**GAO-02-954T**                      Published: Jul 16, 2002. Publicly Released: Jul 16, 2002.                  

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## Highlights

Federal, state, and local governments share responsibility for terrorist attacks. However, local government, including police and fire departments, emergency medical personnel, and public health agencies, is typically the first responder to an incident. The federal government historically has provided leadership, training, and funding assistance. In the aftermath of September 11, for instance, one-quarter of the $40 billion Emergency Response Fund was earmarked for homeland security, including enhancing state and local government preparedness. Because the national security threat is diffuse and the challenge is highly intergovernmental, national policymakers must formulate strategies with a firm understanding of the interests, capacity, and challenges facing those governments. The development of a national strategy will improve national preparedness and enhance partnerships between federal, state, and local governments. The creation of the Office of Homeland Security is an important and potentially significant first step. The Office of Homeland Security's strategic plan should (1) define and clarify the appropriate roles and responsibilities of federal, state, and local entities; (2) establish goals and performance measures to guide the nation's preparedness efforts; and (3) carefully choose the most appropriate tools of government to implement the national strategy and achieve national goals. The President's proposed Homeland Security Act of 2002 would bring many federal agencies with homeland security responsibilities--including public health preparedness and response--into one department to mobilize and focus assets and resources at all levels of government. GAO believes that the proposed reorganization has the potential to repair fragmentation in the coordination of public health preparedness and response programs at the federal, state, and local levels. The proposal would institutionalize the responsibility for homeland security in federal statute. In addition to improving overall coordination, the transfer of programs from multiple agencies to the new department could reduce overlap among programs and facilitate response in times of disaster. There are concerns about the proposed transfer of control of public health assistance programs that have both public health and homeland security functions from Health and Human Services to the new department. Transferring control of these programs, including priority setting, to the new department has the potential to disrupt some programs that are critical to basic public health responsibilities. GAO does not believe that the President's proposal is sufficiently clear on how both the homeland security and public health objectives would be accomplished.

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## Topics

Homeland Security

Biological warfareBioterrorism hospital preparedness programBioterrorism preparedness and response programCounterterrorismEmergency preparednessEmergency responseEmergency response fundsFederal agency reorganizationHealth care planningHealth care programsHealth hazardsHomeland securityInteragency relationsIntergovernmental relationsMetropolitan medical response systemPresidential proposalsProposed legislationSecurity threatsStrategic national stockpileTerrorismEmergency medical response plansEmergency medical response teams