Report: Emergency health officers strained for time to train

By Brittany Ballenstedt

February 22, 2007

Officers deployed as part of a uniformed service run by the Health and Human Services Department have trouble finding time to train, and many lack hands-on experience that would help them better respond to public health emergencies, according to a new report from the department's inspector general.

"[Public Health Service] Commissioned Corps officers deployed in response to hurricanes Katrina and Rita provided valuable services, but the corps could improve its response to public health emergencies," the report found.

The corps is one of seven U.S. uniformed services and is made up of officers commissioned on the basis of their health-related training. Their role is to provide health care and other services in areas with a shortage of health professionals. The HHS secretary has the authority to make decisions about where to deploy the corps, and the president also may use it in times of war or emergency.

Officers in the health corps played a major part in the aftermath of Katrina and Rita, with 2,119 of them working with state, local and private agencies. State health officials said the corps officers integrated "seamlessly" into emergency operations centers in the early days of response, and especially helped states to identify and understand available federal assets.

But the report found that while most officers met readiness standards, the cost of meeting such standards was often high.

Officers are regularly employed with agencies within and outside HHS, meaning they must simultaneously fulfill their responsibilities to their regular agency and to the corps. As agency employees, officers must negotiate with their supervisors for time to maintain their readiness training. If they are unable to train during normal work hours, officers often must use personal time to meet the standards.

According to the report, 28 percent of officers said they spend more than 15 hours of personal time each month to keep up with the standards. Another 12 percent, many with young children or a workweek that greatly exceeds 40 hours, stated that maintaining their readiness status creates a significant hardship.

The report also found that 52 percent of officers sent out in response to the hurricanes had no deployment experience. Field commanders reported that inexperienced officers were unfamiliar with response protocols and that the more experienced officers had to spend time training and orienting the new officers in the field.

On the training front, 36 percent of officers said their training did not adequately prepare them for field operations. Most acknowledged that the computerized training models were overly broad and did little to prepare them for the conditions and situations they encountered. Another 13 percent expressed concern that their agency workloads limited their opportunity to undergo training.

Furthermore, though state officials generally were satisfied with the response effort, many needs remained unmet, especially in the nursing, mental health and dental areas, the report found. State officials said many officers lacked adequate skills in administering immunizations and providing primary, acute and emergency care.

The IG also found that agencies were unwilling or unable to allow some of the officers to deploy, while logistical difficulties delayed others. Many incurred mission-related expenses and were not reimbursed promptly, which could affect their ability to deploy to future public health emergencies, the report said.

The report is one of many assessing the government's response to the hurricanes, mainly Katrina. Criticisms emerged following the disaster, regarding mismanagement and a lack of preparedness, especially in the government's delayed response to the flooding of New Orleans.

The IG recommended that the corps implement more hands-on, focused training and seek funding to allow officers to be paid for the time spent keeping their skills up to date. Deployments should be staggered to mitigate the loss of experience as officers end their tours, the report said.

The report also suggested that deployable officers get government travel cards to make mission-related purchases so they do not have to use personal accounts. Lawmakers have sought to crack down on the use of government travel and purchase cards, however, stating that they need to have lower spending limits and stronger auditing standards.

The health corps is undergoing a transformation to improve response to public health emergencies, and officials said in response to the report that they are planning to address most of the shortcomings cited.

By Brittany Ballenstedt

February 22, 2007