For example, in the preparation of the Five-Year Counterterrorism and Technology Plan for the Administration, the Attorney General of the United States directed the Department of Justice, Office of Justice Programs, to host a meeting of individuals who represent the various emergency response disciplines that would most likely be involved in the response to a terrorist event. More than 200 stakeholders representing each of the response disciplines, including fire services and HAZMAT personnel; law enforcement and public safety personnel; emergency medical and public health professionals; emergency management and state government officials; and various professional associations and organizations all attended the two-day session. Collectively, they made recommendations to the Attorney General; James Lee Witt, Director of FEMA; Dr. Hamre, the Deputy Secretary of Defense, and other Federal officials on ways to improve assistance for state and local communities. These recommendations have been incorporated in the Attorney General's Five-Year Plan.

The most critical issue identified by stakeholders was the need for a central federal point of coordination. Due to the size and complexity of both the problem of terrorism and of the federal government itself, it was no surprise that the many different avenues through which aid may be acquired, by state and local officials, and the resulting inconsistency of those programs was deemed to be simply overwhelming. In essence, the federal government, though well intentioned, was not operating in an optimal manner nor was it effectively serving its constituents with regard to Domestic Preparedness programs and issues.

With careful consideration of the Stakeholders' recommendations, the Attorney General consulted the National Security Council, Federal Emergency Management Agency, Department of Health and Human Services, and other relevant agencies regarding the creation of a single coordination point within the federal government to better meet the needs of the Nation. It was agreed that the FBI, in conjunction with its existing responsibilities for coordinating federal assets during an actual terrorist event, would lead the interagency coordination initiative now known as the National Domestic Preparedness Office.

It is intended that the NDPO will serve as a much needed clearinghouse to provide information to local and state officials who must determine the preparedness strategy for their community. In keeping with Stakeholder's requests, the NDPO will also provide a forum for the establishment of agreed upon recommended minimum standards upon which federal programs should be built.

Federal Participants in the NDPO currently include the Department of Defense, Department of Energy, the Department of Health and Human Services, the Environmental Protection Agency, the Office of Justice Program, the Federal Bureau of Investigation, the Federal Emergency Management Agency, the National Guard Bureau, and in the near future, the U.S. Coast Guard, the Nuclear Regulatory Agency, and the Office for Victims of Crime.

Stakeholders also cited the need for formal representation of state and local officials with the federal agencies in the form of an advisory board to guide the development and delivery of more effective federal programs. Federal agencies agree that their participation is critical to the whole process of Domestic Preparedness. Therefore, in addition to the Advisory Board, it is anticipated that when fully staffed, approximately one-third of the office will be comprised of State and Local experts from various response disciplines. These positions will be filled through the establishment of interagency reimbursable agreements or through contract hires and volunteer service arrangements.

Stakeholders easily identified six broad issue areas in need of coordination and assistance. These areas are: Planning; Training; Exercise; Equipment Research and Development; Information Sharing; and Public Health and Medical Services. I would like to highlight just a few of the ongoing efforts of the NDPO in each of these

areas.

In the area of Planning, the NDPO is coordinating, with FEMA, the implementation of a WMD Resource Database to detail all of the available response assets for consequence management to an incident involving_weapons of mass destruction. NDPO will facilitate the distribution of the United States Government Interagency Domestic Terrorism Concept of Operations Plan and other Planning_guidance for State and Local communities, through the WMD Coordinators in the FBI's field offices to ensure a unified response to a WMD incident. The benefit of the guide is to explain to state and local planners the logistics of how federal assets may be included in their local emergency res onse plans.

In the area of Training, the NDÍ is continuing to coordinate the DoD initiative to maintain a compendium of exisg training courses available to emergency responders; it is establishing a mech ism to ensure that federal training programs comply with national standards ar to provide quality assurance; it is developing

63-249 00-2

a national strategy to make sustained training opportunities and assistance available to all communities and states.

In connection with the Information Sharing program area, the NDPO has implemented, in association with the FBI, a mechanism to grant access by approved personnel outside law enforcement to information that may be important for preparedness and consequence management. Internet web-sites, both public and secure have been established for the sharing of public safety information. Links to existing web

sites will also be built.

In the Exercise program area, the NDPO has adapted a military software application for civilian use to track the lessons learned during exercises and actual events. The NDPO will provide this tool to the communities through the WMD Coordinators and will maintain an After-Action Tracking database for the repository and review of all lessons that might assist other communities.

In the Equipment/Research and Development program area, the NDPO has established a Standardized Equipment List which has been incorporated into the grant application kits used by the Office of Justice Programs. The NDPO will again serve as a clearinghouse for product information provided by private vendors and testing data provided by the Department of Defense to promote synergy and avoid costly duplication in the area of federal research and development.

In the Health and Medical program area, the NDPO, under the guidance of Public Health Service of the Department of Health and Human Services will coordinate efforts to support Metropolitan Medical Response Systems, pharmaceutical stockpiling, the establishment of a nationwide surveillance system to improve the identification of infectious diseases and the integration of the public and mental health care community into WMD response plans.

Last week, the NDPO sponsored the first to two major conferences attended by representatives from Federal, State and local agencies. At that time, the Attorney General was presented with an overview by several communities of their cooperative efforts, which illustrated of the growing cooperation between all levels of government to address their preparedness needs of this Nation to deal with a major terrorist event, including those that involve WMD.

I thank you for the opportunity to speak to you today, and in the future as the NDPO continues to mature into the "one-stop shopping" for domestic preparedness as proposed by the Attorney General of the United States. As she has recently said, "the actions of the first people on the scene can really make the difference between life and death. The key is to work together in a partnership among federal, state and local communities to prepare a coordinated response that saves lives and provides for the safety for all involved". She continued to say that "none of us, federal, state or local can do it alone, we're all in this together". I stand ready to respond to any questions you may have.

Senator SESSIONS. Senator Jon Kyl is here now, and he chairs the Subcommittee on Terrorism and is an expert in these areas. Jon, before we continue, I would like for you to make any comments that you might have.

STATEMENT OF HON. JON KYL, A U.S. SENATOR FROM THE STATE OF ARIZONA

Senator KYL. Well, thank you, Mr. Chairman, and with the indulgence of the panel that is already assembled, I would like to make some brief comments because this is a critical issue and I would like at least for the other people here to know what we have been doing as well. I appreciate very much your willingness to chair the hearing between our two subcommittees. As you know, Senator Feinstein is the ranking member on our other subcommittee and she has been very helpful on this as well.

There have been a number of incidents-the World Trade Center bombing, the use of sarin in the Tokyo subway, the bombing of the Murrah Building-coupled with predictions of increased terrorist efforts to acquire weapons of mass destruction, that have really shocked a lot of Americans into beginning to think about how well prepared our communities are to address an incident involving weapons of mass destruction.

In many respects, they see the task as daunting. It involves coordinating a response across many jurisdictions, as has just been pointed out, many autonomous community entities, including law enforcement, fire and rescue, private and public health officials, military, intelligence, and many Federal agencies. Moreover, the response needed is different in each case.

For example, biological attack represents unique challenges, as individuals may be infected in one city or State and move to another before symptoms emerge. In this case, the first responder may be a public health official, perhaps in a rural part of the State. It therefore becomes essential that information, diagnosis and antidotes be shared with every corner of the country, which is an unimaginably difficult task.

The Nunn-Lugar-Domenici legislation from 1996 wisely forecasted the need to coordinate these efforts to ensure an effective overall response. Last year, the city of Phoenix, where I come from, conducted one of the preparedness drills that resulted from the legislation. Many problems surfaced during the exercise. The FBI was notified too late. Hospitals were not updated about the mock chemical attack. Mock patients were overlooked or were not decontaminated before being transported. Communication was too slow. Despite the problems, the drill was declared 85-percent effective, not a spectacular success, but at least not a failure.

DOD's implementation of the Domestic Preparedness Program has met with some criticism. For example, a November 1998 report by GAO identified a number of challenges facing the successful implementation of the program, and I will be anxious to receive responses from DOD and DOJ to some of the GAO criticisms.

So, Mr. Chairman, I look forward to hearing from our witnesses today. I have got some very specific questions about the operational aspects of the Domestic Preparedness Program, and if I don't get into all of them today, I will submit them for writing and the witnesses can respond later.

So, again, thank you, and thank you to the panel for allowing me to interrupt.

Senator SESSIONS. Well, thank you, and thank you for your consistent leadership on this issue.

I was just given a note, a sad note, but it also perhaps indicates why we are here. The note is that we have a shooting at a high school in Denver. Eight people have been shot. A masked gunman with a machine gun is on the scene. So we are having so much of that today, and it is not much to go from a gun to a bomb, to a chemical weapon. So I guess that is the nature of the world we are going to be living in for some time.

And I hope for the two Senators' benefit that as we go through this we will think about not just what we want accomplished, but how it is this Government is going to do it, because there are so many agencies involved, so many people that have a mission and a desire to contribute, that we have got to make sure that they are not duplicating one another and working effectively.

Dr. Hughes, would you make your statement at this time?

STATEMENT OF JAMES M. HUGHES

Dr. HUGHES. Mr. Chairman, Senator Kyl, Senator Feinstein, thank you for the invitation to discuss the need to enhance the public health capacity in the United States to respond to the threat of bioterrorism. I will briefly describe CDC's actions to strengthen our Nation's public health laboratories and disease surveillance and control programs to ensure an effective response to acts of biological and chemical terrorism.

In the past, an attack with a biological agent was considered very unlikely. However, many experts currently believe that it is no longer a matter of if, but when such an attack will occur. They point to activities by groups such as Aum Shinryko which, in addition to releasing nerve gas in Tokyo's subway, experimented with botulism and anthrax.

The initial response to an attack on civilians by a bioterrorist is likely to be made by the public health community rather than by the military or emergency responders. When people are exposed to agents such as those causing anthrax or smallpox, they will be unaware of the exposure and will not feel sick for some time. This delay between exposure and onset of illness, known as the incubation period, is characteristic of infectious diseases. The incubation period may range from several hours to a few weeks, depending on the nature of the exposure and pathogen.

Protection against terrorism requires investment in the public health system. This point was underscored in a recent report issued by Institute of Medicine, which stresses the need for longterm public health improvements in surveillance, epidemiology and laboratory capacity.

In 1998, CDC issued "Preventing Emerging Infectious Diseases: A Strategy for the 21st Century," our plan for preventing emerging diseases. It focuses on four goals, each of which has direct relevance to preparedness for bioterrorism-disease surveillance and outbreak response, applied research, infrastructure and training, and disease prevention and control. This plan emphasizes the need to be prepared for the unexpected, whether it be the next naturaloccurring influenza pandemic or the deliberate release of organisms causing smallpox or anthrax.

CDC, working in collaboration with State and local health departments, many other public health partners, the HHS Office of Emergency Preparedness, and other Federal agencies and departments, has begun the effort to upgrade national public health capabilities to respond to biological and chemical terrorism.

Because terrorists may employ a wide range of agents, this country's infectious disease surveillance networks must have enhanced capacity to detect unusual events, unidentified agents and unexplained illnesses. In addition, State and Federal epidemiologists must be trained to consider the possibility of unusual or rare threat agents when a suspicious outbreak occurs and be prepared to address questions related to transmission, treatment and prevention. This past February, CDC announced the availability of nearly $41 million in cooperative agreement funds for our State and local health department partners who will be on the front line in the event of a bioterrorism episode. This announcement, along with other extramural and intramural strategies, focuses on strength

ening four components of the public health infrastructure to improve the national capacity to address biological and chemical terrorism.

First, detection of unusual events will most likely occur at the local level initially. Therefore, it is essential to train physicians and other health care workers who may be the first to examine and treat the victims, and to upgrade the surveillance systems of State and local health departments which will be relied upon to spot unusual patterns of disease and to identify any additional cases as the disease spreads throughout the community and potentially beyond, as Senator Kyl noted.

Second, investigation and containment of outbreaks will also take place at the local level initially. For this reason, it is imperative that State and local health departments have sufficient resources to conduct timely epidemiologic investigations. CDC is also working to establish a national pharmaceutical stockpile.

Third, rapid laboratory diagnosis will be critical so that prevention and treatment measures can be implemented quickly. CDC is working with public health partners to plan the development of a multi-level network of laboratories, including hospital labs, commercial labs, State and local public health labs and highly specialized Federal facilities, which will provide the most timely diagnosis of a biological agent in the event of a suspected terrorist attack. This network will not only enhance public health capacity to address bioterrorism, but will also contribute to the overall public health capacity to address naturally-occurring infectious diseases. Fourth, strengthening coordination and communication among clinicians, emergency departments, infection control practitioners, hospitals, pharmaceutical companies, law enforcement and emergency response personnel and public health personnel is of paramount importance. We will also need to ensure that the public is provided with accurate and timely information.

CDC is working to ensure that Federal, State and local public health agencies are prepared to work with the medical emergency response and law enforcement communities to address biological and chemical terrorism. CDC will assist States and major cities in developing local bioterrorism preparedness plans that are well integrated into existing emergency response plans at local, State and Federal levels.

In conclusion, the tools we develop in response to bioterrorism threats will ensure that we are prepared for man-made threats, and that we are also able to recognize and control naturally-occurring emerging infectious diseases. A strong and flexible public health infrastructure is the best defense against any disease outbreak.

Thank you very much for your attention and I will be happy to answer any questions you may have.

Senator SESSIONS. Thank you.

[The prepared statement of Dr. Hughes follows:]

PREPARED STATEMENT OF JAMES M. HUGHES, M.D.

I am Dr. James M. Hughes, Director National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC). Thank you for the invitation to discuss the need to enhance the public health capacity in the United States to respond to the threat of bioterrorism. I will provide a brief discussion of the current situation