Recovery Act Funds Efforts to Address Infections in Surgery Centers

HHS Secretary Kathleen Sebelius today provided the down payment for a nationwide effort to reduce healthcare-associated infections (HAIs)  in same-day surgical centers. The first effort will begin later this month in 12 states under provisions of the American Recovery and Reinvestment Act of 2009, administered by the Centers for Medicare & Medicaid Services (CMS).

“Keeping patients healthy is one of the requirements of the Recovery Act, and the first 12 states that have volunteered to focus attention on these surgical centers are taking a giant step in helping to reduce infections that affect millions of patients every year,” said Sebelius.  “CMS’s efforts with states to reduce the number of infections quickly are just one part of protecting the health of the nation’s healthcare system.”

“People go to the hospital to get well, not take on a new infection.  These Recovery Act funds will help to identify why there has been such an increase in health-care associated infections and, importantly, what can be done to prevent them,” Sebelius said. “This is what the Recovery Act is all about:  putting people to work to solve an important issue and improve the quality of life for Americans for many years to come.”

Increasingly, healthcare delivery is being shifted to outpatient settings such as ambulatory care facilities, long -term care facilities, and free standing specialty care sites. The number of ambulatory surgery centers has grown dramatically and continues to increase. The Centers for Disease Control and Prevention (CDC) saw an increase in the number of HAIs in outpatient settings due to unsafe medical practices.  The overall burden of HAIs in outpatient settings is unknown; however, it is evident from the infections that have been identified that it is a significant problem resulting from very basic infection control failures, and requires additional oversight by CMS.

The 12 states – Maine, New Jersey, Maryland, Florida, North Carolina, Indiana, Michigan, Arkansas, Oregon, Utah, Wyoming and Kansas – will survey more than 125 ambulatory surgery centers (ASCs) before Sept. 30, 2009, at an estimated cost of up to $1 million. The onsite reviews, paid for out of Recovery Act funds, are designed to ensure that the facilities are following Medicare’s health and safety standards. As part of the new initiative, state surveyors will employ a new CMS survey process that uses a tool developed in conjunction with CDC.  In addition, Recovery Act funds will increase the number of ASCs surveyed.

ASCs account for 43 percent of all same-day (ambulatory) surgery in the United States, amounting to about 15 million procedures every year.  Typical surgical procedures conducted in ASCs include endoscopies and colonoscopies (including removal of identified polyps), orthopedic procedures, plastic/reconstructive surgeries, and eye, foot, and ear/nose/throat surgeries.

In addition to the funds being made available today, an additional $9 million will be available in October 2009 for all states to make additional inspections of ASCs with the new, improved survey tool. The CDC will also make $40 million available to state public health departments to create or expand state-based HAI prevention and surveillance efforts, and strengthen the public health workforce trained to prevent HAIs.  These funds support activities outlined in HHS’ 2009 Action Plan to Prevent Health care-Associated Infections, available at

“We will make sure that providers have good information about ways to prevent serious infections,” said Sebelius. “And we will make onsite inspections to ensure that good infection control practices are being followed.”

The following is a list of states and the funding they will receive:

 Arkansas: $14,000

 Florida: $16,250

 Indiana: $62,500

 Kansas: $53,500

 Maine:  $13,500

 Maryland:  $73,000

 Michigan: $53,000

 New Jersey: $125,000

 North Carolina:  $34,000

 Oregon:  $53,500

 Utah: $62,500

 Wyoming:  $11,500

 Total for states and the District of Columbia: $572,250