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Public Health and Medical Emergency Management: Issues in the 112th Congress [February 18, 2011]

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"Key recent events--the 2001 terrorist attacks, Hurricane Katrina, and the H1N1 influenza ('flu') pandemic, among others--sharpened congressional interest in the nation's ability to respond to health threats. For the response to health emergencies, most authority resides with state and local governments, and most capacity resides in the private sector. The federal government plays a key role, however, providing numerous forms of assistance for planning and preparedness, as well as for response and recovery. Previous Congresses passed a number of laws intended to establish clear federal leadership roles and responsibilities and effective organizational structures, in the Departments of Health and Human Services (HHS) and Homeland Security (DHS) in particular. Nonetheless, challenges persist in coordinating federal preparedness and response efforts. From FY2002 through FY2010, Congress provided about $11.4 billion in grants to states and territories to strengthen public health and medical system capacity in preparedness for health threats. However, depending on the incident, dedicated funding for the actual response to these threats may or may not be available. For example, it is not clear that infectious disease incidents (such as bioterrorism or a flu pandemic) would qualify for major disaster assistance under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (the Stafford Act). Also, although the HHS Secretary has authority for a Public Health Emergency Fund, Congress has not appropriated monies to the fund for many years. Finally, there is no federal assistance program designed purposefully to cover uncompensated or uninsured health care costs for disaster victims."

Library of Congress. Congressional Research Service

Lister, Sarah A.

2011-02-18
Comparison of the World Trade Center Medical Monitoring and Treatment Program and the World Trade Center Health Program Created by Title I of P.L. 111-347, the James Zadroga 9/11 Health and Compensation Act of 2010 [January 25, 2011]

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"In the wake of the September 11, 2001, terrorist attacks, Congress passed appropriations to provide limited health screening and treatment services to persons involved in rescue, recovery, and cleanup operations around the former site of the World Trade Center. This program, now known as the World Trade Center (WTC) Medical Monitoring and Treatment Program (MMTP), is not authorized in statute but rather relies on discretionary appropriations to provide services to eligible individuals. Since its inception in FY2002, the MMTP has received approximately $475 million in federal funds, and over 57,000 responders and community members have met initial eligibility requirements for the program. On January 2, 2011, President Barack Obama signed into law P.L. 111-347, the James Zadroga 9/11 Health and Compensation Act of 2010. Title I of P.L. 111-347 replaces the MMTP with a program authorized in statute and financed through mandatory federal spending, partially matched by New York City. This program, called the World Trade Center Health Program (WTCHP), will provide full medical screening and treatment benefits to eligible WTC responders and community members beginning in July 2011. In addition, Title I of P.L. 111-347 establishes formal eligibility requirements based on a person's activities after September 11, 2001, and his or her current health conditions. [...] The WTCHP will sunset at the end of FY2016 or FY2015 if a federal spending cap is met. Total federal spending on the program is capped at $1.556 billion over the life of the program."

Library of Congress. Congressional Research Service

Lister, Sarah A.; Szymendera, Scott

2011-01-25
Comparison of the Current World Trade Center Medical Monitoring and Treatment Program and the World Trade Center Health Program Proposed by Title I of H.R. 847 [December 14, 2010]

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"In the wake of the September 11, 2001, terrorist attack on New York City, Congress passed appropriations to provide limited health screening and treatment services to persons involved in rescue, recovery, and cleanup operations around the former site of the World Trade Center. This program, now known as the World Trade Center (WTC) Medical Monitoring and Treatment Program (MMTP), is not authorized in statute but rather relies on discretionary appropriations to provide services to eligible individuals. [...] Title I of H.R. 847, as amended and passed by the House of Representatives, would eliminate the current MMTP and replace it with a program authorized in statute and financed through mandatory federal spending, partially matched by New York City. This program, proposed to be called the World Trade Center Health Program (WTCHP), would provide full medical screening and treatment benefits to eligible WTC responders and community members. [...] The proposed WTCHP would sunset at the end of FY2020, or in FY2019 if a federal spending cap is met. Total federal spending on the program would be capped at $3.348 billion over the life of the program. New York City would contribute 10% of the program's costs until FY2019, after which its contribution would become equal to one-ninth of federal spending in the remaining fiscal years. In addition to persons already receiving services under the MMTP, the WTCHP would serve up to 25,000 new responders and 25,000 new community members. The House of Representatives passed an amendment in the nature of a substitute to H.R. 847 on September 29, 2010. The Senate version of the bill, S. 1334, was referred to the Senate Committee on Health, Education, Labor, and Pensions, where it was the subject of a hearing on June 29, 2010. The Senate bill has not otherwise advanced. However, on December 9, 2010, cloture on the motion to proceed to H.R. 847 was voted on but not invoked in the Senate."

Library of Congress. Congressional Research Service

Lister, Sarah A.; Szymendera, Scott

2010-12-14
Comparison of the Current World Trade Center Medical Monitoring and Treatment Program and the World Trade Center Health Program Proposed by Title I of H.R. 847 [October 15, 2010]

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"In the wake of the September 11, 2001, terrorist attack on New York City, Congress passed appropriations to provide limited health screening and treatment services to persons involved in rescue, recovery, and cleanup operations around the former site of the World Trade Center. This program, now known as the World Trade Center (WTC) Medical Monitoring and Treatment Program (MMTP), is not authorized in statute but rather relies on discretionary appropriations to provide services to eligible individuals. Since its inception in FY2002, the MMTP has received approximately $475 million in federal funds, and over 57,000 responders and community members have met initial eligibility requirements for the program. Title I of H.R. 847, as amended and passed by the House of Representatives, would eliminate the current MMTP and replace it with a program authorized in statute and financed through mandatory federal spending, partially matched by New York City. This program, proposed to be called the World Trade Center Health Program (WTCHP), would provide full medical screening and treatment benefits to eligible WTC responders and community members. In addition, Title I of H.R. 847 would establish formal eligibility requirements based on a person's activities after September 11, 2001, and his or her current health conditions. Health benefits would be provided by a national network of providers, and the program would be administered by the Department of Health and Human Services (HHS)."

Library of Congress. Congressional Research Service

Szymendera, Scott; Lister, Sarah A.

2010-10-15
Food Safety: Foodborne Illness and Selected Recalls of FDA-Regulated Foods [April 15, 2010]

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"Consumers and the media often focus on recalls--particularly those that are extensive and/or that involve widely consumed products--as indicators of the safety of the U.S. food supply. In many but certainly not all cases, products subject to a recall may have sickened or killed people or other animals. It is not always clear, however, how useful recall data are as a measure of the burden of foodborne illness or the effectiveness of federal food safety programs. For example, does a relatively high number of recalls signify a failure of the system to keep unsafe products from being consumed? Or is it actually an indication that the safety net is working by finding and getting tainted products off the market? Conversely, is a relatively low number of recalls an indication of the system's effectiveness, or simply of not reporting or finding all defective food products? Because of these questions, caution should be exercised in using recall data as the basis for concluding that certain changes are needed in the nation's food safety systems. This report describes several systems to monitor foodborne illnesses, discussing their strengths and the gaps that remain in understanding the burden of foodborne illness in the United States. Next, this report presents recent data on more serious recalls of FDA [Food and Drug Administration]-regulated foods, also discussing the strengths and gaps associated with the information. Finally, this report describes three recent foodborne outbreaks that led to nationwide recalls of FDA-regulated foods: (1) Salmonella in peanut products, (2) melamine in pet foods and dairy products, and (3) E. coli in spinach. Following each description are discussions of associated policy issues, and, if applicable, how these issues are addressed in food safety legislation pending before the 111th Congress. Descriptions of selected authorities in the Federal Food, Drug, and Cosmetic Act (FFDCA), FDA's principal food safety law, are provided in the Appendix."

Library of Congress. Congressional Research Service

Becker, Geoffrey S.; Lister, Sarah A.

2010-04-15
CRS Issue Statement on Public Health and Emergency Preparedness [January 15, 2010]

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From the Document: "The H1N1 influenza pandemic provided policymakers with a mixed review of the nation's readiness to respond to health threats. In many respects the pandemic response was streamlined by prior planning efforts. Nonetheless, the incident has refocused congressional attention on a number of unresolved issues with respect to the federal role in preparing for and responding to public health emergencies. Among them, how should the Departments of Health and Human Services (HHS) and Homeland Security (DHS) operationalize their shared responsibility in preparing for and responding to public health emergencies? How can federal officials determine if a state is sufficiently prepared, and what activities should states be required to undertake using federal grant funds? How can the federal government assure the availability of drugs and vaccines for bioterrorism when there is no commercial market for these products? To what extent, if any, should the federal government be responsible for the costs of health care for disaster victims? The 111th Congress has been and will likely remain invested in these and many other issues through consideration of authorizing and appropriations legislation, and the conduct of oversight and investigations."

Library of Congress. Congressional Research Service

Lister, Sarah A.

2010-01-15
2009 Influenza A(H1N1) 'Swine Flu' Outbreak: An Overview [May 5, 2009]

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"On April 29, 2009, in response to the global spread of a new strain of influenza, the World Health Organization (WHO) raised its influenza ("flu") pandemic alert level to Phase 5, one level below declaring that a global influenza pandemic was underway. According to WHO, "the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short. […] This report provides an overview of key actions taken and authorities invoked by WHO and the U.S. government. First, it discusses the WHO process to determine the phase of a threatened or emerging flu pandemic and touches on a number of related issues. The report then examines actions taken by the Departments of Homeland Security and Health and Human Services and provides information about appropriations and funding for pandemic flu activities. Finally, the report summarizes U.S. government pandemic flu planning documents and lists sources for additional information about the situation as it unfolds. This report will be continually updated to reflect unfolding events."

Library of Congress. Congressional Research Service

Lister, Sarah A.; Redhead, C. Stephen

2009-05-05
2009 Influenza A(H1N1) 'Swine Flu' Outbreak: An Overview [May 20, 2009]

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"On April 29, 2009, in response to the global spread of a new strain of influenza, the World Health Organization (WHO) raised its influenza ('flu') pandemic alert level to Phase 5, one level below declaring that a global influenza pandemic was underway. According to WHO, 'the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.' Officials now believe the outbreak began in Mexico in March 2009, or perhaps earlier. The novel flu virus was first identified in California in late April 2009. Health officials quickly linked the new flu strain to many of the illnesses in Mexico. Since then, growing numbers of cases have been reported around the world. As of May 20, 2009, more than 10,000 cases had been reported in 41 countries in North and South America, Europe, Asia, and Oceania. Most of the reported cases are in Mexico, the United States, and Canada. Health officials note that reported cases likely represent only a fraction of actual infections. For example, a U.S. official commented that there may actually have been upwards of 100,000 cases thus far in the United States."

Library of Congress. Congressional Research Service

Redhead, C. Stephen; Lister, Sarah A.

2009-05-20
2009 H1N1 "Swine Flu": CRS Experts [October 26, 2009]

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This report "provides access to names and contact information for CRS experts on policy concerns relating to swine influenza A virus (H1N1). Policy areas identified include: 1) identification, diagnosis, and surveillance of the virus; 2) treatment and prevention-antiviral drugs (Tamiflu, Relenza) and vaccines; 3) declarations of emergencies; 4) official plans and organizational responsibilities; and 5) restrictions on travel and trade."

Library of Congress. Congressional Research Service

Lister, Sarah A.

2009-10-26
Hurricane Katrina: The Public Health and Medical Response [September 21, 2005]

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"Hurricane Katrina struck the Gulf Coast in late August 2005, causing catastrophic wind damage and flooding in several states, and a massive dislocation of victims across the country. The storm is one of the worst natural disasters in the nation's history. Early estimates are that hundreds of people were killed and about one million displaced. In response to a series of disasters and terrorist attacks over the past decade, and especially since the terror attacks of 2001, Congress, the Administration, state and local governments and the private sector have made investments to improve disaster preparedness and response. New federal authorities and programs to strengthen the nation's public health system were introduced in comprehensive bioterrorism preparedness legislation in 2002. Congress also created a new Department of Homeland Security (DHS) in 2002 to provide national leadership for coordinated preparedness and response planning. A new National Response Plan (NRP), launched by DHS in December 2004, has met its first major test in the response to Hurricane Katrina. According to the NRP, the Department of Health and Human Services (HHS) is tasked with coordinating the response of the public health and medical sectors following a disaster. HHS works with several other agencies to accomplish this mission, which includes assuring the safety of food, water and environments, treating the ranks of the ill and injured, and identifying the dead. HHS activities are coordinated with those of other lead agencies under the overall leadership of DHS."

Library of Congress. Congressional Research Service

Lister, Sarah A.

2005-09-21
Pandemic Influenza: Domestic Preparedness Efforts [November 10, 2005]

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"Global pandemic preparedness and response efforts are coordinated by the World Health Organization (WHO). The U.S. Department of Health and Human Services (HHS) released a draft pandemic flu preparedness and response plan in August 2004, and a final plan in November 2005. President Bush announced a national strategy to coordinate pandemic preparedness and response activities across federal agencies. Domestic response activities will be carried out under the broad, all-hazards blueprint for a coordinated federal, state and local response laid out in the National Response Plan, released by the Department of Homeland Security (DHS) in 2004. Even in light of the plans discussed above, if a flu pandemic were to occur in the next several years, the U.S. response would be affected by the limited availability of a vaccine (the best preventive measure for flu), as well as by limited availability of certain drugs used to treat severe flu infections, and by the general lack of surge capacity within our healthcare system. The U.S. healthcare system is largely private, while the public health system is largely based in state, rather than federal, authority. This structure creates numerous challenges in assuring the needed response capacity, and coordinating the various response elements. Planning is further complicated by the fact that while periodic influenza pandemics have been seen over the years, their timing and severity have been unpredictable."

Library of Congress. Congressional Research Service

Lister, Sarah A.

2005-11-10
BioWatch Program: Detection of Bioterrorism [November 19, 2003]

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"The BioWatch Program uses a series of pathogen detectors co-located with Environmental Protection Agency air quality monitors. These detectors collect airborne particles onto filters, which are subsequently transported to laboratories for analysis. It is expected that this system will provide early warning of a pathogen release, alerting authorities before victims begin to show symptoms and providing the opportunity to deliver treatments earlier, decreasing illness and death. The BioWatch Program, funded and overseen by DHS, has three main elements each coordinated by different agencies, sampling, analysis, and response. The Environmental Protection Agency (EPA) maintains the sampling component, the sensors that collect airborne particles. The Centers for Disease Control and Prevention (CDC) coordinates analysis, the laboratory testing of the samples, though testing is actually carried out in state and local public health laboratories. Local jurisdictions are responsible for the public health response to positive findings. The Federal Bureau of Investigation (FBI) is designated as the lead agency for the law enforcement response if a bioterrorism event is detected. The BioWatch Program has raised concerns in some quarters, with questions about its general effectiveness, the siting of pathogen detectors, the reliability of its results, its cost and workforce requirements, and the ability of public health officials to respond to BioWatch results. Efforts to develop integrated response plans, lower the system cost, and develop complementary and next-generation systems continue."

Library of Congress. Congressional Research Service

Shea, Dana A.; Lister, Sarah A.

2003-11-19
Pandemic Influenza: An Analysis of State and Local Preparedness and Response Plans [September 24, 2007]

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This Congressional Research Service report "describes an approach to the analysis of state pandemic plans, and presents the findings of that analysis. State plans that were available in July 2006 were analyzed in eight topical areas: (1) leadership and coordination; (2) surveillance and laboratory activities; (3) vaccine management; (4) antiviral drug management; (5) other disease control activities; (6) communications; (7) healthcare services; and (8) other essential services. A history of federal funding and requirements for state pandemic planning is provided in an Appendix. This analysis is not intended to grade or rank individual state pandemic plans or capabilities. Rather, its findings indicate that a number of challenges remain in assuring pandemic preparedness, and suggest areas that may merit added emphasis in future planning efforts."

Library of Congress. Congressional Research Service

Lister, Sarah A.; Stockdale, Holly

2007-09-24
Homeland Security Department: FY2009 Appropriations [September 25, 2008]

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This CRS report details the FY2009 appropriations made for the Department of Homeland Security. "The Administration requested a net appropriation of $38.9 billion in budget authority for FY2009. The House Appropriations Committee reported its version of the FY2009 DHS Appropriations bill on June 24, 2008. The bill was filed on September 18, 2008, as H.R. 6947, and the accompanying report has been numbered H.Rept. 110-862. This report has been updated using draft versions of both the reported bill and report, and refers to the bill as draft-H.R. 6947. Draft- H.R. 6947 would provide a net appropriation of $41.1 billion in budget authority for DHS for FY2009. This amounts to an increase of $2.2 billion or nearly 6% increase over the President's request. The Senate reported its version of the bill on June 19, 2008. S. 3181 would provide $41.3 billion in net budget authority for DHS for FY2009, a $2.4 billion or 6% increase over the President's request. On September 23, 2008, the House Rules Committee reported H.Res. 1488 for consideration of the Senate amendment to H.R. 2638, the Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009. H.R. 2638 was originally introduced as the FY2008 DHS Appropriations Act, but has been amended to serve as the legislative vehicle for the proposed Continuing Resolution, a Disaster Relief Emergency Supplemental, the Department of Defense FY2009 Appropriations Act, the FY2009 Department of Homeland Security Appropriations Act, and the FY2009 Military Construction and Veterans Assistance Act. On September 24, 2008, the House passed H.R. 2638."

Library of Congress. Congressional Research Service

Lake, Jennifer E.; Lister, Sarah A.; Nunez-Neto, Blas

2008-09-25
Bovine Spongiform Encephalopathy (BSE, or 'Mad Cow Disease'): Current and Proposed Safeguards [Updated March 1, 2004]

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"Shortly after the first case of bovine spongiform encephalopathy (BSE or 'mad cow disease') in the United States was announced in December 2003, U.S. Department of Agriculture (USDA) and other officials announced measures to improve existing safeguards against the introduction and spread of BSE. Previously, these safeguards, often called the 'three firewalls,' were: (1) USDA restrictions on imports of ruminants and their products from countries with BSE; (2) a ban on feeding most mammalian proteins to cattle and other ruminants, issued by the Food and Drug Administration (FDA); and (3) a targeted domestic surveillance program by USDA's Animal and Plant Health Inspection Service (APHIS), the agency responsible for animal health monitoring and disease control. As Members of Congress conduct oversight of the BSE issue and consider possible legislative options, some have asked whether the expanded agency actions will protect further against BSE, whether they are scientifically sound, and what cost they will impose on taxpayers and industry. Also at issue is whether they will restore foreign markets' confidence in the safety of U.S. beef, and whether other types of actions should be considered, among other questions. This report will be updated if events warrant."

Library of Congress. Congressional Research Service

Becker, Geoffrey S.; Lister, Sarah A.

2004-03-01
Bisphenol A (BPA) in Plastics and Possible Human Health Effects [August 13, 2010]

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"Bisphenol A (BPA) is used to produce certain types of plastic that are used in thousands of formulations for myriad products. Containers made with these plastics may expose people to small amounts of BPA in food and water. Medical devices and other more ubiquitous products, such as thermal paper coatings, also may contribute significantly to human exposure. Some animal experiments have found that fetal and infant development may be harmed by small amounts of BPA, but scientists disagree about the value of the animal studies for predicting harmful effects in people. In the United States and elsewhere, scientific disagreement about the possibility of human health effects that may result from BPA exposure has led to conflicting regulatory decisions regarding the safety of food containers, especially those intended for use by infants and children. In the United States, a conclusion by the Food and Drug Administration (FDA) that BPA use is safe conflicted with earlier findings by one panel of scientific advisors, and was later challenged by a second panel. These events prompted some to question FDA's process for the assessment of health risks such as this, and others to question the agency's fundamental ability to conduct such assessments competently. Recently, FDA expressed concern about possible health effects from BPA exposure and announced that it was conducting new studies on the matter, pending possible changes in its regulatory approach."

Library of Congress. Congressional Research Service

Schierow, Linda-Jo; Lister, Sarah A.

2010-08-13
'Wounded Warrior' and Veterans Provisions in the FY2008 National Defense Authorization Act [February 13, 2008]

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"This report summarizes provisions in Division A, Titles XVI and XVII, of the National Defense Authorization Act for Fiscal Year 2008, P.L. 110-181, signed by the President on January 28, 2008. Titles XVI and XVII address matters related to the care and treatment of servicemembers and former servicemembers (i.e., veterans) who were wounded, or who contracted an illness, while serving on active duty. These individuals are widely referred to as 'wounded warriors.' […] The provisions vary in scope. Some of them alter specific aspects of existing services or benefits programs in either the Department of Defense (DOD) or the Department of Veterans Affairs (VA). Others call for comprehensive and long-term redesign of programs or systems in one or both of the departments. Congress and others have determined that certain programs and systems that involve both departments are particularly problematic in providing continuity and quality of care and services to wounded warriors. Among the problems addressed in the act are the efficient maintenance and transfer of servicemembers' health and benefits records between the departments, and the separate evaluations of disability by each department. Efforts to address these and other transition problems were already underway in both departments, partly in response to the recommendations of several DOD and independent commissions and task forces. The act codifies various mandates for these activities, including deadlines. This report does not attempt to analyze provisions in the act, but provides brief outlines of the matters addressed. This report will not be updated."

Library of Congress. Congressional Research Service

Lister, Sarah A.; Panangala, Sidath Viranga; Scott, Christine A.

2008-02-13
Bisphenol A (BPA) in Plastics and Possible Human Health Effects [May 5, 2008]

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"Bisphenol A (BPA) is used to produce certain types of plastic. Containers made of these plastics may expose people to small amounts of BPA in food and water. Some animal experiments have found that fetal and infant development may be harmed by small amounts of BPA, amounts to which many people may be exposed, but scientists disagree about the value of the animal studies for predicting harmful effects in people. At least one regulatory decision in the face of the scientific disagreement has led to a congressional inquiry into the extent to which the decision was based on good science. Legislation proposed in April 2008, S. 2928, would prohibit use of BPA in some products intended for use by children."

Library of Congress. Congressional Research Service

Schierow, Linda-Jo; Lister, Sarah A.

2008-05-05
Suicide Prevention Among Veterans [May 5, 2008]

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"Numerous news stories in the popular print and electronic media have documented suicides among servicemembers and veterans returning from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). In the United States, there are more than 30,000 suicides annually. Suicides among veterans are included in this number, but it is not known in what proportion. There is no nationwide system for surveillance of suicide specifically among veterans. Recent data show that about 20% of suicide deaths nationwide could be among veterans. It is not known what proportion of these deaths are among OIF/OEF veterans. Veterans have a number of risk factors that increase their chance of attempting suicide. These risk factors include combat exposure, post-traumatic stress disorder (PTSD) and other mental health problems, traumatic brain injury (TBI), poor social support structures, and access to lethal means. Several bills addressing suicide in veterans have been introduced in the 110th Congress. On November 5, 2007, the Joshua Omvig Veterans Suicide Prevention Act (P.L. 110-110) was signed into law, requiring the Department of Veterans Affairs (VA) to establish a comprehensive program for suicide prevention among veterans. More recently, the Veterans Suicide Study Act (S. 2899) was introduced. This bill would require the VA to conduct a study, and report to Congress, regarding suicides among veterans since 1997. The VA has carried out a number of suicide prevention initiatives, including establishing a national suicide prevention hotline for veterans, conducting awareness events at VA medical centers, and screening and assessing veterans for suicide risk."

Library of Congress. Congressional Research Service

Lister, Sarah A.; Panangala, Sidath Viranga; Sundararaman, Ramya

2008-05-05
Homeland Security Department: FY2008 Appropriations [Updated July 17, 2007]

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"This report describes the FY2008 appropriations for the Department of Homeland Security (DHS). The Administration requested a net appropriation of $35.5 billion in net budget authority for FY2008. The requested net appropriation for major components of the department included the following: $8,783 million for Customs and Border Protection (CBP); $4,168 million for Immigration and Customs Enforcement (ICE); $3,608 million for the Transportation Security Administration (TSA); $8,457 million for the U.S. Coast Guard; $1,399 million for the Secret Service; $1,047 for the National Protection and Programs Directorate (NPP); $5,042 million for the Federal Emergency Management Agency (FEMA); $30 million for US Citizenship and Immigration Services (USCIS); $799 million for the Science and Technology Directorate (S&T); and $562 million for the Domestic Nuclear Detection Office (DNDO). The House passed H.R. 2638 on June 15, 2007. H.R. 2638 would provide $37.4 billion in net budget authority for DHS for FY2008. H.R. 2638 contains the following in net budget authority for major components of DHS: $8,923 million for CBP; $4,192 million for ICE; $3,842 million for the TSA; $8,352 million for the U.S. Coast Guard; $1,396 million for the Secret Service; $1,035 for the NPP; $7,239 million for FEMA; $30 million for USCIS; $777 million for S&T; and $556 million for the DNDO. The Senate Appropriations Committee reported its bill, S. 1644, on June 14, 2007. S. 1644 would provide $37.6 billion in net budget authority for DHS for FY2008."

Library of Congress. Congressional Research Service

Lake, Jennifer E.; Lister, Sarah A.; Nunez-Neto, Blas

2007-07-17
Pandemic and All-Hazards Preparedness Act (P.L. 109-417): Provisions and Changes (P.L. 109-417): Provisions and Changes [Updated March 12, 2007]

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"The 109th Congress passed P.L. 109-417, the Pandemic and All-Hazards Preparedness Act. The act reauthorized a number of expiring preparedness and response programs in the PHS Act, and established some new authorities, including the creation of a Biomedical Advanced Research and Development Authority (BARDA), a new office in HHS to support, coordinate, and provide oversight of advanced development of vaccines and biodefense countermeasures. The act's provisions reflected the concerns of Members of the 109th Congress and others regarding the flawed response to Hurricane Katrina in 2005, and the threat of a possible influenza pandemic. A comparison of provisions in P.L. 109-417 with preexisting law is provided in Table 1 later in this report. The 110th Congress will likely be interested in the implementation of provisions in P.L. 109-417, and in the continued evolution of relationships between HHS, DHS, the states, and others among whom coordination is essential in a time of heightened concern about national security. Members of the 110th Congress may wish to consider legislation to address additional expiring public health authorities, such as the Select Agent program to control access to pathogens that could be used for bioterrorism, which expires at the end of FY2007. Congress may also wish to examine the adequacy of certain permanent emergency response and funding authorities of the Secretary of HHS."

Library of Congress. Congressional Research Service

Gottron, Frank; Lister, Sarah A.

2007-03-12
Bovine Spongiform Encephalopathy (BSE, or 'Mad Cow Disease'): Current and Proposed Safeguards [Updated May 18, 2007]

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"Through mid-May 2007, the United States had confirmed three cases of bovine spongiform encephalopathy (BSE, or 'mad cow disease'): the first in December 2003 in a Canadian-born cow found in Washington state, the second in June 2005 in cow in Texas, and the third in March 2006 in a cow in Alabama. Shortly after the first case, U.S. Department of Agriculture (USDA) and other officials announced measures to improve existing safeguards against the introduction and spread of BSE. Previously, the major safeguards were: (1) USDA restrictions on imports of ruminants and their products from countries with BSE; (2) a ban on feeding most mammalian proteins to cattle and other ruminants, issued by the Food and Drug Administration (FDA); and (3) a targeted domestic surveillance program by USDA's Animal and Plant Health Inspection Service (APHIS), the agency responsible for animal health monitoring and disease control."

Library of Congress. Congressional Research Service

Becker, Geoffrey S.; Lister, Sarah A.

2007-05-18
Overview of the U.S. Public Health System in the Context of Emergency Preparedness [Updated March 17, 2005]

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"This report describes the U.S. public health infrastructure: the structure, organization, and legal basis of domestic public health activities. In contrast with healthcare, public health practice is aimed at decreasing the burden of illness and injury in populations, rather than individuals. Public health agencies use epidemiologic investigation, laboratory testing, information technology, public and provider education, and other tools to support their mission, activities that in turn rely on an adequate and well-trained public health workforce. Federal leadership for public health is based in the Department of Health and Human Services (HHS) and in particular at the Centers for Disease Control and Prevention (CDC). Most public health authority, such as mandatory disease reporting, licensing of healthcare providers and facilities, and quarantine authority, is actually based with states as an exercise of their police powers. Local and municipal health agencies vary in size, governance, and authority, but they are the front line in responding to public health threats. In 2001, terrorist attacks on the nation brought the weaknesses of our public health system into sharp focus. Prior to the 2001 terrorist attacks, Congress passed the Public Health Threats and Emergencies Act (P.L. 106-505), to address the decaying public health infrastructure and to prepare for bioterrorism and other public health emergencies."

Library of Congress. Congressional Research Service

Lister, Sarah A.

2005-03-17
Disability Evaluation of Military Servicemembers [May 7, 2007]

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From the Document: "On February 18, 2007, the Washington Post published the first in a series of articles describing problems with outpatient medical care and other services provided at the Walter Reed Army Medical Center (WRAMC). The series noted, among other things, concerns about the processes used to evaluate disability in injured military servicemembers. Both the Department of Defense (DOD) and the Department of Veterans Affairs (VA) conduct disability evaluations and assign disability ratings to servicemembers or veterans under their respective authorities. An individual's disability rating, from either department, affects the scope of pay and benefits for which he or she is eligible, and the cost to the respective department of providing such benefits. There are significant differences between the disability evaluations performed by DOD and VA, as well as civilian disability evaluations conducted by the Social Security Administration (SSA) and workers' compensation programs. Most notably, the DOD disability evaluation is focused on the effect of any disabling condition on the performance of the servicemember's duties in the military, while the other three systems evaluate an individual's prospects for gainful employment in the civilian economy."

Library of Congress. Congressional Research Service

Lister, Sarah A.; Henning, Charles A.

2007-05-07
Transmissible Spongiform Encephalopathies (TSEs), Including 'Mad Cow Disease': Public Health and Scientific Issues [Updated March, 1, 2004]

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"On December 23, 2003, the U.S. Secretary of Agriculture announced that a cow in Washington state had tested positive for bovine spongiform encephalopathy (BSE, or Mad Cow disease), representing the first domestic case. The Secretary announced expanded protections against BSE on December 30, 2003. On January 26, 2004, the U.S. Secretary of Health and Human Services announced additional safety measures for products regulated by the U.S. Food and Drug Administration (FDA) to protect public health. Both have stressed that the human health impact of finding one BSE positive cow is believed to be minimal. BSE is a member of a group of diseases called Transmissible Spongiform Encephalopathies (TSEs). Although the predominant theory is that TSEs are caused by prions or proteinaceous infectious particles (a novel disease mechanism first described in the 1980s), some scientists believe a virus may eventually be identified as the infectious agent. While some TSEs, such as scrapie in sheep, have been known for over 200 years, others, including BSE, appear to have emerged quite recently. Some TSEs seem to affect only one species and others, like BSE, appear to have jumped the "species barrier" to infect more than one species. This event has transformed prion diseases from a rare and esoteric area of research to a matter of significant public health concern. BSE is believed to have been transmitted to people who ate contaminated beef, leading to the identification in 1996 of a new human disease, variant Creutzfeld-Jakob disease (vCJD), in the United Kingdom."

Library of Congress. Congressional Research Service

Johnson, Judith A. (Judith Ann), 1957-; Lister, Sarah A.

2004-03-01
2005 Gulf Coast Hurricanes: The Public Health and Medical Response [Updated January 20 ,2006]

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"Hurricane Katrina struck the Gulf Coast in late August 2005, causing catastrophic wind damage and flooding in several states, and a massive dislocation of victims across the country. The storm is one of the worst natural disasters in the nations history. Early estimates are that more than 1 thousand people were killed and about 1 million displaced. Hurricane Rita, which made landfall along the Gulf Coast in late September 2005, was ultimately less lethal than Katrina, but prompted aggressive preparedness efforts by governments and citizens shaken by the devastation of the earlier storm. In response to a series of disasters and terrorist attacks over the past decade, in particular the terror attacks of 2001, Congress, the Administration, state and local governments and the private sector have made investments to improve disaster preparedness and response. New federal authorities and programs to strengthen the nations public health system were introduced in comprehensive legislation in 2002. Congress also created the Department of Homeland Security (DHS) in 2002 to provide national leadership for coordinated preparedness and response planning. A new National Response Plan (NRP), launched by DHS in December 2004, met its first major test in the response to Hurricane Katrina."

Library of Congress. Congressional Research Service

Lister, Sarah A.

2006-01-20
Homeland Security Department: FY2007 Appropriations [Updated July 26, 2006]

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"This report describes the FY2007 appropriations for the Department of Homeland Security (DHS). The Senate passed H.R. 5441 on July 13, 2006, which would provide $32.8 billion in net budget authority for DHS for FY2007. The House passed H.R. 5441, on June 6, 2006, which would provide $33.2 billion in net budget authority for DHS in FY2007. The Administration requested a net appropriation of $31.9 billion in net budget authority for FY2007, of which $31.0 billion is discretionary budget authority, and $1 billion is mandatory budget authority."

Library of Congress. Congressional Research Service

Lake, Jennifer E.; Lister, Sarah A.; Nunez-Neto, Blas

2006-07-26
Bovine Spongiform Encephalopathy (BSE, or 'Mad Cow Disease'): Current and Proposed Safeguards [Updated September 20, 2006]

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"U.S. Department of Agriculture (USDA) and other officials announced measures to improve existing safeguards against the introduction and spread of bovine spongiform encephalopathy (BSE, or 'mad cow disease'). Previously, the major safeguards were: (1) USDA restrictions on imports of ruminants and their products from countries with BSE; (2) a ban on feeding most mammalian proteins to cattle and other ruminants, issued by the Food and Drug Administration (FDA); and (3) a targeted domestic surveillance program by USDA's Animal and Plant Health Inspection Service (APHIS), the agency responsible for animal health monitoring and disease control. On January 26, 2004, FDA announced planned changes to its safeguards, including additional bovine materials banned from the human foods and cosmetics it regulates; a ban on poultry litter, restaurant waste, and ruminant blood products from ruminant feed; and stricter oversight of feed manufacturing. In lieu of these changes, FDA on October 6, 2005, proposed a ban, in all types of animal feed, of some higher-risk cattle parts. A final rule is pending."

Library of Congress. Congressional Research Service

Becker, Geoffrey S.; Lister, Sarah A.

2006-09-20
Homeland Security Department: FY2008 Appropriations [Updated August 20, 2007]

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"This report describes the FY2008 appropriations for the Department of Homeland Security (DHS). The Administration requested a net appropriation of $35.5 billion in net budget authority for FY2008. The requested net appropriation for major components of the department included the following: $8,783 million for Customs and Border Protection (CBP); $4,168 million for Immigration and Customs Enforcement (ICE); $3,608 million for the Transportation Security Administration (TSA); $8,457 million for the U.S. Coast Guard; $1,399 million for the Secret Service; $1,047 for the National Protection and Programs Directorate (NPP); $5,042 million for the Federal Emergency Management Agency (FEMA); $30 million for US Citizenship and Immigration Services (USCIS); $799 million for the Science and Technology Directorate (S&T); and $562 million for the Domestic Nuclear Detection Office (DNDO). The House passed H.R. 2638 on June 15, 2007. H.R. 2638 would provide $37.4 billion in net budget authority for DHS for FY2008. H.R. 2638 contains the following in net budget authority for major components of DHS: $8,923 million for CBP; $4,192 million for ICE; $3,842 million for the TSA; $8,352 million for the U.S. Coast Guard; $1,396 million for the Secret Service; $1,035 for the NPP; $7,239 million for FEMA; $30 million for USCIS; $777 million for S&T; and $556 million for the DNDO. The Senate Appropriations Committee reported its bill, S. 1644, on June 14, 2007. The Senate took up the House bill on July 19, 2007, and substituted its text with that in S. 1644. On July 26, 2007, the Senate passed its version of H.R. 2638."

Library of Congress. Congressional Research Service

Lake, Jennifer E.; Lister, Sarah A.; Nunez-Neto, Blas

2007-08-20
Food Safety: Federal and State Response to the Spinach E.coli Outbreak [November 13, 2006]

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"In September 2006, government officials were alerted to an outbreak of E. coli O157:H7 infections associated with the consumption of tainted fresh spinach. For several weeks, the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) investigated the situation as additional cases were identified nearly daily. This report details the events as they unfolded, and includes the number of cases, the detection of the first case, and the process by which relevant agencies acted as subsequent cases were reported. This report will be updated in response to any further developments."

Library of Congress. Congressional Research Service

Lister, Sarah A.; Porter, Donna Viola

2006-11-13

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