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Statement by
Kevin Yeskey  M.D.
Deputy Assistant Secretary, Director,
Office of Preparedness and Emergency Operations
U.S. Department of Health and Human Services

The U.S. Department of Health & Human Service’s Role in the National Response Framework and Collaborative Emergency Response Efforts with the Department of Veterans Affairs 

House Committee on Veteran’s Affairs
Subcommittee on Oversight and Investigations
United States House of Representatives

Wednesday June 23, 2010

Thank you, Mr. Chairman and Members of the Subcommittee.  My name is Dr. Kevin Yeskey, and I am the Deputy Assistant Secretary for Preparedness and Response, in the Office of the Assistant Secretary for Preparedness and Response (ASPR), at the Department of Health and Human Services (HHS).  I direct ASPR’s Office of Preparedness and Emergency Operations, which oversees the medical planning and operations for the Department.  I appreciate the opportunity to comment on the Department’s role in the National Response Framework, and specifically about how we coordinate with and utilize the US Department of Veterans Affairs in our response efforts.

HHS adheres to the National Response Framework which establishes a comprehensive, national, all-hazards approach to domestic incident response.  Within the NRF are 16 Emergency Support Functions.  The Secretary of Health and Human Services leads all Federal public health and medical response to emergencies and incidents covered by the NRF, known as Emergency Support Function or ESF #8. Within HHS, and on behalf of the Secretary, ASPR coordinates national ESF #8 preparedness and response actions.

Among the ESF #8 functions are medical care, public health surveillance, patient movement, and fatalities management.  In carrying out this responsibility, HHS depends on public health and medical resources from within HHS, including the National Disaster Medical System (NDMS), the Commissioned Corps of the U.S. Public Health Service, and civilians from our component agencies, such as the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration.  Additionally, we request assistance and support from our interagency partners, including the Department of Veterans Affairs (VA). 

As we develop our plans and execute our response to disasters, HHS and the VA work closely together.  In my remaining testimony, I would like to discuss areas where HHS and VA collaborate in support of our common goal of providing high quality public health and medical care to those in their time of greatest need.

With regard to our relationship with the U.S. Department of Veterans Affairs, there is a long standing tradition of collaboration between the staffs of the two Departments. Consequently, we have shared a lengthy history in health related efforts, including emergency preparedness activities, beginning with extensive collaboration on the creation and management of the National Disaster Medical System.  HHS has developed “playbooks” for 14 of the 15 national planning scenarios.  These playbooks serve as a guide to our response to disasters, such as earthquakes and hurricanes.  The VA and other ESF #8 partners provide significant input into each of the playbooks as they are developed and revised.  Additionally, at the request of the VA, HHS has placed a liaison in the VA’s Office of Public Health and Environmental Hazards.  This liaison provides continuity of communications between the two Departments in the area of preparedness and response.

When HHS responds to an event, the VA provides liaison officers to the HHS operations center.  When HHS deploys public health and medical assets to an affected area, we use personnel from the NDMS, a partnership between the VA, Department of Defense, Department of Homeland Security, and HHS.  Disaster Medical Assistance Teams provide acute care for victims, often at or near the area of the disaster.  When these teams need to be augmented with additional clinicians, we have turned to the VA for them and they have provided appropriate personnel.  Most recently, the VA provided three surgeons and two anesthesiologists for our medical teams deployed in response to the earthquake disaster in Haiti.  These clinicians immediately integrated into the teams and provided outstanding care.  In the hurricane season of 2008, VA provided personnel to completely staff two of our Federal Medical Stations and, in past hurricane seasons, the VA  has provided  VA hospital sites for us to set up Federal Medical Stations.  They have willingly provided staff and space when HHS has had the need for such support.

Through the NDMS, HHS has responsibility for transporting patients from disaster sites.  HHS, DoD, and VA have key functions in moving patients.  One of their key functions in patient movement is managing the Federal Coordination Centers (FCCs).  These FCCs are critical to our role in both patient movement and the provision of definitive care to patients evacuated during a public health emergency.  FCCs recruit hospitals to participate in the NDMS and coordinate the receipt of patients in host cities.  Nationwide, we have 62 FCCs, two-thirds of them are managed by the VA.  DoD manages the other one-third.  NDMS has over 1600 participating hospitals nation-wide. In the 2008 hurricane season, VA-managed FCCs coordinated the receipt of medically evacuated patients in Arkansas and Oklahoma.  When NDMS was activated for the Haiti earthquake, VA personnel coordinated the receipt and distribution of patients evacuated to Florida and Georgia to receive life-saving definitive care.

HHS regards the VA as an integral partner in our preparedness and response activities.  The VA has provided expertise in the development of our preparedness plans.  The clinical support provided by VA has provided HHS with crucial medical care to victims of disasters.   

We greatly respect the work the VA does in its support to veterans on a daily basis.  We also appreciate the breadth and depth of clinical expertise the VA provides our medical response teams. 

During emergencies, whenever HHS has asked for assistance, VA has reliably stepped up to the plate and provided the requested support.  I believe that HHS’s partnership with VA is a strong and extremely cooperative one that enables both Departments to serve our nation in times of emergency. 

Again, thank you for the opportunity to be here today.  At this time, I will be happy to answer any questions you may have.

Last revised: June 18, 2013