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85–125 PDF 2003

HOW EFFECTIVELY ARE FEDERAL STATE AND

LOCAL GOVERNMENTS WORKING TOGETHER

TO PREPARE FOR A BIOLOGICAL, CHEMICAL

OR NUCLEAR ATTACK?

HEARING

BEFORE THE

SUBCOMMITTEE ON GOVERNMENT EFFICIENCY,

FINANCIAL MANAGEMENT AND

INTERGOVERNMENTAL RELATIONS

OF THE

COMMITTEE ON

GOVERNMENT REFORM

HOUSE OF REPRESENTATIVES

ONE HUNDRED SEVENTH CONGRESS

SECOND SESSION

APRIL 2, 2002

Serial No. 107–167

Printed for the use of the Committee on Government Reform

(

Available via the World Wide Web: http://www.gpo.gov/congress/house

http://www.house.gov/reform

(II)

COMMITTEE ON GOVERNMENT REFORM

DAN BURTON, Indiana, Chairman

BENJAMIN A. GILMAN, New York

CONSTANCE A. MORELLA, Maryland

CHRISTOPHER SHAYS, Connecticut

ILEANA ROS-LEHTINEN, Florida

JOHN M. MCHUGH, New York

STEPHEN HORN, California

JOHN L. MICA, Florida

THOMAS M. DAVIS, Virginia

MARK E. SOUDER, Indiana

STEVEN C. LATOURETTE, Ohio

BOB BARR, Georgia

DAN MILLER, Florida

DOUG OSE, California

RON LEWIS, Kentucky

JO ANN DAVIS, Virginia

TODD RUSSELL PLATTS, Pennsylvania

DAVE WELDON, Florida

CHRIS CANNON, Utah

ADAM H. PUTNAM, Florida

C.L. ‘‘BUTCH’’ OTTER, Idaho

EDWARD L. SCHROCK, Virginia

JOHN J. DUNCAN, JR., Tennessee

——— ———

HENRY A. WAXMAN, California

TOM LANTOS, California

MAJOR R. OWENS, New York

EDOLPHUS TOWNS, New York

PAUL E. KANJORSKI, Pennsylvania

PATSY T. MINK, Hawaii

CAROLYN B. MALONEY, New York

ELEANOR HOLMES NORTON, Washington,

DC

ELIJAH E. CUMMINGS, Maryland

DENNIS J. KUCINICH, Ohio

ROD R. BLAGOJEVICH, Illinois

DANNY K. DAVIS, Illinois

JOHN F. TIERNEY, Massachusetts

JIM TURNER, Texas

THOMAS H. ALLEN, Maine

JANICE D. SCHAKOWSKY, Illinois

WM. LACY CLAY, Missouri

DIANE E. WATSON, California

STEPHEN F. LYNCH, Massachusetts

———

BERNARD SANDERS, Vermont

(Independent)

KEVIN BINGER, Staff Director

DANIEL R. MOLL, Deputy Staff Director

JAMES C. WILSON, Chief Counsel

ROBERT A. BRIGGS, Chief Clerk

PHIL SCHILIRO, Minority Staff Director

SUBCOMMITTEE ON GOVERNMENT EFFICIENCY, FINANCIAL MANAGEMENT AND

INTERGOVERNMENTAL RELATIONS

STEPHEN HORN, California, Chairman

RON LEWIS, Kentucky

DAN MILLER, Florida

DOUG OSE, California

ADAM H. PUTNAM, Florida

JANICE D. SCHAKOWSKY, Illinois

MAJOR R. OWENS, New York

PAUL E. KANJORSKI, Pennsylvania

CAROLYN B. MALONEY, New York

EX OFFICIO

DAN BURTON, Indiana HENRY A. WAXMAN, California

J. RUSSELL GEORGE, Staff Director and Chief Counsel

JUSTIN PAULHAMUS, Clerk

(III)

C O N T E N T S

Page

Hearing held on April 2, 2002 ................................................................................ 1

Statement of:

Burton, Dr. Richard, associate director, California Department of Health

Services; Ray Riordan, emergency preparedness officer, East Bay Municipal Utility District; Janet Cherry, associate, the Cadmus Group,

Inc.; Patricia Dalton, Director, Strategic Issues, U.S. General Accounting Office; Larry A. Mefford, Associate Special Agent in Charge, San

Francisco Field Office; Dr. Steven Bice, Director, National Pharmaceutical Stockpile, Center for Disease Control and Prevention; and Ron

Castleman, regional director, Region VI, Federal Emergency Management Agency .................................................................................................. 67

Canton, Lucien G., director, mayor’s Office of Emergency Services, city

of San Francisco; George Vinson, Special Advisor to the Governor on

State Security, State of California; John F. Brown, M.D., M.P.A.,

F.A.C.E.P., attending physician, San Francisco General Hospital, assistant professor, University of California, San Francisco; Dr. Frances

Edwards-Winslow, director of emergency services, city of San Jose;

Mario H. Trevino, chief of department, San Francisco Fire Department;

Prentice Sanders, Assistant Chief, San Francisco Police Department;

Ronald W. Cochran, laboratory executive director, Lawrence Livermore

National Laboratory ..................................................................................... 12

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

Bice, Dr. Steven, Director, National Pharmaceutical Stockpile, Center

for Disease Control and Prevention, prepared statement of ..................... 104

Brown, John F., M.D., M.P.A., F.A.C.E.P., attending physician, San Francisco General Hospital, assistant professor, University of California,

San Francisco, prepared statement of ......................................................... 41

Burton, Dr. Richard, associate director, California Department of Health

Services, prepared statement of ................................................................... 69

Canton, Lucien G., director, mayor’s Office of Emergency Services, city

of San Francisco, prepared statement of ..................................................... 15

Castleman, Ron, regional director, Region VI, Federal Emergency Management Agency, prepared statement of ..................................................... 114

Cherry, Janet, associate, the Cadmus Group, Inc., prepared statement

of ..................................................................................................................... 86

Dalton, Patricia, Director, Strategic Issues, U.S. General Accounting Office, prepared statement of ........................................................................... 123

Edwards-Winslow, Dr. Frances, director of emergency services, city of

San Jose, prepared statement of ................................................................. 48

Honda, Hon. Michael M., a Representative in Congress from the State

of California, prepared statement of ........................................................... 6

Horn, Hon. Stephen, a Representative in Congress from the State of

California, prepared statement of ................................................................ 3

Mefford, Larry A., Associate Special Agent in Charge, San Francisco

Field Office, prepared statement of ............................................................. 92

Riordan, Ray, emergency preparedness officer, East Bay Municipal Utility

District, prepared statement of .................................................................... 77

Sanders, Prentice, Assistant Chief, San Francisco Police Department,

prepared statement of ................................................................................... 28

Trevino, Mario H., chief of department, San Francisco Fire Department,

prepared statement of ................................................................................... 22

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HOW EFFECTIVELY ARE FEDERAL STATE

AND LOCAL GOVERNMENTS WORKING TOGETHER TO PREPARE FOR A BIOLOGICAL,

CHEMICAL OR NUCLEAR ATTACK?

TUESDAY, APRIL 2, 2002

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON GOVERNMENT EFFICIENCY, FINANCIAL

MANAGEMENT AND INTERGOVERNMENTAL RELATIONS,

COMMITTEE ON GOVERNMENT REFORM,

San Francisco, CA.

The subcommittee met, pursuant to notice, at 10 a.m., in the

Phillip Burton Federal Building and U.S. Courthouse, Ceremonial

Courtroom, San Francisco, CA, Hon. Stephen Horn (chairman of

the subcommittee), presiding.

Present: Representatives Horn and Honda.

Staff present: J. Russell George, staff director and chief counsel;

Bonnie Heald, deputy staff director; and Justin Paulhamus, clerk.

Mr. HORN. A quorum being present, this hearing of the Subcommittee on Government Efficiency, Financial Management and

IntergovernmentaL Relations will come to order.

On September 11, 2001, the world witnessed the most devastating attacks ever committed on U.S. soil. Despite the damage and

enormous loss of life, the attacks failed to cripple this Nation. To

the contrary, Americans have never been more united in their fundamental belief in freedom and their willingness to protect that

freedom.

The diabolical nature of those attacks and then the deadly release of anthrax sent a loud and clear message to all Americans:

We must be prepared for the unexpected. We must have the mechanisms in place to protect this Nation and its people from further

attempts to cause massive destruction.

The aftermath of September 11th clearly demonstrated the need

for adequate communications systems and rapid deployment of

well-trained emergency personnel. Yet despite billions of dollars in

spending on Federal Emergency Programs, there remain serious

doubts as to whether the Nation is equipped to handle a massive

chemical, biological or nuclear attack.

Today, the subcommittee will examine how effectively Federal,

State and local agencies are working together to prepare for emergencies. We want those who live in the great State of California

and the good people of San Francisco and San Jose and Long

Beach, CA, to know that they can rely on these systems; should the

need arise.

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We are fortunate to have witnesses today whose valuable experience and insight will help the subcommittee better understand the

needs of those on the frontlines. We want to hear about their capabilities and their challenges and concerns. We want to know what

the Federal Government can do to help with what they may not be

doing.

We welcome all of our witnesses and look forward to their testimony.

[The prepared statement of Hon. Stephen Horn follows:]

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Mr. HORN. We are delighted to have with us today Representative Michael Honda from the San Jose area, former mayor. He will

be the ranking Democrat.

We will do as we do in Washington, that the witnesses and especially those at the State and local level and the first responders,

will have a summary of their written statement. I have read them

all and they are excellent. Don’t read them to us because we just

don’t have the time.

The General Accounting Office goes with us everywhere because

they are our arm for research and what we want to do is get the

essence of it because your statement is automatically in the record

when I call on you. Give us the best points. If we had GAO, we

would have a 40-page presentation or so and they have done 50

studies on the subject. Hopefully there will be more that will help

many of you.

With that, I will swear you in following Mr. Honda’s opening

statement. I now call on him for up to 5 minutes on an opening

statement.

Mr. HONDA. Thank you, Mr. Chairman. I would like to begin by

thanking my colleague Congressman Steve Horn for calling this

field hearing, and especially for his tireless work throughout the

past decade in Congress.

I would especially like to recognize the expertise and dedication

in the area of information security, an issue that is closely related

and closely impacts my Silicon Valley District as well as the entire

Nation. Congressman Horn is retiring from Congress this year,

and, on behalf of the entire California Delegation, I would like to

thank him for his service, his dedication, and vision.

I would like to compliment the Chair for bringing such a diverse

group of Federal, State, and local officials together, and especially

for allowing these State and local representatives to speak early in

this program.

Local civil servants, firemen, law enforcement, personnel,

healthcare workers, and many others are on the frontlines in the

event of a terrorist attack. We in Washington must do our best to

ensure that they are adequately equipped and trained to handle

any such crisis. That is why it is essential that Congress maintain

an open dialog with our first-responders and be responsive to their

concerns.

States and counties are struggling financially to meet their

homeland security needs. In the first 21⁄2 months since September

11th, California local governments have encountered budget overruns of 13 percent in public safety. Cities and counties in California alone estimate over $1 billion in additional one-time and ongoing funding needs for 2002.

On numerous occasions, local officials have expressed to me the

difficulty in adequately preparing their communities and in equipping their first-responders. Many have been forced to double and

sometimes triple their expenditures for everything from 911 operators to police overtime.

Emergency response forces that were once considered more than

adequate are now finding themselves under funded and overworked

often forcing local agencies to delay maintenance and training, or

defer the purchase of new equipment.

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Cities and local municipalities are facing a squeeze on many levels. As they spend more on police overtime and security, they face

lower revenue due to an economic slowdown. States are facing

similar challenges. This means that localities are not receiving as

much funding as they have in the past in the State budget. As local

agencies try to improve their capabilities by increasing training for

first-responders, building better Emergency Response Systems, and

making other needed improvements, they are forced to tap into an

ever-decreasing budget.

The tragic and sudden events of September 11th, and the almost

constant state of alert that all levels of government have been

forced to maintain thereafter, have caused a reexamination of

homeland security throughout the Nation. It is vitally important

that the Federal Government understand this and act to meet

unfulfilled and growing local needs.

I hear people throw around the term ‘‘homeland security’’ as if

it were term, a mainstay of America’s vocabulary. But in truth,

‘‘homeland security’’ is a fairly new term, and its use denotes a

comprehensive and coordinated approach to domestic defense.

Just as the term is new, so is an effort of this magnitude, urgency, and expense.

Last, I would like to share that those of us in Congress understand, at least the Chair and I understand our role and we are

here to hear from the locals as to the kinds of needs that you are

faced with on a daily basis.

If we are going to develop and implement a comprehensive approach to homeland security that can deal with catastrophic events

like biological, chemical or nuclear attacks, we must be sure to

work closely with our colleagues at the State and local level to create an integrated response that maximizes all resources in our

portfolio by minimizing delays and lack of coordination.

I look forward to your testimony this morning. Thank you.

[The prepared statement of Hon. Michael M. Honda follows:]

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Mr. HORN. I thank you, gentlemen. Now, as you know, since it

is an investigative committee of the House we swear in all witnesses. That includes your staff also. If they are going to whisper

to you in the question period, we may as well get everybody involved.

[Witnesses sworn.]

Mr. HORN. The clerk will note that the six witnesses accepted the

oath. We are delighted to have you here and we thank you. You

have submitted wonderful statements and we are going to use

those for a basic report to the House of Representatives.

Then, as I said earlier, we would appreciate it if you would, in

the 5 or 6 or 7 minutes, hit the high-points of what you have put

in for the record. Let us start now with Mr. Canton, the Director

of the Mayor’s Office of Emergency Services in the city of San

Francisco.

We are delighted to have you here, Mr. Canton.

STATEMENTS OF LUCIEN G. CANTON, DIRECTOR, MAYOR’S OFFICE OF EMERGENCY SERVICES, CITY OF SAN FRANCISCO;

GEORGE VINSON, SPECIAL ADVISOR TO THE GOVERNOR ON

STATE SECURITY, STATE OF CALIFORNIA; JOHN F. BROWN,

M.D., M.P.A., F.A.C.E.P., ATTENDING PHYSICIAN, SAN FRANCISCO GENERAL HOSPITAL, ASSISTANT PROFESSOR, UNIVERSITY OF CALIFORNIA, SAN FRANCISCO; DR. FRANCES

WINSLOW, DIRECTOR OF EMERGENCY SERVICES, CITY OF

SAN JOSE; MARIO H. TREVINO, CHIEF OF DEPARTMENT, SAN

FRANCISCO FIRE DEPARTMENT; PRENTICE SANDERS, ASSISTANT CHIEF, SAN FRANCISCO POLICE DEPARTMENT;

RONALD W. COCHRAN, LABORATORY EXECUTIVE DIRECTOR,

LAWRENCE LIVERMORE NATIONAL LABORATORY

Mr. CANTON. Good morning. My office represents a strategic capability for the Mayor of San Francisco. Our job is to coordinate

interagency planning and to stimulate departments talking to each

other and dealing with incidents that require the services of more

than one department.

I think one of the points I would like to make this morning is

that terrorism is not new to San Francisco. We have experienced

this over the years in the 1960’s and 1970’s. We saw shootings. We

saw bombings. It is not something that we don’t think about.

However, even with that background, even with our history,

without the use of Federal funding that we received from the

Nunn-Lugar-Domenici funding in 1996, it is more than likely that

we would not have been able to develop the capacity that we have

today.

From that point of view, Federal funding was absolutely essential to getting us interested and getting us started and providing

us with the political will to do things.

The other thing is that this particular program had a lot of benefits for us as a city. Even though the funding is small and had

some things we had to commit to doing, it allowed us to increase

our capability to respond. It also allowed us to work together better

as a team so there were a lot of good that went beyond just what

the funding provided for.

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That, however, should not be taken as an indicator that we are

prepared for a terrorist attack. I think you will hear from my colleagues that, we better than anybody, understand how much more

we still have to do.

One of the concerns that we had about the funding that was provided was that it really was for first response. A first response

without a followup capability, the ability to deal with the victims

of a particular incident really doesn’t do much. We realized that

the type of incident that we were looking at would involve all hospitals and ambulance services, not only in San Francisco, but

throughout the Bay Area.

Our concern really was that the funding was a good start, but

it was not really enough for everything we needed. One of the problems we had was that funding was based on a needs assessment

done at a national level. They never really came down to us, they

never asked, ‘‘What do you need at the local level?’’ A lot of things

we consider very important to the area, our mutual aid programs,

our ability to respond and work together, our ability to assist other

jurisdictions, were not considered.

The issue of hospitals and the problems we have within the San

Francisco Bay Area were not addressed in any of the funding. Essentially, we took the money that was provided and took the capabilities we had existing, and tried to do as much as we could with

what we had. Again, I don’t think we should look at the funding

received under Nunn-Lugar as meeting all the needs for the city

of San Francisco. I think it’s a good start. I think we’ve come a long

way but there is still a lot more to be done.

Part of the problem that we’ve experienced with the funding is,

again, that it is scattered through a number of different Federal

agencies. The application processes that are involved, the reporting

requirements that are involved vary from agency to agency. In

many cases we don’t know when grant funds are available until the

last possible minute and it is difficult for us to apply for them.

In many cases the type of requirements that are put on us to get

those grant funds are really completely onerous compared to the

amount of funding that we are going to be provided. In many cases

we have to look and say, ‘‘Is the little bit of money we are getting

appropriate for the level of work we are going to have to commit

to this?’’

One of the other things that we found is a number of programs

that have been preexisting have been diminishing in funds over the

years. I mention in my statement about the Emergency Management Preparedness Improvement Grant. That money has seen a

substantial decline in the city of San Francisco over the last few

years.

The other thing that we’ve noticed is that a lot of the requirements for the funds that we are provided with are restrictive. For

example, one of our teams wanted an extra laptop computer. That

was not allowed under a particular funding program and we had

to submit other items. We get grant funds but we are not really

able to make decisions about how we use those funds.

We feel we need funding that allows us the flexibility to respond

to what we feel are our needs. Part of the problem that we have

here is the city like all the other jurisdictions in the United States

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right now, is undergoing a budget crunch. We are looking at a significant shortfall that is going to affect our ability to respond and

it is going to make it very difficult for us to do contingency planning.

Consequently, Federal funds are important but we need to decide

what areas those can be used in. For us in many cases it is easier

for us to get things through our budget, to justify single expenditures or capital expenditures, than it is for us to add additional positions for planning and for doing the sort of administrative work

that some of these programs require.

It’s very important that as we look at how we can stimulate

things, we look at the flexibility at the local level to be able to say,

‘‘I want to use this much money for this purpose and this much

money for that purpose,’’ and give us that flexibility.

What do we envision we would need? A block grant that’s from

a single source, somebody that we can deal with. We are more than

happy to be held accountable for funds that are provided to us.

We’ve been doing that for years. That’s part of our job. What we

would like to see are those requirements reduced to the point

where they are manageable and we can give you some concrete evidence of what we’ve done.

On the other side of the coin, there are other things that you will

hear my colleagues speak about such as intelligence sharing. One

of the problems that we have is it is very difficult for us to know

exactly what’s going on and what is happening in the intelligence

community. That is even to the point where some of our senior law

enforcement officials are not cleared to receive the type of information they need.

There’s very little intelligence that actually reaches us through

the emergency management community. The State of California

has tried to fill the gap for us but it is very difficult because there

is no preexisting condition.

The last thing I would like to mention is that we really do need

some national priorities. What is it you expect us to be able to do

at the local level? What is it we should be focusing on? What is important to us? Also to remember as we do this, as we set these priorities that we are committed at the local level to multi-hazard

planning. We cannot forget that we have things like earthquakes

and tsunamis that we have to deal with on a day-to-day basis. Any

capability we develop must be able to be used for multi-hazard

planning. Thank you.

[The prepared statement of Mr. Canton follows:]

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Mr. HORN. Well, thank you. That’s well said and well done. Since

you mentioned the intergovernmental problems here on information, I am going to put in the record at this point after your testimony the letter that Mr. Shays, who is Subcommittee on National

Security, Veterans Affairs and International Relations. I joined him

in that, or he joined with me.

That is the letter to Mr. Sensenbrenner, the chairman of the

Committee on Judiciary, and we will have that come up when we

get back from the District where he gets H.R. 3483, the Intergovernmental Law Enforcement Information Sharing Act of 2001. I

talked to Mr. Sensenbrenner before I left and came out here and

he said that should have been done months ago and we are going

to do it. The FBI is being very helpful on this.

Let us go on now to the people that are really on the firing line.

That’s Mario H. Trevino, the Chief of the Department of Fire for

the city of San Francisco.

Mr. TREVINO. Good morning. Thank you, Mr. Chairman. I would

like to begin by thanking you for the invitation to testify before

you. But mostly to thank you for continuing to take the potential

threat of terrorism as seriously as you obviously do.

The events of September 11th, as you stated previously, have

very dramatically illustrated the responsibility that we in the fire

service will bear in the event of a domestic terrorist attack.

Our fire department here in San Francisco has since participated

in a number of preparedness efforts and drills in conjunction with

other local State and Federal agencies which I would be happy to

describe for you more fully once we get the microphones straightened out.

Most significantly what we’ve done is we have redirected our

planning and training efforts to focus on terrorism type incidents.

For example, in the event of a bomb-type situation we need to focus

on training our people to be aware of the potential for secondary

devices and to maintain the security of our personnel since we

know that we will be unable to help anyone if we ourselves become

injured. We are doing everything we can to harden the city and

county of San Francisco against such potential threats.

At the Federal level there is expertise, I think, located in various

different components around the country. It seems that the most

important message we would like to extend to you is what is necessary for us is a single point of contact for emergency agencies to

deal with through the Federal Government so that we can not only

provide input, but also receive information. As my companion, Lou

Canton, has indicated, it is essential that we get up-to-the-minute

intelligence information as it is allowed to be received by agencies

such as ours.

A second point that, I think, is very important is in the issue of

grant funding. We are encouraged by the level of funding that is

making its way through Congress at this time, the $900 million in

fire grants and the potential for $3.5 billion for homeland security.

The point that I would like to make is it is essential that those

funds, if past through the States, as I understand they will be, that

process is done so without any redirection of those funds so that

as much of the money as possible comes to the aid of the emergency agencies that will be responding.

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We know, and I know after 29 years of experience in the fire

service, that in the event of such a disaster the first responders

that you see represented here today will be alone and work the disaster until other assistance arrives and that could be anywhere

from hours to days.

I would also like to make a point of the fact that I am a member

of the Terrorism Committee of the International Association of Fire

Chiefs.

We work very diligently to try and preplan not only for our individual fire departments, but for fire departments across the country and bring those messages back to them to help them identify

funding, help them identify strategies, and to direct whatever efforts they can to make them as solvent and as effective as possible.

I am prepared to answer any questions you may have.

[The prepared statement of Mr. Trevino follows:]

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Mr. HORN. Thank you. We will now move to the Assistant Chief

of the San Francisco Police Department, Prentice Sanders.

We are glad to have you here, Mr. Sanders.

Mr. SANDERS. I am very honored to be here, sir, and certainly

want to thank you and your committee for having the interest in

our first-responders and the people who are going to be on the

frontlines in dealing with a new phenomenon in our American system of government.

We have, as law enforcement, had to switch to an entirely new

job. We are beyond not only keeping our traditional job of fighting

crime in our streets. We are now set with a job of preparing for

and deterring acts of violence similar to those of war.

We are also looking at new systems of how we are to respond to

massive damage. In 1996 the Nunn-Lugar bill responded to Washington. I responded to Washington with a team, and the team that

you are looking at here at the table, to attempt to cope with something that is totally out of the American—we didn’t have any experience at it.

However, San Francisco, based on some prior natural disasters,

we had a little bit of a head start. San Francisco received some

Federal grants and we started to see where best to use those Federal grants, even though they were not adequate to cover all the

things that we needed.

What have we done to this point? In 1998 San Francisco purchased some protective equipment. Being police officers we will almost always be the first-responders when there is trouble, and certainly as depicted in our heros and brothers and sisters in New

York and Washington, DC, we are the ones who have to run toward whatever is going on that is a catastrophe. We started to look

at how we can protect those individuals and receive the type of

equipment and protective clothing they would need.

We also formed a Metropolitan Medical Task Force and a team

where all safety personnel, medical personnel, and those persons

who will be responsible for handling the very first stages after an

event. We put together that team and started to setup systems to

deliver services and stabilize situations wherever they may happen.

And certainly keeping in mind weapons of mass destruction both

chemical, biological, radiological and other highly explosive systems.

What do we need? Certainly, I was very happy when I learned

that you brought your committee here. We need funds. The greatest ideas in the world can’t be consummated without having adequate funding. We are looking at the funding that we have and

looking at the system of delivering that funding.

We would like to work with our State and Federal people to see

that we can get that funding in an adequate fashion so that we can

have in place an adequate system of responding to the kinds of catastrophes that our world now tells us that exist.

That is an overview of what we have done. Let’s talk about what

we’ve planned. Law enforcement is in an entirely new learning

mode. The San Francisco Police Department developed the fivephase program to begin to answer mass casualty incidents. We also

have been holding tabletop exercises and drills with the other

members of our team so that we learn to work as a team. Like any

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other good team, each party knows their part in the play and carries that part out.

We focused a great deal on schools because if there would be a

catastrophe there, whatever catastrophe may happen in our city,

we want to be sure that our young people are able to, first of all,

be safe and able to coordinate a system that can reunite them with

their families at the earliest possible time.

The responsive procedures we are setting-up, and we’re certainly

learning from one another, our extension of our police procedures

and handling of violent mass casualty incidents. We have coordinated among all of the other jurisdictions, public safety jurisdictions within our jurisdictions and neighboring jurisdictions.

What’s up now? Deterrents and response. Deterrents have now

become, as I pointed out—there are people among us who would

bring this upon us. We have setup deterrents and then created a

response form methodology for responding to it.

I will be happy to answer any questions, and certainly inside of

the document that I gave you is a detailed look at the plans for San

Francisco. Again, we appreciate you coming and showing interest

in our city.

[The prepared statement of Mr. Sanders follows:]

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Mr. HORN. We thank you now only for your oral statement but

your written statement as well. That was very helpful.

We now go to Dr. John Brown, the Attending Physician for the

San Francisco General Hospital and Assistant Professor at the University of California, San Francisco. For those that didn’t know

they had a campus in San Francisco, they have one of the world’s

greatest medical schools in dental, I guess, and nursing is still

there. I remember seeing it when Earl Warren was still Governor

and that was one of his great contributions. Thank you for coming.

Mr. BROWN. Thank you, Representative Horn and Representative

Honda. I appreciate the opportunity to talk with you. I am Dr.

John Brown, the medical director of the San Francisco Emergency

Medical Services System. I also work as an attending physician at

the Emergency Department at San Francisco General Hospital.

I would just like to highlight a few areas of the testimony I’ve

submitted to you. First, I want to say that we have come a long

way in the 4-years of our participation in the Metropolitan Medical

Response System Process. We have established the multidisciplinary Metropolitan Medical Task Force to upgrade our abilities to

respond in the field to any terrorist attack or event.

We have a very detailed concept of operations and response plan

for biological threats. We have trained a large number of personnel,

most is medical and public safety, including the hospital personnel.

And we have conducted some major drills in that area and distributed a level of decontamination equipment and personal protective

equipment to all the hospitals in our system.

We, do need however, to sustain this effort and we have a dire

need for continuing funding of the MMRS program. We need sustained funding for the areas of our pharmaceutical cache of equipment and supplies in case of—to be able to respond immediately

in case of a terrorist attack.

We need to enhance our ability to take care of large numbers of

casualties in the field quickly. We need to enhance our training of

public safety and healthcare providers. We need improved decontamination equipment for our personnel and a cache of equipment

and supplies at the treatment facilities themselves.

Finally, we need to expand our drills and exercises to include

drills within our region and increasing and improved drills without

State and Federal partners.

I would like to concentrate most of my testimony on the current

status of our healthcare system. The healthcare system, especially

the emergency-care system, is very stressed and has little excess

capacity to deal with the large number of casualties that an attack

of weapons of mass destruction might generate.

I think without our funding levels being preserved, we will be

sliding backward to the level of preparation where we were 2 or 3

years ago which was not as good. We will obviously do the best we

can with what we have in any circumstance, but years of cost-cutting at the Federal and State levels in healthcare and healthcaretraining programs have left us with little in reserve for large-scale

emergencies.

Currently, I am recommending that we develop a surge capacity

in San Francisco to be expanded in order to handle a weapons of

mass destruction incident. We do rely on our regional partners, the

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other hospitals, and healthcare systems in our region to assist us

in time of disaster.

However, the American Hospital Association did a report in 1999

that found a decrease of 8.1 percent in the number of emergency

departments nationwide since 1994. In that same period there’s

been a decrease in total in-patient hospital beds of 15.6 percent.

Our capacity is diminishing throughout the country.

During the attacks on the World Trade Center and Pentagon of

September 11, 2001, San Francisco had a peak hospital bed availability of 198 in-patient beds. This meant that with optimal notification and time for mobilization, which is approximately 3 to 4

hours, a total of 198 hospital beds were available in all 10 of our

hospital facilities to treat any victims from an attack if we had had

an attack in San Francisco on that day. While these are in-patient

beds only, not emergency department treatment spaces, we have a

lot more of those. Emergency departments face similar constraints.

Ambulance diversion rates, which are a marker for how busy

emergency departments are, have been going up slowly over the

past several years. We average in San Francisco 6 percent ambulance diversion during the summer months and 12 percent during

the winter. Any terrorist attack that were to take place during this

high diversion period would mean very little capacity available to

treat additional victims.

We do rely on only one level-one trauma center which is San

Francisco General Hospital which adds vulnerability to our system.

We have no permanent medical helicopter landing facilities in San

Francisco that we could utilize to transfer patients rapidly.

With appropriate funding, disaster hospital capabilities can be

incorporated into the current system by several mechanisms; increasing the current stock of hospital beds, increasing the size of

current emergency departments, opening new emergency departments, having a disaster hospital capability constructed and the

ability to utilize that rapidly, being able to convert sub-acute facilities such as skilled nursing facilities, skilled nursing beds into

acute beds, and then developing a Federal disaster hospital response such as the hospital ships or fleet hospitals that are in the

military system.

I thank you for your time and attention. I would be happy to answer questions.

[The prepared statement of Dr. Brown follows:]

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Mr. HORN. Thank you very much. We will get into a lot more of

this because you’ve made a whole series of good points in your written paper and we will be working that one over for questions.

We now go to Dr. Frances Edwards-Winslow, the Director of

Emergency Services for the city of San Jose.

Dr. EDWARDS-WINSLOW. Good morning, Representative Horn and

Representative Honda. It’s an honor to be here with you this morning to share some information about my city, San Jose, the capitol

of Silicon Valley and the largest city in the Bay Area.

We have a long history of involvement in civil defense in San

Jose going back to the 1950’s and the cold war period. We have

continued to develop our capabilities and emergency preparedness

from that time forward looking at dual use as an important focus

for us.

San Jose is aware of many natural disasters. This is earthquake

month and, in fact, at this moment California is holding a duckand-cover drill throughout the State, sponsored by the Office of

Emergency Services, to remind all of us that disasters can come

with no notice.

Because of this basis, we were able to rapidly join the NunnLugar-Domenici program to create some new capacities in the city

of San Jose building on our existing capacities. We had existing

Neighborhood Watch programs, Community Emergency Response

Team, and Safe School Initiatives all in place in 1997 when we,

like San Francisco and 26 other American cities, were invited to

join the Nunn-Lugar-Domenici program and begin receiving Federal assistance to enhance our capabilities for emergency response,

especially for explosions, chemical attacks, and biological attacks

related to terrorism and other hostile actions.

The Nunn-Lugar-Domenici program provided direct funding to

the 27 selected cities. This money came to us through contractual

arrangements and other agreements with our Federal partners. We

performed specific work and in exchange they gave us financial and

other kinds of support so that we could, as my colleagues have already described, establish the Metropolitan Medical Task Force to

respond at the field level, a Metropolitan Medical Response System

to care for patients, including physicians offices and hospitals, as

Dr. Brown has described.

We received training, equipment, and supplies. However, at this

point we have no promise of sustainment of these efforts we have

bought at such a great expense. The city of San Jose spent $1 million in police overtime alone in the first year of our participation

in this program. In order to be a very active partner with our Federal colleagues, we need to ensure that the Federal Government

continues to be our partner with us in this extremely important

multi-use effort.

Our biggest expense at this time is the cost of training our personnel. Police and fire personnel generally cannot receive adequate

training in an on-duty mode. They need to be in an off-duty environment which usually means overtime is paid either to the student sitting in the classroom or someone in the field back-filling for

that student.

In addition, we have developed pharmaceutical stockpiles which

have been described by my colleagues to some degree. My testiVerDate 11-MAY-2000 10:36 Apr 28, 2003 Jkt 000000 PO 00000 Frm 00049 Fmt 6633 Sfmt 6633 D:\DOCS\85125.TXT HGOVREF1 PsN: HGOVREF1
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mony includes a larger list. This material generally has a shelf-life

of about 5 years. We have estimated that we will need $300,000

every 5 years to sustain our existing level of pharmaceuticals

which is not actually adequate for the size of our community.

It is barely adequate for the immediate emergency response

needs. We recognize and appreciate the development of the National Pharmaceutical Stockpile by our colleagues at the Department of Health and Human Services. But for 12 hours, at least, we

will be on our own.

The Push Package will then arrive with the help of the National

Guard. We hope to get that distributed efficiently but then the

larger longer-term care requires the deployment of the National

Pharmaceutical Stockpile which has to come from a vendor managed inventory at various places in the United States. Local preparedness is what will save lives. Patients must be rescued and

treated in the first few hours in order to make a significant difference in the outcome for them.

Furthermore, to make this kind of patient care possible, requires

two levels of surveillance and epidemiology. Explosions, radiological

events, and chemical events are self-announcing. We know immediately that the event has happened and roughly how many victims

we have to deal with. Biological events will be stealth events, unknown until victims begin to be ill because many of the illnesses

present as flu-like symptoms initially.

Dr. Brown and his colleagues will be challenged to differentiate

between flu season events, for example, and an outbreak of something that was induced by a hostile partner. We, therefore, need to

greatly enhance our surveillance and epidemiology capacity not

only in the event of terrorism, but also to improve the public health

of our country and citizens.

We need to find ways to support emergency preparedness of our

hospitals. Dr. Brown has touched on that but I want to emphasize

that our hospitals today are not prepared. They are not prepared

for an earthquake. They are not prepared for a bad hazardous materials accident. They are definitely not prepared for a terrorist attack.

We have no surge capacity left in our system. Here in California

as a former member of the Seismic Safety Commission, I want to

remind you that in 2010 we will close still more hospital facilities

because of their seismic weaknesses. We need some Federal assistance in finding the right answer for balancing current needs, potential disaster response needs, and catastrophic events that we all

surely hope will not happen.

Medicare and insurance currently give no money to hospitals to

provide ‘‘Environment of Care’’ activity to ensure that disasters can

be appropriately responded to and this needs to change.

Finally, I want to emphasize the very, very difficult position that

our elected officials are in at the local level in California. Because

of Proposition 13 they are already dealing with very straightened

budget available to them. The demands from the community for

many types of services continue to exist. Neighborhood services,

traffic calming, and environmental issues go on and develop as our

communities enlarge.

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We are the capital of the Silicon Valley. Our colleagues in San

Francisco are also very involved in high-technology. We all hope to

continue to work with our colleagues at the Federal level so that

we can provide community services and support for this vibrant

part of our national economy. Thank you.

[The prepared statement of Dr. Edwards-Winslow follows:]

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Mr. HORN. Thank you. You have given us a lot of things to think

about and we will work that into questions.

Our last presenter on panel one is Ronald W. Cochran, the Laboratory Executive Director of the Lawrence Livermore National

Laboratory, our friends across the Bay.

Mr. COCHRAN. Thank you, Mr. Chairman and Congressman

Honda. It’s a privilege for me to be here with you today to talk

about some of the things that Lawrence Livermore is doing to help

State and local governments.

I will discuss that but I also want to shift a little bit in the direction of deterrence and early detection. If we can deter these weapons of mass destruction events or get rapid detection if there is the

start of an event, say a biological attack, then we can minimize the

response problems that people are going to have.

I think that my colleagues here have identified a great capability

to respond to disastrous events, and that’s very important. However, if we can prevent them from happening, that may give us an

even greater leverage in being prepared for the future.

Most of you know, I think, about Lawrence Livermore as a nuclear laboratory but in recent years we have also expanded into the

areas of biological and chemical weapons and threats. The terrorists have now demonstrated that they hope to use what I call our

infrastructures against us—our aircraft, our computer systems,

entry into our borders, ports and so forth.

By investing in technology I think that we can continue to enjoy

the freedoms that we have by being better able to deter or prevent

and detect these threats.

Starting with the nuclear area, our Nuclear Threat Assessment

Program is readily available to all States. That is the program

which evaluates threat letters, for example, to determine whether

they represent a viable threat or not. We have been doing that now

for about 20 years.

We also have membership in all of the emergency search team

activities for nuclear events. We have in particular for the local

areas a radiological assessment program where we provide technical and operational expertise to agencies in the event of a radiological incident or emergency. We do things like respond to the situation if someone has a threat of a truck, for example, that has

been triggering radioactive alarms. We can go in and tell them

whether or not that’s a valid problem.

We even have a rapid deployment capability called ‘‘HOTSPOT’’

where we can be deployed to any location by military aircraft to

provide local radiological field support. We have developed a lot of

sensors for detecting and tracking nuclear materials. We actually

were working with the county of Los Angeles to do a potential test

for being able to track the movement of radioactive materials in

case there were a terrorist threat.

Turning to the bio-terrorism area, we have actually developed

some very interesting biological detection instrumentation. It’s

based on looking at the DNA signatures of the materials, the

pathogens, that would be a threat. We are developing the DNA signatures of all the threat pathogens that one might be interested in

and working with the Center for Disease Control and prevention to

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validate those. Then we will distribute them to the public health

agencies.

Additionally, we made a technology breakthrough in that we now

have handheld instruments that can detect within a very few minutes whether you have a biological threat or not.

In the past, in fact in the somewhat distant past, the only way

to detect this was to watch people and see if they were getting sick

or not. Then more recently there have been ways to detect it within

a day or two. These current units actually are units that the first

responders can take into the field and know within a few minutes

whether they are faced with a real biological threat or not.

We are developing a system called BASIS which is Biological

Aerosol Sentry and Information System which was actually used at

the Salt Lake City Olympics for checking in the air to get rapid detection of any biological release that might be threatening to the

people there.

Now, at the Salt Lake City Olympics we hadn’t automatized it

yet. We’ve still got some work to do, but the device actually works

so you can get rapid detection of any contaminants in the air of

that type.

I will talk some more about some of the technology for prevention, but we also provide support to State and local agencies in the

area of atmospheric releases. We have a capability called the Atmospheric Release Advisory Capability which we operate at Livermore. It is available to track the movement of toxins anywhere in

the world at any time. State agencies can call on this capability if

they have concerns about a release. We’ve actually tracked toxins

in rivers as well as toxins in the air. This is something that is provided as a service.

Additionally, we have a forensic science center which can do

analysis of chemicals and biological agents to tell whether or not

there is a real anthrax threat, for example. We can do that very,

very quickly.

Turning back to some of the things that we still need in the prevention area, there’s a pressing need for technologies to improve

the screening of passengers, baggage, and cargo at airports and

ports. We are looking at a wide variety of technologies including

computer tomography, x-ray scanning, gamma-ray imaging, neutron interrogation, and ultrasonic and thermal imaging to be able

to do this.

As you know, at present there are techniques for checking baggage and checking people and, to a limited extent, checking cargos

at shipping ports, but they still have great limitations. We need to

improve those and we are working to do that.

We are establishing at Livermore a national test bed so that

companies, for example, who are developing capabilities for checking cargo containers would have a place to checkout the performance, the advantages and the limitations of their equipment. We

will be operating that based on direction from the Department of

Energy to provide that capability for the Nation.

We have developed some other technologies which I think are

useful to first responders. For example, we developed a micropower radar device which can see through up to about 30 feet of

rubble. We actually tested that at the World Trade Center. If there

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is someone still alive under the rubble, it can detect movement

from breathing. It may make it possible to find people that you

can’t locate otherwise very easily.

We also have remote monitoring instruments that analyze the

hazardous gases coming off a location like the World Trade Center.

We have these mounted on aircraft and we have used those to let

first responders know what they were getting into.

For the State of California, we have done a great deal of vulnerability and risk assessment looking at bridges, dams, and other

structures. Based on some of our analyses, steps have been taken

to protect the bridges that weren’t taken before.

We have helped the California Highway Patrol find ways to stop

large tanker trucks filled with fuel which are mobile missiles. This

has been a recent development. We are very pleased with some of

the steps that have been taken there.

In summary, effective defense against terrorism is going to require the integration of science and technology with the operations,

because the stuff we develop is no good unless the people who need

to use it can use it. You must be certain that you can take it into

the field, it will work, it won’t fall apart, it will be durable, and

give you accurate answers. That is what we are working on.

The events of September 11th have lent a new urgency to our efforts. We are working even harder to try to get these instruments,

which have been in development for some years into the field and

into commercial hands. As more money becomes available with the

Nation’s response to the attacks, we will be able to move faster.

Thank you very much.

Mr. HORN. Thank you. We will now start the question period. I

will take the first 5 minutes. Mr. Honda will take the next 5 minutes. We will do that until we are worn out or thereabouts.

On this issue of x-rays in particular, Customs has major needs

for these containers. I happen to have both the biggest ports in the

United States, Long Beach and Los Angeles. Together they equal

Singapore which is the world’s largest.

But in those containers we never know. It’s about 2 percent now.

It was 1 percent and now it’s 2 percent. In other words, 100 containers come off and they look at one or two. Is there a body in

there? With that Chinese gang in Shanghai where they have

charged $30,000 to get one of these young people into the United

States, obviously they don’t have $30,000 but the labor crowd in

this country in the garment industry, in restaurants, so forth.

What they do is they have an indentured servant and they make

up the $28,000 and the person works it off. Where our Labor Department has been for the last 10 years I will never know but they

ought to be going in there. I happen to have been an assistant to

the Secretary of Labor under Eisenhower and when we saw those

conditions, we moved right in. We saw it in migrant workers.

My boss came out and personally got rid of the lousy conditions

they had in the Central Valley. What we need is to let the Customs

official know there is somebody who has a body there so nobody

makes a terrible mistake. When you are talking about 1.6 million

containers in the Alameda corridor between those two ports, Long

Beach and Los Angeles, and every 4 months it’s 1.6 million, that’s

a lot of containers moving all over America. Do you have any

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thoughts on that, where we are getting, and how we can have Customs use it? What else could Customs use?

Mr. COCHRAN. Yes, sir. As you point out, that’s a very, very difficult problem. People are working on that. At present the best

thing that they have is basically an x-ray machine which they can

use and can see under many circumstances. In other words, if the

container is not fully loaded, for example, and if you have a good

person who can interpret the signal they are getting back on the

TV screen, they can catch things like people or other illicit materials coming in.

Those are in the early stages of being on the commercial market

but you can buy those. They are somewhat expensive at present.

I think that cost will come down. They do require a very highly

skilled operator to monitor what they see going through and to be

able to interpret it.

The direction that we are trying to go is to leap beyond that, to

go to something which will not only give you a good interrogation

when the container is not fully loaded, but get to one that will actually check the hardest thing we can check. For example, a container that is fully loaded and perhaps has a nuclear weapon in the

middle of it could be reliably detected.

Those are harder. You probably can only do those with high-energy neutrons. That is one of the things we are looking at to see

if we can accomplish it. We plan to have a test unit within the next

few months to actually see if we can reliably do a chemical analysis

of what’s in the container without damaging either people or other

things that might be in the container. At present the x-rays are

about the best we have.

Mr. HORN. Well, thank you on that. I want to move to another

question. I particularly want to know how law enforcement is doing

it in San Francisco. When we started this series of hearings in

Nashville, Tennessee, it was very clear that with the great military

forts that are in Tennessee and with their helicopters and hospitals

with the very fine medical school, Vanderbilt, what faulted was

that the frequencies didn’t work. They can’t communicate with

each other. How much of that—I’ve heard from many chiefs of both

fire and law enforcement that apparently a lot of the frequencies

are still sitting around with the Federal Communication Commission.

I remember 10 years ago, or 15 at the university where I was

president, we had exercises in Los Angeles County. Guess what?

We couldn’t get it because all of the frequencies were in the east.

Some of that finally got to the west.

Commissioner Kelly of Customs unfortunately didn’t stay there

long enough because he knew the situation and now he’s back in

the police department of New York. We need to do something. I

just wondered what the chiefs are doing.

Mr. SANDERS. At this time communications is a tremendous problem throughout law enforcement, because historically we are very

jurisdictionalized in the United States. The city next to us, for example, there are times when we can’t contact them. This is an urgent issue, not only here in San Francisco but on the boards and

panels that I participate in statewide.

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Communications is an intelligence at the top of the list. Certainly

there is technology and I join Mr. Cochran in integrating technology with human resources. We have much of that technology

available but in order to take advantage of it, again, it comes back

to funding. Finding a way to find the necessary moneys to integrate technology so that we can talk to one another.

In our tabletop exercises over the past several years we have

found this to be a recurring problem and there has been some

plans put forward that work. Again, when you go to do upgrade

work on old communication systems and to integrate them into

what we need in modern times, we do need the additional funding

and we hope that we can certainly tie in a partnership with the

Federal Government.

Mr. HORN. Any other thoughts on that?

Mr. TREVINO. Yes, sir, Mr. Chairman. Let me add that as you

may know, police and fire here in San Francisco operate using

what is called the 800 megahertz radio frequency, very commonly

used across the country. We also know that in the event of a disaster such as an earthquake the 800 megahertz system can get overloaded and will go down. That has been demonstrated in several

cases.

There is also the potential for different agencies whether they be

law enforcement, emergency medical services, fire, or others to use

different radio frequencies and, thus, as you said, limit our potential ability to communicate.

Now, radio in reputability systems do exist primarily based on

military technology but once again, just to echo Chief Sander’s

statement, they are expensive. The one that I am thinking of, the

TRP–1000, is $50,000 for one unit.

Once again, funding remains an issue and I think it’s important

to note the fact that the City and County of San Francisco spent

a lot more money for preparing for terrorism situations than we

ever receive in from any other source. That does, again, speak to

our hope for Federal funding.

Mr. HORN. Mr. Canton, you want to comment on that?

Mr. CANTON. If I could just add to that. It’s more than just a

problem of procuring radios locally or different sets. There is the

issue of no national standards on how we would use these radios,

no set frequencies that we would use that were all on a common

band.

I think probably the best example of how something can work is

the system that the European government is using now called

TETRA. If we look to that as sort of a model, that’s where we

would like to be able to get to, where, while we work individually

on our own radio frequencies day to day, in the time of an emergency there are common frequencies that we can share with any

law enforcement agency from any State, from the Federal Government, from any outside agency.

We really don’t have that right now. Even if we were to all procure the same radios, we operate on different bands, different frequencies, different talk groups, and there are no national standards

and no idea of when we are going to get the types of frequencies

we need.

Mr. HORN. Chief Sanders.

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Mr. SANDERS. Yes, Congressman Horn. To show you the seriousness of this problem, next month, in May, San Francisco is holding

a regional and State level communications exercise in order to

evaluate very precisely where we are and then take a look where

we can go and maybe connect and make some connections that we

can solve this problem until we find a universal solution to the

problem.

Mr. HORN. Mr. Cochran, you want to comment on that?

Mr. COCHRAN. I have very little to add to what they have said

already. I think that the problem is one that has been around for

quite a while. There are improvements that can be made in going

to a standard frequency.

Perhaps that is something we can help in a little bit. I think

there are commercial companies who could actually do that. Perhaps Congress should encourage them to focus in on this because

this is something that is needed throughout the country. It’s not

just a problem here. Thank you.

Mr. HORN. I now yield 10 minutes to my colleague. Oh, Dr.

Brown.

Dr. BROWN. If I just might add one comment. In the healthcare

field we have also realized the need for this communication. One

of the first actions we took after the 11th was to issue emergency

communication policies that utilized our current communication

systems between hospitals.

We have a computer that links the hospitals called HART. It also

links us with San Mateo County and our regional partners there.

We have now required 800 megahertz radios in all ambulances

both public and private. We conduct regular communication drills.

In the case of the hospitals, communication drill compliance is

tracked on a weekly basis and we provide that feedback to the hospitals. I am pleased to say that before we started this, we had

about 20 or 30 percent compliance. Now we are heading up to 100

percent compliance. I think we also can use the tools that we have

in a better fashion to lick this communication issue.

Mr. HORN. Thank you. Now 10 minutes for my colleague.

Mr. HONDA. Thank you, Mr. Chair. I think Dr. Brown probably

answered one of my concerns, is that you talked about the lack of

hospital beds in the case of an emergency or a spike in needs. Yet,

the daily cost of maintenance of a hospital is based upon how much

it cost to maintain a system. There’s got to be a balance.

What I heard you say is there’s a system already in place that

you developed in the case of an emergency that you would be able

to deploy and utilize other hospitals pretty much like what the fire

fighters do in terms of mutual assistance in deploying first responders, medical personnel, and those kinds of things that are to

address the rescue triage in attendance of victims. Is that correct?

Dr. BROWN. That’s correct, sir. What we have done is to develop

our emergency care plans or multi-casualty incident plans to take

into account the utilization of regional resources. It is also important to note that we have developed the capacity to deploy field resources so we can setup field treatment centers or field-care clinics

that will provide a level of minimum care, but at least that care

will be available to the patients that are triaged to be needing less

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care. That can be deployed from within the city relatively rapidly

in the order of a few hours.

We have tested that. During our millennium celebrations, New

Year’s Eve 1999 through 2000 we partnered with several groups including the U.S. Army Reserve in deploying field-care clinics. We

had eight of them throughout the city. We had them utilizing austere standards of care, testing our supply and resupply procedures,

our communications, and so forth. We do have some capacity to increase our level of low treatment or treatment of less injured individuals.

The problem we run into is, of course, the patients that need

higher levels of care, emergency surgery, intensive care unit care,

that type of thing. We don’t have any substitute for the fixed facilities or the current hospitals and they have very little capacity.

Mr. HONDA. But that’s an ongoing issue, though.

Dr. BROWN. That’s correct, sir.

Mr. HONDA. You mentioned Y2K. Probably that activity was

based upon Chairman Horn’s work on Y2K, so you do get to see

the fruit of your work, Congressman.

The other question, I guess, relative to that is pre-incident, and

that is the identification of an incident. Someone talked about the

difference between a nuclear attack where it is immediately selfevident versus a biological attack or cyber.

In the area of healthcare I understand that there are some tests

or experiments going on to monitor intakes of patients over a period of time to see the incidence of folks coming in with cold symptoms which would equate to probably gathering information quickly

using that kind of information technology to determine whether

there may be an attack with anthrax.

I guess my concern is, have you thought about systems that

could be put in place that would meet the needs of the kinds of attacks that could occur through, say, smallpox which is very infectious and anthrax, which is not infectious? It takes some time and

it has a different epidemiology I guess you would call it. That’s one

end. The other end is the integration of services with, say, other

first-responders, fire fighters, and the police department. Has there

been work in that area?

I guess my ultimate question really is if that is done, what is the

cost of it? Can you share that with us so that we can put it in place

because I think we need to percolate it from the bottom-up rather

than from top-down and say, ‘‘We are going to allocate $10 million

for you all and this is how you are going to spend it.’’ I hear that

is another area of concern. Sure. There were a lot of areas covered

in your question. It’s kind of complex but let me break it down into

two answers and then——

Mr. HONDA. That’s why we have this hearing so that we can

break it down and then put it back together again.

Dr. BROWN. And then if my answers don’t fit your needs, let me

know and I will certainly go into other areas.

There are two types of systems that we have in place. The question boils down to what works and what doesn’t. A good example

is New York City has a rather extensive active surveillance system

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lance calls, emergency department transports, and those type of

things.

This system was in place during the anthrax attacks on the East

Coast and it did not pick-up the anthrax attacks. The anthrax attack was picked-up by an infectious disease physician who was consulted to the Florida case, the gentleman that was working at the

media outlet in Florida.

It is our belief that simply doing a surveillance of one thing or

another may not be what we need to have an effective system.

What we are pursuing is a sentinel events system so that we have

direct notification of the local health authorities as well as the

State and national authorities if a small number of cases appear.

That would be a situation similar to the anthrax attacks that we

have already had. It is my belief that the likelihood of a bio-terror

attack is that there will be a large number of victims. We won’t

have trouble telling that there is something afoot. What we might

have trouble doing is narrowing down among the various types of

syndromes or pathogens, as several of my colleagues have mentioned, to figure out what it is and what is the best way to treat

it and get that treatment out quickly.

To that end, we have developed in San Francisco an emergency

communication system for physicians as well as for hospitals and

we tested this on September 11th as well, a way to notify all the

community physicians of any specialty in any practice setting that

there was a situation that was occurring that they needed to be reporting actively to us what was happening so they had the latest

information on how to advise and treat their patients.

In a large scale attack, we have a communication system. The

way the surveillance system will pick that up we believe is through

the emergency departments and the reporting systems that we

have already in place for the diseases of concern in a bio-terrorist

attack which, as I am sure you know, has recently—the reporting

requirements have recently been expanded to include all those diseases including smallpox.

Dr. BROWN. I think in the case of a highly contagious disease such as smallpox the real problem will be a logistics problem of deploying all of

the researchers to identify who is at risk and who needs a vaccination and getting the vaccinations out rapidly and then tracking the

effectiveness of the vaccination and the further health needs of the

public. We have developed these plans. We are in the process of

operationalizing them. We need to drill them.

The question about the funding, we recently presented to our

local governing body, the Board of Supervisors, what we felt it

would take to sustain the Metropolitan Medical Response System

at a bare-bones minimum. We came up with $5 million in recurring

annual costs and $3 million in a one-time cost.

It’s only for San Francisco. I imagine in other communities that

are larger such as San Jose and other California communities, Los

Angeles and San Diego, that would be a larger amount, but that

was specifically for the MMRS, not for any issues of improving hospital capacity and other things that I have addressed.

Mr. TREVINO. Mr. Chairman, if I may, I would like to buttress

the doctor’s statements. Post September 11th the city and county

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of San Francisco did acquire two detection devices capable of picking up anthrax. Unfortunately, even though those devices are expensive and we consider them state-of-the-art, their effectiveness is

only about 50 percent of the time. That means that we still have

quite a few question marks during a response.

Just to quantify exactly the kind of workload that we have been

under since the September attacks, during the month of October,

which was during the anthrax attacks on the East Coast, our hazardous materials team in the fire department went from an average of six calls per month, which is our normal day-to-day business, up to 220 for the month of October alone, so that gives you

an indication of just what kind of a strain that puts on our resources here.

Mr. HORN. I want to go back to Mr. Brown for a minute on the

smallpox which was a good dialog. Do we have any use for the

smallpox vaccines we had 30, 40, 50 years ago? Does that help us

if you have some rogue country dumping smallpox.

Dr. BROWN. I will give a brief answer, yes. I will have to qualify

my statement by saying my expertise is in emergency medicine and

not in infectious disease. I am sure the Centers for Disease Control

and other Federal resources would have a more specific answer for

you.

My understanding of the use of the smallpox vaccine is that it

has been tested recently and found to contain its potency. In other

words, it will still be effective in treating smallpox cases. I do know

from my studies that it will be effective or useful for up to a week

after the exposure.

However, as Congressman Honda has pointed out, there are

often latent periods during which time we are not aware of all of

the people that have been affected by an attack so it will become

very critical to correctly identify those who are at risk and get the

treatment to them within a short period of time.

Mr. HORN. We have, I believe, testimony that we have quite a

few vaccines there. Ten years ago or 5 years ago it was a mess in

terms of the warehousing. They didn’t know what they were doing

and they didn’t get it out around the country. I just wonder, you

might be in emergency medicine and all but what do you know

about it from your standards on whether it is smallpox or anything

else?

Dr. BROWN. From my perspective for treating a smallpox attack

the crucial factor will be to setup quickly the emergency treatment

centers and prophylactic treatment centers that we would need to

treat a large number of people and to equip those centers with everything they need to provide the immunization and to collect the

information from the patients, potentially draw blood, etc., that

they would need to track the epidemic or the attack.

I know from our planning that we are prepared to do that. We

do need to have the drilling to actually put it in place and see the

timing that it will take for it to occur.

Then all of this, of course, is predicated upon our getting the vaccine from the national pharmaceutical stockpile rapidly so that we

can utilize it to treat the patients.

Mr. HONDA. Just a quick comment. I guess the difference between anthrax and smallpox is that smallpox is infectious and conVerDate 11-MAY-2000 10:36 Apr 28, 2003 Jkt 000000 PO 00000 Frm 00064 Fmt 6633 Sfmt 6633 D:\DOCS\85125.TXT HGOVREF1 PsN: HGOVREF1
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tagious so the drill would probably have to be different. Well, the

drill may be the same but the response may be different in terms

of trying to isolate folks and create a concentric shell around the

point of identification so that we can prevent a mass epidemic.

Dr. BROWN. That is an excellent point. Each of these agents that

could be used in an attack have their own challenges, but in the

case of small pox, it is not only the identification of the people at

risk that might be difficult.

It is also the fact that those people can then potentially spread

the virus, although the most infectious cases of smallpox are people

that have the full-flown syndrome. With this communication system that we can notify all of the physicians, all of the healthcare

personnel in the community to be looking for the syndrome. Hopefully we will be able to identify those infectious—excuse me, contagious patients rapidly and put them in some type of protection

on quarantine status.

Mr. HONDA. Mr. Chair, just to close then on my part, what you

are saying is that we’ve got pieces of the jigsaw puzzle. We have

some ideas where the missing pieces are. It’s a matter of putting

them together. The glue that we have to have is the revenue. That

is No. 1. The flow of revenue is not perfect. That’s why I ask if

there are some cost estimates that can come from local up and then

some suggestions on how that can be distributed once it is authorized and allocated.

It seems to me there are some counties that are quite capable of

being the direct recipients of funds where the State can be bypassed and the State can be utilized where counties may not have

the full breathe of technical assistance or technical folks to be able

to—or full breathe of services where they would need a State coordination where you could combine States together.

That is one impression. What I hear you also saying is that

needs for training and equipment is ongoing but there is initial cost

such as you stated. But then there is also what you didn’t mention

is the cost of substitutes while people are in training. It seems to

me an ongoing cost.

What I am hearing also is the stovepipe effect of all our eight different agencies including the feds. There is nothing lateral to communicate between you so that you have a national system of communication of distribution of materials or meds and things like

that. That would be help for us to hear from you and how you can

put this together so that the plan can move forward and up. I was

hoping for some sort of quick response.

Mr. HORN. Dr. Winslow.

Dr. EDWARDS-WINSLOW. I think that we had a good beginning

with the Nunn-Lugar-Domenici program where six specific agencies

were tasked to work directly with the cities.

Through the Department of Health and Human Services the

MMTF cities across the United States have a contract right now

to develop sustainment cost estimates, and that’s what Mr. Canton

referenced earlier, that San Francisco has been working on the

project and so has San Jose.

Within just a few months there will be information from the

original 27 cities who have had almost 5 years experience now in

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this field. That information, I think, could become a very useful

paradigm because I doubt there will be a great deal of difference.

I think also the cooperative spirit that we experienced in San

Jose among those six Federal partners was a key contributing factor in our local success. I think that needs to be nurtured and encouraged at the Federal level through legislative support and funding so that the appropriate Federal agencies can each contribute

the expertise that they have but in a collegial manner.

The single point source for funding is really critical because, as

my colleagues have pointed out, grant writing is time consuming

and expensive for the local government. Then the reporting requirements that go along with the grants and the contracts often

cost a significant percentage of the money that is received and that

needs to stop.

We need to create sensible Web-based reporting that can be done

electronically that minimizes the use of staff time, but yet gives the

Federal Government the appropriate methods for monitoring the

fact that we should be extremely responsible in the way that we

handle this scarce funding.

Mr. HORN. Thank you. We are going to have on panel two the

question to answer that I’m going to now give to you because some

of you are on national committees of your relevant associations. I

would be just curious if this discussion would be there, especially

on our massive lack of health facilities given Medicare and all the

rest.

I wonder has anybody talked about the Veterans Administration

Hospitals or the military hospitals and are they in on this? Do we

know has somebody done an inventory which if something happened in Texas or in California would there be beds? Would we

have to draw on from the VA or the military?

Dr. BROWN. I can give you a partial answer to the question. The

VA is an integral part of the National Disaster Medical System and

this is a system that will be able to evacuate patients to centers

of care where there is capacity to treat them from a zone that is

heavily impacted such as a city that is under attack.

We have been working with our local VA, the Fort Miley facility,

and working with them in terms of developing a disaster hospital

capability. What looks most promising currently is the ability to

rapidly convert beds that they have in a skilled nursing facility on

their campus to disaster acute care beds.

Now, admittedly the entire facility of that skilled nursing facility

only has 100 beds but to have 100 beds available within a few

hours makes a tremendous difference. And then to have the national disaster medical system bring in other assets such as the

disaster medical assistance teams, volunteer teams of medical personnel.

I happen to serve on California 6, the Bay Area disaster medical

assistance team. To have those teams come in within 6 to 12 hours

to setup additional facilities and additional care will be invaluable

in any disaster scenario.

Mr. HORN. That’s very helpful.

Mr. Canton.

Mr. CANTON. I would just like to point out that the response

mechanism in the United States is actually fairly robust and works

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fairly well. My previous job was with the Federal Emergency Management Agency and I think in the time I was there I saw the Federal Response Plan go from something that was just a concept to

something that really does work in the field.

Our entire emergency response in any operation is based on support to the lowest level. Our emergency operation center supports

the field people that are working on a problem. The State Office

of Emergency Services then supports my operation. Then the Federal Government overlays that.

I think where the problem comes in is that many of the agencies

that are involved in these different plans don’t always work together. They don’t spend time doing exercises, as Dr. Brown mentioned. In many cases they are developing plans in a vacuum and

very independently from some of the other agencies that are involved.

I think the real issue becomes what do we use as the linchpin

for all these different plans that are out there. I think that’s where

you have to eventually come back to the emergency management

community.

I don’t think we’ve been as good a player as we could have been.

I don’t think at some of the State levels that the offices are sufficiently funded to provide the oversight they need. I think in many

cases it really depends on which executive arm of the government

is willing to give the authority to offices of emergency services to

coordinate that work.

We are not first responders but our job is to get the first responders to come together and look beyond just their individual plans

and to make sure the plans mesh together. I think ultimately we

end up being the linchpin and I think ultimately at the Federal

level that brings you back to the Federal Emergency Management

Agency.

Mr. HORN. In your testimony you stated that while reporting requirements for FEMA grants for the emergency management preparedness have been simplified, the amount of grants have decreased, however. With all the additional Federal money that is

being made available, do you anticipate that trend will change next

year for San Francisco?

Mr. CANTON. We are certainly hoping so. We are certainly heartened by all the money, as Chief Trevino, we see moving through

Congress. We are also a little disheartened that this far from the

event of September 11th we still haven’t seen any Federal funds

down here. We are still working out of our own departmental budgets. We are reassigning priorities. In many cases we are cutting

programs so that we can put additional money into these things.

Very little money has reached us.

I would like to hold up that particular program from FEMA as

sort of an example of how things can work well. When that program first started many years ago, it was designed to stimulate the

formation of local offices of emergency services. It was primarily a

program to fund personnel.

Over the years that became very restrictive. There were a number of other things that were layered over that. The reporting requirements got very onerous. Then several years ago FEMA had a

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revision of the program where they said, ‘‘Look, local governments

know how to make best use of their funds.’’

It became, in essence, a block grant. We have a very simple program where at the beginning of the fiscal year we provide a work

plan. We check in at mid-year and at the end of the year we do

a final report. In turn the amount of money that we get we are free

to use as we designate in our work plan.

The problem comes in—it is two fold. One is that the Federal

Government has reduced the amount of funding available in that

program. The second was to a certain extent a self-inflicted wound

where we in the State of California redesigned our funding formula

so that less money went to some jurisdictions and more went to

other jurisdictions. I think it is a combination of things but we are

certainly hoping that more money will be put in this program in

the next fiscal year.

Mr. HORN. There is a lot more things we could ask but let me

ask you one about the national stockpile we have been talking

about on medications. How would they be distributed throughout

the San Francisco Bay region? We do have a CDC witness in the

next panel but has there been any planning on how that would

happen?

Dr. BROWN. Yes, sir. There has been. I sit on the advisory committee for the EMS authority and the Office of Emergency Services

on the national pharmaceutical stockpile. Very briefly stated what

would happen is the material would arrive at a distribution point

somewhere near the communities involved. It would have to be requested by the Governor through a mechanism of declaration of

emergency.

It would also be potentially in competition with other requests by

other communities in other States. If we had an attack of a contagious agent such as smallpox, it is quite conceivable that many,

many communities would be affected and so decisions would have

to be made to triage the material.

Once the material arrived at the site, it would be broken down

by assistance of State assets, and potentially Federal assets, the

National Guard and so forth, and then distributed to the communities.

We have in San Francisco several distributionsites that we have

designated. Again, we have in our plan and in our training of our

personnel indicated how this material would be accessed quickly

and transitioned to put into patients’ hands.

Dr. BROWN.

Again, the limitation is that we have not drilled that with our

Federal and State partners and we need to be doing that rapidly.

Mr. HORN. Chief Sanders, I think you wanted to comment on

some of these questions.

Mr. SANDERS. Thank you very much, Congressman. As I have listened to my colleagues and to your questions, a major incidence

has come up of deterrence. Thirty-eight years of law enforcement

has taught me that even in our traditional law enforcement prevention of crime is extremely important.

Here in San Francisco we have taken that into consideration in

this circumstance in developing a personal emergency plan, standardize plan on how to report emergencies, train the citizens on

65

what to do and have themselves ready to respond for a period of

time until the official forces can get to them.

One of the other areas we look at in deterrence is regional intelligence cross-training. I know that in law enforcement if there is

a bank robber on the East Bay, I know that when he or she runs

out of the bank there, they will come over here. We need to share

our law enforcement information both horizontally and vertically.

I do know of some bills in Congress to get that done so we can

break down some of the old barriers so that we could share information. To join Mr. Cochran, there is a piece of technology I recently have reviewed called a threat detector where we actually

look for people.

These bombs and devices of destruction are placed there by people. Certainly we know from the intelligence coming since September 11th that there are cells of these anti—actually, they are warriors. They think of themselves as warriors in a world war against

whomever they regard as an enemy.

We need to track these individuals just as we track other criminals around our country and around the world. There is technology,

again, available for that. We are able to check people at the airports. I am going to have to deploy troops at my own police offices

at the San Francisco International Airport to replace the National

Guard.

Also, I would like to have those officers rather than just stand

there and watch and respond to just physical incidences in their

area, provide them with information that can be given to them by

technology. This threat detector can check every wanted person in

nanoseconds.

For example, all 19—as I am informed, all 19 of the highjackers

in the September 11th event were on watch lists. That information

never got to local law enforcement. We would like to work with all

of the governments, State, local, and Federal to work out a system

where we can share that information and be able to respond to it.

You are absolutely correct.

I mentioned the letter I wrote to Chairman Sensenbrenner of the

Judiciary and the bill number of mine is H.R. 3483, the Intergovernmental Law Enforcement Information Sharing Act of 2001. I

would hope if enough chiefs of police and fire and all the rest would

support that, we could deal with it.

The FBI has been very good without legal part. This should have

been in the earlier and Mr. Sensenbrenner realized that. He’s going

to move that as fast as he can.

Mr. SANDERS. Thank you, sir. That would be very, very helpful,

again, in law enforcement helping us to do the new job that we’ve

been assigned to in homeland security.

Mr. HORN. Yes.

Mr. CANTON. Chief Sanders touched on one area that I think is

very important that we sometimes overlook, and that is what do we

tell the public? What do we want the public to do?

One of the things we felt after September 11th here in San Francisco was that we really didn’t have a good message initially to answer when people asked us, ‘‘What should we be doing about this?’’

A lot of our effort in the first week was to develop just such a message.

66

We have national programs for crime prevention. We have national programs for a variety of different things, emergency management, but we really aren’t seeing yet a national program that

answers that question for people ‘‘what should they be doing?’’

Again, I think there are models out there if you look at how

Great Britain deals with terrorism, with how Israel does. There are

posters. There are flyers. There are Web sites. There are things

that tell people how they can empower themselves. I think that

should be part of any program, too. You have to remember the public needs to be a partner in this.

Certainly by providing intelligence information to the police, by

being alert to the signs of a potential terrorist attack, they can, in

fact, play a role. I think we need to stress that we are all in this

together and we need their help as much as we need the help of

the emergency services.

Mr. HORN. Well said.

Mr. Cochran, before we close this out, you mentioned on the xray machine that it can, in fact, see or think there is a human lift

under the rubble. Are these devices available to local police and fire

departments and, if so, at what cost?

Mr. COCHRAN. There were two things. The x-rays were looking

at containers and the radar devices were looking through rubble.

The radar devices are just starting to be made available. They are

very inexpensive. I don’t know what the exact cost would be but

no more than a few hundred dollars at most. They can be made

available to first responders over the course of the next several

months or year.

Mr. HORN. That would really be helpful to a lot of people that

felt that maybe it couldn’t be done.

Mr. COCHRAN. There are always issues that we’ve got to work

our way through and sometimes you get blocked but then there are

usually work-arounds and you have to find those. Thank you.

Mr. HORN. Well, thank you. We’ll have additional questions. If

you wouldn’t mind, there are a few key things from both the majority and the minority. We will put them in the record at this point.

We would like to have your ideas on it.

We have taken a lot of your time and we thank you for coming

in here. We are now going to start with panel two and we dismiss

panel one. If you are staying around and you see something crazy

that we’re dealing with in panel two, you are certainly welcome to

speak-up as you are going to the door.

OK. Panel two. Dr. Burton, Mr. Riordan, Ms. Cherry, Ms. Dalton,

Mr. Mefford, Dr. Bice, and our person that is following us across

America, Mr. Ron Castleman. We are glad to see him always.

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STATEMENTS OF DR. RICHARD BURTON, ASSOCIATE DIRECTOR, CALIFORNIA DEPARTMENT OF HEALTH SERVICES; RAY

RIORDAN, EMERGENCY PREPAREDNESS OFFICER, EAST BAY

MUNICIPAL UTILITY DISTRICT; JANET CHERRY, ASSOCIATE,

THE CADMUS GROUP, INC.; PATRICIA DALTON, DIRECTOR,

STRATEGIC ISSUES, U.S. GENERAL ACCOUNTING OFFICE;

LARRY A. MEFFORD, ASSOCIATE SPECIAL AGENT IN

CHARGE, SAN FRANCISCO FIELD OFFICE; DR. STEVEN BICE,

DIRECTOR, NATIONAL PHARMACEUTICAL STOCKPILE, CENTER FOR DISEASE CONTROL AND PREVENTION; AND RON

CASTLEMAN, REGIONAL DIRECTOR, REGION VI, FEDERAL

EMERGENCY MANAGEMENT AGENCY

Mr. HORN. You’ve probably heard how we go about this. That is,

we do swear in all witnesses so if you will stand and raise your

right hand and affirm the oath.

[Witnesses sworn.]

Mr. HORN. Thank you. It will be seven witnesses and the clerk

will note that. We will start this down the line as we have it in

panel two’s agenda and that will be with Dr. Richard Burton, the

Associate Director of the California Department of Health Services.

Dr. BURTON. Thank you, Chairman. I appreciate the opportunity

to come and share some thoughts this morning from the California

Department of Health Services. In my previous experience, I’ve

been working with the California Department of Health Services

for the last month and a half. About 10 years before that I was a

local health officer here in California and before that about 10

year’s experience as a flight surgeon with Marine Corps.

Since the aftermath of September 11th we have refocused a lot

of our energies in California in our partnership with State and

local public health officials, the public health officials were tasked

with the primary responsibility of coordinating public health responses in the State. We do that in conjunction with our partners

in law enforcement, OES fire, and George Benson, the special adviser on State preparedness here for the Governor.

At the local level they are also coordinating with the first-responders that were represented on the first panel and in conjunction with their multiple private sector of medical care providers.

I think what we would like to highlight in today’s testimony is

the appreciation we have for the funding that has been made available from the Federal level for public health preparedness and for

hospital preparedness.

That funding has been in just the last month or so from the Center for Disease Control and HRSA has come to California and we

are currently in the process of preparing the applications that were

required by Federal oversight in order to receive the full extent of

those funds and make them available to enhance our preparedness.

The issues that have come up so far as preparedness from the

first panel relating to planning and readiness assessment, surveillance, or public health, intelligence gathering, and epidemiology capacity or laboratory capacity that we need to have in order to assess biologic agents, and also the potential threat they have to a

community dealing with risk communication and information technology, and also in dealing with education and training both within

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the public health field and with our partners that are first-responders in law enforcement fire, OES, EMS.

All of those issues are parts of the planning process and application process that the Center for Disease Control and HRSA have

incorporated into their funding allocations.

In order for us to be successful at addressing all of those issues

and recognizing our partnership with the local jurisdictions, there

are 61 independent public health jurisdictions in the State of California.

The Department of Health Services has developed focused area

work groups with representation from local public health jurisdictions and expertise from academia along with the expertise within

the State Health Department. If flushed out, the assessments and

needs and where we can best enhance our ability to serve the residents of California and that has informed the application that is

currently being put together. I guess in closing, on these comments

I would be happy to answer any questions. We have heard a number of presentations this morning that have referenced new and

emerging technologies that can be of great benefit to us and our

ability to detect a threat and also to manage it once an occurrence

has taken place. Those technologies are very promising.

I know what I’ve heard from my local colleagues in public health

and the State colleagues in public health that while we make use

of these emerging technologies, we need to assure that we have the

human intelligence and professional capability to manage the technologies, interpret the technologies, and make the policy recommendations that will best serve the constituents and the residents in California. Thank you, sir.

[The prepared statement of Dr. Burton follows:]

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Mr. HORN. Thank you.

Mr. Riordan.

Mr. RIORDAN. Thank you, Mr. Chairman, Representative Honda

for inviting us. My name is Ray Riordan, the Emergency Preparedness Officer for East Bay Municipal Utility District. I have been an

emergency manager for city and county agencies for the last 16

years, the last 9 years being with East Bay Municipal Utility District.

East Bay MUD is a large water and waste water utility in the

State of California. We serve 1.3 million water customers and

685,000 wastewater customers. While I’m here representing the

District, I am also making commentary with many of the other

water utilities we coordinate with in the Bay Area and the smaller

water utilities in the State of California.

Water systems have several key critical priorities that they must

pay attention to as a water manager. First and foremost is public

health right in line with balancing fire fighting. The fire fighters

want the wet stuff to put on that red stuff as a way of managing

the public safety.

We also pay strong attention to our multi-hazard responsibilities

here in the State of California with the many seismic events, as

well as the technological or other natural events that we have to

face.

In the State of California alone, again, because we are a large

water utility, I don’t want to sway one direction or the other. There

are over 10,000 water systems in the State of California licensed

with the State Department of Health. There are many water utilities in the State of California that are both public and private and

may serve to store water, provide water supply, transport water,

treat water, or provide distribution.

We at East Bay MUD are large enough to be able to work with

large agencies. Since 1952 we have been part of California Utilities

Emergency Association. Since 1998 we have been part of the FBI’s

National Structure Protection Commission.

Large utilities like ourselves are able to respond effectively to

large events such as the terrorism events. We took immediate actions as did many other water utilities. For the first time in our

history we limited access to our water supply reservoirs from recreators. We had to close down our reservoirs for the first time in our

history because conventional wisdom indicated that there would be

a large concern for the water supply or the structural integrity of

the dams if something were placed outside those dams.

Immediately after the event we began response by looking at our

systems and even conducting a preliminary vulnerability assessment reflecting on what is our real risk versus what is our perceived risk within the media and the public.

We instituted new corporate procedures including how we provide public information. One of the key issues that we have as a

water industry is just how much information do we have to have

or provide easily to the public in the Freedom of Information Act.

This is a significant issue for us.

We increased our security procedures and our vendor systems to

the point of more than doubling the cost of operational contracts

as well as looking at the future cost of capital improvement.

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Because of the lack of coordination or information immediately

available on the terrorism threat we began to work closely with six

other public water utilities within the Bay Area, the San Francisco

Bay Area representing over 6 million water customers.

We formed an ad hoc committee called the Bay Area Security Information Collaborative [BASIC], as a way of sharing information

on the threat, the risk, providing educational information and coordination. We did this in conjunction with information that we did

receive from the FBI and the EPA who have provided invaluable

support.

To this point I mentioned our security contracts. We have in- creased our security contracts from $1.4 million to over $2.3 million, almost doubling our budget. We see that EPA funds are available for $125,000 at this time

are only for the large utilities and we need to pay attention to the

smaller utilities as well. It is estimated that we will have $20 million in improvements necessary for capital improvements. This is

waging a significant impact on our capital resources.

We need Federal support on the science of detection. Right now

we rely on looking at health information from hospitals, how many

people have become ill at hospitals? We respond to a need by testing our water system on a regular basis. We need to have a better

understanding of what it is we are testing for.

We need support on the science of detection.

We also need support and Federal resources on response coordination. It is very difficult to get a single source of information for

the water systems as to how to respond. We also have to pay attention to when a water system does become a target for a terrorist

event, that it becomes a crime scene, and we have to understand

better how to respond to that situation.

In closing, a key issue that we have paid attention to and have

discovered is that you don’t have to actually contaminate a water

system. You just need to affect public confidence in the water system, convince the media or the public the water system has been

contaminated. That would be enough of a crisis for water systems

to respond to.

It is a large psychological effect. Last our concern is on confidentiality. If we do the security vulnerability assessments, how much

of that information do we have to publish because then we are putting out the information for the potential terrorists to use back

against us as a water system.

We in California have done a lot of work on natural and technological preparedness and we would like to see some additional

funding for the security event without additional regulations that

we already see in our emergency preparedness programs we currently hold. Thank you very much for the time.

[The prepared statement of Mr. Riordan follows:]

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Mr. HORN. Well, thank you.

We now go to Janet Cherry, Associate of The Cadmus Group. We

put your very fine—we will put it in again, but we got it when we

were in Albuquerque so your record is in there. Go ahead because

we didn’t have you there. We just had the paper.

Ms. CHERRY. Mr. Chairman and Congressman Honda, thank you

for the opportunity to testify today. My name is Janet Cherry and

I am a registered professional engineer for The Cadmus Group, Inc.

The following testimony is intended to address the need for examining the vulnerability of public water systems, particularly small

water systems, to acts of terrorism.

Money has already been appropriated for the large water systems to perform vulnerability assessment, but small water systems

have been neglected.

Large water systems are prepared technically, financially, and

managerially to address security issues in small water systems.

Large water systems possess the necessary professionals to identify

security issues and the funds to implement the appropriate measures to maintain security.

Small systems often lack both the financial means and personnel

to identify and reconcile security issues. Small water system treatment plants are very vulnerable since some of the treatments

plants do not have personnel onsite 24-hours a day, 7 days a week

making vandalism or other acts of destruction easy to perform

when staff are not present.

Small water systems are often located in rural or remote areas

again making these systems easier targets than the systems located in metropolitan areas. To provide an idea of how many small

water systems exist, there are approximately 426 water systems

that serve fewer than 10,000 people in the San Francisco area

alone.

Water systems use the multiple barrier approach to prevent contamination or loss of service. This approach includes selecting the

highest quality and least vulnerable source water, protecting the

source, installing the appropriate treatment, and providing water

through properly designed and maintain infrastructure.

Even with this multiple barrier approach being practiced by

water systems, unintentional contamination still occurs such as

water-borne disease outbreaks. When water-borne disease outbreaks occur, there is a time lag between the time of exposure and

when an outbreak is recognized by the public health community.

For instance, on September 3, 1999, the New York Department

of Health received reports of at least 10 children hospitalized with

bloody diarrhea or E. Coli infection in counties near Albany, New

York. E. Coli is a pathogen that naturally occurs in the environment and is harmful to humans if ingested.

All children had attended the Washington County Fair near Albany, NY held between August 23rd and August 29th. In total 65

people were hospitalized, 11 children experienced kidney failure,

and 2 people died. This example illustrates the typical chain of

events for an E. Coli outbreak. Now, E. Coli is regularly tested by

approved laboratory methods and the symptoms are promptly recognized by the medical community. It was still up to 11 days before

the outbreak was known by public health officials.

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If small water systems were to be intentionally contaminated by

unknown pathogens or chemicals, the strain on the public health

and medical community would be immense. As we start to address

the vulnerability and resulting security measures for small water

systems, we must not treat it as a new or complex concept. Conversely, security should be treated as an extension of the system’s

public health plan to deliver safe drinking water reliably and consistently.

State public health departments have developed a sanitary survey process to assist water systems in delivering safety drinking

water reliably and consistently. This process assess the adequacy

of a water system’s multiple barriers to prevent contamination or

loss of service.

A sanitary survey consist of an onsite visit to evaluate all areas

of the water system. Its primary concern is to identify areas where

inadvertent contamination or service interruption could occur, but

it also includes an element of security. Sanitary surveys have typically focused on vandalism and theft in the past, but they could be

modified easily to address any risk deemed relevant including terrorism. The key to successfully addressing vulnerability of small

water systems is to buildupon an existing process, the sanitary survey process familiar to small water systems and State and Federal

officials.

The sanitary survey is an established process and all federally

regulated public water systems are required to have a sanitary survey conducted every 3 to 5 years.

Also, it is important that the vulnerability and security of small

water systems receive attention as Federal lending agencies such

as the EPA Drinking Water State Revolving Fund and the Department of Agriculture Rural Utility Service continue to invest in

water system upgrades and improvement and expansions. It is only

logical that these investments be properly protected. Thank you.

[The prepared statement of Ms. Cherry follows:]

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Mr. HORN. Thank you.

We are going to rearrange the schedule a little here because I am

calling on Ms. Dalton of the GAO at the end and I want to move

you to the end. Then you can do the statement and we will see

what is missing. I begin with Larry A. Mefford, the Associate Special Agent in Charge of the FBI, San Francisco Field Office.

Mr. MEFFORD. Thank you, Mr. Chairman, Congressman Honda.

Thank you for the opportunity to talk about this very important

topic today.

As you know, the FBI is undergoing a significant shift in how we

approach counterterrorism and our responsibilities in that arena.

Clearly we are focused on attempting to improve our ability to collect relevant intelligence data under the constitutional parameters

that we work under to interpret that data and disseminate it to the

agencies and to the general public that have a need to know, to

conduct joint training opportunities and efforts with these agencies,

and to conduct joint investigative activities.

In the Bay Area the methods that we are using to employ this

strategy is basically two-fold. In 1997 we formed the Bay Area

Joint Terrorism Task Force, which since September 11th has expanded to include a total of 25 law enforcement agencies; and today

consist of the largest law enforcement agencies in this region, consisting of about 65 investigators that are focused fulltime on investigating and preventing acts of terrorism in this region.

Concurrently at the same time working with California OES we

developed the Bay Area Terrorism Working Group, which is a

group of consequence management and disaster agencies that are

focusing on the post-incident response capabilities of all the agencies. In the area of intelligence development, we are attempting to

develop improved methods of communication with the various law

enforcement and disaster agencies, and the general public throughout this region. One of the methods that we have employed is the

development of a Web page which is code-word accessed for all law

enforcement agencies in this region.

This is maintained by the Bay Area Joint Terrorism Task Force;

and on this Web page we place relevant intelligence data, background information, and other intelligence information that they

would need to do their jobs. We also have a corresponding Web

page that we operate in conjunction with the Bay Area Terrorism

Working Group so that the consequence management and disaster

agencies can also have access to some of this data.

We are in the process of developing an interagency training initiative so that we can go to various police departments and disaster

agencies and provide on-scene training by members of the Joint

Terrorism Task Force. Not only FBI personnel, but outside agency

personnel also. We can explain and hopefully educate the agencies

regarding what factors to look for.

For example, we have studied the 19 terrorists responsible for

the acts on September 11th. We’ve looked at their methods of operation very closely, and we would like to relay that information because we think it would be helpful in preventing potential future

acts.

Internally we have also taken steps in the FBI in San Francisco

to develop an in-house capability. We have a 30- agent evidence reVerDate 11-MAY-2000 10:36 Apr 28, 2003 Jkt 000000 PO 00000 Frm 00094 Fmt 6633 Sfmt 6633 D:\DOCS\85125.TXT HGOVREF1 PsN: HGOVREF1
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sponse team that has received specialized training in the area of

terrorism, crime scenes, and responding to acts of chemical, biological, or radioactive terrorism.

As part of this team we have an eight-agent hazardous material

response team that has actually developed the in-house capability

to operate and to collect evidence in the contaminated crime scene.

Working with other disaster agencies in the Bay Area we have developed the capability to respond to the scenes and to complete the

mission of the FBI should such an act occur.

Finally, our special weapons and tactics team, which consist of

46 special agents in this region, they have all been trained to operate in a contaminated environment. We see this as an augmentation to local disaster agencies and obviously gives us the ability to

perform at another level that historically we have not yet had to

perform, fortunately.

Finally, we have a weapons of mass destruction coordinator, as

every FBI Field Office does; and these individuals are assigned specifically to enhance our capabilities and our ability to interface with

other disaster agencies in the region. In the area of intelligence we

are working closely with the State of California. Their anti-terrorism information center, which was formed in San Francisco, we

hope to create an intelligence terrorism center as part of our JTTF

in the Bay Area, interfacing with the State system so that we can

get relevant terrorism threat data to the first responders of any incident.

Clearly, in conclusion, our mission has changed from one of prosecution to one of prevention and we are devoting considerable resources to try to improve our capabilities in that area. Thank you

very much.

[The prepared statement of Mr. Mefford follows:]

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Mr. HORN. Thank you. It is very helpful.

We now will go to Dr. Steven Bice, the Director of the National

Pharmaceutical Stockpile, Center for Disease Control and Prevention. We are delighted to have you here.

Dr. BICE. Thank you, sir. Good morning, Mr. Chairman, Mr.

Honda. I appreciate you inviting me here. Speaking for all the men

and woman of my agency, thank you for sponsoring these kinds of

field hearings and raising important issues and for allowing us to

take part.

Like all other Americans we at CDC were horrified and saddened

by the events which took place in New York, Washington, and

Pennsylvania last fall. But as the Nation’s Disease Control and

Prevention Agency we were also immediately galvanized to action

to provide assistance to our partners in the affected cities and

States.

In my oral comments, I’ll provide a brief overview of CDC’s activities related to September 11th and the subsequent anthrax attacks and how we are working to better prepare our Nation’s

States and cities for threat of public health emergencies including,

of course, terrorism.

The terrorist events of September 11th and later events related

to anthrax have been defining moments for all of us and they have

greatly sharpened the Nation’s focus on public health. The events

created the greatest public health challenge in CDC’s history requiring an unprecedented level of response. CDC has deployed 588

employees since September 11th in response to the World Trade

Center event and the anthrax investigation.

Within 10 minutes of the second plane crashing into the World

Trade Center we initiated an emergency operation center that functioned 24-hours a day, 7 days a week. While all commercial aircraft

were grounded after the attack, CDC’s National Pharmaceutical

Stockpile Program was able to arrange transportation of its emergency response personnel to New York.

For the first time ever CDC deployed the National Pharmaceutical Stockpile sending push packages of medical material to

New York City and to Washington, DC. In response to the cases

of anthrax exposure, our program was also used to deliver antibiotics for post-exposure prophylactics to employees in affected

buildings, postal workers, mail-handlers, and postal patrons.

Within 4 hours of the attack on the World Trade Center CDC

health alert network was activated and began transmitting emergency messages to the top 250 health officials throughout the Nation. Over the next 16 weeks 67 health alerts, advisories, and updates were transmitted ultimately reaching an estimated 1 million

frontline public and private physicians, nurses, laboratorian, and

State and local health officials.

The Epidemic Information Exchange [Epi-X]—public health’s established, secure communications network—immediately developed

a secure conference site for State epidemiologists and local CDC investigative teams for posting information on surveillance and response activities, including HHS reports, CDC health advisory information and health alerts, and reports from State health departments.

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The Morbidity and Mortality Weekly Report [MMWR], CDC’s scientific publication, published reports on an urgent basis and delivered these reports electronically to over 500,000 healthcare providers.

During the height of the Nation’s anthrax crisis in October, CDC

experienced larger than normal traffic on its Web site and conducted daily press and telephone briefings, fielded thousands of

press inquiries, and was featured in television interviews reaching

hundreds of millions of viewers.

At the peak of the anthrax response, CDC had more than 200

personnel in the field assisting State and local partners and hundreds more personnel at headquarters assisting in the effort.

Over all there was a total of 22 cases of anthrax with 11 being

cutaneous or skin form of the disease and 11 being inhalation.

While we deeply regret each illness that occurred, we are very

encouraged by the fact that none of the approximately 10,000 persons who were given antibiotic prophylactics developed anthrax despite significant exposure to anthrax spores. Last fall’s events revealed serious gaps in our Nation’s public health defenses against

biological, chemical, and radiological threats. These gaps include

inadequate epidemiologic and laboratory search capacity, an insufficient knowledge base concerning sampling and remediation, and

lack of information concerning infectious dose and host susceptibility.

In addition, the public health system needs to improve its ability

to convey information and to provide treatment and preventive

measures to large numbers of persons and a way of assuring compliance with treatment regimes.

This will require extensive preparedness planning, cooperation

across agencies and between Federal, State, and local counterparts.

It will also require that we work closely with partners in the emergency response community, law enforcement, clinical medicine, academia, and private industry.

CDC will continue to support State and local government officials

in preparing and responding to public health emergencies including

terrorist events by providing assistance and technical guidance in

conducting problem assessment, evacuation, and relocation decisions, proper treatment of victims, epidemiological surveillance,

disease control measures, and studies of exposed populations.

At the request of the State, CDC will deploy trained and rapid

response teams who can assist in protecting the public’s health in

the event of a public health emergency. CDC response teams have

experienced an expertise in medical management, disease prevention strategies, assessing needs, first responder procedures, site

safety, environmental sampling strategies, sampling equipment,

and disease and injury surveillance.

All States and localities must be prepared to address these

threats and mount an effective response. In late January HHS announced a total of $1.1 billion in funding would be provided to

States to assist them in their bio-terrorism preparedness effort.

On January 31st Secretary Thompson notified each Governor of

the amount his or her State would receive to allow them to initiate

and expand planning and building the necessary public health infrastructure.

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In California the State received $60.8 million in funding from the

Center for Disease Control.

In conclusion, CDC is committed to working with other Federal

agencies and partners, State and local health departments, and the

healthcare and first-responder communities to ensure the health

and medical care of our citizens. Although we have made substantial progress in enhancing the Nation’s capability to prepare for

and respond to a terrorist episode, the events of last fall demonstrate that we must accelerate the pace of our efforts to assure

an adequate response capacity. A strong and flexible public health

system is the best defense against any disease outbreak or public

health emergency. Thank you.

[The prepared statement of Dr. Bice follows:]

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Mr. HORN. Thank you.

Mr. Castleman, Ron Castleman, has been at two or three hearings with us. That’s Regional Director in Region VI, Dallas, of the

Federal Emergency Management Agency, FEMA. They do a great

job. We thank you.

Mr. CASTLEMAN. Thank you. Good morning, Mr. Chairman and

Congressman Honda. I am Ron Castleman, Regional Director, Region VI, of the Federal Emergency Management Agency. It is a

pleasure to be here today to discuss how FEMA is assisting State

and local governments to prepare for potential terrorist attacks.

FEMA’s mission is to lead the Nation in preparing for, responding to, and recovering from disasters. Our success requires close coordination with local, tribal, State, and Federal agencies as well as

volunteer organizations.

The Federal Response Plan outlines the process by which Federal

departments and agencies respond as a cohesive team to all types

of disasters in support of State, tribal, and local governments.

This plan has been tested on numerous occasions since its inception in 1992 and the Federal Response Plan again worked well in

response to the terrorist events of September 11, 2001.

FEMA’s preparedness provides financial and technical planning,

training and exercise support to State and local and tribal governments. These programs are designed to strengthen capabilities to

protect public health, safety, and property both before and after

disasters occur.

On May 8, 2001 the President tasked FEMA Director Joe

Allbaugh with creating the Office of National Preparedness [ONP],

within FEMA. The ONP mission is to provide leadership in the coordination and facilitation of all Federal efforts to assist State and

local first-responders and emergency management organizations

with planning equipment, training, and exercises to build and sustain their capabilities to respond to any emergency or disaster including a terrorist incident.

The President’s formation of the Office of Homeland Security further improves the coordination of Federal programs and activities

aimed at combating terrorism. FEMA is working closely with Director Ridge, the OHS, and other agencies to identify and develop the

most effective ways to quickly build and enhance domestic preparedness for terrorist attacks.

In January of this year the President took another important

step to strengthen first-responder efforts to prepare for and respond to incidents of terrorism. The first-responder initiative in the

President’s 2003 budget calls for $3.5 billion most of which would

be distributed to States and local jurisdictions for planning efforts,

critical equipment, and to train and exercise personnel.

FEMA’s Office of National Preparedness will administer these

grants. ONP will also work with our Federal and State partners to

coordinate all terrorism related first-responder programs. To begin

addressing some of the lessons the first responder community

learned on September 11th, ONP will develop national standards

for inner-operability and compatibility in a number of areas including training, equipment, mutual aid, and exercising.

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The first-responder grants coupled with these standards will balance the needs for both flexibility and accountability at the State

and local level.

With respect to California, we continue to work very closely with

the Governor’s Office of Emergency Services and other State offices. Our mechanism for providing support in the past has been

the Nunn-Lugar 120 cities initiative. Recently through our Terrorism Consequence Management Preparedness Assistance Grant Program we have been able to fund terrorism and weapons of mass destruction preparedness activities at the local level.

Our funds are provided to the Governor’s Office of Emergency

Services and they in turn provide them to the California State

Strategic Committee on Terrorism. The areas of focus for the committee includes cyberterrorism, equipment, training, intelligence

and early warning systems, medical, health, resource allocation,

and others.

FEMA has also participated in senior official workshops, chemical weapons, tabletop exercises, as well as biological weapons tabletop exercises in the city of Long Beach and other California cities.

FEMA is well prepared and equipped to respond to terrorist disasters. We are strengthening our preparedness efforts now so that

State, tribal, and local governments and first-responders are well

prepared for disasters and emergencies including incidents of terrorism.

Continued coordination among all levels of government will ensure a safer America. Thank you for your time.

[The prepared statement of Mr. Castleman follows:]

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Mr. HORN. Thank you. We now move to Ms. Dalton. Patricia Dalton is the Director of Strategic Issues of the U.S. General Accounting Office. For some people that don’t really understand what GAO

does, they don’t just sit around and audit. That sort of went out

30 years ago. When Clarence Cannon died and Speaker Rayburn

died they blocked us all the way in terms of doing programmatic

research.

The General Accounting Office began in 1921 and they have done

a splendid job in the last 30 years under a number of fine Comptroller Generals of which none is finer than Mr. Walker, the current Comptroller General of the United States, the person with the

best term in Washington, 15 years and you can’t touch him. He

works for Congress and he works for the American people.

Ms. Dalton, not only on your statement but I think I counted

about 50 different terrorism things you have put together with

your colleagues. Go ahead and tell us if we have missed something

this morning.

Ms. DALTON. Thank you, Mr. Chairman. We appreciate your very

kind remarks. Mr. Chairman, Congressman Honda, I appreciate

the opportunity to be here in San Francisco to discuss issues critical to national preparedness.

GAO has called for the development of a national strategy that

will improve our overall preparedness. The creation of the Office of

Homeland Security under the leadership of Tom Ridge is an important and potentially significant first-step.

As it comes together, we believe there are three key aspects of

the national strategy that should be included. First of all, a definition and clarification of the appropriate rules and responsibilities

of Federal, State, and local entities on which we have heard a considerable amount here this morning at this hearing. Second, the establishment of goals and performance measures to guide our national preparedness efforts. Finally, a careful choice of the most appropriate tools of government to best implement the national strategy and achieve appropriate goals.

I would like to very briefly discuss each one of these points.

First, the roles and missions of Federal, State, and local entities

need to be clarified. Although the Federal Government appears

monolithic to many, in the area of terrorism prevention and response it has been anything but and we have certainly heard about

that this morning. There are more than 40 Federal entities that

have a role in combating and responding to terrorism and 20 Federal entities alone in the bio-terrorism area.

Concerns about coordination, fragmentation and Federal preparedness efforts are well founded. There has been no single leader

in charge of the many terrorism related functions conducted by different Federal departments and agencies.

This lack of leadership has resulted in the Federal Government’s

development of programs to assist State and local governments

that often are similar and potentially duplicative.

This has created confusion at the State and local level. State and

local response organizations believe that Federal programs designed to improve preparedness are not well synchronized or organized and have called for a single focal point, a one-stop center in

some cases.

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The second aspect the national strategy that we believe needs to

be addressed is that performance and accountability measures need

to be included in the strategy. Numerous discussions have been

held about the need to enhance the Nation’s preparedness but national preparedness goals and measurable performance indicators

have not yet been developed.

Clear objectives and measures are critical to a sustainable strategy that provides a framework for defining our roles and our responsibilities.

Finally, appropriate tools need to be selected for designing Federal assistance. Our previous work on Federal programs suggest

that the choice and design of policy tools have important consequences for performance and accountability.

Governments have at their disposal a variety of policy instruments such as grants, regulations, tax incentives, and regional coordination and partnerships that they can use to motivate or mandate other levels of government and private sector entities to take

action to address security concerns.

For example, the Federal Government often uses grants to State

and local governments as a means of delivering Federal programs.

Grants can be designed to: one, target the funds of State and localities with the greatest needs; two, discourage the replacement of

State and local funds with Federal funds through maintenance of

effort requirements that recipients maintain their level of previous

funding; and most importantly, three, strike a balance between accountability and flexibility to the grantees of State and local governments.

Intergovernmental partnerships and regional coordination will

also be important, particularly with respect to information sharing

and mutual aid agreements. National preparedness is a complex

mission that requires unusual interagency, interjurisdictional, and

interorganizational cooperation. We have certainly heard some of

the difficulties at the local level in this area.

An illustration from the Federal perspective of the complexity of

the issues that are being dealt with can be seen at the sea ports.

At least 15 Federal agencies alone have some responsibility for our

ports. Primary are the Coast Guard, Customs, and the Immigration

and Naturalization Service, but there are many others.

Local officials have emphasized the importance of regional coordination. Mutual aid agreements provide a structure for assistance and for sharing resources among jurisdictions in response to

an emergency. They will be critical in any response to emergencies.

Mr. Chairman, in conclusion, as increasing demands are placed

on budgets at all levels of government, it will be necessary to make

sound choices to maintain physical stability. All levels of government and the private sector will have to communicate and cooperate effectively with each other across a broad range of issues to develop a national strategy to better target available resources and

to use all of our available resources to address the urgent national

preparedness needs.

This completes my prepared statement. I would be pleased to answer any question.

[The prepared statement of Ms. Dalton follows:]

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Mr. HORN. Thank you. We will now go to questions and I’ve got

a few just to wrap up the last panel and this one.

Mr. Riordan, we understand that the Department of Defense has

a list of biological agents that it is unwilling to share with water

districts. Is that true?

Mr. RIORDAN. There was a published report that there was a list

of available agents that we could use as a tool for detecting contamination in water systems. It was published prior to September

11th and then right after September 11th, obviously, everyone

started stepping-up the procedure to start figuring out what we

need to test for. We went to the same Web sites and all that information was stripped off.

The same access to that information was now gone because it

was considered classified information. While it was available prior

to that, there wasn’t enough preparedness efforts taking care of

prior to September 11th to give that information out or disseminate

it. When people were aware of it they went to look for it again and

they discovered that it was now considered confidential or classified

so we couldn’t get that same information.

Mr. HORN. Now, we have very fine laboratories at Walter Reed.

We have the Food and Drug, we have the CDC. I just wonder what

is your feeling on that, Dr. Bice, the Director of the Stockpile, but

you are a major employee of the Center for Disease Control and

Prevention. What do you think about this business of not sharing

biological agents with water districts?

Dr. BICE. Mr. Chairman, that is a tough question for me to answer. Let me just say that I am fully aware of the complexities

after September 11th of classifying data and what we thought was

public information prior to that time that we all are now concerned

about that information getting into the wrong hands.

At the same time we are a public health and prevention agency.

We go out of our way to share as much data as we possibly can

with our colleagues in water districts, as well as any other health

related arena.

But there is a classic dilemma when it comes to sharing information which could potentially be useful to terrorists and sharing that

same information with our colleagues to help them better prepare.

Guidelines in this regard would be exceedingly helpful and I know

that Governor Ridge’s Office is moving in that direction.

Mr. HORN. OK. That’s helpful Would you go back to the smallpox

issue which we were talking about. Are those 30-year-old vaccines

still potent?

Dr. BICE. Yes, sir. They are.

Mr. HORN. They are? So they can be used?

Dr. BICE. That’s affirmative. Yes, sir. They can.

Mr. HORN. Have we played out this thing with some of the countries that have that and how many vials of the vaccines do we have

and if you were a foreign power or whatever, that would take how

many and have we got enough in the warehouses now?

Dr. BICE. Sir, the answer to that question is somewhat complex.

I’m not an intelligence expert and so, Mr. Mefford, I will defer that

aspect of an answer to colleagues in FBI and other intelligence

agencies.

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With respect to the vaccines that are either being produced today

under contract to HHS or that are in stockpiles, we will by the end

of this calendar year buy enough vaccine to vaccinate the citizens

of the United States should that become necessary.

Mr. HORN. OK. Let’s see if we have any little roundup things to

get this.

Mr. Mefford, I think we were sort of surprised to hear that there

is still a communication gap when it comes to intelligence. I know

the FBI is doing a lot to do it and I agree with them that if you

are going to give it to somebody in a police department or whatever, you are going to check that person out so that they are not

under pressure and they are not giving out data. I just wondered

here tell us a little on where the FBI is going on this.

Mr. MEFFORD. Yes, Mr. Chairman. In San Francisco we have developed a program where every member, non-FBI member of the

Joint Terrorism Task Force receives a top secret clearance. In addition, their agency can designate other officers from all of the 24 additional agencies that participate in this task force. We are undergoing, right now, a number of security classification background investigations to give designated personnel and all of the participants

of the task force the necessary security clearances to receive the

raw data.

Having said that, as you know, much of the information can be

distilled and we can release it in a public form. Clearly we look for

opportunities to do that. Our problem is we need to better enhance

our capabilities to make rhyme or reason of the vast amount of intelligence data that is out there.

Sometimes we are overwhelmed with information. As you know,

we are struggling with an archaic computer system within the FBI;

but we need to do a better job of analyzing the data and determining exactly what is relevant; and then getting that threat information to the local and State agencies that have a need to know. We

have a ways to go, but the Director has identified our weaknesses;

and we are moving, I think, as rapidly as we possibly can to improve.

Mr. HORN. That’s good.

I now yield 10 minutes to my colleague, Mr. Honda.

Mr. HONDA. Thank you, Mr. Chairman. I want to thank the witnesses for testifying today also.

One of the concerns that came up earlier in the first panel was

funding and grant processes. To both Mr. Castleman and Ms. Dalton, perhaps you can respond to the question. Will there be a one

process or one stop mechanism for grants and flow of revenue for

the Federal down to the local government?

Mr. CASTLEMAN. We are still developing the mechanism which

we hope to be very practical and user friendly for that process.

We’ve been in the business of grants management for some time.

Most recently another subject, fire grants, we were able to do that

over the Internet to make it easier for local fire departments to

apply for grants. We are hoping for something simple and easy to

use for first provider grants as well, but that is still under development.

Mr. HONDA. So it is work in progress?

Mr. CASTLEMAN. Yes.

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Mr. HONDA. The flow of the revenues, would that be done functionally or is it structural meaning will it go through State, county,

local, or will it go to entities that are more complex that could go

directly versus counties that need help from the State?

Mr. CASTLEMAN. It will go to the State for determination down

to the local level from the State.

Ms. DALTON. One of the issues that will need to be addressed is

that there are multiple sources of funding. There are a number of

Federal agencies that are involved in giving money to the State

and local governments. FEMA does have a primary responsibility.

One of the things I believe the States and local governments are

seeing is not just one face to the Federal Government but multiple

faces.

There are some models within the Federal Government in terms

of distribution of funds. For example, in our training and employment programs there has been a move toward one stop centers to

funnel out services and that certainly would be a possible model to

be examined.

What FEMA alone is doing is a good step in the right direction

but we have to look at the total government and present that single face and hopefully the national strategy that Governor Ridge is

developing will start addressing some of those issues. It certainly

is a problem that we need to be dealing with.

Mr. HONDA. So what I hear you saying is that FEMA has just

put one tree in the forest.

Ms. DALTON. Yes, sir.

Mr. HONDA. In your report you indicated there are many agencies with many grant sources. Have you suggestions on how that

can be put out there electronically so that people that want to write

grants can look at a myriad at once and pull from various sources

so that they don’t have to go through a lot of repetitious work? Is

there a way to make it simple?

Ms. DALTON. Certainly I think there are ways to make it simpler

than what it is. It will take a concerted and coordinated effort on

the part of the Federal Government, the Congress, and the executive branch in order to address this issue.

Mr. HONDA. So you are saying you can identify it but it is not

your purview to correct it? It’s up to somebody else to sort of figure

out how to do that?

Ms. DALTON. Right. I think the national strategy should address

some of these issues through the budget process. Hopefully there

will be some solutions. There are, as I said, some models within the

Federal Government alone of trying to integrate the delivery of

services and I think that is what we are talking about here.

Mr. HONDA. I heard you use that term national strategy. Is that

term applicable to a variety of things that we need to do within the

context of counterterrorism?

Ms. DALTON. The national strategy we believe will at least put

a framework and define roles and responsibilities, not just for the

Federal Government but should be State, local, and private sector.

Mr. HONDA. OK.

Mr. RIORDAN. Just one additional item is typical of most grant

applications you have to reveal a report of some sort. I think it is

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very important to maintain the security of the information that is

presided or presented in any reports that do come out of grants.

That is one of the concerns we did have initially of the EPA

grants that came up for water systems, vulnerability assessments.

We don’t want to release a lot of information on what our

vulnerabilities are. I think that is very critical as well is whatever

grant process is decided upon.

Mr. HONDA. There has been a term out there called national

threat risk assessment. Is that being done? If so, by whom? If we

are doing it, when will it be ready? Does anybody know?

Mr. RIORDAN. Well, I do know for the process for the EPA grants,

EPA worked closely with Sandia National Labs on applying their

risk assessment model to the water industry.

They just finished eight different workshops across the Nation

trying to provide this information to the water utilities on how to

apply this risk assessment model to the water industry which presents a huge issue for us as a water industry because our system

spans such a large area, maybe 90 miles worth of facility.

It is not like trying to secure one facility. It may be a multitude

of facilities over a long or large area which creates a major concern

for us because you can’t apply the same information. I do know

that is one risk model that is being presented out there.

Mr. HONDA. Are there other models?

Ms. DALTON. Yes, there are. Usually the risk assessment models

are targeted toward a specific sector. Currently there are a number

of different models that are being used at the Federal level for the

various agencies. As Chairman Horn pointed out, the General Accounting Office has some 60 reports in these various areas, some

of which are dealing with the risk assessments.

Mr. HONDA. Thank you. I think it was Dr. Bice that answered

the question that you have sufficient vaccines for this country for

smallpox. When you answered yes for everyone in this country,

then I assume that you are saying that by the end of the year there

would be approximately 340 million vaccines available?

Dr. BICE. That is approximately the case. Yes sir.

Mr. HONDA. And the deployment of the vaccines to local hospitals

and health centers, how will that be done?

Dr. BICE. Well, sir, it will be held in a repository—several repositories around the United States. It is a policy decision at the congressional level. At HHS it is above my pay grade, sir, to answer

the question but, the truth is, we will have the vaccines. How we

will distribute it in an emergency we have those plans that we’ve

drawn up in the National Pharmaceutical Stockpile Program, but

the truth of the matter is there are policy decisions that have to

precursor that.

Mr. HONDA. Such as cost of distribution and cost of acquisition?

Is that also part of that? Is there a cost to local government on

that?

Dr. BICE. There would definitely be a cost. Not so much of acquisition but a cost of storage and distribution. Once it hit a State

level airfield, a State level facility for them to further distribute it

out to people they would incur human resource costs and transportation costs and others. Yes, sir.

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Mr. HONDA. You said that the stockpile is still viable. The new

stock is it more viable or equal viability?

Dr. BICE. I guess the easiest way to answer the question is that

they are both viable vaccines. They both can be used, the new vaccines as well as the vaccine that is in storage.

Mr. HONDA. So you are saying they are of equal viability and use

even though they have been stored for a couple of decades?

Dr. BICE. A number of years. Yes, sir.

Mr. HONDA. I guess, Ms. Cherry, did you have a comment?

Ms. CHERRY. Yes. Thank you. I would like to add a little bit on

the Sandia Lab vulnerability assessment tool being used by water

systems. This model was originally developed for our nuclear power

facilities and then it was modified to be applied to water systems.

I think it is a good model and has applications for our larger

water systems but it lacks the analyses of the soft side of water

systems being management, operation, and administration. It is

important that whatever model be applied to water systems, that

it look at all aspects of the water systems, not just the infrastructure and water system components.

Mr. HONDA. What did you mean by soft?

Ms. CHERRY. The model looks at the physical infrastructure of

the water system, pumps and pipelines and treatment, and it

doesn’t get into the specifics of management, operation, and administration.

Mr. HONDA. Thank you, Mr. Chair.

Mr. RIORDAN. We would concur as a large water utility we found

the same thing. Even though we all attended that same training

there were a lot of issues not covered by that assessment process.

Dr. BURTON. If I could, I would just share a comment on the

smallpox discussion. Dr. D. A. Henderson and the Office of Public

Health Preparedness has convened a group under the Center for

Disease Control and Advisory Immunization Practices Group that

will be specifically looking at recommendations and policy implications of how best to use the smallpox vaccine as it becomes available. The timeline he set for that is that the recommendations will

be out of that group, national cross-disciplinary group, by sometime

late summer but before the vaccine will be fully available so we

will be ready to use it as best we can.

Mr. HORN. Well, I want to thank this panel and the first panel.

It’s been a very useful and, I think, very realistic matter. Thank

you for taking your time out. You all have a lot of things to do. All

of these things don’t happen unless a lot of people relate to this.

Our subcommittee staff is headed by the gentleman in the back

there, J. Russell George, Staff Director and Chief Counsel. To my

left for this particular hearing is Bonnie Heald, the Deputy Staff

Director, Justin Paulhamus, the Majority Clerk, is that very high

guy that comes and gets things done. Thank you, Justin.

Earl Pierce had to stay at home. He was the professional staff

member who was not here today but helped coordinate everyone’s

testimony. Then from Congressman Honda’s office, Ernest Baynard

is the Communications Director and we appreciate all of his help.

Speaking of communications director, David Schwaegler of the

Lawrence Livermore National Laboratory also was very helpful on

the communications. We are very grateful to the judge of this

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court, Judge Patel and her staff. We appreciate very much what we

could do and couldn’t do and did. We also have the General Services Administration, James Lew, Property Manager, and Ian Keye,

Operational Analyst.

And the court reporters are George Palmer and Susan Palmer.

That’s a tough job with all the people and different things as we

go across the country. Thank you all. With that, we are adjourned.

[Whereupon, at 12:35 p.m., the hearing was adjourned.]

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