Public Health Preparedness: Reliable Information Needed to Inform Situational Awareness of the Medical Reserve Corps
Fast Facts
The Medical Reserve Corps provides volunteer medical and other services to communities in times of emergency. Health and Human Services—the leader of the nation's public health emergency response—oversees, supports, and relies on information from the Medical Reserve Corps about numbers and locations of available volunteers.
However, we found that data on the number of Medical Reserve Corps' volunteers was not always up to date, and that HHS doesn't always complete annual assessments of the Medical Reserve Corps' capacity as required.
We recommended HHS address these issues to increase its awareness of the resources available during emergencies.
Highlights
What GAO Found
The Department of Health and Human Services (HHS) leads the nation's medical and public health preparedness and response to emergencies. In this role, HHS oversees the Medical Reserve Corps (MRC), which provides medical and nonmedical support during and after disasters at the state and local level.
MRC volunteers were essential in the COVID-19 pandemic and other emergencies, according to MRC leaders from six states and one territory. For example, in 2021, Colorado deployed volunteers to provide medical care at wildfire shelters and distribute tests for COVID-19. Volunteers in Hawaii had multi-day deployments providing medical support to displaced individuals in the 2023 wildfire response.
Examples of COVID-19 Volunteer Emergency Response Activities
HHS assisted the MRC by providing funding, technical assistance, training, and guidance. To boost the MRC network after the COVID-19 pandemic response, in 2023, HHS made awards to 33 states and jurisdictions. These awards ranged from $376,000 to $2.5 million.
HHS relies on MRC network unit information—such as volunteer data and technical assistance assessments—to maintain situational awareness of its capabilities. However, GAO found that volunteer data were unreliable. For example, as of July 2024, about 70 percent of all MRC units' volunteer counts did not indicate when the data were updated. In addition, units are to update data quarterly. However, 41 percent of MRC units' reported number of volunteers remained unchanged from 2020 to 2023, though MRC leaders from selected states told GAO that the number of volunteers was significantly higher during the height of the pandemic and later declined. In both instances, HHS was unable to confirm whether units were making the required data updates or whether there was no change. Moreover, some of the unit leaders GAO spoke to confirmed they did not update the volunteer counts for their units as required by HHS. GAO also found that HHS staff had not always conducted required annual technical assistance assessments of the capabilities of the MRC units. Without ensuring regular Medical Corps data updates and technical assistance assessments, HHS risks having incomplete situational awareness as the coordinator for public health and medical emergency preparedness and response.
Why GAO Did This Study
Public health emergencies, such as those resulting from wildfires, hurricanes, and infectious disease outbreaks can be devastating. The MRC is a national volunteer network of medical and other health professionals, comprised of approximately 700 local units. These volunteer resources are accessible to states, territories, and localities for workforce support in emergencies.
The Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 includes a provision for GAO to review states' use of health care volunteers in public health emergencies. This report is follow-up work to our previous reporting and (1) describes MRC leaders' experiences using volunteers, (2) identifies the assistance HHS provided during emergency response, and (3) assesses information HHS uses to maintain situational awareness.
GAO reviewed agency documentation and interviewed department officials on assistance provided during emergency response, and submission of quarterly capability information. GAO also interviewed MRC leaders in six states and Puerto Rico.
Recommendations
GAO is making two recommendations to improve HHS's ability to maintain situational awareness by (1) developing mechanism(s) to ensure volunteer data are updated and (2) ensuring technical assistance assessments are completed annually, as required. HHS concurred with both of GAO's recommendations.
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Administration for Strategic Preparedness and Response | The Assistant Secretary for Strategic Preparedness and Response should develop and implement a mechanism or mechanisms to ensure MRC units regularly update volunteer counts and activity data as required. This could include additional training and guidance for the MRC regional liaisons and unit leaders, automated reminders to help ensure updates are made to the reporting system, and incentives. (Recommendation 1) |
ASPR agreed with the recommendation. As of September 2025, the Office of the Medical Reserve Corps has introduced a mechanism to ensure Medical Reserve Corps units regularly update volunteer counts and activity data as required. Specifically, each regional liaison submits a weekly internal report on the number of units that have reported activity over the last seven days and general description on the types of activities, the number of units reporting activity over the quarter, any emergency activation, and the number of units not reporting activity over the last quarter. The intent of this weekly report is to allow regional liaisons to closely track activity data along with volunteer counts to ensure updates are occurring as required or to identify specific units with no updates to focus outreach and support to ensure updates are made to the reporting system, according to ASPR officials. This fulfills the intent of the recommendation.
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| Administration for Strategic Preparedness and Response | The Assistant Secretary for Strategic Preparedness and Response should ensure that its MRC regional liaisons complete technical assistance assessments of the MRC network as required. (Recommendation 2) |
ASPR agreed with the recommendation. As of September 2025, the Office of the Medical Reserve Corps has ensured that regional liaisons complete technical assistance assessments of the Medical Reserve Corps network as required. Specifically, the Office of the Medical Reserve Corps introduced an internal weekly report for each regional liaison to provide updates on how many Technical Assistance Assessments (TAA) are scheduled in the next seven days; how many total TAAs have been completed in the calendar year to date and the percent of TAAs completed for the calendar year; any trends that have been identified from the TAAs; and the number of units that have not responded to a request for TAA and the number of days each unit has been non-responsive. The Office of the Medical Reserve Corps tracks this information. Through regional liaison coordination efforts with registered Medical Reserve Corps units at the start of 2025, a total of 51 were deregistered or identified for deregistration due to non-compliance with TAAs and other reporting requirements, according to tracking documents. Of the remaining 692 registered Medical Reserve Corps units, around 90 percent have completed their TAA for 2025. The remaining 10 percent of units either completed their TAA by the end of 2025 or requested additional time, according to the Office of the Medical Reserve Corps. This fulfills the intent of the recommendation.
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