Public Health and Medical Preparedness and Response: Issues in the 110th Congress Page: 2 of 6
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CRS-2
Preparedness and Response (ASPR, currently RADM W. Craig Vanderwagen), and
related activities in DHS are coordinated by the Assistant Secretary for Health Affairs and
Chief Medical Officer (currently Jeffrey W. Runge).'
Issues in the 110th Congress
Federal Leadership and Coordination. The PKA provided that the DHS Chief
Medical Officer "shall have the primary responsibility within the Department for medical
issues related to natural disasters, acts of terrorism, and other man-made disasters," while
the PAHPA provided that the "Secretary of [HHS] shall lead all Federal public health and
medical response to public health emergencies and incidents...."2 (Emphasis added.) The
Government Accountability Office (GAO)noted, in the context of pandemic flu planning,
that "... these leadership roles involve shared responsibilities, and it is not clear how these
would work in practice."3 GAO recommended that DHS and HHS conduct training and
exercises to ensure that federal leadership roles are clearly defined and understood.
The Presidential Transition. The transition to a new administration in January
2009 will mark the first such transition for agencies and programs that were established
following the 2001 terrorist attacks. These include the Office of the HHS ASPR and all
of the newly established (versus "legacy") agencies and programs in DHS, including the
Office of Health Affairs (OHA). The transition may be especially challenging for OHA,
which is in the midst of rapid growth in funding and staffing. OHA was established (first
as the office of the Chief Medical Officer) in 2005, received $2 million in FY2006, and
grew to $117 million in FY2008, with $161 million requested for FY2009. OHA is in the
process of hiring permanent staff to carry out a variety of new responsibilities.
HHS Response Capability. The 110th Congress may consider the adequacy of
permanent authorities of the HHS Secretary for responding to public health threats,
including authority to declare a public health emergency. Members of Congress may also
consider how HHS funds disaster response activities that are not reimbursable by FEMA.
Though the HHS Secretary has authority for a no-year Public Health Emergency Fund,
Congress has not appropriated monies to the fund for many years.41See HHS, Assistant Secretary for Preparedness and Response, at [http://www.hhs.gov/aspr], and
DHS, Office of Health Affairs, at [http://www.dhs.gov/xabout/structure/editorial_0880.shtm].
See also CRS Report RL33589, The Pandemic and All-Hazards Preparedness Act (P.L.
109-417): Provisions and Changes to Preexisting Law, by Sarah A. Lister and Frank Gottron
(hereafter CRS Report RL33589), and CRS Report RL33729, Federal Emergency Management
Policy Changes After Hurricane Katrina: A Summary of Statutory Provisions, by Keith Bea,
Coordinator (hereafter CRS Report RL33729).
2 P.L. 109-295, 120 Stat. 1409; P.L. 109-417, 101, 120 Stat. 2832.
3 GAO, "Influenza Pandemic: Opportunities Exist to Clarify Federal Leadership Roles and
Improve Pandemic Planning," GAO-07-1257T, September 26, 2007. See also CRS Report
RL33579, The Public Health and Medical Response to Disasters: Federal Authority and
Funding, by Sarah A. Lister (hereafter CRS Report RL33579).4 See CRS Report RL33579.
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Lister, Sarah A. Public Health and Medical Preparedness and Response: Issues in the 110th Congress, report, June 16, 2008; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metacrs10696/m1/2/?q=infectious+diseases++%22public+health+emergency+fund+%22: accessed June 14, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.