“Building Legal Preparedness for Public Health Emergencies” Remarks by Joe D. Whitley General Counsel U.S. Department of Homeland Security National Association of Attorneys General East Lansing, MI April 19, 2005

Introduction Vision Statement Mission Statement Preserving our freedom, protecting America . . . we secure our homeland. Mission Statement We will lead the unified national effort to secure America. We will prevent and deter terrorist attacks and protect against and respond to threats and hazards to the nation. We will ensure safe and secure borders, welcome lawful immigrants and visitors, and promote the free-flow of commerce.

DHS Critical Missions Prevent terrorist attacks within the United States; (B) Reduce the vulnerability of the United States to terrorism; (C) Minimize the damage, and assist in the recovery, from terrorist attacks that do occur within the United States; (D) Carry out all functions of entities transferred to the Department, including by acting as a focal point regarding natural and manmade crises and emergency planning;

Critical Missions (cont) (E) Ensure that the functions of the agencies and subdivisions within the Department that are not related directly to securing the homeland are not diminished or neglected except by a specific explicit Act of Congress; (F) Ensure that the overall economic security of the United States is not diminished by efforts, activities, and programs aimed at securing the homeland; and (G) Monitor connections between illegal drug trafficking and terrorism, coordinate efforts to sever such connections, and otherwise contribute to efforts to interdict illegal drug trafficking.

DHS Organization Directorates Border and Transportation Security. Budget of $40.2 billion ($7 billion in fees); employs 180,000 people. Over 22 legacy agencies; largest reorganization in over 50 years. 5 Under Secretaries appointed by the President subject to advice and consent of Senate— Directorates Border and Transportation Security. Emergency Preparedness and Response. Information Analysis and Infrastructure Protection. Science and Technology. _______________________________________________ 5) Management.

DHS Organization (cont) Coast Guard Secret Service Citizenship & Immigration & Ombudsman Civil Rights and Civil Liberties Legislative Affairs General Counsel Inspector General State & Local Coordination Private Sector Coordination International Affairs National Capital Region Coordination Counter-narcotics Small and Disadvantaged Business Privacy Officer Chief of Staff Secretary & Deputy Secretary Information Analysis & Infrastructure Protection Science & Technology Border & Transportation Security Emergency Preparedness & Emergency Response Management

Origin of DHS Components Border and Transportation Security U.S. Customs Service (Treasury) Immigration & Naturalization Service (DoJ) Federal Protective Services (GSA) Transportation Security Administration (DoT) Federal Law Enforcement Training Center (Treasury) Animal & Plant Health Inspection Services (DoA) Directorate of Information Analysis & Infrastructure Protection Critical Infrastructure Assurance Office (Commerce) Federal Computer Incident Response Center (GSA) National Communications System (DoD) National Infrastructure Protection Center (FBI) National Infrastructure Simulation and Analysis Center and Energy Security and Assurance Program (DoE) Non-Directorate Components U.S. Coast Guard (DoT) U.S. Secret Service (Treasury) Office for Domestic Preparedness (DoJ) Directorate of Emergency Preparedness & Response Federal Emergency Management Agency National Disaster Medical System (HHS) Nuclear Incident Response Team (DoE) Domestic Emergency Support Teams (DoJ) National Domestic Preparedness Office (FBI) Directorate of Science and Technology Chemical, Biological, Radiological and Countermeasures Programs (DoE) Environmental Measurements Laboratory (DoE) Lawrence Livermore National Laboratory’s advanced scientific computing research program and activities (DoE) National Bioweapons Defense Analysis Center (DoD) Plum Island Animal Disease Center (DoA)

Medical Preparedness/Protection NDMS (National Disaster Medical System) MMRS (Metropolitan Medical Response System) Biodefense University Centers of Excellence Resources

National Disaster Medical System (NDMS) Concept: NDMS was established by the U.S. Public Heath Services (USPHS) to create a single integrated national medical response capability through specialized teams to support State and local health care agencies that are overwhelmed during a major disaster or emergency. NDMS is comprised of 8,000 personnel (mostly volunteers) and 108 specialized teams. The NDMS teams are activated and deployed for high-threat events, such as National Security Special Events, major transportation accidents, acts of terrorism, technological disasters, and an overseas conventional conflict.

National Disaster Medical System Partners: The NDMS, by the direction of the Department of Homeland Security, is a partnership between Federal, State, and local government as well as the private sector and volunteer organizations. Federal Partners: U.S. Department of Defense, U.S. Department of Veterans Affairs, and the Federal Emergency Management Agency

National Disaster Medical System Primary Components of the System: Medical Response Patient Evacuation Definitive Medical Care

National Disaster Medical System Medical Response Medical Response Teams: Management Support Team (MST) Disaster Medical Assistance Team (DMAT) International Medical and Surgical Response Team (IMSRT) Disaster Mortuary Operational Response Team (DMORT) National Medical Response Team (NMRT)

National Disaster Medical System Management Support Teams (MST): The MST are the first NDMS teams to be deployed within the first 4 hours of a disaster notification to the disaster area. Responsibilities: Gauge the scope of the disaster Provide management support to the other NDMS deployed teams Use the Incident Command System (ICS) Meet with local authorities to determine the needed resources Assist in the integration of Federal assets into the overall disaster response

National Disaster Medical System Disaster Medical Assistance Teams (DMAT): The DMAT are deployed within 4 to 8 hours of a disaster notification to provide on-site medical care during a disaster. The DMAT is a 35 person team of volunteers, which include physicians, nurses, paramedics, emergency medical technicians, pharmacists, mental health specialists, dentists, therapists, laboratory and environmental health specialists, logisticians, and administrative support. Services Provided: Triage Medical and Surgical stabilization Advance life support Acute primary care Objective is to be operational within 6 hours of arrival and sustain 24hr/day operations for 3-days without external support

National Disaster Medical System International Medical and Surgical Response Teams (IMSRT): The IMSRT will deploy to an international disaster site and foreign hospitals within 4 hours of notification to provide health, medical, and evacuation services to U.S. citizens abroad that have become a victim of a disaster. Teams are highly specialized, trained, and equipped to establish a fully functioning field surgical facility anywhere in the world. Services Provided: Triage Initial stabilization Surgical and Critical Care Evacuation

National Disaster Medical System Disaster Mortuary Operational Response Teams (DMORT): The DMORT provide on-site mortuary services for mass casualty events, such as natural disasters, terrorist attacks, and transportation accidents. The teams receive specialized Weapons of Mass Destruction response training, which allows them to provide services to contaminated fatalities and work in contaminated environments. Services Provided: Victim recovery Identification and processing Family assistance Data collection and matching Chemical, nuclear, biological decontamination of remains

National Disaster Medical System National Medical Response Teams (NMRT): Weapons of Mass Destruction (WMD): The NMRT: WMD will deploy to a contaminated environment within 4 to 6 hours of notification to provide emergency medical, agent detection, and decontaminated services to victims of a Weapons of Mass Destruction or hazardous materials incident. The team is comprised of trained and specialized volunteer health, medical, and hazardous materials professionals.

National Disaster Medical System Patient Evacuation Patient evacuation from a disaster area is led by the U.S. Department of Defense Federal Coordinating Center and Global Patients Movement Requirement Center (GPMRC). Federal Coordinating Centers (FCCs) Responsibilities: Develops patient reception, transportation, and communication plans Recruits, trains, and supports response teams Facilitates local emergency planning Coordinates the reception and distribution of patients during system activation Global Patients Movement Requirements Center (GPMRC) Responsibilities: Coordinates patient movement Determine which FCCs will receive patients based on needs, available beds, and Transportation at the disaster site.

National Disaster Medical System Definitive Medical Care The NDMS works with accredited hospitals and other medical facilities that volunteer to be part of a coordinated rapid response to a disaster and major emergencies. The facilities agree to commit a self-determined number of beds for acute care of NDMS patients. Reimbursement of member hospitals that accept NDMS patients is guaranteed by the Federal government.

Metropolitan Medical Response System (MMRS) Concept: The MMRS helps to ensure communities are equipped and trained for a rapid and comprehensive response to emergencies by using local resources. MMRS in Action: In an emergency each communities MMRS plan is put into action initiating an integrated emergency response. The Incident Commander requests local emergency response assets and any needed Federal and State support.

Biodefense Interagency effort DHS Directorates directly involved IA and IP (Information Analysis and Infrastructure Protection) S&T (Science and Technology) Mission: To prevent, protect against, respond to, and recover from acts of bioterrorism against the American people IA and IP: Assesses intelligence and information about threats and vulnerabilities S&T: Focuses on research, development, testing, and evaluation of methods to protect and prevent bio terrorist acts

Biological Countermeasures BioWatch (Generations 1, 2, 3) Environmental sensor system Autonomous pathogen detection system National Bio Surveillance Integration System Interagency process Biodefense Knowledge Center National Bioforensic Analysis Countermeasure Center (NBACC)

University Centers of Excellence Mission: Stimulate, coordinate, leverage and utilize the unique intellectual capital in the academic community to address current and future homeland security challenges, and to educate and inspire the next generation of scientists and engineers dedicated to homeland security. Examples: Center for Risk and Economic Analysis of Terrorism Events National Center for Foreign Animal and Zoonotic Disease Defense National Center for Food Protection and Defense Georgia Institute of Technology (partner with University of Minnesota) Center of Excellence for Behavioral and Social Research on Terrorism and Counter-Terrorism Center for High Consequence Event Preparedness and Response

Resources National Contact Information: Department of Homeland Security National Disaster Medical System Section 500 C Street SW, Suite 713 Washington, DC 20472 Phone: 1-800-USA-NDMS (800-872-6367) Fax: (202) 646-4618 Regional Contact Information: Georgia Hospital Association (770-249-4500) (www.gha.org) Georgia Division of Public Health (404-657-2700) (http://health.state.ga.us) State of Georgia Office of Homeland Security (404-635-7030) (http://www.gahomelandsecurity.com) Local FEMA POC: Don Wetter (770-220-5665) Joe Whitley, General Counsel, DHS (202-692-4232)