[House Hearing, 112 Congress]
[From the U.S. Government Printing Office]
ENSURING EFFECTIVE PREPAREDNESS RESPONSES AND RECOVERY FOR EVENTS
IMPACTING HEALTH SECURITY
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HEARING
before the
SUBCOMMITTEE ON EMERGENCY
PREPAREDNESS, RESPONSE,
AND COMMUNICATIONS
of the
COMMITTEE ON HOMELAND SECURITY
HOUSE OF REPRESENTATIVES
ONE HUNDRED TWELFTH CONGRESS
FIRST SESSION
__________
MARCH 17, 2011
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Serial No. 112-12
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Printed for the use of the Committee on Homeland Security
[GRAPHIC] [TIFF OMITTED] TONGRESS.#13
Available via the World Wide Web: http://www.gpo.gov/fdsys/
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COMMITTEE ON HOMELAND SECURITY
Peter T. King, New York, Chairman
Lamar Smith, Texas Bennie G. Thompson, Mississippi
Daniel E. Lungren, California Loretta Sanchez, California
Mike Rogers, Alabama Sheila Jackson Lee, Texas
Michael T. McCaul, Texas Henry Cuellar, Texas
Gus M. Bilirakis, Florida Yvette D. Clarke, New York
Paul C. Broun, Georgia Laura Richardson, California
Candice S. Miller, Michigan Danny K. Davis, Illinois
Tim Walberg, Michigan Brian Higgins, New York
Chip Cravaack, Minnesota Jackie Speier, California
Joe Walsh, Illinois Cedric L. Richmond, Louisiana
Patrick Meehan, Pennsylvania Hansen Clarke, Michigan
Ben Quayle, Arizona William R. Keating, Massachusetts
Scott Rigell, Virginia Vacancy
Billy Long, Missouri Vacancy
Jeff Duncan, South Carolina
Tom Marino, Pennsylvania
Blake Farenthold, Texas
Mo Brooks, Alabama
Michael J. Russell, Staff Director/Chief Counsel
Kerry Ann Watkins, Senior Policy Director
Michael S. Twinchek, Chief Clerk
I. Lanier Avant, Minority Staff Director
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SUBCOMMITTEE ON EMERGENCY PREPAREDNESS, RESPONSE, AND COMMUNICATIONS
Gus M. Bilirakis, Florida, Chairman
Joe Walsh, Illinois Laura Richardson, California
Scott Rigell, Virginia Hansen Clarke, Michigan
Tom Marino, Pennsylvania, Vice Vacancy
Chair Bennie G. Thompson, Mississippi
Blake Farenthold, Texas (Ex Officio)
Peter T. King, New York (Ex
Officio)
Kerry A. Kinirons, Staff Director
Natalie Nixon, Deputy Chief Clerk
Curtis Brown, Minority Professional Staff Member
C O N T E N T S
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Page
Statements
The Honorable Gus M. Bilirakis, a Representative in Congress From
the State of Florida, and Chairman, Subcommittee on Emergency
Preparedness, Response, and Communications..................... 1
The Honorable Laura Richardson, a Representative in Congress From
the State of California, and Ranking Member, Subcommittee on
Emergency Preparedness, Response, and Communications........... 3
Witness
Dr. Alexander G. Garza, Assistant Secretary for Health Affairs,
Chief Medical Officer, Department of Homeland Security:
Oral Statement................................................. 5
Prepared Statement............................................. 6
Appendix
Questions From Chairman Gus M. Bilirakis of Florida.............. 19
ENSURING EFFECTIVE PREPAREDNESS
RESPONSES AND RECOVERY FOR EVENTS
IMPACTING HEALTH SECURITY
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Thursday, March 17, 2011
U.S. House of Representatives,
Subcommittee on Emergency Preparedness, Response,
and Communications,
Committee on Homeland Security,
Washington, DC.
The subcommittee met, pursuant to call, at 2:07 p.m., in
Room 311, Cannon House Office Building, Hon. Gus M. Bilirakis
[Chairman of the subcommittee] presiding.
Present: Representatives Bilirakis, Richardson, and Clarke.
Mr. Bilirakis. Good afternoon. The Subcommittee on
Emergency Preparedness, Response, and Communications will come
to order.
The subcommittee is meeting today to receive testimony from
Dr. Alexander Garza on how the Department of Homeland
Security's Office of Health Affairs is working to provide
health security for our Nation.
I now recognize myself for an opening statement.
Last week the subcommittee held a hearing to examine FEMA's
capacity to ensure effective preparedness and response to
terrorist attacks, natural disasters, and other emergencies. I
now look forward to having a similar conversation with the
Assistant Secretary to ensure that the Office of Health Affairs
is meeting its mandates with respect to preparedness, response,
and recovery and thereby doing its part to meet the Nation's
health security challenges.
While this hearing has been scheduled for some time, it is
particularly timely in light of the recent catastrophe in
Japan. Our thoughts are with the Japanese people as they
continue to respond to this tragedy and begin to recover. Of
course, the United States stands ready to assist our ally in
this difficult time.
As we work to assist Japan, we must also reflect on our own
level of preparedness and learn from Japan's experience so we
can be better prepared here in the United States.
The Office of Health Affairs' mission is to provide health
and medical expertise in support of the Department's mission to
prepare for, respond to, and recover from all hazards impacting
the Nation's security; that is, to protect our health in the
case of a National incident with health consequences.
This is a valid mission that I think is not always well
understood, but OHA's accomplishments are real. For example,
during the 2009 H1N1 influenza outbreak, the Assistant
Secretary briefed the Secretary and other DHS leaders on
matters such as where the flu was spreading, whether closing
the border with Mexico could slow its progression, and how DHS
could mobilize resources to assist in the response.
Staff in the workforce division are working to ensure that
emergency medical personnel, such as EMTs with the Border
Patrol, are adequately credentialed when they cross State lines
in the course of their duties. OHA operates the BioWatch
program, a deployment of detectors in more than 30 metropolitan
areas designed to detect aerosolized agents of bioterrorism.
The subcommittee looks forward to learning more about these
successes, as well as on-going challenges. I would particularly
like to hear more about OHA's work with interagency partners on
the development, procurement, and distribution of medical
countermeasures. This is a topic that this subcommittee will
consider more specifically in the future, but I would like to
begin our conversation today.
The President's fiscal year 2012 budget request includes
$161 million for OHA's affairs, a $21 million increase over
fiscal year 2011, the continuing resolution. The BioWatch
program accounts for the vast majority of this spending.
While BioWatch is not the only activity for which your
office is responsible, it is however the most expensive. The
request includes $115 million for BioWatch, $25 million of
which will go towards operational testing of Next Generation
technology. If successful, this new system would enable a
drastic decrease in detection time from the current 12-36 hours
to 4-6 hours. It would also provide detectors that could
function reliably indoors. Such milestones would be important
advances, but I and other Members are concerned that the
timeline for deployment has been repeatedly delayed.
I am also concerned that the testing phase includes only
one type of technology. There have been two viable competitors
going through the process, and now you are down to one before
you have even gotten to the field and operational testing and
evaluation.
I look forward to hearing from you about why this is the
case and how we can increase competition to ensure that at the
end of the day we have a robust BioWatch program with the best
technology, CONOPS, and buy-in from the communities in which it
is deployed.
Finally, I would like to discuss the National
Biosurveillance and Integration System, NBIC, which seeks to
achieve the important goal of fusing many inputs of
biosurveillance data to provide early detection of an Event of
National Significance, such as an anthrax outbreak.
The President's budget requests $7 million for NBIC, an
amount consistent with historical funding levels for this
program. While an effective National biosurveillance capability
is an important component of preparedness and response, the
necessary cooperation from other Federal agencies remains
lacking and has led to an ineffective NBIC that has not met its
statutory mandates.
Continued funding at this level under the current operating
scheme will be money wasted. While we are pleased that DHS has
recognized the shortcomings of NBIC and has developed a plan to
confront its challenges, I believe we really need to see a
demonstrable increase in value prior to supporting on-going
appropriations.
With that, I look forward to hearing from Dr. Garza on his
budget request and all the activities and challenges of his
office.
I now recognize the Ranking Minority Member, Ms. Richardson
from California, for any statement she may have. You are
recognized.
Ms. Richardson. Thank you, Mr. Chairman. Good afternoon. I
would like to thank Dr. Garza for appearing before this
committee today and expressing this committee's deep gratitude
for your current and previous service to our country.
But let me start by saying that our thoughts and of course
our prayers, and I join with the Chairman, as we continue to be
thoughtful of our friends in Japan as they search for
survivors, or continue I should say, and recover from one of
the greatest disasters that was certainly known in Japan and
maybe in the world.
I supported the President's decision to work in an
expeditious way to assist with the relief and efforts by
deploying U.S. military and FEMA's urban search and rescue
teams and any other assets that might be required in the
region.
This disaster has caused damage to areas in Hawaii and in
my own home State of California, and it demonstrates how one
emergency can spiral into others. The effects of the earthquake
and the subsequent tsunami are now prompting a public health
emergency, including concerns regarding the radiation seeping
from nuclear reactors. It is a truly a tragedy of historic
proportions, and one that we all must learn from in order to
prepare in our own home bases.
As a representative of the 37th Congressional district, I
understand the potential effects of earthquakes and tsunamis
that could have on cities, neighboring areas, and our
infrastructure. In my district alone, we have various oil
refineries that produce more than 1 billion barrels per day. We
are home to a number of gas treatment facilities, petrochemical
facilities, all that abut against the Nation's largest ports,
which aside from all of that going on, when you consider the
fact that we are in due proximity to the Pacific ocean and the
San Adreas fault, preparations still needs to be in order.
I am committed to ensuring that we are doing everything we
can to learn from and assist in what has occurred in Japan.
Therefore, today's hearing can provide us with a better
understanding on how well DHS is prepared to respond to the
health effects of both natural and man-made disasters.
As you know, the previous administration's reorganization
efforts created the Office of Health Affairs. Since its
founding, there have been concerns, though, however, on how
well OHA fits within the Department's enterprise.
Dr. Garza, during your confirmation hearing, you stated
that OHA is a young entity and in many ways a work in progress.
In these tough economic climate times, it is important that
each homeland security investment is dedicated to programs that
are effective, efficient, and not duplicative. Unfortunately,
there have been many programs within OHA's responsibilities
that have not always met those standards.
The BioWatch program, which is vital to our preparedness
effort, has suffered from some management issues in the past as
well as not having the ability of upgrades and the
developmental delays of the Gen-3 technologies. A more glaring
demonstration of some of our growing pains has been the
inability to fully establish the National Biosurveillance and
Integration Center. The GAO found that the NBIC relied upon
publicly available internet information. This is completely
opposite to the vision and intention of the Congress.
Finally OHA's workforce protection efforts appears to mimic
those designated for the DHS Office of Safety and Environmental
Programs. We must do all that we can to protect DHS staff to
ensure that they can protect the Nation, but duplicating
efforts are not effective.
Dr. Garza, I look forward to hearing your plans today, your
plans to address the concerns that we have laid out in this
committee, and also hopefully to share with us OHA's mission
and how you plan on expanding that further.
With that, I look forward to your testimony. Thank you for
being here.
Mr. Bilirakis. Thank you, Ms. Richardson. Appreciate it
very much. Other Members of the subcommittee are reminded that
opening statements may be submitted for the record.
I am pleased to welcome Dr. Garza before the subcommittee.
Dr. Garza is the Assistant Secretary for Health Affairs and
Chief Medical Officer for the Department of Homeland Security.
He manages the Department's medical and health security
matters, oversees the health aspects of contingency planning
for all chemical, biological, radiological, and nuclear
hazards, and leads a coordinated effort to ensure that the
Department is prepared to respond to biological and chemical
weapons of mass destruction.
Prior to joining the Department in August 2009, Dr. Garza
spent 13 years as a practicing physician and medical educator.
He most recently served as Director of Military Programs at the
ER One Institute at Washington Hospital Center and has served
as the Associate Medical Director of the Emergency Medical
Services for the State of New Mexico and Director of the EMS
for the Kansas City, Missouri Health Department.
Dr. Garza holds a medical degree from the University of
Missouri, Columbia School of Medicine, a Master's of Public
Health from the St. Louis School of Public Health, and a
Bachelor of Science in biology from the University of Missouri,
Kansas City.
Prior to earning his medical degree, he served as a
paramedic and an emergency medical technician. He is a fellow
in the American College of Emergency Physicians and a member of
the American Public Health Association.
Welcome, Dr. Garza. Your entire written statement will
appear in the record. I ask you to summarize your testimony.
You are now recognized, sir.
STATEMENT OF ALEXANDER G. GARZA, MD, MPH, ASSISTANT SECRETARY
FOR HEALTH AFFAIRS, CHIEF MEDICAL OFFICER, DEPARTMENT OF
HOMELAND SECURITY
Dr. Garza. Thank you and good afternoon, Chairman
Bilirakis, Ranking Member Richardson, and distinguished Members
of the committee. Thank you for inviting me to testify before
you today.
It is a privilege to be here to discuss the Office of
Health Affairs and my strategic priorities. OHA serves as the
principal authority for all medical and health issues for the
Department of Homeland Security. We look at health through the
prism of National security, providing medical, public health,
and scientific expertise in support of the Department's mission
to prepare for, respond to, and recover from all threats.
Our responsibilities include serving as the principal
adviser to Secretary Napolitano and FEMA Administrator Fugate
on medical and public health issues. We lead and coordinate
biological and chemical defense programs. We provide medical
and scientific expertise to support DHS preparedness and
response efforts, and we lead the Department's workforce,
health protection, and medical support activities. OHA,
furthermore, serves as the point of contact for State and local
governments on medical and public health issues for the
Department.
Our role is indeed unique within the Federal Government. We
are the only health office broadly tasked to bridge the divide
between security threats and risks and health issues. We focus
on how the health impacts of disasters and catastrophic events
will affect our homeland security operations and our workforce
health protection measures. We also work across multiple
disciplines. We take a one-health approach in order to fully
understand how health issues affect the security of the
homeland.
Almost all issues involving health and catastrophic events
are multi-factorial and complex. They do not fit cleanly into a
single ownership model. This is where DHS and OHA bridge the
different disciplines needed to develop a complete picture.
We don't have to look far to see the significance of how
having a robust and effective preparedness and response system
protects the Nation. Look at the headlines over the past year
and what dominated the news cycle. A year and a half ago,
everyone was concerned with the H1N1 pandemic. After that came
Haiti. After that came Deepwater Horizon. As both of you have
mentioned today, the unfolding disaster in Japan.
Each threat, whether it is overt or covert, intentional or
accidental, man-made or naturally occurring, brings with it its
own health and homeland security challenges, and it is my
mission to make sure that the homeland security is able to meet
its mission of a safe and secure homeland where the American
way of life can thrive.
I want to thank this committee for the opportunity to
testify. I look forward to answering any questions you may
have.
Thank you.
[The statement of Dr. Garza follows:]
Prepared Statement of Alexander G. Garza
March 17, 2011
Chairman Bilirakis, Ranking Member Richardson, and distinguished
Members of the committee: Thank you for inviting me to testify before
you today. It is a privilege to be here to discuss my strategic
priorities and the fiscal year 2012 budget for the Office of Health
Affairs.
I would like to begin by providing an overview of the mission of
the DHS Office of Health Affairs (OHA) and our role within the Homeland
Security Enterprise. OHA serves as DHS's principal authority for all
medical and health issues. We look at health ``through the prism of
National security,'' providing medical, public health, and scientific
expertise in support of the DHS mission to prepare for, respond to, and
recover from all threats.
OHA's responsibilities include serving as the principal advisor to
the Secretary and FEMA Administrator on medical and public health
issues; leading and coordinating biological and chemical defense
programs; providing medical and scientific expertise to support DHS
preparedness and response efforts; and leading the Department's
workforce health protection and medical support activities. OHA also
serves as the primary DHS point of contact for State and local
governments on medical and public health issues.
To execute these responsibilities, we developed a Strategic
Framework that outlines our mission space within the Department, and
enumerates four overarching goals: (1) To provide expert health and
medical advice to DHS leadership; (2) to build National resilience
against health incidents; (3) to enhance National and DHS medical first
responder capabilities; and (4) to protect the DHS workforce against
health threats.
Today I will discuss a number of initiatives that help us achieve
our goals and contribute to the health security of the Nation. I will
also highlight how our fiscal year 2012 budget request supports these
efforts.
biodefense
OHA operates, manages, and supports the Department's biological
defense and surveillance programs. Our work is primarily focused on the
operational areas of detection and surveillance, as well as helping to
build preparedness at the State and local level.
Detection
One of our primary responsibilities is to mitigate the consequences
of biological incidents through early detection. OHA uses early
detection as a tool to make the Nation more resilient against health
events. Prompt identification of a biological event has the potential
to improve the delivery of medical countermeasures and save lives.
OHA's BioWatch program is a Federally-managed, locally-operated,
Nation-wide bio-surveillance system designed to detect the intentional
release of aerosolized biological agents. This program deploys
collection devices and analytical capability in more than 30 high-risk
metropolitan areas throughout the Nation. BioWatch provides public
health experts with a warning of the presence of a biological agent
before exposed individuals develop symptoms of illness. This ``detect-
to-treat'' approach provides public health officials with an
opportunity to respond to the release of a biological agent as quickly
as possible in order to mitigate the potentially catastrophic impact on
the population.
In addition to providing critical early detection capabilities, the
BioWatch program has built a collaborative capacity that did not
previously exist among the Federal Government, State and local public
health, and emergency management. This partnership provides a model of
interaction for future endeavors.
OHA is committed to providing cutting-edge, technically robust
early detection solutions. The fiscal year 2012 budget request supports
continued operations for our deployed detection systems and includes an
increase from current services to fund the start of operational testing
and evaluation of the Generation-3 automated detection system. The Gen-
3 system will advance current detection technology by providing an
automated detection capability that is expected to significantly reduce
the time between a release of a biothreat agent and confirmation of
that release by BioWatch technology. Current detection capabilities,
termed Gen-1/2, consist of outdoor aerosol collectors whose filters are
manually retrieved for transport to and subsequent analysis in a
Laboratory Response Network (LRN) facility. This system, while
extremely beneficial, is labor-intensive and the results may not be
available until 12-36 hours after the release of a biological agent has
occurred. The transition to an automated detection system (Gen-3) will
improve the time to detect to 4-6 hours, increase population coverage,
and provide greater overall cost effectiveness.
Biosurveillance
Another key element to an overarching biodefense framework is
biosurveillance. OHA is focused on developing and maintaining an
integrated, real-time, multidiscipline surveillance picture.
To that end, OHA manages the National Biosurveillance Integration
System (NBIS)--a consortium of Federal partners that was established to
rapidly identify and monitor biological events of National concern.
NBIS collaborates among Federal and State partners to collect, analyze,
and share human, animal, plant, food, and environmental biosurveillance
information. The National Biosurveillance Integration Center (NBIC)
integrates this information from Federal agencies and State, local,
private sector, and international sources to provide early warnings of
a possible biological attack or pandemic. By identifying those bio-
events that have reached reporting thresholds and publishing reports
using the Biosurveillance Common Operating Picture (BCOP)--which is
currently being piloted in four States--the NBIC and NBIS enhance
recognition of biological events of National concern, reduce response
time, and promote effective response.
While the NBIC and NBIS have been successful in helping us to
achieve our biosurveillance mission, there is still much more work to
do in order to achieve a true National capability. OHA is currently
working with our partners and stakeholders to continue to enhance and
improve the NBIC while successfully meeting the statutory requirements
and Congressional intent. We will continue to work with our
stakeholders to increase collaboration and data integration, improve
analysis, and ensure high-quality and timely reporting. The fiscal year
2012 budget request supports our ability to maintain current efforts,
and enhance the system in this manner.
chemical defense
OHA leads the Department's coordinated efforts to protect against
high-consequence chemical events. OHA integrates chemical defense
expertise into National planning and partners with State and local
jurisdictions to build capabilities and develop resilience for high-
consequence chemical events.
OHA's Chemical Defense Program (CDP) provides health and medical
expertise related to chemical preparedness, detection, response, and
resilience--all critical to a comprehensive approach to protect against
a chemical attack. Technologies and operations already employed at the
Federal, State, and local level are being leveraged to create a
comprehensive chemical defense framework. The chemical defense
framework will create synergies and efficiencies among the many on-
going, but currently separate, chemical defense efforts. This framework
will integrate DHS's current capabilities as well as strengthen
relationships both horizontally and vertically amongst all Federal,
State, local, and Tribal chemical defense stakeholders.
The Baltimore Demonstration Project is an example of a current CDP
project that is focused on enhancing chemical defense preparedness and
response by emphasizing partnerships with Federal, State, and local
stakeholders. The fiscal year 2012 budget request will allow OHA to
continue to provide health and medical expertise related to chemical
preparedness, response, and resilience in support of an integrated
chemical defense framework to protect against high-consequence events.
building resilience
OHA provides health and medical expertise to planning and exercise
efforts that advance National preparedness and response capabilities
for threats that have potential health consequences. The Anthrax
Response Exercise Series (ARES), which we completed in partnership with
FEMA last fall, is an example of this work. The workshops included
Federal, State, regional, and local public health and emergency
management professionals and were designed to help coordinate roles,
responsibilities, and critical response actions following a wide-area
anthrax attack. This year, as well as in fiscal year 2012, we plan to
continue to build on the success of ARES by conducting workshops in
additional high-threat cities.
OHA works directly with State and local leaders to develop
capabilities to respond to health threats. We have done this by
expanding local public health participation in, and coordination with,
the National network of fusion centers; and by developing guidance for
health and medical experts to better access Federal grant and training
programs to improve public health preparedness capability.
Additionally, OHA works to provide Department leaders with
appropriate subject matter expertise both in steady state and during
events which encompass public health, medicine, food defense,
agricultural security, veterinary defense, pandemic influenza
preparedness, and other threats. Our Food, Agriculture, and Veterinary
Defense (FAVD) Branch initiative leads the coordination of the
Department's programs to ensure the security of our Nation's food,
agriculture, human and animal health. FAVD experts support the
Department's efforts to enhance preparedness through capabilities
development and facilitate the integration of the emergency management
services community into Federal, State, local, territorial, and Tribal
food and agriculture sector disaster preparedness activities.
emergency medical services
OHA coordinates the Department's medical first responder
activities. This includes providing support to DHS personnel who
perform operational medicine, including emergency medical services
(EMS). DHS has thousands of medical personnel deployed throughout the
country who provide care for wide-ranging and often remotely deployed
personnel, from Border Patrol agents in the Southwest desert to
personnel engaged in counternarcotics and counter-smuggling operations.
OHA supports these personnel by developing health guidance and policy;
providing medical countermeasures; collaborating with the DHS
Management Directorate to provide occupational health protection for
use in dangerous work environments; and facilitating health screening
programs to help ensure that responders are able to support the
Department's missions while minimizing health threats.
workforce health protection
Finally, OHA works each day to build resilience within the
Department and protect the DHS workforce against health threats by
implementing activities that promote employee resilience. Initiatives
include the development of medical guidance for DHS personnel, the
provision of standards and guidelines to DHS medical care providers,
and the oversight of DHS quality improvement and medical training.
Additionally, we provide guidance, protocols, and support to DHS
components and offices for medical countermeasure storage and
dispensing.
The fiscal year 2012 budget request includes additional funding to
support the DHS Together employee and organizational resilience
initiative to ensure that DHS employees have the tools and resources
necessary to manage the stresses inherent in their occupations. DHS
Together was introduced to employees a little over a year ago. During
the initial training effort, approximately 190,000 employees received
training about resilience and participated in a dialogue about methods
to improve the workplace. Moving forward, OHA will utilize an
overarching resilience framework that will unify existing activities
and provide a platform for leadership to build a culture of support.
This initiative will have a direct impact on the resiliency and
wellness of the DHS workforce and provide the resources and information
necessary to effectively manage the stress associated with work. The
annual planning, production, and distribution of resilience training
and information on a Department-wide scale will maximize participation
and increase the program's ability to effectively improve the
resilience of the workforce.
conclusion
Thank you again for the opportunity to testify today regarding the
strategic objectives of the Office of Health Affairs and the fiscal
year 2012 budget request. I look forward to your questions.
Mr. Bilirakis. Thank you, Dr. Garza.
I recognize myself for 5 minutes for questions.
As the Chief Medical Officer for DHS and adviser to FEMA,
which is responsible for guiding State and local preparedness
and response, what would your message to the public be about
the appropriate use of potassium iodide in any nuclear event?
Dr. Garza. Yes, sir. FEMA has worked diligently on
addressing the nuclear issues surrounding homeland security,
and that involves whether it is an accidental release, a man-
made release, or an intentional release of nuclear material. We
focus on the whole-picture consequence management, of which
potassium iodide is part of that. But what we would truly like
to focus on, and I think Administrator Fugate has said this
well, is developing a whole-of-community response, of which
potassium iodide would be part of, but really developing the
community aspect of how we deal with disasters since we all
know that all disasters are local.
Mr. Bilirakis. FEMA has a formal role in regulating off-
site emergency plans and preparedness in support of nuclear
power plants to ensure appropriate protective measures can be
taken in the event of a radiological emergency to protect the
health and safety of the public. Is OHA working to advise
FEMA's guidance and review of State and local response plans
from a health perspective? If not, why? What entity is
providing the expertise to FEMA, if not OHA?
Dr. Garza. As I mentioned in my opening statement, we are
the principal health adviser for FEMA. So in that respect I do
have two physicians that work with FEMA on exactly these
issues, amongst a multitude of issues, as well as a public
health service officer who works with their day-to-day
operations.
So we are involved in every aspect of what FEMA does,
whether it is exercising, whether it is planning, whether it is
going out into the communities and exercising as well. So we
are very much involved with the aspects of what they do.
Beyond that, the rest of the office is also included in the
development of planning for responses such as this.
If I can shift a little bit and use for example our
biological planning programs, we really view it as a whole-of-
DHS approach where it is not just FEMA, but it also involves
our office and it involves our policy offices as well as our
operational components. But we really view it as a whole-of-DHS
approach to planning as well.
Mr. Bilirakis. Thank you. My next question, and I mentioned
this to Administrator Fugate last week, I am concerned that the
President's budget proposes to eliminate the Metropolitan
Medical Response System Grant Program as a stand-alone program,
and to instead roll it into the State Homeland Security Grant
Program. MMRS provides funding to enhance the ability to
respond to mass casualty incidents. While grants are not your
personal responsibility, I know that OHA has an interest in
ensuring that States and localities have the tools they need to
prioritize medical response capabilities. Do you feel that
consolidation is the right approach?
Second, if the grants were to be consolidated, how will
your office work with FEMA to ensure that the medical
preparedness remains a priority within the larger grant program
and that States and localities do not lose the capacity they
have gained to date under the program?
Dr. Garza. Yes, sir. So we do work with them on the grants
program, providing the advice on how grant money should be
spent for public health infrastructure, for improving public
health response to natural disasters. We do have natural allies
over there in Mr. Serino and Mr. Fugate because I truly do
believe they understand the public health aspects of disasters.
I can say that because Mr. Serino comes from the Public Health
Department in Boston.
Furthermore, the grant alignment has always been an issue
between HHS and DHS and how the money is divided up and spent
on public health measures. I can only speak from my experience
in working with both of those entities that there is a renewed
focus and I think a very active effort to make sure that those
programs, those grant programs between DHS and HHS are becoming
more aligned, and so we can identify where the gaps and seams
are in order to support public health and emergency responders
with grant dollars.
Mr. Bilirakis. Thank you very much.
I yield to the Ranking Member, Ms. Richardson, for 5
minutes.
Ms. Richardson. Thank you, Mr. Chairman.
My first question, Dr. Garza, is the Government
Accountability Office noted that the public health response
involved Federal shared responsibilities, and yet it is unclear
how these roles would really work in practice. It was
recommended that DHS and HHS conduct training and exercises to
ensure that the Federal leadership roles are clearly defined
and understood. Has that happened as of yet?
Dr. Garza. It has happened, and it has happened on a couple
of different platforms. As you may know, our office in
conjunction with FEMA did conduct a number of exercises around
the country, discussing biological release incidents. Those
were mostly geared towards the State and locals, but we did
have Federal partners there as well. The culmination of those
events were a Federal workshop, which was here in Washington,
DC, and it involved multiple different partners across the
Federal Government. So it wasn't just DHS and HHS; it also
involved our partners within DHS such as TSA, but also partners
outside such as EPA and other people that we know are going to
play a significant role in any large-scale response.
Ms. Richardson. Who would ultimately be the final decision-
maker?
Dr. Garza. The decision-maker for?
Ms. Richardson. If an incident occurred and all these
groups are together.
Dr. Garza. I think it really depends on what the event is.
So as we saw a couple of years ago with the H1N1 pandemic,
clearly that was a public health issue. The President was
correct in putting HHS at the lead for that.
So I think it very much depends on the situation at hand.
Clearly if there is a large event in the country that involves
multiple disciplines, it would have to be argued one way or the
other which department was going to be the lead agency.
Ms. Richardson. So have we argued that?
Dr. Garza. There are different Homeland Security
Presidential Directives that direct who is in charge of large
events. So HSP-5 states that the Secretary of Homeland Security
would be in charge of coordinating a large-scale Federal event.
Ms. Richardson. Is that clear to everyone?
Dr. Garza. As I discuss it with other people, I haven't
heard any arguments one way or the other.
Ms. Richardson. I am not trying to be difficult. I have
been in several circumstances where you have got multiple
people who have their various competing interests, and it is
important to ultimately have a final who is in charge here.
Because we have had that problem before.
Dr. Garza. Yes, ma'am.
Ms. Richardson. I did want to associate myself with the
remarks of the Chairman of my concerns of consolidating the
Metropolitan Medical Response System Grant Program, and I know
what your answer was, but I do want to express that I am
concerned about the consolidation of that program. When Mr.
Fugate was here, I suggested if we were going to go into the
sort of consolidated idea, that there would have to be some
sort of commitments in writing from the State and local
agencies that if they chose to then direct the majority of
their funds to another area than this area, that they would
have to be able to document that the concerns and the needs of
this particular section had in fact been met. He agreed to work
on some sort of language to that effect. So we look forward to
those issues.
In terms of the development of OHA, over the past few years
your existence, roles, and responsibilities have shifted and
expanded. As a result, the office has become reorganized and
kind of fits into several different priorities, as we have seen
them, being biosurveillance and workforce resilience.
What is your overall mission for OHA and how does OHA
assert your authority despite its statutory limits and its
position within the Department? Are DHS agencies compelled to
consult with you regarding health-related issues before
implementing policies related to the medical and public health
issues?
Dr. Garza. The missions within our office fit into what I
feel are one of four different sets. One is of course to
support the Secretary on public health issues. You have already
mentioned biosurveillance, but that would fit into a broader
picture of biodefense. But we really view that as an all-
hazards, so we include chemical and other issues as well.
You correctly pointed out workforce health protection as
one of our main tenets. Then the fourth would be working with
our first responders around the country as well as within DHS.
I do feel that the Department does look towards us to get
public health opinions and medical opinions on issues that are
on-going for DHS. So, for instance, with the incident unfolding
in Japan, we recently issued guidance for our workers who are
deploying there, specifically our USAR teams, as well as
guidance for some of our workers that will be working back here
in the continental United States for questions that may come up
about contamination and other issues.
Ms. Richardson. I yield back the balance of my time.
Mr. Bilirakis. Thank you. Now I recognize the gentleman
from Michigan, Mr. Clarke, for 5 minutes.
Mr. Clarke. Thank you, Mr. Chairman.
Mr. Garza, thank you for being here. I am going to ask a
couple of questions, but let me give you the context. I
represent a metro Detroit area, the Detroit border sector. It
is a pretty large area. Only 4 miles of it, though, is under
operational control. Our State is surrounded by the Great
Lakes, one of the largest bodies of fresh water in the world.
Our Detroit border, much of it, is right in the middle of the
water. We also have a large water and sewage treatment plant.
Now, for all of these reasons, I am concerned that our
border sectors are vulnerable to an attack on a mass scale with
chemicals or biological or radiological or nuclear weapons. No.
1, we don't have enough trained health professionals to be able
to respond to such an attack, to help people recover from it,
and to prevent mass casualties and to prevent people from being
sick as a result of the attack.
To give you an example, in Detroit, our hospitals have to
hire nurses from Canada and they have got to come from Canada
to Detroit every day to work because we don't have enough
trained nurses in the city of Detroit.
How do you think that we could best have the staffing
capacity to respond to such an attack in the event that it
could happen? That is one question.
My other question has to deal with the Homeland Security
Presidential Directive No. 18. There I had questions on how we
can make sure that we have the adequate inventory of medical
countermeasures needed to respond to such a widespread attack.
I might as well just give you all of my sub-questions
related to that. For example, how do we stockpile the
antibiotics that we would need for anthrax? The last point
related to that Presidential Directive, this relates to jobs,
very important to metro Detroit and very important to our
country. Do you have any thoughts on how the Department can
work more effectively with the biotech and pharmaceutical
sectors to help develop those new countermeasures that are
referred to in Tier II of that Presidential Directive?
I know that is a lot. But, No. 1, we need the people to be
able to help respond to an attack in case it happens. In order
to prevent one, and to prepare us for it, we need to have the
medical countermeasures available; and then how do we build a
capacity to produce the new ones that we need to be effective
in the future?
Dr. Garza. Thank you. Let me try to tackle the staffing
question first. Of course I am not going to be able to come up
with nurses and doctors overnight, but recognizing that the
health care system in the United States is very stressed, as it
is right now across the country, but I think this gets back to
your original point, which is preparedness, and preparedness
doesn't merely just involve the health care sector, it involves
multiple different public services as well as private
industries in the community.
This brings me back to my whole-of-community point where if
there is a disaster, it really is going to take a whole-of-
community effort because, as you adequately stated, the health
care sector is already under tremendous strains. If you threw a
catastrophic event on top of that, it is going to need help.
The help is going to have to come from the community.
As far as the medical countermeasures go, that is under the
purview of the CDC through the Strategic National Stockpile on
making sure that there are doses adequate for the American
public. There are many different programs for storing
countermeasures. The Strategic National Stockpile is National,
but there are also State and local programs spread throughout
the country.
As far as procuring items that go into the stockpile, DHS
has the responsibility to develop the threat and risk
assessment for the country and give that to HHS, to BARDA, and
say these are the things that we are worried about and we would
like for you to develop countermeasures for these. BARDA then
takes that request and then develops the countermeasures,
interacting with just the people you are talking about, the
pharmaceutical and the biotechnology industry.
Above and beyond that, our Science and Technology Director
does work with a lot of universities in developing technologies
and other things for biological and chemical defense as well.
Mr. Clarke. Thank you.
Mr. Bilirakis. It looks like we have time for one more
round, Doctor. So I am going to begin and recognize myself for
another 5 minutes, and then we will go around.
My question has to do with EMS credentialing. It has come
to our attention that some of the DHS components that employ
medical personnel, such as the Border Patrol, occasionally run
into problems with State credentialing when they cross State
borders in the course of their daily duties.
How can the committee be helpful to ensure that the 3,000-
plus medical personnel within the Department have the
credentialing coverage they need?
I know this is so very important, so we are very
interested. I am going to talk with the Ranking Member about
this, too, on how we can be helpful, but we need some guidance
from you.
Dr. Garza. Yes, Mr. Chairman. That is an important
question. As you mentioned, we have around 3,500 EMTs and
paramedics who work in very difficult environments. The
majority of our population of EMTs and paramedics work in very
austere environments where health care is 4 hours away. A lot
of times these are on the Southwest border where we have to
move assets very quickly in order to accomplish the mission.
Recognizing that medical licensure is a State's authority,
we have had some issues of being able to move our assets
quickly. To that end, we have tried to develop a system for EMS
services throughout DHS, so not just focusing on Customs and
Border Protection, but also our medics at Secret Service, with
any of our other organizations, to develop a system where we
can do training, education, licensuring, and credentialing,
which you talked about, as well as addressing the issues of
cross-border.
We have also done an outreach to those States where this is
mostly affected, which are mostly border States, to bring them
to the table to say this is what we would like to do and are
you comfortable with this, tell us what your concerns are
because we would much rather have them feeling comfortable with
what we need to do as an organization in moving our assets
around. To date we have been very successful in discussing
these issues with them, and a lot of them are very supportive.
Now whether the solution comes from an agreement between
the States or whether it comes from legislation at the Federal
level to allow DHS medics to operate, much like Federal gun
carriers do, from State to State, I think is open to
discussion.
Mr. Bilirakis. All right. What are the three most important
components of the chemical, biological, radiological, and
nuclear defense endeavor that OHA provides? How is this
reflected in your budget request?
Dr. Garza. Of course as you mentioned, our BioWatch program
is a large part of our budget. It is a Nation-wide program, and
I know a lot of people get fixated on the machinery of the
BioWatch, but what I do want to impress upon the committee is
that BioWatch is much more than a machine. It is a community of
people that operate within the program. The real beauty I
believe of BioWatch is bringing those different people
together, and I think it exemplifies what DHS is, which is a
community of people that are there for security. So of course
BioWatch is a big part of what we do. We are committed to
pushing the technology because we know that decreasing the
amount of time for detection gives us more time to decide and
to treat.
In addition to that is our chemical defense program which
we recently empowered to take a much more appropriate role,
which is looking at more end-to-end strategies instead of just
focusing on detection. Chemical is much different than bio,
which is different than rad, and they each deserve their own
attention.
Last, I would focus on the biosurveillance picture. As you
mentioned before, the National Biosurveillance Integration
Center has had some challenges, and we understand that and we
appreciate that. But what we have done is we have gone back and
we have gone back to our customers that we integrate with
within the system, and it is a system. It is not merely just a
DHS-centric place. It really does have to involve the system.
Recognizing that a system can only be built on trust, we have
taken a step back and gone to our partners and said, what can
we do to improve the trust between our organizations and what
can we do to improve the analysis of data, to improve the flow
of information, and what sort of value can DHS bring to you? So
bringing it down from very DHS-centric and focusing more on the
system is very important to us.
Mr. Bilirakis. Thank you. My last question has to do with
BioWatch, and I mentioned this in my opening statement, and I
think you referred to it as well, Ms. Richardson.
Your budget calls for an additional $25 million to support
testing the next generation of BioWatch sensors, known as
Generation-3. Considerable resources have gone into BioWatch,
as you know, the development since President Bush announced the
rapid stand-up of this capability in his 2003 State of the
Union Address. Now more than 30 cities have these sensors
deployed, and we wait for the faster and more efficient
Generation-3 machines that will significantly reduce the time
it takes to detect a bioterror attack. Of course, that is so
very important. It will theoretically save lives, as I said, to
have this rapid and automated capability.
Will the Office of Health Affairs use the fiscal year 2012
funds to work with State and local stakeholders to develop
response protocols and comprehensive concepts of operation
plans? These are critical elements, of course, of a successful
BioWatch program that have been criticized for being absent
from the architecture. That is my first question.
Then why has it taken so long to get this new automated
detection equipment developed and on-line? Does your
acquisition strategy allow for spiral or incremental
development; that is, getting technology out there, gain
experience with it, and make upgrades and improvements?
I know it is a long question.
Dr. Garza. Thank you. Let me tackle the second question
first.
The acquisition strategy, I think, is very solid. There
have been slips in getting it through the testing and
evaluation, but I think the big picture to focus on here is
what a tremendous leap in technology that we are talking about.
This is first-in-world technology. No other industry, no
other country, not DOD, is not doing what we are attempting to
do with biological detection. We are basically taking something
that is very technically concentrated and really scrunching it
down into a box. We are talking about amplifying DNA of
bacteria and looking for it, and this is not an easy project.
With that being said, the testing and evaluation has done
exactly what it is supposed to do, which is make sure that we
are spending tax dollars wisely, that we are not going to spend
money on a machine that doesn't work.
The other side of that, and as you mentioned in your
concept of operation side for the communities, is we have to
make sure that this new technology is going to be right all the
time. We cannot be wrong on either side of the coin. What that
means is we can never miss a detection. So we can never miss an
anthrax spore. We can never go off when there is no anthrax
spore there because the ramifications of that are huge. You
have seen how difficult it is to evacuate a city when 6 inches
of snow fall. You can imagine how complicated it would be if we
had a large-scale incident.
So we take that very seriously and we are being very
methodical in working through testing and evaluation. This is a
first-in-kind technology. So yes, there is going to be some
hiccups along the way, and we expect that. But overall, the
testing and evaluation is going very well.
The second part of your question on working with the
communities, absolutely you are right. I tried to emphasize
that previously by saying BioWatch is so much more than a
machine. It is a community of people that understand
biodefense. It is not just your public health people, but it is
also law enforcement, it is your emergency responders. It is
your EPA people, it is your public affairs people because,
quite frankly, messaging is going to be huge in a bioevent.
So we go out into these communities and we develop these
concept of operations, and we are developing them now before we
even consider deploying Gen-3 because we know what a huge issue
this is going to be, and we want to make sure that the
communities are comfortable with what we are doing, and, that
we can take care of whatever concerns or questions they have,
and make sure that this technology, as well as people that
surround it, are able to do their job.
Mr. Bilirakis. Thank you, sir. I appreciate those answers.
Now I recognize Ms. Richardson for 5 minutes or so, since I
took a little longer. You are recognized.
Ms. Richardson. You are the Chairman. You can take as much
time as you want.
Mr. Bilirakis. I am going to hold you to that.
Ms. Richardson. Absolutely.
Dr. Garza, the budget request for the National
Biosurveillance Integration Center at the Office of Health
Affairs was cut from $13 million down to $7 million. This
program has been what some would say almost a complete failure
to date. We estimate that it would take a substantial
investment to upgrade the subpar facilities at the Nebraska
Avenue complex where the NBIC currently resides and to make it
a viable program. Instead you are cutting the program nearly in
half.
Would you first of all please explain the reason for the
cut?
Dr. Garza. Of course we support the President's budget as
proposed. Let me get back though to what NBIC should really
focus on, and it really, I do not believe, should focus on
infrastructure and buildings. I think that was part of the
reason why it hasn't been successful so far, is that there was
a lot of focus on technology. Of course technology can only get
you so far. At the end of the day, what it really takes is
interpersonal and trusted relationships. I know this from
serving in the military. I know this from being a paramedic, I
know this from being a medical adviser, that you have to know
the person that is on the other end.
So when we took a step back, what is it going--and the
other reason is because data, although we would like to say we
have a lot of real-time data, when it comes to bio, the data is
very slow in coming because, if you remember, it has to come
from that local provider to the State to any of different
Federal agencies, and it has to be vetted all the way along. So
data is very slow in moving. We cannot afford to wait. So what
it really takes is a trusted environment where when people
recognize these anomalies that are going on amongst the data,
within a trusted environment, are able to talk to each other
and say I am seeing this, what does it mean to you, and
bringing that from multiple different points of view. They have
to be able to trust that DHS is not going to take their data
and display it somewhere without their okay, without them
vetting their own data.
Ms. Richardson. Dr. Garza, I am sorry. I only have--you
have taken now 2 minutes and 15 seconds. My question is pretty
specific. It originally had a budget of $13 million, you are
suggesting to cut it to $7 million. Why? You danced around the
idea it is buildings and now we are switching to talking to one
another. If you can more specifically answer the question, and
briefer because now I have used 2 minutes and 22 seconds.
Dr. Garza. I apologize. The majority of that was an
appropriation for a project that was working in the State of
North Carolina which has been stripped out of the budget.
Ms. Richardson. So what is happening in Nebraska?
Dr. Garza. The Nebraska Avenue complex?
Ms. Richardson. Yes.
Dr. Garza. Current operations are going on in the Nebraska
Avenue complex. It currently occupies real estate which is
somewhat valuable to DHS because it is in a secure environment.
So there are options going on on where we are going to move
that center. But the budget cut was specifically for the North
Carolina project.
Ms. Richardson. Why do you feel that is not necessary
anymore?
Dr. Garza. I do feel that it is necessary to be reaching
out with States and locals.
Ms. Richardson. So why are we stripping it out?
Dr. Garza. It was stripped out, I believe, through the CR.
It was in the original 2011 budget, if I remember correctly. I
can get back with you on that, ma'am, just to be sure we are
not confusing numbers.
Ms. Richardson. Okay. Then my last question, you started to
get into people talking to each other, which I guess gets to
the point of the inadequate participation that we know have
occurred between the agencies. Would it be just a better
solution to go ahead and zero out all of the funding and direct
it to more viable programs?
Dr. Garza. I do not believe that that would be a good
option.
Ms. Richardson. Why?
Dr. Garza. The reason for that is because it would solidify
the silos where datas live right now. It would not cure the
problem of integrated biosurveillance.
Ms. Richardson. So I would say to you, Dr. Garza, because
now they are just ringing for votes, clearly due to the cuts
that are being involved, whether it is CR or whether within the
administration, there seems to be a perception of the viability
and the effectiveness of the program. So if you could more in
writing provide to us why this really needs to exist and what
are you going to do to fix it, and what are we losing by
cutting down to this point.
Dr. Garza. Yes, ma'am.
Ms. Richardson. Thank you. I yield back.
Mr. Bilirakis. Thank you very much. Dr. Garza, thank you
for the valuable testimony, and Members for their questions.
The Members of the subcommittee may have some additional
questions for you, and we ask you to respond to in writing. The
hearing record will be held open for 10 days.
Without objection, the subcommittee stands adjourned.
[Whereupon, at 2:55 p.m., the subcommittee was adjourned.]
A P P E N D I X
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Questions From Chairman Gus M. Bilirakis of Florida
biowatch
Question 1a. The subcommittee is concerned to hear that OHA is down
to only one viable competitor for Generation-3 BioWatch technology,
after discontinuing testing of a second vendor's candidate technology.
The problem appears to be a difference in interpretation of test
results. This decision comes after the Science and Technology (S&T)
Directorate invested over $35 million developing this vendor's
technology.
Why was this vendor discontinued, and were formal, written
processes in place to determine that discontinuation was reasonable?
Answer. The Department discontinued funding for one of two vendors
competing in the BioWatch Generation-3 (Gen-3) Test, Evaluation, and
Acquisition Program due to its failure to meet the acceptance criteria
on a key performance parameter. Specifically, the Department's decision
to not provide further funding was due to the vendor system exhibiting
false positives when challenged with biological agents of concern based
on the clearly stated requirements for automated performance. OHA as
the Program Executive made the decision to not continue funding HSSSI
through Phase I. This decision was briefed to and concurred with by
Office of General Counsel (OGC), Office of Procurement Operations
(OPO), Science and Technology (S&T) Testing and Evaluation/Standards
and Acquisition Program Management Division (APMD) as well as the Under
Secretary for Management. Given that a response to a bioterrorism event
will result in significant disruption to society, any response must be
predicated on the extremely accurate detection of a biological agent of
concern.
Question 1b. Was the decision validated by S&T or an independent
assessment team?
Answer. The Independent Test Activity (Los Alamos National
Laboratory) conducted the test and provided the data. The data and
analysis were reviewed by the BioWatch Program as well as the
Operational Test Agent (the National Assessment Group, Office of
Secretary of Defense, Under Secretary for Acquisition, Technology &
Logistics). The summary of results was provided to members of the
BioWatch Coordinating Committee. The BioWatch Coordinating Committee
includes OHA, DHS Office of Procurement Operations, DHS Office of the
General Counsel, the S&T Directorate Chemical/Biological Division, the
S&T Test and Evaluation/Standards (T&E/Standards) Division, the DHS
Office of Policy, and the DHS Acquisition Program Management Division
within the Management Directorate.
Question 1c. Do you believe that, now with only one competitor
proceeding to operational testing, this is a capability we can
reasonably expect to procure?
Answer. According to industry responses to the Request for
Information that was recently issued to support the Phase II Gen-3
Acquisition, it appears that potentially two vendors may be capable of
submitting a compliant proposal. We believe the Phase II procurement to
be of low risk because of the technology maturity required to be
accepted.
Question 1d. How are you maximizing opportunities for competition
in the procurement process?
Answer. The Department stresses the importance of establishing and
maintaining competition through a number of different venues, including
requirements definition, data rights, market research, acquisition
planning, and a strong competition advocate program. DHS defines
requirements at a level that is not vendor-specific, but instead is
defined in terms of salient characteristics/generic specifications. The
Department also emphasizes the importance of negotiating sufficient
data rights for each procurement (with consideration of price a key
factor) to facilitate future competitions. Strong market research and
adequate acquisition planning are two additional keys to maximizing
competition. In this regard, DHS has issued a comprehensive market
research guide and an expanded Acquisition Planning Guide that have
both been widely embraced by DHS components.
The Gen-3 test, evaluation, and acquisition program is flexible and
promotes industry involvement by providing an initial operational
capability with the explicit intent of delivering additional improved
capability incrementally over time. With a sensor and component open
architecture arrangement, this will allow the Department to consider
technology insertion appropriately in a cost-effective manner.
This strategy affords the Department two major benefits--first, the
ability to deploy a proven Gen-3 capability now to meet current threats
and risk, while second, encouraging industry to continue improving
autonomous technology for later insertion into the Gen-3 system.
DHS also maintains a robust competition advocate program. The DHS
Competition Advocate, who is a Senior Executive, is responsible for
ensuring the Department maximizes competition. The DHS Competition
Advocate works with each component to establish annual competition
goals, encourages components to attain competition goals, and
identifies and resolves barriers to competition. As part of this
effort, the DHS Competition Advocate monitors competition data as
reported to the Federal Procurement Data System--Next Generation on a
monthly basis. Quarterly reports are prepared for Competition Advocate
review, and action, as appropriate. Mid-year reports are provided to
the Chief Procurement Officer and to the Heads of the Contracting
Activities regarding year-to-date competitive accomplishments versus
established goals. Corrective action plans are requested if mid-year
goals/achievements gaps are greater than 10 percentage points.
Question 1e. Can you provide a performance rating or other
documentation of MFSI/Hamilton Sundstrand's performance as a vendor?
Answer. The answer has been retained in committee files.
Question 2. When can we expect a cost-benefit analysis to
strategically justify the Generation 3 acquisition against an analysis
of a broad set of alternatives?
Answer. The BioWatch Program, the Department, and outside entities
have previously conducted analyses of options to provide appropriate
protection to the U.S. public against the highest-risk biological
pathogens as determined by the Biological Terrorism Risk Assessment. An
important conclusion of these analyses has been confirming the
importance of early detection.
Because of the inherent characteristics of certain biological
pathogens and their effects on humans, providing medical
countermeasures prior to the presence of symptomatic conditions is
critical to saving lives. Studies have shown this is most effectively
done through deployment of an early detection system. Other than the
current BioWatch system and potential BioWatch Generation-3 system,
there are no other technically mature approaches available for
alternative consideration and deployment in the foreseeable future.
This was the same conclusion expressed in the National Academy of
Sciences (NAS) Report, BioWatch and Public Health Surveillance:
Evaluating Systems for the Early Detection of Biological Threat. The
NAS analysis considered the current risk environment, options to
protect the public, current, and near-term technical capabilities and
solutions, and appropriate response protocols that would be used.
national biosurveillance and integration center
Question 3. Your revised plan for the National Biosurveillance and
Integration Center incorporates subject matter experts at the National
laboratories, and data fusion architecture from the Department of
Defense. What is it about this plan that you believe will enable the
Office of Health Affairs to get past the major challenge that other
agencies simply do not want to coordinate with DHS on this issue and
share information?
Answer. The Office of Health Affairs (OHA) is in the process of
developing an emergent strategy for the future of the National
Biosurveillance Integration System (NBIS) and the center that supports
it. This process has involved both the retrospective review of relevant
reports from the Government Accountability Office (GAO), the National
Biosurveillance Advisory Subcommittee (NBAS), the National Academy of
Sciences (NAS), and others, as well as the engagement of stakeholder
groups within and from outside of Government to help identify and craft
a sound way forward.
Our ultimate success depends on trust. In a renewed effort to be
more inclusive, we are taking steps to build upon existing
relationships while forging new ones with thought leaders. Rather than
a top-down approach, we are listening intently to the observations of
engaged stakeholders who share the view that we all need to work
together to ``get this right''.
OHA believes it important and appropriate to leverage and reinforce
the successful investments of others in Government as part of any
system design. To that end, OHA has been exploring the incorporation of
tools and expertise from a wide range of Government activities,
including those at the Department of Defense (DOD) and the National
laboratories. The emergent strategy will be based on feedback we have
received and will incorporate elements of outside entities where that
makes sense. These initiatives are aligned with and designed to
complement the on-going activities of the National Security Staff (NSS)
and the Office of Science and Technology Policy (OSTP) with respect to
the overall state of National biosurveillance.
risk communication
Question 4a. Homeland Security Presidential Directive--10
(Biodefense for the 21st Century), issued in 2004, called for the
Department of Homeland Security, in coordination with other appropriate
Federal departments and agencies, to develop comprehensive coordinated
risk communication strategies to facilitate emergency preparedness for
biological weapons attacks. This includes travel and citizen
advisories, international coordination and communication, and response
and recovery communications in the event of a large-scale biological
attack.
Has a coordinated risk communication strategy for biological
attacks been issued to date?
Question 4b. If not, when can we expect to see it?
Answer. A draft coordinated risk communication strategy for
biological attacks has been developed by the DHS Office of Public
Affairs. A ``For Official Use Only'' copy of the draft is attached to
the main workflow.
executive order on medical countermeasure distribution after a
biological attack
Question 5. Please provide the Department's status in implementing
the Presidential Order on ``Establishing Federal Capability for the
Timely Provision of Medical Countermeasures Following a Biological
Attack.'' Traditional points of dispensing (``PODs''), while a critical
piece of our Nation's medical response, may not be sufficient by
themselves to meet the time-sensitive need for medical countermeasures
immediately after exposure to certain biological agents.
Specifically, considering the short 48-hour window to dispense
medical countermeasures after an anthrax attack, what is OHA doing to
ensure DHS employees, first responders, and the general public are all
protected?
Answer. DHS Office of Health Affairs has been working closely with
DHS Component and Offices (Federal Emergency Management Agency (FEMA),
Policy, Operations Coordination, and others), as well as with Federal
interagency partners, including Health and Human Services (HHS),
Department of Defense (DoD), Veterans Affairs (VA), U.S. Postal Service
(USPS), and Department of Justice (DOJ) to respond to and implement all
actions called for in Executive Order (EO) 13527.
Section 2 of the EO directed the establishment of a National U.S.
Postal Service Medical Countermeasures (MCM) dispensing model for U.S.
cities to respond to a large-scale biological attack, as well as a plan
for supplementing local law enforcement personnel with local Federal
law enforcement and other appropriate personnel, to escort U.S. Postal
workers delivering MCM. That National Postal Model (NPM) and plan were
developed and submitted to the National Security Staff (NSS) on June
30, 2010. Since the approval of the NPM by the NSS, HHS and USPS Joint
Program Enterprise have continued to develop this capability by
conducting pilot programs and exercises in Minneapolis/St. Paul, MN and
Louisville, KY.
Section 3 of the EO directed the establishment of a rapid Federal
response capability to augment an affected community's resources to
dispense medical countermeasures following a biological attack. On
March 30, 2010, the Secretary of Health and Human Services (HHS) and
the Secretary of Homeland Security (DHS) submitted a concept document
(Operational Concepts and Requirements for a Federal Medical
Countermeasures Rapid Response) to the NSS for review. This resulted in
the development of a comprehensive operational plan integrating Federal
Government activities, the Federal Interagency Operational Plan--Rapid
Medical Countermeasure Dispensing (FIOP-MCM). The FIOP-MCM was
submitted to the NSS on September 30, 2010.
The FIOP-MCM documents a concept of operation to provide rapid
Federal, interagency support for medical countermeasure distribution
operations within affected communities. This is accomplished through a
variety of point of dispensing (POD) strategies that utilize mostly
local Federal employees including the Department of Defense and
National Guard. The FIOP provides a Federal plan that enhances response
efforts and can be easily and effectively integrated into State and
local planning.
USNORTHCOM presented a Commander's Estimate of DoD capabilities to
the NSS on June 13, 2011. These capabilities are currently being
integrated into the existing FIOP-MCM along with updated information
from our interagency partners to include the Department of Veteran
Affairs (VA). Validation of this integrated Federal capability to
support community dispensing operations will culminate in a tabletop
exercise for Senior Officials that will take place before Sept. 9,
2011. Subsequently, the updated version of the FIOP-MCM will be
submitted to the NSS before September 11, 2011.
Section 4 of the EO addresses the need to ensure that Executive
branch mission essential functions can continue following a large-scale
biological attack. A plan was developed and submitted to the NSS on
June 30, 2010. An implementation plan and considerations for a concept
of operations were submitted to the NSS on September 30, 2010. In
follow-up to feedback received from the NSS in January 2011, DHS and
HHS have co-chaired a Federal interagency working group to develop
Department and agency plans that meet the specific intent of the EO.
Seven pilot agencies, as chosen by the NSS, have agreed upon four
tenets that will serve as the minimal level of engagement across the
interagency. Planning will initially focus on pilot participants
including HHS, DHS, Department of Justice (DOJ), USPS, Environmental
Protection Agency (EPA), VA, and DoD.
DHS Workforce Health Efforts
OHA has developed a DHS Medical Countermeasures (MCM) Program at
the direction of Secretary Napolitano to provide emergency antibiotics
to all DHS employees in the event of a biological attack. Currently,
OHA has purchased and stockpiled over 6 million tablets of antibiotics
for DHS employees and individuals in the custody or care of DHS and has
identified 2 dozen medical storage locations for local MCM stockpiles,
or ``caches.'' OHA has pre-positioned MCM in these medical storage
caches around the Nation and is currently exploring options for
expanding pre-positioned stockpiles to additional storage locations
throughout the country that will, when achieved, significantly increase
the efficiencies of MCM distribution to DHS employees.
personnel budget
Question 6. Your fiscal year 2012 budget requests $1.5 million for
DHSTogether, described as an initiative to ensure that Department
employees have the tools and resources they need to manage the stress
inherent to their occupations. Can you please explain what this is, and
what this money will achieve?
Answer. DHS' ability to protect the Nation depends upon a healthy
and operationally ready workforce who must work effectively under
stressful and demanding conditions. In October 2009, the Office of
Health Affairs (OHA) was tasked to create a cross-cutting Department of
Homeland Security (DHS) employee and organizational resilience and
wellness program. OHA proceeded with a unified ``One DHS'' approach to
improve consistency and standardization of employee and organizational
support across the Department through creation of the DHSTogether
program. In 2010, DHSTogether launched the first-ever DHS-wide employee
resilience training to be completed by the DHS workforce. Since the
beginning, this program has proven to be very well received and has
achieved success across its offerings of trainings, symposia, and
studies. Moving forward, OHA will utilize an overarching resilience
framework that will unify existing activities, provide a platform for
leadership, and build a culture of support. The program will have a
direct impact on the resiliency and wellness of the DHS workforce and
provide the resources and information necessary to effectively manage
the stress associated with protecting the Nation. The annual planning,
production, and distribution of resilience training and information on
a Department-wide scale will maximize participation and increase the
program's ability to effectively improve the resilience of the
workforce.
The budget for fiscal year 2012 requests $1.5 million to continue
DHSTogether initiatives through the following:
DHS Resilience and Wellness Study
$500,000
DHSTogether will fund a contractor-managed evaluation of current
programs within the Department and across the Federal Government to
identify best practices, determine gaps, and identify resources. The
study will focus on the development of a One-DHS approach to creating
resilience that takes into account the diversity of DHS and its
distinct missions and operations. The outcome of this study will be a
thorough long-term strategic plan aiming to ensure success as well as a
significant and meaningful increase in employee resilience, wellness,
and operational readiness.
DHSTogether Communications Plan
$200,000
Funding for this initiative will support development of a strategic
communications plan to inform DHS leadership and employees on
resilience issues and initiatives, including interactive education and
training materials. Initial communications messages will focus on the
resources and tools available to assist employees in handling the
stresses and other challenges that come with protecting the Nation.
DHS-Wide Resilience and Wellness Training
$250,000
Funding for this initiative will support training, which will
include the development, production, and delivery of employee and
supervisor training topics to support DHS readiness and employee
resiliency, including suicide prevention and risk reduction, resilient
leadership, and decision-making under stress. Training will incorporate
resilience and suicide prevention concepts into existing mandatory
supervisor and Leadership Training Curricula, and will address critical
incident stress management (CISM) needs throughout the Department.
DHS-Wide Tool for Individual Health Risk Factor Assessment
$400,000
DHSTogether will fund a contractor-managed individual health risk
assessment and management tool for DHS employees to individually
determine the impacts of their lifestyle on their personal health and
well-being. This health risk factor assessment will allow DHS to better
understand the education, support, and training needs of our workforce,
and how to target needs to the appropriate subgroups. By identifying
the individual health risks of DHS employees, the Department aims to
make recommendations to improve the health of its workforce, which also
ensures that our operational readiness will be at the highest capacity
possible. This initiative also incorporates a uniform data collection
policy for tracking and measuring resiliency data.
Consistency of DHS Programs and Policies
$150,000
DHSTogether will fund a comprehensive study to identify and measure
the impact of existing Departmental policies, procedures, and programs
that support employee and organizational resilience. The study will
catalogue best practices and baseline capabilities through leadership
interviews and a well-being index, and recommend actions to improve
overall employee resiliency.
integrated consortium of laboratory networks (icln)
Question 7. When does OHA anticipate taking over management of the
ICLN from the S&T Directorate?
Answer. Per the Technology Transition Agreement (TTA) between the
Science and Technology Directorate (S&T) and OHA, transition of the
ICLN to OHA is conditional upon: (1) OHA obtaining funds to support
ICLN operations; (2) OHA designating Federal staff to assume full-time
duties of the ICLN Network Coordinating Group (NCG) chairmanship and
management of the program; and (3) S&T completing functionality of the
ICLN Integrated Response Architecture (IRA). OHA has identified the
funds and Federal billet to support transition of the ICLN in fiscal
year 2012, and S&T is continuing efforts to promote confidence in lab
networks' analytical capabilities to support other networks in surge
roles. S&T is practicing the IRA and developing a more facile data
exchange capability across the Networks, to assure IRA functionality
prior to transition. Formal transition is currently scheduled for the
third quarter of fiscal year 2012.
first responder guidance
Question 8. In 2009, DHS published draft guidance for protecting
emergency responders before and after an anthrax attack. What is the
status for issuance of the final guidance document?
Answer. OMB and NSS staff has been working with DHS/OHA to ensure
the document is responsive to the concerns raised by Federal
departments and agencies that will be our partners in implementing this
guidance. OHA is now finalizing the guidance for approval and
publication. Upon approval, the guidance will posted by DHS on the
responder community of interest website. Finally, OHA will inform all
first responder stakeholders that the guidance has been issued. It is
important to note that in the interim, the draft guidance that was
initially published for public comment in 2009 should guide first
responders; no major changes to that guidance are being contemplated.
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