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Statement by
Tommy G. Thompson
Secretary, Department of Health and Human Services
on
HHS and the Department of Homeland Security
before the
House Select Committee on Homeland Security

July 16, 2002

Thank you, Mr Chairman and members of the Committee for giving me the opportunity to appear before you today to discuss the proposed Department of Homeland Security. I strongly support the reorganization initiative that the President announced earlier this month.

The threat of terrorism in its myriad forms has become an ever-present part of our daily lives. The new Department will enable us to make further significant advances in protecting the American people from those who are bent upon inflicting death, destruction, and social disorder to achieve their ideological ends. We are pleased that the Congress is giving the President's proposal prompt and thorough attention. I look forward to working with this Select Committee to ensure passage of the legislation for the new Department.

The President's proposal deals with certain terrorism-related activities that currently are the responsibility of the Department of Health and Human Services (HHS). Some of these HHS activities would be transferred to the Department of Homeland Security (DHS). For other relevant public health and medical activities, DHS would assume responsibility for setting goals and providing strategic direction but would rely upon HHS to implement and operate the activities on a day-to-day basis.

I will discuss examples from each group of activities in turn.

EXAMPLES OF ACTIVITIES PROPOSED FOR TRANSFER FROM HHS TO DHS

HHS functions conveyed to the new Department in the President's proposal include:

• The Select Agent registration enforcement program;
• The Office of the Assistant Secretary for Public Health Emergency Preparedness; and
• The Strategic National Stockpile (formerly the National Pharmaceutical Stockpile).

Select Agent Registration Program

Within HHS, the Centers for Disease Control and Prevention (CDC) currently regulates the transfer of certain dangerous pathogens and toxins � commonly referred to as "Select Agents" � from one registered facility to another. These agents are used in research laboratories across America. Examples are the bacterium that causes anthrax, the bacterium that causes Plague, and the virus that causes Ebola, a lethal hemorrhagic fever. Select Agents are prime candidates for use by would-be bioterrorists and thus, when used in research, must be kept constantly under safe and secure conditions.

The recently enacted Public Health Security and Bioterrorism Preparedness and Response Act of 2002 authorized HHS to promulgate and enforce regulations concerning the possession and use of Select Agents, as well as their transfer. While CDC has done its best to manage the Select Agent program, CDC is a public health agency and not a regulatory body. We believe that the new department, with its strong multi-purpose security and regulatory infrastructure, will be well-suited to prevent nefarious or other irresponsible uses of Select Agents. HHS will be prepared to provide DHS with whatever scientific expertise and other technical assistance it may seek to help it manage the program. Under the Administration bill, the Secretary of Homeland Security would administer the select agents program in consultation with HHS, and HHS would continue to make key medical and scientific decisions, such as which biological agents should be included in the select agents list.

Office of the Assistant Secretary for Public Health Emergency Preparedness

The Public Health Security and Bioterrorism Preparedness and Response Act of 2002 created the HHS Office of the Assistant Secretary for Public Health Emergency Preparedness. The responsibilities of this new office include the supervision of the Office of Emergency Preparedness, the National Disaster Medical System, the Metropolitan Medical Response Systems, and related HHS emergency management functions. This cluster of activities is a logical and proper candidate for transfer to DHS � thereby enabling seamless integration of national public health and medical emergency management assets with the Nation's new preparedness and response infrastructure at DHS. The Public Health Service Officers and other HHS employees who have faithfully performed disaster relief work over the years have done a wonderful service for our Nation. They are a credit to HHS as they surely will be to the new Department.

Strategic National Stockpile

CDC currently manages 12 "push packages" of pharmaceutical and medical supplies and equipment strategically located around the United States; additional lots of pharmaceuticals and caches of medical supplies are maintained by manufacturers under special contractual arrangements with CDC. You may recall that one of the push packages was dispatched to New York City on September 11th and that elements of the stockpile were used to respond to the anthrax attacks. I strongly believe that CDC has done an exemplary job managing the Strategic National Stockpile (formerly called the National Pharmaceutical Stockpile) and this fine work has set the stage for integration of the Stockpile with other national emergency preparedness and response assets at DHS.

The President's proposal is designed to achieve this integration by tapping the strengths of DHS and HHS in a precisely coordinated way. Thus, the Secretary of Homeland Security will assume responsibility for continued development, maintenance, and deployment of the Stockpile � making it an integral part of the larger suite of federal response assets managed by FEMA and other future DHS components � while the [[Secretary of Health and Human Services??]] will continue to determine its contents. The arrangement will ensure effective blending of the public health expertise of HHS with the logistical and emergency management expertise of DHS.

DHS FUNCTIONS TO BE CARRIED OUT THROUGH HHS

The President's proposal clearly designates the following two activity areas that the Secretary of Homeland Security will carry out through the Department of Health and Human Services. However, certain specific program level details and administrative choices are still being studied in order to ensure the most seamless transition, and to give the greatest possible levels of efficiency and effectiveness to our fight against the threat of biological warfare and to protect the public health.

Civilian Human Health-Related Biological, Biomedical and Infectious Disease Defense Research and Development

The President's proposal provides that the new Department's civilian human health-related biological, biomedical, and infectious disease defense research and development work shall - unless the President otherwise directs - be carried out through HHS. The Department of Homeland Security will work through the HHS, especially the National Institutes of Health (NIH) to foster research and development that will enhance national capabilities for dealing with bioterrorism and other public health emergencies. As the agency responsible for assessing threats to the homeland, DHS will have the authority to define the policy framework and provide overall strategic direction regarding the Nation's biological and biomedical countermeasure research priorities in consultation with the Secretary of HHS. Working within this guidance, NIH will conduct and fund relevant research and development � striving constantly, as now, to ensure that the program is of the highest quality and engages the foremost scientists and engineers in all pertinent disciplines.

The NIH program will continue to focus on four primary areas:

1. the creation and maintenance of centers of excellence in bioterrorism related microbiology;
2. microbial genomics, with a view to identifying targets for new or improved drugs, diagnostics, and vaccines, as well as elucidating the genetic bases for microbial virulence and antibiotic resistance;
3. initial development of drugs, diagnostics, and vaccines; and
4. advanced development and initial procurement of vaccines for the Strategic National Stockpile

Certain Public Health-Related Activities

The President's proposal provides that the new Department shall - unless otherwise directed by the President - carry out through HHS certain public health related activities (such as programs to enhance the bioterrorism preparedness of state and local governments and non-federal public and private health care facilities and providers). The object of this provision is to continue the important role that HHS plays in assisting state and local governments and the hospital and public health community in preparing for and responding to large scale public health emergencies, while integrating these activities into the overall mission of DHS.

An example of public health activities that will be integrated into DHS are the state and local bioterrorism preparedness grants that went out earlier this year. As you know, the bill that the President signed into law in January provided for $1.1 billion to 62 states, territories and three major cities (Chicago, Los Angeles, and New York City). Washington, D.C. was counted as a state in the funding formula. And, as of today, virtually all of this money has been distributed. The preparedness funds were divided into two parts. The CDC distributed a total of $918 million to state and local health departments to support bioterrorism, infectious diseases and public health emergency preparedness activities. The Health Resources and Services Administration is providing $125 million to the states to develop regional hospital plans and enhance the ability of hospitals to deal with large numbers of casualties. For both of these programs, we released 20% of the funds immediately to enable states to begin their planning without delay. Next, experts throughout my department reviewed each proposal for certain benchmark criteria before releasing the remaining 80%.

I was quite impressed by the speed with which the states and municipalities developed their plans. It shows the seriousness with which they are taking the need for preparedness. Now that we have good plans, we will continue to work with the states and municipalities on implementation and strengthening areas of the plans which need more work.

Under the President's proposal, the Secretary of Homeland Security, in consultation with the Secretary of Health and Human Services, will establish the Nation's anti-terrorism preparedness and response program and priorities, including the state and local preparedness grants. However, the implementation of the public health components of that program will be carried out largely through HHS. This structure will allow a seamless transition to ensure that federal dollars are spent wisely to prepare our communities, throughout the nation, for any type of bioterrorist attack.

CONCLUSION

Mr. Chairman and members of the Committee, our Nation needs a Department of Homeland Security. I strongly support the President's proposal and look forward to doing whatever is necessary to effect a smooth and swift transition of responsibilities and operations. I believe that the President's proposal strikes the right balance: it plays to the strengths of HHS and recognizes this agency's core mission - the protection of our Nation's public health - while capitalizing on the strategic and logistical strengths of the new Department of Homeland Security. We will ensure that HHS fulfills its obligations to the new Department and provides it with whatever public health, medical, and scientific expertise it may require.

At this time, I would be happy to answer your questions.