Department of Health and Human Services

OFFICE OF 

INSPECTOR GENERAL 

T C C 

HE  OMMISSIONED  ORPS
R H
ESPONSE TO  URRICANES 

K R
ATRINA AND  ITA

Daniel R. Levinson

Inspector General 

February 2007

OEI-09-06-00030
 Office of Inspector General 

http://oig.hhs.gov 
The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, 
as amended, is to protect the integrity of the Department of Health and Human Services 
(HHS) programs, as well as the health and welfare of beneficiaries served by those 
programs.  This statutory mission is carried out through a nationwide network of audits, 
investigations, and inspections conducted by the following operating components: 
Office of Audit Services 
The Office of Audit Services (OAS) provides all auditing services for HHS, either by 
conducting audits with its own audit resources or by overseeing audit work done by others. 
Audits examine the performance of HHS programs and/or its grantees and contractors 
in carrying out their respective responsibilities and are intended to provide independent 
assessments of HHS programs and operations.  These assessments help reduce waste, 
abuse, and mismanagement and promote economy and efficiency throughout HHS. 
Office of Evaluation and Inspections 
The Office of Evaluation and Inspections (OEI) conducts national evaluations to provide 
HHS, Congress, and the public with timely, useful, and reliable information on 
significant issues.  Specifically, these evaluations focus on preventing fraud, waste, or 
abuse and promoting economy, efficiency, and effectiveness in departmental programs.  
To promote impact, the reports also present practical recommendations for improving 
program operations. 
Office of Investigations 
The Office of Investigations (OI) conducts criminal, civil, and administrative 
investigations of allegations of wrongdoing in HHS programs or to HHS beneficiaries 
and of unjust enrichment by providers.  The investigative efforts of OI lead to criminal 
convictions, administrative sanctions, or civil monetary penalties. 
Office of Counsel to the Inspector General 
The Office of Counsel to the Inspector General (OCIG) provides general legal services to 
OIG, rendering advice and opinions on HHS programs and operations and providing all 
legal support in OIG's internal operations. OCIG imposes program exclusions and civil 
monetary penalties on health care providers and litigates those actions within HHS. 
OCIG also represents OIG in the global settlement of cases arising under the Civil False 
Claims Act, develops and monitors corporate integrity agreements, develops compliance 
program guidances, renders advisory opinions on OIG sanctions to the health care 
community, and issues fraud alerts and other industry guidance.    E X E C U T I V E   S U M M A R Y  

OBJECTIVE 
1.	 To evaluate the U.S. Public Health Service Commissioned Corps 
(the Corps) response to Hurricanes Katrina and Rita. 
2.	 To identify whether and how the Corps could improve its response to 
public health emergencies. 
BACKGROUND 
The U.S. Public Health Service Commissioned Corps, one of seven U.S. 
uniformed services, is made up entirely of officers commissioned on the 
basis of their health-related training.  Agencies within and outside the 
Department of Health and Human Services (the Department) employ 
Corps officers to provide health care and related services in health 
professional shortage areas.  In addition, the Secretary of the 
Department has the authority to deploy the Corps in response to public 
health emergencies. Hence, Corps officers must simultaneously fulfill 
their responsibilities to their employer agency and to the Corps. 
In August and September 2005, respectively, Hurricanes Katrina and 
Rita struck the Gulf Coast.  In response to health care and public health 
needs in the affected areas, the Corps carried out the largest 
deployment in its 207-year history. More than 2,100 officers worked 
with State, local, and private agencies in response to the hurricanes. 
Since 2003, the Corps has been engaged in a continuous effort to 
improve its response capacity.  On January 18, 2006, the Secretary 
announced the latest phase in this effort, in which the Corps will 
increase the number of officers by 10 percent, create a team-oriented 
deployment process, and improve the recruitment process. 
For this evaluation, we:  (1) surveyed a stratified random sample of 
350 Corps officers; (2) analyzed Corps administrative databases; 
(3) interviewed and collected documentation from Corps field 
commanders, Corps management components, and the Office of the 
Assistant Secretary for Preparedness and Response (ASPR, then known 
as the Office of Public Health Emergency Preparedness); (4) interviewed 
State health officials; and (5) interviewed seven agencies that employ 
Corps officers. 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  i  E X E C U T I V E   S U M M A R Y

FINDINGS 
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 
Commissioned Corps provided valuable support to States, but more 
officersespecially nurses, mental health professionals, and dentists 
were needed.  While most deployed officers met Corps readiness 
standards, many lacked experience, effective training, and familiarity 
with response plans. Agencies were unwilling or unable to allow some 
officers to deploy, while logistical difficulties delayed others arrival in 
the field. Confusion surrounded some officers arrival, but most field 
assignments were appropriate and officers felt safe at their locations. 
Most officers were equipped adequately, but some lacked working 
communications devices and other basic tools. Many officers personally 
incurred mission-related expenses and some were not reimbursed 
promptly, which could affect their ability to deploy to future public 
health emergencies. 
RECOMMENDATIONS 
Although the transformation of the Corps may alleviate many of the 
issues it experienced in responding to Hurricanes Katrina and Rita, the 
Corps also should take the following actions to improve its effectiveness 
and efficiency: 
Institute more effective training for Corps officers. The Corps should 
implement more hands-on, focused training and seek funding to allow 
Corps officers to be paid for time spent in training. 
Improve the system used to contact officers for deployment. The 
Corps should develop a system to quickly and reliably contact officers 
for deployment. 
Work with the Office of the Assistant Secretary for Preparedness 
and Response to streamline deployment-related travel. The Corps 
should work with the Office of the Assistant Secretary for Preparedness 
and Response to establish a system for rapid deployment. 
Stagger deployments to ensure continuity of operations. The Corps 
should stagger deployments to mitigate the loss of experience as officers 
end their tours, especially during lengthy responses. 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  ii  E X E C U T I V E   S U M M A R Y  
Improve its ability to coordinate mission assignments and 
communications in the field.  The Corps should work with the Office of 
the Assistant Secretary for Preparedness and Response to develop more 
effective systems to ensure that officers arrive when and where they are 
needed with a clear understanding of their assignments and to increase 
the variety of communications equipment available to officers. 
Ensure that all deployable officers have Federal Government travel 
credit cards. All deployable officers should have official Government 
travel credit cards with which to make mission-related purchases so 
they do not use personal accounts. The Corps should work with the 
Office of the Assistant Secretary for Preparedness and Response to 
review the procedures used to reimburse officers for mission-related 
expenses. 
AGENCY COMMENTS 
The Assistant Secretary for Health agreed with the Office of Inspector 
Generals (OIG) recommendations for improving the Corps response to 
public health emergencies.  As part of the Corps comprehensive 
transformation process and its efforts to improve the Office of Force 
Readiness and Deployments practices, the Corps is currently 
addressing OIGs recommendations. 
This evaluation was conducted in conjunction with the Presidents 
Council on Integrity and Efficiency (PCIE) as part of its examination of 
relief efforts provided by the Federal Government in the aftermath of 
Hurricanes Katrina and Rita.  As such, a copy of the report has been 
forwarded to the PCIE Homeland Security Working Group, which is 
coordinating Inspectors General reviews of this important subject.  
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  iii    T A B L E   O F   C O N T E N T S  

EXECUTIVE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  i

I N T RO DUC T IO N   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  1

F I N D IN G   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   8

 Response valuable, but some shortcomings . . . . . . . . . . . . . . . . . . . . . . .  8

R E C O MMEN D A T ION S  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  14

  Agency Comments  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  15

APPENDIXES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  17

 A:  	 Commissioned Corps Employer Agencies

  and Professional Categories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  17

  B: Commissioned Corps Management Structure. . . . . . . . . . . . . . . . .  18

  C: Commissioned Corps Standards of Readiness. . . . . . . . . . . . . . . . .  19

  D: Emergency Support Function #8  . . . . . . . . . . . . . . . . . . . . . . . . . . .  20

  E: Statistical Confidence Intervals  . . . . . . . . . . . . . . . . . . . . . . . . . . .  21

  F:  AgencyComments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  23

A C K NO WL E D G M E N T S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  24
   I N T R O D U C T I O N  

OBJECTIVES 
1.	 To evaluate the U.S. Public Health Service Commissioned Corps 
(the Corps) response to Hurricanes Katrina and Rita. 
2.	 To identify whether and how the Corps could improve its response to 
public health emergencies. 
BACKGROUND 
The U.S. Public Health Service Commissioned Corps is one of seven 
U.S. uniformed services.  The Corps is made up entirely of officers who 
were commissioned on the basis of their health-related training.  A 
primary purpose of the Corps is to provide health care and related 
services to health professional shortage areas.1  The Secretary of the 
Department of Health and Human Services (the Secretary) has the 
authority to deploy the Corps in response to public health emergencies,2 
and the President may utilize the Corps in time of war or emergency.3 
Although the Corps recruits officers, those officers actually are 
employed by other agencies within and outside the Department.  Hence, 
Corps officers must simultaneously fulfill their responsibilities to their 
employer agency and the Corps.  Officers provide a variety of 
professional skills to their employer agencies, including clinical, 
environmental health, and engineering services. (See Appendix A for a 
complete list of Department and external agencies that employ Corps 
officers and the professional categories of skills that Corps officers 
provide.) 
2003 Transformation 
In 2003, the Corps developed a transformation plan that reorganized its 
management structure, revised its officers standards of readiness, and 
created a new mission statement.  The Corps implemented the 
1 As defined by 42 U.S.C.  254e(a), the term health professional shortage area means  
(A) an area in an urban or rural area (which need not conform to the geographic 
boundaries of a political subdivision and which is a rational area for the delivery of health 
services) which the Secretary determines has a health manpower shortage and which is not 
reasonably accessible to an adequately served area, (B) a population group which the 
Secretary determines has such a shortage, or (C) a public or nonprofit private medical 
facility or other public facility which the Secretary determines has such a shortage.  
2 42 U.S.C.  247d(a). 
3 42 U.S.C.  217. 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  1  I N T R O D U C T I O N  
transformation plan before Hurricanes Katrina and Rita struck. The 
Corps is structured as follows. 
The Corps management structure. The Assistant Secretary for Health 
administers the Public Health Service4 within the Office of Public 
Health and Science. Pursuant to Title 42 of the United States Code 
(U.S.C.)  204, the Corps is a component of the Public Health Service.5 
Within the Office of Public Health and Science, the Office of 
Commissioned Corps Force Management and the Office of the Surgeon 
General form the broad management structure of the Corps.  The Office 
of Commissioned Corps Force Management establishes performance 
standards and measurements for the Corps, while two offices in the 
Office of the Surgeon General handle most other Corps functions. 
Within the Office of the Surgeon General, the Office of Commissioned 
Corps Operations (OCCO) administers the Corps day-to-day operational 
functions, including general training, career development, and other 
personnel functions.  The Office of Force Readiness and Deployment 
(OFRD) administers deployment training and readiness, contacts 
officers for deployments, and assembles deployment rosters. The Office 
of the Assistant Secretary for Preparedness and Response (ASPR, then 
known as the Office of Public Health Emergency Preparedness), located 
in the Office of the Secretary, handles travel and other logistics for 
deployed officers.  (See Appendix B for more details on Corps 
management.) 
The Corps standards of readiness.  Unless Corps officers are exempted, 
they are required to meet certain standards of readiness prior to being 
placed on an OFRD deployment roster.  The Corps standards of 
readiness consist of health and safety requirements (such as 
immunizations), physical readiness, and training and competency 
standards. According to former Surgeon General Richard Carmona, 
72 percent of Corps officers met the standards of readiness as of October 
2005, up from the 23 percent who met the standards in January 2003.6 
4 42 U.S.C.  202.

5 For a historical description of the U.S. Public Health Service Commissioned Corps visit 

U.S. Public Health Service Commissioned Corps, The History of the Commissioned Corps.  
Available online at http://www.usphs.gov/html/history.html. 

6 Letter from former Surgeon General Richard Carmona to all commissioned officers, 

October 3, 2005.  Available online at 

http://dcp.psc.gov/PDF_docs/SGLetterreadinessOct305.htm. Accessed December 12, 2005.   

  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  2  I N T R O D U C T I O N  
(See Appendix C for the standards of readiness as of October 2005.7) 
The Corps mission statement. At the time of Hurricanes Katrina and 
Rita, the Corps mission statement was as follows:  Protecting, 
promoting, and advancing the health and safety of the Nation.  As 
Americas uniformed service of public health professionals, the 
Commissioned Corps achieves this mission through: 
  Rapid and effective response to public health needs, 
  Leadership and excellence in public health practices, and 
  The advancement of public health science. 
Deploying the Commissioned Corps 
The Departments Concept of Operations Plan (CONOPS)8 establishes 
the framework for managing and coordinating its response to public 
health and medical emergencies.  The CONOPS is coordinated with 
other emergency response plans, such as the National Response Plan.9 
Under the National Response Plan, Emergency Support  
Function #8 (ESF #8) provides the mechanism for coordinated Federal 
assistance to supplement State, local, and tribal resources in response 
to public health care needs.  To request resources such as Corps officers 
or supplies during a public health emergency, State health officials are 
required to submit an action request form to the Federal Emergency 
Management Agency (FEMA), which generally will be collocated with 
other Federal, State, and local agencies in a temporary joint field office. 
Once FEMA approves the request, it will issue a mission assignment to 
the Department, which will mobilize the requested resources.  (See 
Appendix D for a flowchart depicting this process.) 
Once the Secretary authorizes the Corps to deploy, the Assistant 
Secretary for Health establishes the scope, size, and duration of the 
deployment.  At the request of the Assistant Secretary for Health, the 
Surgeon General deploys the Corps and manages day-to-day operations 
in cooperation with the ASPR.  These two officials are charged with 
ensuring that Corps officers with the appropriate skills are deployed 
when necessary.  Within the Surgeon Generals office, OFRD contacts 
7 MANUAL CIRCULAR  COMMISSIONED CORPS PERSONNEL PHS NO. 377.   

Available online at http://dcp.psc.gov/PDF_docs/Man_circ_377.pdf. Accessed  

December 12, 2005. 

8 U.S. Department of Health and Human Services, Concept of Operations Plan (CONOPS)

for Public Health and Medical Emergencies, June 2006.  

9 U.S. Department of Homeland Security, National Response Plan, December 2004. 

  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  3  I N T R O D U C T I O N  
Corps officers and their employer agencies to request the mobilization.  
If an officer is able to deploy and his or her agency supervisor approves 
the deployment, OFRD places the officer on a deployment roster.  ASPR 
receives the deployment rosters from OFRD and makes the officers 
travel arrangements through a contractor. 
The Corps Response to Hurricanes Katrina and Rita  
In late summer and early fall 2005, Hurricanes Katrina and Rita 
devastated the Gulf Coast.  On August 29, Hurricane Katrina made 
landfall in Louisiana as a Category 3 storm, causing an estimated 
$81 billion in damage and 1,833 deaths.10  On September 24, Hurricane 
Rita made landfall between Texas and Louisiana, also as a Category  
3 storm, causing estimated total damage of $10 billion and at least  
62 deaths.11 
In response to health care and public health needs in the areas affected 
by the hurricanes, the Corps carried out the largest deployment in its 
207-year history. According to Corps administrative data, 2,119 of the 
6,122 Corps officers (35 percent) on active duty between August 26 and 
November 7, 2005, deployed at least once in 
Table 1: Corps Deployment Locations 
response to Hurricanes Katrina or Rita.  These 
officers served a total of 2,372 missions (some 
Mission location  Number  Percentage 
officers deployed more than once). The Corps 
Louisiana  814  45.8% 
itself deployed officers for 1,777 of these missions 
Mississippi  453  25.5%  (75 percent), while agencies that employed Corps 
officers deployed the remainder.  As shown in 
Washington, DC/Maryland  283  15.9% 
Table 1, officers deployed by the Corps served 
Texas  184  10.4% 
mainly in States directly affected by the 
Georgia  43  2.4% 
hurricanesLouisiana, Mississippi, and Texas 
Total  1,777  100.0%  though a significant number filled roles in 
national and regional headquarters.12  Of officers 
Source: Office of Inspector General analysis of Corps 
administrative data, 2006.  deployed to the Gulf Coast, 81 percent served on 
10 National Hurricane Center.  Tropical Cyclone Report, Hurricane Katrina,  
23-30 August 2005.  December 20, 2005, updated August 10, 2006.  Available online at 
http://www.nhc.noaa.gov/pdf/TCR-AL122005_Katrina.pdf. Accessed August 12, 2006.  
11 National Hurricane Center.  Tropical Cyclone Report, Hurricane Rita,  
18-26 September 2005.  March 17, 2006, updated August 14, 2006.  Available online at 
http://www.nhc.noaa.gov/pdf/TCR-AL182005_Rita.pdf. Accessed August 14, 2006.  
12 Federal disasters were declared in Alabama, Florida, Louisiana, and Mississippi for 
Hurricane Katrina and in Louisiana and Texas for Hurricane Rita.  However, Alabama and 
Florida did not request assistance that resulted in Corps deployments.  
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  4  I N T R O D U C T I O N  
teams that rendered direct services to affected communities and 
19 percent served on the Secretarys Emergency Response Teams or at 
local operations centers, such as Camp Phoenix in Baton Rouge. 
Corps 2006 Transformation 
On January 18, 2006, the Secretary announced that the Corps 
transformation would continue into its next phase, which would enable 
it to address public health challenges more quickly and efficiently.  
From February through March 2006, the Corps developed strategies to 
increase its size and improve its ability to respond quickly to urgent 
public health needs by: 
	 Increasing the number of officers by 10 percent, to a total of 
6,600; 
	 Improving response operations and team-oriented deployment 
processes; and 
	 Changing the recruitment process so that it includes stronger 
personal incentive programs and a better approach for assigning 
officers.13 
Rapid Deployment Force and Health and Medical Response Team. In response 
to recommendations 57c and 60 of the White House report, The Federal 
Response to Hurricane Katrina:  Lessons Learned,14 in 2006 the Corps 
commenced implementing a tiered response plan, which will include a 
Rapid Deployment Force (RDF).15  The Corps also is developing plans for a 
Public Health Service Health and Medical Response (HAMR)16 team. 
The Corps response plan will consist of four response tiers: 
	 Tier one will constitute the RDF.  The RDF will be strategically 
located in multiple locations and staffed for rapid deployment 
across the Nation. Tier one will be expected to report to a point 
of departure within 12 hours of notification. 
13 U.S. Department of Health and Human Services news release, New Initiative 

Announced to Transform the US Public Health Service Commissioned Corps,  

January 18, 2006.  Available online at 

http://www.os.dhhs.gov/news/press/2006pres/20060118.html. Accessed January 18, 2006.   

14 Frances Fragos Townsend, The Federal Response to Hurricane Katrina:  Lessons

Learned, February 2006. 

15 Letter from RADM John Babb, U.S. Public Health Service Commissioned Corps, to Corps 

officers, April 28, 2006.  

16 Transformation Working Group on Readiness, February 2006. 

  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  5  I N T R O D U C T I O N  
	 Tier two also will be strategically located for rapid deployment 
across the Nation and staffed with applied public health and 
mental health teams.  However, tier two will be expected to 
report to a point of departure within 36 hours of notification. 
	 Tier three will consist of officers not placed in tier one or two.  
Tier three will be expected to report to a point of departure 
within 72 hours of notification.   
	 Tier four will consist of officers in the Corps inactive reserve. 
There is no specific time requirement for reporting to a point of 
departure upon notification. 
Under the HAMR team concept, the Corps would create and maintain a 
cadre of full-time, equipped teams dedicated to training for and 
responding to public health emergencies. 
METHODOLOGY 
For this evaluation, we:  (1) surveyed a stratified random sample of 
200 deployed Corps officers and 150 Corps officers who did not deploy; 
(2) analyzed Corps administrative databases; (3) interviewed and 
collected documentation from Corps field commanders, Corps 
management components, and ASPR officials; (4) interviewed State 
health officials; and (5) interviewed selected agencies that employ Corps 
officers. 
Corps officer surveys.  To obtain perspectives about the Corps emergency 
response operations, we surveyed a stratified random sample of Corps 
officers. We administered two surveys:  one 
Table 2: Corps Officer Survey Characteristics 
to 200 officers who deployed in response to 
Population  Sample  Response  Hurricanes Katrina and/or Rita between 
Stratum 
Count  Count  Count 
August 26 and November 7, 2005; and one 
Deployed  2,173  200  197  to 150 officers who did not deploy during 
that period.17 Our sampling method allowed 
Nondeployed  3,949  150  133 
us to project the results of the survey to the 
Total  6,122  350  330  population of all officers who were on the 
Corps roster during that time. Appendix E 
Source:  Office of Inspector General, 2005. 
contains statistical confidence intervals for 
all projected survey figures presented in this report.  We received 
17 We selected this time period to obtain information about the initial experiences that 
officers encountered during Hurricanes Katrina and Rita.    
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  6  I N T R O D U C T I O N  
197 responses from deployed officers and 133 responses from 
nondeployed officers, for an overall response rate of 94 percent.  Ten 
officers whom we selected as part of the deployed sample indicated in 
the survey that they had not deployed, and nine selected as part of the 
nondeployed sample indicated that they had deployed.  Hence, our 
analysis refers to 196 deployed and 134 nondeployed officers.   
Table 2 (previous page) shows population, sample, and response counts 
for the officer survey. 
Corps administrative databases.  At the time of our evaluation, the Corps 
maintained several databases with personnel, readiness, and historical 
deployment information for all of its officers (it has since combined 
those separate databases into a single system). We used information 
from these databases to identify our universe of deployed and 
nondeployed officers and to analyze officers deployment history and the 
extent to which they met the standards of readiness. We did not 
validate the information contained in these databases. 
Field commanders and Corps management components. To gain insight into 
Corps field operations, we interviewed and obtained documentation from the 
seven field commanders who managed Corps emergency response operations 
throughout Louisiana, Mississippi, and Texas.  We also interviewed and 
obtained documentation about the Corps responses to Hurricanes Katrina 
and Rita from each of the Corps management  components. 
State health officials.  To gather stakeholder perspectives on the Corps 
responses to Hurricanes Katrina and Rita, we interviewed State health 
officials in Louisiana, Mississippi, and Texas. 
Agencies that employ Corps officers. To understand the viewpoint of 
agencies that employ Corps officers, we interviewed officials at seven 
agencies that together employed 87 percent of the officers in our sample.18 
These included both Department and external agencies. 
Standards 
This study was conducted in accordance with the Quality Standards for 
Inspections issued by the Presidents Council on Integrity and 
Efficiency and the Executive Council on Integrity and Efficiency. 
18 These agencies were the Indian Health Service, the Centers for Disease Control and 
Prevention, the Food and Drug Administration, the Health Resources and Services 
Administration, the Bureau of Prisons, the National Institutes of Health, and the 
Department of Homeland Security.   
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  7    F I N D I N G  

Commissioned Corps officers deployed in  The Corps provided valuable 
response to Hurricanes Katrina and Rita provided  assistance in response to the 
public health threats triggered by 
valuable services, but the Corps could improve its 
Hurricanes Katrina and Rita and 
response to public health emergencies 
addressed the health care needs 
of those affected.  Officers provided critical clinical and environmental 
health and engineering services to affected communities and valuable 
support to State health officials.  However, the Corps was not able to 
meet some State needs. Furthermore, deficiencies in officer 
preparation, deployment logistics, field operations, and officer 
reimbursement diminished the effectiveness and efficiency of the 
response. 
Corps officers provided valuable support to States but could not meet 
some needs 
Corps officers in Joint Field Offices worked side-by-side with State 
officials, and both partners generally reported very positive working 
relationships.  According to State health officials, these officers 
integrated seamlessly into emergency operations centers in the early 
days of the response. Perhaps most important to State health officials, 
Corps officers helped the States identify and understand the Federal 
assets available for their use. They also helped States understand the 
situation on the ground in affected areas.  One State health official 
reported, There were some lessons learned, but overall we got what we 
needed.  They were extremely beneficial. 
Overall, approximately 67 percent of officers deployed by the Corps 
served on teams that provided health care and public health services in 
hurricane-affected areas.  State health officials credited these officers 
with saving many lives. Officers employed their clinical skills to 
provide a variety of services, including primary and emergent care, 
pharmacy, and veterinary medicine. Meanwhile, Corps environmental 
health officers and engineers helped assess and counter public health 
threats caused by the hurricanes and subsequent flooding. 
Although State health officials generally were satisfied with the relief 
services the Corps provided, some needs were not met, especially in the 
nursing, mental health, and dental areas.  Corps officers and field 
commanders also identified the need for more nursing and mental 
health professionals, the latter for both hurricane victims and response 
personnel. One State health official noted that a small number of Corps 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  8  F I N D I N G

officers lacked adequate skills in administering immunizations and 
providing primary, acute, and emergent care. 
Although most deployed Corps officers met readiness standards, many 
lacked experience, effective training, and familiarity with response plans 
Readiness.  According to our survey, 96 percent of the officers who 
deployed in response to Hurricanes Katrina and Rita met the Corps 
readiness standards.19  This preparation helped the Corps better 
respond to the hurricanes:  70 percent of deployed officers said that 
meeting the standards helped improve their performance in the field. 
Officers deployed to hurricane-affected areas were significantly more 
likely than those deployed to national or regional command centers to 
state that meeting the standards improved their performance. 
Although this level of readiness is valuable, attaining it exacts a cost. 
As agency employees, officers must negotiate with their supervisors for 
time to maintain their readiness.  If they cannot obtain sufficient time 
during working hours, officers must use personal time to meet the 
standards. According to our survey, 28 percent of officers spend more 
than 15 hours of personal time each month keeping up with the 
standards.  Approximately 12 percent of officers, mainly those who 
reported having young children or a regular workweek that greatly 
exceeded 40 hours, stated that maintaining their readiness status 
creates a significant hardship for them. 
Experience. Fifty-two percent of the Corps officers deployed in response 
to the hurricanes had no previous deployment experience, which 
hindered the Corps overall effectiveness.  Field commanders reported 
that inexperienced officers were unfamiliar with response protocols and 
that more experienced personnel had to spend time training and 
orienting the new officers in the field.  Furthermore, the Corps 
standard 2-week deployment meant that these inexperienced officers 
often left the relief operation soon after they had become comfortable in 
their roles. To counter this, some officers voluntarily extended their 
tours; nevertheless, 80 percent of deployments lasted 15 or fewer days.  
Although all interview respondents noted the lack of experience as a 
problem, the Corps did not use many of its experienced officers in the 
response.  Of all officers deployed by the Corps or their employer 
19 Corps administrative data show that approximately 85 percent of deployed Corps officers 
met the readiness standards at the time of deployment. 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  9  F I N D I N G  
agencies, only 57 percent of the experienced officers on the Corps active 
duty roster deployed for hurricane relief operations. 
The number of inexperienced officers increased as the response to 
Hurricane Katrina continued and Hurricane Rita arrived.  Field 
commanders and State health officials noted that while the initial wave 
of officers was relatively experienced, officers deployed later were less 
experienced.  Corps administrative data support this perception, 
showing that the proportion of officers with previous deployment 
experience steadily declined as the response continued.  (See 
Table 3 below.) One field commander stated,  . . . [The] Corps threw 
everything into Katrina[we] didnt have the resources to reload for 
Rita. 
Table 3: Previous Experience of Deployed Officers, by Week, in 2005 
Week Starting 
22-Aug  29-Aug  5-Sep  12-Sep  19-Sep  26-Sep  3-Oct  10-Oct  17-Oct  24-Oct 
Number of 
48  541  224  125  307  134  102  54  46  42 
officers 
Percentage with 
69%  54%  57%  50%  44%  37%  36%  35%  35%  24%
experience 
Source:  Office of Inspector General analysis of the Corps administrative data, 2006. 
Training. Certain respondents viewed Corps training prior to the 
hurricanes as ineffectual in some respects.  Thirty-six percent of 
deployed officers stated that their Corps training did not adequately 
prepare them for field operations; some field commanders agreed. Most 
commonly, officers said that the Corps computerized training modules 
were overly broad and did little to prepare them for the conditions and 
situations they encountered during the response.  Officers called for 
more hands-on practical training.  About 24 percent of the surveyed 
officers volunteered that team-based training, as outlined in the Corps 
2006 transformation, would have been beneficial.20  Some officers, about 
13 percent of those surveyed, expressed concern that their agency 
workloads limited their opportunity to undergo Corps training.  This 
20 We did not solicit input on particular ways to enhance Corps training but instead asked 
generally how Corps training and emergency response could be improved. 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  10  F I N D I N G

situation, they said, could be improved by providing Corps funding and 
dedicated time for training courses and exercises. 
Familiarity with response plans. Many deployed officers were unfamiliar 
with the framework for public health emergency responseonly  
37 percent were familiar with the CONOPS and 61 percent with  
ESF #8. As the primary guides to the responsibilities of the 
Department in response to a terrorist attack or natural disaster, these 
documents are an important part of the incident command structure. 
The field commanders we interviewed all agreed that deployed officers 
should be familiar with ESF #8, but some believed that it was less 
important that officers be familiar with CONOPS. 
Agencies were unwilling or unable to allow some officers to deploy; 
logistical difficulties delayed others arrival in the field 
Agency release.  According to our survey of Corps officers, 17 percent of 
the officers who did not participate in the Corps response to the 
hurricanes received requests to deploy that they could not fulfill.  
Agency responsibilities prevented 56 percent of this group from 
deploying, generally because the officers could not obtain supervisory 
approval.  For example, one officer related that his agency supervisor 
stated that the officers priority was the agency rather than hurricane 
relief.  Agencies could not spare others because the officers primary 
work locations already were understaffed or because the agencies 
needed them for their own response operations. 
Logistical difficulties.  Delays in notification and travel challenges meant 
that Corps officers were not always available when and where they 
were expected.  Although the first wave of Corps officers arrived 
quickly, replacements arrived 2 to 3 days after the States request.  
Several Corps field commanders and State health officials reported that 
delays led to difficulties in the field. For example, one State health 
official stated that beyond the first cadre of officers, by the time  
they . . . arrived, our needs had changed. 
Many Corps officers did not receive the requests to deploy until well 
after they were made, which delayed their travel significantly. 
Forty-six percent of officers who were requested to deploy received the 
requests more than 12 hours after they were sent, and 13 percent 
received them after a delay of more than 72 hours.  More than half of 
the officers (55 percent) contacted for Hurricanes Katrina and Rita said 
the contact method used by the Corps was not ideal.  For example,  
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  11  F I N D I N G

28 percent of officers told us that the best way to contact them was via 
personal cell phone, but only 9 percent were contacted that way. 
Once officers received notifications, the travel system used for 
deployments presented further challenges.  One-half of deployed Corps 
officers departed more than 48 hours after receiving the initial requests, 
and 29 percent left more than 72 hours afterward.  The most frequently 
cited problem was obtaining approved travel orders for flights, ground 
transportation, and lodging. Our interview respondents attributed this 
to difficulties with the travel coordinator contracted for the response as 
well as to the impact of the hurricanes on flight schedules and other 
travel components. 
Confusion surrounded some Corps officers arrival in the field, but most 
field assignments were appropriate and officers felt safe at their locations 
According to our survey, 37 percent of officers did not receive clear 
direction on their assignments during field operations.  Because they 
were unsure what to do, 10 percent of officers were unable to 
immediately begin relief operations upon arriving in the field. 
Furthermore, 15 percent of officers were initially sent to the wrong 
locations or to locations where their skills were not needed, meaning 
that they could not start rendering services until their situations were 
resolved.  Although incoming travel delays and local transportation 
deficiencies contributed to the problem, poor communication and the 
lack of a formal system to track officers movements were major factors 
according to our respondents. 
Once they commenced field operations, most Corps officers were 
satisfied with their assigned duties. Approximately 87 percent of 
deployed Corps officers reported that their field assignments made 
appropriate use of their professional skills.  Some, though, were not 
used effectively.  For example, one State health official used a team of 
surgeons to assess special needs shelters, which he conceded was 
probably a misuse of their skills. Several survey respondents noted 
that their professional skills went unusedfor example, one dentist was 
assigned as a supply officerbut few believed the assignments were 
inappropriate in the context of the overall response. 
Deployed officers generally viewed their personal security and that of 
supplies as adequate. According to our survey, about 82 percent of 
officers believed that both they and the medical and other supplies at 
their locations were safe.  A few reported that supplies, especially 
pharmaceuticals, were not secured adequately and disappeared on 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  12  F I N D I N G

occasion.  Several others indicated that the behavior of patients and 
their families caused them to feel unsafe because of insufficient security 
personnel at their sites. 
Most officers were equipped adequately, but some lacked working 
communications devices and other basic tools 
Deployed Corps officers generally had the tools they needed to do their 
jobs but sometimes lacked certain equipment or supplies.  Although 
78 percent of officers believed that they had been issued necessary 
equipment, some officers and field commanders reported that they had 
not had functioning communications equipment or had been forced to 
use their personal cell phones (at their own expense) to communicate. 
Having a greater variety of redundant communications equipment, such 
as satellite phones and walkie-talkies in addition to cell phones, would 
have helped when one mode was inoperable.  Other needs that survey 
respondents mentioned included pharmaceuticals, medical reference 
texts, additional food and water, and beds that could accommodate 
obese patients.  Several officers stated that if they and their colleagues 
had not brought personal medical devices, such as blood pressure cuffs 
and stethoscopes, these basic tools would not have been available onsite. 
Many officers personally incurred mission-related expenses and some were 
not reimbursed promptly, which could affect future deployments 
During the response to Hurricanes Katrina and Rita, just 62 percent of 
deployed officers had Federal Government travel credit cards, and  
56 percent of the officers reported that they personally paid for  
mission-related expenses.  The most common items included food, cell 
phone bills, ground transportation, and supplies, with the amounts 
ranging from $10 to almost $2,700.  Many expenses were not 
reimbursed promptly29 percent of officers were repaid more than  
3 months after they submitted vouchers for the expenses, and, at the 
time of our survey, 16 percent said they had not been repaid.  Half the 
officers in our survey said that not being reimbursed for mission-related 
expenses would create a significant barrier to deployment.  Agency 
representatives agreed that the failure to promptly reimburse officers 
could affect their ability to deploy to future public health emergencies. 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  13    R E C O M M E N D A T I O N S  

The Corps currently is undergoing a substantial transformation that 
may address many of the issues it encountered in response to 
Hurricanes Katrina and Rita.  In so doing, the Corps should address 
and resolve the problems identified in this report.  We recommend that 
the Commissioned Corps: 
Institute More Effective Training for Corps Officers 
Improved training is a major focus of the Corps transformation efforts. 
As the Corps develops its training program, it should implement more 
hands-on focused training and rely less on computer-based modules. 
The Corps should seek funding that would be used to grant officers time 
away from their agency jobs to train for public health response. 
Improve the System Used To Contact Officers for Deployment 
Although the Corps maintains a variety of contact information for its 
officers, many requests to deploy were received significantly after they 
were made.  More than half of the officers contacted for Hurricanes 
Katrina and Rita said that the methods used to contact them were not 
ideal. The Corps should develop a system to quickly and reliably 
contact officers for deployment. 
Work With the Office of the Assistant Secretary for Preparedness and 
Response To Streamline Deployment-Related Travel 
Corps officers, leadership, and agency representatives believe that the 
travel system used during the hurricanes caused delays in reaching the 
field for numerous officers.  The Corps should work with ASPR to 
improve the current system, or acquire a new one, so that officers can be 
deployed efficiently and rapidly. 
Stagger Deployments To Ensure Continuity of Operations 
Numerous respondents reported that the Corps had difficulty keeping 
experienced officers in the field.  The Corps standard 2-week 
deployment contributed to this problem.  To counter this, some officers 
voluntarily extended their tours, but a more systematic approach is 
needed for long deployments.  The Corps should consider staggering 
deployments to mitigate the loss of experience as officers end their 
tours. 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  14  R E C O M M E N D A T I O N S  
Improve Its Ability To Coordinate Mission Assignments and 
Communications in the Field 
Confusion over mission assignments led to less than optimal response in 
some instances. Although poor travel logistics contributed to the 
problem, Corps management and ASPR also lacked an effective means 
to position and track officers in the field.  The Corps should work with 
ASPR to develop more effective systems to ensure that officers arrive 
when and where they are needed with a clear understanding of their 
responsibilities.  The systems should be flexible enough to respond as 
needs change.   The Corps also should work with ASPR to expand the 
variety of communications equipment issued to Corps officers to ensure 
that they can effectively communicate with leadership. 
Ensure That All Deployable Officers Have Federal Government Travel  
Credit Cards 
According to our survey, 38 percent of the officers deployed in response 
to Hurricanes Katrina and Rita did not have Federal Government travel 
credit cards21 and more than half personally incurred mission-related 
expenses.  All deployable officers should have official Government travel 
credit cards with which to make mission-related purchases.  The Corps 
should work with ASPR to review procedures for reimbursing officers 
for mission-related expenses incurred during deployments to ensure 
that appropriate and prompt reimbursements are made. 
AGENCY COMMENTS 
The Assistant Secretary for Health agreed with the Office of Inspector 
Generals (OIG) recommendations for improving the Corps response to 
public health emergencies.  As part of the Corps comprehensive 
transformation process and its efforts to improve OFRDs practices, the 
Corps is currently addressing OIGs recommendations.   
21 Government-issued travel credit cards are issued and billed to Government employees for 
authorized official business expenses associated with temporary duty travel, including cash 
travel advances.  Use of the Government-issued travel credit card is governed by General 
Services Administration (GSA) travel regulations and accompanying travel policies issued 
by the respective Government employer agency.  GSA offers courses on the proper use of 
Government-issued travel credit cards.  Government-issued travel credit cards differ from 
International Merchant Purchase Authorization Cards (IMPAC).  An IMPAC is used by 
cardholders to procure items for their respective components.  However, the cardholder is 
not personally billed.  Use of an IMPAC is governed by Federal Acquisition Regulations and 
accompanying policies issued by the respective Government employer agencies.  
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  15  R E C O M M E N D A T I O N S  
Specifically the Corps is developing more effective deployment-related 
training programs for officers, improving contact and communication 
mechanisms for officer deployments, and revamping its travel systems 
in support of deployments.  The Assistant Secretary for Health stated 
that the OIGs recommendations will assist his office, working in 
collaboration with ASPR, in its efforts to continuously improve the 
Departments response to public health emergencies.  The Assistant 
Secretary for Healths comments are included in their entirety in 
Appendix F. 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  16  A P P E N D I X   A  
  AA PP PP EE NN DD II XX    ~~    AB   

Commissioned Corps Employer Agencies and Professional 
Categories 
Corps Officer Employers  Corps Professional Categories 
  Department of Health and Human Services  Dentist 
Office of the Secretary  Dietitian 
Agency for Healthcare Research and Quality  Engineer 
Agency for Toxic Substance and Disease Registry  Environmental Health 
Centers for Disease Control and Prevention  Health Services 
Centers for Medicare & Medicaid Services  Nurse 
Food and Drug Administration  Pharmacist 
Health Resources and Services Administration  Physician 
Indian Health Service  Scientist 
National Institutes of Health  Therapist 
Substance Abuse and Mental Health Services Administration  Veterinarian 
Office of Public Health and Science 
Program Support Center 
External Agencies 
Federal Bureau of Prisons 
District of Columbia Commission on Mental Health Services 
Environmental Protection Agency 
U.S. Citizenship and Immigration Services 
National Oceanic and Atmospheric Administration 
National Park Service 
U.S. Coast Guard 
U.S. Marshals Service 
U.S. Department of Agriculture 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  17    A P P E N D I X   ~   B  

Commisioned Corps Management Structure 
Office of Commissioned Corps Force Management 
The Office of Commissioned Corps Force Management reports directly to 
the Assistant Secretary for Health.22 The office became operational on 
April 18, 2004.23 It establishes performance standards and measurements 
for the Commissioned Corps (Corps) operations. 
Office of the Surgeon General 
The Office of the Surgeon General reports to the Assistant Secretary for 
Health with respect to the administration of Corps operations.  The 
Surgeon General provides leadership and management oversight for the 
Corps involvement in Department of Health and Human Services 
emergency preparedness and response activities.24 
  Office of Commissioned Corps Operations 
The Office of Commissioned Corps Operations (OCCO) carries 
out the day-to-day management and administration of major 
Corps operational functions.  The OCCO recruits Corps 
personnel, oversees Corps personnel matters, and advises the 
Assistant Secretary for Health and the Surgeon General on 
matters related to Corps operations.25 
  Office of Force Readiness and Deployment 
The Office of Force Readiness and Deployment (OFRD) is also 
located within the Office of the Surgeon General.  The OFRD 
administers deployments to a variety of situations, including 
public health challenges that exceed the capabilities of local, 
State, or operating division resources; public health requirements 
under the national response plan;26 or declared emergencies.27 
22 Office of Commissioned Corps Force Management.  Available online at 

http://dcp.psc.gov/OCCFM.asp. Accessed December 9, 2005.    

23 Ibid. Accessed December 27, 2005. 

24 U.S. Department of Health and Human Services, About the Office of the Surgeon

General.  Available online at http://www.surgeongeneral.gov/aboutoffice.html. Accessed 

December 9, 2005.      

25 Office of Commissioned Corps Operations.  Available online at 
http://dcp.psc.gov/occo.asp. Accessed December 9, 2005. 
26 National Response Plan, U.S. Department of Homeland Security.  Available online at 
http://www.dhs.gov/dhspublic/interapp/editorial/editorial_0566.xml. Accessed 
December 9, 2005. 
27 Office of Force Readiness and Deployment, Essentials.  Available online at 
http://oep.osophs.dhhs.gov/ccrf/ccrf_essentials.htm#BACKGROUND. Accessed   
December 12, 2005. 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  18    A P P E N D I X   ~   C  

Commissioned Corps Standards of Readiness as of October 2005 
A. Health and Safety Standards 
i.  Physical examination and medical history 
ii.  Immunizations 
iii. Height and weight reporting 
B. Physical Readiness Standards 
   i.  Physical fitness standards 
ii.  Annual physical fitness tests 
C.  Training and Professional Competency Standards 
   i.  PHS Commissioned Corps Readiness Training Modules (12) 
ii.  Basic Life Support 
iii.  Professional Competency 
   iv.  Uniforms 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  19    A P P E N D I X   ~   D  
EESSFF ##88 MMeeddiiccaall AAccttiioonn RReeqquueesstt PPrroocceessss ((AARRFF))
Identify need 
ESF #8/PHS 
does not 
generate an 
State local EOC or  ARF 
State liaison to ESF #8 
health official 
for personnel 
Director DHH 
ESF #8 State LNO 
Assign State # (different from 
JFO and ARF#) and create
State E Team 
E team resource request
1. Research & discuss with State authorities & 
ESF #8 
2. Match requests with available resources 
3. Create ARF; forward to DHH  ARF signed by approved State
EOC State authority 
4. Communicate with ESF #8  authority only
5. Request State E-Team copy & file 
JFO  FEMA approves  FEMA Processes ARF  FEMA 
disapproves 
Communicate with
ESF #8 finance/admin  Sent to SOC for 
Signed/reviewed/  ESF #8 State liaison 
action 
tasked by Ops  ESF #8 finance & 
admin (constant and 
ongoing) 
Source: CAPT (S) Debra Scott, United States Public Health Service Commissioned Corps, September 2005. Used with permission. 
NOTES: 
EOC refers to Emergency Operations Center 
LNO refers to State Liaison Officer. 
JFO refers to Joint Field Office 
SOC refers to Secretarys Operational Center 
State E Team refers to State Emergency Team 
OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  20    A P P E N D I X   ~   E  
Statistical Confidence Intervals 
Corps Officer Characteristic  n  Point Estimate  95% Confidence Interval 
Deployed officers who met readiness requirements  196  95.6%  93.0% to 98.3% 
Deployed officers who stated that meeting readiness requirements 
196  70.2%  63.7% to 76.6% 
improved performance 
Officers who spend more than 15 hours per month meeting readiness 
330  27.6%  22.5% to 32.7% 
requirements 
Officers for whom meeting readiness requirements creates a significant 
330  12.4%  8.46% to 16.3% 
hardship 
Deployed officers who said training was not adequate  196  36.1%  29.4% to 42.8% 
Deployed officers who were familiar with CONOPS  196  37.2%  30.2% to 44.1% 
Deployed officers who were familiar with ESF #8  196  60.2%  53.3% to 67.1% 
Nondeployed officers who received deployment requests  330  17.4%  11.0% to 23.7% 
Nondeployed officers who couldnt respond because of agency 
134  55.9%  36.5% to 75.4% 
responsibilities 
Officers who received the requests to deploy more than 12 hours after 
330  46.0%  38.6% to 53.4% 
they were sent 
Officers who received the requests to deploy more than 72 hours after 
330  12.7%  7.27% to 18.2% 
they were sent 
Officers who received the requests to deploy by other than optimal means  330  54.5%  47.7% to 61.4% 
Officers for whom the personal cell phone would have been the optimal 
330  28.3%  22.1% to 34.5% 
means of contact 
Officers contacted by personal cell phone  330  8.68%  4.92% to 12.4% 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  21  A P P E N D I X   E
  A P P E N D I X   ~   E  
Statistical Confidence Intervals (continued) 
Corps Officer Characteristic  n  Point Estimate  95% Confidence Interval 
Deployed officers who left more than 48 hours after receiving the requests 
196  49.5%  42.4% to 56.6% 
to deploy 
Deployed officers who left more than 72 hours after receiving the requests 
196  29.2%  22.4% to 36.1% 
to deploy 
Officers deployed to the Gulf Coast who said their assignments were not 
164  37.0%  29.5% to 44.5% 
clearly communicated 
Officers deployed to the Gulf Coast who said they could not immediately 
164  9.67%  5.46% to 13.9% 
begin work because of confusion over assignments 
Officers deployed to the Gulf Coast who said they were initially sent to the 
164  15.4%  10.2% to 20.5% 
wrong locations 
Deployed officers who said their assignments were appropriate  196  86.9%  81.9% to 91.9% 
Deployed officers who said they were satisfied with the security of 
196  81.8%  76.7% to 87.1% 
themselves and of supplies 
Deployed officers who said they were adequately equipped  196  78.1%  72.6% to 83.6% 
Officers who said the lack of reimbursement would significantly affect their 
330  50.2%  43.2% to 57.2% 
ability to deploy 
Deployed officers who paid for mission-related expenses from personal 
196  56.2%  49.2% to 63.2% 
accounts 
Deployed officers who had Government travel credit cards  196  62.4%  55.5% to 69.3% 
Deployed officers reimbursed more than 3 months after they incurred the 
196  28.8%  19.8% to 37.7% 
expenses 
Deployed officers who had not been repaid at the time of the survey  196  15.8%  9.18% to 22.5% 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  22  ..
A P PEN 0
x F
Agency Comments
DEPARTMENT OF HEALTH AND HUMAN SERVICES Office Of the Secretary
(A.-'t..
~.~~~
:.....ia (J Assistant Secretary tor Health
Office of Public Health and Scienc.e
Washington D,C. 20201
JAN 3 0 2007
TO: Inspector General, Deparent of  Health and Human Services
FROM: Assistat Secret' fOi" Health
SUBJECT: Inspector General's Report (OEI-09-06-00030) -INFOllATION
I am writig to express my appreciation for your repqrt entitled ''Te Commissioned
Corps' Response to Hurcanes Katrna and Rita" (OEI-09'06-00030). The evaluation
conducted by your sta included interiews with  a strtified random sampling of offcers,
review of our databases, and interiews with members of our Deparent and those state
heath officials we served durg the response. From the design  as well as the findings
and conclusions, it is evident that much careful and thoughtf consideraton was  given
thoughout the evaluation. I concur with the  fidigs and the recommendaions  as to how
the Commissioned Corps of  the U.S. Pulic Health Serce (Corps) can improve its
futUe responses to public health emergencies.
The recommendations. of the report mirror many of the prepardness and response areas
we are addressing as  par of the business practice improvements with the Offce of
Force Readiness and Deploymentand our comprehensive Trafonnation effort. We are
developing more effective deployment-related trainng program for our offcers,
improving contact/communcation  mechansms with offcers when deployments are
necessar, and revamping our travel systems in support of deployments. Our Corps'
Trasfonnation will greatly enhance our ability to respond effectively to public health
emergencies by developing a tota force managenient approach to officer selections,
training, readiness and assignents. The tranfonned Corps wil be better able to deploy
offcers with the appropriate skill sets required to respond to  the wide aray of  public
health emergencies our Nation will face.
The recommendations contained withn your report will assist us, workig in
collaboration with the Assistat Secretay for Preparedess and Response, in our goal of .
.~-
continuously improving our Deparent's response to  public health eiergencies and
assurng that the Corps remains the Deparent's premier and primary deployable asset.
Than you for your Offce's dilgence and timeliness in the preparation of  this report.
-= - John O. Agwobi -
U.S. Public Health Service
OE 1-09-06-00030 THE COMMISSIONED CORPS' RESPONSE TO HURRICANES KATRINA AND RITA 23 AA PP PP EE NN DD II XX    E~    A  
  A C K N O W L E D G M E N T S  

This report was prepared under the direction of Paul A. Gottlober, 
Regional Inspector General for Evaluation and Inspections in the San 
Francisco regional office, and Deborah W. Harvey, Assistant Regional 
Inspector General.  Other principal Office of Evaluation and Inspections 
staff who contributed include: 
Michael Henry, Project Leader 
Scott Hutchison, Program Analyst 
Rob Gibbons, Program Analyst 
Mark Richardson, Program Specialist 
Ayana Everett, Program Specialist 
Elise Stein, Director, Public Health and Human Services Branch 
Barbara Tedesco, Mathematical Statistician 
  OEI-09-06-00030  THE COMMISSIONED CORPS RESPONSE TO HURRICANES KATRINA AND RITA  24