[House Hearing, 107 Congress]
[From the U.S. Government Publishing Office]
HOW EFFECTIVELY ARE FEDERAL STATE AND LOCAL GOVERNMENTS WORKING
TOGETHER TO PREPARE FOR A BIOLOGICAL, CHEMICAL OR NUCLEAR ATTACK?
=======================================================================
HEARING
before the
SUBCOMMITTEE ON GOVERNMENT EFFICIENCY,
FINANCIAL MANAGEMENT AND
INTERGOVERNMENTAL RELATIONS
of the
COMMITTEE ON
GOVERNMENT REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED SEVENTH CONGRESS
SECOND SESSION
__________
APRIL 2, 2002
__________
Serial No. 107-167
__________
Printed for the use of the Committee on Government Reform
Available via the World Wide Web: http://www.gpo.gov/congress/house
http://www.house.gov/reform
______
85-125 U.S. GOVERNMENT PRINTING OFFICE
WASHINGTON : 2003
____________________________________________________________________________
For Sale by the Superintendent of Documents, U.S. Government Printing Office
Internet: bookstore.gpr.gov Phone: toll free (866) 512-1800; (202) 512�091800
Fax: (202) 512�092250 Mail: Stop SSOP, Washington, DC 20402�090001
COMMITTEE ON GOVERNMENT REFORM
DAN BURTON, Indiana, Chairman
BENJAMIN A. GILMAN, New York HENRY A. WAXMAN, California
CONSTANCE A. MORELLA, Maryland TOM LANTOS, California
CHRISTOPHER SHAYS, Connecticut MAJOR R. OWENS, New York
ILEANA ROS-LEHTINEN, Florida EDOLPHUS TOWNS, New York
JOHN M. McHUGH, New York PAUL E. KANJORSKI, Pennsylvania
STEPHEN HORN, California PATSY T. MINK, Hawaii
JOHN L. MICA, Florida CAROLYN B. MALONEY, New York
THOMAS M. DAVIS, Virginia ELEANOR HOLMES NORTON, Washington,
MARK E. SOUDER, Indiana DC
STEVEN C. LaTOURETTE, Ohio ELIJAH E. CUMMINGS, Maryland
BOB BARR, Georgia DENNIS J. KUCINICH, Ohio
DAN MILLER, Florida ROD R. BLAGOJEVICH, Illinois
DOUG OSE, California DANNY K. DAVIS, Illinois
RON LEWIS, Kentucky JOHN F. TIERNEY, Massachusetts
JO ANN DAVIS, Virginia JIM TURNER, Texas
TODD RUSSELL PLATTS, Pennsylvania THOMAS H. ALLEN, Maine
DAVE WELDON, Florida JANICE D. SCHAKOWSKY, Illinois
CHRIS CANNON, Utah WM. LACY CLAY, Missouri
ADAM H. PUTNAM, Florida DIANE E. WATSON, California
C.L. ``BUTCH'' OTTER, Idaho STEPHEN F. LYNCH, Massachusetts
EDWARD L. SCHROCK, Virginia ------
JOHN J. DUNCAN, Jr., Tennessee BERNARD SANDERS, Vermont
------ ------ (Independent)
Kevin Binger, Staff Director
Daniel R. Moll, Deputy Staff Director
James C. Wilson, Chief Counsel
Robert A. Briggs, Chief Clerk
Phil Schiliro, Minority Staff Director
Subcommittee on Government Efficiency, Financial Management and
Intergovernmental Relations
STEPHEN HORN, California, Chairman
RON LEWIS, Kentucky JANICE D. SCHAKOWSKY, Illinois
DAN MILLER, Florida MAJOR R. OWENS, New York
DOUG OSE, California PAUL E. KANJORSKI, Pennsylvania
ADAM H. PUTNAM, Florida CAROLYN B. MALONEY, New York
Ex Officio
DAN BURTON, Indiana HENRY A. WAXMAN, California
J. Russell George, Staff Director and Chief Counsel
Justin Paulhamus, Clerk
C O N T E N T S
----------
Page
Hearing held on April 2, 2002.................................... 1
Statement of:
Burton, Dr. Richard, associate director, California
Department of Health Services; Ray Riordan, emergency
preparedness officer, East Bay Municipal Utility District;
Janet Cherry, associate, the Cadmus Group, Inc.; Patricia
Dalton, Director, Strategic Issues, U.S. General Accounting
Office; Larry A. Mefford, Associate Special Agent in
Charge, San Francisco Field Office; Dr. Steven Bice,
Director, National Pharmaceutical Stockpile, Center for
Disease Control and Prevention; and Ron Castleman, regional
director, Region VI, Federal Emergency Management Agency... 67
Canton, Lucien G., director, mayor's Office of Emergency
Services, city of San Francisco; George Vinson, Special
Advisor to the Governor on State Security, State of
California; John F. Brown, M.D., M.P.A., F.A.C.E.P.,
attending physician, San Francisco General Hospital,
assistant professor, University of California, San
Francisco; Dr. Frances Edwards-Winslow, director of
emergency services, city of San Jose; Mario H. Trevino,
chief of department, San Francisco Fire Department;
Prentice Sanders, Assistant Chief, San Francisco Police
Department; Ronald W. Cochran, laboratory executive
director, Lawrence Livermore National Laboratory........... 12
Letters, statements, etc., submitted for the record by:
Bice, Dr. Steven, Director, National Pharmaceutical
Stockpile, Center for Disease Control and Prevention,
prepared statement of...................................... 104
Brown, John F., M.D., M.P.A., F.A.C.E.P., attending
physician, San Francisco General Hospital, assistant
professor, University of California, San Francisco,
prepared statement of...................................... 41
Burton, Dr. Richard, associate director, California
Department of Health Services, prepared statement of....... 69
Canton, Lucien G., director, mayor's Office of Emergency
Services, city of San Francisco, prepared statement of..... 15
Castleman, Ron, regional director, Region VI, Federal
Emergency Management Agency, prepared statement of......... 114
Cherry, Janet, associate, the Cadmus Group, Inc., prepared
statement of............................................... 86
Dalton, Patricia, Director, Strategic Issues, U.S. General
Accounting Office, prepared statement of................... 123
Edwards-Winslow, Dr. Frances, director of emergency services,
city of San Jose, prepared statement of.................... 48
Honda, Hon. Michael M., a Representative in Congress from the
State of California, prepared statement of................. 6
Horn, Hon. Stephen, a Representative in Congress from the
State of California, prepared statement of................. 3
Mefford, Larry A., Associate Special Agent in Charge, San
Francisco Field Office, prepared statement of.............. 92
Riordan, Ray, emergency preparedness officer, East Bay
Municipal Utility District, prepared statement of.......... 77
Sanders, Prentice, Assistant Chief, San Francisco Police
Department, prepared statement of.......................... 28
Trevino, Mario H., chief of department, San Francisco Fire
Department, prepared statement of.......................... 22
HOW EFFECTIVELY ARE FEDERAL STATE AND LOCAL GOVERNMENTS WORKING
TOGETHER TO PREPARE FOR A BIOLOGICAL, CHEMICAL OR NUCLEAR ATTACK?
----------
TUESDAY, APRIL 2, 2002
House of Representatives,
Subcommittee on Government Efficiency, Financial
Management and Intergovernmental Relations,
Committee on Government Reform,
San Francisco, CA.
The subcommittee met, pursuant to notice, at 10 a.m., in
the Phillip Burton Federal Building and U.S. Courthouse,
Ceremonial Courtroom, San Francisco, CA, Hon. Stephen Horn
(chairman of the subcommittee), presiding.
Present: Representatives Horn and Honda.
Staff present: J. Russell George, staff director and chief
counsel; Bonnie Heald, deputy staff director; and Justin
Paulhamus, clerk.
Mr. Horn. A quorum being present, this hearing of the
Subcommittee on Government Efficiency, Financial Management and
IntergovernmentaL Relations will come to order.
On September 11, 2001, the world witnessed the most
devastating attacks ever committed on U.S. soil. Despite the
damage and enormous loss of life, the attacks failed to cripple
this Nation. To the contrary, Americans have never been more
united in their fundamental belief in freedom and their
willingness to protect that freedom.
The diabolical nature of those attacks and then the deadly
release of anthrax sent a loud and clear message to all
Americans: We must be prepared for the unexpected. We must have
the mechanisms in place to protect this Nation and its people
from further attempts to cause massive destruction.
The aftermath of September 11th clearly demonstrated the
need for adequate communications systems and rapid deployment
of well-trained emergency personnel. Yet despite billions of
dollars in spending on Federal Emergency Programs, there remain
serious doubts as to whether the Nation is equipped to handle a
massive chemical, biological or nuclear attack.
Today, the subcommittee will examine how effectively
Federal, State and local agencies are working together to
prepare for emergencies. We want those who live in the great
State of California and the good people of San Francisco and
San Jose and Long Beach, CA, to know that they can rely on
these systems; should the need arise.
We are fortunate to have witnesses today whose valuable
experience and insight will help the subcommittee better
understand the needs of those on the frontlines. We want to
hear about their capabilities and their challenges and
concerns. We want to know what the Federal Government can do to
help with what they may not be doing.
We welcome all of our witnesses and look forward to their
testimony.
[The prepared statement of Hon. Stephen Horn follows:]
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Mr. Horn. We are delighted to have with us today
Representative Michael Honda from the San Jose area, former
mayor. He will be the ranking Democrat.
We will do as we do in Washington, that the witnesses and
especially those at the State and local level and the first
responders, will have a summary of their written statement. I
have read them all and they are excellent. Don't read them to
us because we just don't have the time.
The General Accounting Office goes with us everywhere
because they are our arm for research and what we want to do is
get the essence of it because your statement is automatically
in the record when I call on you. Give us the best points. If
we had GAO, we would have a 40-page presentation or so and they
have done 50 studies on the subject. Hopefully there will be
more that will help many of you.
With that, I will swear you in following Mr. Honda's
opening statement. I now call on him for up to 5 minutes on an
opening statement.
Mr. Honda. Thank you, Mr. Chairman. I would like to begin
by thanking my colleague Congressman Steve Horn for calling
this field hearing, and especially for his tireless work
throughout the past decade in Congress.
I would especially like to recognize the expertise and
dedication in the area of information security, an issue that
is closely related and closely impacts my Silicon Valley
District as well as the entire Nation. Congressman Horn is
retiring from Congress this year, and, on behalf of the entire
California Delegation, I would like to thank him for his
service, his dedication, and vision.
I would like to compliment the Chair for bringing such a
diverse group of Federal, State, and local officials together,
and especially for allowing these State and local
representatives to speak early in this program.
Local civil servants, firemen, law enforcement, personnel,
healthcare workers, and many others are on the frontlines in
the event of a terrorist attack. We in Washington must do our
best to ensure that they are adequately equipped and trained to
handle any such crisis. That is why it is essential that
Congress maintain an open dialog with our first-responders and
be responsive to their concerns.
States and counties are struggling financially to meet
their homeland security needs. In the first 2\1/2\ months since
September 11th, California local governments have encountered
budget overruns of 13 percent in public safety. Cities and
counties in California alone estimate over $1 billion in
additional one-time and ongoing funding needs for 2002.
On numerous occasions, local officials have expressed to me
the difficulty in adequately preparing their communities and in
equipping their first-responders. Many have been forced to
double and sometimes triple their expenditures for everything
from 911 operators to police overtime.
Emergency response forces that were once considered more
than adequate are now finding themselves under funded and
overworked often forcing local agencies to delay maintenance
and training, or defer the purchase of new equipment.
Cities and local municipalities are facing a squeeze on
many levels. As they spend more on police overtime and
security, they face lower revenue due to an economic slowdown.
States are facing similar challenges. This means that
localities are not receiving as much funding as they have in
the past in the State budget. As local agencies try to improve
their capabilities by increasing training for first-responders,
building better Emergency Response Systems, and making other
needed improvements, they are forced to tap into an ever-
decreasing budget.
The tragic and sudden events of September 11th, and the
almost constant state of alert that all levels of government
have been forced to maintain thereafter, have caused a
reexamination of homeland security throughout the Nation. It is
vitally important that the Federal Government understand this
and act to meet unfulfilled and growing local needs.
I hear people throw around the term ``homeland security''
as if it were term, a mainstay of America's vocabulary. But in
truth, ``homeland security'' is a fairly new term, and its use
denotes a comprehensive and coordinated approach to domestic
defense.
Just as the term is new, so is an effort of this magnitude,
urgency, and expense.
Last, I would like to share that those of us in Congress
understand, at least the Chair and I understand our role and we
are here to hear from the locals as to the kinds of needs that
you are faced with on a daily basis.
If we are going to develop and implement a comprehensive
approach to homeland security that can deal with catastrophic
events like biological, chemical or nuclear attacks, we must be
sure to work closely with our colleagues at the State and local
level to create an integrated response that maximizes all
resources in our portfolio by minimizing delays and lack of
coordination.
I look forward to your testimony this morning. Thank you.
[The prepared statement of Hon. Michael M. Honda follows:]
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Mr. Horn. I thank you, gentlemen. Now, as you know, since
it is an investigative committee of the House we swear in all
witnesses. That includes your staff also. If they are going to
whisper to you in the question period, we may as well get
everybody involved.
[Witnesses sworn.]
Mr. Horn. The clerk will note that the six witnesses
accepted the oath. We are delighted to have you here and we
thank you. You have submitted wonderful statements and we are
going to use those for a basic report to the House of
Representatives.
Then, as I said earlier, we would appreciate it if you
would, in the 5 or 6 or 7 minutes, hit the high-points of what
you have put in for the record. Let us start now with Mr.
Canton, the Director of the Mayor's Office of Emergency
Services in the city of San Francisco.
We are delighted to have you here, Mr. Canton.
STATEMENTS OF LUCIEN G. CANTON, DIRECTOR, MAYOR'S OFFICE OF
EMERGENCY SERVICES, CITY OF SAN FRANCISCO; GEORGE VINSON,
SPECIAL ADVISOR TO THE GOVERNOR ON STATE SECURITY, STATE OF
CALIFORNIA; JOHN F. BROWN, M.D., M.P.A., F.A.C.E.P., ATTENDING
PHYSICIAN, SAN FRANCISCO GENERAL HOSPITAL, ASSISTANT PROFESSOR,
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO; DR. FRANCES WINSLOW,
DIRECTOR OF EMERGENCY SERVICES, CITY OF SAN JOSE; MARIO H.
TREVINO, CHIEF OF DEPARTMENT, SAN FRANCISCO FIRE DEPARTMENT;
PRENTICE SANDERS, ASSISTANT CHIEF, SAN FRANCISCO POLICE
DEPARTMENT; RONALD W. COCHRAN, LABORATORY EXECUTIVE DIRECTOR,
LAWRENCE LIVERMORE NATIONAL LABORATORY
Mr. Canton. Good morning. My office represents a strategic
capability for the Mayor of San Francisco. Our job is to
coordinate interagency planning and to stimulate departments
talking to each other and dealing with incidents that require
the services of more than one department.
I think one of the points I would like to make this morning
is that terrorism is not new to San Francisco. We have
experienced this over the years in the 1960's and 1970's. We
saw shootings. We saw bombings. It is not something that we
don't think about.
However, even with that background, even with our history,
without the use of Federal funding that we received from the
Nunn-Lugar-Domenici funding in 1996, it is more than likely
that we would not have been able to develop the capacity that
we have today.
From that point of view, Federal funding was absolutely
essential to getting us interested and getting us started and
providing us with the political will to do things.
The other thing is that this particular program had a lot
of benefits for us as a city. Even though the funding is small
and had some things we had to commit to doing, it allowed us to
increase our capability to respond. It also allowed us to work
together better as a team so there were a lot of good that went
beyond just what the funding provided for.
That, however, should not be taken as an indicator that we
are prepared for a terrorist attack. I think you will hear from
my colleagues that, we better than anybody, understand how much
more we still have to do.
One of the concerns that we had about the funding that was
provided was that it really was for first response. A first
response without a followup capability, the ability to deal
with the victims of a particular incident really doesn't do
much. We realized that the type of incident that we were
looking at would involve all hospitals and ambulance services,
not only in San Francisco, but throughout the Bay Area.
Our concern really was that the funding was a good start,
but it was not really enough for everything we needed. One of
the problems we had was that funding was based on a needs
assessment done at a national level. They never really came
down to us, they never asked, ``What do you need at the local
level?'' A lot of things we consider very important to the
area, our mutual aid programs, our ability to respond and work
together, our ability to assist other jurisdictions, were not
considered.
The issue of hospitals and the problems we have within the
San Francisco Bay Area were not addressed in any of the
funding. Essentially, we took the money that was provided and
took the capabilities we had existing, and tried to do as much
as we could with what we had. Again, I don't think we should
look at the funding received under Nunn-Lugar as meeting all
the needs for the city of San Francisco. I think it's a good
start. I think we've come a long way but there is still a lot
more to be done.
Part of the problem that we've experienced with the funding
is, again, that it is scattered through a number of different
Federal agencies. The application processes that are involved,
the reporting requirements that are involved vary from agency
to agency. In many cases we don't know when grant funds are
available until the last possible minute and it is difficult
for us to apply for them.
In many cases the type of requirements that are put on us
to get those grant funds are really completely onerous compared
to the amount of funding that we are going to be provided. In
many cases we have to look and say, ``Is the little bit of
money we are getting appropriate for the level of work we are
going to have to commit to this?''
One of the other things that we found is a number of
programs that have been preexisting have been diminishing in
funds over the years. I mention in my statement about the
Emergency Management Preparedness Improvement Grant. That money
has seen a substantial decline in the city of San Francisco
over the last few years.
The other thing that we've noticed is that a lot of the
requirements for the funds that we are provided with are
restrictive. For example, one of our teams wanted an extra
laptop computer. That was not allowed under a particular
funding program and we had to submit other items. We get grant
funds but we are not really able to make decisions about how we
use those funds.
We feel we need funding that allows us the flexibility to
respond to what we feel are our needs. Part of the problem that
we have here is the city like all the other jurisdictions in
the United States right now, is undergoing a budget crunch. We
are looking at a significant shortfall that is going to affect
our ability to respond and it is going to make it very
difficult for us to do contingency planning.
Consequently, Federal funds are important but we need to
decide what areas those can be used in. For us in many cases it
is easier for us to get things through our budget, to justify
single expenditures or capital expenditures, than it is for us
to add additional positions for planning and for doing the sort
of administrative work that some of these programs require.
It's very important that as we look at how we can stimulate
things, we look at the flexibility at the local level to be
able to say, ``I want to use this much money for this purpose
and this much money for that purpose,'' and give us that
flexibility.
What do we envision we would need? A block grant that's
from a single source, somebody that we can deal with. We are
more than happy to be held accountable for funds that are
provided to us. We've been doing that for years. That's part of
our job. What we would like to see are those requirements
reduced to the point where they are manageable and we can give
you some concrete evidence of what we've done.
On the other side of the coin, there are other things that
you will hear my colleagues speak about such as intelligence
sharing. One of the problems that we have is it is very
difficult for us to know exactly what's going on and what is
happening in the intelligence community. That is even to the
point where some of our senior law enforcement officials are
not cleared to receive the type of information they need.
There's very little intelligence that actually reaches us
through the emergency management community. The State of
California has tried to fill the gap for us but it is very
difficult because there is no preexisting condition.
The last thing I would like to mention is that we really do
need some national priorities. What is it you expect us to be
able to do at the local level? What is it we should be focusing
on? What is important to us? Also to remember as we do this, as
we set these priorities that we are committed at the local
level to multi-hazard planning. We cannot forget that we have
things like earthquakes and tsunamis that we have to deal with
on a day-to-day basis. Any capability we develop must be able
to be used for multi-hazard planning. Thank you.
[The prepared statement of Mr. Canton follows:]
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Mr. Horn. Well, thank you. That's well said and well done.
Since you mentioned the intergovernmental problems here on
information, I am going to put in the record at this point
after your testimony the letter that Mr. Shays, who is
Subcommittee on National Security, Veterans Affairs and
International Relations. I joined him in that, or he joined
with me.
That is the letter to Mr. Sensenbrenner, the chairman of
the Committee on Judiciary, and we will have that come up when
we get back from the District where he gets H.R. 3483, the
Intergovernmental Law Enforcement Information Sharing Act of
2001. I talked to Mr. Sensenbrenner before I left and came out
here and he said that should have been done months ago and we
are going to do it. The FBI is being very helpful on this.
Let us go on now to the people that are really on the
firing line. That's Mario H. Trevino, the Chief of the
Department of Fire for the city of San Francisco.
Mr. Trevino. Good morning. Thank you, Mr. Chairman. I would
like to begin by thanking you for the invitation to testify
before you. But mostly to thank you for continuing to take the
potential threat of terrorism as seriously as you obviously do.
The events of September 11th, as you stated previously,
have very dramatically illustrated the responsibility that we
in the fire service will bear in the event of a domestic
terrorist attack.
Our fire department here in San Francisco has since
participated in a number of preparedness efforts and drills in
conjunction with other local State and Federal agencies which I
would be happy to describe for you more fully once we get the
microphones straightened out.
Most significantly what we've done is we have redirected
our planning and training efforts to focus on terrorism type
incidents. For example, in the event of a bomb-type situation
we need to focus on training our people to be aware of the
potential for secondary devices and to maintain the security of
our personnel since we know that we will be unable to help
anyone if we ourselves become injured. We are doing everything
we can to harden the city and county of San Francisco against
such potential threats.
At the Federal level there is expertise, I think, located
in various different components around the country. It seems
that the most important message we would like to extend to you
is what is necessary for us is a single point of contact for
emergency agencies to deal with through the Federal Government
so that we can not only provide input, but also receive
information. As my companion, Lou Canton, has indicated, it is
essential that we get up-to-the-minute intelligence information
as it is allowed to be received by agencies such as ours.
A second point that, I think, is very important is in the
issue of grant funding. We are encouraged by the level of
funding that is making its way through Congress at this time,
the $900 million in fire grants and the potential for $3.5
billion for homeland security.
The point that I would like to make is it is essential that
those funds, if past through the States, as I understand they
will be, that process is done so without any redirection of
those funds so that as much of the money as possible comes to
the aid of the emergency agencies that will be responding.
We know, and I know after 29 years of experience in the
fire service, that in the event of such a disaster the first
responders that you see represented here today will be alone
and work the disaster until other assistance arrives and that
could be anywhere from hours to days.
I would also like to make a point of the fact that I am a
member of the Terrorism Committee of the International
Association of Fire Chiefs.
We work very diligently to try and preplan not only for our
individual fire departments, but for fire departments across
the country and bring those messages back to them to help them
identify funding, help them identify strategies, and to direct
whatever efforts they can to make them as solvent and as
effective as possible. I am prepared to answer any questions
you may have.
[The prepared statement of Mr. Trevino follows:]
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Mr. Horn. Thank you. We will now move to the Assistant
Chief of the San Francisco Police Department, Prentice Sanders.
We are glad to have you here, Mr. Sanders.
Mr. Sanders. I am very honored to be here, sir, and
certainly want to thank you and your committee for having the
interest in our first-responders and the people who are going
to be on the frontlines in dealing with a new phenomenon in our
American system of government.
We have, as law enforcement, had to switch to an entirely
new job. We are beyond not only keeping our traditional job of
fighting crime in our streets. We are now set with a job of
preparing for and deterring acts of violence similar to those
of war.
We are also looking at new systems of how we are to respond
to massive damage. In 1996 the Nunn-Lugar bill responded to
Washington. I responded to Washington with a team, and the team
that you are looking at here at the table, to attempt to cope
with something that is totally out of the American--we didn't
have any experience at it.
However, San Francisco, based on some prior natural
disasters, we had a little bit of a head start. San Francisco
received some Federal grants and we started to see where best
to use those Federal grants, even though they were not adequate
to cover all the things that we needed.
What have we done to this point? In 1998 San Francisco
purchased some protective equipment. Being police officers we
will almost always be the first-responders when there is
trouble, and certainly as depicted in our heros and brothers
and sisters in New York and Washington, DC, we are the ones who
have to run toward whatever is going on that is a catastrophe.
We started to look at how we can protect those individuals and
receive the type of equipment and protective clothing they
would need.
We also formed a Metropolitan Medical Task Force and a team
where all safety personnel, medical personnel, and those
persons who will be responsible for handling the very first
stages after an event. We put together that team and started to
setup systems to deliver services and stabilize situations
wherever they may happen. And certainly keeping in mind weapons
of mass destruction both chemical, biological, radiological and
other highly explosive systems.
What do we need? Certainly, I was very happy when I learned
that you brought your committee here. We need funds. The
greatest ideas in the world can't be consummated without having
adequate funding. We are looking at the funding that we have
and looking at the system of delivering that funding.
We would like to work with our State and Federal people to
see that we can get that funding in an adequate fashion so that
we can have in place an adequate system of responding to the
kinds of catastrophes that our world now tells us that exist.
That is an overview of what we have done. Let's talk about
what we've planned. Law enforcement is in an entirely new
learning mode. The San Francisco Police Department developed
the five-phase program to begin to answer mass casualty
incidents. We also have been holding tabletop exercises and
drills with the other members of our team so that we learn to
work as a team. Like any other good team, each party knows
their part in the play and carries that part out.
We focused a great deal on schools because if there would
be a catastrophe there, whatever catastrophe may happen in our
city, we want to be sure that our young people are able to,
first of all, be safe and able to coordinate a system that can
reunite them with their families at the earliest possible time.
The responsive procedures we are setting-up, and we're
certainly learning from one another, our extension of our
police procedures and handling of violent mass casualty
incidents. We have coordinated among all of the other
jurisdictions, public safety jurisdictions within our
jurisdictions and neighboring jurisdictions.
What's up now? Deterrents and response. Deterrents have now
become, as I pointed out--there are people among us who would
bring this upon us. We have setup deterrents and then created a
response form methodology for responding to it.
I will be happy to answer any questions, and certainly
inside of the document that I gave you is a detailed look at
the plans for San Francisco. Again, we appreciate you coming
and showing interest in our city.
[The prepared statement of Mr. Sanders follows:]
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Mr. Horn. We thank you now only for your oral statement but
your written statement as well. That was very helpful.
We now go to Dr. John Brown, the Attending Physician for
the San Francisco General Hospital and Assistant Professor at
the University of California, San Francisco. For those that
didn't know they had a campus in San Francisco, they have one
of the world's greatest medical schools in dental, I guess, and
nursing is still there. I remember seeing it when Earl Warren
was still Governor and that was one of his great contributions.
Thank you for coming.
Mr. Brown. Thank you, Representative Horn and
Representative Honda. I appreciate the opportunity to talk with
you. I am Dr. John Brown, the medical director of the San
Francisco Emergency Medical Services System. I also work as an
attending physician at the Emergency Department at San
Francisco General Hospital.
I would just like to highlight a few areas of the testimony
I've submitted to you. First, I want to say that we have come a
long way in the 4-years of our participation in the
Metropolitan Medical Response System Process. We have
established the multidisciplinary Metropolitan Medical Task
Force to upgrade our abilities to respond in the field to any
terrorist attack or event.
We have a very detailed concept of operations and response
plan for biological threats. We have trained a large number of
personnel, most is medical and public safety, including the
hospital personnel. And we have conducted some major drills in
that area and distributed a level of decontamination equipment
and personal protective equipment to all the hospitals in our
system.
We, do need however, to sustain this effort and we have a
dire need for continuing funding of the MMRS program. We need
sustained funding for the areas of our pharmaceutical cache of
equipment and supplies in case of--to be able to respond
immediately in case of a terrorist attack.
We need to enhance our ability to take care of large
numbers of casualties in the field quickly. We need to enhance
our training of public safety and healthcare providers. We need
improved decontamination equipment for our personnel and a
cache of equipment and supplies at the treatment facilities
themselves.
Finally, we need to expand our drills and exercises to
include drills within our region and increasing and improved
drills without State and Federal partners.
I would like to concentrate most of my testimony on the
current status of our healthcare system. The healthcare system,
especially the emergency-care system, is very stressed and has
little excess capacity to deal with the large number of
casualties that an attack of weapons of mass destruction might
generate.
I think without our funding levels being preserved, we will
be sliding backward to the level of preparation where we were 2
or 3 years ago which was not as good. We will obviously do the
best we can with what we have in any circumstance, but years of
cost-cutting at the Federal and State levels in healthcare and
healthcare-training programs have left us with little in
reserve for large-scale emergencies.
Currently, I am recommending that we develop a surge
capacity in San Francisco to be expanded in order to handle a
weapons of mass destruction incident. We do rely on our
regional partners, the other hospitals, and healthcare systems
in our region to assist us in time of disaster.
However, the American Hospital Association did a report in
1999 that found a decrease of 8.1 percent in the number of
emergency departments nationwide since 1994. In that same
period there's been a decrease in total in-patient hospital
beds of 15.6 percent. Our capacity is diminishing throughout
the country.
During the attacks on the World Trade Center and Pentagon
of September 11, 2001, San Francisco had a peak hospital bed
availability of 198 in-patient beds. This meant that with
optimal notification and time for mobilization, which is
approximately 3 to 4 hours, a total of 198 hospital beds were
available in all 10 of our hospital facilities to treat any
victims from an attack if we had had an attack in San Francisco
on that day. While these are in-patient beds only, not
emergency department treatment spaces, we have a lot more of
those. Emergency departments face similar constraints.
Ambulance diversion rates, which are a marker for how busy
emergency departments are, have been going up slowly over the
past several years. We average in San Francisco 6 percent
ambulance diversion during the summer months and 12 percent
during the winter. Any terrorist attack that were to take place
during this high diversion period would mean very little
capacity available to treat additional victims.
We do rely on only one level-one trauma center which is San
Francisco General Hospital which adds vulnerability to our
system. We have no permanent medical helicopter landing
facilities in San Francisco that we could utilize to transfer
patients rapidly.
With appropriate funding, disaster hospital capabilities
can be incorporated into the current system by several
mechanisms; increasing the current stock of hospital beds,
increasing the size of current emergency departments, opening
new emergency departments, having a disaster hospital
capability constructed and the ability to utilize that rapidly,
being able to convert sub-acute facilities such as skilled
nursing facilities, skilled nursing beds into acute beds, and
then developing a Federal disaster hospital response such as
the hospital ships or fleet hospitals that are in the military
system.
I thank you for your time and attention. I would be happy
to answer questions.
[The prepared statement of Dr. Brown follows:]
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Mr. Horn. Thank you very much. We will get into a lot more
of this because you've made a whole series of good points in
your written paper and we will be working that one over for
questions.
We now go to Dr. Frances Edwards-Winslow, the Director of
Emergency Services for the city of San Jose.
Dr. Edwards-Winslow. Good morning, Representative Horn and
Representative Honda. It's an honor to be here with you this
morning to share some information about my city, San Jose, the
capitol of Silicon Valley and the largest city in the Bay Area.
We have a long history of involvement in civil defense in
San Jose going back to the 1950's and the cold war period. We
have continued to develop our capabilities and emergency
preparedness from that time forward looking at dual use as an
important focus for us.
San Jose is aware of many natural disasters. This is
earthquake month and, in fact, at this moment California is
holding a duck-and-cover drill throughout the State, sponsored
by the Office of Emergency Services, to remind all of us that
disasters can come with no notice.
Because of this basis, we were able to rapidly join the
Nunn-Lugar-Domenici program to create some new capacities in
the city of San Jose building on our existing capacities. We
had existing Neighborhood Watch programs, Community Emergency
Response Team, and Safe School Initiatives all in place in 1997
when we, like San Francisco and 26 other American cities, were
invited to join the Nunn-Lugar-Domenici program and begin
receiving Federal assistance to enhance our capabilities for
emergency response, especially for explosions, chemical
attacks, and biological attacks related to terrorism and other
hostile actions.
The Nunn-Lugar-Domenici program provided direct funding to
the 27 selected cities. This money came to us through
contractual arrangements and other agreements with our Federal
partners. We performed specific work and in exchange they gave
us financial and other kinds of support so that we could, as my
colleagues have already described, establish the Metropolitan
Medical Task Force to respond at the field level, a
Metropolitan Medical Response System to care for patients,
including physicians offices and hospitals, as Dr. Brown has
described.
We received training, equipment, and supplies. However, at
this point we have no promise of sustainment of these efforts
we have bought at such a great expense. The city of San Jose
spent $1 million in police overtime alone in the first year of
our participation in this program. In order to be a very active
partner with our Federal colleagues, we need to ensure that the
Federal Government continues to be our partner with us in this
extremely important multi-use effort.
Our biggest expense at this time is the cost of training
our personnel. Police and fire personnel generally cannot
receive adequate training in an on-duty mode. They need to be
in an off-duty environment which usually means overtime is paid
either to the student sitting in the classroom or someone in
the field back-filling for that student.
In addition, we have developed pharmaceutical stockpiles
which have been described by my colleagues to some degree. My
testimony includes a larger list. This material generally has a
shelf-life of about 5 years. We have estimated that we will
need $300,000 every 5 years to sustain our existing level of
pharmaceuticals which is not actually adequate for the size of
our community.
It is barely adequate for the immediate emergency response
needs. We recognize and appreciate the development of the
National Pharmaceutical Stockpile by our colleagues at the
Department of Health and Human Services. But for 12 hours, at
least, we will be on our own.
The Push Package will then arrive with the help of the
National Guard. We hope to get that distributed efficiently but
then the larger longer-term care requires the deployment of the
National Pharmaceutical Stockpile which has to come from a
vendor managed inventory at various places in the United
States. Local preparedness is what will save lives. Patients
must be rescued and treated in the first few hours in order to
make a significant difference in the outcome for them.
Furthermore, to make this kind of patient care possible,
requires two levels of surveillance and epidemiology.
Explosions, radiological events, and chemical events are self-
announcing. We know immediately that the event has happened and
roughly how many victims we have to deal with. Biological
events will be stealth events, unknown until victims begin to
be ill because many of the illnesses present as flu-like
symptoms initially.
Dr. Brown and his colleagues will be challenged to
differentiate between flu season events, for example, and an
outbreak of something that was induced by a hostile partner.
We, therefore, need to greatly enhance our surveillance and
epidemiology capacity not only in the event of terrorism, but
also to improve the public health of our country and citizens.
We need to find ways to support emergency preparedness of
our hospitals. Dr. Brown has touched on that but I want to
emphasize that our hospitals today are not prepared. They are
not prepared for an earthquake. They are not prepared for a bad
hazardous materials accident. They are definitely not prepared
for a terrorist attack.
We have no surge capacity left in our system. Here in
California as a former member of the Seismic Safety Commission,
I want to remind you that in 2010 we will close still more
hospital facilities because of their seismic weaknesses. We
need some Federal assistance in finding the right answer for
balancing current needs, potential disaster response needs, and
catastrophic events that we all surely hope will not happen.
Medicare and insurance currently give no money to hospitals
to provide ``Environment of Care'' activity to ensure that
disasters can be appropriately responded to and this needs to
change.
Finally, I want to emphasize the very, very difficult
position that our elected officials are in at the local level
in California. Because of Proposition 13 they are already
dealing with very straightened budget available to them. The
demands from the community for many types of services continue
to exist. Neighborhood services, traffic calming, and
environmental issues go on and develop as our communities
enlarge.
We are the capital of the Silicon Valley. Our colleagues in
San Francisco are also very involved in high-technology. We all
hope to continue to work with our colleagues at the Federal
level so that we can provide community services and support for
this vibrant part of our national economy. Thank you.
[The prepared statement of Dr. Edwards-Winslow follows:]
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Mr. Horn. Thank you. You have given us a lot of things to
think about and we will work that into questions.
Our last presenter on panel one is Ronald W. Cochran, the
Laboratory Executive Director of the Lawrence Livermore
National Laboratory, our friends across the Bay.
Mr. Cochran. Thank you, Mr. Chairman and Congressman Honda.
It's a privilege for me to be here with you today to talk about
some of the things that Lawrence Livermore is doing to help
State and local governments.
I will discuss that but I also want to shift a little bit
in the direction of deterrence and early detection. If we can
deter these weapons of mass destruction events or get rapid
detection if there is the start of an event, say a biological
attack, then we can minimize the response problems that people
are going to have.
I think that my colleagues here have identified a great
capability to respond to disastrous events, and that's very
important. However, if we can prevent them from happening, that
may give us an even greater leverage in being prepared for the
future.
Most of you know, I think, about Lawrence Livermore as a
nuclear laboratory but in recent years we have also expanded
into the areas of biological and chemical weapons and threats.
The terrorists have now demonstrated that they hope to use what
I call our infrastructures against us--our aircraft, our
computer systems, entry into our borders, ports and so forth.
By investing in technology I think that we can continue to
enjoy the freedoms that we have by being better able to deter
or prevent and detect these threats.
Starting with the nuclear area, our Nuclear Threat
Assessment Program is readily available to all States. That is
the program which evaluates threat letters, for example, to
determine whether they represent a viable threat or not. We
have been doing that now for about 20 years.
We also have membership in all of the emergency search team
activities for nuclear events. We have in particular for the
local areas a radiological assessment program where we provide
technical and operational expertise to agencies in the event of
a radiological incident or emergency. We do things like respond
to the situation if someone has a threat of a truck, for
example, that has been triggering radioactive alarms. We can go
in and tell them whether or not that's a valid problem.
We even have a rapid deployment capability called
``HOTSPOT'' where we can be deployed to any location by
military aircraft to provide local radiological field support.
We have developed a lot of sensors for detecting and tracking
nuclear materials. We actually were working with the county of
Los Angeles to do a potential test for being able to track the
movement of radioactive materials in case there were a
terrorist threat.
Turning to the bio-terrorism area, we have actually
developed some very interesting biological detection
instrumentation. It's based on looking at the DNA signatures of
the materials, the pathogens, that would be a threat. We are
developing the DNA signatures of all the threat pathogens that
one might be interested in and working with the Center for
Disease Control and prevention to validate those. Then we will
distribute them to the public health agencies.
Additionally, we made a technology breakthrough in that we
now have handheld instruments that can detect within a very few
minutes whether you have a biological threat or not.
In the past, in fact in the somewhat distant past, the only
way to detect this was to watch people and see if they were
getting sick or not. Then more recently there have been ways to
detect it within a day or two. These current units actually are
units that the first responders can take into the field and
know within a few minutes whether they are faced with a real
biological threat or not.
We are developing a system called BASIS which is Biological
Aerosol Sentry and Information System which was actually used
at the Salt Lake City Olympics for checking in the air to get
rapid detection of any biological release that might be
threatening to the people there.
Now, at the Salt Lake City Olympics we hadn't automatized
it yet. We've still got some work to do, but the device
actually works so you can get rapid detection of any
contaminants in the air of that type.
I will talk some more about some of the technology for
prevention, but we also provide support to State and local
agencies in the area of atmospheric releases. We have a
capability called the Atmospheric Release Advisory Capability
which we operate at Livermore. It is available to track the
movement of toxins anywhere in the world at any time. State
agencies can call on this capability if they have concerns
about a release. We've actually tracked toxins in rivers as
well as toxins in the air. This is something that is provided
as a service.
Additionally, we have a forensic science center which can
do analysis of chemicals and biological agents to tell whether
or not there is a real anthrax threat, for example. We can do
that very, very quickly.
Turning back to some of the things that we still need in
the prevention area, there's a pressing need for technologies
to improve the screening of passengers, baggage, and cargo at
airports and ports. We are looking at a wide variety of
technologies including computer tomography, x-ray scanning,
gamma-ray imaging, neutron interrogation, and ultrasonic and
thermal imaging to be able to do this.
As you know, at present there are techniques for checking
baggage and checking people and, to a limited extent, checking
cargos at shipping ports, but they still have great
limitations. We need to improve those and we are working to do
that.
We are establishing at Livermore a national test bed so
that companies, for example, who are developing capabilities
for checking cargo containers would have a place to checkout
the performance, the advantages and the limitations of their
equipment. We will be operating that based on direction from
the Department of Energy to provide that capability for the
Nation.
We have developed some other technologies which I think are
useful to first responders. For example, we developed a micro-
power radar device which can see through up to about 30 feet of
rubble. We actually tested that at the World Trade Center. If
there is someone still alive under the rubble, it can detect
movement from breathing. It may make it possible to find people
that you can't locate otherwise very easily.
We also have remote monitoring instruments that analyze the
hazardous gases coming off a location like the World Trade
Center. We have these mounted on aircraft and we have used
those to let first responders know what they were getting into.
For the State of California, we have done a great deal of
vulnerability and risk assessment looking at bridges, dams, and
other structures. Based on some of our analyses, steps have
been taken to protect the bridges that weren't taken before.
We have helped the California Highway Patrol find ways to
stop large tanker trucks filled with fuel which are mobile
missiles. This has been a recent development. We are very
pleased with some of the steps that have been taken there.
In summary, effective defense against terrorism is going to
require the integration of science and technology with the
operations, because the stuff we develop is no good unless the
people who need to use it can use it. You must be certain that
you can take it into the field, it will work, it won't fall
apart, it will be durable, and give you accurate answers. That
is what we are working on.
The events of September 11th have lent a new urgency to our
efforts. We are working even harder to try to get these
instruments, which have been in development for some years into
the field and into commercial hands. As more money becomes
available with the Nation's response to the attacks, we will be
able to move faster. Thank you very much.
Mr. Horn. Thank you. We will now start the question period.
I will take the first 5 minutes. Mr. Honda will take the next 5
minutes. We will do that until we are worn out or thereabouts.
On this issue of x-rays in particular, Customs has major
needs for these containers. I happen to have both the biggest
ports in the United States, Long Beach and Los Angeles.
Together they equal Singapore which is the world's largest.
But in those containers we never know. It's about 2 percent
now. It was 1 percent and now it's 2 percent. In other words,
100 containers come off and they look at one or two. Is there a
body in there? With that Chinese gang in Shanghai where they
have charged $30,000 to get one of these young people into the
United States, obviously they don't have $30,000 but the labor
crowd in this country in the garment industry, in restaurants,
so forth.
What they do is they have an indentured servant and they
make up the $28,000 and the person works it off. Where our
Labor Department has been for the last 10 years I will never
know but they ought to be going in there. I happen to have been
an assistant to the Secretary of Labor under Eisenhower and
when we saw those conditions, we moved right in. We saw it in
migrant workers.
My boss came out and personally got rid of the lousy
conditions they had in the Central Valley. What we need is to
let the Customs official know there is somebody who has a body
there so nobody makes a terrible mistake. When you are talking
about 1.6 million containers in the Alameda corridor between
those two ports, Long Beach and Los Angeles, and every 4 months
it's 1.6 million, that's a lot of containers moving all over
America. Do you have any thoughts on that, where we are
getting, and how we can have Customs use it? What else could
Customs use?
Mr. Cochran. Yes, sir. As you point out, that's a very,
very difficult problem. People are working on that. At present
the best thing that they have is basically an x-ray machine
which they can use and can see under many circumstances. In
other words, if the container is not fully loaded, for example,
and if you have a good person who can interpret the signal they
are getting back on the TV screen, they can catch things like
people or other illicit materials coming in.
Those are in the early stages of being on the commercial
market but you can buy those. They are somewhat expensive at
present. I think that cost will come down. They do require a
very highly skilled operator to monitor what they see going
through and to be able to interpret it.
The direction that we are trying to go is to leap beyond
that, to go to something which will not only give you a good
interrogation when the container is not fully loaded, but get
to one that will actually check the hardest thing we can check.
For example, a container that is fully loaded and perhaps has a
nuclear weapon in the middle of it could be reliably detected.
Those are harder. You probably can only do those with high-
energy neutrons. That is one of the things we are looking at to
see if we can accomplish it. We plan to have a test unit within
the next few months to actually see if we can reliably do a
chemical analysis of what's in the container without damaging
either people or other things that might be in the container.
At present the x-rays are about the best we have.
Mr. Horn. Well, thank you on that. I want to move to
another question. I particularly want to know how law
enforcement is doing it in San Francisco. When we started this
series of hearings in Nashville, Tennessee, it was very clear
that with the great military forts that are in Tennessee and
with their helicopters and hospitals with the very fine medical
school, Vanderbilt, what faulted was that the frequencies
didn't work. They can't communicate with each other. How much
of that--I've heard from many chiefs of both fire and law
enforcement that apparently a lot of the frequencies are still
sitting around with the Federal Communication Commission.
I remember 10 years ago, or 15 at the university where I
was president, we had exercises in Los Angeles County. Guess
what? We couldn't get it because all of the frequencies were in
the east. Some of that finally got to the west.
Commissioner Kelly of Customs unfortunately didn't stay
there long enough because he knew the situation and now he's
back in the police department of New York. We need to do
something. I just wondered what the chiefs are doing.
Mr. Sanders. At this time communications is a tremendous
problem throughout law enforcement, because historically we are
very jurisdictionalized in the United States. The city next to
us, for example, there are times when we can't contact them.
This is an urgent issue, not only here in San Francisco but on
the boards and panels that I participate in statewide.
Communications is an intelligence at the top of the list.
Certainly there is technology and I join Mr. Cochran in
integrating technology with human resources. We have much of
that technology available but in order to take advantage of it,
again, it comes back to funding. Finding a way to find the
necessary moneys to integrate technology so that we can talk to
one another.
In our tabletop exercises over the past several years we
have found this to be a recurring problem and there has been
some plans put forward that work. Again, when you go to do
upgrade work on old communication systems and to integrate them
into what we need in modern times, we do need the additional
funding and we hope that we can certainly tie in a partnership
with the Federal Government.
Mr. Horn. Any other thoughts on that?
Mr. Trevino. Yes, sir, Mr. Chairman. Let me add that as you
may know, police and fire here in San Francisco operate using
what is called the 800 megahertz radio frequency, very commonly
used across the country. We also know that in the event of a
disaster such as an earthquake the 800 megahertz system can get
overloaded and will go down. That has been demonstrated in
several cases.
There is also the potential for different agencies whether
they be law enforcement, emergency medical services, fire, or
others to use different radio frequencies and, thus, as you
said, limit our potential ability to communicate.
Now, radio in reputability systems do exist primarily based
on military technology but once again, just to echo Chief
Sander's statement, they are expensive. The one that I am
thinking of, the TRP-1000, is $50,000 for one unit.
Once again, funding remains an issue and I think it's
important to note the fact that the City and County of San
Francisco spent a lot more money for preparing for terrorism
situations than we ever receive in from any other source. That
does, again, speak to our hope for Federal funding.
Mr. Horn. Mr. Canton, you want to comment on that?
Mr. Canton. If I could just add to that. It's more than
just a problem of procuring radios locally or different sets.
There is the issue of no national standards on how we would use
these radios, no set frequencies that we would use that were
all on a common band.
I think probably the best example of how something can work
is the system that the European government is using now called
TETRA. If we look to that as sort of a model, that's where we
would like to be able to get to, where, while we work
individually on our own radio frequencies day to day, in the
time of an emergency there are common frequencies that we can
share with any law enforcement agency from any State, from the
Federal Government, from any outside agency.
We really don't have that right now. Even if we were to all
procure the same radios, we operate on different bands,
different frequencies, different talk groups, and there are no
national standards and no idea of when we are going to get the
types of frequencies we need.
Mr. Horn. Chief Sanders.
Mr. Sanders. Yes, Congressman Horn. To show you the
seriousness of this problem, next month, in May, San Francisco
is holding a regional and State level communications exercise
in order to evaluate very precisely where we are and then take
a look where we can go and maybe connect and make some
connections that we can solve this problem until we find a
universal solution to the problem.
Mr. Horn. Mr. Cochran, you want to comment on that?
Mr. Cochran. I have very little to add to what they have
said already. I think that the problem is one that has been
around for quite a while. There are improvements that can be
made in going to a standard frequency.
Perhaps that is something we can help in a little bit. I
think there are commercial companies who could actually do
that. Perhaps Congress should encourage them to focus in on
this because this is something that is needed throughout the
country. It's not just a problem here. Thank you.
Mr. Horn. I now yield 10 minutes to my colleague. Oh, Dr.
Brown.
Dr. Brown. If I just might add one comment. In the
healthcare field we have also realized the need for this
communication. One of the first actions we took after the 11th
was to issue emergency communication policies that utilized our
current communication systems between hospitals.
We have a computer that links the hospitals called HART. It
also links us with San Mateo County and our regional partners
there. We have now required 800 megahertz radios in all
ambulances both public and private. We conduct regular
communication drills. In the case of the hospitals,
communication drill compliance is tracked on a weekly basis and
we provide that feedback to the hospitals. I am pleased to say
that before we started this, we had about 20 or 30 percent
compliance. Now we are heading up to 100 percent compliance. I
think we also can use the tools that we have in a better
fashion to lick this communication issue.
Mr. Horn. Thank you. Now 10 minutes for my colleague.
Mr. Honda. Thank you, Mr. Chair. I think Dr. Brown probably
answered one of my concerns, is that you talked about the lack
of hospital beds in the case of an emergency or a spike in
needs. Yet, the daily cost of maintenance of a hospital is
based upon how much it cost to maintain a system. There's got
to be a balance.
What I heard you say is there's a system already in place
that you developed in the case of an emergency that you would
be able to deploy and utilize other hospitals pretty much like
what the fire fighters do in terms of mutual assistance in
deploying first responders, medical personnel, and those kinds
of things that are to address the rescue triage in attendance
of victims. Is that correct?
Dr. Brown. That's correct, sir. What we have done is to
develop our emergency care plans or multi-casualty incident
plans to take into account the utilization of regional
resources. It is also important to note that we have developed
the capacity to deploy field resources so we can setup field
treatment centers or field-care clinics that will provide a
level of minimum care, but at least that care will be available
to the patients that are triaged to be needing less care. That
can be deployed from within the city relatively rapidly in the
order of a few hours.
We have tested that. During our millennium celebrations,
New Year's Eve 1999 through 2000 we partnered with several
groups including the U.S. Army Reserve in deploying field-care
clinics. We had eight of them throughout the city. We had them
utilizing austere standards of care, testing our supply and
resupply procedures, our communications, and so forth. We do
have some capacity to increase our level of low treatment or
treatment of less injured individuals.
The problem we run into is, of course, the patients that
need higher levels of care, emergency surgery, intensive care
unit care, that type of thing. We don't have any substitute for
the fixed facilities or the current hospitals and they have
very little capacity.
Mr. Honda. But that's an ongoing issue, though.
Dr. Brown. That's correct, sir.
Mr. Honda. You mentioned Y2K. Probably that activity was
based upon Chairman Horn's work on Y2K, so you do get to see
the fruit of your work, Congressman.
The other question, I guess, relative to that is pre-
incident, and that is the identification of an incident.
Someone talked about the difference between a nuclear attack
where it is immediately self-evident versus a biological attack
or cyber.
In the area of healthcare I understand that there are some
tests or experiments going on to monitor intakes of patients
over a period of time to see the incidence of folks coming in
with cold symptoms which would equate to probably gathering
information quickly using that kind of information technology
to determine whether there may be an attack with anthrax.
I guess my concern is, have you thought about systems that
could be put in place that would meet the needs of the kinds of
attacks that could occur through, say, smallpox which is very
infectious and anthrax, which is not infectious? It takes some
time and it has a different epidemiology I guess you would call
it. That's one end. The other end is the integration of
services with, say, other first-responders, fire fighters, and
the police department. Has there been work in that area?
I guess my ultimate question really is if that is done,
what is the cost of it? Can you share that with us so that we
can put it in place because I think we need to percolate it
from the bottom-up rather than from top-down and say, ``We are
going to allocate $10 million for you all and this is how you
are going to spend it.'' I hear that is another area of
concern. Sure. There were a lot of areas covered in your
question. It's kind of complex but let me break it down into
two answers and then----
Mr. Honda. That's why we have this hearing so that we can
break it down and then put it back together again.
Dr. Brown. And then if my answers don't fit your needs, let
me know and I will certainly go into other areas.
There are two types of systems that we have in place. The
question boils down to what works and what doesn't. A good
example is New York City has a rather extensive active
surveillance system of their EMS system where they are
monitoring things like ambulance calls, emergency department
transports, and those type of things.
This system was in place during the anthrax attacks on the
East Coast and it did not pick-up the anthrax attacks. The
anthrax attack was picked-up by an infectious disease physician
who was consulted to the Florida case, the gentleman that was
working at the media outlet in Florida.
It is our belief that simply doing a surveillance of one
thing or another may not be what we need to have an effective
system. What we are pursuing is a sentinel events system so
that we have direct notification of the local health
authorities as well as the State and national authorities if a
small number of cases appear. That would be a situation similar
to the anthrax attacks that we have already had. It is my
belief that the likelihood of a bio-terror attack is that there
will be a large number of victims. We won't have trouble
telling that there is something afoot. What we might have
trouble doing is narrowing down among the various types of
syndromes or pathogens, as several of my colleagues have
mentioned, to figure out what it is and what is the best way to
treat it and get that treatment out quickly.
To that end, we have developed in San Francisco an
emergency communication system for physicians as well as for
hospitals and we tested this on September 11th as well, a way
to notify all the community physicians of any specialty in any
practice setting that there was a situation that was occurring
that they needed to be reporting actively to us what was
happening so they had the latest information on how to advise
and treat their patients.
In a large scale attack, we have a communication system.
The way the surveillance system will pick that up we believe is
through the emergency departments and the reporting systems
that we have already in place for the diseases of concern in a
bio-terrorist attack which, as I am sure you know, has
recently--the reporting requirements have recently been
expanded to include all those diseases including smallpox.
Dr. Brown.
I think in the case of a highly contagious disease such as
smallpox the real problem will be a logistics problem of
deploying all of the researchers to identify who is at risk and
who needs a vaccination and getting the vaccinations out
rapidly and then tracking the effectiveness of the vaccination
and the further health needs of the public. We have developed
these plans. We are in the process of operationalizing them. We
need to drill them.
The question about the funding, we recently presented to
our local governing body, the Board of Supervisors, what we
felt it would take to sustain the Metropolitan Medical Response
System at a bare-bones minimum. We came up with $5 million in
recurring annual costs and $3 million in a one-time cost.
It's only for San Francisco. I imagine in other communities
that are larger such as San Jose and other California
communities, Los Angeles and San Diego, that would be a larger
amount, but that was specifically for the MMRS, not for any
issues of improving hospital capacity and other things that I
have addressed.
Mr. Trevino. Mr. Chairman, if I may, I would like to
buttress the doctor's statements. Post September 11th the city
and county of San Francisco did acquire two detection devices
capable of picking up anthrax. Unfortunately, even though those
devices are expensive and we consider them state-of-the-art,
their effectiveness is only about 50 percent of the time. That
means that we still have quite a few question marks during a
response.
Just to quantify exactly the kind of workload that we have
been under since the September attacks, during the month of
October, which was during the anthrax attacks on the East
Coast, our hazardous materials team in the fire department went
from an average of six calls per month, which is our normal
day-to-day business, up to 220 for the month of October alone,
so that gives you an indication of just what kind of a strain
that puts on our resources here.
Mr. Horn. I want to go back to Mr. Brown for a minute on
the smallpox which was a good dialog. Do we have any use for
the smallpox vaccines we had 30, 40, 50 years ago? Does that
help us if you have some rogue country dumping smallpox.
Dr. Brown. I will give a brief answer, yes. I will have to
qualify my statement by saying my expertise is in emergency
medicine and not in infectious disease. I am sure the Centers
for Disease Control and other Federal resources would have a
more specific answer for you.
My understanding of the use of the smallpox vaccine is that
it has been tested recently and found to contain its potency.
In other words, it will still be effective in treating smallpox
cases. I do know from my studies that it will be effective or
useful for up to a week after the exposure.
However, as Congressman Honda has pointed out, there are
often latent periods during which time we are not aware of all
of the people that have been affected by an attack so it will
become very critical to correctly identify those who are at
risk and get the treatment to them within a short period of
time.
Mr. Horn. We have, I believe, testimony that we have quite
a few vaccines there. Ten years ago or 5 years ago it was a
mess in terms of the warehousing. They didn't know what they
were doing and they didn't get it out around the country. I
just wonder, you might be in emergency medicine and all but
what do you know about it from your standards on whether it is
smallpox or anything else?
Dr. Brown. From my perspective for treating a smallpox
attack the crucial factor will be to setup quickly the
emergency treatment centers and prophylactic treatment centers
that we would need to treat a large number of people and to
equip those centers with everything they need to provide the
immunization and to collect the information from the patients,
potentially draw blood, etc., that they would need to track the
epidemic or the attack.
I know from our planning that we are prepared to do that.
We do need to have the drilling to actually put it in place and
see the timing that it will take for it to occur.
Then all of this, of course, is predicated upon our getting
the vaccine from the national pharmaceutical stockpile rapidly
so that we can utilize it to treat the patients.
Mr. Honda. Just a quick comment. I guess the difference
between anthrax and smallpox is that smallpox is infectious and
contagious so the drill would probably have to be different.
Well, the drill may be the same but the response may be
different in terms of trying to isolate folks and create a
concentric shell around the point of identification so that we
can prevent a mass epidemic.
Dr. Brown. That is an excellent point. Each of these agents
that could be used in an attack have their own challenges, but
in the case of small pox, it is not only the identification of
the people at risk that might be difficult.
It is also the fact that those people can then potentially
spread the virus, although the most infectious cases of
smallpox are people that have the full-flown syndrome. With
this communication system that we can notify all of the
physicians, all of the healthcare personnel in the community to
be looking for the syndrome. Hopefully we will be able to
identify those infectious--excuse me, contagious patients
rapidly and put them in some type of protection on quarantine
status.
Mr. Honda. Mr. Chair, just to close then on my part, what
you are saying is that we've got pieces of the jigsaw puzzle.
We have some ideas where the missing pieces are. It's a matter
of putting them together. The glue that we have to have is the
revenue. That is No. 1. The flow of revenue is not perfect.
That's why I ask if there are some cost estimates that can come
from local up and then some suggestions on how that can be
distributed once it is authorized and allocated.
It seems to me there are some counties that are quite
capable of being the direct recipients of funds where the State
can be bypassed and the State can be utilized where counties
may not have the full breathe of technical assistance or
technical folks to be able to--or full breathe of services
where they would need a State coordination where you could
combine States together.
That is one impression. What I hear you also saying is that
needs for training and equipment is ongoing but there is
initial cost such as you stated. But then there is also what
you didn't mention is the cost of substitutes while people are
in training. It seems to me an ongoing cost.
What I am hearing also is the stovepipe effect of all our
eight different agencies including the feds. There is nothing
lateral to communicate between you so that you have a national
system of communication of distribution of materials or meds
and things like that. That would be help for us to hear from
you and how you can put this together so that the plan can move
forward and up. I was hoping for some sort of quick response.
Mr. Horn. Dr. Winslow.
Dr. Edwards-Winslow. I think that we had a good beginning
with the Nunn-Lugar-Domenici program where six specific
agencies were tasked to work directly with the cities.
Through the Department of Health and Human Services the
MMTF cities across the United States have a contract right now
to develop sustainment cost estimates, and that's what Mr.
Canton referenced earlier, that San Francisco has been working
on the project and so has San Jose.
Within just a few months there will be information from the
original 27 cities who have had almost 5 years experience now
in this field. That information, I think, could become a very
useful paradigm because I doubt there will be a great deal of
difference.
I think also the cooperative spirit that we experienced in
San Jose among those six Federal partners was a key
contributing factor in our local success. I think that needs to
be nurtured and encouraged at the Federal level through
legislative support and funding so that the appropriate Federal
agencies can each contribute the expertise that they have but
in a collegial manner.
The single point source for funding is really critical
because, as my colleagues have pointed out, grant writing is
time consuming and expensive for the local government. Then the
reporting requirements that go along with the grants and the
contracts often cost a significant percentage of the money that
is received and that needs to stop.
We need to create sensible Web-based reporting that can be
done electronically that minimizes the use of staff time, but
yet gives the Federal Government the appropriate methods for
monitoring the fact that we should be extremely responsible in
the way that we handle this scarce funding.
Mr. Horn. Thank you. We are going to have on panel two the
question to answer that I'm going to now give to you because
some of you are on national committees of your relevant
associations. I would be just curious if this discussion would
be there, especially on our massive lack of health facilities
given Medicare and all the rest.
I wonder has anybody talked about the Veterans
Administration Hospitals or the military hospitals and are they
in on this? Do we know has somebody done an inventory which if
something happened in Texas or in California would there be
beds? Would we have to draw on from the VA or the military?
Dr. Brown. I can give you a partial answer to the question.
The VA is an integral part of the National Disaster Medical
System and this is a system that will be able to evacuate
patients to centers of care where there is capacity to treat
them from a zone that is heavily impacted such as a city that
is under attack.
We have been working with our local VA, the Fort Miley
facility, and working with them in terms of developing a
disaster hospital capability. What looks most promising
currently is the ability to rapidly convert beds that they have
in a skilled nursing facility on their campus to disaster acute
care beds.
Now, admittedly the entire facility of that skilled nursing
facility only has 100 beds but to have 100 beds available
within a few hours makes a tremendous difference. And then to
have the national disaster medical system bring in other assets
such as the disaster medical assistance teams, volunteer teams
of medical personnel.
I happen to serve on California 6, the Bay Area disaster
medical assistance team. To have those teams come in within 6
to 12 hours to setup additional facilities and additional care
will be invaluable in any disaster scenario.
Mr. Horn. That's very helpful.
Mr. Canton.
Mr. Canton. I would just like to point out that the
response mechanism in the United States is actually fairly
robust and works fairly well. My previous job was with the
Federal Emergency Management Agency and I think in the time I
was there I saw the Federal Response Plan go from something
that was just a concept to something that really does work in
the field.
Our entire emergency response in any operation is based on
support to the lowest level. Our emergency operation center
supports the field people that are working on a problem. The
State Office of Emergency Services then supports my operation.
Then the Federal Government overlays that.
I think where the problem comes in is that many of the
agencies that are involved in these different plans don't
always work together. They don't spend time doing exercises, as
Dr. Brown mentioned. In many cases they are developing plans in
a vacuum and very independently from some of the other agencies
that are involved.
I think the real issue becomes what do we use as the
linchpin for all these different plans that are out there. I
think that's where you have to eventually come back to the
emergency management community.
I don't think we've been as good a player as we could have
been. I don't think at some of the State levels that the
offices are sufficiently funded to provide the oversight they
need. I think in many cases it really depends on which
executive arm of the government is willing to give the
authority to offices of emergency services to coordinate that
work.
We are not first responders but our job is to get the first
responders to come together and look beyond just their
individual plans and to make sure the plans mesh together. I
think ultimately we end up being the linchpin and I think
ultimately at the Federal level that brings you back to the
Federal Emergency Management Agency.
Mr. Horn. In your testimony you stated that while reporting
requirements for FEMA grants for the emergency management
preparedness have been simplified, the amount of grants have
decreased, however. With all the additional Federal money that
is being made available, do you anticipate that trend will
change next year for San Francisco?
Mr. Canton. We are certainly hoping so. We are certainly
heartened by all the money, as Chief Trevino, we see moving
through Congress. We are also a little disheartened that this
far from the event of September 11th we still haven't seen any
Federal funds down here. We are still working out of our own
departmental budgets. We are reassigning priorities. In many
cases we are cutting programs so that we can put additional
money into these things. Very little money has reached us.
I would like to hold up that particular program from FEMA
as sort of an example of how things can work well. When that
program first started many years ago, it was designed to
stimulate the formation of local offices of emergency services.
It was primarily a program to fund personnel.
Over the years that became very restrictive. There were a
number of other things that were layered over that. The
reporting requirements got very onerous. Then several years ago
FEMA had a revision of the program where they said, ``Look,
local governments know how to make best use of their funds.''
It became, in essence, a block grant. We have a very simple
program where at the beginning of the fiscal year we provide a
work plan. We check in at mid-year and at the end of the year
we do a final report. In turn the amount of money that we get
we are free to use as we designate in our work plan.
The problem comes in--it is two fold. One is that the
Federal Government has reduced the amount of funding available
in that program. The second was to a certain extent a self-
inflicted wound where we in the State of California redesigned
our funding formula so that less money went to some
jurisdictions and more went to other jurisdictions. I think it
is a combination of things but we are certainly hoping that
more money will be put in this program in the next fiscal year.
Mr. Horn. There is a lot more things we could ask but let
me ask you one about the national stockpile we have been
talking about on medications. How would they be distributed
throughout the San Francisco Bay region? We do have a CDC
witness in the next panel but has there been any planning on
how that would happen?
Dr. Brown. Yes, sir. There has been. I sit on the advisory
committee for the EMS authority and the Office of Emergency
Services on the national pharmaceutical stockpile. Very briefly
stated what would happen is the material would arrive at a
distribution point somewhere near the communities involved. It
would have to be requested by the Governor through a mechanism
of declaration of emergency.
It would also be potentially in competition with other
requests by other communities in other States. If we had an
attack of a contagious agent such as smallpox, it is quite
conceivable that many, many communities would be affected and
so decisions would have to be made to triage the material.
Once the material arrived at the site, it would be broken
down by assistance of State assets, and potentially Federal
assets, the National Guard and so forth, and then distributed
to the communities.
We have in San Francisco several distributionsites that we
have designated. Again, we have in our plan and in our training
of our personnel indicated how this material would be accessed
quickly and transitioned to put into patients' hands.
Dr. Brown.
Again, the limitation is that we have not drilled that with
our Federal and State partners and we need to be doing that
rapidly.
Mr. Horn. Chief Sanders, I think you wanted to comment on
some of these questions.
Mr. Sanders. Thank you very much, Congressman. As I have
listened to my colleagues and to your questions, a major
incidence has come up of deterrence. Thirty-eight years of law
enforcement has taught me that even in our traditional law
enforcement prevention of crime is extremely important.
Here in San Francisco we have taken that into consideration
in this circumstance in developing a personal emergency plan,
standardize plan on how to report emergencies, train the
citizens on what to do and have themselves ready to respond for
a period of time until the official forces can get to them.
One of the other areas we look at in deterrence is regional
intelligence cross-training. I know that in law enforcement if
there is a bank robber on the East Bay, I know that when he or
she runs out of the bank there, they will come over here. We
need to share our law enforcement information both horizontally
and vertically.
I do know of some bills in Congress to get that done so we
can break down some of the old barriers so that we could share
information. To join Mr. Cochran, there is a piece of
technology I recently have reviewed called a threat detector
where we actually look for people.
These bombs and devices of destruction are placed there by
people. Certainly we know from the intelligence coming since
September 11th that there are cells of these anti--actually,
they are warriors. They think of themselves as warriors in a
world war against whomever they regard as an enemy.
We need to track these individuals just as we track other
criminals around our country and around the world. There is
technology, again, available for that. We are able to check
people at the airports. I am going to have to deploy troops at
my own police offices at the San Francisco International
Airport to replace the National Guard.
Also, I would like to have those officers rather than just
stand there and watch and respond to just physical incidences
in their area, provide them with information that can be given
to them by technology. This threat detector can check every
wanted person in nanoseconds.
For example, all 19--as I am informed, all 19 of the
highjackers in the September 11th event were on watch lists.
That information never got to local law enforcement. We would
like to work with all of the governments, State, local, and
Federal to work out a system where we can share that
information and be able to respond to it. You are absolutely
correct.
I mentioned the letter I wrote to Chairman Sensenbrenner of
the Judiciary and the bill number of mine is H.R. 3483, the
Intergovernmental Law Enforcement Information Sharing Act of
2001. I would hope if enough chiefs of police and fire and all
the rest would support that, we could deal with it.
The FBI has been very good without legal part. This should
have been in the earlier and Mr. Sensenbrenner realized that.
He's going to move that as fast as he can.
Mr. Sanders. Thank you, sir. That would be very, very
helpful, again, in law enforcement helping us to do the new job
that we've been assigned to in homeland security.
Mr. Horn. Yes.
Mr. Canton. Chief Sanders touched on one area that I think
is very important that we sometimes overlook, and that is what
do we tell the public? What do we want the public to do?
One of the things we felt after September 11th here in San
Francisco was that we really didn't have a good message
initially to answer when people asked us, ``What should we be
doing about this?'' A lot of our effort in the first week was
to develop just such a message.
We have national programs for crime prevention. We have
national programs for a variety of different things, emergency
management, but we really aren't seeing yet a national program
that answers that question for people ``what should they be
doing?''
Again, I think there are models out there if you look at
how Great Britain deals with terrorism, with how Israel does.
There are posters. There are flyers. There are Web sites. There
are things that tell people how they can empower themselves. I
think that should be part of any program, too. You have to
remember the public needs to be a partner in this.
Certainly by providing intelligence information to the
police, by being alert to the signs of a potential terrorist
attack, they can, in fact, play a role. I think we need to
stress that we are all in this together and we need their help
as much as we need the help of the emergency services.
Mr. Horn. Well said.
Mr. Cochran, before we close this out, you mentioned on the
x-ray machine that it can, in fact, see or think there is a
human lift under the rubble. Are these devices available to
local police and fire departments and, if so, at what cost?
Mr. Cochran. There were two things. The x-rays were looking
at containers and the radar devices were looking through
rubble. The radar devices are just starting to be made
available. They are very inexpensive. I don't know what the
exact cost would be but no more than a few hundred dollars at
most. They can be made available to first responders over the
course of the next several months or year.
Mr. Horn. That would really be helpful to a lot of people
that felt that maybe it couldn't be done.
Mr. Cochran. There are always issues that we've got to work
our way through and sometimes you get blocked but then there
are usually work-arounds and you have to find those. Thank you.
Mr. Horn. Well, thank you. We'll have additional questions.
If you wouldn't mind, there are a few key things from both the
majority and the minority. We will put them in the record at
this point. We would like to have your ideas on it.
We have taken a lot of your time and we thank you for
coming in here. We are now going to start with panel two and we
dismiss panel one. If you are staying around and you see
something crazy that we're dealing with in panel two, you are
certainly welcome to speak-up as you are going to the door.
OK. Panel two. Dr. Burton, Mr. Riordan, Ms. Cherry, Ms.
Dalton, Mr. Mefford, Dr. Bice, and our person that is following
us across America, Mr. Ron Castleman. We are glad to see him
always.
STATEMENTS OF DR. RICHARD BURTON, ASSOCIATE DIRECTOR,
CALIFORNIA DEPARTMENT OF HEALTH SERVICES; RAY RIORDAN,
EMERGENCY PREPAREDNESS OFFICER, EAST BAY MUNICIPAL UTILITY
DISTRICT; JANET CHERRY, ASSOCIATE, THE CADMUS GROUP, INC.;
PATRICIA DALTON, DIRECTOR, STRATEGIC ISSUES, U.S. GENERAL
ACCOUNTING OFFICE; LARRY A. MEFFORD, ASSOCIATE SPECIAL AGENT IN
CHARGE, SAN FRANCISCO FIELD OFFICE; DR. STEVEN BICE, DIRECTOR,
NATIONAL PHARMACEUTICAL STOCKPILE, CENTER FOR DISEASE CONTROL
AND PREVENTION; AND RON CASTLEMAN, REGIONAL DIRECTOR, REGION
VI, FEDERAL EMERGENCY MANAGEMENT AGENCY
Mr. Horn. You've probably heard how we go about this. That
is, we do swear in all witnesses so if you will stand and raise
your right hand and affirm the oath.
[Witnesses sworn.]
Mr. Horn. Thank you. It will be seven witnesses and the
clerk will note that. We will start this down the line as we
have it in panel two's agenda and that will be with Dr. Richard
Burton, the Associate Director of the California Department of
Health Services.
Dr. Burton. Thank you, Chairman. I appreciate the
opportunity to come and share some thoughts this morning from
the California Department of Health Services. In my previous
experience, I've been working with the California Department of
Health Services for the last month and a half. About 10 years
before that I was a local health officer here in California and
before that about 10 year's experience as a flight surgeon with
Marine Corps.
Since the aftermath of September 11th we have refocused a
lot of our energies in California in our partnership with State
and local public health officials, the public health officials
were tasked with the primary responsibility of coordinating
public health responses in the State. We do that in conjunction
with our partners in law enforcement, OES fire, and George
Benson, the special adviser on State preparedness here for the
Governor.
At the local level they are also coordinating with the
first-responders that were represented on the first panel and
in conjunction with their multiple private sector of medical
care providers.
I think what we would like to highlight in today's
testimony is the appreciation we have for the funding that has
been made available from the Federal level for public health
preparedness and for hospital preparedness.
That funding has been in just the last month or so from the
Center for Disease Control and HRSA has come to California and
we are currently in the process of preparing the applications
that were required by Federal oversight in order to receive the
full extent of those funds and make them available to enhance
our preparedness.
The issues that have come up so far as preparedness from
the first panel relating to planning and readiness assessment,
surveillance, or public health, intelligence gathering, and
epidemiology capacity or laboratory capacity that we need to
have in order to assess biologic agents, and also the potential
threat they have to a community dealing with risk communication
and information technology, and also in dealing with education
and training both within the public health field and with our
partners that are first-responders in law enforcement fire,
OES, EMS.
All of those issues are parts of the planning process and
application process that the Center for Disease Control and
HRSA have incorporated into their funding allocations.
In order for us to be successful at addressing all of those
issues and recognizing our partnership with the local
jurisdictions, there are 61 independent public health
jurisdictions in the State of California.
The Department of Health Services has developed focused
area work groups with representation from local public health
jurisdictions and expertise from academia along with the
expertise within the State Health Department. If flushed out,
the assessments and needs and where we can best enhance our
ability to serve the residents of California and that has
informed the application that is currently being put together.
I guess in closing, on these comments I would be happy to
answer any questions. We have heard a number of presentations
this morning that have referenced new and emerging technologies
that can be of great benefit to us and our ability to detect a
threat and also to manage it once an occurrence has taken
place. Those technologies are very promising.
I know what I've heard from my local colleagues in public
health and the State colleagues in public health that while we
make use of these emerging technologies, we need to assure that
we have the human intelligence and professional capability to
manage the technologies, interpret the technologies, and make
the policy recommendations that will best serve the
constituents and the residents in California. Thank you, sir.
[The prepared statement of Dr. Burton follows:]
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Mr. Horn. Thank you.
Mr. Riordan.
Mr. Riordan. Thank you, Mr. Chairman, Representative Honda
for inviting us. My name is Ray Riordan, the Emergency
Preparedness Officer for East Bay Municipal Utility District. I
have been an emergency manager for city and county agencies for
the last 16 years, the last 9 years being with East Bay
Municipal Utility District.
East Bay MUD is a large water and waste water utility in
the State of California. We serve 1.3 million water customers
and 685,000 wastewater customers. While I'm here representing
the District, I am also making commentary with many of the
other water utilities we coordinate with in the Bay Area and
the smaller water utilities in the State of California.
Water systems have several key critical priorities that
they must pay attention to as a water manager. First and
foremost is public health right in line with balancing fire
fighting. The fire fighters want the wet stuff to put on that
red stuff as a way of managing the public safety.
We also pay strong attention to our multi-hazard
responsibilities here in the State of California with the many
seismic events, as well as the technological or other natural
events that we have to face.
In the State of California alone, again, because we are a
large water utility, I don't want to sway one direction or the
other. There are over 10,000 water systems in the State of
California licensed with the State Department of Health. There
are many water utilities in the State of California that are
both public and private and may serve to store water, provide
water supply, transport water, treat water, or provide
distribution.
We at East Bay MUD are large enough to be able to work with
large agencies. Since 1952 we have been part of California
Utilities Emergency Association. Since 1998 we have been part
of the FBI's National Structure Protection Commission.
Large utilities like ourselves are able to respond
effectively to large events such as the terrorism events. We
took immediate actions as did many other water utilities. For
the first time in our history we limited access to our water
supply reservoirs from recreators. We had to close down our
reservoirs for the first time in our history because
conventional wisdom indicated that there would be a large
concern for the water supply or the structural integrity of the
dams if something were placed outside those dams.
Immediately after the event we began response by looking at
our systems and even conducting a preliminary vulnerability
assessment reflecting on what is our real risk versus what is
our perceived risk within the media and the public.
We instituted new corporate procedures including how we
provide public information. One of the key issues that we have
as a water industry is just how much information do we have to
have or provide easily to the public in the Freedom of
Information Act. This is a significant issue for us.
We increased our security procedures and our vendor systems
to the point of more than doubling the cost of operational
contracts as well as looking at the future cost of capital
improvement.
Because of the lack of coordination or information
immediately available on the terrorism threat we began to work
closely with six other public water utilities within the Bay
Area, the San Francisco Bay Area representing over 6 million
water customers.
We formed an ad hoc committee called the Bay Area Security
Information Collaborative [BASIC], as a way of sharing
information on the threat, the risk, providing educational
information and coordination. We did this in conjunction with
information that we did receive from the FBI and the EPA who
have provided invaluable support.
To this point I mentioned our security contracts. We have
increased our security contracts from $1.4 million to over $2.3
million, almost doubling our budget.
We see that EPA funds are available for $125,000 at this
time are only for the large utilities and we need to pay
attention to the smaller utilities as well. It is estimated
that we will have $20 million in improvements necessary for
capital improvements. This is waging a significant impact on
our capital resources.
We need Federal support on the science of detection. Right
now we rely on looking at health information from hospitals,
how many people have become ill at hospitals? We respond to a
need by testing our water system on a regular basis. We need to
have a better understanding of what it is we are testing for.
We need support on the science of detection.
We also need support and Federal resources on response
coordination. It is very difficult to get a single source of
information for the water systems as to how to respond. We also
have to pay attention to when a water system does become a
target for a terrorist event, that it becomes a crime scene,
and we have to understand better how to respond to that
situation.
In closing, a key issue that we have paid attention to and
have discovered is that you don't have to actually contaminate
a water system. You just need to affect public confidence in
the water system, convince the media or the public the water
system has been contaminated. That would be enough of a crisis
for water systems to respond to.
It is a large psychological effect. Last our concern is on
confidentiality. If we do the security vulnerability
assessments, how much of that information do we have to publish
because then we are putting out the information for the
potential terrorists to use back against us as a water system.
We in California have done a lot of work on natural and
technological preparedness and we would like to see some
additional funding for the security event without additional
regulations that we already see in our emergency preparedness
programs we currently hold. Thank you very much for the time.
[The prepared statement of Mr. Riordan follows:]
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Mr. Horn. Well, thank you.
We now go to Janet Cherry, Associate of The Cadmus Group.
We put your very fine--we will put it in again, but we got it
when we were in Albuquerque so your record is in there. Go
ahead because we didn't have you there. We just had the paper.
Ms. Cherry. Mr. Chairman and Congressman Honda, thank you
for the opportunity to testify today. My name is Janet Cherry
and I am a registered professional engineer for The Cadmus
Group, Inc. The following testimony is intended to address the
need for examining the vulnerability of public water systems,
particularly small water systems, to acts of terrorism.
Money has already been appropriated for the large water
systems to perform vulnerability assessment, but small water
systems have been neglected.
Large water systems are prepared technically, financially,
and managerially to address security issues in small water
systems. Large water systems possess the necessary
professionals to identify security issues and the funds to
implement the appropriate measures to maintain security.
Small systems often lack both the financial means and
personnel to identify and reconcile security issues. Small
water system treatment plants are very vulnerable since some of
the treatments plants do not have personnel onsite 24-hours a
day, 7 days a week making vandalism or other acts of
destruction easy to perform when staff are not present.
Small water systems are often located in rural or remote
areas again making these systems easier targets than the
systems located in metropolitan areas. To provide an idea of
how many small water systems exist, there are approximately 426
water systems that serve fewer than 10,000 people in the San
Francisco area alone.
Water systems use the multiple barrier approach to prevent
contamination or loss of service. This approach includes
selecting the highest quality and least vulnerable source
water, protecting the source, installing the appropriate
treatment, and providing water through properly designed and
maintain infrastructure.
Even with this multiple barrier approach being practiced by
water systems, unintentional contamination still occurs such as
water-borne disease outbreaks. When water-borne disease
outbreaks occur, there is a time lag between the time of
exposure and when an outbreak is recognized by the public
health community.
For instance, on September 3, 1999, the New York Department
of Health received reports of at least 10 children hospitalized
with bloody diarrhea or E. Coli infection in counties near
Albany, New York. E. Coli is a pathogen that naturally occurs
in the environment and is harmful to humans if ingested.
All children had attended the Washington County Fair near
Albany, NY held between August 23rd and August 29th. In total
65 people were hospitalized, 11 children experienced kidney
failure, and 2 people died. This example illustrates the
typical chain of events for an E. Coli outbreak. Now, E. Coli
is regularly tested by approved laboratory methods and the
symptoms are promptly recognized by the medical community. It
was still up to 11 days before the outbreak was known by public
health officials.
If small water systems were to be intentionally
contaminated by unknown pathogens or chemicals, the strain on
the public health and medical community would be immense. As we
start to address the vulnerability and resulting security
measures for small water systems, we must not treat it as a new
or complex concept. Conversely, security should be treated as
an extension of the system's public health plan to deliver safe
drinking water reliably and consistently.
State public health departments have developed a sanitary
survey process to assist water systems in delivering safety
drinking water reliably and consistently. This process assess
the adequacy of a water system's multiple barriers to prevent
contamination or loss of service.
A sanitary survey consist of an onsite visit to evaluate
all areas of the water system. Its primary concern is to
identify areas where inadvertent contamination or service
interruption could occur, but it also includes an element of
security. Sanitary surveys have typically focused on vandalism
and theft in the past, but they could be modified easily to
address any risk deemed relevant including terrorism. The key
to successfully addressing vulnerability of small water systems
is to buildupon an existing process, the sanitary survey
process familiar to small water systems and State and Federal
officials.
The sanitary survey is an established process and all
federally regulated public water systems are required to have a
sanitary survey conducted every 3 to 5 years.
Also, it is important that the vulnerability and security
of small water systems receive attention as Federal lending
agencies such as the EPA Drinking Water State Revolving Fund
and the Department of Agriculture Rural Utility Service
continue to invest in water system upgrades and improvement and
expansions. It is only logical that these investments be
properly protected. Thank you.
[The prepared statement of Ms. Cherry follows:]
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Mr. Horn. Thank you.
We are going to rearrange the schedule a little here
because I am calling on Ms. Dalton of the GAO at the end and I
want to move you to the end. Then you can do the statement and
we will see what is missing. I begin with Larry A. Mefford, the
Associate Special Agent in Charge of the FBI, San Francisco
Field Office.
Mr. Mefford. Thank you, Mr. Chairman, Congressman Honda.
Thank you for the opportunity to talk about this very important
topic today.
As you know, the FBI is undergoing a significant shift in
how we approach counterterrorism and our responsibilities in
that arena. Clearly we are focused on attempting to improve our
ability to collect relevant intelligence data under the
constitutional parameters that we work under to interpret that
data and disseminate it to the agencies and to the general
public that have a need to know, to conduct joint training
opportunities and efforts with these agencies, and to conduct
joint investigative activities.
In the Bay Area the methods that we are using to employ
this strategy is basically two-fold. In 1997 we formed the Bay
Area Joint Terrorism Task Force, which since September 11th has
expanded to include a total of 25 law enforcement agencies; and
today consist of the largest law enforcement agencies in this
region, consisting of about 65 investigators that are focused
fulltime on investigating and preventing acts of terrorism in
this region.
Concurrently at the same time working with California OES
we developed the Bay Area Terrorism Working Group, which is a
group of consequence management and disaster agencies that are
focusing on the post-incident response capabilities of all the
agencies. In the area of intelligence development, we are
attempting to develop improved methods of communication with
the various law enforcement and disaster agencies, and the
general public throughout this region. One of the methods that
we have employed is the development of a Web page which is
code-word accessed for all law enforcement agencies in this
region.
This is maintained by the Bay Area Joint Terrorism Task
Force; and on this Web page we place relevant intelligence
data, background information, and other intelligence
information that they would need to do their jobs. We also have
a corresponding Web page that we operate in conjunction with
the Bay Area Terrorism Working Group so that the consequence
management and disaster agencies can also have access to some
of this data.
We are in the process of developing an interagency training
initiative so that we can go to various police departments and
disaster agencies and provide on-scene training by members of
the Joint Terrorism Task Force. Not only FBI personnel, but
outside agency personnel also. We can explain and hopefully
educate the agencies regarding what factors to look for.
For example, we have studied the 19 terrorists responsible
for the acts on September 11th. We've looked at their methods
of operation very closely, and we would like to relay that
information because we think it would be helpful in preventing
potential future acts.
Internally we have also taken steps in the FBI in San
Francisco to develop an in-house capability. We have a 30-
agent evidence response team that has received specialized
training in the area of terrorism, crime scenes, and responding
to acts of chemical, biological, or radioactive terrorism.
As part of this team we have an eight-agent hazardous
material response team that has actually developed the in-house
capability to operate and to collect evidence in the
contaminated crime scene. Working with other disaster agencies
in the Bay Area we have developed the capability to respond to
the scenes and to complete the mission of the FBI should such
an act occur.
Finally, our special weapons and tactics team, which
consist of 46 special agents in this region, they have all been
trained to operate in a contaminated environment. We see this
as an augmentation to local disaster agencies and obviously
gives us the ability to perform at another level that
historically we have not yet had to perform, fortunately.
Finally, we have a weapons of mass destruction coordinator,
as every FBI Field Office does; and these individuals are
assigned specifically to enhance our capabilities and our
ability to interface with other disaster agencies in the
region. In the area of intelligence we are working closely with
the State of California. Their anti-terrorism information
center, which was formed in San Francisco, we hope to create an
intelligence terrorism center as part of our JTTF in the Bay
Area, interfacing with the State system so that we can get
relevant terrorism threat data to the first responders of any
incident.
Clearly, in conclusion, our mission has changed from one of
prosecution to one of prevention and we are devoting
considerable resources to try to improve our capabilities in
that area. Thank you very much.
[The prepared statement of Mr. Mefford follows:]
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Mr. Horn. Thank you. It is very helpful.
We now will go to Dr. Steven Bice, the Director of the
National Pharmaceutical Stockpile, Center for Disease Control
and Prevention. We are delighted to have you here.
Dr. Bice. Thank you, sir. Good morning, Mr. Chairman, Mr.
Honda. I appreciate you inviting me here. Speaking for all the
men and woman of my agency, thank you for sponsoring these
kinds of field hearings and raising important issues and for
allowing us to take part.
Like all other Americans we at CDC were horrified and
saddened by the events which took place in New York,
Washington, and Pennsylvania last fall. But as the Nation's
Disease Control and Prevention Agency we were also immediately
galvanized to action to provide assistance to our partners in
the affected cities and States.
In my oral comments, I'll provide a brief overview of CDC's
activities related to September 11th and the subsequent anthrax
attacks and how we are working to better prepare our Nation's
States and cities for threat of public health emergencies
including, of course, terrorism.
The terrorist events of September 11th and later events
related to anthrax have been defining moments for all of us and
they have greatly sharpened the Nation's focus on public
health. The events created the greatest public health challenge
in CDC's history requiring an unprecedented level of response.
CDC has deployed 588 employees since September 11th in response
to the World Trade Center event and the anthrax investigation.
Within 10 minutes of the second plane crashing into the
World Trade Center we initiated an emergency operation center
that functioned 24-hours a day, 7 days a week. While all
commercial aircraft were grounded after the attack, CDC's
National Pharmaceutical Stockpile Program was able to arrange
transportation of its emergency response personnel to New York.
For the first time ever CDC deployed the National
Pharmaceutical Stockpile sending push packages of medical
material to New York City and to Washington, DC. In response to
the cases of anthrax exposure, our program was also used to
deliver antibiotics for post-exposure prophylactics to
employees in affected buildings, postal workers, mail-handlers,
and postal patrons.
Within 4 hours of the attack on the World Trade Center CDC
health alert network was activated and began transmitting
emergency messages to the top 250 health officials throughout
the Nation. Over the next 16 weeks 67 health alerts,
advisories, and updates were transmitted ultimately reaching an
estimated 1 million frontline public and private physicians,
nurses, laboratorian, and State and local health officials.
The Epidemic Information Exchange [Epi-X]--public health's
established, secure communications network--immediately
developed a secure conference site for State epidemiologists
and local CDC investigative teams for posting information on
surveillance and response activities, including HHS reports,
CDC health advisory information and health alerts, and reports
from State health departments.
The Morbidity and Mortality Weekly Report [MMWR], CDC's
scientific publication, published reports on an urgent basis
and delivered these reports electronically to over 500,000
healthcare providers.
During the height of the Nation's anthrax crisis in
October, CDC experienced larger than normal traffic on its Web
site and conducted daily press and telephone briefings, fielded
thousands of press inquiries, and was featured in television
interviews reaching hundreds of millions of viewers.
At the peak of the anthrax response, CDC had more than 200
personnel in the field assisting State and local partners and
hundreds more personnel at headquarters assisting in the
effort.
Over all there was a total of 22 cases of anthrax with 11
being cutaneous or skin form of the disease and 11 being
inhalation.
While we deeply regret each illness that occurred, we are
very encouraged by the fact that none of the approximately
10,000 persons who were given antibiotic prophylactics
developed anthrax despite significant exposure to anthrax
spores. Last fall's events revealed serious gaps in our
Nation's public health defenses against biological, chemical,
and radiological threats. These gaps include inadequate
epidemiologic and laboratory search capacity, an insufficient
knowledge base concerning sampling and remediation, and lack of
information concerning infectious dose and host susceptibility.
In addition, the public health system needs to improve its
ability to convey information and to provide treatment and
preventive measures to large numbers of persons and a way of
assuring compliance with treatment regimes.
This will require extensive preparedness planning,
cooperation across agencies and between Federal, State, and
local counterparts. It will also require that we work closely
with partners in the emergency response community, law
enforcement, clinical medicine, academia, and private industry.
CDC will continue to support State and local government
officials in preparing and responding to public health
emergencies including terrorist events by providing assistance
and technical guidance in conducting problem assessment,
evacuation, and relocation decisions, proper treatment of
victims, epidemiological surveillance, disease control
measures, and studies of exposed populations.
At the request of the State, CDC will deploy trained and
rapid response teams who can assist in protecting the public's
health in the event of a public health emergency. CDC response
teams have experienced an expertise in medical management,
disease prevention strategies, assessing needs, first responder
procedures, site safety, environmental sampling strategies,
sampling equipment, and disease and injury surveillance.
All States and localities must be prepared to address these
threats and mount an effective response. In late January HHS
announced a total of $1.1 billion in funding would be provided
to States to assist them in their bio-terrorism preparedness
effort.
On January 31st Secretary Thompson notified each Governor
of the amount his or her State would receive to allow them to
initiate and expand planning and building the necessary public
health infrastructure.
In California the State received $60.8 million in funding
from the Center for Disease Control.
In conclusion, CDC is committed to working with other
Federal agencies and partners, State and local health
departments, and the healthcare and first-responder communities
to ensure the health and medical care of our citizens. Although
we have made substantial progress in enhancing the Nation's
capability to prepare for and respond to a terrorist episode,
the events of last fall demonstrate that we must accelerate the
pace of our efforts to assure an adequate response capacity. A
strong and flexible public health system is the best defense
against any disease outbreak or public health emergency. Thank
you.
[The prepared statement of Dr. Bice follows:]
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Mr. Horn. Thank you.
Mr. Castleman, Ron Castleman, has been at two or three
hearings with us. That's Regional Director in Region VI,
Dallas, of the Federal Emergency Management Agency, FEMA. They
do a great job. We thank you.
Mr. Castleman. Thank you. Good morning, Mr. Chairman and
Congressman Honda. I am Ron Castleman, Regional Director,
Region VI, of the Federal Emergency Management Agency. It is a
pleasure to be here today to discuss how FEMA is assisting
State and local governments to prepare for potential terrorist
attacks.
FEMA's mission is to lead the Nation in preparing for,
responding to, and recovering from disasters. Our success
requires close coordination with local, tribal, State, and
Federal agencies as well as volunteer organizations.
The Federal Response Plan outlines the process by which
Federal departments and agencies respond as a cohesive team to
all types of disasters in support of State, tribal, and local
governments.
This plan has been tested on numerous occasions since its
inception in 1992 and the Federal Response Plan again worked
well in response to the terrorist events of September 11, 2001.
FEMA's preparedness provides financial and technical
planning, training and exercise support to State and local and
tribal governments. These programs are designed to strengthen
capabilities to protect public health, safety, and property
both before and after disasters occur.
On May 8, 2001 the President tasked FEMA Director Joe
Allbaugh with creating the Office of National Preparedness
[ONP], within FEMA. The ONP mission is to provide leadership in
the coordination and facilitation of all Federal efforts to
assist State and local first-responders and emergency
management organizations with planning equipment, training, and
exercises to build and sustain their capabilities to respond to
any emergency or disaster including a terrorist incident.
The President's formation of the Office of Homeland
Security further improves the coordination of Federal programs
and activities aimed at combating terrorism. FEMA is working
closely with Director Ridge, the OHS, and other agencies to
identify and develop the most effective ways to quickly build
and enhance domestic preparedness for terrorist attacks.
In January of this year the President took another
important step to strengthen first-responder efforts to prepare
for and respond to incidents of terrorism. The first-responder
initiative in the President's 2003 budget calls for $3.5
billion most of which would be distributed to States and local
jurisdictions for planning efforts, critical equipment, and to
train and exercise personnel.
FEMA's Office of National Preparedness will administer
these grants. ONP will also work with our Federal and State
partners to coordinate all terrorism related first-responder
programs. To begin addressing some of the lessons the first
responder community learned on September 11th, ONP will develop
national standards for inner-operability and compatibility in a
number of areas including training, equipment, mutual aid, and
exercising.
The first-responder grants coupled with these standards
will balance the needs for both flexibility and accountability
at the State and local level.
With respect to California, we continue to work very
closely with the Governor's Office of Emergency Services and
other State offices. Our mechanism for providing support in the
past has been the Nunn-Lugar 120 cities initiative. Recently
through our Terrorism Consequence Management Preparedness
Assistance Grant Program we have been able to fund terrorism
and weapons of mass destruction preparedness activities at the
local level.
Our funds are provided to the Governor's Office of
Emergency Services and they in turn provide them to the
California State Strategic Committee on Terrorism. The areas of
focus for the committee includes cyberterrorism, equipment,
training, intelligence and early warning systems, medical,
health, resource allocation, and others.
FEMA has also participated in senior official workshops,
chemical weapons, tabletop exercises, as well as biological
weapons tabletop exercises in the city of Long Beach and other
California cities.
FEMA is well prepared and equipped to respond to terrorist
disasters. We are strengthening our preparedness efforts now so
that State, tribal, and local governments and first-responders
are well prepared for disasters and emergencies including
incidents of terrorism.
Continued coordination among all levels of government will
ensure a safer America. Thank you for your time.
[The prepared statement of Mr. Castleman follows:]
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Mr. Horn. Thank you. We now move to Ms. Dalton. Patricia
Dalton is the Director of Strategic Issues of the U.S. General
Accounting Office. For some people that don't really understand
what GAO does, they don't just sit around and audit. That sort
of went out 30 years ago. When Clarence Cannon died and Speaker
Rayburn died they blocked us all the way in terms of doing
programmatic research.
The General Accounting Office began in 1921 and they have
done a splendid job in the last 30 years under a number of fine
Comptroller Generals of which none is finer than Mr. Walker,
the current Comptroller General of the United States, the
person with the best term in Washington, 15 years and you can't
touch him. He works for Congress and he works for the American
people.
Ms. Dalton, not only on your statement but I think I
counted about 50 different terrorism things you have put
together with your colleagues. Go ahead and tell us if we have
missed something this morning.
Ms. Dalton. Thank you, Mr. Chairman. We appreciate your
very kind remarks. Mr. Chairman, Congressman Honda, I
appreciate the opportunity to be here in San Francisco to
discuss issues critical to national preparedness.
GAO has called for the development of a national strategy
that will improve our overall preparedness. The creation of the
Office of Homeland Security under the leadership of Tom Ridge
is an important and potentially significant first-step.
As it comes together, we believe there are three key
aspects of the national strategy that should be included. First
of all, a definition and clarification of the appropriate rules
and responsibilities of Federal, State, and local entities on
which we have heard a considerable amount here this morning at
this hearing. Second, the establishment of goals and
performance measures to guide our national preparedness
efforts. Finally, a careful choice of the most appropriate
tools of government to best implement the national strategy and
achieve appropriate goals.
I would like to very briefly discuss each one of these
points. First, the roles and missions of Federal, State, and
local entities need to be clarified. Although the Federal
Government appears monolithic to many, in the area of terrorism
prevention and response it has been anything but and we have
certainly heard about that this morning. There are more than 40
Federal entities that have a role in combating and responding
to terrorism and 20 Federal entities alone in the bio-terrorism
area.
Concerns about coordination, fragmentation and Federal
preparedness efforts are well founded. There has been no single
leader in charge of the many terrorism related functions
conducted by different Federal departments and agencies.
This lack of leadership has resulted in the Federal
Government's development of programs to assist State and local
governments that often are similar and potentially duplicative.
This has created confusion at the State and local level.
State and local response organizations believe that Federal
programs designed to improve preparedness are not well
synchronized or organized and have called for a single focal
point, a one-stop center in some cases.
The second aspect the national strategy that we believe
needs to be addressed is that performance and accountability
measures need to be included in the strategy. Numerous
discussions have been held about the need to enhance the
Nation's preparedness but national preparedness goals and
measurable performance indicators have not yet been developed.
Clear objectives and measures are critical to a sustainable
strategy that provides a framework for defining our roles and
our responsibilities.
Finally, appropriate tools need to be selected for
designing Federal assistance. Our previous work on Federal
programs suggest that the choice and design of policy tools
have important consequences for performance and accountability.
Governments have at their disposal a variety of policy
instruments such as grants, regulations, tax incentives, and
regional coordination and partnerships that they can use to
motivate or mandate other levels of government and private
sector entities to take action to address security concerns.
For example, the Federal Government often uses grants to
State and local governments as a means of delivering Federal
programs. Grants can be designed to: one, target the funds of
State and localities with the greatest needs; two, discourage
the replacement of State and local funds with Federal funds
through maintenance of effort requirements that recipients
maintain their level of previous funding; and most importantly,
three, strike a balance between accountability and flexibility
to the grantees of State and local governments.
Intergovernmental partnerships and regional coordination
will also be important, particularly with respect to
information sharing and mutual aid agreements. National
preparedness is a complex mission that requires unusual
interagency, interjurisdictional, and interorganizational
cooperation. We have certainly heard some of the difficulties
at the local level in this area.
An illustration from the Federal perspective of the
complexity of the issues that are being dealt with can be seen
at the sea ports. At least 15 Federal agencies alone have some
responsibility for our ports. Primary are the Coast Guard,
Customs, and the Immigration and Naturalization Service, but
there are many others.
Local officials have emphasized the importance of regional
coordination. Mutual aid agreements provide a structure for
assistance and for sharing resources among jurisdictions in
response to an emergency. They will be critical in any response
to emergencies.
Mr. Chairman, in conclusion, as increasing demands are
placed on budgets at all levels of government, it will be
necessary to make sound choices to maintain physical stability.
All levels of government and the private sector will have to
communicate and cooperate effectively with each other across a
broad range of issues to develop a national strategy to better
target available resources and to use all of our available
resources to address the urgent national preparedness needs.
This completes my prepared statement. I would be pleased to
answer any question.
[The prepared statement of Ms. Dalton follows:]
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Mr. Horn. Thank you. We will now go to questions and I've
got a few just to wrap up the last panel and this one.
Mr. Riordan, we understand that the Department of Defense
has a list of biological agents that it is unwilling to share
with water districts. Is that true?
Mr. Riordan. There was a published report that there was a
list of available agents that we could use as a tool for
detecting contamination in water systems. It was published
prior to September 11th and then right after September 11th,
obviously, everyone started stepping-up the procedure to start
figuring out what we need to test for. We went to the same Web
sites and all that information was stripped off.
The same access to that information was now gone because it
was considered classified information. While it was available
prior to that, there wasn't enough preparedness efforts taking
care of prior to September 11th to give that information out or
disseminate it. When people were aware of it they went to look
for it again and they discovered that it was now considered
confidential or classified so we couldn't get that same
information.
Mr. Horn. Now, we have very fine laboratories at Walter
Reed. We have the Food and Drug, we have the CDC. I just wonder
what is your feeling on that, Dr. Bice, the Director of the
Stockpile, but you are a major employee of the Center for
Disease Control and Prevention. What do you think about this
business of not sharing biological agents with water districts?
Dr. Bice. Mr. Chairman, that is a tough question for me to
answer. Let me just say that I am fully aware of the
complexities after September 11th of classifying data and what
we thought was public information prior to that time that we
all are now concerned about that information getting into the
wrong hands.
At the same time we are a public health and prevention
agency. We go out of our way to share as much data as we
possibly can with our colleagues in water districts, as well as
any other health related arena.
But there is a classic dilemma when it comes to sharing
information which could potentially be useful to terrorists and
sharing that same information with our colleagues to help them
better prepare. Guidelines in this regard would be exceedingly
helpful and I know that Governor Ridge's Office is moving in
that direction.
Mr. Horn. OK. That's helpful Would you go back to the
smallpox issue which we were talking about. Are those 30-year-
old vaccines still potent?
Dr. Bice. Yes, sir. They are.
Mr. Horn. They are? So they can be used?
Dr. Bice. That's affirmative. Yes, sir. They can.
Mr. Horn. Have we played out this thing with some of the
countries that have that and how many vials of the vaccines do
we have and if you were a foreign power or whatever, that would
take how many and have we got enough in the warehouses now?
Dr. Bice. Sir, the answer to that question is somewhat
complex. I'm not an intelligence expert and so, Mr. Mefford, I
will defer that aspect of an answer to colleagues in FBI and
other intelligence agencies.
With respect to the vaccines that are either being produced
today under contract to HHS or that are in stockpiles, we will
by the end of this calendar year buy enough vaccine to
vaccinate the citizens of the United States should that become
necessary.
Mr. Horn. OK. Let's see if we have any little roundup
things to get this.
Mr. Mefford, I think we were sort of surprised to hear that
there is still a communication gap when it comes to
intelligence. I know the FBI is doing a lot to do it and I
agree with them that if you are going to give it to somebody in
a police department or whatever, you are going to check that
person out so that they are not under pressure and they are not
giving out data. I just wondered here tell us a little on where
the FBI is going on this.
Mr. Mefford. Yes, Mr. Chairman. In San Francisco we have
developed a program where every member, non-FBI member of the
Joint Terrorism Task Force receives a top secret clearance. In
addition, their agency can designate other officers from all of
the 24 additional agencies that participate in this task force.
We are undergoing, right now, a number of security
classification background investigations to give designated
personnel and all of the participants of the task force the
necessary security clearances to receive the raw data.
Having said that, as you know, much of the information can
be distilled and we can release it in a public form. Clearly we
look for opportunities to do that. Our problem is we need to
better enhance our capabilities to make rhyme or reason of the
vast amount of intelligence data that is out there.
Sometimes we are overwhelmed with information. As you know,
we are struggling with an archaic computer system within the
FBI; but we need to do a better job of analyzing the data and
determining exactly what is relevant; and then getting that
threat information to the local and State agencies that have a
need to know. We have a ways to go, but the Director has
identified our weaknesses; and we are moving, I think, as
rapidly as we possibly can to improve.
Mr. Horn. That's good.
I now yield 10 minutes to my colleague, Mr. Honda.
Mr. Honda. Thank you, Mr. Chairman. I want to thank the
witnesses for testifying today also.
One of the concerns that came up earlier in the first panel
was funding and grant processes. To both Mr. Castleman and Ms.
Dalton, perhaps you can respond to the question. Will there be
a one process or one stop mechanism for grants and flow of
revenue for the Federal down to the local government?
Mr. Castleman. We are still developing the mechanism which
we hope to be very practical and user friendly for that
process. We've been in the business of grants management for
some time. Most recently another subject, fire grants, we were
able to do that over the Internet to make it easier for local
fire departments to apply for grants. We are hoping for
something simple and easy to use for first provider grants as
well, but that is still under development.
Mr. Honda. So it is work in progress?
Mr. Castleman. Yes.
Mr. Honda. The flow of the revenues, would that be done
functionally or is it structural meaning will it go through
State, county, local, or will it go to entities that are more
complex that could go directly versus counties that need help
from the State?
Mr. Castleman. It will go to the State for determination
down to the local level from the State.
Ms. Dalton. One of the issues that will need to be
addressed is that there are multiple sources of funding. There
are a number of Federal agencies that are involved in giving
money to the State and local governments. FEMA does have a
primary responsibility. One of the things I believe the States
and local governments are seeing is not just one face to the
Federal Government but multiple faces.
There are some models within the Federal Government in
terms of distribution of funds. For example, in our training
and employment programs there has been a move toward one stop
centers to funnel out services and that certainly would be a
possible model to be examined.
What FEMA alone is doing is a good step in the right
direction but we have to look at the total government and
present that single face and hopefully the national strategy
that Governor Ridge is developing will start addressing some of
those issues. It certainly is a problem that we need to be
dealing with.
Mr. Honda. So what I hear you saying is that FEMA has just
put one tree in the forest.
Ms. Dalton. Yes, sir.
Mr. Honda. In your report you indicated there are many
agencies with many grant sources. Have you suggestions on how
that can be put out there electronically so that people that
want to write grants can look at a myriad at once and pull from
various sources so that they don't have to go through a lot of
repetitious work? Is there a way to make it simple?
Ms. Dalton. Certainly I think there are ways to make it
simpler than what it is. It will take a concerted and
coordinated effort on the part of the Federal Government, the
Congress, and the executive branch in order to address this
issue.
Mr. Honda. So you are saying you can identify it but it is
not your purview to correct it? It's up to somebody else to
sort of figure out how to do that?
Ms. Dalton. Right. I think the national strategy should
address some of these issues through the budget process.
Hopefully there will be some solutions. There are, as I said,
some models within the Federal Government alone of trying to
integrate the delivery of services and I think that is what we
are talking about here.
Mr. Honda. I heard you use that term national strategy. Is
that term applicable to a variety of things that we need to do
within the context of counterterrorism?
Ms. Dalton. The national strategy we believe will at least
put a framework and define roles and responsibilities, not just
for the Federal Government but should be State, local, and
private sector.
Mr. Honda. OK.
Mr. Riordan. Just one additional item is typical of most
grant applications you have to reveal a report of some sort. I
think it is very important to maintain the security of the
information that is presided or presented in any reports that
do come out of grants.
That is one of the concerns we did have initially of the
EPA grants that came up for water systems, vulnerability
assessments. We don't want to release a lot of information on
what our vulnerabilities are. I think that is very critical as
well is whatever grant process is decided upon.
Mr. Honda. There has been a term out there called national
threat risk assessment. Is that being done? If so, by whom? If
we are doing it, when will it be ready? Does anybody know?
Mr. Riordan. Well, I do know for the process for the EPA
grants, EPA worked closely with Sandia National Labs on
applying their risk assessment model to the water industry.
They just finished eight different workshops across the
Nation trying to provide this information to the water
utilities on how to apply this risk assessment model to the
water industry which presents a huge issue for us as a water
industry because our system spans such a large area, maybe 90
miles worth of facility.
It is not like trying to secure one facility. It may be a
multitude of facilities over a long or large area which creates
a major concern for us because you can't apply the same
information. I do know that is one risk model that is being
presented out there.
Mr. Honda. Are there other models?
Ms. Dalton. Yes, there are. Usually the risk assessment
models are targeted toward a specific sector. Currently there
are a number of different models that are being used at the
Federal level for the various agencies. As Chairman Horn
pointed out, the General Accounting Office has some 60 reports
in these various areas, some of which are dealing with the risk
assessments.
Mr. Honda. Thank you. I think it was Dr. Bice that answered
the question that you have sufficient vaccines for this country
for smallpox. When you answered yes for everyone in this
country, then I assume that you are saying that by the end of
the year there would be approximately 340 million vaccines
available?
Dr. Bice. That is approximately the case. Yes sir.
Mr. Honda. And the deployment of the vaccines to local
hospitals and health centers, how will that be done?
Dr. Bice. Well, sir, it will be held in a repository--
several repositories around the United States. It is a policy
decision at the congressional level. At HHS it is above my pay
grade, sir, to answer the question but, the truth is, we will
have the vaccines. How we will distribute it in an emergency we
have those plans that we've drawn up in the National
Pharmaceutical Stockpile Program, but the truth of the matter
is there are policy decisions that have to precursor that.
Mr. Honda. Such as cost of distribution and cost of
acquisition? Is that also part of that? Is there a cost to
local government on that?
Dr. Bice. There would definitely be a cost. Not so much of
acquisition but a cost of storage and distribution. Once it hit
a State level airfield, a State level facility for them to
further distribute it out to people they would incur human
resource costs and transportation costs and others. Yes, sir.
Mr. Honda. You said that the stockpile is still viable. The
new stock is it more viable or equal viability?
Dr. Bice. I guess the easiest way to answer the question is
that they are both viable vaccines. They both can be used, the
new vaccines as well as the vaccine that is in storage.
Mr. Honda. So you are saying they are of equal viability
and use even though they have been stored for a couple of
decades?
Dr. Bice. A number of years. Yes, sir.
Mr. Honda. I guess, Ms. Cherry, did you have a comment?
Ms. Cherry. Yes. Thank you. I would like to add a little
bit on the Sandia Lab vulnerability assessment tool being used
by water systems. This model was originally developed for our
nuclear power facilities and then it was modified to be applied
to water systems.
I think it is a good model and has applications for our
larger water systems but it lacks the analyses of the soft side
of water systems being management, operation, and
administration. It is important that whatever model be applied
to water systems, that it look at all aspects of the water
systems, not just the infrastructure and water system
components.
Mr. Honda. What did you mean by soft?
Ms. Cherry. The model looks at the physical infrastructure
of the water system, pumps and pipelines and treatment, and it
doesn't get into the specifics of management, operation, and
administration.
Mr. Honda. Thank you, Mr. Chair.
Mr. Riordan. We would concur as a large water utility we
found the same thing. Even though we all attended that same
training there were a lot of issues not covered by that
assessment process.
Dr. Burton. If I could, I would just share a comment on the
smallpox discussion. Dr. D. A. Henderson and the Office of
Public Health Preparedness has convened a group under the
Center for Disease Control and Advisory Immunization Practices
Group that will be specifically looking at recommendations and
policy implications of how best to use the smallpox vaccine as
it becomes available. The timeline he set for that is that the
recommendations will be out of that group, national cross-
disciplinary group, by sometime late summer but before the
vaccine will be fully available so we will be ready to use it
as best we can.
Mr. Horn. Well, I want to thank this panel and the first
panel. It's been a very useful and, I think, very realistic
matter. Thank you for taking your time out. You all have a lot
of things to do. All of these things don't happen unless a lot
of people relate to this.
Our subcommittee staff is headed by the gentleman in the
back there, J. Russell George, Staff Director and Chief
Counsel. To my left for this particular hearing is Bonnie
Heald, the Deputy Staff Director, Justin Paulhamus, the
Majority Clerk, is that very high guy that comes and gets
things done. Thank you, Justin.
Earl Pierce had to stay at home. He was the professional
staff member who was not here today but helped coordinate
everyone's testimony. Then from Congressman Honda's office,
Ernest Baynard is the Communications Director and we appreciate
all of his help. Speaking of communications director, David
Schwaegler of the Lawrence Livermore National Laboratory also
was very helpful on the communications. We are very grateful to
the judge of this court, Judge Patel and her staff. We
appreciate very much what we could do and couldn't do and did.
We also have the General Services Administration, James Lew,
Property Manager, and Ian Keye, Operational Analyst.
And the court reporters are George Palmer and Susan Palmer.
That's a tough job with all the people and different things as
we go across the country. Thank you all. With that, we are
adjourned.
[Whereupon, at 12:35 p.m., the hearing was adjourned.]