING LEGISLATION .............................................................................................................................. 27 APPROPRIATIONS HISTORY ............................................................................................................................... 28 APPROPRIATIONS NOT AUTHORIZED BY LAW ...................................................................................................... 29 ASSISTANT SECRETARY FOR PREPAREDNESS AND RESPONSE .................................................................................. 30 Summary of Request ............................................................................................................................... 30 Preparedness and Emergency Operations .............................................................................................. 34 National Disaster Medical System .......................................................................................................... 44 Civilian Volunteer Medical Reserve Corps .............................................................................................. 54 Hospital Preparedness Program ............................................................................................................. 59 Preparedness and Response Innovation................................................................................................. 82 Biomedical Advanced Research and Development Authority ................................................................ 85 Project BioShield ..................................................................................................................................... 98 Strategic National Stockpile .................................................................................................................. 103 Policy and Planning ............................................................................................................................... 113 Operations ............................................................................................................................................ 120 ASSISTANT SECRETARY FOR ADMINISTRATION ................................................................................................... 123 Cybersecurity ........................................................................................................................................ 123 NONRECURRING EXPENSES FUND .................................................................................................................... 132 IMMEDIATE OFFICE OF THE SECRETARY ............................................................................................................ 136 Office of National Security .................................................................................................................... 136 PANDEMIC INFLUENZA ................................................................................................................................... 139 ASSISTANT SECRETARY FOR HEALTH................................................................................................................. 152 2 Public Health and Social Services Emergency Fund Homelessness ........................................................................................................................................ 152 U.S Public Health Service (USPHS) Commissioned Corps Readiness Training ....................................... 154 BUDGET AUTHORITY BY OBJECT CLASS ............................................................................................................. 156 SALARIES AND EXPENSES ................................................................................................................................ 157 DETAIL OF FULL-TIME EQUIVALENTS (FTE) ....................................................................................................... 158 DETAIL OF POSITIONS .................................................................................................................................... 159 SUMMARY OF PROPOSED CHANGES TO PERFORMANCE MEASURES ..................................................................... 160 GOOD ACCOUNTING OBLIGATION IN GOVERNMENT ACT (GAO-IG ACT) REPORT .................................................. 167 3 Public Health and Social Services Emergency Fund We are pleased to present the Fiscal Year (FY) 2021 Congressional Justification for the Public Health and Social Services Emergency Fund (PHSSEF). The FY 2021 Budget Request directly supports the United States’ ability to prepare for, respond to, and recover from the consequences of a wide range of natural and man-made medical and public health threats and includes the FY 2021 budget justification for the Office of the Assistant Secretary for Preparedness and Response (ASPR), Cybersecurity, the Office of National Security (ONS), the Office of Global Affairs pandemic influenza program, and the U.S. Public Health Service Commissioned Corps led by the Office of the Assistant Secretary for Health (OASH). Office of the Assistant Secretary for Preparedness and Response ASPR’s mission at its core is to save lives and protect Americans. On behalf of HHS, ASPR leads the public health and medical response to disasters and public health emergencies, in accordance with the National Response Framework and Emergency Support Function #8. HHS also supports other federal entities who lead Emergency Support Function #6 with respect to the human and social services, including recovery. ASPR coordinates across HHS, the federal interagency, and supports state, local, territorial, and tribal health partners in preparing for and responding to emergencies and disasters. ASPR also enhances medical surge capacity by organizing, training, equipping, and deploying federal public health and medical personnel and providing logistical support for federal responses to public health emergencies. At the state and local level ASPR supports readiness by coordinating federal grants and cooperative agreements and carrying out drills and operational exercises. Through coordinating the Public Health Emergency Medical Countermeasures Enterprise, including the Biomedical Advanced Research and Development Authority (BARDA) and Strategic National Stockpile (SNS), ASPR oversees advanced research, development, procurement, and stockpiling of medical countermeasures (e.g. vaccines, medicines, diagnostics, and other necessary medical supplies). ASPR continues to respond to catastrophic hurricanes and other natural disasters by activating National Disaster Medical System (NDMS) personnel to communities impacted by the storms. NDMS is supported by a workforce of up to 6,700 authorized intermittent federal employees organized into 71 teams. Throughout FY 2019, NDMS teams provided public health and medical support for the following: Hurricane Dorian in Florida and Puerto Rico, Presidential State of the Union Address, the National Police Officer Memorial, and the National Independence Day Celebration, United Nations General Assembly, and Representative Elijah Cummings lying in state at the United States Capitol. NDMS teams contain clinical providers and specialized medical service professionals, including physicians, nurses, fatality management professionals, paramedics, veterinarians, and other support staff, such as logisticians and information technology specialists. Years of investment have yielded this coordinated response;