President Biden signed an Executive Order directing his administration to improve the “customer experience and service delivery” to the American people, building in accountability and transparency “into everything we do and that we’re good stewards of taxpayers dollars. “We have to prove democracy still works, that our government still works and can deliver for our people,” he stated.
Biden’s executive order is intended to promote fiscal stewardship by improving the Government’s delivery of services to the American people. The Executive Order directs 17 federal agencies to take more than 30 actions that aim to improve people’s lives and make it easier and simpler to access government services and benefits.
Under the Executive Order, retirees will be able to claim their Social Security benefits online more easily; Medicare recipients will receive personalized online tools so they can save money on drugs, manage their health care, and access expanded customer support options; taxpayers will be able to save time by having the option to schedule customer support callbacks; travelers will be able to renew their passports securely online; and more.
“These efforts are part of the Biden Administration’s commitment to rebuild trust in government and put people at the center of everything the government does.”
Here is a fact sheet from the White House spelling out how services will be improved:
The Federal Government interacts with millions of people each day and provides vital services during some of the most critical moments in people’s lives. Whether searching for vaccine safety information, claiming retirement benefits, receiving health insurance, passing through a security checkpoint, or checking the status of a farm loan application, Americans expect Government services to be responsive to their needs. But too often, people have to navigate a tangled web of Government websites, offices, and phone numbers to access the services they depend on. The Biden-Harris Administration is committed to ensuring an effective, equitable, and accountable Government that meets the needs of its people.
Today, the President is taking decisive action to promote fiscal stewardship by improving the Government’s service delivery to its customers, the American people. The President will sign an Executive Order, Transforming Federal Customer Experience and Service Delivery to Rebuild Trust in Government, directing that Government leaders account for the experiences of the public in seeking Government services. The President is making sure we’re building accountability and transparency into everything we do and that we’re good stewards of taxpayer dollars. As the President has said: “We have to prove democracy still works, that our government still works and can deliver for our people.”
The Executive Order directs Federal agencies to put people at the center of everything the Government does. Specifically, the Executive Order includes 36 customer experience (CX) improvement commitments across 17 Federal agencies, all of which aim to improve people’s lives and the delivery of Government services. The Executive Order also creates a sustained, cross-government service delivery process that aligns to the moments that matter most in people’s lives – like turning 65, having a child, or applying for a small business loan. As part of this framework, the Administration will work to identify and define critical services that meet customers’ needs and expectations, assess performance delivery and report it publicly, incorporate customer feedback during each interaction, and ultimately ensure services deliver a better experience to the public. Every interaction between the Government and the public, whether it involves filing taxes or renewing a passport, is an opportunity to deliver the value, service, and efficiency that the public expects and deserves.
The Government has designated 35 High-Impact Service Providers in Federal agencies as key service providers due to the volume and types of benefits, services, and programs they deliver to the public. As part of this Executive Order, agencies commit to putting their customers at the center of everything they do. These actions include modernizing programs, reducing administrative burdens, and piloting new online tools and technologies that can provide a simple, seamless, and secure customer experience. The types of high-quality interactions the American people should expect to have with their Government, and that the Executive Order addresses, include:
For the 54.1 million Americans who are over the age of 65, and the nearly 4 million Americans who become eligible for Social Security benefits each year, who manage their retirement and health care benefits:
Retirees will be able to claim their benefits online, receiving updates on the status of their application throughout the process.
Medicare recipients will receive personalized online tools so they can save money on drugs, manage their health care, access expanded customer support options (including an in-network pharmacy finder tool), and enjoy a streamlined enrollment experience with the Social Security Administration.
FILING AND MANAGING YOUR TAXES
For the 240 million individuals and businesses who file tax returns each year and the 167 million people who call the IRS for help:
Filers will save time by having the option to schedule customer support call-backs.
Filers will be provided with new online tools and services to ease the payment of taxes, which may include automatic direct deposit refunds based on prior year tax returns, tax credit eligibility tools, and expanded electronic filing options.
SURVIVING A DISASTER
For the 25 million individuals, families, and small businesses who live through a Federally recognized natural disaster each year:
After a disaster, more survivors will be able to focus on helping their families, businesses, and communities because of streamlined assistance processes, rather than having to navigate a complex Government bureaucracy to get the help they need. Disaster survivors will no longer need to navigate multiple assistance forms across multiple agencies to get the help they need, saving time and energy to allow them to focus on their recovery and well-being. Survivors will have access to more flexible mechanisms to provide supporting documentation, such as virtual inspections and submitting photos of disaster damage from a mobile phone.
For the more than 2 million daily passengers who travel through U.S. airports each year:
Americans will be able to renew their passports securely online, saving time from having to wait and the effort and cost required to print, go to a post office, and use a paper check. This new online process will be done with safety and security.
Passengers will have shorter security and check-in lines at airports due to increased use of technologies, like new security machines and computers with advanced screening features that streamline these processes.
Passengers with urgent, time-sensitive questions or concerns will find it easier to connect with and get help from the Transportation Security Administration through additional channels of communication.
FINANCING POST-SECONDARY EDUCATION
For the 1 in 6 Americans, or approximately 45 million people, who are managing their student loans:
Direct Loan borrowers will need to navigate only a single repayment portal on StudentAid.gov, so that they can apply for, manage, and repay their loans without having to visit multiple websites and manage multiple sets of credentials for different aspects of their student loans.
Public Service Loan Forgiveness candidates, including civil servants and active-duty service members, will be able to apply for the program with less paperwork than currently and without having to fill out forms with information they have already provided to the Federal government previously.
Students and borrowers can receive relevant recommendations for other benefits and services they may qualify for, like health care subsidies, broadband support, and food assistance, in order to connect them with support to lower additional economic barriers to post-secondary education completion.
MANAGING VA HEALTH CARE AND BENEFITS
For the 200,000 service members who transition to civilian life each year and the more than 18 million Veterans across the United States:
Service members and veterans will be able to use Login.gov accounts to access VA.gov and its information about the health care and benefits they’ve earned, and outdated and duplicate VA.gov sign-in options will be removed across VA websites and mobile apps.
Veterans and beneficiaries, and their caregivers or other designated representatives, will be able to access digital services through a single, integrated, and fully inclusive digital platform on VA.gov and a flagship VA mobile application so that VA’s customers don’t have to use separate portals, websites, or mobile applications when managing their health care and benefits online.
Low-income families can more easily enroll in Federal benefits and recertify their income status more easily across programs using direct certification, a process that automatically certifies income-eligible individuals without extra paperwork, instead of managing multiple, complicated processes that waste time and cause frustration.
Those navigating across multiple programs can expect a “no-wrong door” approach – interacting with one Federal program can help get them connected with other benefits and streamline enrollment for which they are eligible.
FINANCING YOUR BUSINESS
For the more than 30 million small business owners who may seek credit to grow their businesses and the 90% of U.S. farms that are small and family-owned:
Small business owners will be able to submit applications knowing that they will receive prompt and consistent service, such as reduced call center wait times, across Small Business Administration programs, including loans, grants, and certifications, because the agency will measure these experiences.
Farmers will be able to quickly and easily apply for loans from the Department of Agriculture with the support of digital tools, saving time, reducing unnecessary paperwork, and avoiding unnecessary trips to a county office.
SUPPORTING WOMEN, INFANTS, AND CHILDREN
For women seeking maternal health care and nutrition access in the critical early years of children’s lives:
More patients will be able to get more automated access to their electronic prenatal, birth, and postpartum health records (including lab results, genetic tests, ultrasound images, and clinical notes) to improve their experience and support better care coordination.
For the women who deliver 43% of all births in the United States each year covered by Medicaid, patients will have access to safer and more equitable care because of strengthened requirements for maternal health quality measurement, including perinatal quality and patient care experience, and measures will be evaluated by race and ethnicity to better identify and address inequities in maternal health care delivery and outcomes.
7 million women and their children, including half of all infants born in the United States who are eligible for benefits through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), will be able to grocery shop online, providing an alternative way to access healthy foods for their families.
MANAGING YOUR HEALTH
All Americans should be able to access the vital health services they need at the time that they need them. Under this Executive Order:
Patients will have increased ability to use telehealth with their doctors, connecting rural Americans, individuals with disabilities, or individuals seeking the convenience of remote options with the health care they need.
UPDATING YOUR PERSONAL INFORMATION ONCE
For the more than 30 million people who move each year, and approximately 2 million people who change their names each year:
Individuals who move their residences can update their addresses one time with the Federal Government and choose which other Federal or State entities they would like that information shared with.
Individuals seeking to change their names will be able to do so without having to appear in person at a Social Security Administration office, provide a wet signature, and submit original documents.
USA.gov will be redesigned as a centralized and streamlined “digital Federal front door” so the public can get access to all Government benefits, services, and programs in just 1 to 3 clicks, taps, or commands from the USA.gov homepage, without navigating duplicate and outdated Federal websites. That home page will feature a new user experience based on the key life events, moments that matter most, and top tasks that Americans experience throughout their lives when interacting with Government.
Tribal communities will be able to expect more streamlined and integrated grants application processes, rather than having to provide information over and over again to the Federal government and navigate across multiple agency websites.
The Fish and Wildlife Service will provide more of their service transactions online, including for special use permits for National Wildlife Refuge System locations and several high-volume application forms required for individuals and businesses that import, export, or re-export animals, plant, and their products internationally. These transactions currently can take weeks or even months to process, and can require multiple paper forms to be mailed.
This Executive Order is a continuation of the launch of the President’s Management Agenda (PMA) Vision, which prioritizes delivering excellent, equitable, and secure Federal services and customer experience. The PMA recognizes that improving the delivery, efficiency, security, and effectiveness of Government programs will advance equity, enhance people’s everyday interactions with public services, and provide greater opportunities for those who need it the most.
The Government’s primary mission is to serve. By placing people at the center of everything we do, the Government will be able to deliver timely, modern, and secure services to you – the people. We will rebuild trust in our Government, ensure no one is left behind, and inspire others to join us in serving future generations of Americans.
This afternoon, President Biden outlined his vision and new elements of his agenda for advancing racial equity for Americans who have been underserved and left behind, signing four executive actions to advance racial equity and take the first steps to root out systemic racism in housing and criminal justice.
“Equal opportunity is the fundamental promise of America. But systemic racism and discrimination in our economy, laws, and institutions have put the promise of America out of reach for too many families of color,” he stated.
President Biden renewed the federal government’s commitment to making the American Dream real for families across the nation by taking bold and ambitious steps to root out inequity from our economy and expand opportunities for communities of color and other underserved Americans.
His executive orders direct the Department of Housing and Urban Development (HUD) to take steps necessary to redress racially discriminatory federal housing policies that have contributed to wealth inequality for generations; end the Department of Justice’s (DOJ) use of private prisons; recommitted the federal government to respect Tribal sovereignty and strengthen the Nation-to-Nation relationship between the United States and Tribal Nations; and combat xenophobia against Asian Americans and Pacific Islanders.
These orders build on actions the President took during his first week in office to advance equity, which historians have described as one of the most robust efforts to advance racial justice in the first weeks of any new administration. On his first day in office, President Biden signed an unprecedented Executive Order establishing a whole-of-government initiative to address racial equity and support underserved communities, and redress systemic racism in federal policies, laws, and programs. He took immediate action to roll back harmful policies, such as President Trump’s 1776 Commission and ban on diversity and inclusion training for federal employees and contractors. In the days ahead, President Biden will reinvigorate the federal government’s role as a model employer by expanding and building on the efforts of the Obama-Biden Administration, by requiring all agencies to take affirmative steps to promote diversity, equity, and inclusion, as well as by requiring accessibility.
President Biden committed to embedding racial equity across his Administration’s response to COVID-19 and the economic crisis. In his first week in office, he signed executive actions to provide relief to American families that will aid families of color that are being disproportionately impacted by this economic crisis. He directed the Department of Agriculture to address the growing crisis of hunger facing more than one in five Black and Latino households by increasing access to nutritious food for millions of children missing meals due to school closures, issuing new guidance to help an additional 12 million Americans access nutrition assistance, and beginning the process to increase the value of supplemental nutrition assistance program benefits to better reflect today’s grocery costs.
The President extended the pause on federal student loan payments and collections, protecting borrowers burdened by educational debt, who are disproportionately Americans of color. He extended the federal government’s foreclosure and eviction moratoriums until February 28, 2021, helping families who are more likely to be rent burdened to stay safely housed. President Biden directed the Department of Treasury to take steps to make the delivery of stimulus benefits more equitable to help the 8 million households, many of whom are families of color, who never received the first stimulus checks they were entitled to. And, the President began the process of requiring federal contractors to pay a $15 minimum wage and provide emergency paid leave to workers bringing financial relief to low wage workers.
These actions are just the start. The President is committed to working with Congress to pass bold legislation that advances racial equity, including increasing funding for small businesses, investing in Historically Black Colleges and Universities and other Minority Serving Institutions, and tripling funding for Title I schools, which serve a majority of low-income students. As the President has said, he is focused on ensuring that small businesses owned by people of color and others who have been historically disadvantaged – many of whom were shut out of previous relief packages – receive support.
And President Biden’s American Rescue Plan will provide immediate, direct relief to communities and families bearing the brunt of the crisis – including communities and families of color. Economists estimate that the investments in the American Rescue Plan will lift over eight million Black, Latino, and Asian Americans out of poverty and will provide relief across sectors where families of color are most disproportionately impacted in this crisis: in food and financial security, healthcare access, and education and child care. The President’s rescue plan will expand protections for frontline workers, 40 percent of whom are people of color. It will increase and extend Unemployment Insurance benefits, supporting the one in ten Black workers and one in eleven Latino workers who are unemployed. And, the plan will provide critical relief to Native American communities and Tribes.
Before signing the additional executive orders, President Biden remarked, “In my campaign for President, I made it very clear that the moment had arrived as a nation where we face deep racial inequities in America and system- — systemic racism that has plagued our nation for far, far too long.
“I said it over the course of the past year that the blinders had been taken come off the nation of the American people. What many Americans didn’t see, or had simply refused to see, couldn’t be ignored any longer.
“Those 8 minutes and 46 seconds that took George Floyd’s life opened the eyes of millions of Americans and millions of people around — all over the world. It was the knee on the neck of justice, and it wouldn’t be forgotten. It stirred the conscience of tens of millions of Americans, and, in my view, it marked a turning point in this country’s attitude toward racial justice…
“COVID-19 has further ripped a path of destruction through every community in America, but no one has been spared, but the devastation in communities of color has been nothing short of stunning. Just look at the numbers: 40 percent of frontline workers — nurses, first responders, grocery store workers — are Americans of color, and many are still living on the edge. One in ten black Americans is out of work today. One in eleven Latino Americans is out of work today. One in seven households in America — about one in four black, one in five Latino households in America — report that they don’t have enough food to eat in the United States of America.
“Black and Latino Americans are dying of COVID-19 at rates nearly three times that of white Americans. And it’s not white Americans’ fault, but it’s just a fact. And the Americans now know it, especially younger Americans.
“One of the reasons I’m so optimistic about this nation is that today’s generation of young Americans is the most progressive, thoughtful, inclusive generation that America has ever seen. And they are pulling us toward justice in so many ways, forcing us to confront the huge gap in economic inequity between those at the top and everyone else, forcing us to confront the existential crisis of climate; and, yes, forcing us to confront systemic racism and white supremacy.
“It’s just been weeks since all of America witnessed a group of thugs, insurrectionists, political extremists, and white supremacists violently attack the Capitol of our democracy. And so now — now is the time to act. It’s time to act because that’s what the faith and morality calls us to do…
“We have never fully lived up to the founding principles of this nation, to state the obvious, that all people are created equal and have a right to be treated equally throughout their lives. And it’s time to act now, not only because it’s the right thing to do, but because if we do, we’ll all be better off for it.
“For too long, we’ve allowed a narrow, cramped view of the promise of this nation to fester. You know, we’ve — we’ve bought the view that America is a zero-sum game in many cases: ‘If you succeed, I fail.’ ‘If you get ahead, I fall behind.’ ‘If you get the job, I lose mine.’ Maybe worst of all, ‘If I hold you down, I lift myself up.’
“We’ve lost sight of what President Kennedy told us when he said, “A rising tide lifts all boats.” And when we lift each other up, we’re all lifted up. You know, and the corollary is true as well: When any one of us is held down, we’re all held back. More and more economic studies in recent years have proven this, but I don’t think you need economic studies to see the truth.
“Just imagine if instead of consigning millions of American children to under-resourced schools, we gave each and every three- and four-year-old child a chance to learn, to go to school — not daycare, school — and grow and thrive in school and throughout. When they’ve done that — the places it’s been done, it shows they have an exponentially greater chance of going all the way through 12 years of school and doing it well.
But, you know, does anyone — does anyone in this whole nation think we’re not all better off if that were to happen?
“Just imagine if instead of denying millions of Americans the ability to own a home and build generational wealth — who made it possible for them buy a home, their first home — and begin to build equity to provide for their families and send their children off to school, does anyone doubt that the whole nation will be better off?
“Just imagine: Instead of denying millions of young entrepreneurs the ability to access capital, we made it possible to take their dream to market, create jobs, reinvest in their own communities. Does anyone doubt this whole nation wouldn’t be better off?
“Just imagine if more incredibly creative and innovative — how much more creative and innovative we’d be if this nation held — held the historic black colleges and universities to the same opportunities — and minority-serving institutions — that had the same funding and resources of public universities to compete for jobs and industries of the future. You know, just ask the first HBCU graduate elected as Vice President if that’s not true.
“But to do this, I believe this nation and this government need to change their whole approach to the issue of racial equal- — equity. Yes, we need criminal justice reform, but that isn’t nearly enough. We need to open the promise of America to every American. And that means we need to make the issue of racial equity not just an issue for any one department of government; it has to be the business of the whole of government.
“That’s why I issued, among the first days, my whole-of-government executive order that will, for the first time, advance equity for all throughout our federal policies and institutions. It focuses on the full range of communities who have been long underserved and overlooked: people of color; Americans with disabilities; LGBTQ Americans; religious minorities; rural, urban, suburban communities facing persistent poverty.
“And I’ve asked Ambassador Susan Rice to lead the administration’s charge through the White House and Domestic Policy Council because I know she’ll see it through. Every White House, every White House component, and every agency will be involved in this work because advancing equity has to be everyone’s job….
“In the weeks ahead, I’ll be reaffirming the federal government’s commitment to diversity, equity, and inclusion and accessibility, building on the work we started in the Obama-Biden administration. That’s why I rescinded the previous administration’s harmful ban on diversity and sensitivity training, and abolished the offensive, counter-factual 1776 Commission. Unity and healing must begin with understanding and truth, not ignorance and lies….
“I ran for President because I believe we’re in a battle for the soul of this nation. And the simple truth is, our soul will be troubled as long as systemic racism is allowed to persist. We can’t eliminate it if — it’s not going to be overnight. We can’t eliminate everything.
“But it’s corrosive, it’s destructive, and it’s costly. It costs every American, not just who have felt the sting of racial injustice. We aren’t just less of a — we are not just a nation of morally deprived because of systemic racism; we’re also less prosperous, we’re less successful, we’re less secure.
“So, we must change, and I know it’s going to take time. But I know we can do it. And I firmly believe the nation is ready to change, but government has to change as well. We need to make equity and justice part of what we do every day — today, tomorrow, and every day.
Here’s a summary of the additional executive actions fostering racial equity that President Biden signed:
Advance Fair Housing. President Biden will sign a Presidential Memorandum “Redressing Our Nation’s and the Federal Government’s History of Discriminatory Housing Practices and Policies.” This memorandum recognizes the central role the federal government has played implementing housing policies across the United States, from redlining to mortgage discrimination to destructive federal highway construction, that have had racially discriminatory impacts. The Fair Housing Act requires the federal government to advance fair housing and combat housing discrimination, including disparate impact discrimination that appears neutral but has an unjustified discriminatory effect in practice. This Presidential Memorandum directs HUD to examine the effects of the previous Administration’s regulatory actions that undermined fair housing policies and laws. And, it directs HUD to take steps necessary based on that analysis to fully implement the Fair Housing Act’s requirements.
Reform our Incarceration System to End the Use of Private Prisons. More than two million people are currently incarcerated in the United States, and a disproportionate number of these individuals are people of color. Mass incarceration imposes significant costs on our society and communities, while private prisons profiteer off of federal prisoners in less safe conditions for prisoners and correctional officers alike. President Biden is committed to reducing mass incarceration while making our communities safer. That starts with ending DOJ’s reliance on private prisons. The Order directs the Attorney General not to renew Department of Justice contracts with privately operated criminal detention facilities.
Reaffirm the Federal Government’s Commitment to Tribal Sovereignty and Consultation. The Biden Administration is committed to re-establishing federal respect for Tribal sovereignty, strengthening the Nation-to-Nation relationship between the federal government and American Indian and Alaska Native Tribes, empowering self-determination, and advancing racial justice for Native communities. This Executive Order reinvigorates the commitment of all federal agencies to engage in regular, robust, and meaningful consultation with Tribal governments.
Combat Xenophobia Against Asian American and Pacific Islanders. While bullying and discrimination against Asian Americans and Pacific Islanders (AAPIs) is a long-standing and unacceptable problem in our country, rates of harassment and violence against AAPIs have risen dramatically in the past year. President Biden will sign a Presidential Memorandum acknowledging the harm that these actions have caused, and establishing that the policy of his Administration is to condemn and denounce anti-Asian bias and discrimination. This Memorandum directs the Department of Health and Human Services, in coordination with the COVID-19 Health Equity Task Force, to consider issuing guidance describing best practices to advance cultural competency, language access, and sensitivity towards AAPIs in the federal government’s COVID-19 response. It also directs the Department of Justice to partner with AAPI communities to prevent hate crimes and harassment against AAPIs.
The President Releases National COVID-19 Strategy and Signs Executive Actions to Expand Testing, Administer Vaccines, Advance Racial Equity, and Safely Reopen Schools and Businesses
Today, on his first full day in the White House, President Joe Biden released the National Strategy for the COVID-19 Response and Pandemic Preparedness — a comprehensive, 198-page roadmap to guide America out of this pandemic. To jumpstart this strategy, he signed 10 Executive Orders and other directives and took additional actions to move quickly to contain the COVID-19 crisis by expanding testing, administering vaccines, advancing racial equity, and safely reopening schools and businesses. These steps build on actions President Biden took yesterday to rejoin the World Health Organization, encourage masking, and to create his White House COVID-19 Response Team.
Here are more details on the steps that President Biden took today to immediately put his National Strategy into action.
IMMEDIATELY EXPAND EMERGENCY RELIEF AND EXERCISE THE DEFENSE PRODUCTION ACT (DPA)
Manufacture and Deliver Supplies for Vaccination, Testing, and Personal Protective Equipment (PPE) President Biden is taking immediate action to fill supply shortfalls for vaccination supplies, testing supplies, and PPE, and to ensure that these critical supplies equitably reach American communities, especially communities of color and other underserved communities hit hardest by the virus. The President will issue an Executive Order directing relevant agencies to exercise all appropriate authorities, including the DPA, to accelerate manufacturing, delivery, and administration to meet shortfalls in equipment and supplies needed for the COVID-19 response, beginning with action to increase the availability of critical supplies such as N95 masks, isolation gowns, nitrile gloves, PCR sample collection swabs, test reagents, pipette tips, laboratory analysis machines for PCR tests, high-absorbency foam swabs, nitrocellulose material for rapid antigen tests, rapid test kits, and all the necessary equipment and material to accelerate the manufacture, delivery, and administration of COVID-19 vaccine.
Reimburse States So They Can Deploy the Emergency Personnel and Supplies Americans Need The President will issue a Presidential Memorandum directing the Federal Emergency Management Administration (FEMA) to increase federal reimbursement to states and Tribes from 75 percent to 100 percent of the cost for National Guard personnel and emergency supplies, such as PPE, cleaning and sanitizing efforts, and the personnel and equipment needed to create vaccination centers. The order also includes restoring full reimbursement for eligible costs necessary to support safe school reopening through the FEMA Disaster Relief Fund. To help address the health and financial crises faced by Tribal Nations throughout our country and to advance Tribal sovereignty in our COVID-19 response, this Memorandum also expands FEMA resources for Tribal governments.
MITIGATE SPREAD THROUGH EXPANDING TESTING, TREATMENT, AND THE PUBLIC HEALTH WORKFORCE, AND ESTABLISHING CLEAR PUBLIC HEALTH STANDARDS
Establish the Pandemic Testing Board, Expand Testing, and Strengthen the Public Health Workforce To control the COVID-19 pandemic and safely reopen schools and businesses, the U.S. must have wide-spread testing. President Biden will issue an Executive Order that establishes the COVID-19 Pandemic Testing Board to bring the full force of the federal government’s expertise to expanding testing supply and increasing access to testing. The federal government will increase testing capacity by directing the use of the DPA and other authorities to procure more tests and expand manufacturing capacity where possible. The Executive Order will promote surge capacity for testing in the United States, onshore test manufacturing, expand the public health workforce, support COVID-19 screening for schools, and ensure that underserved communities, including communities of color, can equitably access tests.
Bolster Access to COVID-19 Treatments and Clinical Care Effective treatments for COVID-19 are critical to saving lives. President Biden will sign an Executive Order directing studies, including large-scale randomized trials, to identify treatments for COVID-19 and to ensure that such studies address the needs of diverse populations. The Executive Order establishes a comprehensive, integrated, equitable, and coordinated preclinical drug discovery and development program to allow therapeutics to be evaluated and developed in response to pandemic threats. The Order also outlines steps to improve clinical care, provide assistance to long-term care facilities and intermediate care facilities for people with disabilities, increase health care workforce capacity, expand access to programs designed to meet long-term health needs of patients recovering from COVID-19, and support access to safe and effective COVID-19 therapies for those without coverage.
Improve Data to Combat COVID-19 Metrics and metric-driven public health guidance will be essential to controlling the pandemic. President Biden’s Executive Order will enhance the United States’ collection, production, sharing, and analysis of data to support an equitable COVID-19 response and recovery. The federal government will work with state, local, Tribal and territorial governments to aggregate and analyze data to track access to vaccines and testing, reopen schools and businesses, and address disparities in COVID-19 infections and health outcomes. And, the federal government will create publicly available dashboards with national and state-by-state level information, consistent with privacy protections, on cases, testing, vaccinations, and hospital admissions to make real-time information available to policymakers and the public.
MOUNT A SAFE, EFFECTIVE, COMPREHENSIVE VACCINATION CAMPAIGN
Take Immediate Actions to Convert Vaccines into Vaccinations The Biden-Harris Administration will spare no effort to ensure the public can get vaccinated safely, effectively and equitably. To meet the aggressive vaccination target of 100 million shots by the end of his first 100 days in office, President Biden will take immediate action to improve the vaccination program. Yesterday, he directed FEMA to begin standing up the first federally-supported community vaccination centers, with the goal of standing up 100 centers in the next month. The Centers for Disease Control and Prevention (CDC) will also launch the federal pharmacy program — making vaccines available to communities in their local pharmacies beginning next month. And, he tasked the U.S. Public Health Services Commissioned Corps with expanding its workforce and preparing for deployment. Central to this effort will be expanded support and collaboration with state, local, Tribal and territorial governments, including the establishment of COVID Response Liaisons for each state — a model based on the response to Hurricane Sandy.
SAFELY REOPEN SCHOOLS, BUSINESSES, AND TRAVEL WHILE PROTECTING OUR WORKERS
Direct Action to Support Students & Safely Reopen Schools President Biden will issue an Executive Order directing the Departments of Education and Health and Human Services (HHS) to provide guidance on safe reopening and operating for schools, child care providers, and institutions of higher education. Ensuring the safety of students and educators and adherence to science will be paramount. And, the Order directs the Departments of Education and Health and Human Services to collect data around reopening and school closures so state and local officials have metrics to inform decision-making and can better understand the impact of closures on students from families with low-incomes, students of color, English-language learners, students with disabilities and others.
The COVID-19 Response Team will work to ensure that testing materials, support for contact tracing, and vaccinations for teachers are equitably provided to support in-person care and learning. Finally, the order encourages the Federal Communications Commission to increase connectivity options for students lacking reliable home broadband, so that they can continue to learn if their schools are operating remotely.
This work will be supported by the Presidential Memorandum directing FEMA to offer reimbursement for eligible emergency supplies, such as PPE for schools and child care providers.
The Administration will engage with educators and their unions, students and their families, state and local education and public health officials, civil rights advocates, and other experts in the field. And, the Department of Education will work with HHS to ensure that guidance for schools is updated based on the latest science and any developments in the pandemic, including the spread of new coronavirus variants that may have a higher transmission rate. The Administration will always be honest about the challenges we face, directly addressing how and whether changes in the pandemic may impact the reopening of schools or the ability of schools to remain open.
Help Protect Workers from COVID-19 Millions of Americans, many of whom are people of color, immigrants, and low-wage workers, continue to put their lives on the line to keep the country functioning through the pandemic. President Biden will sign an Executive Order calling on the Occupational Safety and Health Administration (OSHA) to immediately release clear guidance for employers to help keep workers safe from COVID-19 exposure. It also asks OSHA and Mine Safety and Health Administration to determine whether to establish emergency temporary standards that require employers to take steps to keep workers safe from COVID-19 and it directs OSHA to enforce worker health and safety requirements, targeting the worst violators. With the goal of protecting all workers from COVID-19, the order instructs agencies to explore ways to protect workers who are not always covered by OSHA standards, such as those who are self-employed.
Promote Safe Travel To protect travelers from COVID-19, President Biden will issue an Executive Order to require mask-wearing in airports, on certain modes of public transportation, including many trains, airplanes, maritime vessels, and intercity buses. For air travel, this Executive Order also requires international travelers to produce proof of a negative COVID-19 test prior to departing for the United States and to comply with CDC guidelines for self-isolation and self-quarantine upon arrival. The Executive Order also calls for the consideration of additional public health measures in domestic travel and for consultation with foreign governments and other stakeholders to implement public health measures for safe travel, including at land and sea borders.
PROTECT THOSE MOST AT RISK AND ADDRESS INEQUITIES FACED BY COMMUNITIES OF COLOR AND OTHER UNDERSERVED GROUPS
Advance Health Equity in the Nation’s COVID-19 Response In order to address the disproportionate and severe impact of COVID-19 on communities of color and other underserved populations, President Biden will issue an Executive Order to ensure an equitable pandemic response and recovery. The order establishes a COVID-19 Health Equity Task Force to provide specific recommendations to the President for allocating resources and funding in communities with inequities in COVID-19 outcomes by race, ethnicity, geography, disability, and other considerations. The federal government will expand equity data collection; increase access to PPE, testing, therapies, and vaccines in underserved communities and high-risk settings; and assess and update pandemic response plans to ensure equity. The health workforce, including community-based workers, will be expanded to assist with contact tracing, vaccination, and linkage to care. Additionally, the Biden Administration will work with states, local jurisdictions, Tribal communities, and territories to address unmet basic needs, including food, housing, and childcare, for individuals and families affected by COVID-19.
RESTORE U.S. GLOBAL LEADERSHIP AND BUILD BETTER PREPAREDNESS
Advance U.S. Global Leadership, Support the Health and Humanitarian Response to COVID-19, and Protect Against Future Biological Threats America’s withdrawal from the world stage and retreat from the World Health Organization has impeded progress on the global COVID-19 response and left the United States and the world more vulnerable to future pandemics. Yesterday, President Biden signed letters to the United Nations Secretary General and World Health Organization Director General to cease America’s withdrawal from the organization and to outline U.S. intent to work constructively with the WHO to strengthen and reform it. Today, President Biden will sign a Presidential Directive to restore America’s leadership, support the international pandemic response effort, promote resilience for future threats, and advance global health security and the Global Health Security Agenda. This directive restores U.S. leadership and seeks to support the international health and humanitarian response to the COVID-19 pandemic and its secondary impacts, global health security and diplomacy, and better biopreparedness and resilience for emerging and future biological threats.
RACIAL EQUITY IMPACT
The COVID-19 crisis has shined a light on and exacerbated the persistent racial inequities in our healthcare system and our economy. Americans of color are being infected and dying from COVID-19 at higher rates, while workers of color disproportionately put themselves at risk of exposure to COVID-19 on the frontline of this crisis to keep our country running. Changing the course of the COVID-19 crisis requires mobilizing an equitable response across the whole of our government. The new COVID-19 Health Equity Task Force will intensely focus on these issues. The actions to expand the availability of testing and vaccines in communities of color, and other underserved communities, ensure that new clinical treatments are developed to serve diverse Americans, and safely reopen our schools so that children who are facing disproportionately high risks of learning loss can get back into the classroom. These actions will also support Native communities and Tribal governments to address the health and economic crises in Indian country.
These executive actions will help keep millions of workers healthy and safe from COVID-19. They direct agencies to provide new guidance so that employers and schools know what they need to do to keep workers safe. They’ll increase access to personal protective equipment, testing, and vaccines that will help reduce the spread of COVID-19 in workplaces across the country. They’ll help ensure more people are wearing masks when they travel, immediately providing more protection to many airline workers, bus drivers, and other transportation workers, and providing Americans safe ways to travel to work.
With the support of funding from the President’s American Rescue Package, the President’s plan to safely reopen schools will help students engage in in-person learning, parents return to work and prevent more educators from being laid off, as we combat the virus and make schools safe for students and educators again.
These measures will help keep workers safe and healthy, get more Americans back to work, and ultimately reduce the spread of the virus.
Surprise! There wasn’t any Trump Administration plan to distribute COVID-19 vaccines. And those supplies that were supposedly held in reserve? The jokes on you – there aren’t any. The incoming Biden Administration – locked out of meaningful engagement during the transition – finds it has to basically create a vaccine distribution program almost from scratch, while holding to a goal of administering 100 million doses in the first 100 days. As each day continues to post new record numbers of deaths (well over 400,000 now, with as many as 100,000 more deaths by February forecast), hospitalizations choking state’s health care systems, the number of infections soaring over 22 million and new strains that are even more transmissible, Biden’s first Executive Order, signed within minutes of entering the White House, was to require mask-wearing at federal facilities and in interstate commerce, while launching a national, patriotic campaign to mask-up for 100 days. And the first order of business for the Biden Administration has been to introduce, for the first time, a national strategy to get a handle on the coronavirus pandemic that has so devastated lives and livelihoods.
Here it is: –Karen Rubin/news-photos-features.com
National Strategy for the COVID-19 Response and Pandemic Preparedness
January 21, 2021
We can and will beat COVID-19. America deserves a response to the COVID-19 pandemic that is driven by science, data, and public health — not politics. Through the release of the National Strategy for the COVID-19 Response and Pandemic Preparedness, the United States is initiating a coordinated pandemic response that not only improves the effectiveness of our fight against COVID-19, but also helps restore trust, accountability and a sense of common purpose in our government.
On January 9, 2020, the World Health Organization announced that there were 59 cases of coronavirus-related pneumonia. Just one year later, the United States has experienced over 24 million confirmed COVID-19 cases and over 400,000 COVID-19 deaths. America has just 4% of the world’s population, but 25% of the world’s COVID-19 cases and 20% of all COVID-19 deaths. And our nation continues to experience the darkest days of the pandemic, with record numbers of cases, hospitalizations and deaths. Over 77,000 Americans lost their lives to COVID-19 in December, and across our nation businesses are closing, hospitals are full, and families are saying goodbye to their loved ones remotely.
The National Strategy provides a roadmap to guide America out of the worst public health crisis in a century. It outlines an actionable plan across the federal government to address the COVID-19 pandemic, including twelve initial executive actions that will be issued by President Biden during his first two days in office:
The National Strategy is organized around seven goals:
Restore trust with the American people.
Mount a safe, effective, and comprehensive vaccination campaign.
Mitigate spread through expanding masking, testing, treatments, data, health care workforce, and clear public health standards.
Immediately expand emergency relief and exercise the Defense Production Act.
Safely reopen schools, businesses, and travel while protecting workers.
Protect those most at risk and advance equity, including across racial, ethnic and rural/urban lines.
Restore U.S. leadership globally and build better preparedness for future threats.
To execute on the National Strategy, the White House will establish a COVID-19 Response Office responsible for coordinating the pandemic response across all federal departments and agencies. Through implementation of the National Strategy, the United States will make immediate progress on the seven goals. To monitor outcomes, the National Strategy will establish a data-driven, evidence-based approach to evaluating America’s progress in the fight against COVID-19.
The federal government cannot solve this crisis alone. Full implementation of the National Strategy for COVID-19 will require sustained, coordinated, and complementary efforts of the American people, as well as groups across the country, including State, local, territorial, and Tribal governments; health care providers; businesses; manufacturers critical to the supply chain; civic, religious and civil rights organizations; and unions. It will also require a global effort to contain the virus and advance health security.
America has always risen to the challenge and we will do so now. In collaboration with the people of this country, the United States government will lead an effective COVID-19 response that gets us back to our lives and loved ones. As we’ve seen during this pandemic, we can’t solve our problems as a divided nation. The only way we come through this is together as fellow Americans and as the United States of America.
Goal 1: Restore trust with the American people.
The federal government should be the source of truth for the public to get clear, accessible, and scientifically accurate information about COVID-19. To rebuild the trust of the American people, the National Strategy will signal clear public leadership and a commitment to a robust whole-of-government response that puts science first. The federal government will be transparent with the American people, maintaining an open line of communication with the public and all stakeholders. To continue to restore trust, the United States will:
Establish a national COVID-19 response structure where decision-making is driven by science and equity. The Biden-Harris Administration has developed a unified plan to rebuild expert leadership across the government and regain the trust of the American public. As part of the strategy, on his first day in office, President Biden issued Executive Order Organizing and Mobilizing the U.S. Government to Provide a Unified And Effective Response to Combat COVID-19 and to Provide United States Leadership on Global Health and Security establishing a White House COVID-19 national response structure to coordinate across the U.S. Government and restoring the White House Directorate on Global Health Security and Biodefense established by the Obama-Biden Administration. The COVID-19 Response office will establish clear lines of communications with all governors, state public health officials and immunization managers, and local leaders.
Conduct regular expert-led, science-based public briefings. The federal government will conduct regular, expert-led, science-based public briefings and release regular reports on the state of the pandemic. Experts and scientists at the U.S. Centers for Disease Control and Prevention (CDC) will also develop clear, evidence-based, metric-driven public health guidance and effectively and frequently communicate and distribute guidance and updates to the American people.
Publicly share data around key response indicators. Metrics and metric-driven public health guidance will be essential to controlling the pandemic. President Biden will issue Executive Order Ensuring a Data-Driven Response to COVID-19 and Future High Consequence Public Health Threats directing steps to enhance federal agencies’ collection, production sharing, and analysis of, and collaboration with respect to, data to support an equitable COVID-19 response and recovery. As further detailed in National Strategy Goals Two, Three, and Six, the federal government will track a range of performance measures and data including cases, testing, vaccinations, and hospital admissions, and will make real-time information readily available to the public and to policymakers at the federal, state, and local level. The CDC will also maintain a public dashboard tracking COVID-19 cases at the county level, so that Americans can gauge the level of transmission in their own communities to make their own informed choices.
Engage the American people. The federal government cannot solve this crisis alone. It will take regular engagement with the public, state and local leaders, the private sector, unions, community volunteers, and health care providers to guide policy and implementation. The Administration will prioritize outreach to state and local governments, the public and private sectors, vulnerable communities, students, workers, and community leaders, using input from these stakeholders to drive the government’s COVID-19 response.
Lead science-first public health campaigns. The Administration will lead world-class public education campaigns — covering topics like masking, testing, vaccinations and vaccine hesitancy — designed with diversity and inclusivity in mind, including communications in multiple languages, to maximize reach and effectiveness. The campaigns will be coordinated, across national, state, and local levels, and engage with the private and public sector. They will be anchored by science and fact-based public health guidance. The Administration will work to counter misinformation and disinformation by ensuring that Americans are obtaining science-based information.
Goal 2: Mount a safe, effective, comprehensive vaccination campaign.
The United States will spare no effort to ensure Americans can get vaccinated quickly, effectively, and equitably. The federal government will execute an aggressive vaccination strategy, focusing on the immediate actions necessary to convert vaccines into vaccinations, including improving allocation, distribution, administration, and tracking. Central to this effort will be additional support and funding for state, local, Tribal, and territorial governments — and improved line of sight into supply — to ensure that they are best prepared to mount local vaccination programs. At the same time, the federal government will mount an unprecedented public campaign that builds trust around vaccination and communicates the importance of maintaining public health measures such as masking, physical distancing, testing, and contact tracing even as people receive safe and effective vaccinations. To mount a safe, effective, comprehensive vaccination campaign, the United States will:
Ensure the availability of safe, effective vaccines for the American public. The national vaccination effort will be one of the greatest operational challenges America has ever faced. To ensure all Americans can be vaccinated quickly, the President has developed a plan for expanding vaccine manufacturing and purchasing COVID-19 vaccine doses for the U.S. population by fully leveraging contract authorities, including the Defense Production Act; deploying onsite support to monitor contract manufacturing operations; and purchasing additional FDA-authorized vaccines to deliver as quickly as possible. The effort includes prioritizing supplies that could cause bottlenecks, including glass vials, stoppers, syringes, needles, and the “fill and finish” capacity to package vaccine into vials.
Accelerate getting shots into arms and get vaccines to the communities that need them most. The success of the national vaccination effort will depend on reaching communities across the United States. To achieve this, the federal government will take a series of steps to simplify and strengthen the allocation and distribution process. In order to expand the supply available to states, the Administration will end the policy of holding back significant levels of doses, instead holding back a small reserve and monitoring supply to ensure that everyone receives the full regimen as recommended by the FDA. The United States will accelerate the pace of vaccinations by encouraging states and localities to move through the priority groups more quickly — expanding access to frontline essential workers and individuals over the age of 65, while staying laser-focused on working to ensure that the highest-risk members of the public, including those in congregate facilities, can access the vaccine where and when they need it. The Administration will also improve the allocation process by providing states and localities with clear, consistent projections to inform their planning. Through it all, the United States will work to ensure that the vaccine is distributed quickly, effectively and equitably, with a focus on making sure that high-risk and hard-to-reach communities are not left behind.
Create as many venues as needed for people to be vaccinated. The federal government — in partnership with state and local governments — will create as many venues for vaccination as needed in communities and settings that people trust. This includes, but is not limited to federally run community vaccination centers, in places like stadiums and conference centers, federally-supported state and locally operated vaccination sites in all 50 states and 14 territories, pharmacies and retail stores, federal facilities like Veterans Affairs hospitals, community health centers, rural health clinics, critical access hospitals, physician offices, health systems, urgent care centers, and mobile and on-site occupational clinics.
Focus on hard-to-reach and high-risk populations. As the United States accelerates the pace of vaccinations nationwide, we remain focused on building programs to meet the needs of hard-to-reach and high-risk populations, and meeting communities where they are to make vaccinations as accessible and equitable as possible. The federal government will deploy targeted strategies to meet the needs of individuals at increased risk and others who need to take extra precautions, according to the CDC, as well as the communities hardest hit by this pandemic. Local public health officials will play a critical role.
Fairly compensate providers, and states and local governments for the cost of administering vaccinations. Fairly compensating providers, and state and local governments for the costs of vaccine administration will be critical to expanding vaccination participation. President Biden will work with Congress to expand the Federal Medicaid Assistance Percentage (FMAP) to 100 percent for vaccinations of Medicaid enrollees—with the goal of alleviating state costs for administration of these vaccines and supporting states in their work to meet the needs of their communities. The Department of Health and Human Services will ask the Centers for Medicare & Medicaid Services to consider whether current payment rates for vaccine administration are appropriate or whether a higher rate may more accurately compensate providers. The federal government will fund vaccine supply and will greatly expand funding for vaccine administration by allowing state and local governments to reimburse vaccination administration expenses through the FEMA Disaster Relief Fund and by ensuring that workforce and equipment expenses for state and local-run sites are also eligible.
Drive equity throughout the vaccination campaign and broader pandemic response. The federal government will drive equity in vaccinations by using demographic data to identify communities hit hardest by the virus and supporting them, ensuring no out-of-pocket costs for vaccinations, and making sure vaccines reach those communities. Working with state, local, and community-based organizations and trusted health care providers, like community health centers, will be central to this effort.
Launch a national vaccinations public education campaign. The United States will build public trust through an unprecedented vaccination public health campaign at the federal, State, Tribal, territorial, local and community level. The public education campaign will support vaccination programs, address vaccine hesitancy, help simplify the vaccination process for Americans, and educate the public on effective prevention measures. The campaign will be tailored to meet the needs of diverse communities, get information to trusted, local messengers, and outline efforts to deliver a safe and effective vaccine as part of a national strategy for beating COVID-19.
Bolster data systems and transparency for vaccinations. The operational complexity of vaccinating the public will make robust data and its use in decision-making related to vaccinations more important than ever. The federal government, with CDC, will track distribution and vaccination progress, working hand-in-hand with states and localities to support their efforts. The Administration will build on and strengthen the federal government’s approach to data collection related to vaccination efforts, removing impediments and developing communication and technical assistance plans for jurisdictions and providers. The Administration, through HHS and other federal partners, will rely on data to drive decision-making and the national vaccinations program.
Monitor vaccine safety and efficacy. The Administration will ensure that scientists are in charge of all decisions related to vaccine safety and efficacy. The FDA will also continue to honor its commitment to make relevant data on vaccine safety and efficacy publicly available and to provide opportunities for public, non-governmental expert input. Through expanded and existing systems, the CDC and FDA will ensure ongoing, real-time safety monitoring. Through it all, the Administration will communicate clearly with the American public to continue to build trust around the vaccine and its benefits for individuals, their families and communities.
Surge the health care workforce to support the vaccination effort. A diverse, community-based health care workforce is essential to an effective vaccination program. The United States will address workforce needs by taking steps to allow qualified professionals to administer vaccines and encourage states to leverage their flexibility fully to surge their workforce, including by expanding scope of practice laws and waiving licensing requirements as appropriate.
Goal 3: Mitigate spread through expanding masking, testing, treatment, data, workforce, and clear public health standards.
A comprehensive national public health effort to control the virus — even after the vaccination program ramps up — will be critical to saving lives and restoring economic activity. The federal government will partner with state, local, Tribal, and territorial leaders to implement a cohesive strategy to significantly reduce the spread of COVID-19 and release clear public health guidance to the public about what to do and when, including implementing mask mandates; expanding testing; strengthening the public health workforce; modernizing data collection and reporting capabilities for COVID-19 and future epidemics; and providing equitable access to treatment and clinical care. To mitigate the spread of COVID-19 through clear public health standards, the United States will:
Implement masking nationwide by working with governors, mayors, and the American people. The President has asked the American people to do what they do best: step up in a time of crisis and wear masks. He has issued Executive Order Protecting the Federal Workforce and Requiring Mask-Wearing which directs compliance with CDC guidance on masking and physical distancing in federal buildings, on federal lands, and by federal employees and contractors. Additionally, the President will issue Executive Order Promoting COVID-19 Safety in Domestic and International Travel which directs applicable agencies to take immediate action to require mask-wearing on some airplanes, trains, and certain other forms of public transportation in the United States. He has called on governors, public health officials, mayors, business leaders, and others to implement masking, physical distancing, and other CDC public measures to control COVID-19.
Scale and expand testing. To control the COVID-19 pandemic and safely reopen schools and businesses, America must have wide-spread testing. A national testing strategy is a cornerstone to reducing the spread of COVID-19 and controlling outbreaks, and clear federal guidance and a unified national approach to implementation are essential. The President will issue Executive Order Establishing the National Pandemic Testing Board and Ensuring a Sustainable Public Health Workforce for COVID-19 and Other Biological Threats which establishes the COVID-19 Pandemic Testing Board to oversee implementation of a clear, unified approach to testing. The federal government will expand the rapid testing supply and double test supplies and increase testing capacity. The Administration will also increase onshore test manufacturing, fill testing supply shortfalls, enhance laboratory capacity to conduct testing over the short- and long-term, and expand surveillance for hotspots and variants.
Effectively distribute tests and expand access to testing. The federal government will support school screening testing programs to help schools reopen. The Administration will also stand up a dedicated CDC Testing Support Team, fund rapid test acquisition and distribution for priority populations, work to spur development and manufacturing of at-home tests and work to ensure that tests are widely available. Through Executive Order Establishing the National Pandemic Testing Board and Ensuring a Sustainable Public Health Workforce for COVID-19 and Other Biological Threats the President will direct agencies to facilitate testing free of charge for those who lack health insurance and to clarify insurers’ obligation to cover testing. The federal government will also provide testing protocols to inform the use of testing in congregate settings, schools, and other critical areas and among asymptomatic individuals. Further, technical assistance will support more widespread adoption of testing to improve timely diagnosis and public confidence in the safety of settings like schools.
Prioritize therapeutics and establish a comprehensive, integrated COVID-19 treatment discovery and development program. Effective treatments for COVID-19 are critical to saving lives. The federal government will establish a comprehensive, integrated, and coordinated preclinical drug discovery and development program, with diverse clinical trials, to allow therapeutics to be evaluated and developed rapidly in response to COVID-19 and other pandemic threats. This includes promoting the immediate and rapid development of therapeutics that respond to COVID-19 by developing new antivirals directed against the coronavirus family, accelerating research and support for clinical trials for therapeutics in response to COVID-19 with a focus on those that can be readily scaled and administered, and developing broad-spectrum antivirals to prevent future viral pandemics. President Biden will issue Executive Order Improving and Expanding Access to Care and Treatment for COVID-19 which also outlines steps to bolster clinical care capacity, provide assistance to long-term care facilities and intermediate care facilities for people with disabilities, increase health care workforce capacity, expand access to programs designed to meet long-term health needs of patients recovering from COVID-19, and support access to safe and effective COVID-19 therapies for those without coverage.
Develop actionable, evidence-based public health guidance. CDC will develop and update public health guidance on containment and mitigation that provides metrics for measuring and monitoring the incidence and prevalence of COVID-19 in health care facilities, schools, workplaces, and the general public, including metric-driven reopening guidance that the federal government communicates widely. Informed by up-to-date national and state data, the CDC will provide and update guidance on key issues such as physical distancing protocols, testing, contact tracing, reopening schools and businesses, and masking. The CDC also will provide focused guidance for older Americans and others at higher risk, including people with disabilities.
Expand the U.S. public health workforce and increase clinical care capacity for COVID-19. In addition to supporting the surge in health care workers for vaccination efforts detailed in Goal Two, the federal government will also build and support an effective public health workforce to fight COVID-19 and the next public health threat. As part of the President’s commitment to provide 100,000 COVID-19 contact tracers, community health workers, and public health nurses, the Administration will establish a U.S. Public Health Jobs Corps, provide support for community health workers, and mobilize Americans to support communities most at-risk. The United States will also provide technical support for testing, contact tracing, and other urgent public health workforce needs to better prepare for public health crises.
Improve data to guide the response to COVID-19. Federal agencies will make increased use of data to guide the public health response against COVID-19. To that end, Agencies will collect, aggregate, share, and analyze non-personally identifiable data, and take steps to make it publicly available and in a machine-readable form to enhance COVID-19 response efforts. And the federal government will facilitate evidence-based decision-making through focused data-based projects. These efforts will require collaboration with state, local, Tribal, and territorial governments to aggregate and analyze data for critical decisions to track access to vaccines and testing, reopen schools and businesses, address disparities in COVID-19 infections and health outcomes, and enhance critical monitoring capacity where needed. In addition, critical response activities such as workforce mobilization and vaccination appointment scheduling may require new technology solutions. The federal government will provide technical support to ensure that these systems meet mission critical requirements to support a robust response.
Goal 4: Immediately expand emergency relief and exercise the Defense Production Act.
It’s past time to fix America’s COVID-response supply shortage problems for good. The United States will immediately address urgent supply gaps, which will require monitoring and strengthening supply chains, while also steering the distribution of supplies to areas with the greatest need. As new vaccines, testing protocols, and treatments are developed, they will also need to be manufactured in sufficient supply. To respond to this unprecedented operational challenge, the President is immediately expanding emergency relief by giving state and local governments the support they need. To make vaccines, tests, Personal Protective Equipment (PPE), and other critical supplies available for the duration of the pandemic, the President has directed the use of all available legal authorities, including the Defense Production Act (DPA), instructing departments and agencies to expand the availability of critical supplies, to increase stockpiles so that PPE is available to be used in the recommended safe manner, and to start to fill all supply shortfalls immediately. To expand emergency relief and strengthen the supply chain, the government will:
Increase emergency funding to states and bolster the Federal Emergency Management Agency (FEMA) response. The President will issue a Presidential Memorandum entitled Extend Federal Support to Governors’ Use of National Guard to Respond to COVID-19 and to Increase Reimbursement and other Assistance Provided to States, directing FEMA to fully reimburse states for the cost of National Guard personnel and emergency supplies, including emergency supplies like PPE for schools and child care providers.
Fill supply shortfalls by invoking the Defense Production Act (DPA). The United States is taking immediate action to fill supply shortfalls for vaccination supplies, testing supplies, and PPE. The President will issue Executive Order A Sustainable Public Health Supply Chain which directs agencies to fill supply shortfalls using all available legal authorities, including the DPA, and the United States has identified twelve immediate supply shortfalls that will be critical to the pandemic response, including shortages in the dead-space needle syringes available to administer the vaccine. The President has directed relevant agencies to exercise all appropriate authorities, including the DPA, to accelerate manufacturing, delivery, and administration to meet shortfalls in these twelve categories of critical supplies, including taking action to increase the availability of supplies like N95 masks, isolation gowns, nitrile gloves, polymerase chain reaction (PCR) sample collection swabs, test reagents, pipette tips, laboratory analysis machines for PCR tests, high-absorbency foam swabs, nitrocellulose material for rapid antigen tests, rapid test kits, low dead-space needles and syringes, and all the necessary equipment and material to accelerate the manufacture, delivery, and administration of COVID-19 vaccine.
Identify and solve urgent COVID-19 related supply gaps and strengthen the supply chain.The A Sustainable Public Health Supply Chain executive order will also direct federal agencies to fill supply shortfalls using all available legal authorities.The federal government will focus on the near-term goal of building a stable, secure, and resilient supply chain with increased domestic manufacturing in four key critical sectors:
Antigen and molecular-based testing;
PPE and durable medical equipment;
Vaccine development and manufacturing; and
Therapeutics and key drugs.
The federal government will immediately focus on procuring supplies that will be critical to control the spread of COVID-19 by initiating contracts, entering into purchase commitments, making investments to produce supplies and expanding manufacturing capacity.
Secure the pandemic supply chain and create a manufacturing base in the United States. To respond more effectively to this crisis, and ensure that the United States is able to respond more quickly and efficiently to the next pandemic, we need a resilient, domestic public health industrial base. The U.S. Government will not only secure supplies for fighting the COVID-19 pandemic, but also build toward a future, flexible supply chain and expand an American manufacturing capability where the United States is not dependent on other countries in a crisis. To this end, A Sustainable Public Health Supply Chain will direct the development of a new Pandemic Supply Chain Resilience Strategy.
Improve distribution and expand availability of critical materials. After conducting a review of existing COVID-19 and related pandemic supply chain distribution plans and working in consultation with state and regional compacts, the United States will coordinate distribution plans, prioritizing areas of highest-risk and highest need, and set up a structure to improve the distribution of critical materials. To work toward expanding the affordability and accessibility of supplies, A Sustainable Public Health Supply Chain will direct the Department of Defense (DOD), HHS, and Department of Homeland Security (DHS) to develop recommendations to address the pricing of COVID-19 supplies. The federal government will also reduce the opacity of the market for critical supplies and supply chains by clearly and rapidly communicating with states, health care providers, and manufacturers about federal interventions.
Goal 5: Safely reopen schools, businesses, and travel, while protecting workers.
Reopening schools, businesses, travel, and our economy will require major, unified federal investments in rapid testing, an expanded rapid response public health workforce, clear guidance and protections, and support for people to stay home when they are infected to stop the spread of COVID-19. At the same time that the United States takes immediate steps to achieve an overall decrease in COVID-19 spread, it will also support the safe operation of schools, businesses, and travel. To protect workers and safely reopen, schools, businesses, and travel, the United States will:
Implement a national strategy to support safely reopening schools. The United States is committed to ensuring that students and educators are able to resume safe, in-person learning as quickly as possible, with the goal of getting a majority of K-8 schools safely open in 100 days. The President will issue Executive Order Supporting the Reopening and Continuing Operation of Schools and Early Childhood Education Providers which directs a national strategy for safely reopening schools, including requiring the Departments of Education and HHS to provide guidance on safe reopening and operating, and to develop a Safer Schools and Campuses Best Practices Clearinghouse to share lessons learned and best practices from across the country. Presidential Memorandum Extend Federal Support to Governors’ Use of National Guard to Respond to COVID-19 and to Increase Reimbursement and other Assistance Provided to States will restore full reimbursement for eligible costs necessary to support safe school reopening through the FEMA Disaster Relief Fund and the President has called on Congress to provide at least $130 billion in dedicated funding to schools, $350 billion in flexible state and local relief funds that will help districts avoid lay-offs and close budget gaps, and additional resources so that schools can safely reopen, including funds to implement screening testing. The Administration will release a handbook that helps schools and local leaders implement the precautions and strategies necessary for safe reopening. It will also work with states and local school districts to support screening testing in schools, including working with states to ensure an adequate supply of test kits.
Support safe operations at child care centers and at-home providers. With enrollments down and costs up due to COVID-19 precautions, child care providers are struggling to stay afloat while providing vital services to their communities. Due to increased costs and lower enrollment, a recent survey of child care providers showed that most child care providers expect that they will close within a few months without relief, or are uncertain how long they can stay open. If not addressed, child care providers will close and millions of parents will be left to make devastating choices between caring for their children and working to put food on the table. President Biden has called on Congress to provide $25 billion in emergency stabilization to support hard-hit child care providers through the pandemic. These funds would help providers pay rent, utilities, and payroll, as well as cover pandemic-related costs like personal protective equipment, ventilation supplies, smaller group sizes, and alterations to physical spaces that improve safety. The President has also called on Congress to provide $15 billion to help families struggling to afford child care.
Support equitable reopening and operation in higher education. College enrollment for high school graduates was down more than 20% in 2020 compared to 2019, and students from low-income families are nearly twice as likely to report canceling their plans to attend college. Reopening and keeping colleges open is critical to ensuring that all Americans have a shot at a college credential — but it must be done safely, to protect the health of students, faculty, staff, and the broader community. To support colleges through the pandemic, President Biden has requested that Congress provide an additional $35 billion in emergency stabilization funds for higher education.
Protect workers and issue stronger worker safety guidance. It is critical that the federal government protect the health and safety of America’s workers and take swift action to prevent workers from contracting COVID-19 in the workplace. The President will issue Executive Order Protecting Worker Health and Safety which directs the Occupational Safety and Health Administration (OSHA) to issue updated guidance on COVID-19 worker protections. It also directs OSHA and the Mine Safety and Health Administration (MSHA) to consider whether emergency temporary standards, including with respect to mask-wearing, are necessary. President Biden is taking steps to cover workers not typically covered by OSHA or MSHA by directing agencies like the Department of Transportation to keep workers safe. He has also called on Congress to extend and expand emergency paid leave; to allow OSHA to issue standards covering a broad set of workers, like many public workers on the frontlines; to provide additional funding for worker health and safety enforcement, and to provide grant funding for organizations to help keep vulnerable workers healthy and safe from COVID-19.
Provide guidance and support to safely open businesses. To maintain safe operations during the pandemic, businesses need to know how to change their practices to protect employees and customers. As the conditions of the pandemic continue to evolve and more Americans get vaccinated, the business community needs clear information from the federal government on what to expect and how to adapt their operations. Many businesses affected by the pandemic–particularly the smallest ones–need additional support to adjust their physical spaces and purchase PPE and supplies. The United States will immediately work to prioritize funds under the recent COVID relief package to the companies hardest hit by COVID-19 and in compliance with public health restrictions, ensuring that small businesses have the funds they need to operate safely. Further, the Small Business Administration will work with the Department of Labor to disseminate updated OSHA guidance on worker safety and support businesses in implementing the updated guidance.
Promote Safe Travel. Ensuring that people can safely travel will be critical for families and to jumpstarting the economy, which is why the President will issue an executive order that requires mask-wearing on certain public modes of transportation and at ports of entry to the United States. For international air travel, Executive Order Promoting COVID-19 Safety in Domestic and International Travel will require a recent negative COVID-19 test result prior to departure and quarantine on arrival, consistent with CDC guidelines. The Executive Order will also direct agencies to develop options for expanding public health measures for domestic travel and cross-border land and sea travel and calls for incentives to support and encourage compliance with CDC guidelines on public transportation.
Goal 6: Protect those most at risk and advance equity, including across racial, ethnic and rural/urban lines.
The COVID-19 pandemic has exposed and exacerbated severe and pervasive health inequities among communities defined by race, ethnicity, geography, disability, sexual orientation/gender identity, and other factors. Addressing this pandemic’s devastating toll is both a moral imperative and pragmatic policy. The federal government will address disparities in rates of infection, illness and death. Each of the goals of this National Strategy include comprehensive actions that will address these disparities and advance equity. In addition, the United States will:
Establish the COVID-19 Health Equity Task Force. The President will issue Executive Order Ensuring an Equitable Pandemic Response and Recovery which establishes a high-level task force to address COVID-19 related health and social inequities and help coordinate an equitable pandemic response and recovery. The Task Force will convene national experts on health equity and provide recommendations on how to mitigate COVID-19 health inequities.
Increase data collection and reporting for high risk groups. The fragmented and limited availability of data by race, ethnicity, geography, disability and other demographic variables delays recognition of risk and a targeted response. President Biden will issue the Executive Order Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats directing federal agencies to expand their data infrastructure to increase collection and reporting of health data for high risk populations, while reaffirming data privacy. Using these data, the federal government will identify high-risk communities, track resource distribution and evaluate the effectiveness of the response. Finally, HHS will optimize data collection from public and private entities to increase the availability of data by race, ethnicity, geography, disability, and other demographic variables, as feasible.
Ensure equitable access to critical COVID-19 PPE, tests, therapies and vaccines. The continued surge of COVID-19 highlights the critical importance of meaningful access to PPE, tests, therapies, and vaccines to prevent spread and reduce illness and death in high-risk populations and settings. The federal government will center equity in its COVID-19 response, providing PPE, tests, vaccines, therapeutics and other resources in a fair and transparent way. A targeted, stakeholder- and data-informed vaccination communication campaign will be launched to encourage vaccination in all communities. Additionally, the CDC will work with states and localities to update their pandemic plans. Finally, through prioritizing diverse and inclusive representation in clinical research and strengthening enforcement of anti-discrimination requirements, the federal government will increase access to effective COVID-19 care and treatment.
Expand access to high quality health care. The federal government will work to expand affordable coverage to increase access to care during this pandemic, and the Task Force will provide recommendations to align federal incentives with improved clinical outcomes. Specific actions include efforts to increase funding for community health centers, provide greater assistance to safety net institutions, strengthen home- and community-based services, expand mental health care, and support care and research on the effects of long COVID.
Expand the clinical and public health workforce, including community-based workers. In order to assure equitable PPE distribution, testing, contact tracing, social support for quarantine and isolation and vaccination, there must be sufficient workforce to serve the communities in greatest need. The federal government will augment the health workforce, including with community based workers, as outlined in Goal Three above, to help fill this critical gap. The federal government will create a United States Public Health Workforce Program of new community based workers to assist with testing, tracing and vaccination. Additionally, it will deploy federal workers to assist with the COVID-19 response in under-resourced areas.
Strengthen the social service safety net to address unmet basic needs. With millions of families already struggling pre-pandemic to meet basic needs, including food, housing and transportation, COVID-19 has exacerbated these challenges. These challenges contribute to difficulties by many to adhere to public health guidance regarding social distancing and quarantine/isolation. This Administration is committed to addressing these needs in multiple ways, including providing paid sick leave, child care support, and rental assistance, with requested Congressional appropriations. Additionally, it will undertake agency actions to designate COVID-19 health equity leads and extend eligibility and enrollment flexibilities for select programs during the pandemic, as well work with community-based, multi-sector organizations to align health and social interventions.
Support communities most at-risk for COVID-19. The federal government is committed to supporting populations that are most vulnerable to COVID-19. Whether residing in congregate settings (such as prisons, nursing and group homes, and homeless shelters), serving as essential workers, living as a person with a disability, or bearing the burden of chronic medical conditions, these vulnerable populations are disproportionately composed of people of color. The CDC will develop and update clear public health guidance for such high-risk populations and settings to further minimize the risk of COVID infection, and work with states to update their pandemic plans to incorporate such guidance as necessary.
Goal 7: Restore U.S. leadership globally and build better preparedness for future threats.
U.S. international engagement to combat COVID-19, promote health, and advance global health security is urgent to save lives, promote economic recovery, and develop resilience against future biological catastrophes. America’s withdrawal from the world stage has impeded progress on a global COVID-19 response and left the U.S. more vulnerable to future pandemics. The Biden-Harris Administration will restore America’s role in leading the world through global crises, advancing global health security and the Global Health Security Agenda, including by supporting the international pandemic response effort, providing humanitarian relief and global health assistance, and building resilience for future epidemics and pandemics. The President will issue a National Security Directive that directs steps to restore U.S. leadership globally and build better preparedness. In addition, the United States of America will:
Restore the U.S. relationship with the World Health Organization and seek to strengthen and reform it. The World Health Organization (WHO) is essential to coordinating the international response to COVID-19 and improving the health of all people. On his first day in office, the President sent letters informing the UN Secretary-General and the WHO Director General of his decision to cease the previous Administration’s process of withdrawal from the WHO and meet its financial obligations. The United States is participating in the WHO Executive Board meeting this month, and will take actions to strengthen and reform the WHO.
Surge the international COVID-19 public health & humanitarian response. The United States will commit to multilateralism in the international COVID-19 public health and humanitarian response. The President will restore U.S. leadership on the global COVID-19 response and health security, laying out an active role for the United States in surging the health and humanitarian response to COVID-19, and supporting global vaccine distribution and research and development for treatments, tests, and vaccines. The United States will support the Access to COVID-19 Tools (ACT) Accelerator, join the COVID-19 Vaccines Global Access (COVAX) Facility, and seek to strengthen other existing multilateral initiatives, such as the Coalition for Epidemic Preparedness Innovations; Gavi, the Vaccine Alliance; and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. The United States will also take steps to enhance humanitarian relief and support for the capacity of the most vulnerable communities to prevent, detect, respond to, mitigate, and recover from impacts of COVID-19, such as food insecurity and gender-based violence.
Restore U.S. leadership to the international COVID-19 response and advance global health security and diplomacy. The United States will promote sustainable global health and global health security, rebuild health security alliances, elevate U.S. efforts to support the Global Health Security Agenda, and revitalize U.S. leadership. The United States will advance global health security financing, promote efforts to harmonize crisis response and early warning for public health emergencies, and strengthen global pandemic supply chains. The United States will also work within the UN Security Council and with partners to strengthen multilateral public health and humanitarian cooperation on the COVID-19 response, global institutions to combat disease, and a global health security architecture to prevent, detect, and respond to future biological threats.
Build better biopreparedness and expand resilience for biological threats. The United States is committed to strengthening U.S. biopreparedness and capacity to counter COVID-19 and future biological threats. The President has immediately restored the White House National Security Council Directorate for Global Health Security and Biodefense, originally established by the Obama-Biden administration. He has reconstituted White House and Administration-wide infrastructure for monitoring and responding to emerging biological risks. And to improve the United States’ preparedness, the Administration will work to secure funding and Congressional support to establish an integrated, National Center for Epidemic Forecasting and Outbreak Analytics to modernize global early warning and trigger systems to prevent, detect, and respond to biological threats. The United States will also review and seek to strengthen our pandemic supply chain, public health workforce, medical countermeasure development and distribution, bioeconomic investment and technology-related risks.