Public Health Emergency - Leading a Nation Prepared
When incident needs challenge or exceed the medical or public health response capabilities of local, State, Tribal, or regional response assets, Federal public health and medical assistance may be made available under ESF #8 of the NRP. This support may be provided in response to a variety of public health and medical events, including the following:
The Pandemic and All Hazards Preparedness Act amended section 2801 of the PHS Act to state that the Secretary of HHS shall lead all Federal public health and medical response to public health emergencies and incidents covered by the NRP. Federal public health and medical assistance provided under ESF #8 of the NRP may be categorized according to the functional areas described below.
Medical Care Personnel is a key functional area of the ESF #8 response. The USPHS Commissioned Corps provides public health, humanitarian, and clinical services and personnel during an emergency, disaster, or other urgent public health need. Based on lessons learned from Hurricane Katrina, the USPHS adopted a tiered response posture of rapidly deployable, well-trained, and well-equipped teams. Below is a brief description of the USPHS teams currently available. Other USPHS teams may be phased in across coming years as the USPHS continues to examine and enhance its response capability.
Overview of USPHS Commissioned Corps teams
USPHS active duty officers who are not members of the aforementioned teams comprise supporting personnel who can deploy as teams or individuals within 72 hours of notification. Beyond the 72-hour mark, the USPHS Inactive Reserve Corps may be called on to augment the Active Duty Corps.
The National Disaster Medical System (NDMS) is another source of public health and medical personnel under ESF #8. The NDMS helps maintain our national capability to deliver quality medical care during domestic incidents that challenge or exceed normal medical capabilities or infrastructure in an affected area. NDM can provide assistance in three areas—field care, casualty evacuation, and definitive care—to support HHS under ESF #8 of the NRP.
Overview of NDMS teams
The NDMS is a nationwide partnership designed to deliver quality medical care to the victims of, and responders to, a domestic disaster. NDMS provides state-of-the-art medical care under any conditions at a disaster site, in transit from the impacted area, and into participating definitive care facilities. The main NDMS teams consist of the following:
Additional medical care personnel are available through ESF #8 support agencies, such as the VA and DoD, and through the Medical Reserve Corps. During Hurricanes Katrina and Rita, the VA and DoD played significant roles in supporting ESF #8 missions. The VA (both facilities and personnel) was prominently involved in the operation of FMSs, while the DoD supplied aircraft, equipment, and personnel to facilitate the evacuation of patients and persons with special medical needs to facilities where they could receive appropriate care.
The Federal Government can also provide public health and medical equipment to support local response efforts during a public health emergency or disaster. One such deployable asset is the FMS, which can be used as a healthcare platform for stable patients with low acuity or primary healthcare needs. Below is a basic description of the FMS and its operating requirements.
The Federal Medical Station (FMS) is an HHS deployable healthcare platform that can deliver large-scale primary healthcare services anywhere in the U.S. A team of approximately 100 personnel is needed to staff the FMS, with personnel provided primarily by the USPHS. Each FMS contains a three-day supply of medical and pharmaceutical resources to sustain 250 stable primary care based patients who require bedding services. Additional roles for the FMS may include the following:
The FMS must be housed inside a structurally intact building that has roughly 40,000 square feet of space, a 10-person set up team, electricity, heating, air conditioning, ventilation, and clean water services. Reduced bed requirements can be accommodated in smaller facilities. Other operational requirements include bathroom and showering facilities, billeting for staff, and contracted support for food, potable water, laundry, ice, medical oxygen filling, and biomedical waste disposal. The FMS requires 48-96 hours from the time of request to delivery inside the continental U.S. and a 12-hour assembly time.
To address primary healthcare service needs far forward in a disaster area, HHS has a community outreach capability ("Go Bag") that is a rapidly deployable light strike team-based platform. Staffed primarily by the USPHS, each platform has basic medical and pharmaceutical resources to sustain 50 to 100 stable primary care based ambulatory patients.
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