Pennsylvania is changing its emergency management contractor in the middle of a pandemic

The Wolf administration shocked hospital executives and others last month when it canceled its just-renewed contract for health-care emergency management with the Hospital & Healthsystem Association of Pennsylvania, the industry advocacy group that has been griping for months about Wolf and state legislators not doing more to help hospitals financially during the pandemic.

Instead, the Pennsylvania Department of Health chose Public Health Management Corp., a human services nonprofit in Philadelphia, to manage the state’s preparations for health-care emergencies. PHMC was picked under the state’s emergency declaration, which means the state did not have to solicit bids. And while PHMC has expanded steadily through acquisitions that have taken it further into mental-health services, community health, and family services, it will start Wednesday in a new area.

The change in the midst of the coronavirus pandemic came as a surprise, not just to the hospital association, which said it was “shocked and dismayed” by the loss of the work, worth about $5 million a year from a federal grant, but also to many in the health-care industry.

One executive said he was stunned. Another called it “criminal.”

A common understanding is that the Wolf administration grew tired of HAP’s banging the drum for more state financial help, asserting that the state’s hospitals were going to take a $10 billion hit because of COVID-19, without providing details.

There has also been talk of HAP, which sometimes plays a central and secretive role as an interface between hospitals and state government, being too hospital-centric in its emergency preparedness role ― a criticism that has been leveled at many public health officials all over when the scope of COVID-19 losses in nursing homes became clear.

The hospital association declined to comment beyond a statement on its web site describing the work of its emergency preparedness team in training and preparation for emergencies that range “from small-scale flooding, to hurricanes, mass transit accidents, pandemic illness, and large-scale events.”

PHMC, which already does a significant amount of work for state and local government, did not make anyone available to discuss its new role, which includes not just organizing training exercises and disaster planning, but also information exchange among health-care providers and coordination of supplies.

“PHMC is actively working in partnership with the state, existing regional directors, and the existing health-care coalition infrastructure to prioritize a seamless transition,” the nonprofit said in a statement July 1, adding that the PHMC’s chief operating officer will oversee the emergency preparedness work.

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That person, Lauren Lambrugo, “has experience with emergency management through her previous role in Montgomery County,” PHMC said. Lambrugo was the county’s chief operating officer and also has experience in politics.

PHMC said it is seeking to hire a new program director to supervise seven regional managers, whom it hopes to hire from HAP, where they have been overseen by vice president Mark Ross. PHMC did not respond this week to a request for an update on whether it had been able to hire the seven regional managers.

Asked about the personnel transition, Nate Wardle, a spokesperson for the state Department of Health, said: “The expectation is that PHMC will hire qualified personnel to complete the work under the agreement.”

The emergency preparedness program that PHMC is taking over originated in the early 2000s, when the federal government decided to help states prepare for a potential terrorist attack like 9/11. The Pennsylvania Department of Health first contracted with the hospital association in 2012, according to 2017 testimony by a health department official.

Long before COVID-19, the hospital association’s emergency preparedness group helped coordinate responses to events like the 2015 Amtrak derailment in Philadelphia that killed eight and injured 200. The same year, they worked on emergency preparedness for the visit to the city by Pope Francis.

During the coronavirus pandemic, sharing information quickly has been key, said Jessica Caum, program manager in the Philadelphia Department of Public Health for the Bioterrorism and Public Health Preparedness Program.

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Caum said Brian Barth, the hospital association’s regional manager for Southeastern Pennsylvania, “is very good at providing very timely information that gives you a better picture of the entire landscape of the health care community, rather than just trying to get information from individual facilities.”

Barth also helped with resource coordination, particularly with long-term care facilities, Caum said. “HAP is very tuned in,” she said.

As to why Pennsylvania would change its emergency preparedness agency in the middle of a pandemic, Secretary of Health Rachel Levine said in a news release that PHMC is “well-positioned to help move the commonwealth forward in its preparation efforts for future emergencies, including preparations in the case that coronavirus resurges in the fall or winter.”

She also said the department is “looking forward to the opportunity to expand our existing hospital preparedness program, as well as creating an inclusive environment for all members of our health-care system through our health-care coalitions.”