Detailed Information on the
Commissioned Corps:Readiness and Response Program Assessment

Establish two Health and Medical Response (HAMR) Teams. HAMR teams will be full-time teams of commissioned officers (105 officers on each HAMR team) whose three responsibilities (in priority order) include: 1) responding to domestic and international public health emergencies; 2) training themselves and other Corps officers, and while not responding and/or training; 3) maintaining their clinical and professional skills by serving in hard-to-fill locations.

Establish two Health and Medical Response (HAMR) Teams. HAMR teams will be full-time teams of commissioned officers (105 officers on each HAMR team) whose three responsibilities (in priority order) include: 1) responding to domestic and international public health emergencies; 2) training themselves and other Corps officers, and while not responding and/or training; 3) maintaining their clinical and professional skills by serving in hard-to-fill locations.

Develop and conduct annual field-based training for all Tier 1 and Tier 2 response teams.

Proposing legislation to give the Secretary additional authority to require all Corps officers to meet readiness requirements and to deploy in response to emergencies

Developing a performance evaluation tool to measure the timeliness, appropriateness, and effectiveness of individual and team responses.

Establishing baselines for remaining performance measures to guide the continued improvement of all aspects of the Commissioned Corps readiness and response program.

Establishing targets for remaining performance measures to guide the continued improvement of all aspects of the Commissioned Corps readiness and response program.

Measure: Increase the percentage of Officers that meet Corps readiness requirements, thus expanding the capability of the individual Officers.

Explanation:The goal is to increase the number of Officers meeting readiness requirements such that they are effective resources for HHS emergency response. The goal will incorporate all future readiness requirements, including a new standard for physical training in 2007.

Measure: Increase the percentage of Officers that are deployable in the field, thus expanding the capability of the Corps.

Explanation:The goal is to increase the percent of Officers ready and available to be deployed to the field. For example, Officers must meet readiness requirements, have supervisory approval, and have declared their availability to travel within the timeline for their response tier, either through the Office of Force Readiness and Deployment.

Measure: Increase the percent of individual responses that meet timeliness, appropriateness, and effectiveness requirements.

Explanation:Officers will be deployed as individuals or in small groups when the response is of limited scope, or requires a small number of skill-sets to address a public health need. The Corps emergency response function requires frequent and consistent evaluation to ensure the program can provide a timely, appropriate, and effective response to medical emergencies and urgent public health needs experienced by Federal, State, Tribal, or local entities.

Measure: Increase the percent of team responses that meet timeliness, appropriateness, and effectiveness requirements.

Explanation:Response teams will be utilized when the response requires a mix of deployment skill-sets to address a large or complex public health need. The Corps emergency response function requires frequent and consistent evaluation to ensure the program can provide a timely, appropriate, and effective response to medical emergencies and urgent public health needs experienced by Federal, State, Tribal, or local entities. Because the Corps' response function is evolving from an individual-centric deployment to a team-focused deployment, the standard by which response is measured must be re-defined by the Office of the Surgeon General, and the performance evaluation tool must be re-assessed for appropriateness and efficacy.

Measure: Increase the number of response teams formed, thus enhancing the Department's capability to rapidly and appropriately respond to medical emergencies and urgent public health needs.

Explanation:A goal of the Corps emergency response function is to establish specialized teams that are better able to respond to specific types of events.

Measure: Increase the number of response teams which have met all requirements, including training, equipment, and logistical support, and can deploy in the field when needed as fully functional teams, thus enhancing the Department's capability to appropriately respond to medical emergencies and urgent public health care needs.

Explanation:A goal of the Corps emergency response function is to ensure that the specialized teams are fully functional and can provide a timely and appropriate response to medical emergencies and urgent public health needs.

Measure: Cost per Officer to attain or maintain readiness requirements.

Explanation:The cost per Officer to attain or maintain readiness requirements is determined by the annual OFRD budget dedicated to building and maintaining readiness among the Corps divided by the number of Officers meeting readiness requirements.

Is the program purpose clear?

Explanation: The purpose of the Commissioned Corps (Corps) readiness and response program (in the Office of Force Readiness and Deployment (OFRD)) is to provide a timely, appropriate, and effective response to: (a) public health and medical emergencies as directed by the Office of Public Health Emergency Preparedness (OPHEP) and (b) urgent public health needs (as determined by the Surgeon General and the Assistant Secretary for Health). Public health and medical emergencies are: (1) national disasters declared by the President under the Stafford Act, (2) public health emergencies declared by the Secretary of Health and Human Services (HHS), and (3) National Special Security Events (NSSE) declared by the United States Secret Service. The emergency response functions are to ensure that: (1) individual Commissioned Corps Officers (Officers) are appropriately trained and ready to deploy; (2) the Corps deploys the right number of Officers with the right skills (e.g., clinical), in the right category (e.g., physicians, nurses), and in the time needed; (3) the deployment is properly coordinated with other Federal, State and local resources; and (4) the Officers have the necessary equipment and administrative support to perform the mission.

Evidence: HHS has primary responsibility for Emergency Support Function (ESF) #8, the public health and medical services function, under the Department of Homeland Security's National Response Plan Annex and the Corps is listed in this plan as a responder. The OPHEP is the action agent for all activations of ESF #8 and as such assigns public health and medical emergency missions to the Corps. The Public Health Service Act, Title 42 USC, Section 215, grants authority to the HHS Secretary to direct the Surgeon General to detail and deploy officers of the Public Health Service Commissioned Corps to any Federal agency requesting such assistance, or to a State or local health agency upon the request of the State or local health authorities. The HHS Secretary reaffirmed the mission of the Corps in March 16, 2006, Senate testimony: "The Commissioned Corps provides a unique source of well-trained and highly qualified, dedicated public health professionals who are available to respond rapidly to urgent public health challenges and health care emergencies."

Does the program address a specific and existing problem, interest, or need?

Explanation: Each Corps deployment is to a relevant, clearly defined, and unmet need. The immediate medical response capacity of the Corps is a part of Federal emergency planning. Officers are routinely deployed for medical emergencies and urgent public health needs of national disasters (e.g., Hurricane Katrina), Federal agencies, States, and local governments.

Evidence: In 2004, the Corps deployed medical personnel, environmental health personnel, and liaisons to the State of Florida after Hurricane Charley to care for sheltered patients; provided hospital augmentation; and addressed damaged water, waste water, and sewer systems. Also in 2004, the Corps deployed nurses, translators, and epidemiologists to support the Washington, D.C. Department of Health (DOH) in drawing blood from children ages six and under, pregnant females, and nursing mothers because of the high levels of lead in the District's drinking water.

Is the program designed so that it is not redundant or duplicative of any other Federal, state, local or private effort?

Explanation: The Corps is a uniformed service providing emergency and public health services. The Corps deploys for (a) public health and medical emergencies as directed by the OPHEP and (b) urgent public health needs (as determined by the Surgeon General and Assistant Secretary for Health). Deployments are in coordination with and do not duplicate other Federal, State, or local resources. Each State and local government has both an emergency response and public health structure within its jurisdiction. The Federal government does not mobilize resources unless the event exceeds the capacity of the State or local government.

Evidence: OPHEP looks to the Corps for primary responsibility under ESF #8 to address medical emergencies and urgent public health needs, and augment with assets from partner organizations such as the National Disaster Medical System (NDMS). The NDMS provides emergency medical, trauma, and mental health care after a disaster. By contrast, the Corps provides medical, nursing, and pharmacy officers that specialize in the delivery of primary medical care. For instance, in response to a disaster, NDMS would care for individuals with dramatic injuries whereas the Corps would care for individuals with chronic conditions. NDMS seldom responds to public health emergencies and NSSE as there is no funding for salary reimbursement, which is a requirement for all NDMS responses. When requested by State or local authorities, the Surgeon General only declares an urgent public health need and deploys the Corps when no other resources are available (42 USC Section 215b).

Is the program design free of major flaws that would limit the program's effectiveness or efficiency?

Explanation: The inability to require all Officers to meet readiness requirements and to deploy in response to an emergency diminishes the strength of response capability of the Corps readiness and response program. HHS does not have the legal authority to require individual Officers to meet readiness requirements (e.g., training, medical examinations, vaccinations, physical fitness) for deployment. With the exception of executive order by the President to militarize the Corps in time of war or emergency involving the national defense, HHS does not have legal authority to require individual Officers to deploy or to require non-HHS employers to release Officers for emergency deployment. Since there is normally no reimbursement of Officer salaries, some Officers cannot be deployed for budgetary reasons. For example, some supervisors will not allow Officers to deploy because the supervisors can not afford to hire part-time staff to backfill the Officer's position while the Officer is deployed. The Corps lacks a clear formal policy for Corps deployments for public health emergencies declared by the Secretary of HHS. The Corps has policies in place regarding partnerships with OPHEP and the Medical Reserve Corps (MRC) in responding to national disasters declared by the President and is encouraged to develop a policy which identifies the decision making process and the responsibilities of the individual partners for deployments for medical emergencies and urgent public health needs in order to coordinate and collaborate response efforts more effectively.

Evidence: Even though the Corps is a uniformed service, it does not operate under the Uniform Code of Military Justice and HHS does not have similar command authority to require emergency deployment except by Presidential order pursuant to 42 USC Section 217, which has only been used during World War II and the Korean War.

Is the program design effectively targeted so that resources will address the program's purpose directly and will reach intended beneficiaries?

Explanation: The Corps deployment for medical emergencies and urgent public health needs is for a specific purpose, defined mission, and to directly target a defined group of beneficiaries. Recently, the Corps has begun its transformation from an individual-centric deployment to a team-focused deployment in response to the "Federal Response to Katrina Lessons Learned" recommendations. This approach will enable the Corps to respond more quickly, efficiently and effectively.

Evidence: The following two scenarios illustrate the targeting of Corps resources for intended beneficiaries. (1) During the 2005 response to hurricane Katrina, Louisiana requested the Federal government to perform assessments of drinking water, sewer systems, food preparation and refrigeration capabilities, heating and air-conditioning systems, and any presence of mold and mildew in approximately 200 schools across the southern part of the State. The Request for Assistance was processed and approved by the Department of Homeland Security Federal Coordinating Official in Louisiana, and then given to Emergency Support Function #8 (HHS) as a Mission Assignment. OPHEP then tasked the Corps with this responsibility. The Corps put together six assessment teams composed of an environmental health officer, a food safety expert, an environmental engineer, and a public health nurse. These teams then had a defined target and a defined set of beneficiaries (i.e., 200 schools in Southern Louisiana). (2) In 2004 the Washington, DC Department of Health sent a request to the Surgeon General (SG) to provide nurses, physicians, and epidemiologists to investigate the findings of a high concentration of lead in the District's drinking water, and whether or not small children were at particular risk. The SG approved an activation of the Corps for this request and Officers to draw blood from young children, and then establish the blood-lead concentration in those children. The deployed epidemiologists were able to effectively assist the DoH in their recommendations to the City Council, based on the work of the deployed Officers. The team had a defined target and a defined set of beneficiaries (i.e., children in the District of Columbia).

Does the program have a limited number of specific long-term performance measures that focus on outcomes and meaningfully reflect the purpose of the program?

Explanation: The Corps readiness and response program has developed four long-term measures focused on ensuring the coordination of the rapid and effective response to medical emergencies and urgent public health needs. The first performance measure makes certain the Officers have obtained all the necessary training, vaccinations, etc. and are ready to respond. Once the Officers have met all the readiness requirements, it is essential that the Officers have supervisor approval and have declared their availability to travel within the timeline for their response tier, to allow them to be deployed. Therefore the second measure ensures that the Officers are deployable, and the third and fourth measures assess the timeliness, appropriateness, and effectiveness of the individual and team response. Although the first two performance measures are output oriented measures, the success in these measures is directly related to the performance in the third and fourth outcome-oriented performance measure.

Evidence: The Corps long-term performance measures are as follows: (1) increase the percentage of Officers that meet Corps readiness requirements; (2) increase the percentage of Officers that are deployable in the field; (3) increase the percent of individual responses that meet timeliness, appropriateness, and effectiveness requirements; and (4) increase the percent of team responses that meet timeliness, appropriateness, and effectiveness requirements. The first long-term measure is reported in the FY 07 Congressional Justification (CJ) and the other three long-term measures will be reported in the FY 08 CJ.

Does the program have ambitious targets and timeframes for its long-term measures?

Explanation: To date, the Corps readiness and response program has developed four long-term measures, but does not have baselines and/or targets/timeframes for two of its measures. For the first and second long-term measure, the Corps has ambitious targets/timeframes and performance data. The baseline/targets for the third and fourth long-term measure are still under development. In addition, for the third and fourth long-term measure the standards by which the timeliness, appropriateness, and effectiveness of response are assessed must be re-defined by the Office of the Surgeon General.

Evidence: For the first long-term measures, the percent of Officers who meet readiness requirements has grown from 5 percent in 2000 to 71 percent in 2005. Concurrently, the requirements for Officers to be designated as meeting readiness requirements has grown in number, intensity, and appropriateness since 2000, with targets continuously upgraded by the Office of the Surgeon General. Therefore the Corps has succeeded in increasing the percent of Officers who meet readiness requirements as the threshold for meeting these requirements has become increasingly more difficult. The second long-term measure, the percent of Officers that are deployable has a baseline of 40 percent for 2005 and goal to achieve 65 percent by 2009.

Does the program have a limited number of specific annual performance measures that can demonstrate progress toward achieving the program's long-term goals?

Explanation: The Corps readiness and response program has developed two annual measures directly tied to the long-term measures, and focused on the readiness and response of the Corps to medical emergencies and urgent public health needs. As part of the Commissioned Corps Transformation, the Corps is changing from an individual-centric deployment to a team-focused deployment to improve their response capacity; both measures will assess the Corps success at this transformation. Although both annual performance measures are output oriented measures, the success in these measures is directly related to the performance in the long-term outcome-oriented performance measures.

Evidence: The Corps annual measures are as follows: (1) increase the number of response teams formed and (2) increase the number of response teams which have met all the necessary requirements for full functionality and can deploy in the field when needed. The newly developed annual measures will be reported in the FY 08 CJ.

Does the program have baselines and ambitious targets for its annual measures?

Explanation: To date, the Corps readiness and response program has developed two annual measures with ambitious target/timeframes. The Corps readiness and response program has developed a very rigorous schedule to transform the Corps from an individual-centric deployment to team-focused deployment. Both measures will assess the success of the Corps at this transformation

Evidence: For the first annual measure, the goal of having all 36 teams formed by 2009 is ambitious because the OFRD needs to carefully organize each individual team to ensure each team is composed of Officers with the appropriate skill sets. The second annual measure, the goal of having all 36 teams meeting all requirements for full functionality; including training, equipment, and logistical support by 2010 is also very ambitious.

Do all partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) commit to and work toward the annual and/or long-term goals of the program?

Explanation: The OFRD partners with other Departments and with HHS Operating Divisions (OPDIV) and Staff Divisions (STAFFDIV) to which Officers are assigned. OFRD has Memorandums of Agreement/Understanding with Defense Medical Readiness Training Institute (DMRTI) and the Uniformed Services University of Health Sciences (USUHS) to provide training to Officers. These agreements are tied to the long-term goal of increasing the percent of Officers meeting the readiness requirements. In addition, OFRD cooperation with HHS OPDIVs and STAFFDIVs is essential to ensure a timely, appropriate, and effective response. In order to achieve HHS's long-term goal of increasing the percentage of Officers deployable to the field, the Secretary of HHS sent a letter to the OPDIV and STAFFDIV heads requesting their support and the support of their supervisors to assist in the identification and release of Officers to the rapid deployment teams. This cooperation from the OPDIVs and STAFFDIVs will also allow the OFRD to succeed in its annual measure of increasing the number of response teams formed.

Evidence: (1) Memorandum of Agreement between the HHS, Assistant Secretary for Health, OPHS, USPHS, Commissioned Corps, and DMRTI. (2) Memorandum of Understanding between the Office of the Surgeon General, OFRD, and USUHS. (3) Letter from Secretary of HHS sent to the OPDIV and STAFFDIV heads requesting their support for readiness and response efforts (May 5, 2006).

Are independent evaluations of sufficient scope and quality conducted on a regular basis or as needed to support program improvements and evaluate effectiveness and relevance to the problem, interest, or need?

Explanation: Independent evaluations of sufficient scope and quality of the Corps readiness and response program are conducted to support program improvements and demonstrate the effectiveness and relevance of the program. OFRD emergency responses have been evaluated by the HHS Office of Inspector General (OIG), and the OPHEP contractor (the CNA Corporation which evaluates the total HHS response to large events). The recent OIG evaluation provides an in depth evaluation of the Corps readiness and response program. The objective of the OIG evaluation was to: (1) evaluate the U.S. Public Health Service Commissioned Corps' responses to Hurricanes Katrina and Rita; and (2) identify if and how the Corps could improve their response to public health emergencies. The preliminary results of the evaluation were provided in briefings in July 2006. The final OIG report is expected to be made public in January 2007. The CNA reviews evaluated the entire HHS response rather than the OFRD response specifically. However, these reviews provide an overall evaluation of an HHS response of which the Corps was a key player.

Evidence: (1) OIG: The Commission Corps Responses to Hurricanes Katrina and Rita (March 2006). (2) Hurricane Frances and Ivan: Improving the Delivery of HHS and ESF #8 Support by the CNA Corporation (February 2005). (3) Joint OSG-OPHEP Hurricane After Action Retreat: Meeting Summary by the CNA Corporation (April 2006).

Are Budget requests explicitly tied to accomplishment of the annual and long-term performance goals, and are the resource needs presented in a complete and transparent manner in the program's budget?

Explanation: The OFRD FY 2007 budget does not provide a presentation that clearly shows the direct and indirect costs of deployment; ties the impact of funding decisions to the accomplishment of annual and long-term performance goals; and explains why the requested resources are appropriate. In FY 2008, the OFRD budget will include performance goals and begin to align program performance with budget requests.

Evidence: FY 2007 CJ

Has the program taken meaningful steps to correct its strategic planning deficiencies?

Explanation: The Corps readiness and response program is currently making a significant number of corrections to address strategic planning deficiencies. By addressing these deficiencies the Corps will make positive progress in its long-term goal of a ready, deployable Corps carrying out a timely, appropriate, and effective response.

Evidence: (1) Deficiency: Too few Officers who meet readiness standards were available for deployment . Correction: The Corps has increased the number of Officers who meet readiness standards, and are thus eligible to deploy, from 335 Officers in 2000 to over 4,200 in October 2005. This increase has been accomplished via communications from the Surgeon General and the Assistant Secretary for Health, as well as directly relating readiness to the ability to receive awards, serve on Boards, and be promoted. (2) Deficiency: OFRD, Officers, and the "Federal Response to Katrina Lessons Learned" report identified the need to deploy Officers as members of pre-identified response teams rather than as individuals. Correction: OFRD is currently implementing plans to develop Point-of-the-Spear, Tier 1, and Tier 2 response teams to deploy in a team structure.

Does the agency regularly collect timely and credible performance information, including information from key program partners, and use it to manage the program and improve performance?

Explanation: The Corps readiness and response program collects performance information through: (1) studies of the overall Federal emergency response to disasters, (2) an online "Mission Evaluation" form completed by individual Officers at the end of each mission, (3) after action reviews, and (4) discussions with program partners. The Corps uses this data to address operational deficiencies and enhance its emergency response capabilities.

Evidence: The Corps is working to organize and train Officers, into pre-configured and deployable teams in response to Recommendation 57.c of the "The Federal Response to Hurricane Katrina Lessons Learned" report dated February 2006. This recommendation was made in response to the lack of coordination and inefficiencies noted in the response to Hurricane Katrina. By having pre-configured and deployable teams, the goal is to enable the Corps to respond more quickly and efficiently. A common observation noted by Officers deployed to a Secretary's Emergency Response Team (SERT) during the 2004 Florida hurricanes was the need for improved training. As a result, the Corps worked with OPHEP to offer a week-long "SERT Training" course to over 200 Officers. The Corps collaborated in after action review with the nurse and mental health coordinators of the American Red Cross (ARC) to provide training for Corps nurses to better prepare them to deploy in an ARC shelter.

Are Federal managers and program partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) held accountable for cost, schedule and performance results?

Explanation: The OFRD utilizes Annual Performance Plans to hold program managers accountable for performance results. The Annual Performance Plans specify the program goals and the performance goals each individual is expected to meet. For example, the OFRD leadership's Annual Performance Plans held the leadership responsible for meeting the OFRD goal of 70 percent of Officers meeting readiness requirements by 2005. The OFRD uses Memorandums of Agreement (MOA) to hold program partners accountable for performance results. In order to meet the readiness goal, OFRD has a MOA with DMRTI to provide training to the Corps.

Evidence: (1) Annual Performance Plans for the OFRD Director, Response Coordinator, Training Coordinator, and IT/Information Coordinator all have Annual Performance Plans. (2)MOA between HHS, Assistant Secretary for Health, OPHS, USPHS, Commissioned Corps and DMRTI.

Are funds (Federal and partners') obligated in a timely manner, spent for the intended purpose and accurately reported?

Explanation: Almost 90 percent of the OFRD annual budget supports staff salaries, rent, and other overhead expenses. Year-end obligations have historically reflected a low lapsed budget balance (1.62 percent in FY03, 0.10 percent in FY04, and 0.67 percent in FY05.)

Evidence: Regular accounting reports (e.g., quarterly status of funds report) show funds obligated consistent with annual budget and CJ.

Does the program have procedures (e.g. competitive sourcing/cost comparisons, IT improvements, appropriate incentives) to measure and achieve efficiencies and cost effectiveness in program execution?

Explanation: The Corps readiness and response program has one efficiency measure - the cost per Officer to attain or maintain readiness requirements. The Corps readiness and response program also achieves efficiencies and cost effectiveness in other areas such as shared IT functions.

Evidence: Below are two example of how the Corps readiness and response program achieves efficiencies and cost effectiveness. The first example is tied to the Corps efficiency measure. (1) The Corps readiness and response program partners with the others such as the Uniformed Services University of the Health Sciences, Defense Medical Readiness Training Institute (DMRTI) at Fort Sam Houston, and FEMA to provide Officers free or reduced price training. (2) The OFRD partners with others such as the Office of Commissioned Corps Operations and the Medical Affairs Branch of the Personnel Services Center to reduce information technology costs for Officer deployment systems by sharing data, systems, and servers.

Does the program collaborate and coordinate effectively with related programs?

Explanation: The Corps readiness and response program collaborates with Federal and non-Federal programs, States, Tribal programs, and local governments. Many of the OFRD collaborations have been related to deployments while others are related to resource sharing opportunities such as training. The OFRD participates as a representative of the Surgeon General on numerous working groups to create planning documents related to readiness and response. For example, the Corps has partnered with the Medical Reserve Corps (MRC), the American Red Cross (ARC), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Centers for Disease Control and Prevention (CDC), and the OPHEP.

Evidence: The following are examples of collaborate efforts in responding to national disasters: (1) The Corps partners with the MRC in responding to ESF #8 missions. For example, during the response to hurricanes Katrina and Rita, 200 MRC volunteers deployed side by side with Officers. These MRC volunteers (e.g., physicians, nurses (RN and LPN) and mental health providers) were sworn in as intermittent Federal employees. (2) The OFRD collaborates with the ARC, SAMHSA, and CDC to provide a week long training course. The training course titled, "Mental Health in Disasters" was developed for all Corps mental health providers who might be called upon to provide mental and behavioral services after a traumatic event. (3) The OFRD is a partner with the OPHEP in preparing ESF #8 planning documents. These include the National Response Plan Emergency Support Function Annex and the Catastrophic Incident Response Plan on an inter-departmental level, and Concept of Operations Plans, including the HHS Pandemic Plan and an Integrated Response to a Nuclear Event.

Does the program use strong financial management practices?

Explanation: The Corps financial transactions are processed though the HHS Program Support Center's centralized financial systems. The annual audit of HHS has received an unqualified or clean auditor's opinion for the last seven years. The Office of Public Health and Science reported no material weaknesses under Federal Manager's Financial Integrity Act (FMFIA) for FY 2005. Administrative and budget staff routinely monitor overall expenditures through monthly and quarterly budget reviews and monthly commitment registers.

Evidence: (1) FY 05 Assistant Secretary of Health FMFIA assurance statement. (2) Independent Auditor's Report on Financial Statements, Internal Controls, and Compliance with laws and regulations. (see http://www.hhs.gov/of/reports/account/acct05/pdf/section3.pdf ). (3) FY 05 and FY 06 ARC Quarterly report/status of funds.

Has the program taken meaningful steps to address its management deficiencies?

Explanation: The Corps readiness and response program evaluates program management shortcomings in a timely and effective manner. The OFRD has identified program deficiencies and made improvements such as improving Officer readiness, training, protection against disease, systems to notify Officers of deployment, and implementing a team structure for deployment.

Evidence: The following is an example of an identified management deficiency and the corrective action taken. Deficiency: There was a gap between the Corps performance evaluation tool and the program goals of the OFRD. Correction: Beginning in 2005, the OFRD Director began using a Performance Plan to determine program and personal performance goals. This was followed in 2006 with Performance Plans for other OFRD senior program managers. These plans are utilized to bridge the gap between the standard Commissioned Officers Effectiveness Report (COER) and the goals of the Corps readiness and response program.

Has the program demonstrated adequate progress in achieving its long-term performance goals?

Explanation: The Corps readiness and response program has performance data for one of its four long-term measures. The Corps has succeeded in meeting or exceeding its targets for its long-term measure to increase the percentage of Officers that meet Corps readiness recruitments.

Evidence: The Corps has increased the percentage of Officers that meet Corps readiness requirements from 5 percent in 2000 to 71 percent in 2005. Since 2000, the Corps met its goal in 2004, and exceeded its goal in both 2003 and 2005.

Does the program (including program partners) achieve its annual performance goals?

Explanation: The Corps readiness and response program has performance data for one of its two annual measures. The Corps has succeeded in achieving its targets for its annual measure to increase the response teams formed.

Evidence: In 2006, the Corps has succeeded in forming its first 10 response teams out of a total of 36 teams to be formed by 2009. This is the first step in the Commissioned Corps Transformation from an individual-centric deployment to a team focused deployment.

Does the program demonstrate improved efficiencies or cost effectiveness in achieving program goals each year?

Explanation: The Corps readiness and response program has succeeded in decreasing the cost per Officer to attain or maintain readiness requirements for two consecutive years. From 2003 through 2005, the OFRD budget dedicated to readiness has decreased as the number of Officers meeting readiness requirements has increased.

Evidence: The Corps has decreased the cost from $243.20 in 2003 to $115.56 in 2005 for a total savings $127.64 per officer over this time period, almost a 50 percent reduction in spending per Officer.

Does the performance of this program compare favorably to other programs, including government, private, etc., with similar purpose and goals?

Explanation: To date, a comparison has not been done to compare the Corps readiness and response program to other similar programs; such as NDMS, MRC, or other State and local programs.

Evidence: The Corps readiness and response program is encouraged to compare its performance to similar programs; such as NDMS, MRC, or other State and local programs. This comparison would allow the Corps to determine if it is performing favorably in comparison with like programs.

Do independent evaluations of sufficient scope and quality indicate that the program is effective and achieving results?

Explanation: Independent evaluations of sufficient scope and quality of the Corps readiness and response program have indicated varying results. The preliminary findings from the OIG evaluation of the Corps response to Hurricanes Katrina and Rita include: (1) approximately one-third of active duty Officers were deployed, mostly in clinical roles; (2) although most Officers met readiness standards, many Officers lacked deployment experience and operational knowledge; and (3) many Officers encountered logistical difficulties associated with deployments. The OIG recommendations include implementing a system to strategically deploy experienced replacement Officers, improving Officer communication methods for field operations, and improving training (e.g., more active hands on, leadership, and ESF #8 training). The CNA Corporation evaluated OFRD's response to Hurricanes Frances and Ivan. The CNA Corporation's After Action Report provided some recommended areas of improvement for the OFRD including the deployment of Officers in pre-rostered teams. The report recommends that the teams have defined missions and are better equipped and trained. The Commissioned Corps transformation addresses many of the recommendations in the CNA Corporation's evaluation - namely the change from an individual centric deployment to a team-focused deployment.

Evidence: (1) OIG: The Commission Corps Responses to Hurricanes Katrina and Rita (March 2006). (2) Hurricane Frances and Ivan: Improving the Delivery of HHS and ESF #8 Support by the CNA Corporation (February 2005). (3) Joint OSG-OPHEP Hurricane After Action Retreat: Meeting Summary by the CNA Corporation (April 2006).