PM2ch46.pdf

Domestic Disaster Response: FEMA and Other Governmental Organizations

Chapter 46

DOMESTIC DISASTER RESPONSE:

FEMA AND OTHER GOVERNMENTAL

ORGANIZATIONS

Kevin S. Yeskey, MD, FACEP

INTRODUCTION

EVOLUTION OF DOMESTIC DISASTER RESPONSE

THE FEDERAL EMERGENCY MANAGEMENT AGENCY

THE FEDERAL RESPONSE PLAN

Scope

Terrorism Incident Annex

The Federal Radiological Emergency Response Plan

Emergency Support Functions

IMPLEMENTING THE FEDERAL RESPONSE PLAN

THE NATIONAL DISASTER MEDICAL SYSTEM

Disaster Medical Assistance Teams

Medically Related Emergency Support Functions

The Military’s Role

EXAMPLES OF THE SYSTEM AT WORK

EFFORTS FOR THE FUTURE

SUMMARY

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Military Preventive Medicine: Mobilization and Deployment, Volume 2

K.S. Yeskey , Captain, US Public Health Service; Director, Office of Emergency Preparedness and Response, US Department of Homeland

Security, Washington, DC 20528

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Domestic Disaster Response: FEMA and Other Governmental Organizations

INTRODUCTION

The United States has been and remains suscep-

tible to natural and technologic disasters. Hurri-

canes, earthquakes, floods, and tornadoes have

caused significant loss of life and property damage.

Accidents involving hazardous materials occur with

regularity, causing evacuation of populations and

exposure to victims. As coastal regions and areas

surrounding flood plains and fault lines become

more populous, the risk of large-scale injury and

death increases. 1 Additionally, the threat of wide-

spread release of hazardous materials, accidentally

or intentionally, remains significant. The US federal

government, through its various departments and

their respective agencies, is responsible for provid-

ing assistance to state and local governments in

their response to disasters. The Federal Response

Plan (FRP) is the means by which the government

assigns agency responsibility for the various compo-

nents of the disaster response. 2 The National Disas-

ter Medical System (NDMS), a component of the

FRP, has been created to direct the medical response

to domestic disasters. It is important that military

medical personnel understand their role in this in-

tricate yet immense system because they have

played a successful part in many recent domestic

disasters and so will probably be called on again.

EVOLUTION OF DOMESTIC DISASTER RESPONSE

Historically, domestic disaster response has been

fragmented and uncoordinated. 3 Federal agencies

were not integrated into an overall national system

of response. The Defense Production Act of 1950

authorized the President to establish performance

priorities and allocate resources to promote the na-

tional defense. In the 1960s, local civil defense or-

ganizations were the primary means of managing

the aftermaths of disasters. Volunteer organizations,

mainly the American Red Cross, augmented the

local response by running temporary shelters and

providing food.

The Civilian–Military Contingency Hospital Sys-

tem was developed in 1980 by the Department of

Defense (DoD) in recognition of the possibility that

large numbers of casualties from an overseas con-

flict could overwhelm the military’s hospital capac-

ity. This system utilized volunteer private hospitals

that promised inpatient beds to back up the com-

bined medical systems of the DoD and the Veter-

ans Administration. Although the system was never

deployed, it served as the model for the NDMS.

In 1979, the Federal Emergency Management

Agency (FEMA) was established to develop a na-

tional plan for responding to a catastrophic domes-

tic disaster. FEMA was also tasked with providing

a mechanism for the continuity of government

in the event of a domestic nuclear strike. But as

the Cold War ended in the late 1980s, FEMA’s em-

phasis was shifted from continuity of government

toward the coordination of the federal govern-

ment’s response to domestic disasters. In 1981, the

Emergency Preparedness Mobilization Board was

created to establish policy and programs to im-

prove the nation’s preparedness for a catastrophic

disaster. One of the key laws guiding the govern-

ment response is the Robert T. Stafford Disaster

Relief and Emergency Assistance Act (Public Law

93-288, as amended), which allows the federal

government to respond to disasters by giving as-

sistance and protecting the public health, safety, and

property.

THE FEDERAL EMERGENCY MANAGEMENT AGENCY

By executive order (12148, Federal Emergency

Management, July 20, 1979), the director of FEMA

has the authority and responsibility to coordinate

and oversee the federal response during declared

disasters. Coordination is provided by FEMA

through the FRP in support of agencies at national,

regional, and field levels (Figure 46-1). At the

initiation of a federal response, the FEMA director

appoints a Federal Coordinating Officer (FCO)

who assumes command of the overall coordination

and allocation of federal resources. The FCO

works closely with the officials from the affected

states to establish needs and priorities. The FCO

ensures that, in accordance with the FRP, federal

resources are made available to the state and that

the appropriate federal agencies provide those

resources. The FCO’s responsibilities include ad-

ministration and logistics, information and plan-

ning, response operations, and recovery operations

(Figure 46-2).

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Military Preventive Medicine: Mobilization and Deployment, Volume 2

Regional Level Actions

Establish regional response elements

Establish Regional

Operations Center

Deploy advance element

of the

Emergency Response Team

To State operating facilities

To disaster site

Establish Disaster Field Office

Respond with full Emergency Response Team

National Level Actions

Establish national-level support elements

Activate Emergency Support Functions (as required)

Activate Agency Emergency Operations Centers

Establish Emergency Support Team

Convene Catastrophic Disaster Response Group *

* The Catastrophic Disaster Response Group is composed of representatives from all agencies

and departments assisting with the Federal Response Plan. It provides national level

guidance and policy direction on response and operations issues. It operates from FEMA

headquarters.

Fig. 46-1. Sequence of Actions Taken To Establish Response Activities on the Regional and National Levels.

Source: Federal Emergency Management Agency. The Federal Response Plan. Washington DC: FEMA; 1997.

FEMA not only coordinates the response ac-

tivities but also assists the states before disasters

strike. FEMA has training programs for disaster

planners and responders to improve the local

response capability. FEMA also assists states in

the recovery phase of a disaster. Recovery pro-

grams within FEMA include Individual Assis-

tance (eg, temporary housing, grants and loans

to individuals and businesses), Public Assistance

(eg, debris clearance, repair of utilities) and Haz-

ard Mitigation (eg, measures to lessen the impact

of future disasters).

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Domestic Disaster Response: FEMA and Other Governmental Organizations

Federal Coordinating Officer

Deputy

Chief of Staff

Administrative Assistant/Secretary

Special Assistants

Equal Rights

Safety Officer

Environmental Officer

General Counsel

Emergency Information and Media

Affairs

Congressional and Legislative Affairs

Community Relations

Office of Inspector

General

Deputy FCO for

Mitigation *

Comptroller

Operations Section

Information and

Planning Section

Logistics Section

Administration

Section

Operations Support

Branch

Situation Status

Branch

Coordination and

Planning Branch

Personnel Branch

Operations Support

Branch

Planning Support

Branch

Resource Management

Branch

Employee Services

Branch

Operations Support

Branch

Documentation Branch

Supply Branch

Operations Support

Branch

Technical Services

Branch

Support Services

Branch

*No line responsibility for other sections

FCO: Federal Coordinating Officer

Operations Support

Branch

Fig. 46-2. Organization of the Emergency Response Team.

Source: Federal Emergency Management Agency. The Federal Response Plan. Washington DC: FEMA; 1997.

THE FEDERAL RESPONSE PLAN

The FRP was developed in 1992 as a means of

delineating the federal responsibilities for disas-

ter response under the authorization of the

Stafford Act. The FRP has been tested and refined

since it was written. 4–8 A variety of natural disas-

ters of significance have resulted in the activation

of the FRP since its inception. By incorporating

the lessons learned from each disaster, in a rela-

tively short time the FRP has been significantly

improved and refined.

ment state and local disaster response efforts.

Through the FRP, federal response is designed to

be systematic, coordinated, and effective. The FRP

establishes policy, describes a concept of operations

for interagency response, assigns and coordinates

agency responsibilities based on function, and iden-

tifies specific actions to be taken by participating

agencies.

The FRP assists in the efforts to save lives, pro-

tect public health and safety, and protect property.

It does not address recovery assistance, even though

this often occurs concurrently with response efforts.

In those cases where national security is at risk, the

FRP includes national security authorities in the

response. The FRP is an “all hazards” plan, mean-

Scope

The FRP describes the mechanisms by which the

federal government mobilizes its resources to aug-

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