Disaster Preparedness: Limitations in Federal Evacuation Assistance for Health Facilities Should be Addressed
Highlights
Hurricane Katrina demonstrated difficulties involved in evacuating communities and raised questions about how hospitals and nursing homes plan for evacuations and how the federal government assists. Due to broad-based congressional interest, GAO assessed the evacuation of hospital patients and nursing home residents. Under the Comptroller General's authority to conduct evaluations on his own initiative, GAO examined (1) the challenges hospital and nursing home administrators faced, (2) the extent to which limitations exist in the design of the National Disaster Medical System (NDMS) to assist with patient evacuations, and (3) the federal requirements for hospital and nursing home disaster and evacuation planning. GAO reviewed documents and interviewed federal officials, and interviewed hospital and nursing home administrators and state and local officials in areas affected by Hurricane Katrina in Mississippi and Hurricane Charley in Florida.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Homeland Security | To address limitations in how the federal government provides assistance with the evacuation of health care facilities, the Secretary of Homeland Security should clearly delineate how the federal government will assist state and local governments with the movement of patients and residents out of hospitals and nursing homes to a mobilization center where NDMS transportation begins. | The primary responsibility for the National Disaster Medical System, and correspondingly for this recommendation, was transferred to HHS in 2007. HHS has implemented this recommendation by completing the following four actions. (1) HHS and DHS collaborated with state and local departments of health in hurricane-prone regions to determine gaps between needs and available resources for hospital and nursing home evacuations and to determine local, state, or federal resources to fill the gaps. (2) Based on this analysis, HHS and DHS contracted for ground and air ambulances and para-transit services for Gulf and East Coast states. (3) HHS encouraged states to establish regional coalitions for... mutual aid. (4) HHS has completed a hurricane "playbook" that improves the clarity of the role of federal assistance in evacuations. GAO reported on this implementation in April 2008 in GAO-08-544R.
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| Department of Homeland Security | To address limitations in how the federal government provides assistance with the evacuation of health care facilities, the Secretary of Homeland Security should, in consultation with the other NDMS federal partners--the Secretaries of Defense, Health and Human Services, and Veterans Affairs--clearly delineate how to address the needs of nursing home residents during evacuations, including the arrangements necessary to relocate these residents. | The primary responsibility for the National Disaster Medical System (NDMS), and correspondingly for this recommendation, was transferred to HHS in 2007. HHS has substantially implemented this recommendation. In GAO-08-544R (April 2008), we reported that HHS and DHS collaborated with state and local departments of health in hurricane-prone regions to determine gaps between needs and available resources for hospital and nursing home evacuations and to determine local, state, or federal resources to fill the gaps. Nursing homes were included in this analysis. Based on this analysis, HHS and DHS contracted for ground and air ambulances and para-transit services for Gulf and East Coast...
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