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Intent of Evaluation and Performance Measurement for the Hospital Association COVID-19 Preparedness and Response Activities Cooperative Agreement


The $175,000,000 provided through the Hospital Association COVID-19 Preparedness and Response Activities Cooperative Agreement funding opportunity1 supports the urgent preparedness and response needs of health care facilities and organizations, including:

  • Acute care hospitals,
  • Specialty care centers,
  • Outpatient/ambulatory care (includes primary care clinics, urgent care centers, dialysis, community health centers, etc.),
  • Home and residential care (includes long-term care, home health agencies, skilled nursing facilities, etc.),
  • Emergency Medical Services (EMS)/pre-hospital (also includes 911/public safety answering points (PSAP)),
  • Support services (pharmacies, blood banks, medical supply chain),
  • Hospital systems, and
  • Other health care entities on the front lines of the COVID-19 pandemic.2

The primary recipients of this funding are state/jurisdictional hospital associations who execute sub- awards to support the aforementioned entity types in order to adequately and rapidly distribute funds to health care systems and facilities to achieve the preparedness and response capabilities needed for COVID-19. This includes preparing to safely and successfully identify, isolate, assess, transport, and treat patients with COVID-19 or persons under investigation (PUIs) for COVID-19, as well as to prepare for future special pathogen disease outbreaks. The Office of the Assistant Secretary for Preparedness and Response (ASPR) awarded this funding to 53 hospital associations in all states, the District of Columbia, New York City, and Puerto Rico. Recipients will determine how to adequately and rapidly distribute funds to health care systems, facilities, and organizations so they can achieve the preparedness and response capabilities needed for COVID-19.

The purpose of the Hospital Association COVID-19 Preparedness and Response Activities Cooperative Agreement performance measures is to demonstrate the use of funding and operational outcomes that were achieved as a result of this cooperative agreement. The measures will also provide information on funding effectiveness and identify opportunities and challenges posed by supporting health care facilities through hospital associations. Consistent with the full scope of applicable grant regulations (45 CFR Part 75), the purpose of this award, and the underlying funding, the recipients and subrecipients shall provide ASPR with access to COVID-19 data pertinent to the award. This cooperative agreement is likely to generate positive secondary and tertiary effects for the entire health care system and to advance response to outbreaks of other special pathogens. While initial data collection and measurement will apply only to COVID-19 response, in the future, these measures could be used to evaluate response to outbreaks of other special pathogens, especially highly infectious pathogens.

The remainder of this document describes the performance measures ASPR will use to understand the programmatic effectiveness of the funding distributed through the Hospital Association COVID- 19 Preparedness and Response Activities Cooperative Agreement. Where measures ask hospital associations and their sub-recipients to respond to questions regarding ‘ASPR-funded’ activities, these activities include those 1) fully funded by the Hospital Association COVID-19 Preparedness and Response Activities Cooperative Agreement; 2) partially funded by this cooperative agreement and by the facility or organization; and 3) supported by allowable staff positions fully- or partially-funded by the cooperative agreement. Activities or supplies/materials funded by the Hospital Association COVID-19 Preparedness and Response Activities Cooperative Agreement include those that have been or will be retroactively compensated.

All performance measures will be submitted by the hospital association recipients to HHS ASPR, but we strongly urge collaboration with sub-recipients to ensure accurate reporting. Many of the performance measures will use both required quantitative measures and optional qualitative data to measure funding effectiveness and to identify opportunities and challenges posed by supporting health care facilities and organizations through hospital associations.


1. Grants.gov. March 24, 2020. “Hospital Association COVID-19 Preparedness and Response Activities.” Accessed August 2020.
2. Hospital Associations are permitted and encouraged to provide sub-awards to facilities outside their membership.



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