[Congressional Record Volume 152, Number 133 (Wednesday, December 6, 2006)]
[Senate]
[Pages S11317-S11318]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




               PANDEMIC AND ALL-HAZARDS PREPAREDNESS ACT

  Mr. LIEBERMAN. Mr. President, I wanted to give my thanks to Senators 
Burr and Kennedy for working with me and my esteemed colleagues, 
Senators Cochran, Obama, Kohl, and Landrieu, to pass a bill that 
together makes a difference to the health and well-being of Americans 
in the event of a public health emergency--natural or man-made. We saw 
in Hurricane Katrina that local, State, and Federal governments were 
not adequately prepared for a situation that could have been much 
worse. Also, much of the public was not prepared and could not get out 
of harm's way because of issues of capacity and trust. Regardless of 
our preparation then, it is clear that the government and the public 
must become better prepared now. We must come up with a disaster 
preparedness and response system which does a better job of knowing 
what is happening not in government cubicles but on the ground, which 
is able to prioritize the allocation and delivery of finite resources, 
and which utilizes our cumulative man and woman-power to work together 
to get anything that needs to be done, done.
  This is not a perfect bill, but S. 3678, the Pandemic and All-Hazards 
Preparedness Act, does improve the ability of the Federal Government to 
coordinate response to emergencies and disasters. It centralizes 
command and control of Federal public health and medical emergency 
response and for the first time ever, lists the needs of at-risk 
individuals in emergencies as a national preparedness goal.
  Considering the needs of at-risk populations in public health 
emergencies and disasters is perhaps the most vital way to reduce 
casualties when treatment options are limited, environmental exposures 
place the public at risk and or when evacuation is necessary to get 
people out of harm's way. In disasters, the burden of casualties almost 
always fall on populations with unequal ability to protect themselves. 
These populations are termed special-needs populations, at-risk 
populations or at-risk individuals. They are populations who possess 
unique needs or limitations and may as a result not be able to receive, 
comprehend, or respond to public health messaging during emergencies in 
the way that bests support their safety and well-being. They are 
populations that may not able to fully address their own preparedness 
for, response to, and recovery from public health emergencies. At-risk 
individuals include the elderly, children, pregnant women, the poor, 
disabled, individuals with limited English proficiency, and others. 
Forty million Americans are over 65 years old, a number that will reach 
71 million by 2030. There are over 70 million children under age 18. 
There are approximately 7 million pregnant women. Fourteen percent of 
Americans are limited in activity due to a chronic health condition.
  I thank Senators Burr and Kennedy for having the vision to address 
at-risk individuals in S. 3678 but also the willingness to work with 
Senators Cochran, Obama, Kohl, and Landrieu and me to make the language 
concerning at-risk individuals even stronger. The Lieberman-Cochran 
amendment, which has been incorporated into the final S. 3678 managers' 
package, publicly designates a person with a budget, who would ideally 
be called the Director Office of At-Risk Individuals, to oversee the 
implementation of the national preparedness goal concerning at-risk 
individuals; assist Federal agencies responsible with planning for, 
responding to, and recovering from public health emergencies in 
addressing the needs of at-risk individuals; provide guidance to State 
and local public health grant recipients as to how to incorporate the 
needs of at-risk individuals in emergency preparedness and response 
strategies; and develop and disseminate best principles and practices 
regarding outreach to and care of at-risk individuals in public health 
emergencies.
  Senators Cochran, Obama, Kohl, and Landrieu and I believe that a new 
director of At-Risk Individuals will be a great resource to the 
Assistant Secretary in keeping the needs of at-risk individuals central 
as the Secretary works to implement the Nation's disaster preparedness 
goals across the Federal agencies. In the past, the Nation has not done 
enough to break down the artificial silos between the agencies charged 
with the health aspects of disaster planning and response, which is 
vital for the public in general but particularly to at-risk individuals 
in disasters. At-risk individuals are not monolithic, and their 
identities change depending upon the type, location, and character of 
disasters. Yet they are many, and their existence poses consistent 
challenges which must be addressed. These groups include people

[[Page S11318]]

with disabilities, the elderly, non-English speakers, children, the 
poor, and the homeless. We understand that there is often significant 
overlap between at-risk groups. Individuals who are homeless, for 
example, are also poor and often disabled.
  Senators Cochran, Obama, Kohl, and Landrieu and I also believe that a 
new director of At-Risk Individuals will also be a great resource to 
States, which will now have to incorporate the needs of at-risk 
individuals into disaster plans as a condition of receiving Federal 
disaster preparedness funding. The process by which the needs of at-
risk individuals are incorporated into State, let alone Federal 
disaster plans is not obvious and will require both accumulation and 
dissemination of expertise. The committee envisions the Office of At-
Risk Individuals as an ideal repository and resource for information in 
this regard. This information can be gathered from entities already 
doing excellent work in the field. Within HHS, this includes the 
Administration on Aging, the Office on Disability, and Administration 
on Developmental Disabilities. Within DHS, this includes the Office for 
Civil Rights and Civil Liberties, the Preparedness Directorate, and the 
Interagency Coordinating Council on Emergency Preparedness and 
Individuals with Disabilities. Within the community, this includes 
organizations like C.A.R.D. in California and the Kellogg Foundation's 
Redefining Readiness Projects. Within Academia, this includes work done 
by the Center for Civilian Biodefense Studies in Maryland and the New 
York Academy of Medicine. Nationally, this includes the National 
Organization on Disability's Emergency Preparedness, Initiative, the 
Center for Disability and Special Needs Preparedness, and the American 
Academy of Pediatrics.
  Finally, Senators Cochran, Obama, Kohl, and Landrieu and I believe 
that a new Director of At-Risk Individuals can be an important source 
of funding and support for a community engagement process focused on 
organizing ordinary citizens to prepare and to respond to public health 
emergencies. The public is not a passive entity and must be viewed as a 
valuable partner in disaster planning and response. Communities are 
better able, for example, to identify the location of their special 
needs populations, to communicate with them, and to intervene in ways 
that are consistent with the reality of people's lives. In addition, 
during disasters, the governmental response is often delayed, and 
people must be able to protect themselves why they wait for help. Last 
of all, community-derived public health emergency plans must be 
coordinated with local, State and Federal disaster plans and the new 
Office of At-Risk Individuals can fund opportunities to bring all key 
stakeholders together.
  The AARP, the American Red Cross, United Cerebral Palsy, and the 
American Academy of Pediatrics have all endorsed this important 
amendment. These are groups that most would agree know much about at-
risk individuals, disaster preparedness and response.
  In short, the process of addressing the needs of at-risk individuals 
during public health emergencies is a necessary and immense task that 
must be overseen. A new Director of At-Risk Individuals with a budget 
of up to $5 million as specified in S. 3678 will provide the focus, 
expertise, personnel, and institutional memory to assure that the at-
risk language in S. 3678 is followed and that the Government, in 
planning for and responding to emergencies, keeps the needs of all 
Americans, front and center.
  I thank Senators Burr and Kennedy again for writing and passing S. 
3678 and being open to the Lieberman-Cochran language.

                          ____________________