When the medical response to disasters exceeds local, state, or regional capabilities, the federal government's response includes organizational frameworks, response resources, and legal authorities. The National Response Framework guides the nation's response to all types of incidents. One of its annexes, Emergency Support Function 8 (ESF–8) specifically addresses the federal medical response and includes concept of operations and response components (e.g., the National Disaster Medical System). The U.S. Department of Health and Human Services is coordinator and primary agency for ESF-8. Laws, legal authorities, and presidential directives guide the federal medical response to disasters.