EMERGENCY PREPAREDNESS -- CONTENTS -- PREFACE -- WHAT UNITED STATES GOVERNMENTACCOUNTABILITY OFFICE FOUND -- WHY GAO DID THIS STUDY -- WHAT GAO RECOMMENDS -- ABBREVIATIONS -- RESULTS IN BRIEF -- BACKGROUND -- FEDERAL RESPONSIBILITIES RELATING TO STATES'PREPAREDNESS FOR MEDICAL SURGE -- KEY COMPONENTS OF MEDICAL SURGEIN A MASS CASUALTY EVENT -- Altered Standards of Care -- THE FEDERAL GOVERNMENT HASPROVIDED STATES WITH FUNDING,GUIDANCE, AND OTHER ASSISTANCETO PREPARE FOR MEDICAL SURGE -- FUNDING TO PREPARE FOR MEDICAL SURGE -- GUIDANCE TO PREPARE FOR MEDICAL SURGE -- OTHER FEDERAL ASSISTANCE TO PREPAREFOR MEDICAL SURGE -- MANY STATES HAVE MADE EFFORTS TOINCREASE HOSPITAL CAPACITY, PLAN FORALTERNATE CARE SITES, AND DEVELOPELECTRONIC MEDICAL VOLUNTEERREGISTRIES, BUT FEWER HAVE PLANNED FORALTERED STANDARDS OF CARE -- ALL STATES WERE MAKING EFFORTSTO EXPAND HOSPITAL CAPACITY -- EIGHTEEN STATES WERE SELECTINGALTERNATE CARE SITES -- FIFTEEN STATES HAD BEGUN REGISTERING VOLUNTEERSIN ELECTRONIC MEDICAL VOLUNTEER REGISTRIES -- SEVEN OF THE 20 STATES WERE PLANNINGFOR ALTERED STANDARDS OF MEDICAL CARE -- STATES REPORTED CONCERNS RELATED TOALL FOUR KEY COMPONENTS WHENPREPARING FOR MEDICAL SURGE -- HOSPITAL CAPACITY CONCERNS -- ALTERNATE CARE SITE CONCERNS -- ELECTRONIC MEDICAL VOLUNTEERREGISTRY CONCERNS -- ALTERED STANDARDS OF CARE CONCERNS -- OTHER PROGRAMMATIC AND REGULATORY CONCERNS -- CONCLUSION -- RECOMMENDATION FOR EXECUTIVE ACTION -- AGENCY COMMENTS AND OUR EVALUATION -- LIST OF REQUESTERS -- APPENDIX I:FIFTEEN HOSPITAL PREPAREDNESS PROGRAM2006 SENTINEL INDICATORS -- APPENDIX II: SCOPE AND METHODOLOGY -- APPENDIX III: HOSPITAL PREPAREDNESSPROGRAM FUNDING AND MEDICAL SURGEGUIDANCE AND CONFERENCES -- APPENDIX IV: DATA FOR THE FIVE SURGERELATEDSENTINEL INDICATORS FORHOSPITAL CAPACITY FROM THE HOSPITALPREPAREDNESS PROGRAM.

APPENDIX V: COMMENTSFROM THE DEPARTMENTOF HEALTH AND HUMAN SERVICES -- APPENDIX VI: COMMENTS FROM THEDEPARTMENT OF HOMELAND SECURITY -- APPENDIX VII: COMMENTS FROMTHE DEPARTMENT OF DEFENSE -- APPENDIX VIII: COMMENTS FROMTHE DEPARTMENT OF VETERANS AFFAIRS -- ENDNOTES -- INDEX.