Health care coalitions have been manifesting themselves throughout the United States following the release of the national guidance for health care system preparedness. However, there is a saying that, “If you’ve seen one coalition, you’ve seen one coalition.” Over the course of my work with each of the 14 health care coalitions within Georgia, I have found this statement to be certainly true. For the past 8 years, the Institute for Disaster Management in the College of Public Health at the University of Georgia (UGA/IDM) has received substantial and continuous funding via the Healthcare Community Preparedness Program grant from the Georgia Department of Public Health. As the Associate Director of UGA/IDM and the program manager for the last 4 years, I have been able to view the full development of health care coalitions within our state.
In my reflections on our program, I can confidently state that the conceptualization and formation of coalitions in Georgia has changed the face of preparedness in Georgia in a profound and dynamic manner. The concept of health care coalitions is one in which organizations from all response sectors come together to plan, mitigate, and prepare for those top hazards and threats facing each respective community. Too often in the world of emergency preparedness we find ourselves engaging in siloed planning and exercising only to address the needs of our respective agencies while simultaneously failing to prepare our communities at large. This approach wastes funding and prevents relationship development among community response partners. During a disaster is not the time to exchange business cards, and it is my belief that relationship building has been the single greatest achievement since the institution of coalitions.
In the years before coalition development, many of our planning meetings for tabletop and full-scale exercises would predominantly involve hospitals and district public health representatives, and our exercises would begin and end in the emergency department of each hospital. Today it is not uncommon to see hospitals, long-term care facilities, dialysis clinics, hospice facilities, assisted-living institutions, county and district public health offices, county and field emergency managers, local businesses, emergency medical services, city and county law enforcement, and city and county fire departments all planning and preparing together as a coalition. Additionally, our exercises now consider the continuum of disasters and the cumulative effects a disaster can have on a city, county, region, and state with many, and occasionally all, response partners participating. This has dramatically increased the realism of our exercises; has allowed Georgia to develop integrated, interdisciplinary emergency operations plans; and has encouraged the participation of entities that were once overlooked.
By no means has Georgia perfected the health care coalition model; there are still many improvements to be made. Georgia was extremely fortunate to have leaders in the state who had the forethought to introduce a layering approach to disaster preparedness back in 2005 with our Regional Coordinating Hospital system. Having predrawn regional boundaries allowed for a seamless transition into health care coalitions following the mandate from the federal government. Unfortunately, many other states have faced significant political challenges when seeking to delineate such regional coalition boundaries. However, the coalition model is one that Georgia and other states have proven can work. Once people sit together and share open, frank discussions of emergency response priorities and protocols, these groups recognize that the protection of citizens is the unifying goal. At that point, politics can be pushed aside so the real work can begin.
