Mr. Chairman, Members of the Subcommittee, I appreciate the opportunity to appear before you today and provide an overview of the Department of Veterans Affairs’ (VA) state of preparedness.  In carrying out its “Fourth Mission,” VA supports national efforts to prepare for, respond to, and recover from natural disasters, acts of terrorism, and man-made catastrophes.  While serving in this capacity, VA must continue to maximize its service to Veterans.  Today, I will describe for you the strategic planning, preparation, and exercises that take place across the Department, enabling VA to be a national asset while at the same time keeping our promise to our Nation’s Veterans.  I also will share specific examples of VA preparedness efforts, how VA applies lessons learned, how VA planned for the H1N1 influenza pandemic, how it responded after the earthquake in Haiti, and how we have prepared for the upcoming hurricane season.

I am accompanied today by Mr. Kevin Hanretta, Deputy Assistant Secretary for Emergency Management, and Dr. Gregg Parker, Chief Medical Officer for Veterans Integrated Service Network (VISN) 16, Veterans Health Administration (VHA), which includes the parish of New Orleans.  Both VA officials served during Hurricane Katrina—Mr. Hanretta in Headquarters operations and Dr. Parker on the ground in New Orleans.  Together they can provide a firsthand account of VA’s performance during that crisis from a Department-wide and local perspective.  More importantly, each can attest to the knowledge gained through that experience and the ways in which VA has applied those lessons learned to enhance its preparedness.

Since joining the VA team just over a year ago, I have been increasingly impressed with the quality of our dedicated professionals who work to ensure that VA’s preparedness is continuously improved.  The team within the Office of Operations, Security, and Preparedness (OSP) provides an excellent example.  OSP’s mission is to coordinate the Department’s emergency management, preparedness, security, and law enforcement activities to ensure VA can continue to perform its mission-essential functions under all circumstances across the spectrum of threats.  OSP’s success in fulfilling these responsibilities enhances the Department’s capabilities to support our Veterans and the Nation.  President Obama has charged Secretary Shinseki to transform VA into a 21st century organization that is “people-centric, results-driven, and forward-looking.”  Enhancing VA’s preparedness is essential to this task.

Preparedness involves using VA’s capability to maximize our ability to prevent, protect against, mitigate the effects of, respond to, and recover from natural disasters, acts of terrorism, and man-made disasters.  VA’s ability to assist, in case of a national emergency or act of terrorism, depends on how well we anticipate needs, plan for evolving scenarios, and respond with agility to the disaster or threat.  This means positioning personnel and equipment in anticipation that routine modes of transport and communications may be compromised, as well as having contingency plans and mapping out next steps.  It also is important to practice emergency response procedures.  Through training exercises, senior leaders and other responsible personnel gain confidence in knowing what is required to support the mission and to continue operations. 

Leadership Attention

Maximizing preparedness requires the attention of leadership.  VA’s Secretary, Deputy Secretary, and senior leaders take preparedness very seriously and are committed to investing the time, training, and resources necessary to ensure that VA can step up when called to action.  Through his personal participation in national training exercises, Eagle Horizon 2009 and 2010, Secretary Shinseki set the example.  Secretary Shinseki has established three “Fourth Mission” priorities for VA:  personnel accountability, improved communications, and increased capability to serve as a national resource.  These priorities are reinforced with senior leadership on a regular basis during briefings and meetings about operations and have been communicated to every level of the Department.  Additionally, I am pleased to report that, “Ensure Preparedness to meet emergent national needs” is one of the 13 Department-Level Initiatives within VA’s Strategic Plan for FY 2010-2014. 

Increased Capabilities

The Integrated Operations Center (IOC), established in June 2009, continues to evolve and will allow for more comprehensive and active participation by internal VA stakeholders. 

The IOC is the cornerstone of VA’s preparedness effort and serves as the Department’s fusion point for unified command, integrated planning, data collection, and predictive analysis.  OSP Watch Officers staff the VA IOC 24/7.  Each of the Administrations—Veterans Health Administration, Veterans Benefits Administration and National Cemetery Administration—along with the Office of Information and Technology provide 24-hour coverage as well.  The Office of Human Resources and Administration and the Office of Public and Intergovernmental Affairs provide coverage to the IOC on a daily basis during business hours.  All other VA staff offices and organizations are available on-call.  The IOC is the focal point within VA for the receipt, analysis, and dissemination of information related to developing and ongoing events that potentially affect VA.  It forms a nexus that allows for situational awareness, coordinated recommendations, and feedback to VA senior leaders in real time so that they can make timely and proactive decisions.  The IOC also serves as the central point for coordination with interagency stakeholders at the Federal, state, and local levels.   

Planning

VA is an active member of the Federal planning community and has senior representatives on a variety of interagency planning initiatives.  VA plays a key role in national level training exercises and serves as a ready resource for interagency partners.

The Exercise, Training and Evaluation team in OSP coordinates VA participation in all national level exercises.  In addition, this group conducts monthly preparedness and planning meetings with all Departmental Emergency Coordinators, maintains an ongoing comprehensive National Incident Management System (NIMS) training initiative, conducts quarterly Line of Succession Training, and provides real time guidance on all Emergency Management issues to the IOC.

VA recently implemented WebEOC, which is an emergency management National Incident Management System-based collaborative operating platform.  WebEOC further enhances intra- and interagency communications and information sharing and provides VA, through the VA IOC, with real time situational awareness of the Department’s operational status.

Furthermore, in the past year OSP has developed, coordinated, and published Department policy and plans that address VA Continuity, the IOC, VA Serious Incident Reports, VA Devolution, and VA Reconstitution.  Having such plans in place allows for more efficient and effective coordination within the Department.  It also can facilitate communications with external agencies and stakeholders.

Training/Exercises

I am proud to report that the involvement of VA senior leaders in training and exercises is comprehensive and thorough.  Our training and exercise planning includes full-scale participation and after action reviews that involve all Under Secretaries,  Assistant Secretaries, and other Key Officials.  Continuity of Operations and Continuity of Government are fundamental objectives of these planning and exercise programs.  The focus is employee accountability, communications, and increasing our capability to provide services to Veterans as we support national efforts.

In the past 12 months, VA has participated in two national exercises:  Eagle Horizon ’09 and Eagle Horizon ’10.  We deployed more than 200 people during each exercise to our alternate and reconstitution locations.  VA personnel deployed to these sites represent our Emergency Relocation Group, whose components are the Crisis Response Team, the Continuity of Operations Team, and the IOC. 

VA participation in this year’s Eagle Horizon exercise was evaluated by the Department of Homeland Security (DHS).  DHS has not published the results of that review.  However, I am confident that the VA team effectively demonstrated our capability to continue operations, and carry out the Department’s primary and supporting mission essential functions. 

In January 2010, we conducted a comprehensive devolution exercise ensuring that when needed, Department-level command and control could be transferred.  This exercise was important to validate our procedures and led to publication of the first VA Devolution Plan.

Practical Application

Some of the strategies written into OSP policy and practiced during VA and national training exercises are the direct application of lessons learned from our experience with Hurricane Katrina.  Although VHA did not suffer any loss of life resulting from the 2005 hurricane season, and all inpatients affected by the storm were accounted for, VA did have to close two major medical centers (Gulf Port and New Orleans) and evacuate hundreds of patients, staff and family members from them.

Katrina caused significant disruption to health care operations throughout the entire Gulf Coast region.  Yet, through alternate venues, we were able to continue providing care to Veterans.  For example, VA deployed a system of 12 “mobile clinics” to various sites across the region in coordination with local authorities and expanded the capacity of our Community-Based Outpatient Clinic in Baton Rouge, Louisiana.  A key element of our success in this regard was VA’s electronic health record, which enabled VA clinicians across the U.S. to access the medical records of VA patients displaced by Hurricane Katrina.  VHA also took on a significant role in providing care to non-VA beneficiaries in keeping with VA’s “Fourth Mission.”

In the aftermath of Katrina, VHA deployed 1,300 volunteers and staff in a series of 14-day rotations to:

• Operate two Federal Medical Stations (FMS) providing medical services to hundreds of non-VA beneficiaries under the National Response Plan's Emergency Support Function 8.
• Operate VHA mobile medical clinics.
• Deliver food, water, fuel and supplies to affected medical facilities.
• Augment command and control internal and external to VHA.

Medical Emergency Preparedness

Important lessons learned from Katrina that VHA applies today include:

• Conduct a comprehensive assessment of all VA medical centers (VAMC) preparedness to operate independently.
• Provide equipment and supplies, as well as funds to train and exercise Federal Coordinating Centers (FCC).
• Train and prepare cadres to support future FMS operations.
• Provide an internal VHA patient evacuation system that does not rely on external resources.
• Procure deployable command and control, medical, pharmacy, housing and hygiene units.
• Enhance the registry and abilities of the Disaster Emergency Medical Personnel System (DEMPS).

Since 2005, VA has taken a number of steps to improve our medical emergency preparedness.  After Katrina, VA conducted a business impact analysis and is now nearing completion of a comprehensive 3-year assessment of the readiness of all 153 VA medical centers.  We provided $2 million for FCC patient reception team caches that can be used to support receipt of patients under the Department of Defense (DoD)-VA Contingency Plan as well as the National Disaster Medical System (NDMS).  In addition, VA has procured and tested prototype Dual-Use Passenger/Patient Vehicles capable of transporting various configurations of ambulatory, wheelchair and litter-borne patients.  We have an agreement with the General Services Administration to procure over 130 of these vehicles, beginning this year.  Finally, VHA procured 25 mobile command and control, medical, pharmacy, housing and hygiene units to support internal continuity operations, as well as external taskings under the National Response Framework.  We also have recruited additional DEMPS volunteers and are working on enhancing VA’s ability to identify and deploy volunteers more efficiently in support of both internal and external taskings.

Beyond Katrina

Returning to Secretary Shinseki’s three “Fourth Mission” priorities of accountability, improved communications and increased capability, I would like to highlight certain other accomplishments and emphasize VA’s preparedness should we be called upon to act.

Personnel Accountability

 In 2009, the Assistant Secretary for Human Resources and Administration, John Sepúlveda, convened a Department-wide Employee Accountability Task Force.  Recommendations from that Task Force have resulted in development of the Emergency Employee Information Database (EEIDB).  The EEIDB is a new tool for identifying employee status during an emergency.  Mr. Sepúlveda continues to lead the effort to test and refine this important tool that facilitates employee accountability. 

H1N1 Influenza Pandemic

From the onset, VA carefully monitored the progression of the H1N1 influenza virus.  VHA tracked patient information in order to forecast where and when we would need vaccines.  The receipt and movement of vaccines was carefully managed.  Fortunately, the virus did not manifest as predicted.  Nonetheless, VA continuously responded to the needs of our Veterans and employees, and was prepared to respond as a national asset, if we had been called upon to do so. 

Haiti Earthquake Relief

In preparation to provide support during the Haiti earthquake relief effort, VA quickly validated the list of individuals registered within the DEMPS.  In support of the Department of Health and Human Services (HHS), five VA medical personnel were deployed to Haiti.  VA had a list of available volunteers and was prepared to provide more support.

VA has the responsibility to operate up to 57 FCCs located throughout the United States to transfer civilian patients to civilian hospitals.  At the request of HHS, which is responsible for the NDMS, VA operated two FCCs; one in Tampa, Florida, and one in Atlanta, Georgia.  VA processed more than 100 patients from Haiti.  We used this experience as another opportunity to refine our policies, plans, and procedures.

Hurricane Season

This hurricane season, VA again will focus on serving Veterans, saving lives, protecting property, and ensuring public health and safety.  VA has performed admirably during previous hurricane seasons.  In 2005, following Hurricane Katrina, VA operated 17 of the 18 FCCs activated by HHS; supported 89 military aero-medical missions and processed 2,830 displaced non-VA beneficiary patients to 220 non-Federal hospitals in support of the NDMS.  Additionally, in 2008, following Hurricanes Gustav and Ike, VA operated three FCCs and two HHS Federal Medical Stations. 

The National Oceanic and Atmospheric Administration has forecast increased hurricane activity this year in the Atlantic.  We believe we are well positioned and prepared to continue to serve Veterans and execute our “Fourth Mission” should we be called upon to perform.   

Conclusion

Secretary Shinseki is committed to transforming VA into a “People-centric, Results-driven, and Forward-looking” Department.  Maximizing our preparedness to execute our “Fourth Mission” priorities is a significant element of this transformation.  The Secretary and all senior VA leaders continue to give close attention to preparedness as we continue to invest, plan, train and exercise.   

VA will continue assessing and improving its preparedness procedures.  Nonetheless, I am confident that we have the capability to respond to our Nation’s call as needed during this hurricane season or in response to any other threat or national emergency.

Thank you for your support, time, and interest in providing the best for our Nation’s Veterans who deserve nothing less.  I look forward to your questions.