Hospital Preparedness Program Cooperative Agreement - Disasters and emergencies can happen at any time and in any location. Maintaining health and medical systems is essential. It is recognized that there is a need to be able to ensure that the health and medical systems across the state remain stable and available to provide services in the face of disasters. The Hospital Preparedness Program (HPP) meets this need for the state of North Dakota. North Dakota (ND) currently has a very stable and mature Statewide Health Care Coalition (HCC). This coalition has been in effect since the development of the HPP. It is inclusive of all hospitals, long term care (LTC) facilities, the ND Department of Emergency Services (ND DES), ND Health and Human Services (ND DHHS) and Emergency Medical Services across the state. Representation on the HCC Advisory Committee includes ND DHHS, ND DES, the ND Emergency Medical Services Association, (NDEMSA), the ND Hospital Foundation (NDHF), the ND Long Term Care Association (NDLTCA) and the ND Board of Pharmacy. The ND DHHS also has subject matter expertise in behavioral health and functions as the lead agency for emergency management and emergency support function #8 (ESF8) response. Hospitals throughout the state are given the opportunity to function as closed Points of Dispensing (PODs) to ensure timely prophylaxis of their patients, their employees, and their employee’s families. Personal protective equipment (PPE) will be available within the state medical cache to ensure protection for health care workers in the event of caring for highly infectious patients. The North Dakota Critical Incident Stress Management (NDCISM) program will continue throughout the performance period to provide crisis intervention for health care workers. The NDCISM team will continue to coordinate services with NDDHHS’s Behavioral Health Division to promote the emotional well-being of health care workers. The Medical Response Surge Exercise (MRSE) will continue to be conducted annually throughout the five-year performance period with the statewide HCC. Patient movement exercises and additional exercises, including seminars, tabletop, and functional exercises will be performed to identify potential gaps relative to cybersecurity, including prevention, risk mitigation and resiliency and extended downtime prevention and response. The number of Public Health Emergency Volunteer Reserve – Medical Reserve Corp (PHEVR-MRC) volunteers within the database will remain stable during the five-year performance period. Outreach will be conducted during numerous statewide conferences to recruit new PHEVR-MRC volunteers. The Health Alert Network (HAN) messaging system will continue to be utilized to distribute near real-time information to the statewide HCC, the hospitals, the public health offices, LTC facilities and EMS services. Concentration on the HPP core functions will enhance response readiness, prioritize a risk-based approach to all-hazards planning, strengthen state, local tribal and territorial public health preparedness, and response capability through a continuous cycle of planning, organizing, training, equipping, exercising, evaluation and taking corrective action. Inclusion of modernized data collection and systems will improve situational awareness and information sharing with healthcare systems and other partners. Our goals are to achieve excellence in response by establishing operational readiness in all capabilities and sustain substantial, measurable progress across all capabilities. These outcomes will prevent or reduce morbidity and mortality and result in the earliest possible recovery to pre-incident levels.