Health responders often lacked experience, investigators say
Published 7:15 pm Tuesday, February 20, 2007
The federal response to Hurricanes Katrina and Rita showed that medical personnel deployed to emergencies need more hands-on training rather than relying on computers to prepare, federal investigators say.
The medical teams that responded to the hurricanes often lacked experience and effective training. These teams also did not include enough nurses, dentists and mental health professionals, the investigators said.
The hurricanes, which occurred in August and September of 2005, led to nearly 1,900 deaths and $91 billion in damages. More than 2,100 officers within the U.S. Public Health Service Commission Corps were sent to the Gulf Coast in response. The deployment was the largest in the Corps’ 207-year history.
While state health officials credit the Corps’ with saving many lives, the inspector general for the Department of Health and Human Services said there also was plenty of room for improvement.
“Most commonly, officers said that the Corps’ computerized training … did little to prepare them for the conditions and situations they encountered during the response,” HHS Inspector General Daniel R. Levinson said in a report. “Officers called for more hands-on training.”
Sen. Ted Kennedy, D-Mass., said the report showed that the administration didn’t fulfill its responsibilities to the people living on the Gulf Coast.
“This report documents what we’ve already known to be painfully true: When mental health specialists, dentists, nurses and other health professionals were needed most, bureaucratic hurdles got in the way,” said Kennedy, chairman of the Senate Health, Education, Labor and Pensions Committee. “We owe it to the people of the Gulf Coast to fix these problems now with the urgency that they deserved then.”
The Corps’ officers work throughout the government in basically any place where there is a health need. They conduct research at the National Institutes of Health. They care for patients in federal prisons. They monitor the transmission and control of epidemic diseases at the Centers for Disease Control and Prevention. They also help out during public emergencies.
The inspector general surveyed 196 officers who went to the Gulf Coast and 134 who did not. The aim was to get their views about the Commission Corps’ work. About one out of every five officers who did not go to the Gulf Coast said they had been deployed, but could not go. In most of those cases, the officers could not get their supervisor’s approval.
“For example, one officer related that his agency supervisor stated that the officer’s priority was the agency rather than hurricane relief,” the IG’s report said.
The report also said that many officers stated that they did not see their request to deploy until well after it was issued. About half of those asked to deploy said they did not get the request until at least 12 hours after it was sent. About one in seven said they got the request more than 72 hours after issuance.
“More than half of the officers (55 percent) contacted for Hurricanes Katrina and Rita said the contact method used by the Corps was not ideal,” the report said.
Many officers also incurred expenses related to their mission that they picked up personally. Some of them were not reimbursed promptly, leading the inspector general to recommend that all deployable officers be given travel credit cards from the federal government. Indeed, about one out of every six who did pay out of pocket for mission-related expenses still had not been repaid at the time of the survey.
Failure to reimburse promptly could affect medical officers’ ability to deploy for future emergencies, the investigators said.
The Bush administration announced in January 2006 that it would increase the size of the Commission Corps by about 10 percent to a total of 6,600 members. It also announced that it would work to improve response operations and recruiting.
The inspector general noted that the Commission Corps is undergoing a substantial transformation that may address many of the issues it encountered during the hurricanes. John Agwunobi, the assistant secretary for health, said he agreed with the inspector general’s recommendations.
“The recommendations of the report mirror many of the preparedness and response areas we are addressing,” Agwunobi said in remarks that were attached to the report.
He said the Commission Corps was developing more effective training programs and revamping its travel plans.
“The transformed Corps will be better able to deploy officers with the appropriate skill sets required to respond to the wide array of public health emergencies our nation will face,” Agwunobi said.