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Emergency Responders: Drastically Underfunded, Dangerously Unprepared

Speakers: Warren B. Rudman, chair, Independent Task Force on Emergency Responders, Jamie F. Metzl, project director, Independent Task Force on Emergency Responders, Richard Clarke, senior adviser, Independent Task Force on Emergency Responders, Kevin P. Clark, Baltimore Police Department, R. Michael Mohler, Fairfax County Fire and Rescue, Patrick M. Libbey, National Association of County and City Health Officials, Dan Hanfling, MD, INOVA Health Systems, Paul M. Maniscalco, National Association of Emergency Medical Technicians, and J.R. Thomas, International Association of Emergency Managers
June 30, 2003
Council on Foreign Relations

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Washington, D.C.

Jamie Metzl: My name is Jamie Metzl. I’m a senior fellow here at the Council on Foreign Relations and project director for the Independent Task Force on Emergency Responders. And on behalf of the Council on Foreign Relations and the Independent Task Force, I’d like to welcome you here today for the release of our report, “Drastically Underfunded, Dangerously Unprepared.”

Copies of the report were available at the door, so I hope that everybody who wanted one got one. But if you don’t have one, we can get it to you at the end of this briefing. Our agenda for this morning will be as follows. Senator Rudman, Dick Clarke and I will make some short introductory comments, and then we’ll open the floor for questions and answers.

Then, at 10:15, a panel of emergency responders will come up to answer questions.

At 11:00, we need to clear this room, but we do have access to the room where we were holding the reception before. If there are any journalists who would like to ask questions either to any of us, to the emergency responders or to the emergency responder professional associations that are represented here, please feel free to do so at that time.

I’d like just to make some short preliminary introductions. Because you are here, you know who the people are to my left and my right, but I will do it anyway. Senator Rudman, two-term Republican senator from New Hampshire and now a partner in the law firm of Paul, Weiss, Rifkind, Wharton and Garrison. To my right, Richard Clarke, former longtime senior adviser in the White House and now chairman of Good Harbor Consulting.

I’d also like to recognize some people who are in the crowd today. First, as you all may know from the packets that have been distributed, the Independent Task Force was made up of senior experts, former chairmen of the Joint Chiefs of Staff, former secretaries of state and others. And representing the members of the task force, Norm Ornstein is in the crowd.

Norm, if you could just raise your hand. There you are.

The work that we did in the task force was carried out in extremely close cooperation with two remarkable budgetary organizations, and particularly two individuals, one from each of them, and they are Jim Carafano from the Center for Strategic—representing the Center for Strategic and Budgetary Assessments.

Jim, if you could raise your hand.

And Josh Gordon from the Concord Coalition.

Josh, where are you? Right over there.

The work of the task force was also carried out with the tremendous assistance of a group of over 20 of the leading emergency responder professional associations, who joined us in what we called the Emergency Responders Action Group. And a number of representatives from those organizations are here today.

If you could just, if you were part of that group, if you could just raise your hand.

Great. Thank you very, very much to all of you.

I’d now like to turn the floor over to Senator Rudman.

Warren Rudman: Well, Jamie, thank you very much.

And good morning, and thank all of you for being here. Let me thank Jamie for the extraordinary work that he has done and for Dick Clarke, who has probably more expertise in this area filed away, spanning three presidents in the White House, than anyone that I know. And Dick has been very generous in being the senior consultant to this group.

And I also want to just repeat what Jamie said. We have had extraordinary cooperation from all of the emergency responder organizations in the country, the firemen, the policemen, the EMS people, the public health people, the hospitals, the 911 folks. And I probably left somebody out; I’m sure I have. There are about 20 of them.

But all of you, you are the constituency, if you will, of this report and of the Department of Homeland Security (DHS). And I would simply say that without your help this effort could not be done.

We did not come up with the numbers and the conclusions by ourselves. We came up with them because we listened carefully to what you all had to say.

Because, in the final analysis, you will be the ones that will face the onerous task of responding to additional acts of terrorism in this country, which unfortunately are more likely than unlikely.

Let me simply give you what my bottom line is to this entire study. It is simply this: When we committed United States military forces in Iraq, we were absolutely certain that those troops were equipped with the best state-of-the-art equipment they could possibly have to deal with chemical or biological or other threats.

Our police, our firemen, our emergency responders deserve no less. They are the defenders of this homeland. And the truth is that whether they have the equipment of not, as we saw in New York and here in Washington, these brave young men and women will enter whatever the hazard is, even not knowing what it is, to help fellow citizens.

Knowing that, we have an enormous obligation as a country and as states and cities to assure that our emergency responders are well equipped.

Now, we know what the federal numbers are, and we have them pretty well detailed in our report. What has been more difficult to put together with all the cooperation we’ve had from the organizations is that state and local contributions that are strictly assigned, if you will, to emergency response are very difficult to quantify.

And I’m not sure we’ll find a range in this report. You know, we use a number of about $98 billion. That is a target. There has been some response from DHS that they think that may be too high. Maybe it is, but it may be too low.

What is urgently required, and I have talked to a number of you here in the half hour preceding this meeting, what is urgently required is a national assessment, with all of your organizations, and the National Governors’ Association, and the mayors, the police, the fire organizations, everyone, and there has to be an assessment into what is, if you will, the minimum acceptable standard for equipment and training to allow you all to respond to whatever the threat may be.

Once that is established, then, in our view, it will be relatively easy to find out what the numbers are. It may not be so easy to fulfill those numbers in the appropriations process.

The second point that I think is very important is this is not a political decision. This is truly a national decision based on need. And thus, when you start allocating funds, they cannot be allocated on, if you will, a competitive or a political basis.

They have to be allocated on such things as population density, transportation networks, targets that are more lucrative for terrorists than others.

And to the credit of the department, that’s precisely what Secretary Ridge has said in recent testimony on the Hill.

The purpose of this report is to help all of you and all of those in the federal government and those in Congress who have to make these very tough decisions and to set these priorities.

We think this is probably without a doubt the most exhaustive study to date for these issues. However, we hope that sooner rather than later there will be national standards established, and then deciding on what money is available, those in positions of making policy and law will have to decide what their priorities are.

If someone were to ask me, what are the two greatest priorities that we must deal with as fast as we can, they are as follows. Number one, inter-operability of communications equipment of all emergency responders.

Had that been in effect on 9/11 in New York, I dare say many of those brave young men who died well might not have.

Secondly, I think it’s essential that we give police and fire forces whatever protective gear is the state-of-the-art gear at the time, to protect against chemical and biological attack, because if that happens, and that is not unlikely, it will be those young men and women that will go into harm’s way as people did in Iraq, and certainly we owe them no less than to make sure that they are personally equipped with both communications and with other kinds of equipment.

Those would be my top priorities. Others may disagree. But it’s up to the policy-makers and those who make laws on the Hill to make those allocations. But we urgently recommend it to be done sooner rather than later.

Dick?

Jamie Metzl: Dick Clarke.

Richard Clarke: Thank you, Senator, Jamie.

How much is enough? That’s the question that the Congress is asking itself this year, and will be asking itself next year. How much is enough for emergency responders?

Unfortunately, the Congress is being asked right now to guess at the answer, because there is no process under way to quantify the risk and to quantify the need.

You can quibble about the numbers in our report. The $98 billion the senator mentioned is a floor number in our report, because it does not include any money for the police departments, which would probably raise it well above that number.

But don’t focus so much on a particular number. We’re not going to argue about a particular number. What we are going to argue about is the need for a process, so that we can quantify what additional dollars will buy us.

The Congress needs to know if it spends an additional $10 billion or $20 billion, how much does it reduce the risk to the American people. Right now there is no way for the Congress to know that, because there is no process.

And as Senator Rudman said, there is no standard. We don’t know when a metropolitan area has enough communications equipment, hospital security programs, fire and police, chemical and biological programs, training and equipment. We don’t know when a metropolitan area scores high or low, because there are no standards, and we don’t know what risk we’re running in various metropolitan areas.

There are two things I think we can take away from this report, whether or not we can agree on the numbers.

Number one, we need a process whereby we can quantity the risk and quantify what we get for our money.

And number two, the amount of money we’re spending today is woefully too small and is being delivered woefully too slowly.

Jamie Metzl: Just some final comments about the numbers before we open the floor of your questions.

As Dick and Senator Rudman have said, the figure that we developed in cooperation with many of the groups represented here today of the unmet need is roughly $98.4 billion over five years, or roughly $20 billion a year from all sources, federal, state and local. And that means as much as tripling the low level of current overall expenditures, or quadrupling federal expenditures if one were to believe that this was solely a federal responsibility.

Just a short word on how we got the numbers. As has been mentioned, we pulled together the professional associations and asked them to go to their members to develop their lists of what they see as their minimum essential capabilities that they need to have in order to do their jobs safety and effectively.

But what we asked not to have was a wish list. When those organizations came back to us with their information we went through it very critically.

For example, the fire community, different fire associations came together and presented us with a report that gave a range of possible expenditures for addressing the significant shortfalls in the fire community, and the high level of that range was roughly $85 billion over five years. But we worked with the fire communities, and asked them what are the things that they really needed, what are their greatest needs to address the most urgent shortfalls. Where can we find savings in these figures? The number that we’ve put forward for fire in our report is actually $37 billion.

With interoperable communications, there was a major study done two years ago that estimated that the cost of developing interoperable communications across the country, to be $18 billion.

Rather than taking that number, we worked with the Emergency Number Association to try to look at models around the country for where it could be done less expensively, and found that right here in the nation’s capital, there is an interoperable communications program that uses off-the-shelf technology that is considerably less expensive. And so the number that we put forward in our report for interoperable communications is $7 billion.

We feel that we’ve been very conservative in developing these numbers.

As Dick said, we weren’t able to receive any reliable figures from police departments, even though we traveled around the country meeting with police officials who uniformly told us that they didn’t feel they had the resources or the equipment they need.

But without systematic numbers, we decided it was better to leave police needs out of our report than to add a number that we weren’t entirely comfortable with.

On the flip side of that is that the administration figure for what they believe they’re spending on emergency responders is $3.5 billion, which is the amount of money going to the DHS Office of Domestic Preparedness.

In estimating our figures, we assume that the federal government was spending $5.4 billion annually. So our numbers for what the administration was spending were considerably higher than their numbers for stating what they were spending, because we felt there were expenditures such as funds going to Health and Human Services, funds going for Department of Defense Civil Support Teams, and others, that we though should be counted.

But for us, as Dick and the senator have said, the issue is as much how money is spent as it is how much money is spent, and the two elements of our report, the budget figures and the policy recommendations go very much hand in hand.

If we just throw money at the problem, we’re not going to get to the level of preparedness that we need. If we just change the policy without getting the badly needed resources to the front-line emergency responders, we’re also not going to get where we need to be.

And as we’ve discussed, September 11 was a tremendous shock to the United States, and should be a wake-up call to us all. But as our report shows, the United States is not doing enough, and it would be a terrible, terrible tragedy if it took another disaster like September 11 to drive that point home.

Jamie Metzl: Now we’ll take your questions. Yes. Yes, ma’am.

Question: Can I just ask you to comment on the statement put out by the Department of Homeland Security which calls the numbers, I believe, “grossly inflated,” was the term that they used. If I could just get your comment on that?

Warren Rudman: Well, of course, it is in the nature of government to be very defensive. It is the nature of government to say that everything is all right.

That happened after Iran-Contra, it happened after Watergate, it happened after the recent scandals at the Air Force Academy. You know, “trust us, everything is all right.”

Well, with all due respect, everything is not all right. They hardly had the time to absorb this report in the 36 hours they had it to come to that conclusion, but we understand that that is probably not the feeling of the top management of that department.

Press spokesmen tend to say what they say, and I think we’re all used to that. That is really not an issue as far as we’re concerned. They are doing a lot of things right, they acknowledge many of the things in this report.

They think the numbers are too high, maybe they are. But they don’t know that. And we don’t know that. We will not know that until we have a national standard set up.

But we know this much, from talking to all these organizations of these extraordinary people who deal with emergencies, police, fire, emergency response. We know that they believe that at current levels they are vastly underfunded. They know better than anyone else, because in the final analysis, it’ll not be any federal agency that will respond to a disaster; it will be young firemen and policemen and women, and emergency technicians, and hospital people, in some locality where, when, how, what, we don’t know, but it will be somewhere that will be forced to respond.

Only they have an understanding of what they need, and we will take their word over anybody else’s.

Jamie Metzl: Yes, ma’am.

Question: I wonder if you have a recommendation for what the policy for developing interoperable communications is, recognizing how difficult that’s been for the Defense Department.

This might be a more complicated question. Do you have a recommendation about how it gets done, who takes the lead, how you share the resources?

Warren Rudman: Dick, do you want to handle that?

Richard Clarke: We don’t have a specific technical recommendation. What we do know is that there needs to be significant federal involvement. Among the questions that have to be answered here is the allocation of specter (ph).

The FCC plays a major role. There needs to be a federal interaction with the state and local government. But it’s not a matter of technology. As you just said in your question, the Defense Department has been addressing this issue for years. The Defense Department has largely solved the problem of having the Army being able to talk to the Navy being able to talk to the Air Force.

There were times in the past when that wasn’t true. But as recently proven in the Iraq war, our services were able to communicate with each other.

And what thing that really struck us in looking at communications problems across the country is that we’re using old technology throughout the country. When a fire truck pulls up to a fire, it ought to be able to pull out a computer and, with a wireless and secure connection, know everything about that building that’s on fire: the floor diagrams, whether or not there’s hazardous material in it. Know everything about that building on a computer laptop sitting in a fire truck before the first fire person walks into that building. That’s almost not the case anywhere in this country.

There’s a whole new area of computer-related wireless technology for communications that could greatly assist our emergency responders. It’s just not happening, because there’s not enough money being given to the effort.

And, once again, you can quibble with the numbers in our report. We’ve drawn them from other reports that have gone on for the last several years. The key conclusion I think you need to take away is not that there’s a technological problem, but that there’s a funding problem.

Question: I don’t think it’s a funding issue. I mean I do think it is a funding issue, but it seems to me the process of getting people to work together and who takes the responsibility and who takes the lead becomes more of a stumbling block, because you’re right, the technology is there.

Warren Rudman: It really has to be a joint venture between federal, state law enforcement, local law enforcement, fire departments around the country, who all have to participate in the effort.

Now I would point out to you that D.C. has a plan now in operation which appears to be fairly advanced. And so, it is not impossible. And in many cases, the technology is available.

So I don’t think the process is quite as difficult as you might think it is. I think that the lead has to be taken by the national organizations. And I expect it will be when the money is available.

Jamie Metzl: And in our report, we come down very hard on the need for better planning and coordination. In the September 11 attacks, there were all kinds of people who were emergency responders who we don’t think of as being emergency responders, like welders. And yet we need to think through what the threats are that we face and have coordination mechanisms in place to do things like address inoperable communications.

It’s largely a technological problem. It’s largely a funding problem. But it’s also a coordination and planning problem. As our report says, we need to bring all of those pieces together on this and every other issue.

Yes, sir.

Question: If I could direct this question to Senator Rudman as author of the Graham-Rudman bill and member of the Concord Coalition.

Where do you get the money for this in a time of record budget deficits? Do you recommend raising taxes or cutting spending elsewhere? And where?

Warren Rudman: I consider this a crisis of national proportions. And I think it has to be approached that way. And given my past experience in the Congress, I know that’s going to be difficult to do.

But the combination is a combination of things that you have just mentioned. Whether it means special taxes to raise these funds, reducing other federal programs, whatever it takes.

I know this much. That if we don’t do it, in the next few years if we have an event, particularly one that involves chemical, biological or some sort of nuclear device, dirty or conventional nuclear device, and tens of thousands of Americans are severely injured or lose their lives, there will be a political earthquake in this country, the likes of which we haven’t seen in a long, long time.

The American people have been led to believe that by passing the Department of Homeland Security and doing some other things, that they are now a great deal safer than they were. They are safer, but they’re not safer in terms of what their local emergency responders can do for them.

Nobody is going to disagree with that in the emergency response community. And so, that is a matter for members of Congress to address. And I hope they do.

Question: My question relates to the use of scenarios in trying to build a better understanding of what particular arrangements you’re planning for and whether the task force contemplated using a small number of catastrophic terrorism scenarios or whether you actually did when you went to the first responders and said, What are your requirements?

Jamie Metzl: When we went to the first responders, we used standards of the type of threat they were facing. For example, a biological attack with this many casualties, a chemical attack with X number of casualties, and asked them to develop their numbers in response to those standards.

We also worked with other organizations that had carried out those types of scenarios, including many of the professional associations. We didn’t carry out any of them ourselves, although we certainly recognized the importance of scenarios and exercises.

And in our budget recommendations, we make recommendations for a significant enhancement of funds for just that.

Question: In your recommendations, did you—you mentioned that we need to not play politics with these numbers, these need to be need and threat-based assessments, but both Senator Rudman and Mr. Clarke have significant experience with the political end of that. I wonder how do you practically get over that political obstacle that money will always be politically controlled?

Warren Rudman: Well, we’ve done it in the past. This country, in terms of great national crisis, has done things strictly on a basis of what was needed. I think we’re facing that kind of situation.

I understand the situation, Congress, better than most. And that’s not easy, and it may not be perfect. But we certainly have to improve the way Congress deals with these issues. And part of the recommendation, as you probably have seen, deals with how we think that Congress ought to organize itself in terms of dealing with it.

But you know, the Appropriations Committee, which I served, you know, on a number of occasions, recognizing a crisis did what it had to do. And I think that when—and we’re going to recommend this—certainly when the police and fire and EMS people ask to see their congressmen or their senators and go to them when they’re in their home states and districts and tell them what the situation is and make it very clear that this report states, what they believe, I think you’re going to get some level of attention. If you don’t, then this government is failing in its basic function to protect the American people. I mean the horrors that we’re anticipating here are almost unthinkable, but they’re real.

On September 10, every police and fire department and EMS organization thought that it had adequate means to respond to disasters. On September 12, they recognized it was a whole new world. And recognizing it’s only been less than two years, knowing it takes time to get the ship of state to focus on things, we’re simply hoping to light a fire under this particular issues, to use a poor pun, and to really get this thing moving.

Richard Clarke: Let me answer that, too, if I can? You know, normally when there’s a grave national crisis, as the senator said, the Congress opens up the purse strings. It has not been asked to open up the purse strings adequately. There is a grave national crisis. It’s not over. And we can’t have a 10-year plan to get ready. We can’t take our time to get the emergency responders ready, because there will be further terrorist attacks. As Senator Rudman said, they could involve chemical, biological or radiological material. And it does no good to plan to be ready to deal with that in the year 2013 if the attack comes much sooner than that.

So we are in a grave national crisis. And I’m sure if the Congress is given a plan and given a process and given numbers that make sense, the Congress will respond as historically the Congress always has in crisis and fund a rapid program.

Jamie Metzl: I just want to add to that I sit around and look at the police commissioner of Baltimore, I look at a captain from the Fairfax department, and I think to myself, What happens if three weeks from today there is a chemical attack, for which they don’t even know what chemical it is, let alone have the equipment to deal with it. What do they do? Do they tell their people don’t go in and help all those young people in schools or shopping centers who were afflicted? Do they do that?

Well, of course, they don’t do that. That’s not the way these people are trained. They go in and they do what they have to do.

And that is just is basically, fundamentally a risk that we should not ask anyone to take. We didn’t ask our military to take it. We shouldn’t ask our first responders here at home to take it either.

Question: Since standards are so critical to knowing where to spend the money and how to spend the money, how soon do we need to come up with these standards? It sounds like yesterday, probably. But realistically, when would you like to see this done?

Richard Clarke: Well, Department of Homeland Security is currently doing that. I don’t know what their time table is. That’s something that they have not shared with anyone. But certainly, I would say that if they couldn’t get it done by this fall, then we’re falling behind.

I would like to see the standards set and the appropriations process addressed by the White House and the Congress, to at least get the basics out to these emergency responders on a shortened time frame.

Jamie Metzl: And in our report we call on Congress to mandate the development of those standards and link that development to the appropriation’s process.

Question: In the eyes of some, tax cuts are literally starving discretionary spending with the tax cuts that are going on with the deficits. I mean, you know, really what gives at this point?

Warren Rudman: Well, I’m happy to answer that. It’s not a political question. That’s an academic question.

(LAUGHTER)

Dr. Ornstein could answer that question.

(LAUGHTER)

Look, I am one of the founders and co-chair of the Concord Coalition, and I’ve made my personal view very clear, I think we have a lot of needs in this country, and I oppose the tax cuts. Although I personally benefit from them, I certainly oppose them. And I think that to the extent that we start to reduce our ability to deliver basic needs that are in our own nation’s security, then either we balloon the deficit or we don’t get them done.

But this is not the view of my party, and this is not what’s happened. Have to deal with that reality. But that is a fact of life.

As we say here, you know, we’re talking about emergency responders, a lot of other things in this country that people are concerned about that are not getting met.

But that is a political argument that will be settled again in ’04, one way or the other.

Question: If I can follow up. Is that already the situation, what you describe?

Warren Rudman: Well, I personally...I personally find that it is unacceptable to load this generation’s debt onto my grandchildren. And I see deficits of $400 billion this year. My political opinion is that that’s unacceptable. It certainly makes the task of what we’re recommending here more difficult.

Richard Clarke: Let me just add to that not a political opinion, but an analytical point, that this sounds like a lot of money that we’re talking about here, but compare it to the Defense Department. The Defense Department over the five years that we’re talking about in our report will spend upwards of $2 trillion—$2 trillion.

We have to think about defense in a new way. Defense begins at home with the policeman, the fireman, the doctor. And we have to look at tradeoffs across the whole spectrum of our national defense, a national defense that begins on our own streets and reaches out around the world.

In the context of a $2 trillion budget over the course of the next five years, the kinds of increases we’re talking about to make us safe at home are not large.

Question: Sometimes it seems that the federal strategy for dealing with these kinds of emergencies has rested in part on developing special federal teams, placing them regionally around the country and having them respond, particularly in questions like nuclear or mass casualty chemical attacks.

Are you arguing that every fire department in the country, every police department in the country needs that capability themselves?

Warren Rudman: Absolutely. There is no way that federal teams would be either big enough or geographically placed in the right position to get to a location that needed immediately attention.

Now, obviously, in the kind of disaster we’re talking about, you will not only need these special teams, you will need U.S. military, who are enormously well prepared to deal with it. But you cannot tell local departments wait until the U.S. cavalry arrives. You know, everybody might be unable to function by the time they arrive. Each department must have capability.

Now, much capability? That’s something that the standards will have to determine.

Jamie Metzl: The senator is absolutely right that every policeman and fireman needs to have access to a minimum level of protection.

Warren Rudman: And training.

Jamie Metzl: And training. But that doesn’t mean that every fire station needs to have a fully developed HAZMAT team, EMT, public health lab. In our report, we call for the pooling of resources so that we can have the most efficient use of available resources and the most effective return on national investments in homeland security.

And that’s why our report is very strong about mutual aid agreements. Mutual aid agreements are the types of agreements between, say, fire departments, so that if there is an attack on the Pentagon responders from Montgomery County can come and they work together.

So we need to be pooling resources. At the same time, the federal teams that you mention are critical.

In our report we talk about providing additional funding to FEMA urban search and rescue teams, of which there are 28. The National Guard weapons of mass destruction civil support teams.

But there’s a time lag between when you, let’s say, have a collapsed building, between when you call FEMA, when the building collapses, and when FEMA shows up.

And if that’s eight hours or 12 hours, local fire departments can’t be expected just to sit around saying, Well, let’s wait, FEMA’s going to be here in 12 hours when there are people trapped under these buildings.

So we can’t break the bank, we can’t spend the entire GDP on preparedness, although it would be possible to do so. What we need to think of are what are the minimum essential capabilities that local responders need, how should the national assets be enhanced to build on that base.

So, as the senator said, we definitely need to do both things.

Warren Rudman: Yes, and there’s one other point here, and that is, you know, you’re going to have a panel, and I think a very interesting panel of emergency responders, which I hope that you will all stay, who will be coming up here in about 15 minutes, 10 minutes, actually, and amongst them will be a captain from the Fairfax County Fire Department who responded, of course, to the Pentagon event.

They have highly developed HAZMAT search and rescue operations. The question is how do those get regionalized so that if something happens in an area within 100 miles they can get there and do something, which is part of the coordination process.

So it is true that the feds do have these teams, but let me point out to you, some of these local departments have very sophisticated training and people and equipment to deal with it.

We just want to make sure that when the planning is done that that is looked at, and we talk about that in the report. We don’t need to duplicate, we don’t have to have a major HAZMAT team in every firehouse within 30 miles of where we’re sitting, but we ought to have at least one.

Question: I actually have two questions, the first being, kind of you touched on earlier, but we could basically break the bank, and spending all the money possible and still not be completely prepared for a terrorism attack. So at what point will we know that we’re at the point where we are prepared for this? And will there be any types of committees that will be in charge of making sure the money is being spent in the most productive ways? I mean, like you said, you can’t just throw money at the problem.

Warren Rudman: Well, that’s called the Congress, that’s what those committees are called.

(LAUGHTER)

You don’t need any more committees. The Constitution gives them the power.

Question: OK. So hopefully something will be in place to make sure the money is being spent in the places where it’s needed most. And then to follow that up, what is the future of this report?

Obviously, it is incomplete at this point. Will you guys be considering, I guess, doing more with it, including more numbers as more information becomes available?

Warren Rudman: Yes, well, I will answer the last one first. I would, frankly, like to take retirement from this whole homeland security issue, which I started with Gary Hart in 1998, but, you know, I don’t see any future for this report other than hoping that the emergency responder community and their elected representatives will use it as a very important guidepost to lobbying the Congress to get done what’s being done.

The first part of your question, once the standards are set, and those minimum standards are debated and agreed to, then when those standards are met, we will be minimally prepared.

I can tell you this: We’ll never reach perfection; you don’t in this kind of situation. You never reach perfection. You just hope to do enough to save the maximum number of lives that you can when this kind of thing happens.

Richard Clarke: Let me just add to your answer to your first question. How will you know when you have enough? That’s the whole point. There’s no process in place now to answer that question.

Sure, you could spend the whole gross national product on this first responder budget, and we’re not going to do that. So how do we know how much is enough, and how does the Congress know if they add $10 billion what do they get for that?

How much do they reduce the risk? These things are quantifiable. It is possible to have a process. We just don’t have one now. And that’s why the Task Force Report calls upon the Congress to legislate and require that there be a process in place to tell us what we’re going to get in the way of meeting a set of standards by an additional investment.

Question: Congress has opened the purse strings to the extent that it’s more than tripled funding for the FEMA Assistance to Firefighter Program.

Do you see that as a model for the sort of funding increase you’re talking about now?

Warren Rudman: Certainly is a step in the right direction, absolutely.

Question: Senator, I want to go back to a question that was asked here a couple of minutes ago, where you cited your retirement from homeland security.

For 30 years you have a reputation of grabbing the bull by the horns and reaching some kind of successful resolution. I can assure you that the first responder organizations will clearly be lobbying Congress hard, as we have been, as you know.

My question to you is can we count on you to be up there talking with your former colleagues in helping us push this issue?

Warren Rudman: Oh, absolutely, George. I’ve been asked already, on the weekend, if I’d be willing to testify before committees, and I’ve been doing it regularly for the last three years.

I mean, to me, this is essential piece of public service for anybody who has the opportunity to contribute. And, by the way, if you look at the list of people who are on this task force, as well as the organizations, you look at the people themselves, I mean, people like George Schultz and Bill Webster and two former chairmen of the Joint Chiefs of Staff, two Nobel Prize winners.

I mean, this is a very serious group of people, which is why I get a little bit, not irritated, but a bit surprised when people make flip comments about what, you know, what we try to do here.

I mean, this is very serious business: We’re talking about the lives and the safety of you and your children and your grandchildren, and these are not hypothetical, theoretical things.

You think they are, talking to widows and the husbands who survived their wives who died on September 11 here in New York and up in Pennsylvania. This is not theory. This is deadly serious, with the emphasis on deadly. And I certainly do continue to try to do what I can.

Question: First, for Mr. Clarke, do you agree with the senator’s estimate that by the fall we should expect these needs to be quantified?

And then for everyone wondering until these needs are quantified, to what extent is Congress held responsible for poor distribution, and how much are they working with one hand tied behind their back?

Richard Clarke: I think right now Congress is being forced to work with one arm tied behind their back, because they are being given numbers that have been essentially derived from pulling them out of the air by the administration. And Congress is being forced by the administration to guess about what the right number would be.

During the course of the summer the Congress has the opportunity to require the Department of Homeland Security to submit with next year’s budget a analytical, quantifiable process that says how much is enough, how much do we get for additional expenditures, how can we reduce the risk by doing certain kinds of appropriations. It’s too late to do it for this year’s budget, but the Congress can and should require it for next year’s budget.

Question: Does the equipment that responders need exist today? If not, how much science and technology investment is required to get that equipment?

Warren Rudman: Surprisingly, a lot of what is needed has already been developed. Certainly as part of any good effort here we need some funding for development and testing of new technology. But an awful lot of the technology has been developed and scientists throughout this country and engineers throughout this country since September 11 have diverted their previous activities to look at ways of helping out in homeland security.

And if you go to the centers of scientific development and engineering development in this country, you’ll find that there are new inventions, new equipment, new communications devices, that can solve a lot of these problems. They need to be tested, they need to be evaluated. But it’s not mainly a technological problem anymore. While we need to continue the R&D on some things, mainly we just need to figure out how much is enough and then start spending it.

Question: You talk about interoperability and then you also mention the spectrum, and that is a big issue, is the spectrum. And the FCC and Congress have allocated spectrum interoperability, but the broadcasters have it. Does your report address how to get the broadcasters off that spectrum so that, you know, we can get this to the first responders?

Jamie Metzl: We don’t address that end of the report. Certainly, we’ve talked to people. Congresswoman Jane Harman and others have legislation to try to deal with this issue, but that’s not an issue that we address head on in the report.

Warren Rudman: We’ve taken on some pretty controversial issues in this report, I think controversial enough without deciding on the spectrum allocation.

(LAUGHTER)

We’re going to have what, maybe a five minute break here while we organize?

Jamie Metzl: Yes, well why don’t we just have a 30 second break. So if everyone could just stay seated, we’re going to change the name cards and bring on the first responders.

Thank you very much.

(RECESS)

Jamie Metzl: Why don’t we get started once again. Welcome back. We don’t have enough room on the podium, so we’re going to do this Phil Donahue-style.

I would just like to briefly introduce the emergency responders who are joining us today. Commissioner Kevin Clark, the police commissioner from Baltimore. Before he took his position in Baltimore, in January 2003, was a 20-year veteran of the New York Police Department and reached the rank of deputy chief. He was also one of the emergency responders to the September 11 attacks.

Pat Libbey, the executive director of the National Association of County and City Health Officials, and for more than 20 years the director of the Thurston County Public Health and Social Service Department in Olympia, Washington.

Captain Mike Mohler, captain in the Fairfax County Fire and Rescue Department. Also president of both the Virginia Professional Firefighters and Fairfax County Professional Firefighters and Paramedics Union.

Dan Hanfling, who is the director of emergency management and disaster medicine for the INOVA Health System in Falls Church, Virginia, was also one of the responders to the September 11 attacks on the Pentagon and led a team that successfully diagnosed two of the inhalation anthrax cases the same year.

Next is Chief Paul Maniscalco, who’s on the Executive Council of the National Association of Emergency Medical Technicians, and is an over 25-year veteran of public safety response and EMT supervisory and management.

And finally, we have J.R. Thomas, who is the president of the International Association of Emergency Managers and director of the Franklin County Emergency Management Agency in Columbus, Ohio.

What I’d like to do is start out by asking one question for everybody to address very briefly, and then we will open the floor.

And the one question is this: What are the one or two things in your particular area that you feel you need to be able to do to feel ready to respond to a potential terrorist attack that you’re not able to do due to a lack of resources, and what are the public safety implications of that shortfall?

Let’s start with Commissioner Clark and go straight across.

Kevin Clark: Good morning, everyone.

Local emergency and rescue agencies will more than likely be the first to confront a terrorist incident and be tasked with the immediate assessment of the event, implementation of established plans. So we’ll probably have to improvise at the scene. We’ll have to establish a unified interagency command, control and communications center to filter our deployment operations.

In Baltimore City right now, equipment and training are critical to us. First of all, we definitely need personal protection equipment, and that would come in the area of Tyvek (ph) suits, filter masks, communications equipment that was brought up before. There just are not enough radios just to equip the members of my department; probably a third of the people might have communication capabilities. And also, we’d like the ability to be able to communicate with the other rescue units that will be responding from the fire department and health department.

Just in closing, definitely I’d like some type of heavy equipment that would help in search and rescue. It’s time consuming. You have to get a private contractor in. Everything that we need should be compatible with that of the fire department, who are our first partners in any type of terrorist incident.

And probably what the biggest thing that would happen is first responders cannot function safely without certain type of equipment. So we’d be putting people’s lives at risk, just as the first responders. Of course, significant increased potential for casualties to the public.

So those are the two things. The first responders and the public would be at risk if we do not get funding for equipment and training.

Patrick Libbey: Thank you, and thank you for the opportunity this morning.

I think this country has learned a number of lessons since 9/11. And within the public health community, even more so since what we refer to as 10/04 (ph), that being the start of the anthrax events in this country.

We have learned that we are vulnerable as a population to attacks on our health as an entire population. This is new. This is not event specific. It is not your usual sort of emergency. We also know that your local public health department will likely be the point of first detecting and first responding to these events.

In answering your question then, what do we need in the public health system to be able to better protect the population we serve?

First is the ability to detect closer to real-time an untoward event occurring that is affecting the population’s health.

And then, secondly, sufficiently trained personnel with the capacity to analyze the information, make the call, do the investigation and the initial containment work and activate the balance of the system. It is basically a question of resources tied to people, tied to training and tied to the kinds of exercising that was spoken to in the report.

Jamie Metzl: Captain Mohler?

R. Michael Mohler: Mr. Rudman hit on a couple of very important points as it related to equipment, training, being able to communicate, to be inoperable.

A lot of firefighters gave their lives in New York, law enforcement personnel, EMS personnel. But at the same time, they saved over 20,000. And New York, their fire department is probably one of the few in the country that, as it relates to staffing, meets a national standard. At least two-thirds of the fire departments in the country don’t meet national standards, including Fairfax County.

As a matter of fact, there are no fire departments in the Washington metropolitan area that meet a national standard as it relates to staffing. And that has a direct impact on our ability to save lives.

New York, as tragic and traumatic as that was, their ability to save lives had a lot to do with their staffing levels, it had a lot to do with that. While staffing is important, equipment is important, training is important and interoperability is important. In my mind, interoperability starts with mandating—the president has already mandated a national incident management system.

Our governor in Virginia has followed suit by mandating a national incident management system. But it’s not enough to mandate something from some high post and not see that it gets done at every single level of state and local government. And that, in effect, is what’s happening. Even at the Pentagon, we had the D.C. Fire Department acting independently from the Arlington County Fire Department. That needs to be, you know, unacceptable. Our service people would not think of going into Iraq and having, you know, a command post for the Air Force and a command post for the Army and a command post for the Navy.

And it’s important that the fire service realize that, but it’s also important that while our governors and our president are mandating a national incident management system, that they see to it that all the departments, and I mean, I’m talking all departments, career and volunteer, need to have the training to operate in such a system, because that’s not happening. It sounds good when you say it in a speech, but when you don’t see it happen on the fire ground.

And I can tell you it does not happen—it’s not guaranteed to happen on the fire ground. And that’s where firefighters get killed. Just read all the (inaudible) reports. Firefighters get killed because of failure to implement a management system. And so, I believe that staffing and seeing to it that we are employing what the president is expecting, I see this as two big things.

Jamie Metzl: Great. Dr. Hanfling?

Daniel Hanfling: Good morning. I think boiled down to its core, the first critical issue for American hospitals is actually being met right now. And that is that hospitals too must be recognized as a part of the critical infrastructure of the United States, and their staffs must be considered the front line responders that they are.

With that, then secondarily comes the requirement for funding. And disaster preparedness on September 10 was an unfunded mandate. On September 12, it became an underfunded mandate. And so, this is clearly a step in the right direction towards focusing on that critical area of our, you know, homeland security infrastructure.

I think specifically there are two key areas that need further attention. The first is with respect to development of surge capacity. There’s a lot of discussion about that now. We know our hospitals are overcrowded. I think first and foremost, surge capacity could be considered as a part of the strategic national stockpile in that beds and IP supplies and ventilators and other equipment and the pop-up shelters that they house might in fact be something to add to that national asset. And there are other solutions beyond that.

Beyond surge capacity clearly, as has been described up here in the first session and again just recently, the requirement for curriculum and education. The fact that there need to be standards so that from the health delivery perspective, the roles and responsibilities of our medical work force are focused on the issues that they are going to take forward in order to do their bit of the response in any one of these events that might occur.

Paul Maniscalco: Good morning. I guess from an emergency medical service component representing the EMTs and paramedics, those professional and career and volunteers that turned victims into patients, the real issue is funding. To date, there are no EMS- specific funds.

We have a survey that the National Association of EMTs is conducting, and the early results are too compelling not to share with you. Out of 3,871 respondents, 93 percent responded that they have not seen dollar one in their communities. A combination of 86 percent, 43 percent and 43 percent, gave their systems a grade of D or F in responding.

We need to go back and revisit how we’re handling the funds from Congress. Congress has done some great earmarking, but they’ve missed the mark on a number of different issues, rather than adopting a functional area management approach and looking at the specifics that are required. We have the majority of EMTs and paramedics ambulances, rescue personnel out there without antidotes on their vehicles.

So we’re going to need to take a time-out here. Let’s define what readiness is, understand exactly what the protective equipment requirements are across the public safety spectrum that you’ve heard here, and then move forward.

To sort of go back to what Jamie and Dick and Senator Rudman got to here, do we need to have training across the board? Absolutely. We need to define a basic level of readiness that every police officer, firefighter and paramedic in this country will strive to attain. From there, depending upon threat and risk and vulnerability, you can ratchet up and have speciality add-ons there.

We have to remember that 87 percent, or somewhere thereabouts of emergency responders in this country are volunteer. And when you look at these organizations, they are holding fish fries and spaghetti dinners to raise funds to get their next tank of gas. We’ve got local governments that have career operations online that are just—they don’t have the cash to make the plus-up to get the personnel, to get the personal protective equipment.

So I’m going to steal from Dan, September 10, it was unfunded, September 12, it was underfunded. Congress needs to kind of get off the dime. It’s time for a lot of verbs instead of nouns coming off the Capitol Hill.

Thomas: Jamie, I was never one to draw on or color inside the lines, so I’m going to make three points instead of two.

(LAUGHTER)

The first is an emergency management basically is the organizations in each community that coordinate the rest of the organizations that are here today and others.

J.R. Thomas: Our role is to write plans, to conduct exercises, to conduct training opportunities, to make sure that that mark that is continually moving is trying to be covered.

We look at fire law enforcement, EMS, the hospitals, the public health sector, all those organizations that sometimes in the past have not been thought of as emergency responders or at least part of that emergency response section.

Coordination, then, is the key to this. And there was a question earlier about the interoperability of communications. The process is important along with the equipment. The process is that it’s a cultural issue. We need to work together on a daily basis. Then the interoperability comes into play.

That’s where emergency management comes in. That’s where we have meetings and talk to them in daily communications so that we can help make sure everybody’s on the same page.

The second point, as I mentioned with the planning, is that right now in the administration’s 2004 budget request, there is no funding to support emergency management performance grants, which support our organization. Congress is helping us with that, but the administration has believed that they will not pay for personnel even though those funds have been used for personnel costs since 1950.

That’s a major point. Some of us in larger communities may be OK, but some of us in smaller communities rely upon those grants from the federal government to support their operations. And some of those smaller counties that have that budget crisis right now are the ones that have most disasters. And we look at all hazards, not just the terrorism aspect. And I think the reports also mentions all hazards.

If we plan for terrorism, we’re talking about basically any other major hazard that takes place. EMS responds in basically the same way. Fire and law enforcement, we all have basic jobs to do, and the question is how do we tweak them for terrorism.

But to be able to have those local people in place, to be able to write those plans, is an important issue that, hopefully, Congress will help us out with.

And the third thing and my last comment is about multi-county exercises. A lot of us are on exercises one or two, 10, 15, a year. But now, we’re looking at incidents that may be, and probably will be, cross geographical boundaries. We have to look at that regional approach and be able to have funding for those exercises for those smaller communities that may not be able to participate in some of the other exercises.

Tornadoes don’t recognize county or parish boundaries. Earthquakes don’t. We shouldn’t. We should be taking care of this planning as you saw, certainly, at the Washington, the Pentagon, incident. It takes a number of people outside those normal jurisdictional boundaries to respond, and we need to be able to participate in those multi-county exercises to prepare everybody for that type of situation.

Jamie Metzl: I’d like to ask you collectively what is it you think you’re getting ready for? What sort of terrorist act? Are you getting any guidance from the federal government in terms of intelligence or otherwise on what you should be getting ready for?

Kevin Clark: I’ll answer part of that.

When you say what you’re getting ready for, we already know what happened in New York. So we’re ready for the most catastrophic event that could possibly occur. We’re going to attempt to be as most fully prepared as possible to meet an event such as that.

What happened at the World Trade Center, you could never plan for anything like that. But it was the support that came from the local merchants, the local private industry, is what helped us through. What they gave us, I’m talking about from food to equipment, just came from an outpouring of the goodness of people.

Will it happen this time? I’m sure. This is America. It probably will. We will rely on a handout from other people.

The second part of your question, those who were involved in the alert systems. What we would like at the local level is to be advised a lot sooner, so that we could formulate our plan of action and our deployment into areas.

The focus would help us defer cost, number one. Every time somebody raises an alert level and it’s very vague, where it’s going to happen or who their targeting, all of us just have to deploy every resource that we have.

As far as policing, you know on one end we’re fighting the urban terrorist, the drug dealers, the murderers, the robbers, the rapists, every day. Now I have to redirect personnel to look at symbols and infrastructure.

Is that fair to the American public that I’m supposed to protect? Absolutely not. But if I were armed with information, good intelligence information, let’s get past all of these clearances.

I’m not interested in a clearance. If it deals with Baltimore, I want to know about it so I can prepare and prepare in the areas that I have to be in.

So in that area, I would just ask that there be some more cooperation when we go into these alert statuses that I don’t find out from you, the media. I want to hear it from my counterparts.

Question: If I could just follow up, is there no one on your staff who is cleared to get the latest intelligence that is provoking some of the (inaudible)?

Kevin Clark: I’m not going to get into specifics, but I would like more people to have clearances to get that information. But the point is that we need it soon.

Timely intelligence information helps, not that I turn on CNN and they’re telling me that we just went up to alert (inaudible), we’re going to delta.

I need to know a week before. I’m sure that information is somewhere prior so we can plan and it doesn’t cause anxiety amongst the public when they turn on the television at the same time and get the same information I’m getting. I’d like to be prepared, redirect the course.

Every time that we deploy, it costs this department each year at least $1 million to $1.5 million, every time that alert status goes up. And that’s not even counting in the redirected course where I just split my personnel up to handle, like I said, urban terrorists and the threat of terrorism on the international front. So that’s just one area that I would like to see some improvement in.

R. Michael Mohler: Each and every time that we go into a different state of alert, in the beginning people’s anxiety levels went from here to here. And it’s a natural human phenomena that after a period of time: It’s almost like crying wolf. You know, you begin to let your guard down.

So realizing that that’s just how it’s going to be, making sure that we have a guaranteed sense of readiness regardless of what the event’s going to be, making sure that our protective clothing and our breathing apparatus. Today, they have a technology to modify all that breathing apparatus, which it currently isn’t to be able to respond to chem-bio in a nuclear and radiological events, to make sure that we’ve done everything that we can possibly do to prepare us for any and all of those events, you know, realizing that we’re still going to be running Mrs. Smith’s house fire and Mr. Jones’s car accident and those kind of things.

The bar has been raised extremely, and I can’t say enough about the incident management system. I do believe that it’s unacceptable to self-dispatch, which is what happened at the Pentagon, and it happened in New York. And I honestly believe that lives were lost as a result of not having the kind of discipline that we need to have. And we need to revisit those reports, and we need to take from those reports the things that actually killed firefighters and EMS people unnecessarily, and we need to invoke that same discipline that the military currently has. But those are going to be difficult things for the fire service to talk about, because, you know, it’s about sharing blame.

Daniel Hanfling: There’s an important phrase within the substance of the report, and that is that preparedness needs to be predicated on an all-hazard systems approach. You know, when the star center of the basketball team comes home with his report card, gives it to his coach or to his parents and he has four F’s and a D, the answer isn’t, you know, You’re studying too much for one subject, the answer is, You really need to improve across the full spect

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