Homeland Security: Need to Consider VA's Role in Strengthening	 
Federal Preparedness (15-OCT-01, GAO-02-145T).			 
								 
The federal government, including the Department of Veterans	 
Affairs (VA), plays a key role in managing the medical and other 
consequences of domestic terrorist incidents. One of VA's health 
care missions is to provide backup medical resources to the	 
military health system and communities following domestic	 
terrorist incidents or other major disasters. VA currently	 
assists other agencies that have lead responsibility for	 
responding to disasters, including terrorism. Its areas of	 
responsibility include disaster simulation exercises and	 
maintaining medical stockpiles. VA has	enhanced national	 
emergency preparedness evaluating disaster simulation exercises  
to improve medical response procedures and to strengthen the	 
security of federal pharmaceutical stockpiles to ensure rapid	 
response to local authorities. VA also has resources that could  
play a role in future federal homeland security efforts. Its	 
assets include the bricks, mortar, and human capital components  
of its health care system, graduate medical education programs,  
and expertise involving emergency backup and support activities. 
In managing large-scale medical emergencies arising from	 
terrorist attacks, VA's emergency response capabilities have	 
strengths and shortcomings. Determining how VA can best 	 
contribute to homeland security is especially timely, given the  
extraordinary level of federal activity underway to manage	 
large-scale disasters.						 
-------------------------Indexing Terms------------------------- 
REPORTNUM:   GAO-02-145T					        
    ACCNO:   A02321						        
  TITLE:     Homeland Security: Need to Consider VA's Role in	      
Strengthening Federal Preparedness				 
     DATE:   10/15/2001 
  SUBJECT:   Emergency medical services 			 
	     Emergency preparedness				 
	     Interagency relations				 
	     Terrorism						 
	     Federal Radiological Emergency Response		 
	     Plan						 
								 
	     FEMA Federal Response Plan 			 
	     National Disaster Medical System			 
	     Pentagon						 
	     World Trade Center (NY)				 

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GAO-02-145T
     
Testimony Before the Committee on Veterans' Affairs, House of
Representatives

United States General Accounting Office

GAO For Release on Delivery Expected at 2: 00 p. m. Monday, October 15, 2001
HOMELAND SECURITY

Need to Consider VA's Role in Strengthening Federal Preparedness

Statement of Cynthia A. Bascetta Director, Health Care- Veterans'

Health and Benefits Issues

GAO- 02- 145T

Page 1 GAO- 02- 145T

Mr. Chairman and Members of the Committee: I am pleased to be here as you
discuss the impact of the September 11 events on the mission of the
Department of Veterans Affairs (VA). As the Comptroller General recently
stated, 1 we at GAO, along with all Americans, were shocked and saddened by
the terrorist attacks last month on the World Trade Center and the Pentagon.
Even before these catastrophic events, terrorism was the focus of concerted
emergency response preparations by multiple federal agencies. Now, more than
ever, we must keep our attention and vigilance focused on blunting the
threat and consequences of terrorism.

While state and local governments have primary responsibility for managing
the medical and other consequences of a domestic terrorist incident, the
federal government, including VA, plays a key role to augment the efforts of
state and local authorities. Indeed, consequence management- the measures
taken to alleviate the mass damages and suffering caused by a terrorist
incident- has increasing prominence for federal preparedness as the nation
strengthens its strategy for homeland security. In this regard, one of VA?s
health care missions is to provide backup medical resources to the military
health system and communities following domestic terrorist incidents and
other major disasters.

In the wake of the devastating attacks, you asked us to discuss (1) the
activities VA has undertaken in its emergency preparedness role and (2) VA?s
capabilities as the federal government plans for strengthened homeland
security. To do this, we drew on our work on VA?s participation in federal
terrorism preparedness efforts, 2 other GAO reports on combating terrorism,
and our broader work related to VA?s primary health care mission.

In summary, VA currently plays a supporting role in assisting other agencies
that have lead responsibility for responding to disasters, including
terrorism. In its areas of responsibility- conducting disaster simulation
exercises and maintaining medical stockpiles- VA has taken steps to enhance
national emergency preparedness. Specifically, it has evaluated disaster
simulation exercises to help improve medical response

1 Homeland Security: A Framework for Addressing the Nation?s Efforts (GAO-
01- 1158T, Sept 21, 2001). 2 See related GAO products listed at the end of
this statement.

Page 2 GAO- 02- 145T

procedures and strengthened the security of federal pharmaceutical
stockpiles to ensure rapid response support to local authorities who may be
overwhelmed by terrorist attack.

VA also has resources that could play a role in future federal homeland
security efforts. Its assets include the bricks, mortar, and human capital
components of its health care system, graduate medical education programs,
and expertise involving emergency backup and support activities. In managing
large- scale medical emergencies arising from terrorist attacks, VA?s
emergency response capabilities have strengths and shortcomings. For
example, most VA hospitals and clinics coordinate their emergency plans with
their local communities. On the other hand, like their community hospital
counterparts, VA facilities are less prepared to treat victims of biological
than chemical terrorist attacks. In our view, determining how VA can best
contribute to homeland security is especially timely, given the
extraordinary level of federal activity underway to better prepare for
managing large- scale disasters.

Of VA?s $48.8 billion budget in fiscal year 2001, $20.9 billion was for
carrying out its four health care missions. Its first, most visible health
care mission is to provide medical care for veterans. VA operates a national
health system of hospitals, clinics, nursing homes and other facilities that
provide a broad spectrum of medical, surgical, and rehabilitative care. More
than 3.8 million people received care in VA health care facilities last
year. Under its second mission- to provide education and training for health
care personnel- VA manages the largest medical education and health
professions training program in the United States, training about 85,000
health professionals annually in its medical facilities that are affiliated
with almost 1,400 medical and other schools. Under its third mission- to
conduct medical research- VA funding was about $1.2 billion in 2000 for over
15,000 medical research projects and related medical science endeavors. 3

VA?s fourth mission- to serve as backup to the Department of Defense (DOD)
health system in war or other emergencies and as support to communities
following domestic terrorist incidents and other major disasters- has
attracted greater congressional interest since the

3 These funds come from appropriations, pharmaceutical manufacturers,
National Institutes of Health, and foundations. Background

Page 3 GAO- 02- 145T

September 11 terrorist attacks in the United States. This role, however, is
not new. Since the early 1980s, when a national system was put in place to
provide for local medical responses when a disaster occurs, VA has been
providing medical support. In fiscal year 2001, less than one- half of 1
percent of VA?s total health care budget, $7.9 million, was allocated to
this mission. 4

VA was first formally assigned a federal disaster management role in 1982,
when legislation tasked VA with ensuring the availability of health care for
eligible veterans, military personnel, and the public during military
conflicts and domestic emergencies. 5 In the immediate aftermath of the
September 11 attacks, VA medical facilities in New York, Washington, D. C.,
Baltimore, and Altoona, Pennsylvania, were readied to handle casualties. In
prior emergencies, such as hurricanes Andrew and Floyd and the 1995 bombing
of the federal building in Oklahoma City, VA deployed more than 1,000
medical personnel and provided substantial amounts of medical supplies and
equipment as well as the use of VA facilities. VA?s role as part of the
federal government?s response for disasters has grown with the reduction of
medical capacity in the Public Health Service and military medical
facilities.

VA established an Emergency Management Strategic Healthcare Group with
responsibility for the following six emergency response functions: 6

 Ensuring the continuity of VA medical facility operations. Prior to
emergency conditions, VA emergency management staff are responsible for
minimizing disruption in the treatment of veterans by developing, managing,
and reviewing plans for disasters and evacuations and coordinating mutual
aid agreements for patient transfers among VA facilities. During emergency
conditions these staff are responsible for ensuring that these plans are
carried out as intended.

4 In addition to this amount, in fiscal year 2001, VA received $62 million
from the Department of Health and Human Services (HHS) to support various
aspects of HHS terrorism- related preparedness.

5 The 1982 VA/ DOD Health Resources Sharing and Emergency Operations Act (P.
L. 97- 174) authorized VA to ensure hospital backup to DOD. At the same
time, growing concern about the lack of a medical response plan for
civilians led to a 1984 administrative establishment of a national medical
system that would back up DOD and handle domestic disasters as well.

6 Formerly, VA?s Emergency Management Preparedness Office had this
responsibility.

Page 4 GAO- 02- 145T

 Backing up DOD?s medical resources following an outbreak of war or other
emergencies involving military personnel. In 2001, VA has plans for the
allocation of up to 5,500 of its staffed operating beds for DOD casualties
within 72 hours of notification. 7 In total, 66 VA medical centers are
designated as primary receiving centers for treating DOD patients. In turn,
these centers must execute plans for early release or movement of VA
patients to 65 other VA medical centers designated as secondary support
centers.

 Jointly administering the National Disaster Medical System (NDMS). In
1984, VA, DOD, the Federal Emergency Management Agency (FEMA), and the
Department of Health and Human Services 8 (HHS) created a federal
partnership to administer and oversee NDMS, which is a joint effort between
the federal and private sectors to provide backup to civilian health care in
the event of disasters producing mass casualties. The system divides the
country into 72 areas selected for their concentration of hospitals and
proximity to airports. Nationwide, more than 2,000 civilian and federal
hospitals participate in the system. One of VA?s roles in NDMS is to help
coordinate VA hospital capacity with the nonfederal hospitals participating
in the system.

 Carrying out Federal Response Plan efforts to assist state and local
governments in coping with disasters. Under FEMA?s leadership, VA and other
agencies are responsible for carrying out the Federal Response Plan, 9 which
is a general disaster contingency plan. As a support agency, VA is one of
several federal agencies sharing responsibility for providing public works
and engineering services, mass care and sheltering, resource support, and
health and medical services. VA is also involved with other agencies in
positioning medical resources at high- visibility public events requiring
enhanced security, such as national political conventions. VA also maintains
a database of deployable VA medical personnel that is intended to help the
agency to quickly locate medical personnel (such as nurses, physicians, and
pharmacists) for deployment to a disaster site.

7 Annually, VA?s medical centers estimate the number of beds that could be
made available to receive returning military casualties. As of 2001, VA?s
plan would provide up to 7,574 beds within 30 days of notification.

8 Within HHS, the Office of Emergency Preparedness is in charge of NDMS
activities. 9 The Federal Response Plan is authorized by the Robert T.
Stafford Disaster Relief and Emergency Assistance Act (P. L. 93- 288, as
amended).

Page 5 GAO- 02- 145T

 Carrying out Federal Radiological Emergency Response Plan efforts to
respond to nuclear hazards. Depending on the type of emergency involved, VA
is responsible for supporting the designated lead federal agency 10 in
responding to accidents at nuclear power stations or terrorist acts to
spread radioactivity in the environment. VA also has its own medical
emergency radiological response team of physicians and other health
specialists. When requested by the lead agency, VA?s response team is
expected to be ready to deploy to an incident site within 12 to 24 hours to
provide technical advice, radiological monitoring, decontamination
expertise, and medical care as a supplement to local authorities? efforts.

 Supporting efforts to ensure the continuity of government during national
emergencies. VA maintains the agency?s relocation site and necessary
communication facilities to continue functioning during a major national
emergency.

In addition to these functions, VA plays a key support role in the nation?s
stockpiling of pharmaceuticals and medical supplies in the event of
largescale disasters caused by weapons of mass destruction (WMD). 11 These
stockpiles are critical to the federal assistance provided to state and
local governments should they be overwhelmed by terrorist attack. Under a
memorandum of agreement between VA and HHS? Office of Emergency Preparedness
(OEP), VA maintains at designated locations medical stockpiles containing
antidotes, antibiotics, and medical supplies and smaller stockpiles
containing antidotes, which can be loaned to local governments or
predeployed for special events, such as the Olympic Games. In fiscal year
2001, OEP reimbursed VA $1.2 million for the purchase, storage, and
maintenance of the pharmaceutical stockpiles.

VA also maintains stockpiles of pharmaceuticals for another HHS agency, the
Centers for Disease Control and Prevention (CDC). Under contract with CDC,
VA purchases drugs and other medical items and manages a spectrum of
contracts for the storage, rotation, security, and transportation of
stockpiled items. VA maintains the inventory of pharmaceutical and medical
supplies called ?12- hour push packages,?

10 For example, the Nuclear Regulatory Commission is the lead agency for an
emergency that occurs at a nuclear power plant. In other circumstances, the
Department of Energy or the Environmental Protection Agency could be the
lead federal agency.

11 The term weapons of mass destruction refers to chemical, biological,
radiological, nuclear agents or weapons, and large conventional explosives.

Page 6 GAO- 02- 145T

which can be delivered to any location in the nation within 12 hours of a
federal decision to deploy them. It also maintains a larger stock of
antibiotics, antidotes, other drugs, medical equipment, and supplies known
as vendor- managed inventory 12 that can be deployed within 24 to 36 hours
of notification. In fiscal year 2001, CDC contracts included an estimated
$60 million to reimburse VA for its purchasing and management activities
associated with the stockpiles, including the cost of medical items. 13

Consistent with the agency?s fourth health care mission, VA operates as a
support rather than command agency under the umbrella of several federal
policies and contingency plans for combating terrorism. 14 Its direct
emergency response activities include conducting and evaluating terrorist
attack simulations to develop more effective response procedures and
maintaining the inventories for stockpiled pharmaceuticals and medical
supplies.

Our prior work on federal coordination of efforts to combat terrorism found
that VA led many disaster response simulation exercises and conducted
follow- up evaluations. 15 These exercises are an important part of VA?s
efforts to prepare for catastrophic terrorist attacks. The exercises test
and evaluate policies and procedures, test the effectiveness of response
capabilities, and increase the confidence and skill level of personnel.
Those exercises held jointly with other federal, state, and local agencies
facilitate the planning and execution of multiagency missions and help
identify strengths and weaknesses of interagency coordination.

12 These vendor- managed inventories are carried on the manufacturers?
inventory records as either ?government owned? or ?government reserved? and
may be rotated with the vendor?s normal operating stock in order to ensure
freshness. The 12- hour push packages comprise approximately 20 percent of
the stockpile; the vendor- managed inventory comprises the remaining 80
percent.

13 CDC has been working with VA since 1999 to build its stockpiles. In
addition to the fiscal year 2001 funds, CDC received $51 million in fiscal
year 1999 and $52 million in fiscal year 2000 for purchasing items for the
stockpiles.

14 For a compendium of relevant policy and planning documents, see Combating
Terrorism: Selected Challenges and Related Recommendations (GAO- 01- 822,
Sept. 20, 2001). 15 See Combating Terrorism: Federal Response Teams Provide
Varied Capabilities: Opportunities Remain to Improve Coordination (GAO- 01-
14, Nov. 30, 2000). VA Has Taken Steps

to Enhance Federal Emergency Management Preparedness

VA Has Conducted and Evaluated Disaster Simulation Exercises

Page 7 GAO- 02- 145T

VA has sponsored or participated in a variety of exercises to prepare for
combating terrorism, including those involving several federal agencies and
WMD scenarios. In addition, VA participates in numerous other disaster-
related exercises aimed at improving its consequence management
capabilities. The following are examples of terrorism- related exercises in
which VA has participated.

 In March 1997, in conjunction with the state of Minnesota, VA participated
in the ?Radex North? exercise in Minneapolis, which simulated a terrorist
attack on a federal building. The attack involved simulated explosives laced
with radioactive material, requiring the subsequent decontamination and
treatment of hundreds of casualties. One of the objectives was to test the
capabilities of VA?s radiological response team. The exercise had 500
participants and was designed to integrate the federal medical response into
the state and local response, including local hospitals.

 In July 1997, VA participated in ?Terex ?97? in Nebraska. The exercise?s
main objectives were to provide federal and state public health agencies
with integrated training in disaster response and to assess coordination
among federal, state, and local agencies for responding to a catastrophic,
mass- casualty incident. The VA hospital in Lincoln provided bed space for
mock casualties wounded by simulated conventional explosives. In addition,
VA management staff worked with other federal, state, and local health care
officials to coordinate emergency response efforts.

 In May 1998, VA, DOD, and HHS cosponsored ?Consequence Management 1998? in
Georgia. The 2- day exercise trained and evaluated federal medical response
team personnel in emergency procedures for responding to a WMD attack. In
organizing the event, VA?s radiological response team worked with the Marine
Corps? special response force to decontaminate mock casualties. The VA
medical center in Augusta supplied logistics support, including stockpiled
pharmaceuticals.

 In May 1999, VA sponsored ?Catex ?99? in Minnesota. Over 80 groups
representing federal, state, and local governments, the military, volunteer
organizations, and the private sector worked with VA to train for a
masscasualty WMD incident. In a scenario depicting simultaneous chemical
weapons attacks throughout the Twin Cities region, VA activated and oversaw
an emergency operations center, which coordinated response efforts,
including simulated casualty evacuations to hospitals in Detroit, Cleveland,
Milwaukee, and Des Moines.

Page 8 GAO- 02- 145T

 In May 2000, VA participated in ?Consequence Management 2000? in Georgia.
Developed jointly by VA, DOD, HHS, and various state and local agencies, the
exercise trained federal emergency personnel in procedures and techniques
for responding to a WMD attack. The event also served to familiarize
federal, state, and local agencies with the U. S. Army Reserves? role in the
event of a catastrophic terrorist incident. Simulating a masscasualty
terrorist attack in Georgia, VA emergency response teams performed triage
and decontaminated patients exposed to chemical and radiological agents.
Several VA medical centers in Georgia, Alabama, and South Carolina provided
care to simulated serious casualties.

 In May 2000, VA participated in ?TOPOFF 2000,? a national, ?no- notice?
exercise designed to assess the ability of federal, state, and local
agencies to respond to coordinated terrorist attacks involving WMD. The
event was the largest peace- time terrorism exercise ever sponsored by the
Department of Justice and FEMA, and incorporated three main crisis
simulations: a radiological scenario in Washington, D. C.; a chemical
scenario in New Hampshire; and a biological scenario in Colorado. VA
provided consequence management support to other federal agencies,
identified hospital bed space for potential casualties, and dispatched
medical personnel to various locations. VA also placed its radiological
response team on alert.

VA also conducts follow- up evaluations of these simulation exercises.
Evaluations typically include, among other things, operational limitations,
identified strengths and weaknesses, and recommended actions. Our work shows
that VA has a good record of evaluating its participation in these
exercises. The evaluations generally discuss interagency issues and are
disseminated within VA. Among the favorable findings from VA?s reviews were
that emergency personnel were activated quickly and were deployed to
incident sites fully equipped and prepared; personnel demonstrated high
levels of motivation and technical expertise; and interaction among federal,
state, and local personnel and between civilian and military counterparts
was positive. The reviews also identified the following concerns:

 On- site medical personnel experienced communications problems due to
incompatible equipment.

 Communication between headquarters and field offices was at times hindered
by an over- reliance on a single means of communication.

 Unclear standards and inadequate means for reporting available bed space
also posed problems.

Page 9 GAO- 02- 145T

 Caregivers sometimes had difficulty tracking patients as they progressed
through on- site treatment stages.

 Incident- site security was a recurrent concern, especially with respect
to decontamination controls.

We have made a number of recommendations to federal lead and support
agencies to improve such interagency exercises and follow- up evaluations,
including the dissemination of evaluation results across agencies. 16

VA has improved the internal controls and inventory management of several
medical supply stockpiles it maintains for OEP and CDC to address previously
identified deficiencies. VA is responsible for the purchase, storage, and
quality control of thousands of stockpile supply items. It maintains
stockpiles at several sites around the country for immediate use by federal
agency teams staffed with specially trained doctors, nurses, other health
care providers, and emergency personnel whose mission is to decontaminate
and treat victims of chemical and biological terrorist attacks. In 1999, we
found that VA lacked the internal controls to ensure that the stockpiled
medical supplies and pharmaceuticals were current, accounted for, and
available for use. 17 However, our recent work shows that VA has taken
significant corrective actions in response to our recommendations that have
resulted in reducing inventory discrepancy rates and improved
accountability. 18

At the same time, we have recommended additional steps that, VA, in concert
with OEP and CDC, should take to further tighten the security of the
nation?s stockpiles. These include finalizing and implementing approved
operating plans and ensuring compliance with these plans through periodic
quality reviews. VA supports these recommendations and is taking action with
OEP and CDC to implement them.

16 See GAO- 01- 822. 17 Combating Terrorism: Chemical and Biological
Supplies Are Poorly Managed (GAO/ HEHS/ AIMD- 00- 36, Oct. 29, 1999).

18 Combating Terrorism: Accountability Over Medical Supplies Needs Further
Improvement (GAO- 01- 463, Mar. 30, 2001). VA Has Improved

Inventory Management of Medical Stockpiles

Page 10 GAO- 02- 145T

VA has significant capabilities related to its four health care missions
that have potential applicability for the purpose of homeland security. At
the same time, it is clear that some of these capabilities would need to be
strengthened. How best to employ and enhance this potential will be
determined as part of a larger effort currently underway to develop a
national homeland security strategy. As the Comptroller General recently
noted, this broad strategy will require partnership with the Congress, the
executive branch, state and local governments, and the private sector to
minimize confusion, duplication of effort, and ineffective alignment of
resources with strategic goals. It will also require a systematic approach
that includes, among other elements, ensuring the nation?s ability to
respond to and mitigate the consequences of an attack.

In this regard, VA has a substantial medical infrastructure of 163 hospitals
and more than 800 outpatient clinics strategically located throughout the
United States, including the largest pharmaceutical and medical supply
procurement systems in the world and a nationwide register of skilled VA
medical personnel. In addition, VA operates a network of 140 treatment
programs for post- traumatic stress disorder and is recognized as the
leading expert on diagnosing and treating this disorder.

VA holds other substantial health system assets. For example, the agency has
well- established relationships with 85 percent of the nation?s medical
schools. According to VA, more than half of the nation?s medical students
and a third of all medical residents receive some of their training at VA
facilities. In addition, more than 40 other types of health care
professionals, including specialists in medical toxicology and occupational
and environmental medicine, receive training at VA facilities every year. In
recent years, VA expanded physician training slots in disciplines associated
with WMD preparedness.

In 1998, several government agencies, including VA, contributed to a
presidential report to the Congress on federal, state, and local
preparations and capability to handle medical emergencies resulting from WMD
incidents. 19 The report outlined both strengths and weaknesses in regard to
VA?s emergency response capabilities. The report noted the potential for VA
to augment the resources of state and local responders

19 The report, Preparations for a National Response to Medical Emergencies
Arising from Terrorists? Use of Weapons of Mass Destruction, was required by
the Veterans Benefits Act of 1997 (P. L. 105- 114), and submitted by the
President to the Congress in July 1998. Considering VA?s

Strengths and Limitations Important in Planning for Homeland Security

Page 11 GAO- 02- 145T

because more than 80 percent of VA hospital emergency plans are included in
the local community emergency response plan. However, the report also noted
that

 VA hospitals do not have the capability to process and treat mass
casualties resulting from WMD incidents.

 VA hospitals and most private sector medical facilities are better
prepared for treating injuries resulting from chemical exposure than those
resulting from biological agents or radiological material.

 VA hospitals, like community hospitals, lack decontamination equipment,
routine training to treat mass casualties, and adequate on- hand medical
supplies.

Currently, VA?s budget authority does not include funds to address these
shortcomings.

Myriad federal efforts are underway to strengthen the nation?s ability to
prevent and mitigate the consequences of terrorism. Consideration of what
future role VA may assume in coordination with its federal partners in
consequence management is an important element. Currently, the agency, in a
supporting role, makes a significant contribution to the emergency
preparedness response activities carried out by lead federal agencies.
Expanding this role in response to stepped up homeland security efforts may
be deemed beneficial but would require an analysis of the potential impact
on the agency?s health care missions, the resource implications for VA?s
budget, and the merits of enhancing VA?s capabilities relative to other
federal alternatives.

Mr. Chairman, this completes my prepared statement. I would be happy to
respond to any questions you or other Members of the committee may have.

For more information regarding this testimony, please contact me at (202)
512- 7101. Stephen L. Caldwell, Hannah F. Fein, Carolyn R. Kirby, and Paul
Rades also made key contributions to this statement. Concluding

Observations Contact and Acknowledgments

Page 12 GAO- 02- 145T

Bioterrorism: Public Health and Medical Preparedness (GAO- 02- 141T, Oct. 9,
2001).

Bioterrorism: Federal Research and Preparedness Activities (GAO- 01- 915,
Sept. 28, 2001).

Combating Terrorism: Selected Challenges and Related Recommendations (GAO-
01- 822, Sept. 20, 2001).

Homeland Security: A Framework for Addressing the Nation?s Efforts (GAO- 01-
1158T, Sept. 21, 2001).

Combating Terrorism: Accountability Over Medical Supplies Needs Further
Improvement (GAO- 01- 463, Mar. 30, 2001).

Combating Terrorism: Federal Response Teams Provide Varied Capabilities;
Opportunities Remain to Improve Coordination (GAO/ 01- 14, Nov. 30, 2000).

Combating Terrorism: Chemical and Biological Medical Supplies Are Poorly
Managed (GAO/ HEHS/ AIMD- 00- 36, Oct. 29, 1999).

Combating Terrorism: Analysis of Federal Counterterrorist Exercise (GAO/
NSIAD- 99- 157BR, June 25, 1999).

(290134) Related GAO Products
*** End of document. ***