When needed, the federal government may be able to augment SLTT health and medical service needs. HHS coordinates the federal emergency public health and medical response via ESF #8 – Public Health and Medical Services, which supports medical response assistance for behavioral health needs, survivors and response workers, and veterinary health issues. Federal assistance can support health and medical services in three major ways: by providing more supplies, increased space and expanded care facilities, or personnel assistance.
5.6.1 Supplies, Space, and Personnel Assistance
5.6.1.1 Supplies
During biological incidents of national concern, the federal government may augment MCM supply and logistics. When needed, these materials may be provided by the federal government through the SNS or through state-validated requests under Stafford Act protocols, if a President approves or makes an emergency or major disaster declaration for the incident. However, if the scale of an incident becomes regional or national, local officials’ access to response resources, including the SNS, may be inhibited due to federal and state prioritization of needs. Additional SNS information can be found is KPF 3: Control the Spread of Disease.
When demand outpaces supply and there is a critical need, the Defense Production Act (DPA) serves as the source of presidential authority to expand the supply of materials and services from the U.S. industrial base and expedite delivery to promote national defense. During the COVID-19 pandemic, the DPA was invoked to increase production capacity of critically needed PPE and vaccine supplies to reduce the number of cases and fatalities.
5.6.1.2 Space
Overwhelmed healthcare systems may require SLTT emergency management assistance for the expansion of space and facilities to support stabilization of the Health and Medical Lifeline. Space and facilities assistance from the SNS through FMSs will also be considered upon request.89 These rapidly deployable caches contain beds, supplies, and medicines that can quickly transform any large building into a temporary medical shelter to take low acuity patients during an emergency.
5.6.1.3 Personnel
Biological incidents may require personnel support for SLTT healthcare infrastructure due to exposed or ill staff being unable to work, fear of exposure among staff, patient volume, or other factors. Several departments and agencies provide federal personnel support for healthcare infrastructure. The National Disaster Medical System (NDMS) is a federally coordinated healthcare system and partnership of HHS, DHS, DoD, and the Department of Veterans Affairs that is designed to support SLTT authorities following disasters and emergencies by supplementing health and medical systems and response capabilities.
National Disaster Medical System (NDMS)
Specifically, the NDMS can support patient care and movement, veterinary services, and fatality management support to requesting SLTT authorities or other federal departments via specialized teams that can be deployed in 12-48 hours (see below):90
- Disaster Medical Assistance Teams (DMATs)
- Trauma and Critical Care Teams (TCCTs)
- Disaster Mortuary Operational Response Teams (DMORTs)
- Victim Information Center Teams (VICs)
- National Veterinary Response Teams (NVRTs)
- National Medical Response Teams (NMRTs)
Additional health and medical assistance needs may surpass available NDMS resources, requiring a combination of skilled and non-skilled labor forces to provide service in accordance with their capabilities. Assistance may come from agencies supporting ESF #6 (Mass Care, Emergency Assistance, Housing, and Human Services), ESF #8 (Public Health and Medical Services) such as:
- HHS Commissioned Corps of the U.S. Public Health Service Readiness and Deployment Operations Group (RedDOG), available within 36 hours90
- Rapid Deployment Force – for mass care at shelters (including FMSs) and staffing at MCM/PPE distribution and casualty collection points (available within 12 hours)
- Applied Public Health Team – for assistance in public health assessments, environmental health, infrastructure integrity, food safety, vector control, epidemiology, and surveillance
- Mental Health Team – for assessing stress within the affected population and responders, and providing therapy and counseling
- HHS CDC Epi-Aid teams, which provide epidemiologic assistance to SLTT public health investigations
- Medical Reserve Corps, a national network of medical and public health professionals who are coordinated at the local level to serve as volunteers in natural disasters and emergencies
- NGOs/VOADs and nonclinical volunteers
What Will You Need to Know?
- What federal and SLTT governmental organizations will be part of the public health and medical response?
- What and how will they contribute to the incident response?
- When will NDMS teams be activated, and how are decisions made about where to send teams? Who coordinates these decisions for your jurisdiction, state, or region?