The terrorist and bioterrorist attacks of 2001 instigated a new level of concern among public health and the medical community, concern that the nation was ill prepared to respond to and recover from potential future attacks. The result was the establishment of the National Bioterrorism Hospital Preparedness Program of 2002. This early version of the Hospital Preparedness Program (HPP) focused on building capacity, emphasizing activities such as decontamination, maintaining pharmaceutical caches, identify hospital bed surge capacity, and training providers in the diagnosis of diseases caused by bioterrorism.

The program shifted to an all hazards, capabilities-based approach in 2004. This change meant that hospitals had to do more to meet requirements than simply purchasing equipment and/or supplies. Instead, hospitals had to demonstrate the capability to perform core functions common to all emergency responses.

The Office of the Assistant Secretary for Preparedness and Response, also known as ASPR, was created in 2006 with the passage of the Pandemic and All Hazards Preparedness Act. Its purpose was to serve as the principal adviser to the Secretary of Health and Human Services (HHS) regarding matters related to public health, medical preparedness, and response to public health emergencies. ASPR assumed responsibility for the HPP the following year, placing it in direct relationship with federal response organizations.

After Hurricane Katrina and the H1N1 pandemic, ASPR issued a report, From Hospitals to Healthcare Coalitions: Transforming Health Preparedness and Response in Our Communities for the 2007-2009 reporting periods in which it stated the following:

(T)he HPP recognized that it needed to evolve its preparedness strategies. While much progress has been made, and many facilities used the capabilities they had developed through HPP, better integration of the full spectrum of the healthcare community into preparedness and response activities is necessary to achieve the levels of readiness required to meet the challenges facing the nation….

(T)he HPP is at a point in tis evolution where significant enhancements are necessary in order to more broadly include the entire healthcare community and to make preparedness a community attribute instead of a facility one.

It was at this point that federal funds for emergency preparedness issued through the HPP began to be redirected from individual facilities to community-wide efforts. The resulting change in funding focus, as written in ASPR’s 2012 guidelines (Healthcare Preparedness Capabilities: National Guidelines for Healthcare System Preparedness) was to facilitate and guide preparedness planning to build eight health care-specific capabilities. The first capability, Healthcare System Preparedness, focused on the development, refinement, and sustainment of health care coalitions, or HCCs.

ASPR released a new set of guidelines that will shape the future of AzCHER and other health care coalitions nationwide. The document, 2017-2022 Health Care Preparedness and Response Capabilities, will strengthen the collective ability of our healthcare coalition to prepare for, respond to, and recover from community health care crises. The four Health Care Preparedness and Response Capabilities outlined are as follows:

Foundation for Health Care and Medical Readiness

Health Care and Medical Response Coordination

Continuity of Health Care Service Delivery

Medical Surge


Arizona is home to four regional health care coalitions as well as other coalitions dedicated to preparedness in tribal communities and pediatric populations. As one of the four regional HCCs, AzCHER-Central was informally established in the early 2000s and began growing in size and relevance with ASPR’s change in focus. A memorandum of understanding was developed in 2014 that established formal linkages between hospitals and health care institutions.

Today, AzCHER-Central is a robust network of public and private entities seeking to enhance regional training and exercises, communication efforts, and resource sharing. With a service area that encompasses Gila, Maricopa, and Pinal Counties, the HCC addresses preparedness for a population approaching five million over a 19,300 square mile area.

Strategic Planning activities began in 2017 through which a new mission statement, goals and objectives, structure, and participation agreement were developed. Membership expanded from a focus on hospitals and health care institutions to a more comprehensive network that includes not just health care, but also public health, emergency management, and emergency medical services.

Planning activities are ongoing to address the evolving needs of the health care delivery system, the emergency management system, and the entire community.

AzCHER-Central is a robust network of healthcare entities seeking to enhance communication and resource sharing.