National Disaster Medical System Helping U.S. Hospitals Treat Survivors of Earthquake in Haiti
As part of the ongoing medical response to the Haiti earthquake, USAID announced on February 1, 2010 that the U.S. Department of Health and Human Services (HHS) will utilize additional components of the National Disaster Medical System (NDMS) to help U.S. hospitals provide care to critically ill survivors.
NDMS is managed by HHS. Activation is by the HHS Secretary in response to a public health or medical emergency. The U.S. Department of Defense manages patient movement and provides medical evacuation. Using these additional components, NDMS may reimburse participating U.S. hospitals that treat Haitian patients evacuated with life-threatening injuries due to the earthquake.
Haitian and American patients are being referred by Haitian hospitals, NGOs, the USNS Comfort, or other facilities if they meet criteria for evacuation. These evacuations are reserved for the rare patients with life-threatening conditions that cannot be handled within Haiti or by evacuation to another country. There must also be a reasonable chance that the patient can survive the flight and the treatment in the U.S.
Federal Coordinating Centers
To support this effort, HHS has activated two Federal Coordinating Centers (FCCs) in Atlanta and Tampa. These two centers are staffed by teams from the Department of Veterans Affairs who will meet the flights and arrange ground transport of patients from Haiti to appropriate U.S. hospitals. Under NDMS, up to 60 Federal Coordinating Centers (FCCs) can be activated across the country, if needed, to place patients in participating hospitals. Approximately 1600 hospitals nationwide participate in the National Disaster Medical System. Federal Coordinating Centers in New York, NY; Lyons, NJ; Philadelphia, PA; Washington, DC; and Boston, MA have been put on alert in case additional capacity to treat patients from Haiti is needed.
Accredited hospitals, usually over 100 beds in size and located in large U.S. metropolitan areas, are encouraged to enter into a voluntary agreement with NDMS. Hospitals agree to commit a number of their acute care beds, subject to availability, for NDMS patients. Because this is a completely voluntary program, hospitals may, upon activation of the system, provide more or fewer beds than the number committed in the agreement. Hospitals that admit NDMS patients are guaranteed reimbursement at 110% of Medicare rates by the federal government. NDMS hospitals submit bills to HHS.
NDMS has three components: field medical care; patient movement; and definitive care. Field medical care is accomplished through organized medical teams called Disaster Medical Assistance Teams (DMATs); fatalities management teams called Disaster Mortuary Operational Response Teams (DMORTs); National Veterinary Response Teams (NVRT); and International Medical Surgical Response Teams (IMSuRT) of U.S. surgical specialists. Members of the teams are civilian, non-federal professionals who are activated as intermittent federal employees when needed in a disaster.
NDMS Activation in Response to Haiti Earthquake
HHS activated NDMS on January 13 and immediately called upon the field medical care component, deploying 270 health and medical personnel to Haiti as part of the international medical response. As of February 2, these teams had seen more than 24,500 patients, performed over 100 surgeries, and delivered 28 babies since they began providing care in Haiti on January 17.
NDMS is a partnership between the Departments of Health and Human Services (HHS), Defense (DoD), Homeland Security (DHS), and Veterans Affairs (VA). It began in the 1980s as a mechanism for DoD to bring back mass casualties from a large-scale conflict and as a way to respond to a large civilian disaster. Over the years, the domestic disaster mission has expanded and the military need has diminished.