Federal public health medical assistance consists of medical materiel, personnel, and technical assistance. These resources may provide response capability for the triage, treatment, and transportation of victims or persons with special medical needs; evacuation of patients; infection control; mental health screening and counseling; environmental health services; and other emergency response needs. Exhibit 7-1 presents the full range of support available through ESF #8. A variety of Federal public health and medical assets may be provided, including the following:
USPHS Commissioned Corps teams
- Rapid Deployment Force (RDF): The RDF consists of five pre-identified teams, each with 105 multidisciplinary staff. The teams serve on a rotating call basis, with the on-call team capable of deploying within 12 hours of notification. RDF teams have a built-in command structure and can provide mass care at shelters (including FMSs), and staff Points of Distribution and Casualty Collection Points. The RDF can also conduct community outreach and assessments, among other functions.
- Applied Public Health Team (APHT): The APHT is composed of experts in applied public health and can function as a “public health department in a box.” An APHT can deploy within 36 hours of notification and provide assistance in public health assessments, environmental health, infrastructure integrity, food safety, vector control, epidemiology, and surveillance.
- Mental Health Team (MHT): The MHT consists of mental and behavioral health experts who assess stress and suicide risks within the affected population, manage responder stress, and provide therapy, counseling, and crisis intervention. The MHT can deploy within 36 hours of notification.
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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 in participating definitive care facilities. The main NDMS teams consist of the following:
- Disaster Medical Assistance Team (DMAT): DMATs provide primary and acute care, triage of mass casualties, initial resuscitation and stabilization, advanced life support and preparation of sick or injured for evacuation. The basic deployment configuration of a DMAT consists of 35 persons; it includes physicians, nurses, medical technicians, and ancillary support personnel. They can be mobile within 6 hours of notification and are capable of arriving at a disaster site within 48 hours. They can sustain operations for 72 hours without external support. DMATs are responsible for establishing an initial (electronic) medical record for each patient, including assigning patient unique identifiers in order to facilitate tracking throughout the NDMS.
- Disaster Mortuary Operational Response Team (DMORT): MORTs work under the guidance of local authorities by providing technical assistance and personnel to recover, identify, and process deceased victims. Teams are composed of funeral directors, medical examiners, coroners, pathologists, forensic anthropologists, medical records technicians and transcribers, fingerprint specialists, forensic odonatologists, dental assistants, x-ray technicians, and other personnel. HHS also maintains several Disaster Portable Morgue Units (DPMU) that can be used by DMORTs to establish a stand-alone morgue operation.
- National Veterinary Response Team (NVRT): NVRT provides assistance in identifying the need for veterinary services following major disasters, emergencies, public health or other events requiring Federal support and in assessing the extent of disruption to animal and public health infrastructures.
- National Medical Response Team (NMRT): NMRTs provide medical care following a nuclear, biological, and/or chemical incident. This team is capable of providing mass casualty decontamination, medical triage, and primary and secondary medical care to stabilize victims for transportation to tertiary care facilities in a hazardous material environment. The basic deployment configuration of an NMRT consists of 50 personnel.
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Strategic National Stockpile (SNS)
The SNS is a national repository of antibiotics, chemical antidotes, antitoxins, life-support medications, IV administration and airway maintenance supplies, and medical/surgical items. The SNS is designed to supplement and re-supply State and local public health agencies in the event of a national emergency anywhere and at anytime within the U.S. or its territories. Learn More >>
Federal Medical Station (FMS)
The FMS is an HHS deployable healthcare facility that can provide surge beds to support healthcare systems anywhere in the U.S. that are impacted by disasters or public health emergencies. FMS are not mobile and cannot be relocated once established.
Each FMS comes with a three-day supply of medical and pharmaceutical resources to sustain from 50 to 250 stable primary or chronic care patients who require medical and nursing services. Staffing for an FMS can be provided using displaced local, regional or EMAC providers, or can be provided by the federal government (primary federal staff are Officers of the U.S. Public Health Service Commissioned Corps). Potential roles for an FMS include the following:
- Provide temporary holding and care for patients to decompress a local hospital (increase beds available for patients with disaster-related trauma or illness
- Receive patients from nursing homes and skilled nursing facilities forced to evacuate due to the disaster
- Provide low acuity care for patients with chronic illnesses whose access to care is impeded due to the disaster
Because the equipment and supply cache does not include tents, each FMS requires an appropriate building of opportunity* in which to operate. Significant preparation is needed to employ FMSs in support of local, State, Tribal, and Territorial emergency plans. An FMS must be established in a structurally intact, accessible building with adequate hygiene facilities and functioning utilities (hot and cold potable water, electricity, heating, ventilation, and air conditioning, and internet accessibility or capability).
A 250-bed FMS requires roughly 40,000 square feet of open space, while a 50-bed FMS requires about 15,000 square feet. In addition, wrap around logistical services must be coordinated and in place before an FMS can be operational. Some of these include a 10-12 person set up team, contracted support for patient feeding, laundry, ice, medical oxygen, and biomedical waste disposal. Fewer beds can be set up in smaller facilities, but building attributes and wrap around services remain the same.
Once a request for FMS has been approved, the cache of equipment and supplies will be delivered in 24-48 hours, after which 12 hours is planned for set-up. ASPR Regional Emergency Coordinators are the primary points of contact for FMS preparedness by State, local, Tribal and Territorial authorities. CDC Division of Strategic National Stockpile (DSNS) can assist with site surveys and training for receipt and set-up of FMSs.
Medical Reserve Corps
The MRC is comprised of organized medical and public health professionals who serve as volunteers to respond to natural disasters and emergencies. The MRC program provides the structure necessary to deploy medical and public health personnel in response to an emergency, as it identifies specific, trained, credentialed personnel available and ready to respond to emergencies.
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Learn More about Medical Surge Capacity Capability (MSCC)