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# Federal Support to Expand National Testing Capabilities

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Testing is critical to slow the spread of coronavirus (COVID-19) and mitigate its threat to public health. President Trump has led a historic effort to revolutionize testing in the United States to confront this challenge.

Under President Trump’s Guidelines for Opening America Up Again, states should meet at least five metrics before proceeding to a phased reopening which includes demonstrating a downward trajectory of COVID-19 cases over a 14-day period as well as maintaining a robust system for testing health care workers. The Administration’s Opening Up America Again Testing Overview and Testing Blueprint are designed to facilitate state development and implementation of the robust testing plans and rapid response programs described in the guidelines.
                        - The President’s Testing Blueprint sets forth the partnership between federal, state, local, and tribal governments, along with the private-sector and professional associations, all of which will play important roles in meeting the Nation’s testing needs.
                        - The federal government provides strategic guidance on the best use of available technologies, approves new tests to expand capacity, shares best practices with states, and more.
                        - As different localities have different needs, including the needs of low-income individuals, older adults, persons with disabilities, persons with limited English proficiency, and members of communities of color, states should each develop testing plans and rapid response programs that fit the needs of their communities and ensure equitable delivery of testing to individuals with civil rights protections.
                        - States should make full use of the testing resources available to them, to include leveraging the full capacity available through commercial, hospital and academic laboratories in addition to the capability available through public health laboratories.

To support the Administration’s Testing Blueprint, FEMA, at the direction of the White House Coronavirus Task Force, is working to source and procure testing material – specifically, testing swabs and transport media. The FEMA-sourced material will be provided to states, territories and tribes for a limited duration to help increase testing capacity in support of their individualized reopening and testing plans. Once sourced and procured, the intent is to have this material shipped directly to the necessary location within each state, territory or tribe for their ultimate distribution. Each state, territory and tribal will develop its own distribution strategy to align with its testing plan and unique needs.

### Actions to Increase Testing

As part of the whole-of-America response, HHS and FEMA lead a joint federal Laboratory Diagnostics Task Force focused on multiple paths to increase nationwide COVID-19 testing and support to governors nationwide to have the equipment, supplies, and testing resources needed to reopen safely and responsibly. Key actions taken by this Task Force include:
                        - Supported states in identifying additional testing capacity and increasing use of testing platforms.
                        - Worked with diagnostic test developers and manufacturers to encourage rapid development of new technologies and scale up testing inventory.
                        - Distributed point-of-care analyzers and test kits to public health labs in all 50 states and U.S territories, as well as tribal communities through the Indian Health Service.
                        - Expanded reporting options for hospital diagnostic testing data through the HHS Protect system, which reduces burden on hospitals and ensures that the federal government has access to all in-house hospital laboratory testing data.
                        - Coordinated an interagency project team to include the White House, Food and Drug Administration, the National Institutes of Health, the Centers for Disease Control and Prevention, the Biomedical Advanced Research and Development Authority and the Department of Defense to rapidly characterize the performance of serological diagnostic tests.	                           - Extensive serological antibody testing will provide the nation with more dense, broad-based data to look for prevalence of the COVID-19 antibody. 
                        - Provided expert guidance to assist in rapid response to localized outbreaks in industries providing critical infrastructure.
                        - Collaborated with the Department of Energy labs and manufacturers to expand capacity for sample transportation, storage and preparation for optimal utilization of available tests and testing platforms.
                        - Expanded items supplied by the CDC’s International Reagent Resource (IRR) to help registered public health labs access diagnostics supplies and reagents for COVID-19 testing free of charge, including:	                           - Consolidating ordering of testing supplies under the IRR to simplify the resource request process for states and territories and alleviate the burden on registered public health labs from needing to work with separate suppliers for access to swabs, reagents and other critical diagnostic testing supplies. 

### Community-Based Testing Sites

The Community-Based Testing Sites (CBTS) program, a short-term, high-impact initiative, was developed for states, local public health agencies, healthcare systems, and commercial partners as they work together to stop the spread of COVID-19 in their communities. This program focused initially on healthcare facility workers and first responders who are working around the clock to provide care and ensure the safety of Americans and now provides testing to asymptomatic and symptomatic individuals per the CDC testing criteria.
                        - 41 federal CBTS locations were approved with 151,950 samples tested as of May 5.
                        - CBTS focused initially on testing healthcare facility workers and first responders as they need to know their status to prevent infecting individuals in their care.
                        - The task force also prepared and distributed best practices for nasal self-swabbing to collect samples for COVID-19 testing, resulting in a reduction in the amount of required personal protective equipment.
                        - HHS and FEMA are working with states to assist them as they transition from federal to state managed sites.
                        - Public-Private Partnership (CBTS 2.0) has expanded with private partners to include over 100 sites in 33 states. Through further expansion, the goal is to have over 200 sites in all 50 states, the District of Columbia and Puerto Rico with the ability to perform 15,000 tests per day.

### Federal Reimbursement of Testing

                        - States, territories, tribes, and local governments may seek reimbursement for eligible expenses associated with coronavirus testing through FEMA’s Public Assistance program.
                        - More information on what COVID-19 activities are eligible for reimbursement under the Public Assistance program can be found in the  COVID-19 Pandemic: Eligible Emergency Protective Measures fact sheet  and the  COVID-19 Pandemic: Emergency Medical Care fact sheet .
                        - CDC  provided supplemental funding  through existing cooperative agreements to a number of states and local jurisdictions identified as having the highest number of reported COVID-19 cases and jurisdictions with accelerating or rapidly accelerating COVID-19 cases. These awards support a range of activities such as lab equipment, supplies, staffing, shipping, infection control, monitoring of individuals, and data management.
                        - The President signed the bipartisan Families First Coronavirus Response Act, which offers free coronavirus testing – including free testing through commercial insurance, Medicare, Medicaid, CHIP, Indian Health Service, and TRI-CARE.
                        - The Families First Coronavirus Response Act also appropriates $1 billion to reimburse providers for conducting coronavirus testing for the uninsured.

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Last updated March 17, 2021

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