VA’s fourth mission—to serve as backup to the Department of Defense (DOD) health system in war or other emergencies and as support to communities following domestic terrorist incidents and other major disasters—has attracted greater congressional interest since the September 11 terrorist attacks in the United States. In 1984, VA, DOD, the Federal Emergency Management Agency (FEMA), and the Department of Health and Human Services (HHS) created a federal partnership to administer and oversee NDMS, which is a joint effort between the federal and private sectors to provide backup to civilian health care in the event of disasters producing mass casualties. VA also has its own medical emergency radiological response team of physicians and other health specialists. In addition to these functions, VA plays a key support role in the nation’s stockpiling of pharmaceuticals and medical supplies in the event of large- scale disasters caused by weapons of mass destruction (WMD). Its direct emergency response activities include conducting and evaluating terrorist attack simulations to develop more effective response procedures and maintaining the inventories for stockpiled pharmaceuticals and medical supplies. The exercise had 500 participants and was designed to integrate the federal medical response into the state and local response, including local hospitals. How best to employ and enhance this potential will be determined as part of a larger effort currently underway to develop a national homeland security strategy. VA holds other substantial health system assets. The report outlined both strengths and weaknesses in regard to VA’s emergency response capabilities.
What GAO Found

In the event of a domestic terrorist attack or other major disasters, the Department of Veterans Affairs (VA) is to provide backup medical resources to the military health system and local communities. VA now assists other federal agencies that have lead responsibility for responding to disasters, including terrorism. Its areas of responsibility include disaster simulation exercises and maintaining medical stockpiles. VA's efforts in these areas have enhanced national emergency preparedness by improving medical response procedures and by strengthening the security of federal pharmaceutical stockpiles to ensure rapid response to local authorities. VA also has resources that could play a role in future federal homeland security efforts. Its assets include the bricks, mortar, and human capital components of its health care system; graduate medical education programs; and expertise involving emergency backup and support activities. In managing large-scale medical emergencies arising from terrorist attacks, VA's emergency response capabilities have strengths and weaknesses. Determining how VA can best contribute to homeland security is especially timely given the extraordinary level of federal activity underway to manage large-scale disasters.