Appendix VI: Emergency Preparedness and HHS, in coordination with the Office of Homeland Security (OHS), should develop models for medical responses to a variety of hazards at the federal, state, local, and private levels, [Gilmore Commission, 3rd Report, p. vi]. HHS should fund studies aimed at modeling the size and scope of the healthcare and public health workforce needed to respond to a range of public health emergencies and day-to-day public health issues and a comprehensive assessment of the resources required by the nation's hospital system, [Gilmore Commission, 4th Report, p. vi]. The Secretary of HHS, in conjunction with OHS, should conduct a thorough review of the authorities, structures, and capabilities under the Metropolitan Medical Response System (MMRS) and the National Disaster Medical System (NDMS), [Gilmore Commission, 3rd Report, p. vii]. HHS should reestablish a pre-hospital Emergency Medical Services program office, [Gilmore Commission, 3rd Report, p. vi]. The Congress should amend existing statutes to ensure sufficient authorities and safeguards exist for use of the military across the entire spectrum of terrorist attacks, [Gilmore Commission, 4th Report, p. xi]. The National Command should establish a single, unified command and control structure to execute all functions related to military support or assistance to civil authorities, [Gilmore Commission, 3rd Report, p. x]. Increased readiness for incident response through better capabilities, equipment, training, and exercises Commissions U.S. public health capabilities should be augmented to deal medically and psychologically with potentially large losses of American lives in attacks against the mainland, [Hart-Rudman Commission, 2nd Report, p. 9]. Federal agencies should design training exercises; all major training exercises should be independently evaluated, [Gilmore Commission, 2nd Report, x, 30-31; 3rd Report, p. iv]. Federal agencies should design equipment as part of the all-hazards preparedness-these may be redesigned to include sustainment components, [Gilmore Commission, 3rd Report, p. iv]. Preparedness programs should be designed so that first responders and volunteers can participate, [Gilmore Commission, 3rd Report, p. v]. Congress should increase federal resources for appropriately designed exercises to be implemented at the state, local and private levels, [Gilmore Commission, 4th Report, p. vi]. • The Secretary of Defense should provide funds to the governor of a state when requested for civil support planning, training, exercising and operations by National Guard personnel acting in Title 32 duty status, [Gilmore Commission, 4th Report, p. xii]. • The Secretary of Defense should direct the military departments to institute specific training in those military units most likely to be involved in military support to civil authorities, [Gilmore Commission, 3rd Report, p. x]. All military personnel and units under NORTHCOM should receive special training for domestic missions; and necessary training programs should be established and implemented, [Gilmore Commission, 4th Report, p. x]. • The National Office for Combating Terrorism should oversee the development of standards and certification requirements to encourage the health and medical sector to build and maintain required capabilities, [Gilmore Commission, 2nd Report, pp. x-xi]. Federal, state, local, and private sector organizations should fully implement the American Medical Administration's (AMA) “Report and Recommendations on Medical Preparedness for Terrorism and Other Disasters", [Gilmore Commission, 3rd Report, p. v]. HHS should continue to strengthen the Health Alert Network and other information systems that provide surveillance, epidemiologic and laboratory information, [Gilmore Commission, 4th Report, p. vi]. Medical systems should fully implement the Joint Commission on Accreditation of Health Care Organization's (JCAHO) Revised The Emergency Medical Technician and Paramedic National Standardized Training Curricula should be revised, [Gilmore HHS should evaluate the current processes for providing required technical assistance to states and localities, [Gilmore HHS, in coordination with DHS, should develop an on-going, well coordinated strategy for the education of the public on the prevention, risks, signs, symptoms, and treatment, [Gilmore Commission, 4th Report, p. vii]. Appendix VI: Emergency Preparedness and • DHS should develop metrics to determine the adequacy of preparedness of various critical infrastructure components, [Gilmore Commission, 4th Report, p. xii]. GAO • The Secretary of Defense, or the head of any subsequent lead agency, should use existing state and local emergency management response systems or arrangements to select locations and training structures to deliver courses and consider the geographical proximity of program cities, [GAO/NSIAD-99-3]. The Secretary of Defense should direct the Assistant Secretary of Defense for Special Operations and Low-Intensity Conflict to expeditiously implement the Joint Staff's draft antiterrorism/force protection manager training standard and formulate a timetable for the services to develop and implement a new course that meets the revised standards and ensure that the course has consistency of emphasis across the services, [GAO/NSIAD-00-181]. • The Director, FEMA, should sponsor periodic national-level consequence management field exercises involving federal, state, and local governments. Such exercises should be conducted together with national-level crisis management field exercises, [GAO-01-14]. The Director of FEMA should play a larger role in managing federal exercises to combat terrorism. As part of this, FEMA should seek a formal role as a cochair of the Interagency Working Group on Exercises and help to plan and conduct major interagency counterrorist exercises to ensure that consequence management is adequately addressed, [GAO-01-822]. The Secretaries of Agriculture, Defense, Energy, HHS, and Veterans Affairs; the Directors of Alcohol, Tobacco Firearms and Explosives, FEMA, FBI, and the U.S. Secret Service; the Administrator of EPA; and the Commandant of the U.S. Coast Guard should require their agencies to prepare after-action reports or similar evaluations for all exercises they lead and for all field exercises in which they participate, [GAO-01-822]. Improvements in the public health and medical response to terrorism (generic-not specific to biological terrorism) HHS should continue to provide financial support on the order of $1 billion per year over the next 5 years to strengthen the nation's public health system, [Gilmore Commission, 4th Report, p. v]. Federal, state, local, and private sector organizations should fully implement the AMA “Report and Recommendations on Medical Preparedness for Terrorism and Other Disasters", [Gilmore Commission, 3rd Report, p. v]. Medical systems should fully implement the JCAHO's Revised Emergency Management Standard, [Gilmore Commission, 3rd Report, p. v]. HHS should fund studies aimed at modeling the size and scope of the healthcare and public health workforce needed to respond to a range of public health emergencies and day-to-day public health issues and a comprehensive assessment of the resources required by the nation's hospital system, [Gilmore Commission, 4th Report, p. vi]. Congress should enact statutory provisions for certification of laboratories to test for foot and mouth disease and other highly contagious animal pathogens, [Gilmore Commission, 4th Report, p. ix]. Total recommendations=46 Source: GAO. Related GAO Products Combating Terrorism: Federal Agencies Face Continuing Challenges in Transportation Security: Federal Action Needed to Help Address Border Security: New Policies and Procedures Are Needed to Fill Gaps in the Visa Revocation Process. GAO-03-908T. Washington, D.C.: June 18, 2003. Border Security: New Policies and Procedures Are Needed to Fill Gaps in the Visa Revocation Process. GAO-03-798. Washington, D.C.: June 18, 2003. Rail Safety and Security: Some Actions Already Taken to Enhance Rail Critical Infrastructure Protection: Efforts of the Financial Services Sector to Address Cyber Threats. GAO-03-173. Washington, D.C.: January 30, 2003. Justice Department: Better Management Oversight and Internal Controls Aviation Security: Undeclared Air Shipments of Dangerous Goods and DOT's Enforcement Approach. GAO-03-22. Washington, D.C.: January 10, 2003. Mass Transit: Federal Action Could Help Transit Agencies Address Combating Terrorism: Actions Needed to Improve Force Protection for Border Security: Visa Process Should Be Strengthened as an Related GAO Products Pipeline Safety and Security: Improved Workforce Planning and Communication Needed. GAO-02-785. Washington, D.C.: August 26, 2002. Nonproliferation R&D: NNSA's Program Develops Successful Technologies, but Project Management Can Be Strengthened. GAO-02-904. Washington, D.C.: August 23, 2002. Nuclear Nonproliferation: U.S. Efforts to Help Other Countries Combat Nuclear Smuggling Need Strengthened Coordination and Planning. GAO-02-426. Washington, D.C.: May 16, 2002. Environmental Cleanup: Better Communication Needed for Dealing with Formerly Used Defense Sites in Guam. GAO-02-423. Washington, D.C.: April 11, 2002. Combating Terrorism: Selected Challenges and Related Recommendations. GAO-01-822. Washington, D.C.: September 20, 2001. Combating Terrorism: Actions Needed to Improve DOD Antiterrorism Program Implementation and Management. GAO-01-909. Washington, D.C.: September 19, 2001. FBI Intelligence Investigations: Coordination Within Justice on Combating Terrorism: Accountability Over Medical Supplies Needs Further Improvement. GAO-01-463. Washington, D.C.: March 30, 2001. Critical Infrastructure Protection: Significant Challenges in Developing National Capabilities. GAO-01-323. Washington, D.C.: April 25, 2001. Combating Terrorism: Federal Response Teams Provide Varied GAO-01-14. Washington, D.C.: November 30, 2000. Combating Terrorism: Action Taken but Considerable Risks Remain for Forces Overseas. GAO/NSIAD-00-181. Washington, D.C.: July 19, 2000. |