From the U.S. Government Accountability Office, www.gao.gov Transcript for: Public Health Preparedness: Ensuring an Adequate Number of Trained Emergency Responders Description: Recently, the Department of Health and Human Services deployed about 1,200 medical professionals to respond to the coronavirus pandemic in the U.S. However, HHS has, at times, experienced shortages in the supply of these workers. We talk with Mary Denigan-Macauley, a health policy expert, about HHS's ability to respond to public health emergencies. Related GAO Work: GAO-20-525, Public Health Preparedness: HHS Should Take Actions to Ensure It Has an Adequate Number of Effectively Trained Emergency Responders Released: June 2020 [Intro Music] [Mary Denigan-Macauley]: It's important for HHS to understand the critical skills and competencies of this workforce to understand its response capabilities. [Holly Hobbs]: Hi and welcome to GAO's Watchdog Report, your source for news and information from the U.S. Government Accountability Office. I'm Holly Hobbs. Health and medical professionals working outside of the federal government, such as doctors and nurses, can be used as part of the federal response to a national emergency. Recently, the Department of Health and Human Services deployed about 1,200 of these professionals to respond to the coronavirus pandemic in the U.S. However, HHS has, at times, experienced shortages in the supply of medical responders, and needed to rely on other agencies for help. This has raised questions about HHS's ability to respond to public health emergencies. Today we talk with Mary Denigan-Macauley, a health policy expert and director from our healthcare team. Thank you for joining us, Mary. [Mary Denigan-Macauley]: Thank you for having me, Holly. [Holly Hobbs]: So, Mary, do we know yet if HHS has enough of these kinds of medical professionals to help respond to COVID-19? [Mary Denigan-Macauley]: Unfortunately, we do not know that answer yet. What we do know is that HHS has a target to have 6,300 responders in the National Disaster Medical system. But at the time of our report, it had just about a little more than half that number, 3,700. But it's really not the number that's important. It's important for HHS to understand the critical skills and competencies of this workforce to understand its response capabilities. So, for example, while HHS may know the number of doctors and nurses that are registered in the system, it doesn't know how many events or the types of events an enrollment of 6,300 would prepare us for. [Holly Hobbs]: So how does HHS prepare and plan for health emergencies? [Mary Denigan-Macauley]: HHS has a number of ways it prepares for public health emergencies. For example, it stockpiles critical supplies; it coordinates with federal, state and local and territorial partners as it prepares; and it learns and improves upon the response when it does real life events, or when it does training exercises. And then, it also does it through training and workforce planning. And this current work focused on HHS's workforce planning, and the training for those public health and medical responders that work outside the federal government, but are deployed really as intermittent federal employees during an emergency. So in essence, to be a surge for that medical response. So what we did was we looked at the MDMS responders as part of HHS's planning and preparedness for an all hazard event. It wasn't just one specific event, and even it can be a single isolated incident, such as a forest fire in a localized area that goes beyond that state capability; or it can be a catastrophic event, such as Hurricanes Maria and Irma that hit within two weeks of each other back in September 2017; and the current pandemic that's affecting all 50 states and Puerto Rico. [Holly Hobbs]: And did we find any gaps in those efforts? [Mary Denigan-Macauley]: So we did find gaps in HHS's effort. So, for example, when determining how many and what types of individuals they want enrolled in the national disaster program, HHS didn't take into account a variety of factors. For example, they didn't consider the type of events they need to prepare for, such as a nationwide event like we're seeing right now with COVID, or for multiple events to occur at the same time. And this is really concerning, because as we deal with COVID, right now, NOAA is predicting to have an active hurricane season. And so, being able to respond to the pandemic, and the public emergencies that come up during hurricanes is critical. One of the other things that we found is that they didn't consider the need of at-risk populations that need health care during response, such as elderly or children. And this is concerning because with our work looking at the hurricane response in 2017, HHS's plans for the territories didn't account for the chronic and primary need in an isolated communities, and that was really the primary response back then. [Music] [Holly Hobbs]: So it sounds like HHS plays an important role in responding to public health emergencies, but that the size and need of the emergency could very dramatically impact the department's efforts. Mary, what events lead to GU's interested in reviewing HHS's use of medical responders? [Mary Denigan-Macauley]: As I mentioned, we had done some work looking at HHS's responses to the hurricane back in 2017, we had a concern that they didn't have enough responders to be able to handle the response down there. And in turn, they ended up having to rely on DOD support. And it wasn't just that. This was part of a broad body of work, and Congress also has its eye on the issues. [Holly Hobbs]: Last question, what's the bottom line of this report? [Mary Denigan-Macauley]: The seriousness and the magnitude of our recent natural disasters, which they're predicting are going to continue to rise, and the current COVID pandemic, illustrates the importance of really having to have a skilled workforce, and to respond to all types of public health crises, and some that may occur concurrently. [Holly Hobbs]: That was Mary Denigan-Macauley discussing GAO's recent review of HHS's use of medical responders. Thank you for your time, Mary. [Mary Denigan-Macauley]: Thank you.