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Release Date: April 1, 2008
Rayburn House Office Building
(Remarks as Prepared)
Mr. Chairman, Congressman Rogers, Members of the Subcommittee:
Thank you the opportunity to appear before you today to discuss the Fiscal Year (FY) 2009 budget request for the Office of Health Affairs (OHA) within the Department of Homeland Security (DHS).
First, let me express my deep appreciation for the Subcommittee’s support of our relatively new and growing office and its mission. With the funding that you appropriated in FY 2007 for the Office of the Chief Medical Officer and for the Office of Health Affairs (OHA) in FY 2008, we have made significant strides in improving the medical and health security of the Nation. As a result, the Department is better able to protect the American people and our DHS workforce than it was a year ago.
Yesterday marked the first anniversary of OHA, and I am pleased to provide you with a report on OHA’s progress to date, where we stand today, and our plans for FY 2009. Specifically, I would like to report on the progress that OHA has made in leading the Department’s efforts in protecting our Nation from the threats of a bioterrorist attack and a pandemic, as well as OHA’s progress in leading the Department’s efforts to ensure full integration of our Nation’s medical readiness capabilities and protecting the health and safety of the Department’s own workforce.
Today I represent nearly 200 dedicated OHA employees, contractors and U.S. Public Health Service Officers devoted to our mission and our role as the Department’s principal authority for medical and health security issues. As the Committee is aware, OHA has its beginnings in Secretary Chertoff’s creation of the position of Chief Medical Officer (CMO) within the Preparedness Directorate in 2005 as part of his Second Stage Review. This position was created to provide the Secretary with a medical adviser for health related security issues that may arise during a catastrophic incident.
Congress recognized the position of CMO in the Post-Katrina Emergency Management Reform Act (PKEMRA), P.L. 109-295, and as part of the consequent reorganization, the Secretary established OHA on March 31st 2007. This new Office was established to fill gaps the Department identified in the areas of weapons of mass destruction (WMD) and biodefense operations; planning and readiness; and the health and safety of the DHS workforce.
The following are examples of key gaps now being addressed by OHA:
It is important to note that OHA does not duplicate any function or activity of any existing agency or program, but rather leads the coordination for health and medical functions of the Department to:
The President is requesting $161.3 million for FY 2009 to further objectives of the OHA mission. This amount represents an increase of $44.8 million over the FY 2008 enacted level. OHA’s strategic objectives for FY 2009 include:
The following programs highlight how OHA will utilize its funding to meet these strategic challenges.
BioWatch provides a capability for early detection and warning against biological attacks in over 30 of our Nation’s highest-risk urban areas through placement of a series of biological pathogen detectors. Deployment of such technology is critical to our Nation’s security as the detection of a biological pathogen, such as aerosolized anthrax, at the earliest stages of release is critical to successful treatment of the affected population. Early detection and warning of a biological attack is essential for the rapid identification of the bioagent, which allows prophylactic treatment and prevention of casualties, provides forensic evidence to law enforcement on the source and nature of the attack, and demonstrates a spatial distribution of contamination and population exposure. Relying solely on symptomatic monitoring or post-exposure information provided from the healthcare and public health communities adds significant delays, resulting in increased causalities and loss of life in the tens of thousands. To date, this vital program has conducted over 3 million air samples without a false alarm, and has formed vital partnerships with state and local public health, laboratory, law enforcement, and environmental health entities to further its detection mission. These partnerships have had collateral beneficial effects for our Nation’s biodefense through cooperation across sectors at the local level.
Early detection is critical to protecting the health of the Nation. With anthrax for example, a one day delay in the post-exposure prophylaxis or treatment of exposed individuals could result in many thousands of unnecessary deaths. Early detection and rapid medical treatment is therefore essential to protecting the health of the American people during such an incident of bioterrorism.
If a post-exposure prophylaxis program is initiated early (as would be the case in a well-prepared BioWatch city), it will also reduce the economic impact of an anthrax attack. The cost savings estimates associated with early detection are $15- 25 billion if treated on day 0, $10-20 billion if treated on day 1, $10-16 billion, and $5-7 billion if treated on day 3.
In FY 2009, the President requests $111.6 million for the BioWatch program, an increase of $34.5 million. These funds will be used to procure automated pathogen detectors for deployment in high-threat locations in FY 2009. OHA is also working cooperatively with the Science and Technology Directorate toward the goal of a side-by-side test of various types of advanced detectors in FY 2009. If a thorough operational test and evaluation is successful, OHA’s goal is for a larger deployment of automated detectors in FY 2010 and beyond to decrease times from attack to warning by as much as 24 hours. Such a large scale deployment of new technology would take place only after rigorous third party evaluation and testing and Departmental review.
The Secretary placed NBIC under the authority of OHA at the beginning of FY 2007, and reestablished NBIC as the entity where other Departments and agencies come together to monitor and analyze potential biological threats to the Homeland. Later that year, Congress authorized NBIC in the Implementing Recommendations of the 9/11 Commission Act of 2007, P.L.110-53, to enhance the capability of the Federal government to identify and monitor biological events of national concern by integrating and analyzing data from human, animal, plant, food and environmental monitoring systems. The Act also called on NBIC to disseminate alerts to Federal partners, States and localities to better enable them to prepare for and respond to such biological threats.
While Federal partners continue to operate their respective surveillance programs, NBIC is charged with synthesizing and analyzing information collected from these member agencies and other information sources in order to identify and monitor biological threats. No other place in government serves to integrate this information from across the spectrum of public and private, domestic and international, open or protected sources.
For FY 2009, the President requests $8 million for NBIC, an amount equal to the FY 2008 enacted level. This amount will be used to enhance the participation of our Federal partners and their data sources, complete full implementation of the Biosurveillance Common Operating Picture (BCOP), and continue funding of the base program.
By the conclusion of FY 2008, OHA will have established full NBIC operational capability, deployed the BCOP to all Federal partners, completed Memorandums of Understanding with seven remaining Federal partners, finalized the NBIC Concept of Operations, and established stakeholder groups, including the NBIC Interagency Oversight Council which is comprised of all NBIC federal partners.
OHA’s Division of Food, Agriculture and Veterinary Defense(FAVD) provides expertise to the Secretary on zoonotic, food, and agriculture threats to homeland security, as the Department’s lead for HSPD-9, Defense of United States Agriculture and Food. This includes evaluating and coordinating DHS’ research, grants, and veterinary preparedness and response activities. FAVD utilizes some of the Nation’s premier leaders in veterinary medicine and agro-defense to support its activities.
In FY 2007, the FAVD led the Department’s incident management efforts during the pet food contamination incident and the possible Foot-and-Mouth Disease (FMD) alert in June involving imported swine. This Division was also responsible for the Department’s implementation of the President’s Executive Order on Import Safety.
In FY 2008, FAVD is finalizing metrics and standards for HSPD-9 both for DHS and non-DHS directives. FAVD is also developing strategic guidance and planning for the National planning scenario on foreign animal disease, especially FMD.
For FY 2009, the President requests $727,000 for FAV Defense, an amount equal to the FY 2008 enacted level. This funding will: bridge gaps between existing DHS activities and HSPD-9 requirements; support a liaison program with Federal partners to ensure coordination and collaboration across food, agriculture and veterinary defense programs; finalize a long-term strategic plan for food, agriculture and veterinary defense for the Nation; and increase coordination efforts with the intelligence community to maintain threat awareness.
The Office of Medical Readiness develops policies and programs to enhance all hazards planning, exercises and training, promote integration of state and local medical response capabilities, align DHS emergency preparedness grants and support the medical first responder community. This Office is critical to the coordination of health and medical issues both within DHS and within the interagency as it relates to multidisciplinary, multi-jurisdictional planning, and coordination activities. While focusing on the issues unique to health and medical coordination, OHA does this with close interaction with the Federal Emergency Management Agency and other appropriate DHS and interagency partners.
In FY 2007 and FY 2008, the Office of Medical Readiness completed the pandemic influenza planning and implementation guidance for the Department and has been the Department’s principal agent for all activities related to Pandemic Influenza, including serving as the Department’s representative on the Administration’s Pandemic Implementation Plan development process. OHA led the formation and activities of the Department’s pandemic influenza working groups and oversaw the Department’s pandemic planning activities. The Office provided medical and radiation health guidance to Departmental leaders during catastrophic event exercises, including TOPOFF-4. The Office is also developing end-to-end plans for all of the biological incident scenarios using the Department’s Integrated Planning System in collaboration with DHS Operations Coordination.
For FY 2009, the President requests $7.2 million for the Office of Medical Readiness, and increase of $3.4 million over FY 2008 enacted levels. This funding will help implement many of the programs set for development in FY 2008, including identification of capabilities and responsibilities required for management of medical and biological events (including pandemic influenza) and medical management tools for decision-makers during catastrophic incidents. This increase will support activities that were initiated with funding provided to the Department by the Supplemental Appropriations for Pandemic Influenza.
OHA is also requesting $2 million to begin the process of developing the National Biodefense Architecture (NBA), which will be administered by the Office of Medical Readiness, and will establish a coordinated national biodefense methodology that drives preparedness and response in a way that efficiently utilizes Federal, regional, state, and local resources to ensure the Nation’s ability to prepare for and respond to a biological threat. This architecture will integrate the expertise of stakeholders, and assist them in planning, training, equipping, and exercising for biological events, including responding to various signals/threats/alarms.
The Office of Component Services provides workforce protection guidance to the Secretary and Under Secretary for Management. The Office leads the development of strategy, policy, requirements and metrics for the medical elements of the Department-wide occupational health and safety program. This Office also provides oversight for medical services rendered by or on behalf of DHS, including all Emergency Medical Services (EMS) personnel. The Office provides a forum for leaders of component medical officers to collaborate and share best practices and to participate in reviewing Departmental medical policy and procedure.
The Office of Component Services has led efforts to establish baseline reviews of the Department’s occupational medicine services and health and safety programs for the Department’s workforce. The Office led the Department’s interactions with the Centers for Disease Control and Prevention (CDC) and its Division of Global Migration and Quarantine involving tuberculosis cases at the border, and developed interagency coordination policies to facilitate responses to similar events in the future. The Office has also led the Department’s interaction with CDC in supporting the Federal Emergency Management Agency on actions and policies involving formaldehyde in emergency temporary housing units in the Gulf Coast region.
The Office of Component Services has developed the requirements and an implementation plan for a comprehensive workers injury and disability management system, in conjunction with the DHS Chief Human Capital Officer; developed the Department’s Occupational Safety and Health policies; provided a travel medicine program to support internationally-deployed workforce; and identified key management level occupational health and safety metrics which can drive departmental implementation of occupational health principles.
In FY 2009, this Office will support continued development of a common set of standards, policies, and training opportunities for occupational medical aspects of occupational safety and health programs across the Department. While the office of primary responsibility for this capability is the DHS Office of Safety and Environmental Programs, personnel from OHA will play an integral role in ensuring the success of this program.
OHA is designed to contribute to the health and security of the American people, in full coordination and collaboration with other DHS components and our Federal, state, local and private sector partners. OHA’s responsibilities and activities enhance National planning for and responding to the consequences of catastrophic incidents. This approach is consistent with the incident management coordination mandated by HSPD-5 and will ensure that the full, coordinated force of the Federal government is appropriately applied to management of incidents of any scale.
OHA works closely with all of the Department’s components by supporting their occupational health and safety requirements, and coordinating with others to meet operational requirements. We have spent much of our time over the last two years collaborating with our Federal partners at the Departments of Health and Human Services, Defense, Agriculture, Commerce, Transportation, Justice and Veterans Affairs, the Environmental Protection Agency, the U.S. Postal Service and members of the Intelligence Community on a wide range of activities and initiatives. OHA has reached out to numerous State and local governments and non-governmental organizations, associations and private sector entities to advance the mission of a Nation prepared for health consequences of catastrophic events.
It has been over six years since the attacks of September 11th and the anthrax mailings that followed soon thereafter. While this track record should be acknowledged, we know that the lack of a successful attack is not for a lack of desire or means on the part of our enemies. To manage this risk, our OHA structure is fully aligned with the pillars of biodefense. The expertise of our Offices and personnel provide essential contribution to threat awareness, surveillance and detection, prevention and protection, and response and recovery.
OHA is relatively small in size but very widespread in its mission and influence across DHS and our Federal partners. The program dollars we receive are essential, but Congress’ support of our mission is accomplished only by providing for expert, dedicated people. We appreciate the Committee’s attention to providing for that growth of expertise in our workforce, so that we can fulfill the mandates of the President and Congress.
Mr. Chairman and Members of the Subcommittee, thank you for your support of the critical role of OHA in the Department’s homeland security mission. I look forward to answering any questions you may have.
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This page was last reviewed/modified on April 1, 2008.