Jim Kouri
Emergency preparedness: states are planning for medical surge
By Jim Kouri
December 21, 2008

Potential terrorist attacks and the possibility of naturally occurring disease outbreaks have raised concerns about the "surge capacity" of the nation's health care systems to respond to mass casualty events, according to a report obtained by the National Association of Chiefs of Police

The Government Accountability Office identified four key components of preparing for a medical surge: (1) increasing hospital capacity, (2) identifying alternate care sites, (3) registering medical volunteers, and (4) planning for altering established standards of care. The Department of Health and Human Services (HHS) is the primary agency for hospital preparedness, including medical surge.

GAO was asked to examine (1) what assistance the federal government has provided to help states prepare for medical surge, (2) what states have done to prepare for medical surge, and (3) concerns states have identified related to medical surge. GAO reviewed documents from the 50 states and federal agencies. GAO also interviewed officials from a judgmental sample of 20 states and from federal agencies, as well as emergency preparedness experts.

Following a mass casualty event that could involve thousands, or even tens of thousands, of injured or ill victims, health care systems would need the ability to "surge," that is, to adequately care for a large number of patients or patients with unusual medical needs. The federal government has provided funding, guidance, and other assistance to help states prepare for medical surge in a mass casualty event.

From fiscal years 2002 to 2007, the federal government awarded the states about $2.2 billion through the Office of the Assistant Secretary for Preparedness and Response's Hospital Preparedness Program to support activities to meet their preparedness priorities and goals, including medical surge.

Further, the federal government provided guidance for states to use when preparing for medical surge, including Reopening Shuttered Hospitals to Expand Surge Capacity, which contains a checklist that states can use to identify entities that could provide more resources during a medical surge. Based on a review of state emergency preparedness documents and interviews with 20 state emergency preparedness officials, GAO found that many states had made efforts related to three of the key components of medical surge, but fewer have implemented the fourth.

More than half of the 50 states had met or were close to meeting the criteria for the five medical-surge-related sentinel indicators for hospital capacity reported in the Hospital Preparedness Program's 2006 midyear progress reports.

For example, 37 states reported that they could add 500 beds per million population within 24 hours of a mass casualty event. In a 20-state review, GAO found that all 20 were developing bed reporting systems and most were coordinating with military and veterans hospitals to expand hospital capacity, 18 were selecting various facilities for alternate care sites, 15 had begun electronic registering of medical volunteers, and fewer of the states — 7 of the 20 — were planning for altered standards of medical care to be used in response to a mass casualty event.

State officials in GAO's 20-state review reported that they faced challenges relating to all four key components in preparing for medical surge. For example, some states reported concerns related to maintaining adequate staffing levels to increase hospital capacity, and some reported concerns about reimbursement for medical services provided at alternate care sites.

According to some state officials, volunteers were concerned that if state registries became part of a national database they might be required to provide services outside their own state. Some states reported that they had not begun work on or completed altered standards of care guidelines due to the difficulty of addressing the medical, ethical, and legal issues involved in making life-or-death decisions about which patients would get access to scarce resources.

While most of the states that had adopted or were drafting altered standards of care guidelines reported using federal guidance as they developed these guidelines, some states also reported that they needed additional assistance.

© Jim Kouri


The views expressed by RenewAmerica columnists are their own and do not necessarily reflect the position of RenewAmerica or its affiliates.
(See RenewAmerica's publishing standards.)

Jim Kouri

Jim Kouri, CPP is currently fifth vice-president of the National Association of Chiefs of Police... (more)


Receive future articles by Jim Kouri: Click here

More by this author

September 10, 2017
Trump Justice: 'Dreamer' wanted for murder nabbed by feds in NJ and extradited

July 26, 2017
NJ 12-year-old's suicide a plea for cyber-bullying law: GOP candidate Heather Darling

June 12, 2017
Obama hampered law enforcement investigation of Iranian terrorism funding

June 2, 2017
Prez of Young Democrats and Mayor de Blasio staffer busted for kiddie porn; one victim 6-mos. old

May 29, 2017
The conservative approach to taxation and a healthy business climate

May 24, 2017
U.S. intelligence reports warn of cyber "Cold War"

March 3, 2017
Media attack Trump's terrorism expert Dr. Sebastian Gorka

December 23, 2016
Trump's border wall: The bill was passed and signed into law

December 22, 2016
Dem lawmakers demand commission to probe Trump-Russia conspiracy

December 14, 2016
Outraged Vets: VA hospital death touted as proof of Obama and Democrats indifference

More articles


Stephen Stone
The most egregious lies Evan McMullin and the media have told about Sen. Mike Lee

Siena Hoefling
Protect the Children: Update with VIDEO

Stephen Stone
Flashback: Dems' fake claim that Trump and Utah congressional hopeful Burgess Owens want 'renewed nuclear testing' blows up when examined

Linda Goudsmit
CHAPTER 8: Constructivism Impedes Reality-Testing

Tom DeWeese
The transportation highway to dystopia

Rev. Mark H. Creech
Revelation Chapter 22: Finding comfort in Heaven’s promise

Michael Bresciani
A country without a border, a president without a backbone, a political party that runs on hatred: the new America?

Selwyn Duke
Smartfood gets dumb: Bud Lights itself with 'LGBTQ' Glaad Bag

Stone Washington
The political failings of ESG: Why 2024 is the year for policy reform

Jerry Newcombe
Do manners matter anymore?

Victor Sharpe
Passover's gift: The promised and undivided land

Linda Goudsmit
CHAPTER 7: Politicized education

Pete Riehm
Often the dumbest are the most dangerous

Matt C. Abbott
Taking secrets to the grave: Father Kunz murder, 26 years unsolved

Rev. Mark H. Creech
Revelation Chapter 21: A narrative of two cities, exploring the heavenly city
  More columns


Click for full cartoon
More cartoons


Matt C. Abbott
Chris Adamo
Russ J. Alan
Bonnie Alba
Chuck Baldwin
Kevin J. Banet
J. Matt Barber
Fr. Tom Bartolomeo
. . .
[See more]

Sister sites