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Testimony
Before
the Committee on Veterans Affairs
House
of Representatives
The
Role of HHS's Office of Emergency Preparedness in the Federal
Response Plan
Statement of
Claude
A. Allen
Deputy
Secretary,
Department
of Health and Human Services
For Release
on Delivery
Expected
at 2:00 pm
on
Monday, October 15, 2001
Mr. Chairman and Members
of the Committee, I am Claude A. Allen, Deputy Secretary
of the Department of Health and Human Services (HHS). I
am pleased to be here today to discuss the role of HHS's
Office of Emergency Preparedness (OEP) in the Federal Response
Plan.
The nation watched in disbelief,
on the morning of September 11th, as American
Airlines flight #11 crashed into the North Tower of the
World Trade Center. As we all know, shortly thereafter,
United Airlines flight #175 crashed into its twin building.
Within minutes, we had activated our Department's Emergency
Operations Center (EOC), knowing that our Department and
our National Disaster Medical System (NDMS) partners in
the Department of Veterans Affairs (VA), the Department
of Defense (DoD), and the Federal Emergency Management Agency
(FEMA) might be called upon to assist New York City in its
response.
By the end of that tragic
morning, with the almost simultaneous crashes of American
Airlines flight #77 into the Pentagon, the crash of United
Airlines flight #93 in Pennsylvania and the collapse of
the World Trade Center buildings, Secretary Thompson had
ordered activation of the entire NDMS, including notification
of all of its 7,000 volunteer health workers and 2,000 hospitals.
Verbal mission assignments were being obtained from FEMA,
and teams were beginning to prepare to move during that
day to staging areas around New York City and within Washington,
D.C. It is a day that witnessed heroic actions, rapid responses,
and profound grief.
HHS Preparedness
and Response
The broad goals of a national
response to an emergency, including acts of terrorism, or
any epidemic involving a large population, are to detect
the problem, control the epidemic's spread and
treat the victims. At HHS, our efforts are focused on improving
the nation's public health surveillance network to quickly
detect and identify the biological agent that has been released;
strengthening the capacities for medical response, especially
at the local level; expanding the stockpile of pharmaceuticals
for use if needed; expanding research on disease agents
that might be released; developing new and more rapid methods
for identifying biological agents and improved treatments
and vaccines; improving information and communications systems;
and preventing bioterrorism by regulation of the shipment
of hazardous biological agents or toxins. HHS has also worked
to forge new partnerships with organizations related to
national security.
We are striving at HHS to
strengthen our readiness and response, and our ability to
respond has been greatly improved over the last several
years. The system is not perfect, however, and we must continue
to accelerate our preparedness efforts.
As you know, much of the
initial burden and responsibility for providing an effective
response by medical and public health professionals to a
terrorist attack rests with local governments, which would
receive supplemental support from state and federal agencies.
However, if a disaster or disease outbreak reaches any significant
magnitude, such as what occurred on September 11th,
local resources could be overwhelmed and the federal government
may be required to provide protective and responsive measures
for the affected populations.
Office of Emergency
Preparedness Role in Federal Response
Within my Department, the
Office of Emergency Preparedness is the primary agency responding
to requests for assistance and resources. OEP's main function
is to manage the National Disaster Medical System (NDMS)
as well as the Public Health Service Commissioned Corps
Readiness Force, which could be called into action depending
upon the severity of the event. One of OEP's missions is
to manage and coordinate, on behalf of HHS, the federal
health, medical, and health related social service response
and recovery to major emergencies, federally declared disasters
and terrorist acts. OEP directs and manages Emergency Support
Function #8 (health and medical services) of the Federal
Response Plan. This includes coordinating the activities
of 12 other federal departments nationwide, including the
Departments of Veterans Affairs, Defense, Transportation,
Energy, and Agriculture, the Environmental Protection Agency,
and others.
When there is a disaster,
FEMA, as the Nation's consequence management and response
coordinator, tasks HHS to provide critical services, such
as health and medical care; preventive health services;
mental health care; veterinary services; mortuary activities;
and any other public health or medical service that may
be needed in the affected area. OEP, as the Secretary's
action agent, will direct NDMS, the Public Health Service's
Commissioned Corps Readiness Force, and other federal resources,
to assist in providing the needed services to ensure the
continued health and well being of disaster victims.
The National Disaster Medical
System is the vehicle for providing resources for meeting
the medical and mental health service requirements of ESF
#8, including forensic services. Begun in 1984, NDMS is
a partnership between HHS, VA, DoD, FEMA, state and local
governments, and the private sector. The System has three
components: direct medical care; patient evacuation; and
the non-federal hospital bed system. NDMS was created as
a nationwide medical response system to supplement state
and local medical resources during disasters and emergencies,
to provide back-up medical support to the military and VA
health care systems during an overseas conventional conflict,
and to promote development of community-based disaster medical
systems. The availability of beds in over 2,000 civilian
hospitals is coordinated by VA and DoD Federal Coordinating
Centers. The NDMS medical response component is comprised
of over 7,000 private sector medical and support personnel
organized into approximately 70 Disaster Medical Assistance
Teams, Disaster Mortuary Operational Response Teams, and
speciality teams across the Nation.
Disaster
Response Teams
Our
primary response capability is organized in teams such as
Disaster Medical Assistance Teams (DMATs), specialty medical
teams (such as those that would provide burn and pediatric
care), and Disaster Mortuary Teams (DMORTs). Our 27 level-1
DMATs can be federalized and ready to deploy within hours
and can be self-sufficient on the scene for 72 hours. This
means that they carry their own water, portable generators,
pharmaceuticals and medical supplies, cots, tents, communications
and other mission-essential equipment. These teams have
been sent to many areas in the aftermath of disasters in
support of FEMA-coordinated relief activities. In addition,
staff from OEP and our regional emergency coordinators also
go to the disaster sites to manage the team activities and
ensure that they can operate effectively.
OEP's National Medical Response
Teams (NMRTs) can provide medical treatment after a chemical
or biological terrorist event. Each one is fully deployable
to incident sites anywhere in the country with a cache of
specialized pharmaceuticals to treat up to 5,000 victims
of chemical exposures. The teams have specialized personal
protective equipment, detection devices and patient decontamination
capability.
Our mortuary teams can assist
local medical examiner offices during disasters, or in the
aftermath of airline and other transportation accidents,
when called in by the National Transportation Safety Board
and the Federal Bureau of Investigation.
In the last few years, OEP
has deployed to New York, Florida, Texas, Louisiana, Alabama,
Mississippi, the Virgin Islands and Puerto Rico in the aftermath
of hurricanes and tropical storms. Our mortuary teams and
management support teams have deployed to Rhode Island,
Pennsylvania and California to assist local coroner offices
after airline crashes. And we have supported local and federal
efforts during special events such as World Trade Organization
meetings, NATO 50th Anniversary events, Democratic
and Republican National Conventions, Presidential inaugural
events, and State of the Union Addresses in Washington,
D.C. Most recently, OEP and NDMS have deployed to Texas
to respond to the health and medical needs caused by Tropical
Storm Allison, and to New York, Pennsylvania and Virginia
in the aftermath of the horrors of September 11, 2001.
NDMS Agency Partnerships
HHS, through OEP, manages
and provides medical and mental health services, and mortuary
services during disasters, and DoD has the lead responsibility
for patient evacuation activities. DoD and VA share responsibility
for definitive care activities, including managing a network
of about 2,000 non-federal hospitals to ensure that hospital
beds can be made available through a system of Federal Coordinating
Centers (FCC). In addition, the VA provides other needed
medical support during disasters. During the response to
Tropical Storm Allison, the VA provided additional staffing
to our Emergency Operations Center, dozens of additional
medical and nursing personnel at the scene, and opened its
VA hospital in Houston to receive patients when a majority
of the hospitals in the Houston area were flooded and not
able to receive patients. Currently, the VA is actively
involved with us in New York City and in Washington, D.C.
They have provided staff for our ESF #8 EOC, area managers
to assist our Management Support Team in New York, mental
health experts and crisis counselors, and nurses to treat
burn patients both in New York and Washington.
The VA is partnering with
OEP on other activities as well. The VA is one of the largest
purchasers of pharmaceuticals and medical supplies. Capitalizing
on this buying power, OEP and VA have entered into an agreement
under which the VA manages and stores the four National
Medical Response Team specialized pharmaceutical caches.
The VA has purchased all of the pharmaceuticals and supplies,
rotates the stock, maintains the inventory, ensures the
security of the caches and ensures that the caches are ready
for deployment. Additionally, during FY 2001, OEP provided
funds to the VA to begin to develop plans and curricula
to train NDMS hospital personnel to respond to WMD events.
Other
OEP Activities
OEP is working on
a number of fronts to assist local areas hospitals, and
medical practitioners to effectively deal with the effects
of terrorist acts. HHS is taking the necessary steps to
prepare our Nation for the health effects of terrorism,
recognizing that should a chemical, nuclear, or bombing
terrorist event occur, our cities and local metropolitan
areas would bear the brunt of coping with its effects. In
addition, we realized that the local medical communities
would be faced with severe problems, including overload
of hospital emergency rooms, medical personnel injured while
responding, and potential contamination of emergency rooms
or entire hospitals. Consequently, in FY 1995, HHS began
developing the first prototype Metropolitan Medical Response
System (MMRS). These systems, managed by local governments,
are capable of providing triage and patient decontamination,
population-based pharmaceutical prophylaxis and necessary
medical care. In fact, the health care capacity issues that
they are addressing are important regardless of the cause
of mass casualties - for example, earthquakes, disease pandemics
or terrorist events. To date, OEP has contracted with 97
of the Nation's largest metropolitan areas for MMRS development,
and plans to initiate an additional 25 contracts during
this fiscal year.
In FY 1999, Congress appropriated
funds for OEP to renovate and modernize the Noble Army Hospital
at Ft. McClellan, AL, in order for the hospital to be used
to train doctors, nurses, paramedics and emergency medical
technicians to recognize and treat patients with chemical
exposures. The Noble Training Center is working with universities,
medical centers, and other federal agencies to train medical
practitioners, emergency room staff, hospital administrators,
medical first responders, and others to ensure that our
citizens receive the best possible medical care after a
WMD event. Working with CDC and the VA, a training program
was developed for pharmacists working with distribution
of the National Pharmaceutical Stockpile.
Conclusion
The Department of Health
and Human Services is committed to ensuring the health and
medical care of our citizens. We are prepared to mobilize
quickly the health care professionals required to respond
to a disaster anywhere in the U.S. and its territories and
to assist local medical response systems in dealing with
extraordinary situations, including meeting the unique challenge
of responding to the health and medical effects of terrorism.
The Departments of Veterans Affairs and Defense are critical
partners in these efforts.
Mr. Chairman, that concludes
my prepared remarks. I would be pleased to answer any questions
you may have.
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Last revised: October 17, 2001