HOMELAND SECURITY: New Department Could Improve Coordination but May Complicate Public Health Priority Setting
GENERAL ACCOUNTING OFFICE WASHINGTON DC
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Since the terrorist attacks of September ii, 2001, and the subsequent anthrax incidents, there has been concern about the ability of the federal government to prepare for and coordinate an effective public health response to such events, given the broad distribution of responsibility for that task at the federal level. Our earlier work found, for example, that more than 20 federal departments and agencies carry some responsibility for bioterrorism preparedness and response and that these efforts are fragmented.1 Emergency response is further complicated by the need to coordinate actions with agencies at the state and local level, where much of the response activity would occur. The Presidents proposed Homeland Security Act of 2002 would bring many of these federal entities with homeland security responsibilities- including public health preparedness and response-into one department, in an effort to mobilize and focus assets and resources at all levels of government. The aspects of the proposal concerned with public health preparedness and response would involve two primary changes to the current system, which are found in Title V of the proposed bill. First, the proposal would transfer certain emergency preparedness and response programs from multiple agencies to the new department. Second, it would transfer the control over, but not the operation of, other public health preparedness assistance programs, such as providing emergency preparedness planning assistance to state and local governments, from the Department of Health and Human Services HHS to the new department.
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