The COVID-19 pandemic exposed critical issues regarding the distribution and availability of personal protective equipment (PPE) at the federal level in the United States. Despite efforts by the federal government to allocate and distribute PPE using various data sources, shortages persisted, impacting healthcare facilities and leading to compromised patient care. The federal government's reliance on the Defense Production Act (DPA) and the National Resource Prioritization Cell to manage PPE distribution raised concerns about the effectiveness of their strategies.
In our recent paper published in Public Administration Review and titled "A new acquisition model for the next disaster: Overcoming disaster federalism issues through effective utilization of the Strategic National Stockpile," we address two key questions:
Why was the federal strategy for PPE distribution ineffective during COVID-19?
What reforms are necessary to enhance preparedness for future disasters?
We analyze data from various sources, including FEMA's PPE distribution, interviews with state procurement officers and government representatives, and discussions with key stakeholders involved in the pandemic response, we seek to identify the problems within the United States Strategic National Stockpile (SNS) and propose actionable recommendations to ensure a responsive and agile medical supply chain in future crises.
We also discussed these problems in a recent podcast I recorded with Rob Handfield as part of the Public Procurement Change Agents series, accessible at the following link:
Podcast: Limits of the Strategic National Stockpile during COVID-19
and in a recent blog post I wrote for LSE USAPP, accessible at the following link:
How ‘disaster federalism’ can be improved to create a more resilient response
In our recent paper published in Public Administration Review and titled "A new acquisition model for the next disaster: Overcoming disaster federalism issues through effective utilization of the Strategic National Stockpile," we address two key questions:
Why was the federal strategy for PPE distribution ineffective during COVID-19?
What reforms are necessary to enhance preparedness for future disasters?
We analyze data from various sources, including FEMA's PPE distribution, interviews with state procurement officers and government representatives, and discussions with key stakeholders involved in the pandemic response, we seek to identify the problems within the United States Strategic National Stockpile (SNS) and propose actionable recommendations to ensure a responsive and agile medical supply chain in future crises.
We also discussed these problems in a recent podcast I recorded with Rob Handfield as part of the Public Procurement Change Agents series, accessible at the following link:
Podcast: Limits of the Strategic National Stockpile during COVID-19
and in a recent blog post I wrote for LSE USAPP, accessible at the following link:
How ‘disaster federalism’ can be improved to create a more resilient response
Several issues related to federal government's support emerged from our data, which created a snowballing series of events.
The ad hoc approach to distribution meant that there were no standardized criteria or guidelines for allocating resources. The absence of clear guidelines created inconsistencies and disparities in the distribution process, leading to unequal access to critical resources such as PPE.
This lack of standardized criteria created a competitive environment among states and entities, where each sought to secure as many resources as possible for their own needs. This competition led to hoarding and stockpiling of supplies by some entities, exacerbating the shortages in other areas.
Random distribution and competitive reactions from state and local agencies made it very difficult to share high-quality and timely information among different entities involved in the supply chain. Particularly, the lack of transparency and centralized data sharing made it challenging to track the availability and movement of resources effectively.
Without a coordinated system in place, resources remained in regions or facilities with excess stock, while areas in desperate need struggled to access the necessary supplies. This lack of efficient redistribution further deepened the inequities in resource distribution.
The ad hoc approach to distribution meant that there were no standardized criteria or guidelines for allocating resources. The absence of clear guidelines created inconsistencies and disparities in the distribution process, leading to unequal access to critical resources such as PPE.
This lack of standardized criteria created a competitive environment among states and entities, where each sought to secure as many resources as possible for their own needs. This competition led to hoarding and stockpiling of supplies by some entities, exacerbating the shortages in other areas.
Random distribution and competitive reactions from state and local agencies made it very difficult to share high-quality and timely information among different entities involved in the supply chain. Particularly, the lack of transparency and centralized data sharing made it challenging to track the availability and movement of resources effectively.
Without a coordinated system in place, resources remained in regions or facilities with excess stock, while areas in desperate need struggled to access the necessary supplies. This lack of efficient redistribution further deepened the inequities in resource distribution.
We proposed a series of reforms that can be grouped into four areas: involvement of industry experts, a centralized procurement management. stronger political leadership and better supply chain governance. I highlight here what are the main practical aspects connected to these reforms.
Standardized protocols and guidelines: Developing standardized protocols and guidelines for resource allocation and distribution is essential. These protocols should consider factors such as population size, healthcare facility capacity, and the severity of the crisis. Standardization will help ensure fairness, equity, and consistency in the distribution process, reducing disparities and competition among states and entities.
Strengthened collaboration and communication channels: Establishing strong collaboration and communication channels between state and federal governments is critical. Regular and transparent communication should be maintained throughout the disaster response efforts. This includes sharing information on resource availability, distribution plans, and ongoing needs assessments. Coordinated efforts will facilitate efficient decision-making, resource coordination, and effective response strategies.
Improved stockpile strategies: Reforms are needed to enhance stockpile strategies, such as the Strategic National Stockpile (SNS). This involves expanding the stockpile's size, diversity, and capacity to respond to a wide range of emergencies. Regular maintenance and monitoring of stockpile inventory should be prioritized to ensure the availability of functional and up-to-date supplies.
Better use of regional group purchasing: GPO associations could be used to band together the demand requirements of several smaller states, resulting in a more unified and stronger market presence for PPE and other critical supplies. State and local governments must improve their use of cooperative purchasing contracts through organizations such as NASPO and GSA to design regional supply chains, establish and maintain production agreements with regional producers, and rotate PPE consumption among healthcare entities during normal times. Interviewees also suggested that other organizations (such as GovBuy) could be used for this purpose, providing state procurement organizations with a leveraged approach to purchasing.
Comprehensive disaster planning and preparedness: Long-term planning and preparedness should be prioritized to enhance the coordination between state and federal governments. This includes conducting regular risk assessments, developing robust response plans, and conducting drills and exercises to test the effectiveness of coordination mechanisms. Comprehensive planning will enable a more agile and coordinated response during future disasters.
By implementing these types of reforms, the coordination between state and federal governments can be significantly improved, leading to a more effective and equitable response to future disaster events.
Standardized protocols and guidelines: Developing standardized protocols and guidelines for resource allocation and distribution is essential. These protocols should consider factors such as population size, healthcare facility capacity, and the severity of the crisis. Standardization will help ensure fairness, equity, and consistency in the distribution process, reducing disparities and competition among states and entities.
Strengthened collaboration and communication channels: Establishing strong collaboration and communication channels between state and federal governments is critical. Regular and transparent communication should be maintained throughout the disaster response efforts. This includes sharing information on resource availability, distribution plans, and ongoing needs assessments. Coordinated efforts will facilitate efficient decision-making, resource coordination, and effective response strategies.
Improved stockpile strategies: Reforms are needed to enhance stockpile strategies, such as the Strategic National Stockpile (SNS). This involves expanding the stockpile's size, diversity, and capacity to respond to a wide range of emergencies. Regular maintenance and monitoring of stockpile inventory should be prioritized to ensure the availability of functional and up-to-date supplies.
Better use of regional group purchasing: GPO associations could be used to band together the demand requirements of several smaller states, resulting in a more unified and stronger market presence for PPE and other critical supplies. State and local governments must improve their use of cooperative purchasing contracts through organizations such as NASPO and GSA to design regional supply chains, establish and maintain production agreements with regional producers, and rotate PPE consumption among healthcare entities during normal times. Interviewees also suggested that other organizations (such as GovBuy) could be used for this purpose, providing state procurement organizations with a leveraged approach to purchasing.
Comprehensive disaster planning and preparedness: Long-term planning and preparedness should be prioritized to enhance the coordination between state and federal governments. This includes conducting regular risk assessments, developing robust response plans, and conducting drills and exercises to test the effectiveness of coordination mechanisms. Comprehensive planning will enable a more agile and coordinated response during future disasters.
By implementing these types of reforms, the coordination between state and federal governments can be significantly improved, leading to a more effective and equitable response to future disaster events.