When disaster strikes, the people in its path are our neighbors, our friends, and our families. When a service member comes home wounded, that person is someone’s son or daughter, husband or wife, mother or father. Behind every discussion about preparedness is a person whose life may depend on whether we are ready.
That is why this work matters. Being prepared is a responsibility we share – to our communities, to those who serve, and to the country we love.
President Trump’s Executive Order on Achieving Efficiency Through State and Local Preparedness emphasizes the importance of preparedness at the state, local, and individual levels, supported by a capable and efficient federal government. That approach recognizes something communities across America understand: when trouble comes, the people closest to it are the first to step forward.
Our local hospitals, emergency medical services, public health professionals, emergency managers, and community partners form the foundation of that response. They know their neighbors. They understand the needs of their communities. They are there when the first call comes, and they remain long after the headlines fade.
States build on that foundation, coordinating resources and bringing additional help where it is needed. Most emergencies are managed through those local and state capabilities. We should continue strengthening them.
We also have a responsibility to prepare for the day when a disaster overwhelms even the strongest community. That is where the National Disaster Medical System, or NDMS, becomes essential.
Established in law within the Department of Health and Human Services and operationally led by the Administration for Strategic Preparedness and Response, NDMS provides a national medical backstop when state and local resources are stretched beyond their limits. Its teams bring trained personnel, medical supplies, equipment, and specialized capabilities to communities facing some of their hardest days.
That support can mean additional medical care when hospitals are overwhelmed. It can mean helping move patients to places where care is available. In the most heartbreaking circumstances, it can mean supporting communities as they identify those who have died and help families receive answers with dignity and respect.
These capabilities give state and local leaders additional help when the needs of their communities exceed what they can reasonably manage alone. NDMS also carries a responsibility that reaches beyond disasters here at home.
When the system was established in the 1980s, a central purpose was to help our nation care for large numbers of casualties during a major military contingency. That responsibility remains deeply important.
We ask extraordinary things of the men and women who wear our nation’s uniform. We ask them to leave their families, accept danger, and serve wherever the mission takes them. We owe them a medical system prepared to bring them home and care for them if they are wounded or become ill.
If Department of War and Department of Veterans Affairs medical capabilities are exceeded, NDMS can provide a bridge to additional care utilizing the network of participating civilian hospitals across the country.
In this case, a hospital far from the battlefield becomes part of the promise America makes to those who serve. Frontline responders and healthcare professionals in communities across this nation ultimately fulfill that promise.
The work that prepares NDMS for a domestic disaster also strengthens its ability to support a military contingency. NDMS teams are comprised of trained professionals who deploy to provide emergency medical care, staff medical shelters or medical stations, augment hospital staff, provide veterinary care, conduct disaster mortuary operations, manage logistics, synthesize data, and meet other public health and medical needs. When NDMS team members aren’t responding to disasters, many of these people are the physicians, registered nurses, dentists, paramedics, and other medical and support professionals who serve in our communities every day.
Relationships take time to develop, and they deserve sustained attention and support.
Building and sustaining the NDMS capability requires national coordination. It depends on federal partners, states, healthcare systems, and civilian hospitals preparing together before the need becomes urgent.
As Congress considers legislation, including the reauthorization of the Pandemic and All Hazards and Advancing Innovation Act or PAHPA, NDMS deserves to be part of the conversation. Our ability to care for people during a national crisis is part of our ability to protect this country and strengthening baseline authorities ensures we continue to meet evolving requirements and missions.
To me, patriotism includes doing the work today that our fellow Americans may depend on tomorrow. It means supporting the people who answer the call, preparing for difficult days, and honoring our commitments to those who serve.
A resilient America needs strong communities, capable states, and national resources ready to stand beside them.
NDMS helps us keep that promise – the promise to our neighbors, to our service members, and to one another.
Learn more about the National Disaster Medical System.
