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Introduction. . On September 19, 2001, the Acting Assistant Secretary of Defense (Health Affairs) requested the Inspector General of the Department of Defense to review the DoD medical response to the September 11, 2001, terrorist attacks. The Acting Assistant Secretary wanted to ensure that DoD profits from lessons from the experience, to ensure that execution and policy are in alignment, and to conserve medical resources that may be needed in the future. He expressed concerns that resources may have been expended unnecessarily by initiation of support actions that were not officially requested by Federal agencies coordinating medical assistance.
Objectives. Under the Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1974, the Governor of an affected State may request the President to declare a major disaster or an emergency if an event is beyond the combined capabilities of the affected State and local governments. The Federal Response Plan establishes a process and structure for the systematic, coordinated, and effective delivery of Federal assistance to address the consequences of any major disaster or emergency declared under the Act. The Federal Response Plan organizes the types of Federal response assistance into 12 Emergency Support Functions, each of which has a designated primary agency. The primary agency for Emergency Support Function #8, Health and Medical Services, is the Department of Health and Human Services. The Secretary of the Army is the DoD Executive Agent for military support to civil authorities, and the Director of Military Support acts for the Executive Agent and issues necessary orders.
Results. The Military Health System support following the September 11, 2001, terrorist attacks was generally in accordance with the Federal Response Plan. DoD responded to all requests made through the Federal Response Plan process for military medical assistance and to numerous direct requests from other government agencies. However, in attempting to be responsive to the emerging crisis, the Air Force moved medical personnel and equipment to McGuire Air Force Base, New Jersey, that were not requested through the Federal Response Plan process and ultimately were not required. The Air Force stated that the movement of the personnel and equipment also served the purpose of making the resources available worldwide for Air Force requirements. The Air Force movement of medical resources cost about $500,000 and was not coordinated with the Director of Military Support in advance or immediately after the fact. Although the movement of medical assets was within the authority of the Air Force and was approved by the Secretary of the Air Force, established Federal Response Plan procedures were not followed. Any actions taken outside the coordinated efforts of the Federal Response Plan represent a potentially unnecessary use of DoD resources. See the Finding section for details on the evaluation results.
Summary of Recommendations. We recommend that the Secretary of the Air Force, when moving resources to support civil authorities under the commander's immediate response authority, advise the DoD Executive Agent through the Director of Military Support by the most expeditious means available, and seek approval or additional authorizations as needed, in accordance with DoD Directive 3025.1. We also recommend that the Secretary of the Air Force coordinate with the Director of Military Support to address communications problems identified by the Air Force during its attempt to provide support as a result of the September 11, 2001, terrorist attacks.
Management Comments. The Air Force did not respond to a draft of this
report issued on March 19, 2002. We request that the Secretary of the Air Force
provide comments on this report by July 10, 2002.
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