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WORKING THROUGH AN OUTBREAK: PANDEMIC

FLU PLANNING AND CONTINUITY OF OPERATIONS

HEARING

BEFORE THE

COMMITTEE ON

GOVERNMENT REFORM

HOUSE OF REPRESENTATIVES

ONE HUNDRED NINTH CONGRESS

SECOND SESSION

MAY 11, 2006

Serial No. 109–155

Printed for the use of the Committee on Government Reform

(

Available via the World Wide Web: http://www.gpoaccess.gov/congress/index.html

http://www.house.gov/reform

(II)

COMMITTEE ON GOVERNMENT REFORM

TOM DAVIS, Virginia, Chairman

CHRISTOPHER SHAYS, Connecticut

DAN BURTON, Indiana

ILEANA ROS-LEHTINEN, Florida

JOHN M. MCHUGH, New York

JOHN L. MICA, Florida

GIL GUTKNECHT, Minnesota

MARK E. SOUDER, Indiana

STEVEN C. LATOURETTE, Ohio

TODD RUSSELL PLATTS, Pennsylvania

CHRIS CANNON, Utah

JOHN J. DUNCAN, JR., Tennessee

CANDICE S. MILLER, Michigan

MICHAEL R. TURNER, Ohio

DARRELL E. ISSA, California

JON C. PORTER, Nevada

KENNY MARCHANT, Texas

LYNN A. WESTMORELAND, Georgia

PATRICK T. MCHENRY, North Carolina

CHARLES W. DENT, Pennsylvania

VIRGINIA FOXX, North Carolina

JEAN SCHMIDT, Ohio

——— ———

HENRY A. WAXMAN, California

TOM LANTOS, California

MAJOR R. OWENS, New York

EDOLPHUS TOWNS, New York

PAUL E. KANJORSKI, Pennsylvania

CAROLYN B. MALONEY, New York

ELIJAH E. CUMMINGS, Maryland

DENNIS J. KUCINICH, Ohio

DANNY K. DAVIS, Illinois

WM. LACY CLAY, Missouri

DIANE E. WATSON, California

STEPHEN F. LYNCH, Massachusetts

CHRIS VAN HOLLEN, Maryland

LINDA T. SANCHEZ, California

C.A. DUTCH RUPPERSBERGER, Maryland

BRIAN HIGGINS, New York

ELEANOR HOLMES NORTON, District of

Columbia

———

BERNARD SANDERS, Vermont

(Independent)

DAVID MARIN, Staff Director

LAWRENCE HALLORAN, Deputy Staff Director

TERESA AUSTIN, Chief Clerk

PHIL BARNETT, Minority Chief of Staff/Chief Counsel

(III)

C O N T E N T S

Page

Hearing held on May 11, 2006 ............................................................................... 1

Statement of:

Kriens, Scott, chairman and CEO, Juniper Networks; Paul B. Kurtz,

executive director, Cyber Security Industry Alliance; and Alonzo

Plough, board of directors, Trust for America’s Health ............................. 89

Kriens, Scott .............................................................................................. 89

Kurtz, Paul B. ............................................................................................ 98

Plough, Alonzo ........................................................................................... 108

Walker, David M., Comptroller General, Government Accountability Office, accompanied by Linda D. Koontz, Director for Information Management Issues; Linda Springer, Director, Office of Personnel Management; John O. Agwunobi, M.D., Assistant Secretary for Health, Department of Health and Human Services; and Jeffrey W. Runge, M.D.,

Acting Under Secretary for Science and Technology, Chief Medical

Officer, Department of Homeland Security ................................................ 28

Agwunobi, John O. .................................................................................... 49

Runge, Jeffrey W. ...................................................................................... 68

Springer, Linda .......................................................................................... 43

Walker, David M. ...................................................................................... 28

Letters, statements, etc., submitted for the record by:

Agwunobi, John O., M.D., Assistant Secretary for Health, Department

of Health and Human Services, prepared statement of ............................ 51

Burton, Hon. Dan, a Representative in Congress from the State of Indiana, prepared statement of .......................................................................... 126

Cummings, Hon. Elijah E., a Representative in Congress from the State

of Maryland, prepared statement of ............................................................ 24

Davis, Chairman Tom, a Representative in Congress from the State of

Virginia, prepared statement of ................................................................... 4

Issa, Hon. Darrell E., a Representative in Congress from the State of

California, prepared statement of ................................................................ 128

Kriens, Scott, chairman and CEO, Juniper Networks, prepared statement

of ..................................................................................................................... 92

Kucinich, Hon. Dennis J., a Representative in Congress from the State

of Ohio, prepared statement of .................................................................... 17

Kurtz, Paul B., executive director, Cyber Security Industry Alliance, prepared statement of ........................................................................................ 100

Plough, Alonzo, board of directors, Trust for America’s Health, prepared

statement of ................................................................................................... 111

Runge, Jeffrey W., M.D., Acting Under Secretary for Science and Technology, Chief Medical Officer, Department of Homeland Security, prepared statement of ........................................................................................ 71

Springer, Linda, Director, Office of Personnel Management, prepared

statement of ................................................................................................... 45

Walker, David M., Comptroller General, Government Accountability Office, prepared statement of ........................................................................... 31

Waxman, Hon. Henry A., a Representative in Congress from the State

of California, prepared statement of ........................................................... 8

(1)

WORKING THROUGH AN OUTBREAK: PANDEMIC FLU PLANNING AND CONTINUITY OF

OPERATIONS

THURSDAY, MAY 11, 2006

HOUSE OF REPRESENTATIVES,

COMMITTEE ON GOVERNMENT REFORM,

Washington, DC.

The committee met, pursuant to notice, at 10:10 a.m., in room

2154, Rayburn House Office Building, Hon. Tom Davis (chairman

of the committee) presiding.

Present: Representatives Tom Davis, Shays, Platts, Duncan, Issa,

Foxx, Schmidt, Waxman, Cummings, Kucinich, Davis of Illinois,

Watson, Lynch, Van Hollen, Ruppersberger, and Norton.

Staff present: David Marin, staff director; Lawrence Halloran,

deputy staff director; Ellen Brown, legislative director and senior

policy counsel; Jennifer Safavian, chief counsel for oversight and

investigations; Patrick Lyden, parliamentarian; John Hunter, counsel; Chas Phillips, policy counsel, Rob White, communications director; Andrea LeBlanc, deputy director of communications; Susie

Schulte, professional staff member; Teresa Austin, chief clerk;

Sarah D’Orsie, deputy clerk; Allyson Blandford, office manager;

Leneal Scott, computer systems manager; Karen Lightfoot, minority communications director/senior policy advisor; Robin Appleberry

and Sarah Despres, minority counsels; Richard Butcher and Tania

Shand, minority professional staff members; Earley Green, minority chief clerk; and Jean Gosa, minority assistant clerk.

Chairman TOM DAVIS. Good morning. The committee will come

to order.

We are going to have two very distinguished panels of witnesses

here today to discuss what health experts describe as one of the

largest dangers facing our Nation—the threat of pandemic flu.

We don’t know when or where the next pandemic will strike. We

don’t know what strain of influenza will be the culprit, although

much evidence points to the avian flu. The virulent H5N1 strain

has already caused 115 deaths in Southeast Asia, China, and the

Middle East. Nor do we know if avian flu will turn out to be more

like swine flu, a pandemic that never materialized.

But regardless, we need to improve our readiness because we can

be sure that the next flu pandemic is a matter of when, not if. And

when that time does come, the stakes will be enormous.

Experts have projected that more than half a million Americans

could die. Over 2 million could be hospitalized. Forty percent of the

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work force would be unable to report to work in the event of a U.S.

pandemic flu outbreak.

It is our responsibility to make sure America is prepared, not

just prepared to address the massive health implications of a pandemic, but prepared for the enormous economic and societal disruptions as well. Beyond efforts to protect human health, Government

agencies and private sector businesses must have the ability to

maintain essential functions through an outbreak. Recent natural

disasters and terrorist attacks raise questions about how the Federal Government will continue to operate during emergencies.

Last week, President Bush released the administration’s Implementation Plan for its National Strategy for Pandemic Influenza.

The plan designates the National Response Plan [NRP], as the primary mechanism to coordinate the Federal Government’s response.

Under the NRP, the Department of Homeland Security is the lead

agency to coordinate all Federal activities.

As seen during Hurricane Katrina, the NRP can be ambiguous,

and individual authorities among agencies are not clearly identified. It is the committee’s hope that lessons learned from Katrina

are being applied to any deficiencies in the NRP so the country is

more readily prepared for future disasters.

A key part of the Government’s implementation plan is its emphasis on telework to ensure essential Government operations can

continue during a pandemic, when it may not be possible or advisable for employees to report to work and be in close quarters. Much

to my frustration, the Federal Government has long lagged behind

the private sector in promoting telework, despite the traffic, energy, cost, productivity, and employee morale benefits it can provide.

I was pleased to see the pandemic implementation plan requires

the Office of Personnel Management to develop guidance for Federal departments on continuity of operations planning criteria and

telework to provide instructions for alternative workplace options

during a pandemic.

This is an important step forward, and I am hopeful the pandemic implementation plan will spur the Government to take serious strides in getting more employees to become teleworkers. I am

also hopeful that this will help the Federal Government address

several inadequacies in the COOP planning including—we call it

the COOP planning—including deficient guidance to identify essential functions and ensure continued delivery of services during a

crisis.

The Government’s implementation plan also acknowledges the

limits of the Federal Government while highlighting the importance of preparedness by individuals, communities, and the private

sector. I think all of us here today agree that our State and local

health officials will be on the front lines of pandemic response. It

is our job to provide them with the adequate support and essential

guidance they need to effectively prepare for and respond to a pandemic.

Our experience with last year’s hurricane season is a sad reminder of the need for State and local authorities to be prepared

for anything. Disasters or pandemics don’t happen according to

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plan. Response requires agility, flexibility, and a willingness by

leaders to take action when needed.

We have many important issues today to discuss within the context of pandemic flu. I look forward to a constructive dialog with

our witnesses on these life-and-death issues.

[The prepared statement of Chairman Tom Davis follows:]

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Chairman TOM DAVIS. And I would now recognize the distinguished ranking member, Mr. Waxman, for his opening statement.

Mr. WAXMAN. Thank you, Mr. Chairman, for holding this hearing, and thank you for your leadership on this important issue.

Experts tell us there will be another influenza pandemic. We

don’t know if it is going to be the avian flu or not, but pandemics

happen every so often. They also tell us that the Nation is not prepared to confront this threat. There are multiple holes in our capacity to respond.

We need to increase our vaccine production capacity, strengthen

our public health infrastructure, create adequate hospital surge capacity, and draft contingency plans that will ensure the continued

operation of important Government functions.

Because we do not know when or how severe the next pandemic

that will strike us will be, we don’t have the luxury of time. We

need to act quickly and move beyond the planning stage to the implementation stage.

The administration has taken some important steps. In particular, they have produced several planning documents. But this is

not enough, and some of their actions have actually been counterproductive.

According to the President’s pandemic preparedness plan, the

burden of responding to a flu pandemic will largely fall on State

and local governments. Yet the President’s fiscal year 2000 (sic)

budget cuts more than $200 million from the public health programs at the Centers for Disease Control and Prevention that fund

State and local training and preparedness efforts.

Pandemic preparedness also requires a clear and coherent leadership structure that is capable of responding in an emergency. Unfortunately, the President’s implementation plan, which was released last week, creates divided authority. It would establish the

same type of structure that led to the tragic confusion and delay

in the response to Hurricane Katrina.

Under the President’s plan, HHS is in charge of the medical response, but DHS is in charge of the overall response. There is no

clear delineation of how that will work or who will have final authority over medical operations. This approach ignores the adage

that when everyone is in charge, no one is in charge.

A related weakness is that the core Federal medical asset, the

National Disaster Medical System, is currently a part of DHS. To

lead a medical response, therefore, HHS has to rely on personnel,

supplies, equipment, and communications systems that are actually

controlled by the Department of Homeland Security. Well, this is

the same arrangement—medical assets separated from those

charged with leading the medical response—that was a major factor in the chaos after Hurricane Katrina.

According to the administration officials, there is a plan to move

the National Disaster Medical System out of DHS to HHS. But

these plans are not imminent. We cannot afford to wait until next

year to be ready with a medical response.

Preparing for a flu pandemic will not be easy, and the Federal

plans will change as we learn more about the threat and the best

means of response. But the Nation has a right to expect that the

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Federal Government will not repeat its mistakes, which is what it

seems intent on doing.

One important part of the Federal response is ensuring continuity of operations, and I would like to thank Representative Danny

Davis for his leadership in this area. Today, he will introduce legislation that would require the Federal Government to establish a

demonstration project to test and evaluate telework from alternate

work sites, including from employees’ homes.

This demonstration project will be important for our understanding of the effectiveness of telework and will give us an opportunity

to identify and fix problems that arise.

I want to thank the witnesses for coming today, and I look forward to your testimony.

[The prepared statement of Hon. Henry A. Waxman follows:]

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Chairman TOM DAVIS. Thank you, Mr. Waxman.

Mr. Shays.

Mr. SHAYS. Thank you, Mr. Chairman.

Mr. Chairman, one, thank you for having this hearing. In this

same room—and it is very eerie because I look around, and I don’t

see any TV media here. We are talking about one of the biggest

issues, in my judgment, facing our country. Not unlike a hearing,

I had a few years ago where a doctor of a major medical magazine

said his biggest fear was that a small group of scientists would create an altered biological agent that would wipe out humanity as we

know it.

If we know that influenza killed approximately 30,000 to 50,000

persons a year in the United States and 1 million to 3 million Nation (sic) wide when you don’t have a pandemic, and when we realize that we have had 10 pandemics in the last 300 years—the one

most severe in 1919, when our population was one third the size

worldwide, and we lost 50 million to 100 million people—it should

get our attention. And it is getting the attention of this committee,

and it is getting the attention of some in Government.

But I think what we are going to find is that we need a much

more unified effort to make sure that we minimize the deaths we

know will occur. And I just salute you and others who are working

on this. This is a very, very important hearing we are having

today, and the work of the people that are appearing before us

can’t be measured lightly.

Chairman TOM DAVIS. Thank you very much.

Any other Members wish to make opening statements?

Ms. WATSON. Mr. Chairman.

Chairman TOM DAVIS. Yes, ma’am? The gentlelady from California.

Ms. WATSON. I, too, want to thank you for this hearing.

Biological preparedness is considered crucial in the current world

climate. Our Government has no control over a natural phenomena

that will threaten citizens every year. But the Government Reform

Committee has an important public service to perform in regard to

preparedness for a flu pandemic.

Flu pandemic has the ability to cause death in catastrophic proportions. On one hand, Government should not place the public

into a state of fear. But on the other hand, Government should

educate the public and have a clear plan for action in case of an

outbreak.

Do we have a plan in place? Has this administration and Congress fully funded the resulting solution? Do we have the domestic

manufacturing capability to cover the needs of the United States

during a crisis?

Only one of the two FDA-approved flu vaccine manufacturers in

America, and Chevron Corp. does not have a production facility located on the U.S.-controlled soil.

Mr. Chairman, the administration’s May 3, 2006, Implementation for the National Strategy for Pandemic Influenza leaves too

many concerns. The complete breakdown of DHS leadership, responsiveness, and accountability during the Hurricane Katrina

places congressional oversight into question if we allowed a similar

structure to be approved. ‘‘Fool me once, shame on you. But fool me

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twice’’—we are approaching a hurricane season again. Is the DHS

structure equipped to handle the elemental fury of mother nature

again—are we prepared—much less at the same time as her biological scorn?

So, Mr. Chairman, I am looking forward to today’s testimony and

the positive solutions that our witnesses can provide. The President

has requested $7.1 billion, and the Congress appropriated $3.8 billion in the DOD appropriations act. Is the funding sufficient?

I am interested to hear the panel’s assessment of the Danny

Davis legislation, the Continuity of Operations Demonstration

Project Act. We need a much better system in place to accommodate a flu pandemic or a large natural disaster situation.

So let us put a plan in place that answers the questions and not

creates them. I yield back the balance of my time.

Chairman TOM DAVIS. Thank you very much.

Members will have 7 days to submit opening statements for the

record.

Mr. Davis, do you want to say anything?

Mr. DAVIS OF ILLINOIS. Yes. Thank you very much. Thank you,

Mr. Chairman.

I want to thank you and Ranking Member Waxman for calling

this hearing and for your leadership of the Government Reform

Committee.

In the late 1990’s, the Government Reform and Education and

the Workforce Committees held oversight hearings to examine the

barriers to telecommuting and the development and promotion of

telework programs by Federal agencies.

It was then thought that the primary benefits of telecommuting

were a reduction in traffic congestion and pollution, improvements

to the recruitment and retention of employees, a reduction in the

need for office space, increased worker productivity, and improvements to the quality of life and morale of Federal employees.

These benefits continue to be compelling and valid reasons for

implementing agency-wide telework programs. Representative

Frank Wolf is to be commended for continuously pushing agencies

to increase the number of Federal employees who telecommute.

However, with the Oklahoma City bombing, September 11th,

Hurricane Katrina, and now the possibility of a pandemic, we have

other very compelling reasons to push Federal agencies and ourselves to develop and to implement the infrastructure and work

processes necessary to support telecommuting.

Federal agencies must be able to continue operations during an

emergency. The question we must ask ourselves is this. In the

event of an emergency, are we—this committee, our staffs, and all

of the Federal agencies—prepared to serve the American people if

our primary places of work are no longer available to us?

In conjunction with this hearing, the Government Accountability

Office [GAO], will issue a report entitled ‘‘Continuity of Operations.’’ Selected agencies could improve planning for use of alternate facilities and telework descriptions. From the population of alternate facilities, GAO selected six to evaluate for compliance with

Federal Preparedness Circular [FPC] 65 guidance.

The report, which was requested by Chairman Tom Davis, found

that most of the agencies’ documented plans and procedures related

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to alternate facilities included site preparation and activation

plans. However, none of the agencies had conducted all of the applicable tests and exercises required by FPC 65, including annual

exercises that incorporate deliberate and pre-planned movement of

COOP personnel to an alternate facility.

Further, agencies did not fully identify the levels of resources

necessary to support essential functions, thereby creating the lack

of assurance that facilities are adequately prepared.

Today, I will introduce legislation that will push agencies to address the contingency planning failures detailed in GAO’s reports.

The legislation, a modified version of H.R. 4797, which I introduced

in the 108th Congress, would require the chief human capital officer to conduct and to evaluate a 10-day demonstration project that

broadly uses employees’ contributions to an agency’s operations

from alternate work locations, including home.

The outcome of the demonstration project would provide agencies

and Congress with approaches to gaining flexibility and to identifying work processes that should be addressed during an extended

emergency. The number and types of potential emergency interruptions are unknown, and we must be prepared in advance of an incident with the work processes and infrastructures needed to establish agency operations.

In a world where anything is possible, we must be prepared for

all of the possibilities, and I trust that Chairman Davis will join

with Ranking Member Waxman and others to co-sponsor this bill.

And I thank you, Mr. Chairman, and yield back the balance of

my time.

Chairman TOM DAVIS. Thank you. Well, I probably will.

We have a vote on. I have sent Mr. Shays over to vote so he can

come back. And when he comes back, hopefully, we can keep this

moving because I know we have some time constraints on some of

our witnesses.

Anybody else need to make an opening statement? Mr. Kucinich.

Mr. KUCINICH. I thank the gentleman.

‘‘You are on your own.’’ That has been the credo for the administration’s approach to health care, and it summarizes their approach

to avian flu. The implementation plan gives a little guidance to

State and local governments and businesses and then wishes them

luck.

First, there is the leadership vacuum. The plan calls for HHS to

coordinate the medical response, but calls for Homeland Security to

coordinate Federal operations and resources.

A bipartisan report out of the Senate released in April found that

the department has lagged in fixing the problems that plagued its

atrocious response to Hurricane Katrina. It found that major structural reforms were necessary and that little has changed in the department so far.

So how can we expect Homeland Security to adopt a similar

motto to the one they adopted last summer? The point is we can

expect them to adopt that motto. ‘‘You are on your own.’’

What is more is that the plan has been called ‘‘the mother of all

unfunded mandates.’’ While $7.1 billion for avian flu preparedness

is a step in the right direction, it is simply not enough. Dr. Irwin

Redlener, director of the National Center for Disaster Preparedness

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at Columbia University’s Mailman School of Public Health, called

the budget ‘‘completely unrealistic.’’

A big part of the reason it is insufficient is that it has to make

up for years of steady erosion of the public health infrastructure

due to lack of funding. In fact, Dr. Redlener points out the need

for $5 billion just for staff, equipment and supplies, and general resiliency. Yet the vast majority of the administration’s funding is

going toward the antiviral and vaccine stockpile.

This plan, therefore, gives us inadequate leadership and inadequate funding, which leaves the clear impression that we truly

will be on our own in a pandemic. And a crisis is precisely the time

we need to look out for each other the most.

However, we can be assured that everyone is not left to his or

her own devices. On November 4, 2005, in front of this committee,

HHS Secretary Michael Leavitt stated during the Q&A that he

would not be issuing a compulsory license for the antiviral drug

Tamiflu. He also declared that he was in negotiation with Roche,

manufacturer of Tamiflu, over the cost of the drug being purchased

for the national stockpile.

On one hand, Secretary Leavitt has a congressional mandate to

stockpile enough Tamiflu for 25 percent of the Nation. On the other

hand, he withdrew the threat of compulsory licensing even if Roche

tries to price gouge. In doing so, Mr. Leavitt undercut his own negotiating power and effectively surrendered control of the price to

Roche.

On November 10th, 6 days after the hearing, the New York

Times reported that Roche announced they would be charging developed countries for Tamiflu 15 euros or about $19 for a course

of treatment. Wondering how the price negotiations between HHS

and Roche went, my office recently asked HHS what they were

paying for Tamiflu for the stockpile—the asking price of 15 euros

or $19?

Even with the bulk purchasing power of 810 million pills, HHS

did not bother to get a better deal than the asking price. Lest you

get the impression that this price is fair, allow me to point out that

Roche did not sink a dime into research on their drug. They simply

licensed it from its inventor, Gilead Sciences. That means there is

no need to recoup research costs.

Furthermore, we know it can be sold for a profit for much less.

Cipla, a generics manufacturer in India, for example, is selling

Tamiflu for only $12. That is 36 percent less than what the Federal

Government here is paying. If we paid Cipla’s price instead of

Roche’s, we would save over a half billion dollars.

Now I bet local health agencies and hospitals could save a lot of

lives with that kind of money. Think of what we could do with a

half billion dollars. We could reduce the deficit, put teachers in

classrooms, invest in renewable energy, provide health care to some

of the uninsured.

Those that stand to gain from the inflated prices for pandemic

pharmaceuticals are doing well. Roche’s sales for the first quarter

of 2006 are up 22 percent to $7.7 billion. Gilead Sciences, the company that originally developed Tamiflu and continues to receive

royalties on its sales, outperformed RBC Capital Markets estimate

of $350 million in Tamiflu sales by $163 million.

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In essence, we are telling State and local governments there is

not enough money to fund things like medical personnel and equipment while we are giving away bags of money to the already incredibly profitable pharmaceutical industry. In other words, you

are on your own unless you are a big pharma.

Thank you. I yield back.

[The prepared statement of Hon. Dennis J. Kucinich follows:]

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Chairman TOM DAVIS. Thank you.

The gentleman from Maryland?

Mr. CUMMINGS. Thank you very much, Mr. Chairman, for holding this critically important hearing.

Hurricane Katrina demonstrated with abundant clarity that Government incompetence and poor preparation during a time of national peril are not victimless crimes. Those failures, coupled with

the Government’s inability to secure sufficient quantities of vaccine

courses in a recent flu season, compel us to rigorously question our

Nation’s pandemic flu and continuity of operations plans.

It should give us all pause that a pandemic could result in the

deaths of over 500,000 Americans and infect 25 percent of the

world’s population. The Baltimore Sun on June 12, 2005, reported

in an article entitled ‘‘Fears of Flu Pandemic Spurring Preparations’’ that, ‘‘The threat of an avian flu pandemic from Asia could

cause 12,000 deaths in the State of Maryland early on, with the

possibility of many, many more later.’’

Make no mistake. Such a loss of life would fundamentally undermine our economy and our society. With H5N1 considered likely to

cause a global pandemic, the time is long overdue for our Nation

to have a comprehensive plan to withstand the onslaught of a pandemic.

The White House recently released the Implementation Plan for

the National Strategy for Pandemic Influenza in an effort to provide clarity to the public and to private entities about their respective roles and responsibilities. Unfortunately, this plan suffers from

critical deficiencies that need to be immediately addressed.

To begin, I am concerned that the Department of Homeland Security is charged with coordinating all Federal operations and assets. In no uncertain terms, DHS failed to ably respond to Hurricane Katrina. Nearly a year later, calls for major structural reforms and a substantive change in leadership at DHS have fallen

on deaf ears.

With a pandemic being described as ‘‘Hurricane Katrina hitting

all of America at the same time,’’ how can we be confident in DHS’s

ability to coordinate effectively, dispense resources rapidly, or provide the type of leadership needed to steer this Nation out of a flu

pandemic?

Second, the plan fails to identify a specific individual at the

White House who is charged with the Federal response coordination. As illustrated in Hurricane Katrina, the lack of an identified

ultimate decisionmaker at the White House could result in, one,

unnecessary delays in addressing the needs of State and locals and,

two, an unnecessary delay in comprehending the scope of human

suffering and a loss of life in devastated communities on the

ground.

Furthermore, the plan disturbingly fails to specify how States

ought to distribute limited supplies of vaccines and antivirals.

Make no mistake, who and under what conditions citizens get vaccinated or medicated with antivirals in the midst of a flu pandemic

will be one of the greatest challenges that confront all levels of government.

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Indeed, those decisions will literally be a matter of life and death

for many, and it is not enough to say the Federal Government is

working with the State governments to establish distribution plans.

And finally, Mr. Chairman, I am also deeply concerned that this Congress could find $70 billion for tax cuts that will disproportionately benefit the wealthy, but could not find the resources or the

will to fully fund $7.1 billion requested to expand our vaccine capacity, purchase antivirals, conduct research, and support State

and local preparedness.

The American people are closely watching how its Government

responds to this challenge. One that will no doubt test the wisdom

of our priorities, our ability to effectively govern in a time of international crisis, and the firmness of our resolve to protect our citizens from threats both seen and unseen.

These threats demand that we improve our preparedness efforts

on everything from ensuring our governmental entities are clear as

to their roles and responsibilities, to strengthening our continuity

of operation plans that are essential to keeping Government up and

running in the wake of a disaster.

And with that, Mr. Chairman, I thank you, and I yield back.

[The prepared statement of Hon. Elijah E. Cummings follows:]

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Chairman TOM DAVIS. Thank you, gentlemen.

We now welcome our witnesses. We have before us the Honorable David M. Walker, who is the Comptroller General of the GAO.

We have the Honorable John O. Agwunobi, Assistant Secretary for

Health, Department of Health and Human Services. The Honorable

Jeffrey W. Runge, Acting Under Secretary for Science and Technology, Chief Medical Officer, Department of Homeland Security.

The Honorable Linda Springer, Director, Office of Personnel Management.

Thank you all for being here. As you know, we swear you all in.

So if you would rise?

[Witnesses sworn.]

Chairman TOM DAVIS. I would note for the record that our witnesses have responded in the affirmative.

Comptroller Walker, you have the floor. Thank you for being

here.

And it is my understanding that you have convened a GAO-sponsored conference on Inspector General Act, and that Linda Koontz,

Director for Information Management Issues for GAO, will remain

and answer our questions. Did she stand to be sworn in?

Mr. WALKER. She did, Mr. Chairman.

Chairman TOM DAVIS. OK. Well, that is great. Thank you for

doing that.

So you have a statement and then will be replaced by someone

who will ably be able to answer the questions as well.

Mr. WALKER. Thank you, Mr. Chairman.

Chairman TOM DAVIS. Thank you, Mr. Walker.

Mr. WALKER. I want to thank you, and I want to thank the staff

for your understanding.

The Congress had asked me to convene a panel on the IG Act.

I am chairing it. It is going on right now, and so I appreciate your

indulgence.

Chairman TOM DAVIS. It is easy to understand, and we appreciate and the staff appreciates you even being here.

STATEMENTS OF DAVID M. WALKER, COMPTROLLER GENERAL, GOVERNMENT ACCOUNTABILITY OFFICE, ACCOMPANIED BY LINDA D. KOONTZ, DIRECTOR FOR INFORMATION MANAGEMENT ISSUES; LINDA SPRINGER, DIRECTOR,

OFFICE OF PERSONNEL MANAGEMENT; JOHN O. AGWUNOBI,

M.D., ASSISTANT SECRETARY FOR HEALTH, DEPARTMENT

OF HEALTH AND HUMAN SERVICES; AND JEFFREY W.

RUNGE, M.D., ACTING UNDER SECRETARY FOR SCIENCE

AND TECHNOLOGY, CHIEF MEDICAL OFFICER, DEPARTMENT OF HOMELAND SECURITY

STATEMENT OF DAVID M. WALKER

Mr. WALKER. Thank you very much.

I appreciate the opportunity to participate in the committee’s

hearing on pandemic influenza and continuity planning. As each of

you are well aware, the Government plays many important roles in

responding to emergency situations, such as natural disasters, terrorist events, and pandemic flu outbreaks should they occur.

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But in order to provide both direct emergency response as well

as other essential services, Government agencies must be positioned to continue functioning even when the agencies themselves

are disrupted. Accordingly, agencies are required to develop plans

to ensure continuity of operations, or so-called COOP plans.

In preparing such plans, the executive branch agencies are to follow guidance that is issued by the Federal Emergency Management

Agency [FEMA]. In developing COOP plans, a potentially useful

option is telework. That is employees performing work from remote

sites, often their homes or another location that is not a traditional

office.

As we pointed out in April 2004, telework offers potential benefits to employers, employees, and society as a whole in the normal

course of operations. It is also important and a viable option for

Federal continuity planning, especially as the duration of an emergency is extended, which would be the case if a flu pandemic were

to come to the United States.

According to health experts, absentee rates in a pandemic could

reach 40 percent during peak periods. The need for care for family

members, the need to deal with the illness, and the fear of infection

would have a broad-based effect within the country.

In such a situation, the use of telework or other means to avoid

unnecessary contacts among people, which is referred to as social

distancing measures, is clearly appropriate. This is recognized by

recent executive branch guidance recommending social distancing

measures, such as telework and public health interventions, to control and contain infection during a pandemic outbreak.

GAO recognizes the importance of telework in continuity planning and is striving to lead by example on these issues. For example, about 13.5 percent of GAO employees used telework last year,

as compared to 5.2 percent for Federal civilian employees in 2004.

Furthermore, our current telework policy allows me, during certain emergencies, to approve telework for all employees in an affected area to promote continuity of operations. We are also completing a supplement to our COOP plan that addresses preparation

specific to a pandemic and are coordinating our continuity planning

efforts with those of other legislative branch agencies and of Congress as a whole.

As per your request, the balance of my remarks will focus on the

report that we are issuing today, which was referred to by Mr.

Davis. In 2005, we previously issued a report based upon a survey

of Federal officials responsible for continuity planning at 23 major

agencies. For the current report, we basically reissued the same

survey in order to try to be able to get an update and find out what

type of progress has been made.

This time, more agencies reported plans for essential team members to telework during the COOP event than in the previous survey. However, only a few of the agencies documented that they had

made the necessary preparations to effectively use telework during

an emergency.

For example, although 9 of 23 agencies reported that they expected some of their essential team members to telework during a

COOP event, only 1 agency documented that it had notified its

team members of this expectation. In addition, none of the 23 agenVerDate 11-MAY-2000 12:44 Sep 05, 2006 Jkt 000000 PO 00000 Frm 00033 Fmt 6633 Sfmt 6633 D:\DOCS\28533.TXT HGOVREF1 PsN: HGOVREF1
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cies demonstrated that it could ensure adequate technological capacity to allow designated personnel to telework during an emergency, and only 3 of 23 agencies documented that they had actually

tested the ability of their staff to telework effectively during an

emergency.

One reason why agencies reported these low levels of preparation

for telework is that none of FEMA’s COOP guidance addresses the

steps that agencies should take to ensure that they are fully prepared to use telework during a COOP event. In 2005, when we reported on the previous survey, we recommended that FEMA develop such guidance in consultation with the Office of Personnel

Management. Unfortunately, this guidance has yet to be created.

This guidance suggests the use of telework and recommends that

agencies consider which essential functions should be performed

from remote locations, such as employee homes. That’s the most recent guidance that the agency—that the executive branch has

issued.

However, the guidance still does not address the steps that agencies should take when preparing to use telework during an emergency. For example, it does not address certain necessary preparations, such as informing designated staff that they are expected to

telework or providing them with adequate technical resources and

support to make it effective.

If agencies do not make adequate preparations, they may not be

able to use telework effectively to ensure the continuity of their essential functions in emergencies, including in the event of a pandemic influenza. Accordingly, we recommended in our report that

FEMA establish a timeline for developing such guidance. DHS partially agreed with our recommendation and stated that FEMA will

cooperate with OPM in developing this timeline.

Last week, the White House released an Implementation Plan in

support of the National Strategy for Pandemic Influenza. This plan

calls for OPM to work with DHS and other agencies to revise existing telework guidance and to issue new guidance on human capital

planning and COOP planning. The plan establishes an expectation

that these actions will be completed within the next 3 months.

We’ll see.

We are encouraged that DHS has now established a timeline for

issuing revised telework guidance. However, unless the forthcoming guidance addresses the necessary preparations, agencies may

not be able to use telework effectively to ensure the continuity of

essential functions.

On the other hand, if they prepare telework effectively, agencies

could enable both essential and nonessential employees to contribute to agency missions during the extended emergencies, including

a pandemic influenza.

Mr. Chairman, thank you very much. And I obviously will make

Ms. Koontz available for any questions that you may have or the

other members of the committee.

[NOTE.—The May 2006 GAO report entitled, ‘‘Continuity of Operations, Selected Agencies Could Improve Planning for Use of Alternate Facilities and Telework during Disruptions,’’ GAO–06–713,

may be found in committee files.]

[The prepared statement of Mr. Walker follows:]

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Chairman TOM DAVIS. Thank you, Mr. Walker.

If you don’t mind just coming up here a quick second, we will

start with you, Ms. Springer. Thank you.

STATEMENT OF LINDA SPRINGER

Ms. SPRINGER. Thank you, Mr. Chairman and members of the

committee.

OPM appreciates being invited to testify before this committee

today about the steps we are taking to prepare the Federal Government as an employer for the possibility of a pandemic influenza.

The President’s Implementation Plan for the National Strategy

for Pandemic Influenza tasks OPM with developing appropriate

guidance on human resources management policies relating to a

possible flu epidemic. In addition, the implementation plan directs

OPM to update three existing telework guides.

We’ve approached these tasks with a set of guiding principles in

mind. First, that we should cause no harm. In other words, don’t

induce any panic or contribute to that type of atmosphere in the

Federal work force while, at the same time, maintaining a sense

of urgency.

Communication will be a key to carrying out our role. Our communications with Federal agencies and employees on these HR

issues relating to a possible pandemic epidemic would be credible,

clear, timely, frequent, visible, and sensitive.

In coordination with the White House, we will consult with other

key departments and agencies, as well as the Chief Human Capital

Officers Council and the Federal executive boards, to identify the

issues to be addressed in our guidance materials and the audiences

to which these materials should be directed.

Our policies will strike an appropriate balance between the institutional interests of the Federal Government as an employer and

the needs and concerns of individual Federal employees and their

families.

Finally, we will draw on OPM’s considerable experience in providing advice and assistance to Federal agencies and employees in

emergency situations. The internal pandemic working group we

have already established at OPM has been at work identifying categories of human resource issues for which guidance already exists,

needs revision, or should be developed.

We’ve been aided in this process by keeping an inventory of questions we’ve already received from Federal HR professionals and

from individual employees. I’d like to share a couple of those with

you and give you a sense——

Mr. SHAYS [presiding]. I am going to interrupt you and ask you,

Mr. Walker, why don’t you get on your way? Because you have

things you have to do.

Mr. WALKER. Thank you, Mr. Chairman.

Mr. SHAYS. Thank you. You are making me nervous here.

[Laughter.]

I am sorry to interrupt you.

Ms. SPRINGER. We’ve received so far dozens of questions from

employees from HR professionals in the Federal Government. I will

give you a couple of examples, and you’ll get the flavor of this.

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Question No. 1, what kinds of alternative work arrangements are

available to assist agencies and employees in accomplishing a critical agency mission during a pandemic influenza?

Local health officials have confirmed that since the children in

my son’s daycare center have been exposed to the flu, their families

have also been exposed to the virus. My child is not yet sick. What

leave may I take to care for my child?

Another one. My elderly mother died due to complications from

the flu. I have to make arrangements for and attend her funeral.

May I use sick leave?

If I have been designated as an emergency employee, may I

refuse to report for work if I don’t think it is safe to do so?

And these go on and on and on. And that’s been an ongoing indicator to us of the concern and the interest at all levels throughout

the civilian work force.

So while we have not yet finalized answers to these questions

and the others that we’ve received, or completed our consultation

with other Federal departments and agencies, it is clear that our

guidance materials must include information on alternative work

arrangements.

We’re also keenly aware of this committee’s interest in ensuring

that Federal agencies take appropriate steps to integrate telework

policies into their continuity of operations plans. And let me assure

you that we will include a discussion on teleworking options and

policies in our guidance to Federal agencies, as we’re required to

do under the President’s plan.

Our guidance will also describe relevant leave and work scheduling policies, as well as other benefits and flexibilities designed to

assist Federal employees in the event of a pandemic influenza. In

addition, our guidance will include information on hiring flexibilities and additional categories of guidance that we will identify as

our review continues.

OPM is on track to meet the 3-month deadline specified in the

President’s implementation plan. In addition, we anticipate and

plan to release some information interimly during that 90-day period.

It is important to note that OPM must prepare to carry out its

own responsibilities in the event of a pandemic influenza. We will

be practicing our plan for continuing to carry out the work that

Congress and the President have entrusted to us. We expect that

what we learn from these efforts will help inform the guidance we

provide to other Federal agencies and employees.

Mr. Chairman, I appreciate again the opportunity to testify today

and look forward to any questions you may have.

[The prepared statement of Ms. Springer follows:]

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Mr. SHAYS. Thank you.

I want to make sure I am pronouncing your name correctly. It

is Dr. Agwunobi?

Dr. AGWUNOBI. That is correct.

Mr. SHAYS. Thank you. Your mic needs to be on. So you have to

hit that button there.

Dr. AGWUNOBI. That is correct.

Mr. SHAYS. Thank you. Lovely to have you here. Thank you. You

have the floor.

STATEMENT OF JOHN O. AGWUNOBI, M.D.

Dr. AGWUNOBI. Thank you, Mr. Chairman and members of the

committee, for this opportunity to testify before you on the critically important subject of pandemic influenza preparedness.

Pandemics are, indeed, a fact of life, a reality of living on this

planet. They have occurred numerous times in the past, and they

will likely, unfortunately, occur in the future.

Our ultimate goal must, therefore, be to achieve a constant, yet

flexible state of national preparedness, an enduring national ethic

of readiness for any and, indeed, for all hazards.

If the next pandemic is anything like the one that we experienced as a planet in 1918, I know currently of no nation that can

credibly claim to be ready today. Therefore, much work remains to

be done.

We hope and pray that the next pandemic is a mild one. But as

my colleague Julie Gerberding often says at the CDC, hope is not

a strategy, and prayer is not a plan. More, quite frankly, is expected of Government.

Fortunately, some recent modeling shows that with aggressive

Nation-wide preparedness, exercised readiness—not just a paper

plan, but an exercised plan—and an unhesitant leadership when

the alarm bell rings, that we can actually manage our way through

a pandemic, greatly reducing its negative impact on individuals

and our community.

We learn more with each passing day. And as we learn, we will

continue to strengthen our planning and our preparedness.

On November 1, 2005, the President announced the release of

the National Strategy for Pandemic Influenza, including a request

for $7.1 billion to fund that strategy. Already $3.8 billion has been

appropriated, and our journey of preparedness is now well underway.

This month, the White House released a more detailed implementation plan that delineates 300 critical preparedness tasks for

agencies of Government and the private sector. Of these, 199 are

assigned to the department—the U.S. Department of Health and

Human Services.

HHS is clearly identified as being in charge of all the public

health and medical aspects of preparedness and our response in a

pandemic, and we work very closely with our sister agency, the Department of Homeland Security.

We have international and domestic responsibilities. Our efforts

abroad involve the strengthening of international public health and

medical partnerships and cooperation, global surveillance, and

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rapid response—the building of rapid response capabilities and enhanced capacity globally to respond.

Our efforts at home include improved intra- and interagency collaboration, coordination, at both the horizontal and vertical level

across public health in medical communities, the continued

strengthening of surge capacity across the Nation, enhanced domestic surveillance, and improved State and local planning and exercising of those plans, including a recent effort to reach out to

every State in the form of pandemic summits in which the Secretary himself participated. We’ve now completed 49, and we continue to reach those that we haven’t got to yet.

We focus and recognize the importance of preparedness of individuals and families in this movement to develop a nation prepared

for a pandemic. The development of clear and open risk communication is an essential strategy and a part of our plan.

Our efforts include the stockpiling of pre-pandemic H5N1 vaccine

and efforts to build our capacity to provide 300 million pandemic

vaccine courses within 6 months of the declaration of a pandemic.

Our strategy includes efforts to promote scientific research and to

advance technology used in vaccine development and manufacturing. While we are working to stockpile antiviral drugs, we are also

investing in the search for new and improved antiviral alternatives.

We are working to further the search for rapid, accurate, yet

portable diagnostic tests for H5N1, and we continue to stockpile

other drugs and resources, including ventilators and personal protective equipment.

In conclusion, Mr. Chairman, preparedness is a journey, not a

destination. It’s a journey that must be Nation wide, involve Federal, State, and local leaders in partnership, and include every sector of society. Every individual, every community must do their

part.

In combination, our efforts to prepare for a pandemic can and

will have a dramatic impact on even the worst type of pandemic.

But it may also help us resolve the recurring problems that we

have seen in recent years with seasonal flu vaccine distribution

and perhaps even reduce the dramatic numbers of citizens lost

each year to seasonal influenza. As you know, sir, on average about

36,000 lives are lost per year.

Preparedness for a pandemic makes us a nation better prepared

for any and all hazards, man made or natural. We’re better prepared today than we were yesterday, and Mr. Chairman, I have no

doubt we will be better prepared as a nation tomorrow than we are

today.

Thank you.

[The prepared statement of Dr. Agwunobi follows:]

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Mr. SHAYS. Thank you.

Before you jump in, Mr. Runge, I have heard three kind of memorable statements. Hope is not a strategy. Prayer is not a plan.

Preparedness is a journey, not a destination.

So I want to add mine. When one of the witnesses says, ‘‘We are

taking steps in the right direction,’’ I want to remind you of what

former senator Sam Nunn, his observation, said. It is often not

enough to take steps in the right direction. A gazelle running from

a hungry cougar is ‘‘taking steps in the right direction.’’ But survival in that case, and in ours, is more a matter of speed than direction.

So the question isn’t just are we doing the right things, but are

we doing them in time? The sense of urgency is as critical against

a pandemic flu as the plan to fight the outbreak.

So now I have added mine. And Mr. Runge, you can add one, too,

if you care to. [Laughter.]

STATEMENT OF JEFFREY W. RUNGE

Dr. RUNGE. Thank you, Mr. Chairman.

I would like to add that my name is Jeff Runge, R-U-N-G-E. Yes,

sir. Thank you very much for the chance to——

Mr. SHAYS. Mr. Runge, I apologize.

Dr. RUNGE. That’s no problem.

Mr. SHAYS. It is nice to have you here, Mr. Runge.

Dr. RUNGE. I serve as the Chief Medical Officer for the Department of Homeland Security, as well as the Acting Under Secretary

for Science and Technology. I am very pleased to be here with my

colleague, Dr. Agwunobi, to discuss the role of DHS as the overall

incident manager and the coordinator of the Federal response in

the event of a flu pandemic.

DHS is working very closely with its Federal partners—the HHS,

Department of Defense, USDA, and the Veterans Administration,

and the Homeland Security Council—to prepare for the worst and

to ensure that we are coordinated. Together with our Federal partners, we understand our roles in managing the outbreak of disease,

whether it’s an outbreak that’s confined to the bird population or

whether it is a full-scale human pandemic.

The USDA, with support from its State agriculture counterparts,

will manage an outbreak in the bird population without help from

DHS. HHS will manage the public health and medical aspects of

an outbreak in the human population in prevention, response, and

treatment. DHS will support HHS in fulfilling their responsibilities

in any way we can.

Now even though we recognize the need to be ready at the Federal level, Secretary Leavitt and Secretary Chertoff, as well as Dr.

Agwunobi and I, have made the point on numerous occasions that

preparedness for an incident such as this must be defined at the

local level. We have stood shoulder to shoulder with our colleagues

in HHS and USDA at nearly 50 State pandemic summits, discussing the need to work together with State and local governments,

nongovernmental organizations, faith-based organizations, and the

private sector to ensure a condition of readiness.

Now the mechanism for coordination of a broad Federal response

like this is the National Response Plan. The NRP supports the conVerDate 11-MAY-2000 12:44 Sep 05, 2006 Jkt 000000 PO 00000 Frm 00072 Fmt 6633 Sfmt 6633 D:\DOCS\28533.TXT HGOVREF1 PsN: HGOVREF1
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cept that incidents are handled at the lowest jurisdictional level,

even as it provides the mechanism for a concerted national effort.

Let me digress a moment into the likely scenario if a pandemic

were to present serious and socioeconomic problems for the United

States. The Secretary of Homeland Security, in consultation with

other Cabinet members and the President, would likely declare an

incident of national significance and implement the appropriate coordinating mechanisms. DHS is already ensuring that the appropriate multi-agency coordinating structures are in place well before

an outbreak.

As a threat becomes more imminent and as a situation warrants,

the Secretary may consider activating various elements of the national response, including designating a principal Federal official

[PFO] standing up the joint information center and joint field offices.

Secretary Chertoff has already identified a candidate to become

the national PFO for pandemic influenza. This individual will be

intimately involved in the planning and exercising of all the contingency plans as we work toward the condition of readiness.

In the event we are faced with a pandemic, the Secretary would

also activate a national planning element composed of senior officials of relevant Federal agencies, who have already been identified, to coordinate strategic level national planning and operations.

He would also likely establish as many as five regional joint field

offices that would be staffed and resourced with a deputy principal

Federal official in charge of each of these regional joint field offices

to work directly with their State and local counterparts.

Now this framework provides a coordinated response for all levels of Government, for non-Government agencies and volunteer organizations, and the private sector. This system also affords full coordination between joint regional field offices and the military joint

task forces that might be established.

In the event of a pandemic, obviously, a close, synchronous working relationship with HHS is absolutely essential. Our national

public health and medical resources will unquestionably be taxed,

probably beyond capacity. And DHS will do everything in its power

to assist HHS with its mission.

As our department’s Chief Medical Officer, I am and will be the

primary point of interface with HHS, as well as being Secretary

Chertoff’s advisor on all medical issues, including pandemic influenza.

Implementation of the national strategy announced last week

contains over 300 action items with very aggressive timelines. Dr.

Agwunobi’s department has 199 that they are responsible for primarily. We have 58, and we are supporting other departments in

another 84 items. We are prioritizing them and figuring out how

we can best carry them out.

As the committee understands, the department has many competing priorities right now. But we are fully engaged to make sure

that we are as prepared as we can be. In addition to our job as

overall incident manager, we have some areas of unique responsibility to maintain the function of our Nation’s critical infrastructures, border management, and DHS work force assurance.

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We are also focused on identifying the economic consequences to

our Nation during the pandemic. These issues are interrelated as

we consider policies related to the transportation industry, the flow

of trade across borders, and maintenance of the supply chain for

food and other goods.

Mr. Chairman, as with any illness, prevention is by far the most

effective method of dealing with this disease. We fully support the

efforts of President Bush and the Department of HHS to improve

our domestic vaccine production, to stimulate transformational

change in vaccine technology, and to reinforce the capacity of State

and local public health organizations, as well as educating the public on good health practices.

And one last point, Mr. Chairman. I want to make the point that

the best way to prepare for a pandemic is to strengthen the institutions that we use every day, namely, the public health medical and

emergency services, as well as the support of medical science for

new vaccines and therapeutics.

The collateral benefits that we gain will improve our Nation’s

quality of life as well as our preparedness for any biological incident, whether it’s man made or through a terrorist action.

Thank you, Mr. Chairman. I will be happy to answer any questions.

[The prepared statement of Dr. Runge follows:]

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Chairman TOM DAVIS [presiding]. Thank you very much.

Dr. Agwunobi, let me start with you. What lessons did HHS

learn from Katrina and the 2005 hurricane season that can be applied to pandemic planning and preparedness?

Dr. AGWUNOBI. I think there’s one broad lesson that I think is

very clear. And that is that a pandemic is fundamentally different

than what we saw in Katrina. In Katrina, I think we realized that

an essential part of our response was the rallying to the needs of

those communities by the professionals and the first responders of

other communities from around the Nation.

In a pandemic, we envision that every community will be simultaneously facing the crisis of a pandemic and that there may be—

in fact, it’s probably guaranteed that there will be very limited ability for other States and other communities to rally to the aid of a

community living through a pandemic.

I think other lessons are obvious, and that is that we need to collaborate and strengthen our ability to work with health professionals within every community. Medical Reserve Corps was one

that we used during Katrina and are building upon now. This notion that practitioners from across the Nation can be prepared to

respond to the needs of their own communities if you organize

them beforehand, credential them beforehand, and train them beforehand. And we’re doing just that with the Medical Reserve

Corps.

I think, last, I’ll just add that a great lesson learned and one that

we will buildupon is this notion of a partnership between us and

Homeland Security. The need to not only focus on the health and

medical aspects of a pandemic, but also those other aspects of the

community that might be affected, like critical infrastructure, electricity supplies, water supplies, and the like.

Chairman TOM DAVIS. But given the decentralized nature of the

U.S. public health system, much of the pandemic preparedness

really needs to occur at the State and the local level. One of the

problems of Katrina, of course, is we never got a unified command.

How many State pandemic plans has CDC reviewed or approved?

Dr. AGWUNOBI. I believe the CDC has actually reviewed all of the

State pandemic plans to date. Clearly, those plans change with

time. They’re constantly being improved at the State level, and

CDC is constantly reviewing the updated versions as they are submitted.

Chairman TOM DAVIS. Is every State in compliance and has a

plan at this point as far as you know?

Dr. AGWUNOBI. Every State does have a plan, and those plans

are being improved on a continual basis.

Chairman TOM DAVIS. Do you have performance measures over

these plans?

Dr. AGWUNOBI. The CDC guidance that is being prepared to date

and will be issued with—along with funds designated to enhance

preparedness and exercising of those plans will contain detailed

performance requirements and expectations.

Chairman TOM DAVIS. The States found these guidelines helpful,

do you think?

Dr. AGWUNOBI. I think we’re hearing back from the States that

planning and preparedness is well underway. They recognize that,

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like every nation, that there’s more that needs to be done. We’re

hoping and are beginning to see that these plans are going beyond

the State, but they’re now being developed into communities by

local leaders, and that’s very heartening.

Chairman TOM DAVIS. And let me ask you, to what extent are

you and the Department of Health and Human Services planning

to use telework during a continuity of operations?

Dr. AGWUNOBI. Our continuity of operations plan contemplates

the need for telework and work at offsite settings. I fully expect

that as we release our own implementation plan for the Department of Health and Human Services that it will contain in large

part great plans for telecommuting.

Chairman TOM DAVIS. Dr. Runge, as you saw during Hurricane

Katrina, the National Response Plan can be ambiguous. Individual

authorities among agencies were not always clearly identified. How

are DHS and HHS using the lessons learned from Katrina to fix

deficiencies in the National Response Plan so that the country is

more rapidly prepared for future disasters?

I will tell, in Katrina, not being there rapidly getting things together ended up costing lives and money. In this case, with a pandemic, time is critical and being able to move in. What have we

learned here?

Dr. RUNGE. That’s obviously a great question, and it’s one that

we spent quite a bit of time.

I had the—I would say it was a luxury, but it actually is not a

luxury of joining the department after Katrina and working backward with my new colleagues who arrived on the scene after

Katrina. And we were not happy either with the coordination that

occurred with DHS and HHS, and we have taken tremendous steps

in fixing that.

The deputy secretaries of both agencies, together with our counterparts, have spent many hours talking about how we’re going to

improve the coordination and function of the Emergency Support

Function 8, as well as my chief of staff has spent the last week in

the Gulf States talking about how we are better coordinated with

hurricane preparedness, playbooks. We are coming together with a

pandemic—a playbook for pandemic.

We’ve also, and I think you’ll be interested in this, have been

going department by department and talking about the importance

of using the National Response Plan and that the plan is no good

unless it’s used.

It may be no surprise that the tenets of the National Response

Plan, perhaps because they are a bit ambiguous and unusual for

the nonmilitary, such as myself, that we actually have to sit down

and discuss how to operationalize that coordination. And I think

that we are well on the way toward a completely bolted together

HHS and DHS.

The Office of the Chief Medical Officer was just created as a result of the second stage review, and they have a constant point of

contact for all of these issues. I’m much more confident that we are

better equipped not only for this hurricane season, but in the event

of a pandemic.

Chairman TOM DAVIS. OK. Thank you very much.

To what extent is DHS planning to use telework during——

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Dr. RUNGE. One of our workgroups, Mr. Chairman, is continuity

of Government, continuity of operations. We have quite a bit of expertise in the department. We’ve got an integrated team working

on that issue, headed by Coast Guard Chief Medical Officer, Admiral Higgins.

But I will say, in all fairness, that the other side of our agency,

the Infrastructure Protection Office, has responsibility for the

maintenance of the 17 critical infrastructures of which telecommunications is one, is looking very carefully at this issue.

It’s one thing to say that we’ll all go home and use the Internet

for work. It’s another matter to make sure that the backbone is in

place, that the last mile of copper going into neighborhoods will, in

fact, withstand the increased traffic.

Our Critical Infrastructure Partnership Office has had a couple

of tabletops with the telecommunications industry involving this

issue, and it turns out to be quite a more complex problem than

simply saying, ‘‘Guys, go home and log on.’’

Chairman TOM DAVIS. Absolutely.

Ms. Springer, what happens if a Federal agency doesn’t adequately incorporate telework in its COOP planning for a pandemic?

In other words, what are the risks to that agency and the public

if the agency isn’t prepared to carry out its essential functions?

Ms. SPRINGER. Well, each agency, in my judgment, needs to have

telework as a part of its COOP plan. And as the Comptroller mentioned, the GAO guidance is, in fact, exactly that, that is an important component. So it’s hard for me to imagine that wouldn’t be.

The telework statute, as it exists right now, does not authorize

OPM to regulate the telework program. So we aren’t in the position

to actually direct agencies to include it. But working with FEMA,

I think——

Chairman TOM DAVIS. Would you like to have that authority?

Ms. SPRINGER. I think someone needs to have it.

Chairman TOM DAVIS. OK.

Ms. SPRINGER. But I think certainly from an emergency standpoint, which is different than the routine type of telework, the dayto-day normal condition telework, but in an emergency situation, I

think at a minimum, the FEMA direction needs to be that is a

must component of COOP plans.

Chairman TOM DAVIS. OK. OPM and DHS issue guidelines and

offer assistance in COOP and telework planning, but Federal agencies can take it or leave it. And according to GAO surveys, they

often leave it. Frankly, the progress of Federal agencies in adopting

COOP plans and implementing telework is not very impressive.

In fact, the White House pandemic implementation plan says

nothing at all about requiring Federal agencies to develop COOP

pandemic plans or incorporate telework in those plans. It also

doesn’t require DHS or OPM to review agency plans once they are

developed.

So what steps can OPM take to ensure that other Federal agencies follow your guidance on COOP planning, especially in the face

of pandemic? And what additional authority would OPM need to

assure compliance, and do you think OPM is the right agency?

Ms. SPRINGER. Well, OK. There are several questions you asked

there. Let me answer those because they’re all important.

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At this point, we think roughly half the agencies—or actually,

this is our most recent telework survey. We’re about to go out with

another one, which I think is pretty timely. But about half the reporting agencies had included telework in their COOP plans. About

another half were working to achieve that goal.

As you noted, we’re required under the implementation plan

from the White House to issue guidance. But to the extent that we

want to help to ensure that guidance is actually put into practice,

there are several things we can do. I’ve already arranged to meet

with the inspectors general community, the PCIE, at their June

meeting. And to work with them and encourage them, even though

we don’t have the authority to commit them to do this, but to put

into place a protocol for practicing not just telework, but to make

sure that there is a practice of those plans at their agencies.

I’ve asked our own inspector general at OPM to—at the right

time to evaluate a test that we will be doing of telework. We may

take a Saturday or we may take a week day or two and actually

commit those who are going to telework to actually do that. And

then we’ll have our inspector general—so I think inspector general

commitment and involvement is going to be helpful here.

I think that we will develop best practices. That will be one of

the sets of guidance that we put out. Not just here’s how telework

can work, whether you need an agreement, what needs to be in

writing, that kind of thing. But actually some best practices as a

result of those tests and what we find at OPM.

So those are the things where I see us actually going a little bit

beyond the strict task that we’ve been given under the implementation plan. Beyond that, we don’t have any particular statutory authority. I think that would—that implementation role resides at

this point more likely with FEMA than OPM.

Chairman TOM DAVIS. OK. What role will OPM have in this

June’s interagency COOP exercise Forward Challenge? Are there

plans for an interagency COOP exercise based on a pandemic flu

scenario? And how essential is it for all the Federal agencies to engage in Government-wide exercises for COOP?

Ms. SPRINGER. Well, the last question is the easiest to answer.

It’s essential for everyone to participate. We will be participating

in that June exercise. OPM, as I noted in my opening statement,

has to make sure that OPM is running as well. In addition to the

Government-wide guidance that we provide, we are a guidance

agency.

But our own planning has led to the key essential functions that

we need to do, and about a third of those are internal functions or

infrastructure, keeping things running, telecommunications, things

like that. But then there are others that are more externally focused. So we’ll be testing those in the June exercise.

Chairman TOM DAVIS. All right. Ms. Koontz, let me move to you.

One of the criticisms from GAO was that FEMA didn’t provide adequate guidance to agencies to prepare for telework in the case of

emergencies. Now the White House pandemic implementation plan

directs OPM to issue guidelines for agencies on COOP planning criteria for a pandemic and to update its telework guidelines. Do you

think that is an adequate response?

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Ms. KOONTZ. We’re encouraged that there’s now a timeframe for

issuing this kind of guidance. But what I’m not sure about at this

point is whether the guidance will actually include the specifics on

what agencies need to do to make sure that they are able to use

telework effectively when—during an emergency situation. And

that includes everything from testing to communications to technological capacity.

Chairman TOM DAVIS. If an agency already regularly uses

telework, why does it need to test its COOP telework capabilities?

Ms. KOONTZ. I think as other witnesses have indicated, that testing is just critical of every part of continuity planning. But under

an emergency, particularly a pandemic, you may have a lot more

people teleworking than normal. And it may be—it’s probably important to make sure that you actually have the technological—you

have the communications capacity to do this. You have the software licenses that you need to do this.

Frankly, you don’t know what you don’t know. And what an exercise does is that it shows you those kinds of things, and you can

feed them back into your continuity planning.

Chairman TOM DAVIS. What do you think is the most important

thing agencies can do to prepare to continue operations during a

pandemic?

Ms. KOONTZ. There are many things, but I’ll touch on a few from

the continuity perspective. And that is, first of all, they need to

have a robust telework program that includes all the necessary

preparations.

And then also I think agencies need to strengthen their basic

continuity planning, and that includes identifying essential functions, identifying the interdependencies, identifying what resources

you need, and then testing to make sure that it all works.

Chairman TOM DAVIS. Yes, but for agencies that have already

begun planning to use telework, what should they do to ensure

that the capability will be there in emergencies?

Ms. KOONTZ. We outline a full list of the practices that we think

need to be present, but I’ll highlight several. One is, is that they

need to make sure that agency personnel understand that they are

expected to work during an emergency using telework and understand what they’re supposed to do in that scenario.

They also need to make sure that we have the technological capacity, including telecommunications, and we also need to test to

make sure that we’re able to do that.

Chairman TOM DAVIS. OK. Well, we have a vote on the floor. Unfortunately, somebody didn’t get their amendment made in order

on the defense authorization bill. So they are getting up and moving to adjourn every few minutes.

I think they think that by doing that, they will get maybe their

amendment next time. I am not sure if that works that way or not.

So I think at this point, I am going to let this panel go.

I want to thank you for your testimony. You know, we will stay

in touch with you on this. It is just very, very important. We will

take about a 10-minute recess while we go vote, and then we will

swear in our next panel.

Thank you all very much.

[Recess.]

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Chairman TOM DAVIS. Everybody take their seats. We are going

to move to our second panel. It is a very distinguished panel.

We have Mr. Scott Kriens, who is the chairman and CEO of Juniper Networks. We have Paul Kurtz, the executive director of the

Cyber Security Industry Alliance, and I think we have Alonzo

Plough, who will be out in just a minute.

Let me just say it is our policy that all witnesses be sworn before

you testify, and he will be here—oh, here he comes. Just raise your

hand and say ‘‘I do.’’ Will you please rise and raise your right

hands?

[Witnesses sworn.]

Chairman TOM DAVIS. Thank you, and be seated.

Mr. Kriens, we will start with you.

STATEMENTS OF SCOTT KRIENS, CHAIRMAN AND CEO, JUNIPER NETWORKS; PAUL B. KURTZ, EXECUTIVE DIRECTOR,

CYBER SECURITY INDUSTRY ALLIANCE; AND ALONZO

PLOUGH, BOARD OF DIRECTORS, TRUST FOR AMERICA’S

HEALTH

STATEMENT OF SCOTT KRIENS

Mr. KRIENS. Thank you, Mr. Chairman and members of the committee.

I’d just like to make a couple of comments today in light of what

we heard earlier. And I will skip over the alarming statistics, because I’ve certainly personally heard plenty of those, and get to the

question of what can we do here? And how can we make this better?

Because the real risk of the pandemic is not in the although tragic consequences of the pandemic itself, the real risk of loss is going

to be in how well we do or do not handle it. And we have a great

tool here. The Internet itself was, as many of you know—and I

know you know, Mr. Chairman—was born from research work done

by the Government in the 1960’s.

But sometimes what’s not known about that is it was actually

founded on the concern in the cold war days that centers of communication and through threats from other enemies we would be disrupted as a Nation. And the Internet and the structure of its design was meant to recover communications in the event that major

centers were disrupted and were out of service. And here we are,

40 or 45 years later, with an opportunity to see that vision help

us through other crises.

And yet, while we can do that, we also have evidence presented

earlier from Mr. Walker that isn’t what is happening. While we

have 9 of 23 agencies expected to be able to respond to telework

and to be able to continue operations in the COOP planning that’s

been spoken about, only 1 of those has notified, zero have really

demonstrated the readiness, and only 3 of 23 have tested to be prepared for teleworking.

So while we have plenty of evidence—certainly not only in our

company at Juniper, but throughout Silicon Valley and in other examples across the country and private industry—there are literally

millions of people capable of teleworking and prepared and using

technologies to do so, we somehow find ourselves mysteriously

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underprepared to see the same kind of continuous operations in

command and control exhibited either in the face of a pandemic or

other concerns. So it isn’t what is happening, even though it can

be.

And yet, in Afghanistan, Jim Vanderhoff, the CIO of the State

Department, has deployed telework capabilities for our staff, both

military and civilian, in Afghanistan, who are using telework and

remote capabilities to protect themselves from the dangers in a

country that remote with difficulties of that magnitude in order to

save life and limb, in order to continue operations there.

So while we see ourselves less prepared than we should be in our

own country, we also have examples in locations as remote as Afghanistan where teleworking and the benefits of it and the ability

to operate through difficulty continues.

So in light of that, I’d like to make just a couple of recommendations. And in doing so, perhaps we can use the alarm of this pandemic to make something good come out of something that may be,

in fact, very bad. And the first of those recommendations is, in fact,

to start at the top.

This is a capability that can be deployed today, and we need to

set an example. And our first recommendation I would make and

offer to the committee for consideration is that the executives and

the leadership in Government are those who should adopt teleworking as a primary priority and as an example to set for others.

And that with those proven examples, we have the ability to then

start a wave of acceptance. Not so much by staff reports and by

guidance and by hope and prayer, as was said earlier, but by actual

examples set by senior leadership.

Using telework today to conduct operations before the pandemic

and before the crises so that when it does happen, it’s a capability

that is proven and tested and that we’re all comfortable with. So

that would be probably first and primary recommendation would be

let’s start this at the top and let’s make it work.

The second is to rely on the proven examples. There is proven

capability, and my colleague Mr. Kurtz will speak to some of this

in a moment about the ability of technology to authorize, to authenticate, and to demonstrate the legitimacy and the safety and

security of this use.

It’s protecting our troops in battle. It can certainly protect our

leaders in Government in our own country as a reliable tool. So we

should rely on the safety, security, and proven capabilities of the

technology.

And finally, to call for open standards in the implementation.

These are systems which have been proven, which must and do

interoperate today. And to any extent possible the committee can

provide that kind of open requirement and guidance in the specifics

that it drives to us in industry to deliver these technologies, it will

be enormously valuable.

As a final thought and perhaps a reference, again, to where this

capability has been used, one of the primary directives in engaging

with the enemy is to be able to move, shoot, and communicate. And

we have a very dangerous enemy facing us in this pandemic threat,

and we must be able to move. We must be able to pick the targets

that we are going to attack, and primarily to enable that, we must

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be able to communicate as a Nation and for the Government to

communicate across its leadership in order to make these capabilities a tool and a weapon in the battle that we face.

So, with that, I would like to thank you, Mr. Chairman and the

committee, for the time to come and speak with you today. And certainly I look forward to answering any questions you might have.

[The prepared statement of Mr. Kriens follows:]

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Chairman TOM DAVIS. Thank you very much.

Mr. Kurtz.

STATEMENT OF PAUL B. KURTZ

Mr. KURTZ. Mr. Chairman, it’s a pleasure to be here today. And

beginning, I wanted to recall the little quote on the front of your

report on Katrina, which talked about the five frogs sitting on a

log. And four of the frogs decided to jump off, and how many are

left? And the answer was five.

And I think that’s the theme of what I heard earlier today.

There’s a lot of, if you will, people deciding, but not doing. A lot

of guidance, but no action. And I think the flu pandemic planning

that we all must go through is an opportunity to fundamentally

change the way we do business in the Federal Government.

Obviously, my comments will focus on one of the White House’s

key goals of sustaining the infrastructure and mitigating the impact of a flu pandemic. I note in 1918, there was an ad in a Canadian newspaper, Canadian Bell, which talked about only using telephones for emergency use. Obviously, IT has a much wider use

today. It’s integral to our society. So it’s much more than just emergency use.

We know from what’s happened over the past several years that

we need to take an all-hazards approach to emergency preparedness. We need to have a more resilient society. So with that in

mind, I want to cover four areas today.

First, investing in the capability to distribute—to have a distributed Federal work force. Second, using the flu pandemic to break

down Federal barriers. Third, addressing the burden that a flu

pandemic could have on the overall information infrastructure. And

fourth, offer a few recommendations.

The scenarios that play out that we see on various network TV

shows, I don’t think we need to recall necessarily what could happen during a flu pandemic. But the reality is that today’s Federal

work force, most of the contingency plans are designed for a maximum downtime of 2 or 3 days. And if you actually look at the circulars that are put together, they go out to, if you will, 30 days.

Ensuring the continuity of Government operations for an extended period is a central responsibility of this Government’s leadership. Moreover, when you look at the continuity plans as they

exist today, often they have people moving from one facility together to another facility. And as we know from the White House

plans, that’s not going to play out right in a flu pandemic.

The private sector has been pursuing telework for a long period

of time. In fact, with the events of September 11, a lot of the financial industry, if you will, moved their physical facilities outside

lower Manhattan. Now they’re going one step further, and they’re

actually dispersing their personnel, enabling them to work from a

variety of locations. They call this a distributed work force capability.

AT&T, prior to the merger, of course, had a very aggressive

telework program where a variety of employees involving managers, if you will, essential and nonessential employees were able

to telework on a frequent basis. The benefits are, if you will, well

known and widely accepted in the private sector. But we have

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roughly one tenth of the Federal work force that is able to telework

today, where you have at least 20 percent in the private sector.

When we look at the barriers to a distributed work force, I think

there are a number of issues that would come to mind. In large

part, they’re systemic. I think it’s interesting to note there was a

lot of conversation earlier today about guidance. But just this

March, GSA issued guidance which had a few very key points in

it.

First, agencies now are able to pay for broadband installation

and monthly access. Second, they can provide new or excess equipment for people to use. Third, they can provide help desk support

so we can keep on having task forces, if you will, that talk about

issuing new guidance, or we can actually implement the guidance.

I note that Emergency Preparedness Circular No. 65, which was

recently redone, also includes a reference to telework. So the guidance exists today for Federal agencies to do more in telework.

I do want to note, before I move on to my recommendations, that

we do need to think about the burden on the overall information

infrastructure during a crisis. We saw this after September 11th.

We saw it in Katrina. I know your committee has looked at this.

But we need to think more widely about what would happen. We

need to get the appropriate private sector folks involved from

whether it’s the NSTAC or NIAC, which are both Presidential advisory committee.

If I can look at recommendations, I would say, first of all, we

need a top-down approach from the White House involving the Office of Management and Budget and the Homeland Security to

push down into Federal agencies the need to telework and to set

strict metrics.

Second, as I mentioned, I think NSTAC and NIAC, these Presidential advisory committees need to look closely at the issue of the

burden on the information infrastructure.

And third, I would encourage Congress to pursue a three-pronged

strategy. A, look at what statutory barriers there might be to the

expansion of telework. For example, I understand from my conversations that agencies, if you will, don’t have the incentive to

pursue telework because any gains they may make or—excuse me,

savings they may make have to be returned to the Treasury.

Also there was a recent study that was done that talked about

FISMA being perceived as a potential barrier to telework. I think

it’s worthwhile exploring that issue as well.

And then, finally, I think we ought to think about, if you will,

a carrot and stick approach. Incentivize agencies so they can win

at telework.

Finally, to close, Mr. Chairman, I know last year at this time,

you talked about the need to decentralize Federal agency—Federal

agency operations. And I really don’t think, you know, since last

year, even since September 11th, we’ve really had that change in

mindset, to change from brick and mortar mentality to a decentralized Federal Government operation.

Thank you.

[The prepared statement of Mr. Kurtz follows:]

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Chairman TOM DAVIS. Thank you very much.

Dr. Plough.

STATEMENT OF ALONZO PLOUGH

Mr. PLOUGH. Thank you, Mr. Chairman and members of the

committee.

On behalf of Trust for America’s Health, I really appreciate this

opportunity to testify on this critically important issue of pandemic

influenza preparedness.

I am here representing Trust for America’s Health, where I serve

on the board of directors. I’m currently vice president for the California Endowment, a private philanthropy in the State of California also focused on these issues. But my comments are really with

my hat on as a board member.

My comments are really gleaned from my 20 years of experience,

though, as a local public health official—the last 10, as of last July,

as director of the Seattle and King County Department of Public

Health. And that on-the-ground perspective of what it means to be

an effective responder in communities in disasters are the contexts

that I’m drawing on today.

Recently, the public is catching up with the concern we have had

in the public health community around pandemic influenza. It’s

something that we have warned about for years, but I think recent

events and certainly the visibility of these hearings and the visibility of the recently released report, not to mention heightened

media coverage and made-for-TV movies, has raised these concerns

to new levels.

The question is, how do we make sure that we have

operationalized these responses on the ground that can serve the

public well in the event of a pandemic?

Trust for America’s Health and other health organizations actually hear, and I heard a lot when I was a local health official, of

frustration from individuals and businesses that actually believe

that little or nothing can be done. And certainly a sense of fatalism

does not lead to the kind of collaboration needed to develop a good

response to pandemic influenza.

We have gone over in the previous panel the frightening data on

the infection rates and the absenteeism of 40 percent. When I was

a public health official, I was always asked, ‘‘What keeps you up

at night?’’ Pandemic influenza planning was the single factor that

kept me up at night in the complexity of what I looked at in public

health, mainly because a true response is a collaboration between

Government at all levels, business, schools, faith-based organization, the medical community. We’re behind the curve. We need to

prepare now.

I’m very, very proud that Seattle and King County are recognized

as among the most prepared communities in America for pandemic

influenza, and I think it serves as an example of how a community

can prepare, how the Federal Government can best encourage what

local preparedness looks like. And I’m going to tell you briefly some

of the things we did over those last 10 years to get to that position.

We started by defining clear lines of authority and accountability

during health emergencies. The public health department is in

charge in that jurisdiction, maintaining central coordinating role,

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incident command role around all other governmental structures.

This operational clarity is one of the—or lack of operational clarity

is one of the weakest points of many other local plans, as well as

the Federal plan.

Seattle and King County also benefit from having a unified public health department that includes emergency medical services. It

serves both all the 40 cities in the county as well as the county as

a whole. It means that public health, health care providers, first

responders, trauma units, and hospitals are all connected on the

ground in a way that is not common practice in most cities and

counties across the country.

Additionally, Seattle and King County have an all-hazards approach to Federal preparedness. Despite of how the targeting of the

funds might go, this health department thinks about what do we

have to do to be ready for all kinds of threats? So clear authority,

collaboration throughout the community, judicious use of Federal

funds are the ingredients that led to our success and could be modeled across the Nation.

On May 3rd, the White House unveiled the detailed implementation plan for pandemic influenza. Three hundred activities already

cited today—tied to specific accountability, measured in timelines—

are part of that plan. And while we commend that plan in many

ways, the real measure of effectiveness of a plan is its implementation and how it works on the ground.

And Trust for America’s Health plans to actively monitor the

progress of how this plan is actually carried out with the nuances

of community responsibility, and through that lens, we’ve identified

a few specific concerns.

Well, first, it’s unclear what individual and which agency will

lead the Federal response during a pandemic. The plan currently

gives responsibilities to both the Department of Health and Human

Services and the Department of Homeland Security without making clear which of these departments is ultimately accountable. We

know that at a local level, you do need single accountability.

And Trust for America’s Health strongly believes that HHS

should be designated as the lead agency, with the Secretary

charged with coordinating other Federal efforts. This is a health

crisis, and health expertise should guide all of the decisions. It

would mirror the structure that’s worked so well in Seattle and

King County.

Second, the plan does not adequately address the financial blow

that the country would take during a pandemic outbreak. For example, once an effective vaccine is available, there are no measures

in place to figure out how much it will cost, who will purchase the

600 million doses. We really cannot leave such important implementation decisions to the middle of a national crisis.

Beyond improving the plan, there are other steps that must be

taken to ensure the Nation is prepared. Trust for America’s Health

has identified some specific recommendations that are detailed in

my written testimony. Let me just highlight a couple of those.

Where you live in this country, shouldn’t—rural, urban—where

in the country shouldn’t determine what your level of preparedness

is. We need to be much more even on that. Right now, planning

largely rests on State and local shoulders. It’s unacceptable to leave

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communities virtually on their own with respect to preparing for

pandemic flu, particularly leaving communities with large nonEnglish speaking populations, like in California, with fewer resources at higher risk.

Health and Human Service, in consultation with public health

and medical professionals, should develop much more detailed

guidance for State and local officials so this on-the-ground response

matches the diversity of what preparedness means across our country. There should be priorities for—clear prioritization for the populations that are going to get limited vaccines, incentivizing mechanisms for health care workers, and equitable distribution of federally held stockpile.

Second point is that there will be ongoing life and activity after

a pandemic, and we really need to ensure that the consequence

management system is sound. The Government needs to take steps

right now to ensure sustainability of the health industry.

This kind of response that hospitals and health providers will

have to a pandemic could shut down our emergency care facilities

just at the point when we need them most. People could not seek

diagnostic care because they don’t—can’t pay for this. This is not

a time to have individuals, because they are uninsured, also become high probability carriers of a flu in a flu outbreak.

So it’s very important that we not let affordability of the health

care be a barrier to people seeking treatment and not spreading

this influenza. So Trust has proposed the creation of a standby

Medicaid authority that would grant emergency temporary Medicaid eligibility to individuals who are uninsured. This really helps

to preserve our hospital infrastructure and make sure that individuals get treated and don’t spread the disease.

In conclusion, considerable progress has been made, really even

since the 10 months that I have not been a health officer. Given

where we were a year ago, I’m actually really shocked where we

are today. This plan is a great improvement over the past, and a

lot of progress has been made.

Lots of flaws to fix. A lot of specificity is needed. And Congress

needs to really act now.

Thank you for letting me talk to you.

[The prepared statement of Mr. Plough follows:]

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Chairman TOM DAVIS. Thank you.

Mr. Kriens, you have to leave in a couple of minutes is my understanding. Is that——

Mr. KRIENS. We’ve extended a bit of time. So please.

Chairman TOM DAVIS. All right. Thank you.

Well, let me start. Why do you think that Federal employees

have been slow to roll out or the Federal Government has been

slow to roll out teleworking employees? Now that you are sitting

there, both to ask you and Mr. Kurtz. And how can we get buyin from senior management? How do you do it in the private sector?

I will start with you, Mr. Kriens.

Mr. KRIENS. It’s, as you know, multi-faceted, Mr. Chairman. But

if I were to put it in a commonly used phrase, I think we’re trying

to boil the ocean. And what we really need to do is to have use of

teleworking spread in the same way the Internet itself developed,

which was to sprout up in pockets and then have those pockets

communicate with one another.

Ironically, as we sit here talking about pandemics, it’s something

we call ‘‘viral progress’’ in the deployment of communications and

new technology. Because as people see the benefit of it through use

by others and talk amongst themselves, it makes more progress in

deploying these technologies than anything we can legislate or that

we can dictate or that we can plan a report on.

So it’s one of the reasons for our recommendation that, really, if

this starts with the leadership, such as yourselves and others who

are familiar with this and do use it, taking it to heart and spreading it from the top down, that will do more to motivate progress

and acceleration than anything that we can do from the bottom up.

Chairman TOM DAVIS. We try here at the legislative branch. But

ultimately, this is an executive branch function. We have continued—Mr. Davis has legislation moving, trying to get the Government to move on it. And it has just been very, very slow.

Mr. Kurtz, any comment on that?

Mr. KURTZ. Yes, I would—there are three factors that I intend

to contribute. I think one is Cabinet-level agencies don’t necessarily

have the incentive to aggressively pursue telework. I know that in

the GSA survey that was released last year, it talks about, you

know, who has more telework versus less.

And it’s very interesting to look at several of the senior agencies,

including Labor, Treasury, and HUD. The actual number of people

who are eligible for telework has gone down. So I think, you know,

there is a budgetary issue that needs to be addressed.

Second, I think there is a perception among IT managers that

perhaps FISMA is a barrier. I think that’s probably misplaced. But

FISMA could be used as, if you will, a reason as to why one cannot

pursue telework.

I understand at DHS, at least, that they don’t allow the use of

wireless. Well, it’s kind of hard to telework if you don’t have any

sort of wireless technology capabilities. There are technologies

today to handle all of the security, the authentication issues associated with telework.

The third issue I think is basically managers wanting to have

eyes on their employees. And once again, we have technology that

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is available today that helps managers understand what their employees may be doing from afar. In other words, when I might come

onto the computer, what applications I may access. Those type—

you know, how long I’m on the system.

Those kind of issues, I think, combined, those three, create an

environment where senior-level managers and agencies are not

pursuing telework. You’ll note that I have not said security is an

issue. The technologies are out there today in order to have secure,

reliable telework, and the private sector is case in point.

One final point that I think is fascinating, and you look at

AT&T, the old AT&T, if you will, before the merger. Forty percent

of their management was able to telework. When you ask that

question of Federal executive managers, 30 percent are not allowed. That was the response, 30 percent are not allowed to

telework.

And so, you know, set the standard at the top. Have managers

themselves begun to telework. The guidance is in place. We don’t

need more guidance. It’s just starting to do it.

Chairman TOM DAVIS. In fact, until I think a couple of years ago,

when we passed legislation out of this committee, Federal contractors weren’t allowed to charge telework back to the Government.

And sometimes that is the most productive work.

Mr. Kriens, let me ask you the last-mile solution, such as residential broadband, will be relied on if the Federal civilian employees are to telework. How are these networks designed to ensure resilience?

Mr. KRIENS. The primary source of the resilience is actually in

the dispersity and the breadth of the physical infrastructure itself.

By the time one gets to the last mile, whether that’s a copper wire

or a coaxial cable or, in some cases, as Paul mentioned, a wireless

access, the pure dispersion of that is the very diversity that we

need.

Any one of those points or perhaps even a neighborhood can be

affected, but the protection is in the dispersion of the work force

across many tens or hundreds of square miles. And there are also

for key executives or for key needs an ability to, by the very nature

of the competing entities here as service providers, the cable operator and the wireless operator and the traditional wire line telephone company have built three separate infrastructures.

So in the case of critical executives, it’s quite possible for literally

$50 a month to duplicate redundant capabilities and facilities all

the way into the offices in the home of critical executives. So it’s

a cost issue, but it’s a very modest one in the case of protecting

senior leadership from any physical diversity requirement——

Chairman TOM DAVIS. It has to be done now. I mean, you don’t

want to sit and wait until this thing is on top of us.

Mr. KRIENS. We cannot wait to put this in place when the work

force has been immobilized. Not just the work force that we speak

of, but those who must enable and go out and deploy and make

those connections.

We have the ability to do that now. I think it’s clearly within

reach and within technical means without question. And so, now

is certainly the time, and it’s easily doable.

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Chairman TOM DAVIS. And you don’t feel that basically from

that, that our agency employees that deal with sensitive and classified information, those are very resolvable if we stay ahead of the

game?

Mr. KRIENS. Again, the best example of that is we’re using the

very same technology to protect our troops in battle with the ultimate reliability requirement. They are relying today in work we do

with the defense agency, you know, we are relying on battlefield information as an alternative to deploying contingent troops and materiel in battle because we need that information to know the specificity and location and magnitude of enemy force.

And we are relying on it to that degree that we are keeping our

men and women out of harm’s way as a result of the use of this

technology every day in conditions much more demanding than

those that would be required to reach a given neighborhood in this

country.

Chairman TOM DAVIS. Thank you.

Mr. Issa.

Mr. ISSA [presiding]. Thank you, Mr. Chairman.

I will be fairly brief. I realize that you are, even with an extension, on a short leash time wise. And Mr.—I apologize—Klines?

Mr. KRIENS. Kriens.

Mr. ISSA. Kriens. I apologize. I am a little concerned, though,

about the statement you made on $50 a month. I telecommute relatively effectively, but—and by necessity. But you can’t do it for

$50 a month.

Are you saying that you think that the average Federal employee

or health care provider, first responder will provide all of the software and hardware, and all we have to do is pay for the connection? Where do you get the $50 figure?

Mr. KRIENS. And let me clarify, Congressman Issa, the—I was

really specifically answering the question of redundancy. So there

is an initial cost, as you accurately described, for setting up the

computing capability, the software and security. And that will vary

depending on the amount of performance and processing power.

The $50 a month is actually probably more than it would cost to

deliver the physical redundancy. So that if there were a capability

via your traditional telephone supplier on a DSL line over copper

and one were to seek a cable line for backup or wireless access for

backup, the incremental cost of that access in various counties and

States around this country is in the sometimes $29 to $30 a month

range.

But I was really referring purely to the cost of the chairman’s

question on providing physical diversity. There’s a cost, it would

probably be more in the $100 range, which would be the establishment of the capability, maybe $150 if you wanted to amortize the

equipment as well, in setting up the telecommuting/telework capability.

And then the additional moneys would be for providing the physical redundancy for critical need.

Mr. ISSA. And how many health care professionals do you think

would be required? In other words, give me the gross number of

people so we can do the multiple.

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Mr. KRIENS. The gross number of people that would need to

telework in an emergency?

Mr. ISSA. Yes.

Mr. KRIENS. I’m not sure one would be capable or I’m not capable

certainly of predicting that here without having a guess as to the

magnitude——

Mr. ISSA. More than 100,000?

Mr. KRIENS. More than 100,000 people?

Mr. ISSA. Well, if we look at every location in the Nation——

Mr. KRIENS. Uh-huh.

Mr. ISSA. And we look at every person that you would like to

have this redundancy capability—and I am not trying to be unfair

to your proposal. I actually want to embrace it. I am looking at

when we try to turn, you know, it is like, you know, Dr. Plough?

Mr. PLOUGH. Plough.

Mr. ISSA. Plough. Thank you. Had—I am not doing good on

names today.

Mr. PLOUGH. That’s OK.

Mr. ISSA. But, you know, I appreciate that we need 600 million

doses of X worldwide. But then there is X, Y, Z, A, B, C. In a recent

trip to Geneva, one of the questions, you know, that you have to

ask is, do we invest in the ability to quickly find or quickly refine

and distribute in the future Z when it comes along, or do we stockpile A, B, C, D, E, F, G of various known? And what are the cost

tradeoffs?

So I really believe, and you have Virginia’s former secretary of

technology right behind you. So he will smile when I say this. I

really believe America needs to be connected from a redundancy

standpoint in every home and that this has to be a basic capability.

Then the question is whether you are a health care professional,

an AT&T executive, or a Congressman, or a school teacher, how do

we analyze how much is going to be borne by our middle class citizens, and how much is going to be borne by potentially Government agencies?

Mr. KRIENS. It’s an excellent point, and I have an affinity for

practicality. So let me respond in kind. The actual physical redundancy requirement, I would believe, is actually quite limited because it’s only the senior executive and senior leadership for whom

that degree of accessibility on an uninterrupted basis would be required.

As the reports and various study of this has delineated, there are

executive leadership, there is essential and potentially nonessential, or I would prefer to think of them as perhaps less essential, for whom the redundancy is not a requirement because there

are others who could substitute. And the real availability, which is

a different term, is borne by the fact that the dispersed work force

is scattered over hundreds or, in the case of the country, millions

of square miles.

So there is no effect that would likely take out more than a pocket of them, and there are others who could substitute and fill in

and come from other areas. And as a result, there isn’t a need for

this kind of redundancy or additional expense other than for the

senior.

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And I would just start at the ultimate irreplaceable leadership.

The President of the United States literally has a mobile cell that

follows him across his ranch in Crawford, TX, and goes down into

the gullies when he decides to go chop wood so that he is accessible, obviously, on a moment’s notice.

From there, one could step down——

Mr. ISSA. And his is fully secure at the highest possible security

level, too?

Mr. KRIENS. We spend a lot of time at Juniper making sure of

that, as a matter of fact. But we can quickly move to a case where

much of the leadership really can be substituted for or for which

contingency planning could avoid the hard cost, and it certainly

would echo your point that we have to be practical about this and

reserve those kinds of duplicate costs for only the premium and

really irreplaceable leadership requirements.

Mr. ISSA. And would that number be relatively similar if, instead

of talking about a pandemic, we were looking at the next Hurricane

Katrina?

Mr. KRIENS. It’s an interesting thing. Yesterday, I’m in town also

as a member of the National Security Telecommunications Advisory Committee that reports to the President, and we had our

meeting yesterday. And one of the comments that was made was

that Katrina itself actually replicates in many cases a nuclear

threat example and certainly a pandemic example because the

water didn’t come in and go out.

Most hurricanes and floods and tornadoes and other events happen over the course of 24 or 48 hours, and then we are able to rebuild the infrastructure and recover. And Katrina is actually a fantastically frightening example of what can happen if the threat is

sustained and carries over weeks and months. And there’s an inability to reach infrastructure, to reestablish power, to reestablish

communications, command, and control.

So it’s quite an opportunity for us to learn about how we would

conduct continuous operations, and the pandemic is going to be another example of that, if and when and to what magnitude it hits.

Because we will have extended loss of access to facilities and resources, and we have the wherewithal to continue operations during that extended and very difficult condition.

Mr. ISSA. OK. I am going to not belabor this point, but is one

that I am sure this committee was going to deal with in the future.

One last sort of the exit question that often we ask. When looking at the President’s recent proposals, 300 and some items, if you

were to break them down, how many of them are dual or multiuse and have relatively small cost other than the, if you will, the

preparation, the thinking, the one-time cost of preparing versus

what are the major, when you get to the other extreme, what are

the major items that we have to look at—not in this committee, but

in the Committee on Appropriations—that are significant, very significant dollars and not one time? If you would just touch on the

key ones.

Mr. KURTZ. Maybe I’ll try to come to your—let me try to come

to your question a different way. I’m not going to position myself

as being able to analyze the full plan that the President has put

together. But in your previous question——

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Mr. ISSA. Pick five or six. That would probably do it.

Mr. KURTZ. We’re talking about cost.

Mr. ISSA. Yes.

Mr. KURTZ. And I think there are a couple of things that strike

me when we talk about the area that I know best, and that is on

a communications side. And first of all, just 2 or 3 years ago, we

couldn’t talk about having, if you will, Web-based applications.

They’re far more prevalent than there are today.

You made a statement that, you know, who’s going to buy all the

software? Well, the fact is, I can be at home now, and I can tap

in through technologies that are available today that don’t require

me to have software on my computer. I can use a Web-based application to go in, to tap into the home bank or the enterprise, and

see what I need to do and do my business.

The other thing—the other issue I’d highlight with regard to

cost. A lot of the cost associated with the pandemic or planning a

pandemic, if you will, may be one-time cost or a sum cost. That’s

not the case when you think about telework.

Telework helps us with routine activity every day, everyday business activity in the Federal Government. It also helps us with all

hazards. It’s not just a one-time sum cost to help us with a pandemic. It helps us with a hurricane. It helps us with a terrorist attack. It helps us with a blizzard. And so, if we can change our

mindset to think more broadly about this, then I think it would be

helpful.

And the final comment, if I can, is to think about scope. There’s

a lot of conversation about only essential employees. I disagree. I

think we ought to dig deeper into the agency and think more

broadly about who is included and just as a—as an estimate, you

know, the top third or so of the agency.

So that when we look at contingency plans as the guidance that

the Federal Government has today, it’s 72 hours or so that you can

exist on essential employees. Then you’re dispersing to a location

for like 30 days. It’s only the top employees.

Well, when you look at the plan that the White House has put

together, we’re well beyond 30 days. So the essential employees are

not—not—going to be able to keep the operation going for an extended period of time. So we have to dig down more deeply into

agencies as we think about the flu pandemic.

Mr. PLOUGH. If I could just respond from the public health side?

Mr. ISSA. Yes, please.

Mr. PLOUGH. The President’s plan builds multi-use capacity that

is applicable to many kinds of infectious diseases, earthquake,

floods, because it heightens the connectivity of first responders

with community in a way that, if funded appropriately, is sustainable and builds a missing piece of our protective structure for public health.

So those—there are sustainable and multi-use components of

this. Pandemic is one of the worst cases. If you are properly prepared for pandemic influenza, you are prepared for SARS, you are

prepared for West Nile, you are prepared for an earthquake. You

are prepared for a variety of public health disasters.

Mr. ISSA. Excellent. Well, I don’t have any other questions.

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The record will remain open for 5 legislative days for any additional questions from people that are not able to be at the dais and

so you may revise and extend as your rather cogent capabilities

allow you to think of things.

In addition, I would like to thank you very much for the generosity of your time, being here today, and the thoroughness, including

the fact that no one is rubber-stamping somebody else and that we

do have a very active debate because of this hearing between what

happens on day 1 and what happens after day 30.

And with that, we stand adjourned.

[Whereupon, at 12:17 p.m., the committee was adjourned.]

[The prepared statements of Hon. Dan Burton and Hon. Darrell

E. Issa follow:]

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