After the 9/11 terrorist attacks, the newly formed Department of Homeland Security absorbed the Federal Emergency Management Agency, subsequently creating this new disaster plan in January 2005 as the organizing structure for a national response to a large natural or purposeful disaster. It outlines 15 emergency support functions (ESF) and clearly apportions the responsibility and authority for each to various government agencies. ESF 8 (health and medical services) is assigned to the Department of Health and Human Services.

Local communities are expected to prepare to be self-sustaining for 24 to 48 hours after a disaster in order to allow time for the federal response to engage. When local resources are damaged or overwhelmed and unable to protect and provide health services, the USPHS may deploy members of the USPHS Commissioned Corps-a cadre of approximately 6,000 health professionals, including 1,280 nurses-to provide health care services. This may include everything from augmenting staffing to setting up services where none existed. For more information on the National Response Plan, go to http://www.dhs.gov/dhspublic/interapp/editorial/editorial_0566.xml. -MSK