- HHS' Office of the Assistant Secretary for Preparedness and Response isn't adequately staffed with medical professionals and other responders in the event of another public health emergency, according to a GAO report published Thursday.
- National Disaster Medical System responders are typically physicians, nurses and other medical professionals who work outside the government, but may be asked to deploy and assist with federal public health emergencies. The agency's staffing target of 6,290 responders fell short with just 3,667 responders enrolled in NDMS as of December 2019, according to the report.
- HHS concurred with the report's five recommendations, but said it was premature to assess its response to COVID-19. GAO clarified that the report was meant to address that response, though noted 1,200 public health and emergency responders have been diverted to help with the pandemic.
The findings come as the country grapples with an ongoing pandemic and uncertainty that a second wave of COVID-19 cases could further strain hospitals’ resources.
The office in question is also responsible for maintaining the National Strategic Stockpile, which came under fire earlier this year amid personal protective equipment and ventilator shortages.
Prior to the pandemic, the agency most often responded to natural disasters, deploying six federal medical stations and staff to respond to the 2017 hurricanes in Texas, Puerto Rico, Florida and the U.S. Virgin Islands.
And even then it was understaffed. At the time, a shortage of NDMS responders for the hurricanes led HHS to send the Department of Defense to provide medical response personnel, according to the GAO report.
The accountability agency conducted an audit from July 2019 to June 2020, reviewing ASPR documentation and interviewing officials involved with workforce planning and hiring for NDMS responders.
Adequately staffing responders is tricky — most have regular jobs and may not always be available to deploy. If an emergency occurs in a state, responders in that state may already be assisting through their civilian jobs, such as working in hospitals, hindering their ability to deploy, according to the report.
Responders are organized into five teams: a Disaster Medical Assistance Team, Trauma and Critical Care Team, Disaster Mortuary Operational Response Team, Victim Information Center Team and National Veterinary Response Team. Each involves varying degrees of medical skill or accreditation.
But the GAO report found that ASPR may not be effectively training them for their roles on the ground.
Prior to their deployment to an emergency situation, NDMS responders take online training courses, including a course on wearing and taking off personal protective equipment to protect against infectious disease, biological and chemical threats.
But HHS doesn't know the training’s effectiveness until responders have deployed, at which point, if ineffective, responders could potentially expose themselves to hazards, the report said.
In-person training is most beneficial, but more costly to provide, limiting its application, HHS officials told GAO.
The GAO report outlines recommendations for the agency to strengthen its staffing, including developing a process or approach to prioritize various in-person training needs for responders while taking into account budget constraints.
It also recommends developing a process to evaluate the online versus in-person training courses using GAO-identified key practices for evaluating training.