Public Health Preparedness: Reliable Information Needed to Inform Situational Awareness of the Medical Reserve Corps

What GAO Found

The Department of Health and Human Services (HHS) leads the nation's medical and public health preparedness and response to emergencies. In this role, HHS oversees the Medical Reserve Corps (MRC), which provides medical and nonmedical support during and after disasters at the state and local level.

MRC volunteers were essential in the COVID-19 pandemic and other emergencies, according to MRC leaders from six states and one territory. For example, in 2021, Colorado deployed volunteers to provide medical care at wildfire shelters and distribute tests for COVID-19. Volunteers in Hawaii had multi-day deployments providing medical support to displaced individuals in the 2023 wildfire response.

Examples of COVID-19 Volunteer Emergency Response Activities

HHS assisted the MRC by providing funding, technical assistance, training, and guidance. To boost the MRC network after the COVID-19 pandemic response, in 2023, HHS made awards to 33 states and jurisdictions. These awards ranged from $376,000 to $2.5 million.

HHS relies on MRC network unit information—such as volunteer data and technical assistance assessments—to maintain situational awareness of its capabilities. However, GAO found that volunteer data were unreliable. For example, as of July 2024, about 70 percent of all MRC units' volunteer counts did not indicate when the data were updated. In addition, units are to update data quarterly. However, 41 percent of MRC units' reported number of volunteers remained unchanged from 2020 to 2023, though MRC leaders from selected states told GAO that the number of volunteers was significantly higher during the height of the pandemic and later declined. In both instances, HHS was unable to confirm whether units were making the required data updates or whether there was no change. Moreover, some of the unit leaders GAO spoke to confirmed they did not update the volunteer counts for their units as required by HHS. GAO also found that HHS staff had not always conducted required annual technical assistance assessments of the capabilities of the MRC units. Without ensuring regular Medical Corps data updates and technical assistance assessments, HHS risks having incomplete situational awareness as the coordinator for public health and medical emergency preparedness and response.

Why GAO Did This Study

Public health emergencies, such as those resulting from wildfires, hurricanes, and infectious disease outbreaks can be devastating. The MRC is a national volunteer network of medical and other health professionals, comprised of approximately 700 local units. These volunteer resources are accessible to states, territories, and localities for workforce support in emergencies.

The Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 includes a provision for GAO to review states' use of health care volunteers in public health emergencies. This report is follow-up work to our previous reporting and (1) describes MRC leaders' experiences using volunteers, (2) identifies the assistance HHS provided during emergency response, and (3) assesses information HHS uses to maintain situational awareness.

GAO reviewed agency documentation and interviewed department officials on assistance provided during emergency response, and submission of quarterly capability information. GAO also interviewed MRC leaders in six states and Puerto Rico.