SENATE PERMANENT SUBCOMMITTEE ON INVESTIGATIONS 30 Mr. Chairman and Members of the Subcommittee: Thank you for extending this opportunity to me to submit a statement for the record as you consider the very important issues related to "Global Proliferation of Weapons of Mass Destruction". I am the Executive Director of the Commissioned Officers Association (COA) of the United States Public Health Service, a private, nonprofit, professional organization representing the interests of all officers of the Commissioned Corps of the Public Health Service. My particular interest in the subject of this hearing involves what I believe to be the important role which the Commissioned Corps plays in this area, and the significant potential that exists for expansion of this role. BACKGROUND To appreciate the potential that exists for the Commissioned Corps in responding to terrorist incidents, it's critical to understand the Corps and the resources it possesses. The Commissioned Corps is one of the seven uniformed services, whose members can be called to duty 24 hours a day to respond to public health crises and emerging needs, and can be directed to other duty assignments to accommodate changing public health needs and priorities. The Surgeon General leads the Corps, which is an active duty force of approximately 6250 health care professionals comprised of physicians, nurses, scientists, dentists, engineers, sanitarians, pharmacists, veterinarians, dietitians, therapists and health services officers who serve in all 50 states (see Chart A) and more than 550 locations worldwide. The Commissioned Corps provides officers to serve in the eight agencies of the Public Health Service (PHS). The largest number of officers serve in the Indian Health Service, but other PHS agencies, including the National Institutes of Health, the Centers for Disease Control and Prevention, and the Food and Drug Administration, also rely heavily on the Corps. Commissioned Corps officers also serve in non-PHS agencies, including the U.S. Coast Guard (whose uniformed medical services are staffed exclusively by Corps members), the Federal Bureau of Prisons, the EPA, and the Immigration and Naturalization Service. In addition to staffing the ongoing missions of Federal public health through the agencies of the PHS, the Commissioned Corps is available for critical deployment to address national needs of an urgent or emergent nature (such as response to terrorist incidents). In recent years the Commissioned Corps has addressed a number of public health problems, among them: smallpox eradication; investigation and identification of the newly emergent AIDS epidemic; provision of clinical services for Haitian, Cuban and Southeast Asian refugees; identification and isolation of three separate acute hemorrhagic fever viruses (Ebola, Lassa and Marburg) in Africa; response to the Hanta Virus outbreak in the American Southwest; and, response to the bombing of the Federal Building in Oklahoma City (see Chart B). BENEFITS OF THE CORPS The Commissioned Corps System brings with it several key benefits, in addition to a strong commitment to the public health of the nation. Included among these benefits are: Administrative Authority. The Commissioned Corps is administered entirely within the Department of Health and Human Services, which is important in terms of satisfying the changing roles and demands of the PHS. Departmental authority permits timely development and revision of regulations, policies and procedures. The President may, by Executive Order, militarize the Corps in times of war or emergencies involving national security. The Corps was militarized during the First and Second World Wars and the Korean Conflict. Structure. The active force of the Commissioned Corps includes two components: the regular component, whose officers have made a career commitment to the PHS, and the reserve component, which increases or decreases to meet Service needs. The regular component has an authorized strength of 2,800. Its officers are appointed through Presidential nomination and Senate confirmation. There are about 3,600 reserve officers on active duty. There is also an inactive reserve component, which includes more than 6,000 health professionals who can meet the changing needs of the PHS. Approximately 1,000 inactive reserve officers have indicated their willingness to participate in short tours of active duty each year to meet acute staffing shortages. These "ready reserve" officers are used primarily by the Indian Health Service, the National Health Service Corps, and the Bureau of Prisons. Mobility. Each officer is sworn to serve in any position or area required by the exigencies of the Service. The PHS has broad authority to reassign commissioned officers to meet personnel needs. Flexibility. Commissioned officers retain their rank or grade regardless of assignment. They are able to readily accept new assignments without fear of losing grade or compensation and can be required to fill billets graded higher than their rank. Emergency Response. Commissioned officers may be called to duty 24 hours a day. If necessary, they are required to work irregular and prolonged hours under adverse, physically demanding conditions, without special consideration. The Corps has been the primary source of health professional personnel deployed by the PHS during national and international emergencies. Training. The Corps has been the training ground for many health professionals who have gone on to assume leading roles throughout the country in Federal, State and local public health agencies; in the foreign service; and in health and medical education positions in the private sector. THE COMMISSIONED CORPS AND DISASTER RELIEF The Commissioned Corps is especially well-suited for the critical task of disaster relief, to include responding to nuclear, chemical or biological attacks, because of its ability to maintain preparedness of teams and individuals through cross-agency training and skills maintenance exercises and its ability to require participation of team members. Although most special deployments are modest in size, the Corps also maintains the ability to deploy hundreds of personnel should needs dictate. The ability to quickly and efficiently mobilize trained and highly skilled personnel, along with a substantial standby capacity, provides a unique and critical national resource. Currently, two formal mechanisms exist for Corps officers to be deployed in times of emergency. Disaster Medical Assistance Teams (DMATs) exist around the country as part of the National Disaster Medical System. These standing teams are formed and trained together, in anticipation of team deployment. Commissioned officers serve permanently on the team operating out of Bethesda/Rockville. Other officers staff the Emergency Operations Center in times of emergency. The Commissioned Corps Readiness Force is a volunteer force of Corps officers that serves as a human resource bank to supplement and fill behind when DMATs respond to large, human resource-intensive theaters of operation. This force also responds to special needs situations. The Surgeon General works closely with the Office of Emergency Preparedness (OEP) in identifying the resources necessary to carry out the mission of the OEP. The recent deployment of nearly 100 officers to the United States Virgin Islands (USVI) in |