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U.S. Department of Health and Human Services

Medical Surge Capacity Capability (MSCC)

MSCC Handbook

The primary role of Federal resources in providing medical surge capacity and capability (MSCC) is to support, not supplant, State, Tribal, and jurisdictional response efforts. When the NRF is triggered by a Presidential declaration of a major disaster or emergency under the Stafford Act, Federal assistance generally is provided at the request of the Governor (or his/her designee) of an affected State.

In a catastrophic event, however, Federal assets may be mobilized and deployed to Federal installations in advance of a formal request for assistance. The Catastrophic Incident Supplement of the National Response Framework (NRF) establishes the policies, procedures, and mechanisms by which this may occur. The Federal Government closely coordinates this proactive mobilization with affected States, Tribal Nations, and jurisdictions.

On behalf of the Secretary of HHS, the Assistant Secretary for Preparedness and Response (ASPR) coordinates all aspects of Federal public health and medical assistance under ESF #8. The HHS Secretary’s Operations Center (SOC) is the hub of information management and strategic-level command and control for ESF #8. During an emergency, the HHS Emergency Management Group (EMG) operates out of the SOC to coordinate the ESF #8 response. The ASPR may request that liaisons from the ESF #8 support agencies  and HHS Operating Divisions (OPDIVs)*  be provided to the SOC to ensure a coordinated ESF #8 response.

The HHS Incident Response Coordination Team (IRCT), which is mobilized by the ASPR, coordinates all deployed ESF #8 assets. All field communications to the SOC flow through the IRCT, which is typically led by an HHS Regional Emergency Coordinator. The IRCT team leader is accountable for executing field activities for the ASPR. In a large-scale or complex incident, the Secretary of HHS may also deploy a Senior Health Official (SHO) to be his/her direct representative in the field. When deployed, the SHO is responsible for overarching coordination of deployed ESF #8 assets and provides guidance and leadership to the IRCT. The SHO serves as the senior-level ESF #8 liaison to State, Tribal, jurisdictional, and other Federal officials, including the Department of Homeland Security appointed Principal Federal Official (PFO). The SHO operates at the strategic level and reports to the EMG. Typically, the SHO is part of the PFO Coordination Cell and coordinates with the IRCT leadership.

As the primary Agency for ESF #8, HHS has developed a Concept of Operations Plan (CONOPS) that provides the framework for its management of the public health and medical response to an emergency or disaster.

Learn More about HHS Concept Of Operations Plan (CONOPs) FOR ESF #8

* HHS OPDIVs include the Centers for Disease Control and Prevention (CDC); Centers for Medicare and Medicaid Services (CMS); Food and Drug Administration (FDA); Indian Health Service (IHS); Health Resources and Services Administration (HRSA); Substance Abuse and Mental Health Services Administration (SAMHSA); National Institutes of Health (NIH); Agency for Healthcare Research and Quality (AHRQ); Administration for Children and Families (ACF); and Administration on Aging (AoA).

  • This page last reviewed: February 14, 2012