Report slams DHS disaster medical system for mismanagement

The National Disaster Medical System is in disarray due to a lack of leadership and to persistent breakdowns in its planning, logistics and communications systems, according to a new report from senior Democrats on two key House committees.

The report was prepared by the House Government Reform Committee's minority staff for Rep. Henry A. Waxman (D-Calif.), the committee's senior Democrat, as well as for Reps. Bennie G. Thompson (D-Miss.), senior Democrat on the House Homeland Security Committee, and Charlie Melancon (D-La.).

The $34 million disaster medical program oversees local teams of volunteer doctors, nurses and other medical personnel who are deployed to provide emergency care following a disaster. The teams are paid by the federal government for the duration of the deployment.

The system already was struggling with funding and management issues when it was moved into the Homeland Security Department in 2003. Since then it has eroded further due to poor funding, mismanagement and loss of staffing, the report said.

As a result, the disaster medical system was overwhelmed and ineffective in the recent hurricane season. "When Hurricane Katrina struck the Gulf Coast, the system was unprepared, resulting in major failures in the medical response," the report stated. It cited "poor planning, inept logistics oversight, deficient and delayed supplies and failed or inadequate communications systems" among the problems.

Several previously unreleased internal government reports have documented major gaps in the disaster medical system. In 2002, the Health and Human Services Department initially estimated there were 70 disaster medical teams available, but a department review indicated that only 29 teams were operational and only 16 met all requirements for equipment, staffing and supplies.

In January 2005, a DHS report from Jeffrey Lowell, senior medical adviser to then-Homeland Security secretary Tom Ridge, criticized the program's lack of leadership, mismanagement, reliance on volunteers, and lack of funding. He cited anecdotes of volunteers paying team expenses because federal reimbursements were poorly managed. Lowell left that post in February.

Following Hurricane Katrina, disaster medical team members reported little or no communication between officials at the disaster site and at command centers in Baton Rouge, La. Because of system failures, team members could not track patient and supply movements and could not communicate urgent needs.

Cell phones supplied by DHS to the disaster medical teams failed, and no backup equipment was provided. "Until the Forest Service supplied interoperable radios, teams were completely unable to reach their own members, other agencies and on-site security personnel," the report said.

To improve the system, the Democratic report recommends establishing strong medical leadership over the disaster medical system, putting the system's commander in charge of its medical assets and providing stable and adequate funding.