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Mr. Chairman and Members of the Committee:

Thank you for the opportunity to appear before you today. My name is Ellen Gordon. I’m the Director of the Iowa Division of Emergency Management and am here today representing the National Emergency Management Association (NEMA) and the state emergency management directors who are its core members. I also serve on a congressionally established advisory panel, led by Virginia Governor Jim Gilmore, charged with assessing domestic response capabilities for terrorism involving weapons of mass destruction. It is the state emergency management perspective that I will speak from today.

NEMA is very concerned about the issue of domestic preparedness and has been working in close partnership with the National Governors’ Association to provide policy and program recommendations to the federal government to enhance coordination efforts between agencies with domestic preparedness roles and responsibilities. NEMA and NGA co-sponsored a national policy summit in February of this year that brought together for the first time, policy executives from governors’ offices, state emergency management and law enforcement. NEMA and NGA are also working with the Department of Justice, FEMA and others to clearly define the role of the states and governors in this critically important issue and to provide information, resources and tools to states to enhance preparedness and response capabilities should an incident occur. In the coming year NEMA and NGA, with support provided by DOJ, will sponsor a series of regional terrorism workshops where "teams" of state policy and program officials will come together to identify state and regional issues related to domestic preparedness. We expect to provide additional policy and funding recommendations to congress and the federal government following the completion of those workshops.

The public health systems preparedness and readiness to respond to a WMD incident is well behind the efforts undertaken by the fire and emergency services organizations. The principal reasons appear to be a lack of national program direction that provides for coordination with the National Domestic Preparedness Office, the Department of Justice and FEMA, inadequate funding for local and state preparedness activities, and a concentration of resources and funding towards metropolitan areas.

As a whole, the state directors of emergency management believe that most state public health systems are unprepared to respond to a WMD incident for the following reasons:

• Capabilities at the local level are very disparate in terms of competency and capabilities. The district level is the first level at which medical expertise of a consistent competency is present.

• Most, if not all, funding for equipment, personnel and training has been focused in major urban and metropolitan areas. Terrorism knows no geographic boundaries. NEMA believes every state must have a basic detection and response capability.

• There is little capacity to detect a biological event early and by the time detection and identification are confirmed by a CDC lab the threat will have escalated many times over. This is especially true in small, rural states. Sending samples to labs in other states is not an option in light of the tight time constraints associated with a biological event.

• There is a lack of coordination of information between the medical, emergency management and law enforcement communities.

• Public health services nor private hospitals are equipped to handle WMD issues related to decontamination, mass casualties, and mental health care for victims, first responders and the community at large. Most public health workers have received little or no training in this area.

In Iowa, as in most states, we are reaching out to our state partners in law enforcement, fire, and the state department of public health to integrate them all into a statewide terrorism consequence management strategy. Public health is a critical component of a comprehensive response plan, yet collectively, we are far from where we need to be to have an integrated response capability in every state. States need the immediate help of Congress and the federal government to bring the public health system up to an appropriate level of readiness and capability by:

• Conducting a national assessment of the public health community’s capability to respond to a WMD incident;

• Integrating public health into state level response plans, including urban and rural areas;

• Providing the same level of funding and emphasis that is presently being directed at first responders by DOD and DOJ;

• Strengthening capacities to respond, especially at the local level. We recommend that a public health infrastructure be built that would provide labs to run samples, conduct disease surveillance, and provide computer linkages between local health agencies, hospitals and labs, and the state health agency to monitor and communicate identified trends. This system would facilitate early detection and early treatment of victims;

• Providing training and public awareness programs outside metropolitan areas to public health officials, emergency room personnel, and private sector physicians, particularly in the area of detection;

• Coordinating and funding realistic exercises that engage all key entities and test strengths and identify weaknesses. The Department of Justice’s TOPOFF exercise may help in meeting this need;
• Incorporating WMD preparedness into the medical curriculum at universities and other medical teaching facilities; and

• Developing guidance and training to ensure the safety of medical first responders;

It is up to all of us in the public health and safety community to work harder and more effectively at coordinating all the various players in response to this very complex issue. Plans must be developed in every state that provide for close coordination and communication between public health, law enforcement and emergency management. Funding and resources must be enhanced and used more effectively to prepare the nation’s public health systems for a WMD incident. Readying the nation to respond to domestic terrorism is not a simple task, but it must be done for the safety and well being of citizens throughout this country, living in communities large and small, who depend on their government to be there when they need it most.

Thank you for the opportunity to be here today. NEMA stands ready to serve as a resource for this committee on domestic preparedness and other emergency management related issues.