Press Room Archive

• Press Releases
• Speeches and Statements
• Testimony
• Multimedia
• Contacts
• En Español

Statement for the Record Jeffrey W. Runge, MD Chief Medical Officer Office of Health Affairs before the U.S. House of Representatives Committee on Appropriations Subcommittee on Homeland Security “Bioterrorism Preparedness and Role of DHS Chief Medical Officer”

Release Date: March 29, 2007

Rayburn House Office Building
(Statement for the Record)

Chairman Price, Ranking Member Rogers, and Members of the Subcommittee:

Thank you for the opportunity to share information with you about the new Office of Health Affairs (OHA) within the U.S. Department of Homeland Security (DHS, or Department). OHA is designed to allow an expansion of the original duties of the DHS Chief Medical Officer (CMO) 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 Office of the Chief Medical Officer

In response to the increasingly difficult challenges of protecting our country from bioterrorism and natural agents that threaten the health and well-being of the public, Secretary Chertoff created the position of CMO within the Preparedness Directorate of the Department as part of the Second Stage Review in July 2005. This position was created to provide the Secretary with a counselor from the medical profession to advise him on health care and public health related security issues that may arise during a catastrophic incident. This person also provides expertise in the Department’s responsibilities to the Nation’s biodefense.

The office of the CMO officially commenced operations in September 2005 with a staff of three people. Since becoming operational, the office exceeded many of its original goals and milestones in 2006, including:

• The oversight of the Department’s pandemic influenza preparedness plans and working groups, and establishment of the Pandemic Influenza Program Office to develop and execute the spending plan for the Department’s $47 million share of the Avian Influenza supplemental appropriation;
• The coordination of the Department’s role in national biodefense and biosurveillance including, (1) operate the National Biosurveillance Integration System, and (2) the coordination of the Department’s role in Project BioShield; and,
• The development of a strategy to integrate departmental programs for occupational health,  safety, and wellness that will ensure that all DHS employees have access to standards and best practices for preventing and addressing work-related injuries and illnesses and ensuring operational medical support for employees who are forward-deployed.

The CMO and the Office Of Health Affairs

On January 18, 2007, in response to the changing domestic security needs of the Nation, Secretary Chertoff announced a realignment of the Department that further expands the role of the Office of the CMO. Recognizing the successful start-up of the Office of the CMO and its cross-cutting responsibilities to the Department, Secretary Chertoff proposed that the Office be renamed the Office of Health Affairs (OHA), and report directly to him through the Deputy Secretary. The new structure will address key gaps identified during my first year with the Department:

• Biodefense- There was no principal agent for biodefense activities in the Department, including its obligations under Homeland Security Presidential Directive-9 (Food and Agro-Defense) and Homeland Security Presidential Directive-10 (Biodefense);

• Contingency Planning- The Department had no single point of responsibility for integrated end-to-end contingency planning for catastrophic scenarios involving threats to the health and safety of the population, from pre-event biosecurity issues through physical and environmental recovery;
• Occupational Health And Safety- The Department had no consistent policy for occupational safety and health appropriate for its diverse workforce; and
• Realignment- The CMO’s place in the organization was not consistent with its federal partners.

It is important to note that the OHA does not duplicate any function or activity of any existing agency or program, but rather leads the coordination for certain functions of the Department that have been scattered among other components and expands certain functions that the Department needs at this stage of its development.

Under the realignment, the OHA will continue to be led by the Chief Medical Officer who will also hold the title and rank of Assistant Secretary for Health Affairs. Serving under the Assistant Secretary/CMO is a Deputy Assistant Secretary/Deputy CMO, who serves as a member of the career Senior Executive Service. The Office of the Assistant Secretary (OAS) will contain the business functions necessary to stand up the new office. The OAS will also ensure consistency in policy and communications on health issues in coordination with other components of the Department.

Within the immediate office of the Assistant Secretary, the office of International Affairs and Global Health Security oversees the Department’s global health security activities and serves as the subject-matter expert on all matters related to international aspects of Avian and Pandemic Influenza and other global health security matters including international medical readiness and all-hazard emergency public health planning. The office also maintains high-level liaison with senior foreign partners, international private sector representatives, technical and professional associations, and other Federal agencies to ensure sustainable solutions to those global health security issues that have national implications on homeland security and medical preparedness.

Three Associate Chief Medical Officers will lead the three main divisions of the Office of Health Affairs: (1) WMD & Biodefense, (2) Medical Readiness, and (3) Component Services & Workforce Health Protection. All will be career employees with extensive experience in their respective areas.

The WMD and Biodefense Office will lead the Department’s biodefense activities in coordination with the components and agencies of DHS and across the government. The office integrates the bio-monitoring activities of executive branch Departments that includes biosurveillance, aerosol detection, clinical syndrome detection, mail room observation, and suspicious substance management. The office, in conjunction with the Science and Technology Directorate (S&T), will lead the Department’s responsibilities for veterinary and agro-defense activities covering animal and zoonotic diseases, and agricultural security issues related to livestock, food and water. In addition to bio- and chemical defense, the office will assist the Domestic Nuclear Detection Office by providing subject matter expertise to drive planning for response to radiological and nuclear attacks. The programs within the WMD and Biodefense division include:

• Early Detection Division: The operational components of BioWatch will be transferred from S&T to the OHA on March 31, 2007. BioWatch operates with the inclusion of public and private health personnel at all levels of government, and is currently running in over 30 cities around the country to provide for the early detection of hazardous biological agents. As S&T’s research and development personnel continue to enhance the technology used in BioWatch, the OHA will incorporate these enhancements into the operational portion of the BioWatch program. This office will work closely with local BioWatch partners, and will provide the infrastructure needed for the OHA to further the Department’s biodefense mission with state and local partners. The office will also run the Rapidly Deployable Chemical Detection System (RDCDS) for chemical events and will support detection systems needed for National Special Security Events.
• Biosurveillance Division:  This division will provide the U.S. Government with seamless integration of early warning and biosurveillance information through the stand-up of the National Biosurveillance Integration Center (NBIC). The NBIC is an interagency effort to fuse intelligence with multiple sources of biosurveillance information on human, animal, plant and environmental health measures to provide early warnings of a possible biological attack. The NBIC will house experts from more than 12 Federal agencies working together to provide an integrated view of biological risks, and receiving the integrated information for the benefit of the member agencies.
• Veterinary and Agro-Defense Division:  To enable the Department to perform its duties under HSPD-9, the OHA Veterinary and Agro-Defense personnel will provide advice on veterinary, food, water and Agro-Defense. The division will develop formal processes for internal and external coordination with our Federal partners and other public and private entities to ensure awareness, readiness and response to all disasters related to food, water, animal and agricultural security in coordination with Office of Infrastructure Protection. For example, the office is involved with the assessment of the effects on the Nation of animal diseases such as Foot and Mouth Disease (FMD), Avian Influenza, Rift Valley Fever, and Wheat Rust. These are but a few of the many animal and plant diseases and emerging threats that Veterinary and Agro-Defense is investigating in conjunction with other DHS and Federal agencies.

DHS is responsible for 12 of 19 action items under HSPD-9, Defense of United States Agriculture and Food. OHA will assume responsibility for coordinating DHS’ action items as of March 31, 2007, and is developing a comprehensive five-year strategic plan with goals, objectives, milestones, and measures for each action item. OHA’s coordination of DHS activities does not mean that OHA is taking responsibility for each action item. Rather, OHA will coordinate the implementation of these action items, as carried out by the appropriate component within DHS. In addition, OHA will in the framework of the National Infrastructure Protection Plan engage with state, local, tribal and territorial governments and private sector partners on medical and public health issues, including HSPD-9.

• Medical Countermeasures Division:  The OHA remains committed to advancing the effectiveness of Project BioShield by supporting HHS. The Office of Health Affairs’ responsibility under Project BioShield is to utilize information derived from the Material Threat Determinations and Population Risk Assessments completed by the S&T Directorate in discussions with the Department of Health and Human Services (HHS) to identify medical countermeasures. OHA’s physicians and medical research personnel will work with our partners at HHS to provide subject matter expertise about the use of countermeasures in a manner that ensures the most protection to the public. HHS will continue to have the sole responsibility for developing and executing a strategy for research, procurement, acquisition, storage, and delivery of the countermeasures to and from the National Stockpile using the new HHS Public Health Emergency Medical Countermeasures Enterprise, the governing board of which includes the Assistant Secretary for Health Affairs as an ex-officio member.

The Medical Readiness Office will lead the Department’s engagement with the Federal inter-agency on health and medical issues, ensuring that preparedness and response activities are coordinated in accordance with the National Response Plan (NRP). The office will also lead the Department’s contingency planning and consequence management for chemical, biological, radiological and nuclear hazards, in concert with the DHS Office of Operations Coordination, the Domestic Nuclear Detection Office (DNDO) and the Federal Emergency Management Agency. The Medical Readiness Office is also responsible for the Department’s role in preparation for and response to an outbreak of Pandemic Influenza in coordination with the Department of Health and Human Services.  In addition, the Office will assist with the enhancement of incident management capabilities of states, communities and the private sector, working closely with Federal Emergency Management Agency (FEMA) to optimize DHS grant programs aimed at improving medical readiness. The Medical Readiness Office will engage our federal partners and stakeholders on exercises and interagency plans, requirements and response actions, the development of a catalogue of existing regional planning, and coordination initiatives. The office is developing a methodology and an approach for an interagency pilot project to implement regional all-hazards systems for medical and public health preparedness. The office will also incorporate a first responder division to work closely with DHS, interagency, and first responder partners to address all-hazards preparedness and incorporate first responder capabilities into the Department’s contingency planning and consequence management efforts.

The Component Services & Workforce Health Protection Office is charged with ensuring the Department’s workforce is provided with scientifically-based and regulatory-compliant occupational health and safety standards and practices applied consistently across the Department. This will enhance the ability of the Department to ensure a stable and healthy workforce during critical incidents as well as in the routine performance of duties. To create a culture of wellness throughout DHS, this office will develop policies, standards, requirements and metrics for fitness-for-duty, drug testing, health screening and monitoring, health promotion and management, pre-placement evaluations, and immunizations and deployment physicals in coordination with the Management Directorate.    

This office will also develop medical services policy in coordination with Departmental Management and Operations and provide for oversight of all medical services provided by or on behalf of the Department. Importantly, this will include ensuring effective, caring, and compassionate emergency medical services are delivered in the course of border and immigration services operations. By developing effective workforce health protection and wellness programs and by assisting DHS components in identifying and fulfilling requirements for medical support of operations, Component Services & Workforce Health Protection becomes the Department’s front line of defense for employee health and safety, and a critical partner in the reduction in workplace illness and injuries.

FY 2008 Budget Overview

As the 2008 Fiscal Year approaches, the CMO is adjusting to significant changes from past budgets. Based on our vastly expanding responsibilities and the specialized workforce needed to fulfill our unique mission, the newly created OHA is requesting a budget of $117,933,000 and 49 full time employees (FTEs) for FY 2008.

FY ‘08 Mission

Serving as the principal medical authority for the DHS, the OAS will ensure that the Department’s leaders have relevant intelligence- and science- based health and medical information while providing “24/7” expertise availability to support catastrophic incident management requirements and strategic communications plans. Additionally, as a stand-alone entity, OHA will assume responsibility for its own intrinsic business operations.

Associated FY ‘08 Fiscal Requirement

In FY ‘08, OHA is requesting Salary and Expenses funding of $23,000,000 to support 49 FTE. This includes salary, benefits and expenses for all OHA federal employees; 16 detailees, rent, working capital fund and other administrative services. The OHA will:

• Establish a core of OHA staff physicians and biodefense experts with expertise in all aspects of domestic preparedness, healthcare and public health;
• Establish internal and external databases from which to draw resources for scientifically-based incident management decision making;

• Provide a minimum number of support personnel to execute the operational requirement of the program areas; and
• Fund one FTE to begin baseline planning for OHA continuity of operations and continuity of government activities.

FY ‘08 Mission

The OHA will lead the Department’s biodefense activities, including management of the early detection and warning systems for Chemical Biological Radiological Nuclear Explosive attacks and maintaining a biosurveillance integration program that incorporates effective interagency information sharing and communication. In addition, OHA will lead the Department’s efforts to implement relevant NSC/HSC implementation plan action items under Homeland Security Presidential Directive-9 (Food and Agriculture Security) and under HSPD-10 (Biodefense for the 21

Associated FY ‘08 Fiscal Requirement

In FY ’08, OHA is requesting $90,735,000 in WMD & Biodefense program funds for biodefense activities, to lead the Department’s responsibilities for veterinary and agro-defense activities covering animal and zoonotic diseases, and agricultural security issues related to livestock, food and water. The OHA will:

• Maintain effective 24/7/365 BioWatch operations in existing jurisdictions and as requested for national and local special events;

• Continue to develop requirements driving the spiral development of Generation 2 BioWatch systems;
• Maintain the Rapidly Deployable Chemical Detection System;
• Support HHS’ Project BioShield efforts;

• Support overall coordination of the Department’s HSPD-9 and HSPD-10 mandates such as developing plans to fill the gaps identified in IG & GAO reports; and
• Develop doctrine to coordinate the agro-defense activities of DHS, USDA, FDA, CDC and state agricultural departments.

FY ‘08 Mission

The OHA will develop a coordinated national architecture for WMD planning and catastrophic medical consequence management, serve as the Department’s lead on the development of end–to-end base plans for managing a biological attack, use the outputs of these plans to drive requirements into the DHS medical readiness grant process, and coordinate with Federal, state, local, tribal and territorial governments.

Associated FY ‘08 Fiscal Requirement

In FY ‘08, OHA is requesting $3,448,000 in Medical Readiness program funds to develop and coordinate comprehensive policy, strategy, requirements and metrics for the Department’s medical and public health grants and cooperative agreements; and oversee the WMD medical contingency planning function. The OHA will:

• Engage with interagency stakeholders on exercises and support response activities in order to maintain visibility on interagency plans, requirements, and response actions;

• Identify and evaluate DHS readiness programs and activities related to medical and public health;
• Develop a methodology and approach for an interagency pilot project for regional all-hazards systems for medical and public health preparedness;
• Revise and update the DHS Pandemic Influenza Contingency Plan to reflect updated information from components, interagency partners and the private sector;
• Develop & disseminate to DHS components and interagency partners the requirements for full end-to-end planning; and
• Coordinate with FEMA and HHS to develop risk-based performance objectives for health and medical capabilities required under HSPD-8.

FY08 Mission

The OHA will assume responsibility for developing effective occupational health and safety standards across the Department in coordination with the Management Directorate, as well as providing medical control to existing operational and tactical medical support programs.

Associated FY8 Fiscal Requirement

In FY ’08, OHA is requesting $750,000 in Component Services and Workforce Protection program funds to lead the development of strategy, policy, requirements and metrics for a Department-wide occupational health and safety program, and to assist DHS components in identifying and fulfilling requirements for medical support of tactical operations. The OHA will:

• Develop a catalogue of DHS components' existing occupational health and safety programs and activities;
• Conduct a gap analysis of the existing programs with established standards for federal occupational health and safety;
• Assemble a network of DHS component representatives to set policy and requirements for occupational health and safety, and;
• Develop and distribute a Department-wide guide for Workforce Health Protection.

 

OHA and our Federal Partners

The OHA is designed to contribute to the domestic health and security of the American people, in full coordination and collaboration with other DHS components and our Federal partners. Responsibilities and activities within the OHA will not duplicate or supplant activities currently being provided by other components or programs within DHS or among the departments and agencies of the Executive Branch. Instead, OHA’s responsibilities and activities will enhance other programs in 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 U.S. Government is appropriately applied to incidents of national significance with medical consequences.

The OHA is fully dedicated to supporting the mission of the DHS, and supporting the individual efforts and responsibilities of the offices and components within the Department. OHA will be working closely with all of the Department’s components by supporting their occupational health and safety requirements, and coordinating with others to meet operational requirements including: the Science and Technology Directorate, Intelligence and Analysis, Operations Coordination, the U.S. Secret Service, U.S. Customs and Border Protection, U.S. Immigration and Customs Enforcement, the U.S. Coast Guard, the Office of National Capital Region Coordination, FEMA, and the Transportation Security Administration.

We will work closely with our Federal partners at HHS, Defense, Agriculture, Commerce, Transportation, Justice and Veterans Affairs, along with the Center for Disease Control and Prevention, the Environmental Protection Agency, the U.S. Postal Service and members of the domestic and international Intelligence Community. OHA also will work with state and local governments, and with hundreds of non-government organizations, associations and private sector entities to advance our mission and ensure our efforts reflect the most accurate data and knowledge available.

The Department serves as the integrator of federal, state and local resources that are dedicated to preserving the security of the Nation. The OHA carries forward this mission by ensuring that public health and safety variables for the overall security equation are accurate and fully considered. The mission of the OHA is unique. We are charged with the responsibility of ensuring that all components and entities related to the preservation of and response to public health, veterinary, agricultural, and medical emergencies are identified and addressed. Along with our federal, state and local partners, and with the incorporation of private sector resources, we aim to keep the 300 million people of America safe and healthy while doing so, protect the infrastructure of our country.

Mr. Chairman, it is my hope that you have found this to be an insightful overview for the Office of Health Affairs. I look forward to answering any questions you may have, and I thank you, Ranking Member Rogers and the Members of the Subcommittee for your support of this new and bold mission.  

This page was last reviewed/modified on March 29, 2007.