4 ONP Organization The ONP is organized in FEMA Headquarters under a Director (reporting directly to the FEMA Director) and supported by a Management Services Unit and four Divisions to carry out key its functions to coordinate and implement Federal programs and activities aimed at building and sustaining the national preparedness capability. The divisions and their functional responsibilities include the following: Administration Division - Provide financial and support services, and management of the grant assistance activities for local and State capability building efforts. Program Coordination Division – Ensure development of a coordinated national capability involving Federal, State, and local governments, to include citizen participation, in the overall efforts to effectively deal with the consequences of terrorist acts and other incidents within the United States. Technological Services Division – Improve the capabilities of communities to manage technological hazard emergencies- whether accidental or intentional-and leverage this capability to enhance the capability for dealing with terrorist attacks. Assessment and Exercise - Provide guidance, exercise, and assess and evaluate progress in meeting National goals for development of a domestic consequence management capability. We continue to work with all 55 states and territories and Federally recognized Indian Tribes and Alaskan Native Villages to implement our current and other grant programs to assist State, Tribal and local government to enhance their capabilities to respond to all types of hazards and emergencies such as chemical incidents, incidents involving radiological substances, and natural disasters. The Approach to Biological and Chemical Terrorism We recognize that biological and chemical scenarios would present unique challenges to the first responder community. Of these two types of attacks, we are, in many ways, better prepared for a chemical attack because such an incident is comparable to a largescale hazardous materials incident. In such an event, EPA and the Coast Guard are well connected to local hazardous materials responders, State and Federal agencies, and the chemical industry. There are systems and plans in place for response to hazardous materials, systems that are routinely used for both small and large-scale events. EPA is also the primary agency for the Hazardous Materials function of the Federal Response Plan. We are confident that we would be able to engage the relevant players in a chemical attack based on the hazardous materials model. Bio-terrorism, however, presents the greater immediate concern. With a covert release of a biological agent, the 'first responders' will be hospital staff, medical examiners, private physicians, or animal control workers, instead of the traditional first responders such as 5 police, fire, and emergency medical services, with whom we have a long-term relationship. Across the Government, we are working to enhance our ability to detect biological attacks, better link the public health and emergency response communities, and train and equip traditional first responders to respond to bioterrorism. The President's proposal to create a Department of Homeland Security would strengthen the linkages, detailed below, that are critical to our capacity to respond to bioterrorism. In particular, FEMA has worked with DHHS for several years on the Metropolitan Medical Response Systems (MMRS), which brings together various local medical response elements that have effectively planned, trained and prepared to respond to treat victims of mass casualty events, including chemical, radiological and biological terrorism. Under the program, participating cities plan for the equipment, supplies, training, and transportation requirements for emergencies including possible terrorist attacks. In exercise and planning scenarios, the worst-case scenarios begin with an undetected event and play out as widespread epidemics, rapidly escalating into a national emergency. Response would likely begin in the public health and medical community, with initial requests for Federal assistance probably coming through health and medical channels to the Centers for Disease Control and Prevention (CDC). DHHS leads the efforts of the health and medical community to plan and prepare for a national response to a public health emergency and is the critical link between the health and medical community and the larger Federal response. FEMA works closely with the Public Health Service of DHHS as the primary agency for the Health and Medical Services function of the Federal Response Plan. We rely on the Public Health Service to bring the right experts to the table when the Federal Response Plan community meets to discuss biological scenarios. We work closely with the experts in DHHS and other health and medical agencies, to learn about the threats, how they spread, and the resources and techniques that will be needed to control them. By the same token, the medical experts work with us to learn about the Federal Response Plan and how we can use it to work through the management issues, such as resource deployment and public information strategies. Alone, the Federal Response Plan is not an adequate solution for the challenge of planning and preparing for a deadly epidemic or act of bioterrorism. It is equally true that, alone, the health and medical community cannot manage an emergency with biological causes. We must work together. In recent years, Federal, state and local governments and agencies have made progress in bringing the communities closer together. Exercise Top Officials (TOPOFF) 2000 conducted in May 2000 involved two concurrent terrorism scenarios in two metropolitan areas, a chemical attack on the East Coast followed by a biological attack in the Midwest. This was a successful and useful exercise and we continue to work to implement the lessons learned. 6 In January 2001, the FBI and FEMA jointly published the U.S. Government Interagency Domestic Terrorism Concept of Operation Plan (CONPLAN) with DHHS, EPA, and the Departments of Defense and Energy, and these agencies have pledged to continue the planning process to develop specific procedures for different scenarios, including bioterrorism. The Federal Response Plan and the CONPLAN provide the framework for managing the response to an act of bioterrorism, but we need to continue to practice our response to events of this kind. The Approach to Nuclear Terrorism There are 63 commercial nuclear power plant sites in the United States, located in 33 States. These states and their local governments have radiological emergency response plans for the 10 miles surrounding the plants and 36 states have plans for the 50 miles radius surrounding the plants. The Federal response to a nuclear power plant incident is documented in the Federal Radiological Emergency Response Plan (FRERP), which has 17 Federal agency signatories. The Nuclear Regulatory Commission (NRC) is the lead Federal agency for coordinating the overall response and FEMA is responsible for coordinating nonradiological support. The FEMA Radiological Emergency Preparedness (REP) Program also routinely tests and evaluates the individual site plans, the 10-mile plans for the 63 sites are tested at biennial exercises (approximately 32 exercises per year) and the 50-mile plans for the 36 States are exercised once every six years (approximately six exercises per year). The events of September 11 have now horrifically demonstrated that these plans needed to be expanded further. When September 11 showed us how a commercial jetliner can be used as a weapon of mass destruction, the NRC and FEMA began to work jointly on the preparation of protocols and procedures for dealing with the consequences of a similar attack on a nuclear power plant - a scenario previously not addressed. While some amendments to the emergency response plans may result from this review, it is important to note that the current plans are a valid approach to any nuclear power plant incident, regardless of the cause: terrorism, human error, technological failure, or a natural hazard. The Federal Radiological Preparedness Coordinating Committee (FRPCC) has also conducted tabletop exercises of the FRERP in order to determine Federal agency resources for responding to a terrorist attack, or multiple attacks, with a radiological component. In addition, the FRPCC is evaluating the nuclear/radiological threat posed by Improvised Nuclear Devices and Radiological Dispersal Devices and the preparedness of FRPCC member departments and agencies to deal with these threats. In addition, the Federal Response Subcommittee of the FRPCC has developed information on radiological terrorist devices--such as radiological dispersion devices, improvised nuclear devices, and radiological exposure devices--for the use of the Federal Bureau of Investigation as background and public information. 8 At FEMA, the creation of the Office of National Preparedness and our emphasis on training, planning, equipment, and exercises will enable us to better focus our efforts and will help our nation be better prepared for the future. The President's proposal to create the Department of Homeland Security will integrate these capabilities into a broader whole that will help our Nation respond to the terrorist threat. Thank you, Mr. Chairman. I would be happy to answer any questions you have. Mr. HORN. Thank you. And now we have Dr. Miller, the State epidemiologist for bioterrorism, Colorado Department of Public Health and Environment. STATEMENT OF DR. LISA A. MILLER, STATE EPIDEMIOLOGIST FOR BIOTERRORISM, COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Dr. MILLER. Thank you, and good morning, Mr. Chairman. The previous speaker, I think, gave me a great lead-in to talk about the ways that the Federal Government, and specifically the U.S. Department of Health and Human Services, is aiding both State and local public health and hospitals to become better prepared to deal with bioterrorism. The Colorado Department of Public Health and Environment is the recipient of two Federal grants recently to help us become better prepared. The first grant I'm going to just touch on briefly is Colorado's hospital preparedness grant. And these grant funds are provided through the Department of Health and Human Services via the Health Resources and Services Administration, and they're intended to upgrade the preparedness of hospitals. This grant was developed by the department, but there is oversight from a committee, and this committee has a broad range of representation. And I think that's a really important point to make. This is obviously a very complicated area, and I think you've gotten the picture just from the few speakers before me that we have a lot of coordination to do. So to help coordinate this grant, we have an advisory committee from Veterans Affairs, Indian health service, from community health agencies, and from private providers, to really give us that additional perspective. The Hospital Preparedness Advisory Committee is led by Mr. Larry Wall, who is going to give you comments later. So I'm not going to go into any more detail about that grant, and I'll let Mr. Wall take that one further. The second grant I want to mention briefly is Colorado's public health bioterrorism preparedness grant. And this grant is intended to build public health infrastructure, both at the State public health level and at the local agency level. This grant is actually about 3 years old. We started receiving Federal funds in public health for bioterrorism preparedness in 1999, but recently the Federal Government has increased those funds dramatically, as I'm sure you're aware. We went from receiving about $1 million a year to, this year, $14.6 million. And I want to point out a couple things about this grant. First of all, although the grant is called a bioterrorism grant, it really is intended to help improve the infrastructure of public health so we can respond not only in the, hopefully, unlikely event of a major bioterrorism event, but we can respond to everyday emergencies which we have in public health all the time. We have an example right now going on. We have a new disease in our country, West Nile virus. So this is intended really to help us respond to both that, "everyday emergency" in public health and the other bigger issue of a bioterrorism event. Again, in this grant, we both wrote the grant and have oversight in this grant by a committee. And we wrote the grant with the |