Hurricane season is here, and that’s bad news for hospitals

With the arrival of hurricane season, hospitals and health systems face new problems in responding to weather emergencies this year.

Federal disaster assistance teams help set up a field hospital in North Carolina after Hurricane Helene last October. The Trump administration has cut funds and programs that help hospitals prepare for emergencies and healthcare leaders are worried if hospitals will get the support they need.

The Trump administration has indicated that the states will play a larger role in responding to emergencies. Healthcare leaders also say the reorganization and cuts across the Department of Health and Human Services are dismantling programs that protect the public and help hospitals prepare for disasters.

Tom Cotter, CEO of the Health Response Alliance, tells Chief Healthcare Executive® that he’s concerned about hospitals and health systems getting the assistance that they need during hurricane season.

“Hurricane season, year after year, gets worse and worse,” Cotter says. “These storms are more intense. They're affecting areas that previously haven't been affected, and that happens every year. Now we're layering on top of that a need for novel approaches to responses. And by that, I mean there's no guarantee that there's going to be federal assistance.”

Cotter says it’s unclear if the government will deploy Disaster Medical Assistance Teams, which essentially set up field hospitals in weather emergencies. The Administration for Strategic Preparedness and Response sets up those disaster teams, but in the reorganization of the health department, that agency has been placed under the CDC.

Placing that agency within the CDC could be problematic, as the Administration for Strategic Preparedness and Response has typically worked across federal agencies to tap resources and expertise in emergencies, Cotter says.

More than two months after the health department moved the agency under the CDC, Cotter says it’s not clear how that agency will function.

“No one's really sure,” Cotter says.

“Their intentions are to maintain the same level of response capability, but with an expectation that they would only respond to really large disasters that very clearly overwhelm state local capacity,” he says. “And some of their involvement in deployments for smaller disasters there, they'll probably defer to states wholly on that. I think the big question is: where that line is drawn and who draws it? That's not known at this time.”

Hospital preparedness

The Trump administration has also proposed eliminating the Hospital Preparedness Program, which provides aid to hospitals to plan and respond to public health emergencies. The program received $240 million last year, but there’s no money for the program in the president’s budget for the 2026 fiscal year, the American Hospital Association says.

Cotter says he fears the program “is done.”

“I think it's a pretty good bet that it's going away, and there is no sense of what is going to replace it, if anything,” Cotter says. “I think it's putting states in a very difficult position, because now they have to predict whether or not they need to fund this on their own, which means that they would need to find additional revenue on their own.”

The Hospital Preparedness Program has helped finance healthcare coalitions to deal with storms.

“I think it's a really underappreciated aspect of our healthcare infrastructure and our response capability, because it links all of the different and separate facilities, healthcare facilities, EMS entities and other health entities and emergency management in a way that allows them to cooperate and collaborate and coordinate much more easily in an emergency,” Cotter says.

The program also helped support efforts to manage supplies, such as a shortage of IV fluids, and transferring patients between facilities ahead of hurricanes and other events. Funds also supported staff to plan for disasters and respond in emergencies, and those positions could be at risk, Cotter says.

Becky Hultberg, president and CEO of the Hospital Association of Oregon, tells Chief Healthcare Executive® that she’s concerned about cuts in federal support for hospital preparedness, particularly as Oregon is at risk for wildfires.

“During the pandemic, it was important that hospitals and state governments coordinate and prepare together, and the hospital preparedness funds support those efforts. So we are certainly concerned about that,” Hultberg says. “We look at the possibility of future, future health events like pandemics, also the impact of natural disasters like wildfire in Oregon, where that level of support and coordination was really essential.”

She says those funds were particularly important during devastating wildfires in Oregon in 2020.

“In order to mobilize quickly, those structures need to be in place and supported, and so if we remove the ability to have that infrastructure, our response will not be as coordinated and as effective,” Hultberg says.

‘A lot of anxiety’

The Trump administration says that the Federal Emergency Management Agency is preparing for hurricanes and other weather events, but President Trump has indicated he sees the states taking the lead in disaster response, as the Associated Press has reported. Trump issued an executive order in March calling for state and local governments to take a more active role in preparing for emergencies.

In January, Trump said, “I’d like to see the states take care of disasters. Let the state take care of the tornadoes and the hurricanes and all of the other things that happen.”

The Trump administration rescinded $11 billion in Covid-related funding given to state and local health departments. Public health officials say the money was designed to build up programs to track outbreaks and strengthen emergency response. Democratic attorneys general in 23 states have sued to stop the Trump administration from pulling back the money.

Still, healthcare leaders say state and local health departments have had to cut staffing due to losses of funding.

Cotter says that the turnover in the federal and state levels poses a problem for hospitals in emergencies.

“What is really scary is that there's going to be a major issue with healthcare supply chains or hospitals, and folks aren't going to know who to call, who they have their relationship with in the state and local and federal levels, which is going to delay response,” Cotter says.

“There's a lot of anxiety, I think, in the healthcare sector, that their usual support systems don't exist, and there's no awareness of what has been set up in place, if anything, to substitute it,” he adds.

What hospitals can do

For now, hospitals and health systems should be coordinating with state governments and their state hospital associations, Cotter says. State hospital groups should press their state and local governments for more support.

“It's going to take public funding to maintain capability,” Cotter says.

Healthcare organizations, from large academic medical centers to clinics, should also be looking at external partnerships to help prepare for disasters, including working with vendors, suppliers and local and state governments.

“Start strengthening all those relationships now, so that when you need it, even if there are hiccups and missing positions, you have enough redundancy to ensure that you can get the resources you need when you need it,” he says.

Elizabeth Mort, vice president and chief medical officer of the Joint Commission, told Chief Healthcare Executive® in a January interview that hospitals must prepare for a variety of weather emergencies, even those that may be rare. She pointed to the devastation in western North Carolina from the remnants of Hurricane Helene.

“As a C-suite person, you really need to make sure that your hazard analysis is thorough, accurate, and that you don't ignore things that don't happen frequently, because you never know,” Mort said.

Hospitals should have robust plans for maintaining supplies and the evacuation of patients and staff.

“There's just too much variability in the threats,” Mort said. “So do your hazard analysis. Take it seriously. It's really part of your obligation to take care of patients safely and with high quality.”