[House Hearing, 116 Congress]
[From the U.S. Government Publishing Office]
REVIEWING FEDERAL AND STATE PANDEMIC
SUPPLY PREPAREDNESS AND RESPONSE
=======================================================================
JOINT HEARING
BEFORE THE
SUBCOMMITTEE ON OVERSIGHT, MANAGEMENT,
AND ACCOUNTABILITY
AND THE
SUBCOMMITTEE ON EMERGENCY PREPAREDNESS,
RESPONSE, AND RECOVERY
HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTEENTH CONGRESS
SECOND SESSION
__________
JULY 14, 2020
__________
Serial No. 116-76
__________
Printed for the use of the Committee on Homeland Security
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://www.govinfo.gov/
__________
U.S. GOVERNMENT PUBLISHING OFFICE
43-189 PDF WASHINGTON : 2021
--------------------------------------------------------------------------------------
COMMITTEE ON HOMELAND SECURITY
Bennie G. Thompson, Mississippi, Chairman
Sheila Jackson Lee, Texas Mike Rogers, Alabama
James R. Langevin, Rhode Island Peter T. King, New York
Cedric L. Richmond, Louisiana Michael T. McCaul, Texas
Donald M. Payne, Jr., New Jersey John Katko, New York
Kathleen M. Rice, New York Mark Walker, North Carolina
J. Luis Correa, California Clay Higgins, Louisiana
Xochitl Torres Small, New Mexico Debbie Lesko, Arizona
Max Rose, New York Mark Green, Tennessee
Lauren Underwood, Illinois John Joyce, Pennsylvania
Elissa Slotkin, Michigan Dan Crenshaw, Texas
Emanuel Cleaver, Missouri Michael Guest, Mississippi
Al Green, Texas Dan Bishop, North Carolina
Yvette D. Clarke, New York Jefferson Van Drew, New Jersey
Dina Titus, Nevada
Bonnie Watson Coleman, New Jersey
Nanette Diaz Barragan, California
Val Butler Demings, Florida
Hope Goins, Staff Director
Chris Vieson, Minority Staff Director
------
SUBCOMMITTEE ON OVERSIGHT, MANAGEMENT, AND ACCOUNTABILITY
Xochitl Torres Small, New Mexico, Chairwoman
Dina Titus, Nevada Dan Crenshaw, Texas, Ranking
Bonnie Watson Coleman, New Jersey Member
Nanette Diaz Barragan, California Clay Higgins, Louisiana
Bennie G. Thompson, Mississippi (ex Jefferson Van Drew, New Jersey
officio) Mike Rogers, Alabama (ex officio)
Lisa Canini, Subcommittee Staff Director
Katy Flynn, Minority Subcommittee Staff Director
------
SUBCOMMITTEE ON EMERGENCY PREPAREDNESS, RESPONSE, AND RECOVERY
Donald M. Payne Jr., New Jersey, Chairman
Cedric L. Richmond, Louisiana Peter T. King, New York, Ranking
Max Rose, New York Member
Lauren Underwood, Illinois Dan Crenshaw, Texas
Al Green, Texas Michael Guest, Mississippi
Yvette D. Clarke, New York Dan Bishop, North Carolina
Bennie G. Thompson, Mississippi (ex Mike Rogers, Alabama (ex officio)
officio)
Lauren McClain, Subcommittee Staff Director
Diana Bergwin, Minority Subcommittee Staff Director
C O N T E N T S
----------
Page
Statements
The Honorable Xochitl Torres Small, a Representative in Congress
From the State of New Mexico, and Chairwoman, Subcommittee on
Oversight, Management, and Accountability:
Oral Statement................................................. 1
Prepared Statement............................................. 3
The Honorable Dan Crenshaw, a Representative in Congress From the
State of Texas, and Ranking Member, Subcommittee on Oversight,
Management, and Accountability:
Oral Statement................................................. 4
Prepared Statement............................................. 5
The Honorable Donald M. Payne, Jr., a Representative in Congress
From the State of New Jersey, and Chairman, Subcommittee on
Emergency Preparedness, Response, and Recovery:
Oral Statement................................................. 6
Prepared Statement............................................. 8
The Honorable Bennie G. Thompson, a Representative in Congress
From the State of Mississippi, and Chairman, Committee on
Homeland Security:
Oral Statement................................................. 8
Prepared Statement............................................. 10
Witnesses
Mr. W. Craig Fugate, Senior Advisor, Blue Dot Strategies, and
Former Administrator, Federal Emergency Management Agency:
Oral Statement................................................. 11
Prepared Statement............................................. 13
Mr. Mark Ghilarducci, Director, Office of Emergency Services,
Governor's Office, California:
Oral Statement................................................. 14
Prepared Statement............................................. 16
Mr. Chris P. Currie, Director, Homeland Security and Justice,
U.S. Government Accountability Office:
Oral Statement................................................. 24
Prepared Statement............................................. 25
REVIEWING FEDERAL AND STATE PANDEMIC SUPPLY PREPAREDNESS AND RESPONSE
----------
Tuesday, July 14, 2020
U.S. House of Representatives,
Committee on Homeland Security,
Subcommittee on Oversight, Management, and Accountability,
and the
Subcommittee on Emergency Preparedness, Response, and
Recovery,
Washington, DC.
The subcommittees met, pursuant to notice, at 12:02 p.m.,
via Webex, Hon. Xochitl Torres Small [Chairwoman of the
Subcommittee on Oversight, Management, and Accountability]
presiding.
Present: Representatives Torres Small, Payne, Barragan,
Rose, Underwood, Clarke, Thompson, Crenshaw, Higgins, Guest,
and Bishop.
Also present: Representative Jackson Lee.
Ms. Torres Small. The joint hearing will come to order. Let
me begin by thanking everyone for joining us today. I hope that
my colleagues, our witnesses, and viewers are staying healthy
and safe.
I want to thank Chairman Payne and Ranking Member King of
the Emergency Preparedness, Response, and Recovery Subcommittee
for coming together with Ranking Member Crenshaw and me to hold
this hearing.
We are here to discuss Federal and State efforts to procure
critical supplies in response to the coronavirus pandemic.
First, I want to acknowledge that the Federal Emergency
Management Agency, FEMA, which was put in charge of the Federal
Government's response, was asked to testify today.
While FEMA is not here today, I understand that
Administrator Gaynor plans to appear before the full committee
later this month. I am pleased to hear this because it is vital
that we work together to address this challenge. I look forward
to meeting with Administrator Gaynor in person soon, and
hearing what our witnesses have to share today to inform that
discussion.
There is no denying that the coronavirus pandemic has
presented unparalleled challenges. One of the greatest
challenges has been securing adequate testing supplies and
personal protective equipment, or PPE, such as gowns, gloves,
surgical masks, and N95 respirators.
A surge in global demand for these supplies, most of which
are produced overseas, caused severe shortages, especially for
those on the front lines.
In response, the Federal Government distributed the limited
supplies in the Strategic National Stockpile and expedited PPE
shipments by airlift to distributors' existing customers rather
than to States directly. This caused States to find their own
supplies to distribute to areas with greatest need.
As a result, competition within the United States
intensified as States began competing against each other, the
Federal Government, and other buyers around the world. This
competition for limited resources drove up prices and attracted
new brokers into the marketplace that were inexperienced and
unreliable.
Buyers with less purchasing power, such as smaller States
and rural areas, like those here in the district I serve in New
Mexico, had greater difficulty obtaining supplies.
Some States and major hospitals have been able to replenish
supplies, but reports of shortages among health care workers,
especially those in nursing care settings, still exist.
Demand for supplies is only expected to grow as several
States continue to experience rapidly rising rates of new
infections and hospitalizations. Public health officials also
predict that a second wave of infections will come this fall.
We must also consider the PPE needs of non-health care
workers if we want to successfully reopen the economy, which we
all do.
Therefore, it is important to take this opportunity to
discuss lessons learned from the past 6 months to improve the
procurement and distribution of critical supplies in the
future.
This includes revisiting the appointment of FEMA as the
lead of the Federal response effort in mid-March, more than 6
weeks after the White House Coronavirus Task Force was formed,
a delay that unquestionably put the agency at a disadvantage of
executing such a formidable task.
FEMA is well-versed in responding to disasters, but it has
struggled to procure supplies in the wake of multiple disasters
in the past.
In a joint subcommittee hearing last May, we discussed
long-standing challenges with FEMA's process for vetting
vendors and overseeing disaster contracts awarded by State and
local governments.
I am concerned that FEMA, once again, awarded contracts to
vendors who could not deliver during the pandemic. In one case,
FEMA canceled a $55 million contract for 10 million N95
respirators after the company, which conducts tactical training
and has no history of procuring medical equipment, failed to
deliver the masks.
In another case, FEMA warned States not to use testing
equipment it acquired under a $10 million contract because it
was believed to be contaminated. The company that produced the
equipment was formed just 6 days before FEMA awarded the
contract.
I also worry about whether pandemic response activities
have already fatigued FEMA's historically understaffed
contracting work force, which is concerning since we are only 1
month into the 2020 hurricane season and entering an active
wildfire season.
I look forward to hearing from our witnesses today on their
views of FEMA's role in leading the Federal response effort and
how we can work together to improve the procurement and
distribution of critical pandemic supplies.
Thank you again for joining us today.
Since we have a number of Members joining today, I will be
vigilant in watching the clock and ask that my colleagues be
mindful of the time available for statements and questions.
[The statement of Chairwoman Torres Small follows:]
Statement of Chairwoman Xochitl Torres Small
July 14, 2020
We're here to discuss Federal and State efforts to procure critical
supplies in response to the coronavirus pandemic. First, I want to
acknowledge that the Federal Emergency Management Agency (FEMA), which
was put in charge of the Federal Government's response, was asked to
testify today.
While FEMA is not here, I understand that Administrator Gaynor
plans to appear before the full committee later this month. I look
forward to meeting with Administrator Gaynor in person soon, and
hearing what our witnesses have to share today to inform that
discussion.
There is no denying that the coronavirus pandemic has presented
unparralleled challenges. One of the greatest challenges has been
securing adequate testing supplies and personal protective equipment--
or PPE--such as gowns, gloves, surgical masks, and N95 respirators. A
surge in global demand for these supplies--most of which are produced
overseas--caused severe shortages, especially for those on the front
lines.
In response, the Federal Government distributed the limited
supplies in the Strategic National Stockpile, and expedited PPE
shipments by airlift to distributors' existing customers rather than to
States directly. This caused States to find their own supplies to
distribute to areas with greatest need. As a result, competition within
the United States intensified as States began competing against each
other, the U.S. Government, and other buyers around the world.
The competition for limited resources drove up prices and attracted
new brokers into the marketplace that were inexperienced or unreliable.
Buyers with less purchasing power, such as smaller States and rural
areas like those here in my district in New Mexico, had greater
difficulty obtaining supplies. Some States and major hospitals have
been able to replenish supplies, but reports of shortages among health
care workers--especially those in nursing care settings--still exist.
Demand for supplies is only expected to grow as several States
continue to experience rapidly rising rates of new infections and
hospitalizations. Public health officials also predict that a second
wave of infections will come this fall. We must also consider the PPE
needs of non-health care workers if we want to successfully re-open the
economy.
Therefore, it is important to take this opportunity to discuss
lessons learned from the past 6 months to improve the procurement and
distribution of critical supplies in the future. This includes
revisiting the appointment of FEMA as the lead of the Federal response
effort in mid-March, more than 6 weeks after the White House
Coronavirus Task Force was formed--a delay that unquestionably put the
agency at a disadvantage of executing such a formidable task.
FEMA is well-versed in responding to disasters, but it has
struggled to procure supplies in the wake of multiple disasters in the
past. In a joint subcommittee hearing last May, we discussed long-
standing challenges with FEMA's process for vetting vendors and
overseeing disaster contracts awarded by State and local governments.
I'm concerned that FEMA once again awarded contracts to vendors that
could not deliver during the pandemic.
In one case, FEMA canceled a $55 million contract for 10 million
N95 respirators after the company--which conducts tactical training and
has no history of producing medical equipment--failed to deliver the
masks. In another case, FEMA warned States not to use testing equipment
it acquired under a $10 million contract because it was believed to be
contaminated. The company that produced the equipment was formed just 6
days before FEMA awarded the contract.
I also worry about whether pandemic response activities have
already fatigued FEMA's historically understaffed contracting
workforce, which is concerning since we are only 1 month into the 2020
hurricane season and entering an active wildfire season. I look forward
to hearing from our witnesses today on their views of FEMA's role in
leading the Federal response effort and how we can improve the
procurement and distribution of critical pandemic supplies.
Ms. Torres Small. The Chair now recognizes the Ranking
Member of the Subcommittee on Oversight, Management, and
Accountability, the gentleman from Texas, Mr. Crenshaw, for an
opening statement.
Mr. Crenshaw. Thank you, Chairwoman Torres Small and
Chairman Payne. I am pleased to participate in this hearing
today.
Today's hearing is to examine matters related to the
management and distribution of medical supplies in response to
the pandemic. This topic is of the utmost importance for our
country and to each of our States.
My home State of Texas recently experienced an uptick in
reported cases, as did 33 other States. Many are holding
steady, but only 3 States saw a decline in the number of cases
last week.
As we see cases increasing, we must ensure that our health
care providers and first responders have the equipment they
need to provide treatment while protecting themselves and
slowing the spread of the virus.
The size and scope of this response effort is
unprecedented. We have not experienced anything like this in
the history of our country. Some experts have compared this to
the outbreak of the Spanish flu in 1918, but today we are a
much more mobile society, and our economy and supply chain are
much more interconnected with the world.
While we are using many of the same tools, such as social
distancing, some quarantining, many of the supplies that
doctors and hospitals use today to combat the virus are not
manufactured in the United States.
Because many of our medical supplies and pharmaceuticals
are not produced domestically, we are competing with the rest
of the world for the supplies we need to treat our people.
Countries like China have a stranglehold on our medical supply
chain. We must take steps to regain control of the supply chain
from the Communist regime. This is especially important during
a global pandemic.
To make matters worse, there is evidence that China
deliberately misled the world about the extent of the outbreak
in that country while hoarding critical medical supplies and
decreasing exports to the rest of the world.
If we had known the true number of individuals infected in
China, we would have quickly realized that our stockpile of
ventilators, N95 respirators, and other medical supplies were
not going to be enough to meet the demand and been able to act
earlier to meet the projected need.
While we may have lost critical time at the beginning of
the pandemic, once we began to understand the potential scope
of the outbreak in this country, the administration took steps
to increase the availability of necessary supplies.
FEMA was put in charge of distribution of medical supplies
rather than HHS because of its logistical capabilities and
relationship with State and local emergency managers. FEMA
established Project Airbridge to find medical supplies and
quickly get them to where they were needed.
The President used the Defense Production Act to encourage
U.S. companies to join the fight against COVID-19 by altering
their operations to provide for critical medical supplies.
Ford, GE, and General Motors stepped up to assist with
manufacturing ventilators.
3M doubled its production of N95 masks to 100 million a
month.
Bauer, a U.S. company that makes hockey equipment, stopped
making helmet visors and started producing face shields for
medical professionals.
When wearing a cloth face covering became a way of life for
millions of Americans, MyPillow began producing masks to meet
the demands of Americans' needs.
After it became apparent that hand sanitizer was in short
supply, many distillers, like Whitmeyer's in my district in
Houston, converted from making alcohol for consumption to
producing hand sanitizer.
American companies are not just meeting PPE and medical
equipment demand, but looking forward. In a month-and-a-half,
Houston's Medistar founder, Monzer Hourani, took his idea for a
filter that can kill COVID from an idea to a prototype to a
tested and proven concept that kills 99.8 percent of the virus.
These are just a few examples of U.S. companies stepping up
to support our country during the crisis. Many other companies
have donated portions of their profits to aid in the fight
against COVID.
As we continue to learn more about this virus and the best
ways to prevent its spread, we must continue to build our
stockpile of medical supplies and ensure that our health care
providers and first responders have the tools they need. I look
forward to hearing from our witnesses today on the best ways to
do that.
I yield back.
[The statement of Ranking Member Crenshaw follows:]
Statement of Ranking Member Dan Crenshaw
July 14, 2020
Thank you, Chairwoman Torres Small and Chairman Payne. I am pleased
to participate in this virtual joint hearing today, but I continue to
have concerns about hearings not being held in person. A great deal is
lost in translation when we are not all together in one room discussing
these important issues.
Today's hearing is to examine matters related to the management and
distribution of medical supplies in response to the pandemic. This
topic is of the utmost importance to our country and to each of our
States. My home State of Texas recently experienced an uptick in
reported cases--as did 33 other States--others are holding steady, and
only 3 States saw declines in the number of cases last week.
As we see cases increasing, we must ensure that our health care
providers and first responders have the equipment they need to provide
treatment while protecting themselves and slowing the spread of the
virus.
The size and scope of this response effort is unprecedented. We
have not experienced anything like this in the history of our country.
Some experts have compared this to the outbreak of the Spanish flu in
1918. But today, we are a much more mobile society, and our economy and
supply chain are much more interconnected with the world. While we are
using many of the same tools, such as social distancing and
quarantining, many of the supplies that doctors and hospitals use today
to combat the virus are not manufactured in the United States.
Because many of our medical supplies and pharmaceuticals are not
produced domestically, we are competing with the rest of the world for
the supplies we need to treat our people. Countries like China have a
stranglehold on our medical supply chain, and we must take steps to
regain control of the supply chain from the communist regime. This is
especially important during a global pandemic.
To make matters worse, there is evidence that China deliberately
misled the world about the extent of the outbreak in that country while
hoarding critical medical supplies and decreasing exports to the rest
of the world. Had we known the true number of individuals infected in
China, we would have quickly realized that our stockpile of
ventilators, N95 respirators, and other medical supplies were not going
to be enough to meet the demand and acted earlier to meet the projected
need.
While we may have lost critical time at the beginning of this
pandemic, once we began to understand the potential scope of the
outbreak in this country, the administration took steps to increase the
availability of necessary supplies.
FEMA was put in charge of distribution of medical supplies rather
than HHS because of its logistical capabilities and relationship with
State and local emergency managers. FEMA established Project Airbridge
to find medical supplies and quickly get them to where they were
needed.
The President used the Defense Production Act to encourage U.S.
companies to join the fight against COVID-19 by altering their
operations to provide for critical medical supplies. Ford, GE, and
General Motors stepped up to assist with manufacturing ventilators.
3M doubled its production of N95 masks to 100 million a month.
Bauer, a U.S. company that makes hockey equipment, stopped making
helmet visors and started producing face shields for medical
professionals. As wearing a cloth face covering became a way of life
for millions of Americans, My Pillow began producing masks to meet the
demands of American's need.
After it became apparent that hand sanitizer was in short supply,
many distillers, like Whitmeyer's in my district in Houston, converted
from making alcohol for consumption to producing hand sanitizer.
American companies are not just meeting PPE and medical equipment
demand, but looking forward. In a month-and-a-half Houston's Medistar
founder Monzer Hourani took his idea for a filter that can kill COVID
from an idea to a prototype to a tested and proven concept that kills
99.8 percent of the virus.
These are just a few examples of U.S. companies stepping up to
support our country during this crisis. Many other companies have
donated portions of their profits to aid in the fight against COVID.
As we continue to learn more about this virus and the best ways to
prevent its spread, we must continue to build our stockpile of medical
supplies and ensure that our health care providers and first responders
have the tools they need. I look forward to hearing from our witnesses
today on the best ways to do that.
I yield back.
Ms. Torres Small. Thank you, Ranking Member Crenshaw.
I now recognize the Chairman of the Subcommittee on
Emergency Preparedness, Response, and Recovery, the gentleman
from New Jersey, Mr. Payne, for an opening statement.
Mr. Payne. Thank you, Madam Chair. It is an honor and
privilege to be with you and my colleagues here today.
First, I would like to say I hope everyone and their loved
ones are staying safe and healthy, and my condolences to those
who have lost loved ones because of the coronavirus.
I would like to thank Chairwoman Torres Small and Ranking
Member Crenshaw of the Oversight, Management, and
Accountability Subcommittee for coming together with Ranking
Member King and I to hold this hearing.
I would also like to thank the witnesses for being here
today to discuss the pandemic and the challenges with supplies
and procurement, a topic that is so incredibly important for
our country at this moment.
For too many communities, the pandemic is continuing to get
worse. The magnitude of this pandemic is devastating.
It didn't have to be this way, but there was a clear lack
of leadership, most importantly at the White House itself. The
lack of leadership extended to the Federal Government's
procurement strategy, and those effects have been felt by
States, local governments, and front-line workers who are
trying to contain COVID-19 around the country without the
proper PPE or supplies.
Instead of taking proactive steps early on to invoke the
Defense Production Act, build up our supply reserves, and
initiating a whole-of-Government procurement strategy and
quickly getting testing supplies and other vital medical
equipment out into communities, President Trump was instead
downplaying the threat of this virus and telling the American
people that it was under control and was a problem that was
going away.
I hope that it is clear now, with more than 3 million cases
and well over 130,000 deaths Nation-wide and daily cases on the
rise, that the virus was not and is still not under control.
During the pandemic, States have been left to fend for
themselves while dealing with a market that was oversubscribed
and underregulated. This led to chaos on the front lines with
our health care workers having to reuse masks or use trash bags
as gowns in an effort to try to protect themselves.
Efforts by the Federal Government to address supply
shortages have also been marred with problems. These problems,
including lack of coordination, have plagued the entire Federal
response. The initial response was disorganized and wasted
valuable time that could have been used better to prepare for
what was to come.
These problems continue today:
Rear Admiral Polowczyk, head of the Supply Chain
Stabilization Task Force, recently testified that the Federal
Government still does not have information on the State
stockpiles of PPE or other supplies.
Or, Project Airbridge, which has now been retired, but
where reports have stated that many States and cities were not
aware whether supplies brought into the country through the
Project Airbridge initiative were coming into their
jurisdictions.
Further, some shipments of PPE that FEMA coordinated to
nursing homes around the country were reportedly defective and
inefficient supplies.
Finally, Federal Government contracts for supplies were not
vetted properly before being awarded. This includes a $10
million contract to Fillakit for testing supplies that the
agency then had to tell States not to use because the supplies
were produced in unsanitary conditions.
Given FEMA's history of procurement failures, Congress must
conduct rigorous oversight to ensure past problems are fixed
going forward. Neglecting to correct these mistakes will result
in unnecessary lives lost, an outcome that we all want to
avoid.
Getting it right as soon as possible is especially
important as there are growing reports of PPE shortages once
again as States see a steep increase in new cases.
To explore these topics, I am glad that we have such an
esteemed panel of experts here to help shed light on how we can
do better in procuring and distributing supplies.
Thank you very much, and I yield back.
[The statement of Chairman Payne follows:]
Statement of Chairman Donald M. Payne, Jr.
July 14, 2020
For too many communities, the pandemic is continuing to get worse.
The magnitude of this pandemic is devastating. It didn't have to be
this way, but there was a clear lack of leadership, most importantly at
the White House itself. This lack of leadership extended to the Federal
Government's procurement strategy, and those effects have been felt by
States, local governments, and front-line workers who are trying to
contain COVID-19 around the country without the proper PPE or supplies.
Instead of taking proactive steps early on to invoke the Defense
Production Act, build up our supply reserves, initiating a whole-of-
Government procurement strategy, and quickly getting testing supplies
and other vital medical equipment out into communities, President Trump
was instead downplaying the threat of the virus and telling the
American people that it was ``under control'' and was a ``problem
that's going to go away.''
I hope that it is clear now, with more than 3 million cases and
well over 130,000 deaths Nation-wide, and daily cases on the rise, the
virus was not, and is still not, under control. During the pandemic,
States have been left to fend for themselves while dealing with a
market that was oversubscribed and underregulated. This led to chaos on
the front lines with our health care workers having to reuse masks or
use trash bags as gowns in an effort to try and protect themselves.
Efforts by the Federal Government to address supply shortages have
also been marred by problems. These problems, including lack of
coordination, have plagued the entire Federal response. The initial
response was disorganized and wasted valuable time that could have been
used to better prepare for what was to come. These problems continue
today:
Rear Admiral Polowczyk, head of the Supply Chain Stabilization Task
Force, recently testified that the Federal Government still
does not have information on the State stockpiles of PPE and
other supplies.
Or, Project Airbridge, which has now been retired, but where
reports have stated that many additionally, States and cities
were not aware whether supplies brought into the country
through the Project Airbridge initiative were coming into their
jurisdictions.
Further, the shipments of PPE that FEMA coordinated to nursing
homes around the country were defective or an insufficient
supply.
Finally, Federal Government contracts for supplies were not vetted
properly before being awarded. This includes a $10 million
contract to Fillakit for testing supplies that the agency then
had to tell States not to use because the supplies were
produced in unsanitary conditions.
Given FEMA's history of procurement failures, Congress must conduct
rigorous oversight to ensure past problems are fixed going forward.
Neglecting to correct these mistakes will result in unnecessary lives
lost--an outcome we all want to avoid. Getting it right as soon as
possible is especially important as there are growing reports of PPE
shortages once again as States see a steep increase in new cases.
To help explore these topics, I'm glad that we have such an
esteemed panel of experts here to help shed light on how we can do
better in procuring and distributing supplies.
Ms. Torres Small. Thank you, Chairman Payne.
The Chair now recognizes the Chairman of the full
committee, the gentleman from Mississippi, Mr. Thompson, for an
opening statement.
Mr. Thompson. Thank you very much, Madam Chair.
First of all, let me thank everyone for being here. Like
Chairman Payne indicated, I hope all is well.
Mr. Fugate, it is always good seeing you. You have been a
stellar person all your public career.
The COVID-19 pandemic has put our Nation in crisis. To
date, the United States has reported over 3 million COVID-19
cases and well over 130,000 people have died from complications
associated with the virus. Even as States continue to set daily
records for infections and new ``hotspots'' begin to emerge,
the Nation's top medical experts and scientists are predicting
a second wave of COVID-19 infections.
Obtaining and distributing critical supplies and medical
equipment has proven to be among the most important and
challenging factors in responding to COVID-19.
The American people are looking to the Federal Government
for leadership and support as the Nation navigates these
troubling times. The absence of leadership from the White House
has resulted in the lack of a clear, coordinated Federal
procurement strategy that has caused complications and delays
in States getting essential equipment.
For example, President Trump told Governors, ``The Federal
Government is not supposed to be out there buying vast amounts
of items and then shipping; you know, we are not a shipping
clerk,'' causing panic and chaos in the procurement process and
reducing States' ability to acquire what they need.
In addition, States have to compete not only with each
other for these critical supplies, but also with the rest of
the world, significantly driving up prices.
When FEMA took a larger role in the Federal response 6
weeks after the pandemic started, its main responsibility was
to improve the Nation's access to these critical supplies
through initiatives like the Supply Chain Stabilization Task
Force and Project Airbridge; however, it was unrealistic to
expect FEMA to come in and manage a full-blown crisis while
planning for and responding to natural disasters and to do it
with a contracting work force that had been understaffed and
overworked in recent years.
FEMA's initiatives caused confusion. States reported issues
with communication surrounding equipment availability and
delivery time frames. Just last week, Governor Pritzker of
Illinois called Project Airbridge an utter and complete failure
in testimony before this committee.
That assessment is unsurprising given the accounts of non-
Federal volunteers, led by Jared Kushner, being embedded at
FEMA to work on Project Airbridge. Jared Kushner's actions
further contributed to confusion over who was in charge.
While the committee has repeatedly requested more
information on Project Airbridge, FEMA has yet to provide the
requested documents and information needed for us to do our
oversight work.
Though FEMA was the administration's choice for this
mission because of its experience in disaster contracting and
logistics, it has had a history of disaster contracting
challenges.
Infamous contracting fiascoes like the award made to Bronze
Star and Tribute during the 2017 hurricane season demonstrate
FEMA's difficulty getting its procurement responsibilities
right during the height of disasters.
FEMA still struggles in this area with the agency having to
cancel a $55 million contract with Panthera in May for the
company's failure to deliver any of the N95 masks that the
company promised.
The company had no prior experience obtaining medical
supplies or equipment and its parent company was bankrupt.
Panthera, which is the company, should never have been awarded
a contract in the first place.
As COVID-19 cases continue to rise in States across the
country, we must learn from our mistakes and adapt the Federal
response to better meet the needs of our communities and front-
line workers.
There is still time to get FEMA on track with its
procurement processes in hopes that the Nation's preparedness
posture will be much improved as we continue to battle the
growing first wave of COVID-19 and prepare for a possible
second wave in the fall.
I am grateful to the witnesses for taking the time to be
here today to contribute to this important discussion.
With that, Madam Chair, I yield back the balance of my
time.
[The statement of Chairman Thompson follows:]
Statement of Chairman Bennie G. Thompson
July 14, 2020
The COVID-19 pandemic has put our Nation in crisis. To date, the
United States has reported over 3 million COVID-19 cases and well over
130,000 people have died from complications associated with the virus.
Even as States continue to set daily records for infections and new
``hotspots'' begin to emerge, the Nation's top medical experts and
scientists are predicting a second wave of COVID-19 infections.
Obtaining and distributing critical supplies and medical equipment
has proven to be among the most important and challenging factors in
responding to COVID-19. The American people are looking to the Federal
Government for leadership and support as the Nation navigates these
troubling times.
The absence of leadership from the White House has resulted in the
lack of a clear, coordinated Federal procurement strategy that has
caused complications and delays in States getting essential equipment.
For example, President Trump told Governors ``[t]he Federal Government
is not supposed to be out there buying vast amounts of items and then
shipping. You know, we're not a shipping clerk,'' causing panic and
chaos in the procurement process and reducing States' ability to
acquire what they need. In addition, States having to compete not only
with each other for these critical supplies, but also with the rest of
the world, significantly drove up prices.
When FEMA took a larger role in the Federal response 6 weeks into
the pandemic, its main responsibility was to improve the Nation's
access to these critical supplies through initiatives like the Supply
Chain Stabilization Task Force and Project Airbridge. However, it was
unrealistic to expect FEMA to come in and manage a full-blown crisis
while planning for and responding to natural disasters, and to do it
with a contracting workforce that has been understaffed and overworked
in recent years.
FEMA's initiatives caused confusion. States reported issues with
communication surrounding equipment availability and delivery time
frames. Just last week, Governor Pritzker of Illinois called Project
Airbridge an ``utter and complete failure'' in testimony before this
committee. That assessment is unsurprising given the accounts of non-
Federal volunteers, led by Jared Kushner, being embedded at FEMA to
work on Project Airbridge. Jared Kushner's actions further contributed
to confusion over who was in charge.
While the committee has repeatedly requested more information on
Project Airbridge, FEMA has yet to provide the requested documents and
information needed for us to do our oversight work. Though FEMA was the
administration's choice for this mission because of its experience in
disaster contracting and logistics, it has had a history of disaster
contracting challenges. Infamous contracting fiascos like the awards
made to Bronze Star and Tribute during the 2017 hurricane season
demonstrate FEMA's difficulty getting its procurement responsibilities
right during the height of disasters.
FEMA still struggles in this area, with the agency having to cancel
a $55 million contract with Panthera in May for its failure to deliver
any of the N95 masks that the company promised. The company had no
prior experience obtaining medical supplies or equipment and its parent
company was bankrupt--Panthera should never have been awarded a
contract in the first place.
As COVID-19 cases continue to rise in States across the country, we
must learn from our mistakes and adapt the Federal response to better
meet the needs of our communities and front-line workers.
There is still time to get FEMA on track with its procurement
processes in hopes that the Nation's preparedness posture will be much
improved as we continue to battle the growing first wave of COVID-19
and prepare for a possible second wave in the fall.
Ms. Torres Small. Thank you, Chairman Thompson.
Other Members of the committee are reminded that under the
committee rules, opening statements may be submitted for the
record. Members are also reminded that the subcommittees will
operate according to the guidelines laid out by the Chairman
and Ranking Member in their July 8 colloquy.
I now welcome our panel of witnesses and thank them for
joining today.
Our first witness is Mr. Craig Fugate, who served as the
FEMA administrator throughout the entirety of the Obama
administration. During his tenure, he led the agency for more
than 500 Presidentially-declared major disasters and
emergencies.
Prior to leading FEMA, Mr. Fugate headed the Florida
Division of Emergency Management, where he led the State
through many years of intense disasters and hurricanes, and
before that he worked in emergency management at the local
level in Florida.
Our second witness, Mr. Mark Ghilarducci, serves as the
director of the Governor's Office of Emergency Services for the
State of California. He was first appointed to the position in
July 2013 by Governor Brown and was reappointed by Governor
Newsom in January 2019.
Director Ghilarducci, serves as the Governor's Homeland
Security Advisor and oversees State-wide public safety,
emergency management, emergency communications, and
counterterrorism. He has more than 30 years of experience in
public safety and government management at the local, State,
and Federal levels.
Our final witness, Mr. Chris Currie, is director on the
Homeland Security and Justice team at the Government
Accountability Office. He leads the agency's work on National
preparedness, emergency management, and critical infrastructure
protection issues.
Mr. Currie has been with GAO since 2002 and has been the
recipient of numerous agency awards, including the Meritorious
Service Award in 2008.
Without objection, the witnesses' full statements will be
inserted in the record.
I now ask each witness to summarize his statement for 5
minutes, beginning with Mr. Fugate.
STATEMENT OF W. CRAIG FUGATE, SENIOR ADVISOR, BLUE DOT
STRATEGIES, AND FORMER ADMINISTRATOR, FEDERAL EMERGENCY
MANAGEMENT AGENCY
Mr. Fugate. Thank you, Madam Chair, Chairs, and Ranking
Members of the committee.
We can spend a lot of time talking about what goes wrong in
these types of responses. I want to introduce some ideas that
may be able to minimize these impacts later. It goes back to,
in your opening statement, several key issues we have had.
FEMA was brought in late. A lot of this has to do with that
FEMA is too often only seen as the agency that responds to
Stage 4 natural hazards, even though the Homeland Security Act,
as amended, or also known as the Post-Katrina Emergency
Management Reform Act, essentially gives the President the
authority to use FEMA in any crisis, not just when there is a
Stafford Act declaration.
I think this is something that needs to be reinforced. If
we are going to utilize FEMA as a crisis agency, that role
needs to be further strengthened and defined so that it is not
that FEMA takes over.
In fact, I was a little bit disconcerted when they put FEMA
in charge of this response. I still felt that CDC and Health
and Human Services should have been the lead with FEMA
supporting them, just like we supported USAID in the response
to the Haiti earthquake and we supported Customs and Border and
Health and Human Services family services during the
unaccompanied children on the border and as we supported CDC in
the Ebola crisis.
FEMA is not just about hurricanes, wildfires, or
earthquakes. They are an all-hazard agency. But I think that
strengthening that as the Nation's crisis manager would further
streamline the Federal response to future crises.
It isn't that FEMA takes over, but FEMA helps many agencies
who do not do crisis response full time, as you point out, do
not have the relationships with the State emergency management
teams, like Director Ghilarducci, and often find themselves
struggling in those first days and first weeks to begin that
response.
The second part of this is the Stafford Act. Too often I
think FEMA is defined by what you can declare under the
Stafford Act, and under the Stafford Act, for a major
Presidential declaration, Congress has enumerated what would be
considered a disaster.
Pandemics are absent. So are cyber attacks. In many cases
certain terrorist attacks, unless they involve an explosion or
fire, could conceivably be excluded.
I think by amending the Stafford Act, adding pandemics,
cyber attacks, and other events to that so we are no longer
uncertain about FEMA's role, we could have turned on much of
the individual systems [inaudible] dealing with how to provide
everything from disaster employment, food stamps, crisis
counseling, legal assistance, all things that could have been
turned on in that disaster.
The third area that I think we need to address goes back to
this whole supply chain. I like to say that efficiency is the
enemy of resiliency. What you are seeing in this pandemic in a
just-in-time global delivery system has produced very efficient
low-cost supplies, particularly in the health care industry.
But what we are seeing in this pandemic is only the tip of
what could happen to other industries where we have critical
infrastructures for communications, power systems, water
supplies, treatment systems across the whole vast definitions
of what Homeland Security has defined as critical industries
that are dependent upon international global supply chains.
That has increased our vulnerability through competition, but
also lack of ready access.
I think we need to look at increasing the capabilities of
domestic production. This will not be based upon a business
model that says we get the best value. It is about creating
inefficiencies to build resilience, either through tax credits
or purchasing power.
But if you wait until a crisis occurs and then discover
that your supply chain that you need for critical
infrastructure or supplies is located on the other part of the
world and now there are disruptions, either intentional, or
competition, or the fact that disasters can occur elsewhere and
disrupt our supply chains, we are seeing with the pandemic how
loss of domestic capability and production is actually
impacting our ability to respond.
So I think--I don't know, you know, again, as we look at
this, just like our defense industry, we don't outsource
building our submarines. Why are we outsourcing those supplies
that are critical to key infrastructures that we need to have
up and running?
I think, again, Congress can, in many cases, influence that
through the ability of tax credits, the ability of purchasing
power, and [inaudible] relationships.
This gets to, I think, part of the matter about FEMA
[inaudible] after this. When you tell FEMA to go find whatever
you can find for PPE, you get the results we got.
Thank you, Madam Chair.
[The prepared statement of Mr. Fugate follows:]
Prepared Statement of W. Craig Fugate
July 14, 2020
Chairs Small and Payne, Ranking Members Crenshaw and King, and
Members of the committees, thank you for inviting me to testify today
about ``Reviewing Federal and State Pandemic Supply Preparedness and
Response.''
While others will focus on the current response, I want to focus on
what we can do differently before the next pandemic or other National-
level disaster.
Establish FEMA as the Federal Government's Crisis Manager and
providing funding from the Disaster Relief Fund to support FEMA
response to non-Stafford Act Disasters.
Background.--While FEMA is most noted for the coordination of
Federal disaster response under a Stafford Act Declaration by
the President, other events such as COVID-19 show the need to
utilize the crisis management tools that FEMA brings to a
response. From supporting USAID in the response to the Haiti
Earthquake, CDC during the Ebola crisis, or managing the
unaccompanied children crisis on the boarder, FEMA has brought
needed capabilities. These responses were managed under the
authorities of the Post-Katrina Emergency Management Reform Act
of 2006--Title I: National Preparedness and Response--(Sec.
101). Amends the Homeland Security Act of 2002 (the Act) to
make extensive revisions to emergency response provisions while
keeping the Federal Emergency Management Agency (FEMA) within
the Department of Homeland Security (DHS). Sets forth
provisions regarding FEMA's mission, which shall include: (1)
Leading the Nation's efforts to prepare for, respond to,
recover from, and mitigate the risks of, any natural and man-
made disaster, including catastrophic incidents; (2)
implementing a risk-based, all-hazards-plus strategy for
preparedness; and (3) promoting and planning for the
protection, security, resiliency, and post-disaster restoration
of critical infrastructure and key resources, including cyber
and communications assets.
Amend the Stafford Act to add Pandemic to the definitions for a
Major Disaster.
Background.--CRS Report for Congress: Would an Influenza Pandemic
Qualify as a Major Disaster Under the Stafford Act? October 20,
2008 Edward C. Liu, Legislative Attorney, American Law
Division.
Establish a standing Disaster Review Body like the National
Transportation Safety Board to review the response to COVID-19 and
other major disasters.
Background.--https://www.healthaffairs.org/do/10.1377/
hblog20180720.1685- 27/full/.
Review all critical National infrastructures for supply chain
dependencies outside of the United States and determine whether to
provide incentives to increase reserves and domestic manufacturing
capabilities.
Background.--Efficiency is the enemy of resiliency. Just-in-time
delivery systems and outsourced global supply chains has
reduced the cost of many goods and services required for our
Nation's infrastructure. However, that has also created
vulnerabilities in global crises and disruptions to the supply
chains. I would focus on the DHS's definitions of Critical
Infrastructure Sectors. https://www.cisa.gov/critical-
infrastructure-sectors.
Ms. Torres Small. I now recognize Mr. Ghilarducci to
summarize his statement for 5 minutes.
STATEMENT OF MARK GHILARDUCCI, DIRECTOR, OFFICE OF EMERGENCY
SERVICES, GOVERNOR'S OFFICE, CALIFORNIA
Mr. Ghilarducci. Well, good morning, Chairman Payne,
Chairwoman Torres Small, Ranking Members King and Crenshaw, and
Members of the subcommittee. Thank you for inviting me to
testify on the Federal Government's personal protective
equipment procurement and distribution.
I also discuss the State of California's response to the
COVID-19 global pandemic, particularly the State's strategy for
emergency procurement and distribution of life-saving PPE,
which has been the largest disaster logistics and commodity
distribution operation in the history of the State of
California.
On behalf of the State of California, I want to begin by
extending my sincere gratitude to all of the Federal agencies
who have provided coordination, assistance, and funding in
helping California respond to the COVID-19 pandemic.
Along with most of the Nation and the world, California has
been severely impacted by the COVID-19 pandemic. As of July 13,
the State has 336,508 cases and has tragically lost 7,087 lives
to the disease.
However, California began dealing with indirect effects of
this pandemic long before any other State, in January, when the
State coordinated and accepted flights of repatriated citizens
from China.
Shortly after, California coordinated with the U.S.
Department of Health and Human Services in an unprecedented
operation to safely disembark and quarantine all passengers on
the Grand Princess cruise ship.
In January 2020, as the COVID caused the entire city of
Wuhan in the Hubei Province in China to quarantine, California
rose to meet the need when the State Department began
repatriation flights to bring American citizens home. Cal OES
activated the State Operations Center and worked with the State
Department, Department of Defense, Department of Homeland
Security, Department of Health and Human Services, and other
Federal agencies and State agencies to assist in the
coordination of these missions.
On February 1, there were 6 confirmed positive COVID-19
cases in California. By late February, the State had enhanced
its capabilities dedicated to COVID response after the first
case of community transmission in the State.
By March 4, the Governor declared a state of emergency in
anticipation of increasing rates of the COVID-19 infection. At
that time, resource requests for PPE were accelerating,
prompting the State Operations Center to begin distributing the
21 million N95 masks and 1 million surgical masks we had in our
reserves.
On March 6, Cal OES received notification from the U.S.
Department of Health and Human Services that the Grand Princess
cruise ship was heading to California from Hawaii. The Grand
Princess, which normally ported in San Francisco, initially
went to Mexico before coming back to California to offload and
pick up passengers. It then set sail to Hawaii.
There were an unknown number of sick people on the ship.
California supported the CDC, Health and Human Services, and
ASPR with several high-profile missions to the Grand Princess
while still at sea, including transporting medical staff and
necessary PPE, testing of staff and passengers, delivery of
essential medications to passengers, and several evacuations of
sick individuals.
This was a major operation that demanded California provide
incident management support and large quantities of logistical
support to Health and Human Services, the lead Federal agency,
including medical personnel and PPE.
At this time our partners at FEMA Region IX were very
responsive and provided as much assistance as possible given
they were not yet the lead Federal agency. Following an
extensive effort involving multiple levels of government, the
State developed a plan with the ship to berth at the Port of
Oakland. The first passengers disembarked on March 9 and the
last passengers disembarked on March 16 in a meticulous process
to protect the health of everyone involved.
Passengers, including Californians, other U.S. citizens,
and foreign nationals, were transported to and quarantined at
Travis Air Force Base, Marine Corps Air Station Miramar, and
other alternate care sites established by the State to ensure
that no COVID-19 spread in the community before they returned
home.
During the repatriation in the Grand Princess operation it
quickly became clear that Health and Human Services had trouble
with maintaining the tactical scope and scale to respond to the
issues that arose during these missions. All deployed staff
from Health and Human Services had specific purposes and were
inflexible or unable to respond to evolving needs in the State
in a timely way for challenges we were addressing.
Recently we have heard that the Federal Government has
considered placing HHS back in the lead coordination role for
this pandemic. This is concerning as we believe it would
unnecessarily slow down and complicate the National response
that is under way.
FEMA's infrastructure and experience leading operations
across the entire Federal family and assisting States has
actually been incredibly valuable and should be continued.
Overall, the most significant challenge of the Federal
Government's response to the pandemic has been the lack of a
coordinated, centralized approach to secure, obtain, and
distribute PPE.
The Federal Government's response to the on-going PPE
crisis should be characterized as challenging or really
unsuccessful. In a global pandemic, with world-wide competition
for critical life-saving assets, a National strategy to
leverage Federal buying power and consolidate asset acquisition
and distribution was nonexistent.
In fact, every State----
Ms. Torres Small. Mr. Ghilarducci, I apologize. Your time
has expired. If you can just summarize the rest of your
comments.
Mr. Ghilarducci. So the bottom line is that overall the
efforts of obtaining and coordinating on a National scale,
since we are talking about PPE and the need to get it in a
timely fashion, setting up a competition where States were
competing with each other and States were competing with the
Federal Government for limited commodities that were absolutely
necessary for life saving is not a position that we should be
in as a State or as a country.
This is problematic. Supply chains and having a capacity to
have domestic supplies enhances domestic supplies. When you
don't have those capabilities, implementing the Defense
Production Act in a real way to be able to adequately and
rapidly provide PPE is critical. In this case that did not
happen.
[The prepared statement of Mr. Ghilarducci follows:]
Prepared Statement of Mark Ghilarducci
Tuesday, July 14, 2020
Chairman Payne, Chairwoman Torres Small, Ranking Members King and
Crenshaw, and Members of the subcommittees, thank you for inviting me
to testify on the Federal Government's personal protective equipment
(PPE) procurement and distribution during the COVID-19 pandemic.
Along with most of the Nation and the world, California has been
severely impacted by the COVID-19 pandemic. As of July 11, the State
has 312,344 cases and has tragically lost 6,945 lives to COVID-19.
However, California began dealing with indirect effects of this
pandemic long before any other State--since January, when the State
coordinated and accepted flights of repatriated citizens from China.
repatriation flights to california
In January 2020, as COVID-19 caused the entire city of Wuhan in the
Hubei Province of China to quarantine, the State of California was
notified by the U.S. State Department (DOS) of the need to activate the
pre-established Repatriation Plan. California rose to meet the need
when the DOS began repatriation flights to bring American citizens
home. The California Governor's Office of Emergency Services (Cal OES)
activated the State Operations Center (SOC) and worked with the DOS,
Department of Defense, U.S. Department of Homeland Security, U.S.
Department of Health and Human Services (HHS), and other Federal and
State agencies to assist and coordinate these missions.
Repatriation flights landed at March Air Reserve Base, Travis Air
Force Base, and Marine Corps Air Station Miramar in late January and
early February. California served as the gateway for thousands of
Americans to return home safely. This required close coordination on
the State's part with not only multiple Federal and State agencies and
departments, but also local fire and law enforcement, public health,
and emergency management to provide the necessary logistical needs,
such as appropriate sheltering and medical support for the repatriated
citizens who were placed under quarantine upon arrival. As well, the
Federal Government issued travel advisories for China, which resulted
in tens of thousands of travelers immediately passing through or
traveling to San Francisco, Los Angeles, and San Diego airports.
On February 1, there were 6 confirmed positive COVID-19 cases in
California. Throughout the month of February, the California Department
of Public Health, in conjunction with the California Health and Human
Services Agency, continued to monitor cases and work with local public
health departments on contact tracing in the State. In late February,
the State enhanced its capabilities dedicated to COVID-19 response
after the first case of community transmission in the State.
On March 4, the Governor declared a State of Emergency to build on
the work already under way by the State and engage all levels of
government in anticipation of higher rates of COVID-19 infection. At
that time, resource requests for PPE were accelerating, prompting the
SOC to begin distributing the 21 million N95 masks and 1 million
surgical masks from its reserves.
grand princess response
On March 6, Cal OES received notification from HHS that the Grand
Princess cruise ship was heading to California from Hawaii. The Grand
Princess, normally ported in San Francisco, initially went to Mexico
before coming back to California to offload and pick up passengers. It
then set sail to Hawaii. There were an unknown number of sick people on
the ship. California supported the Centers for Disease Control and
Prevention (CDC) and the HHS Office of Assistant Secretary of
Preparedness and Response (ASPR) with several high-profile missions to
the Grand Princess while still at sea. This included transporting
medical staff and necessary PPE, testing of staff and passengers,
delivery of essential medications for passengers, and several
evacuations of sick individuals.
This was a major operation that demanded California provide large
quantities of logistical support to HHS, the lead Federal agency,
including medical personnel and PPE. At this time, our partners at the
Federal Emergency Management Agency (FEMA) Region IX were very
responsive and provided as much assistance as possible, given they were
not the lead Federal agency.
Following an extensive effort involving multiple levels of
government, the State developed a plan for the ship to berth at the
Port of Oakland. The plan ensured the passengers, 21 of which had
tested positive for COVID-19, could disembark safely and receive
medical treatment. With HHS as the lead, California provided support by
establishing a dockside medical receiving and processing capability.
The first passengers disembarked on March 9, and the last passengers
disembarked on March 16, in a meticulous process to protect the health
of everyone involved. Passengers, including Californians, other U.S.
citizens, and foreign nationals, were transported to, and quarantined
at, Travis Air Force Base, Marine Corps Air Station Miramar and at
other alternate care sites established by the State to ensure there was
no COVID-19 spread in the community before they returned home.
coordination with the federal government
In January, as discussed above, the lead Federal agency during the
repatriation and Grand Princess mission was HHS. It quickly became
clear that HHS had trouble with maintaining the tactical ability to
respond to the issues that arose during those missions. All deployed
staff from HHS had specific purposes and were inflexible and/or unable
to respond to evolving needs of the State in the challenges we were
addressing.
Once the pandemic spread across the Nation, it was clear there was
no strategic initiative or coordinated plan from HHS, the White House,
or the CDC. Outside of the CDC, there was very little Federal guidance
provided to the States. Regarding PPE, specifically, there was one
brief mention of cost eligibility provided in a FEMA fact sheet on
emergency protective measures. At the same time, our partners at FEMA
Region IX, who had embedded at the SOC along with HHS, worked to
adjudicate and provide critical technical assistance where possible,
including those related to Federal resources, the State's procurement,
and ultimately FEMA's distribution of PPE.
On March 13, the President issued an Emergency Declaration, and on
March 19, the Governor issued a State-wide stay-at-home order,
requiring all non-essential activity to cease. On March 22, the
Governor requested, and the President approved, a Major Disaster
Declaration for California for Direct Federal Assistance, Emergency
Protective Measures, and Public Assistance. This action initiated the
switch in lead Federal agency from HHS to FEMA.
Given the complexity of the situation and how late into the
response they took over Federal responsibility, FEMA was both
challenged and worked to be incredibly responsive. FEMA did the best
they could to organize information and operations to assist our State.
FEMA Region IX is still embedded in the SOC and has played a critical
role in the State's Logistics and Commodity Movement Task Force and in
communicating across the entire Federal family. Particularly, the FEMA
Region IX administrator and liaison officers have been highly
communicative and supportive, especially in moving the State's requests
through the relevant Federal departments.
federal resource procurement and distribution
Strategic National Stockpile
The same week as the Major Disaster Declaration on March 22,
following requests by the State to HHS for deployment of the Strategic
National Stockpile (SNS), California received its initial allotment of
PPE from the SNS. It quickly became apparent that the Federal
Government had not effectively maintained the SNS. Although the State
had planned on a complete and fully functional SNS, HHS provided the
State with only a percentage of PPE necessary to keep health care
workers and front-line workers safe. Notably, the SNS allocation to
California was absent any ventilators to treat those affected most
seriously by COVID-19. Of the SNS resources that were received, many of
the N95 respirators were expired. In the end, California only received
75 percent of the total SNS allocation that it had expected and planned
for. The separate SNS allocation dedicated specifically to the county
of Los Angeles included a small number of ventilators, and
unfortunately, all of the ventilators were inoperable and required
refurbishment by the State, delaying the deployment of these critical
resources.
California received only 75 percent of its allotment from the SNS,
comprising:
N95 Masks.--20 million
Surgical Masks.--10 million
Face Shields.--600,000
Surgical Gowns.--600,000
Coveralls.--100,000
Gloves.--600,000
Goggles.--300,000.
Federal Testing Supply Distribution
In addition to PPE, California has received the following monthly
allocation of testing supplies from the Federal Government:
------------------------------------------------------------------------
Swabs Transport Media
------------------------------------------------------------------------
May............................... 1.2 million 900,000
June.............................. 1.5 million 900,000
-------------------------------------
Total....................... 2.7 million 1.8 million
------------------------------------------------------------------------
California has requested 1.2 million swabs and 1.2 million units of
media for the month of July, and we expect to receive these amounts
based on our communications with HHS. Additionally, HHS provides a
weekly allocation of Abbot ID Now test kits to the State. Our initial
allocation was 2,400 tests per week, although recently the amount has
increased. On July 9, California received word that the Federal
Government is providing us with an additional 50 Abbott ID Now devices
and 15,000 tests to address current surge needs. This is a huge one-
time increase in rapid point-of-care testing for the State and will be
immensely helpful.
Like Federally-distributed PPE, however, testing supplies and
processes have also had significant issues.--Initially, there was much
confusion and discoordination with both distribution of testing
supplies and the roll-out of the testing sites across the country.
Although California was actively working to implement a State-wide
testing process, HHS had an inflexible approach requiring the State to
follow a ``one size fits all'' strategy, which was very problematic.
Nevertheless, the State adjusted to meet HHS requirements. In the end,
HHS changed course and allowed the State to implement their own system.
This simply cost valuable time and much unnecessary strain.
As well, early on, there were complexities with getting appropriate
and sufficient testing supplies, to include swabs and media. The
ability to get testing supplies in a timely fashion was inconsistent
and on more than one occasion, the testing supplies provided were the
wrong ones. Currently, about 760,000 units of the viral transport media
manufactured by Fillakit are in quarantine in one of our State
warehouses due to potential quality assurance issues. FEMA is aware of
this issue and is working hard with the U.S. Food and Drug
Administration (FDA) to resolve the problem.
On July 8, to address a recent spike in positive cases throughout
the State, California submitted additional requests for testing
supplies to the Federal Government, including:
Roche Cobas 6,800/8,800 test reagents, to support 30,000
tests per day.
Roche extraction reagents for MP96, Compact, and LC 2.0, to
support 20,000 tests per day between the 3 machine types.
50 Abbott ID Now machines to place in prisons/jails for
symptomatic testing and 15,000 cartridges per day to support
this testing prison/jail testing over the next 6 months and in
Imperial County's 2 hospitals.
100 Cepheid GeneXpert machines to place in skilled nursing
facilities and in Imperial County's El Centro Hospital, and
480,000 cartridges to support skilled nursing facility testing
over the next 6 months.
Qiagen RNA extraction reagents, to support 15,000 tests per
day.
Additional 200 BD Max supplies boxes per week, to support
Imperial Public Health Lab.
Biomerieux EasyMAG RNA extraction kits, to support 30,000
reactions per week.
29 Hologic Panther Fusions machines to place in 29 public
health labs, reagents to support 20,000 tests per day, and
Hologic TMA reagents to support 15,000 tests.
Federal Medical Personnel
Obtaining consistent Federal medical resources has been challenging
as well. This is more understandable, given the Nation-wide impact from
the pandemic and the need for resources by all States. However, the
lack of a strategic, coordinated approach to resource allocation has
been problematic. As well, the reluctance to utilize or commit DOD
assets and facilities for the long term has been a challenge. The
inability to secure Federal resources for more than short durations
results in a ``revolving door'' approach of assets, requiring the State
to continually shop for resources during a pandemic that has exhausted
resources. Beyond the request for Federal assets, California has
actively pursued contracts with private medical providers and early on,
launched a State-wide Health Corps initiative. Through the Health
Corps, the State leverages available medical professionals and deploys
them strategically to locations throughout the State.
More recently, on July 6, California requested an additional 190
professional medical staff from the Federal Government to deploy from
July 15 to September 15. These personnel will assist California's
efforts in Imperial County to address the on-going surge at the U.S.-
Mexico border, as well as intensive care unit (ICU) capability
throughout the State. This request included:
----------------------------------------------------------------------------------------------------------------
Mid-Level
Providers (Nurse
MD Intensivists-ICU and ER Practioners/ Respiratory ICU/ER Critical Total Requested
Physicians Therapists Care RNs Staff
Assistants)
----------------------------------------------------------------------------------------------------------------
30.............................. 20................ 20................ 120............... 190.
----------------------------------------------------------------------------------------------------------------
Again, FEMA has been very helpful and as of July 10, all 190 staff
have been identified for this mission from the Department of Defense
and from HHS, which will immensely assist the State.
Operation Airbridge
To begin, the overall approach by the Federal Government to secure,
obtain, and distribute PPE to States has been an on-going challenge and
should be characterized as an overall failure. In a global pandemic
with world-wide competition for critical life-saving assets, a National
strategy to leverage Federal buying power and consolidate asset
acquisition and distribution was nonexistent. In fact, every State was
on their own. It became the wild-wild west, with little or no oversight
or support by the Federal Government. The amount of fraud,
misrepresentation and promises broken by suppliers and would-be
profiteers was simply astounding. Every State was left to compete with
each other, as well as with other countries, for the same commodities.
As well, with Operation Airbridge, the States were left to compete
with our own Federal Government. This approach was horrendous,
resulting in massive costs and a lack of ability to secure the
necessary PPE we needed for our health care workers. Although the
Federal Government implemented a hybrid version of the Defense
Production Act, it was not leveraged as designed and really had no
positive effect on States.
Operation Airbridge was a program in which the Federal Government
partnered with several U.S.-based private medical suppliers to scour
manufacturers in China to obtain as much PPE as possible. The Federal
Government utilized its assets to find, procure, and transport PPE. It
then allocated the PPE to private medical suppliers to provide to their
customers, mostly hospitals, and retained some of the PPE to build into
the SNS. As we understand it, roughly half of the obtained resources
went to medical supply companies and 20 percent went to the medical
supply companies to sell to others, with priority for hot spots in the
country. The final 30 percent was allocated to FEMA for distribution
via the SNS.
As of July 3, California has received the following from the
Federal Government through Operation Airbridge:
N95 Masks.--14,757,500
Surgical & Procedural Masks.--87,552,500
Eye/Face Shields.--2,792,400
Gowns & Coveralls.--34,612,300
Gloves.--2,164,685,500.
While this effort did bring more resources into the United States,
it compounded the difficulty that States were facing with securing PPE.
In essence, this process ``cornered the market'' when the market
already had limited availability. Any resources that were left or that
could be obtained in the Asian market were almost entirely unavailable
because of Operation Airbridge.
Lack of communication from the Federal Government caused another
issue with Operation Airbridge. We did not get notification of the
program until it had been active already for weeks. Our FEMA liaisons
were given very little information about the operation. Once
information did start to flow, the State was only told which counties
were prioritized but was not given a breakdown of which facilities had
received which resources. At a time when the State was developing a
strategy to distribute PPE procured through its own contracts, the lack
of communication caused confusion and inefficiency in resource
allocation.
Operation Airbridge has been somewhat effective, but the supply
chain has still not recovered. It helped fill gaps and confirm another
commodity flow into the State, but with the consequence of driving
market prices up, further increasing competition, and limiting the
number of resources we could secure independently.
PPE Shipments to Skilled Nursing Facilities
FEMA established a separate program specifically to distribute PPE
to skilled nursing facilities. This effort, however, was not directly
coordinated with the State. The State was notified of this program only
after the PPE had been distributed and had little visibility over
delivery dates, quantity, and locations. While this effort was well-
intentioned and critically needed, there have been complaints on the
quality of some products, such as gowns that fit like ponchos or masks
that were not usable.
Battelle Critical Care Decontamination Systems
Through partnership with FEMA, the State-leveraged Battelle
Critical Care Decontamination systems to decontaminate N95 respirators,
allowing for their reuse during the supply chain shortage of this
critical piece of PPE. The FDA issued an Emergency Use Authorization
for the Battelle units, which can decontaminate one mask up to 20 times
and can clean up to 80,000 masks per day.
On April 20, the first Battelle site was established in Burbank.
The second was established in Fremont on April 25. As of July 8,
California's Battelle units have decontaminated 151,356 N95 respirators
for 319 facilities, with 1,864 facilities signed up for the service.
california's ppe procurement and distribution strategy
Early on in the pandemic it became very clear to the State that
given the volatile, competitive market fueled by scare resources, the
limited availability of PPE, an unpredictable Chinese government, and
an on-going tremendous need for PPE, continuation down the same path
was unsuitable. We needed a more strategic approach. We leveraged the
systems and concepts we have utilized in many previous disasters to
develop a multi-prong strategy to build a more manageable, reliable,
and sustainable pipeline to meet the needs now, and for the duration of
the event, as well as prepare for needs to re-open the economy. As we
have seen across the country, some industries need to utilize PPE that
have never been required to use it before, in order to mitigate any
potential for COVID-19 infection. We set a path to build a sustainable,
reliable capability that we could move us from a defensive position to
an offensive one.
The State's PPE strategy is aligned with the Governor's 6
indicators and 4 stages of reopening. It is informed by resource
requests received by relevant industry sectors' prior efforts to secure
PPE, existing burn rates of PPE, and immediate needs to support
operations.
Detailed further below, California's PPE strategy includes:
Contracts;
Contributions website and Safely Making CA;
State PPE distribution and guidance; and
Leveraged procurement agreements for sectors to purchase
their own PPE.
State Contracts
The challenge of obtaining PPE during the world-wide supply chain
shortage was worsened by fraudulent and dishonest vendors, overstated
capabilities, and individuals and companies using the ``seller's
market'' to take advantage of the global pandemic. There were cases
where States were successful in getting PPE orders filled only for the
shipments to be diverted, or the orders suspended, by the Federal
Government. California lost shipments of swabs and face shields to this
situation and saw diversions of 3 million N95 respirators. The State
also lost several orders of N95 respirators due to the Chinese
government shutting down PPE manufacturers and halting commodities
shipments out of the country following market volatility and criticism
against China.
Central to the State's PPE procurement strategy has been its
contract with the California-based BYD Motors, which has significant
manufacturing capabilities in China. Critical to this effort was the
assistance California received from FEMA, the FDA, and the National
Institute for Occupational Safety and Health (NIOSH) in moving through
the certification process for the masks produced by BYD. Since
receiving NIOSH certification, this contract allowed California to
provide tens of millions of surgical masks and N95 respirators.
California also added to its PPE pipeline by entering into agreements
with numerous other State-based companies, who ``re-tooled'' production
lines to provide assets, including:
Bloom Energy in San Jose to repair and refurbish
ventilators;
Anheuser Bush in Los Angeles to produce hand sanitizer;
St. Johns Knits in Los Angeles to manufacture gowns and face
coverings;
Oakley in Orange County to produce face shields;
Virgin Orbit Rocket in Long Beach to produce ventilators;
Ustrive Manufacturing in Los Angeles to produce cloth face
masks and reusable gowns;
Biotix in San Diego to produce face shields;
Advoque in Santa Clara to produce N95 masks, and
Daniels Woodland in Paso Robles to produce gowns.
Contract Vetting and Price Gouging Prevention
The State rapidly incorporated procedures and on-going checks and
balances in partnership with local, State, and Federal law enforcement,
including the Federal Bureau of Investigation, the U.S. Attorney's
Office, and the U.S. Department of Homeland Security. The purpose of
this enhanced vetting process was to help the State avoid nefarious
actors and fraudulent orders.
The Governor took an additional step to combat price gouging by
issuing Executive Order N-44-20 on April 3, prohibiting a company from
raising the selling price of any consumer good by more than 10 percent
above the regular selling price of that item on February 4, 2020.
Products on which suppliers had increased the cost were excepted.
Contributions Website and Safely Making CA Portal
On March 18, the State launched a COVID-19 website to serve as a
one-stop shop for information on COVID-19 State and Federal resources.
A key component of this website was the Medical Supply Contributions
portal, established on April 4 to facilitate the donation and
distribution of PPE and other supplies from vendors and individuals.
The vetting process for this includes filtering a donation or
request through a Contributions Group to determine whether the vendor
has provided enough information, a Validation Group to ensure the
resource will meet State specifications, and finally a Procurement
Group to either pursue or disqualify the request.
To connect California businesses seeking PPE directly with
California businesses selling PPE, the administration worked with the
California Manufacturing Technology Association to establish the
website Safely Making CA. This website fills a critical gap in helping
businesses obtain non-medical grade PPE to assist in the reopening of
the State. The portal also offers free licenses for cloud-based
collaboration software so manufacturers can upload designs and
specifications to the portal.
State PPE Distribution and Guidance
As part of California's distribution strategy, the SOC implemented
a Standard Operating Procedure (SOP) for Non-Healthcare Sector and
State Agency PPE Requests, which outlines the request submission
protocol and the adjudication and prioritization process for PPE
allocation to non-health care sectors and State agencies. Per the SOP,
the SOC evaluates unmet needs through coordination with State agencies,
who solicit feedback from industry stakeholders.
The PPE distribution process is also informed by the California
Division of Occupational Safety and Health and the California
Department of Public Health, which have been key in developing
reopening and worker safety guidance documents spanning numerous
industries in California.
To ensure compliance with Federal and State laws, recipients of PPE
are required to maintain documentation and ensure no duplication of
funds. As of July 8, California has distributed:
N95 Masks.--80,542,775
KN95 Masks.--2,339,450
Surgical Masks.--201,533,482
Cloth Masks.--9,244,100
Face Shields.--13,941,214
Goggles.--1,012,609
Gowns.--14,157,598
Coveralls.--266,340
Gloves.--62,710,803
Hand Sanitizer.--8,382,421
Collection Kits.--3,937,986.
Leveraged Procurement Agreements
A major part of the State's PPE strategy is leveraged procurement
agreements. Moving forward, the California Department of General
Services (DGS) has issued a competitive procurement for N95 and
surgical masks. The State's intent is for public entities to leverage
this procurement vehicle to purchase their own PPE, rather than have
the State continue to directly procure and distribute these resources.
The Request for Information closed on May 28, and DGS is in the process
of preparing the Request for Proposal. Once it is in place in
September, the State-wide procurement agreement will last for 1 year,
with opportunities to extend if necessary.
medical and testing supplies and capacity
California has built public-private partnerships to drastically
expand our ability to collect and process specimens. Through these
efforts, we are now equipped to test over 100,000 specimens per day.
Despite this progress, we still have work ahead of us to ensure the
supply chain is stable and that we build adequate access to testing,
particularly among low-income and minority communities.
A particular problem arose with the procurement of swabs during
this pandemic. The world's production center of critically necessary
swabs for COVID-19 testing is located in Italy's hardest-hit province,
which caused a global shortage of this resource. This limited supply in
materials caused a slow start in California's ability to test. We were
conducting only about 2,000 tests per day in early April. This shortage
required us to innovate quickly to build out a new supply chain for
swabs, as well as viral transport media and specimen collection kits.
To date, California has distributed the following:
----------------------------------------------------------------------------------------------------------------
Collection Kits Swabs Transport Media (vials)
----------------------------------------------------------------------------------------------------------------
Total................................ 414,000................ 3.4 million............ 2.2 million.
----------------------------------------------------------------------------------------------------------------
As a result of these efforts, California averaged just under
106,000 tests per day from the week of July 1 to July 7. Our ultimate
goal is to reach a consistent and sustainable minimum of 100,000 tests
per day. As of July 9, California has conducted over 5 million tests.
Despite this progress, new spikes in cases and new supply chain
issues are raising concern that our testing capacity will again be
insufficient to meet the demand. A number of commercial laboratories
are processing samples from testing sites across the Nation, not just
from within California, and are becoming overwhelmed with the large
volume. Additionally, labs within California are experiencing shortages
of chemical reagents and machine cartridges, limiting processing
capabilities and slowing result time lines. To address this, California
has instructed all labs to prioritize samples from high-risk groups,
including individuals who are COVID-19 symptomatic and those who are
hospitalized or in long-term care facilities.
California is taking steps to further build out its testing
capacity, even amid the current challenges. We are deploying new
testing modalities, such as pooled testing, to better leverage
resources. We are proactively matching organizations with laboratories
to ensure we are leveraging all public and private lab capacity across
the State. We have issued a survey to all local public health and
academic labs to better understand supply constraints and fully utilize
lab capacity for PCR testing. Finally, we are continuing to work with
our Federal partners to address supply chain issues. Now more than
ever, we need the Federal Government to help ensure a strong and
sustainable supply chain so that we may continue and further build our
testing capabilities.
Medical Surge Capacity and State Stockpile
In addition to the actions California has taken to date, we are
fully aware of the possibility of concurrent medical events
overwhelming our health care system. The State knows it needs to be
prepared for a worst-case scenario, especially given the many unknowns
of COVID-19 transmission, its interaction with influenza, and the speed
at which non-pharmaceutical interventions can be instituted.
The State's role in this situation is to support the health care
system and protect vulnerable populations by augmenting existing
supplies with the State stockpile. It is almost impossible to predict
what the ``right'' amount of PPE is for fall surge planning. Variables
include the number of patients hospitalized, the geographic extent of
the surge, how much inventory is being produced, how much PPE
institutions have in reserve, and the affordability of available PPE to
the private sector. The State is using data available from Johns
Hopkins University, assumptions collected by the California Health and
Human Services Agency, industry association partners, and internal Cal
OES data on local demand history and PPE burn rates to arrive at
informed estimates for the State's fall surge PPE stockpile. These
recommendations are:
N95 Masks.--100,000,000
Surgical Masks.--200,000,000
Cloth Masks.--500,000
Face Shields.--10,000,000
Gowns.--50,000,000
Gloves (pairs).--200,000,000
Coveralls.--1,500,000.
Emergency Management Assistance Compact (EMAC)
Through the Emergency Management Assistance Compact (EMAC),
California has been able to provide assistance to other States.
California lent ventilators to States that experienced an earlier
COVID-19 spike and delivered PPE for reimbursement. California's
ventilator and PPE EMAC resources include:
Ventilators.--Illinois, 100; Nevada, 50; Maryland, 50;
Washington DC, 50; New Jersey, 100; New York, 100; Delaware,
50; Michigan, 50. TOTAL: 1,500.
PPE.--Arizona, 10,000,000 Surgical Masks, 500,000 Face
Shields; Alaska, 13,000,000 Surgical Masks; Nevada, 3,000,000
Surgical Masks; Oregon, 1,000,000 Surgical Masks. TOTAL:
17,500,000.
conclusion and recommendations
Thank you for the opportunity to testify before you and for your
commitment to ensuring strong preparedness and response to this
pandemic. To conclude, I offer the following recommendations:
FEMA should increase the Federal share to 100 percent of the
total eligible costs for emergency protective measures
(Category B), including direct Federal assistance, to reduce
the economic burden on State and local governments experiencing
significant economic impacts, and ensure the continuity of
public safety and medical/health services during this prolonged
disaster. California made this request of the Federal
Government on March 22, to include the first 90 days of the
major disaster declaration. To date, this request has not been
addressed by FEMA for California, nor for any other State that
has made this same request.
Congress should increase the appropriation to the Emergency
Management Performance Grant (EMPG) by 85 percent and reform
the match requirement. This pandemic has made it clear that the
Federal Government must invest in building and enhancing robust
emergency management capabilities on the State and local level.
EMPG funding enables State, local, and Tribal governments to
prepare for all hazards through planning, training, exercises,
and developing professional expertise. It also supports
response capabilities, emergency operation centers, public
outreach campaigns, and alert and warning programs. EMPG's
dollar-for-dollar match requirement has been difficult for
local government to match as many have not fully rebounded from
the recession. Due to the global economic crisis initiated by
the pandemic, it is more important than ever that the dollar-
for-dollar match be reformed to a percentage cost match
consistent with the Hazard Mitigation Grant Program, currently
at 25 percent.
The SNS needs a thorough review and overhaul to build
process transparency and support more realistic expectations
and planning on the part of State and local government. The
Federal Government must better understand the demand for life-
saving SNS resources, procure and maintain those resources, and
deploy them effectively.
The Defense Production Act should be more broadly invoked
for this pandemic, particularly to produce N95 respirators, to
relieve the supply chain.
The Federal Government should establish centralized
commodity buying. The Federal Government would have far greater
purchasing power than individual States. Leveraging this
purchasing power and securing commodities for States will
relieve pressure on the supply chain and competition between
States in purchasing PPE and testing materials.
As a Nation, we need to encourage more ventilator
manufacturing. With the current domestic manufacturing
capability and supply, the Nation is still far short of the
ventilators that would be needed in the worst-case scenario.
The Federal Government must improve its coordination.
Particularly, coordination and communication must improve
between HHS/ASPR, CDC, FEMA, border agencies, and regulators,
to include internal communication between the headquarters and
regional staff for these entities. Better coordination will
allow for more streamlined communication with States and more
efficient resource management and delivery, including funding.
The Federal Government should lead unified, coordinated
communications during disasters, including guidance and
education for States and localities, as well as talking points
for Government officials to use when communicating with their
constituents.
Ms. Torres Small. Thank you for your testimony. Thank you.
I now recognize Mr. Currie to summarize his statement for 5
minutes.
STATEMENT OF CHRIS P. CURRIE, DIRECTOR, HOMELAND SECURITY AND
JUSTICE, U.S. GOVERNMENT ACCOUNTABILITY OFFICE
Mr. Currie. Thank you, Chairwoman Torres Small, Chairman
Payne, Chairman Thompson, Ranking Member Crenshaw, and other
Members that are here today. I appreciate the opportunity to be
here to talk about GAO's work on the response to COVID-19 so
far.
Just 3 weeks ago, we issued our first report on the overall
Federal response to COVID-19. The report covers over $2
trillion in Federal spending and programs, some of those
programs which are brand-new and on a scale that we have never
seen before.
Our folks have been working around the clock to provide
oversight of this funding, and our goal, as always, is to
provide accurate, fair, and balanced information to you, the
Congress, and also the American people.
This pandemic and the scale of the Federal response is not
even closely comparable to any disaster or public health
emergency the country has faced, and we have been looking at
this for over 2 decades, really since the anthrax attacks in
early 2000. We have seen a marshalling of resources and a
distribution of supplies that 8 months ago we would have
thought was impossible. For example, for the first time in
history every State in the Union, District of Columbia, most
territories, and several Tribes all have Federal disaster
declarations at the same time. That has never happened before.
I think it is important that we recognize the Federal,
State, and local officials responding to COVID-19 around the
clock and the millions of health care workers on the front
lines.
Let me just be clear that there have been major challenges.
However, unlike other disasters where we can only look back at
the response, we are still responding to the pandemic and will
be for a while. As a result, we have a unique ability in this
case to make course corrections now to address rising COVID-19
cases and looming challenges this fall when flu season hits and
health experts expect COVID-19 to get even worse than it is
now.
I want to outline some of the challenges that we have seen
in our work over the last few months, not to point fault or
focus on the past, but to help figure out how we get better as
we move forward.
First, it is clear that existing preparedness and response
structures and resources were overwhelmed. For example, we now
know that the Strategic National Stockpile was not adequate to
cover Nation-wide gaps in our public health system and
underinvestments in that system for several decades. It is also
more clear now that prior efforts to plan and prepare for a
large pandemic were both, No. 1, insufficient, and No. 2, the
gaps they did identify and who was supposed to address those
gaps were not fixed in time for COVID-19.
To its credit, FEMA was brought in, as you have said and
others have said, mid-response in early March to lead the
massive logistical effort of supply acquisition and
distribution given these gaps. New command structures were
established, comprised of Federal agencies to manage this
effort. Historical efforts to procure and distribute supplies,
such as Project Airbridge and the use of the Defense Production
Act to manufacture things like respirators or ventilator
components, were undertaken.
However, as we just reported a few weeks ago, it is clear
that there has been confusion about, No. 1, who is exactly
making resource decisions at the Federal level and how these
are being prioritized for distribution to State and local
governments.
Again, this is not surprising given the scale of the
response, but as new supply and testing shortages arise now, we
have to get more clear about roles and responsibilities moving
forward between the various levels of Government.
Second, coordination and communication have to get better.
We have heard from States and others that it has not been clear
why Federal resources were provided when they were and how they
were prioritized.
This has to work both ways, too. As States in the private
sector build their stockpiles and capabilities, the Federal
Government needs to know what resources they have so they can
understand where the gaps are and do advance planning so those
gaps can be filled when supply distributions ramp up again here
soon as we get closer to the fall.
Last, the Federal Government has tremendous contracting
resources and capabilities. It is one of the key strengths it
brings to help States and local governments in these types of
disasters or emergencies. We have reported that the use of
advance contracts and coordination of these contracts help
States to avoid the need for noncompetitive contracts after
disasters. It also helps to avoid contract awards to companies
that we later find out are unable to deliver on their promises.
FEMA also needs to ensure that they have adequate contract
staff to handle this load, an issue that has been a challenge
and will be a challenge as we get further into hurricane
season.
Real quickly, the last issue I want to point out is on
after-action reporting. Years and years of work have shown us
that after-action reports sometimes are not completed, and when
they are, the gaps they identify are never followed up on. It
is going to be critical that every Federal agency in this
response, which is almost all of them, follow up on these
actions.
Thank you very much, and I look forward to your questions.
[The prepared statement of Mr. Currie follows:]
Prepared Statement of Chris P. Currie
July 14, 2020
gao highlights
Highlights of GAO-20-685T, a testimony before the Subcommittee on
Oversight, Management, and Accountability, and the Subcommittee on
Emergency Preparedness, Response, and Recovery, Committee on Homeland
Security, House of Representatives.
Why GAO Did This Study
The COVID-19 pandemic shows how biological threats have the
potential to cause loss of life and sustained damage to the economy,
societal stability, and global security. During the pandemic, 57 major
disaster declarations were simultaneously issued for all U.S. States,
the District of Columbia, and U.S. territories--the first time in
history this has occurred. FEMA had obligated about $5.8 billion for
the response as of May 31, 2020.
This statement addresses: (1) FEMA's role in managing the COVID-19
pandemic, including efforts to acquire and distribute critical medical
supplies, as well as (2) potential challenges for this and other
biological incident responses. This statement is based on products GAO
issued from August 2003 to June 2020, as well as on-going efforts to
monitor contract obligations. For these products, GAO reviewed relevant
Presidential directives, statutes, regulations, policies, strategic
plans, other reports, as well as Federal procurement data; and
interviewed Federal and State officials, among others.
GAO provided a copy of new contract obligation information in this
statement to the Department of Homeland Security for review.
What GAO Recommends
GAO made many recommendations in prior reports designed to address
facets of many of the challenges discussed in this statement. Federal
agencies have not fully implemented all of these but, in many cases,
have taken steps. GAO will continue to monitor these efforts.
covid 19.--fema's role in the response and related challenges
What GAO Found
The Federal Emergency Management Agency (FEMA) administrator,
together with key officials from the Department of Health and Human
Services, is responsible for managing the whole-of-Nation COVID-19
pandemic response. As a primary agency responsible for managing the
response, FEMA has worked in coordination with other Federal agencies
to increase the availability of supplies for COVID-19--including
distributing supplies to States and others through Project Airbridge in
an effort to expedite distribution. FEMA's contract obligations in
response to COVID-19 totaled about $1.6 billion as of May 31, 2020,
with obligations for goods such as surgical gowns and N95 masks
accounting for $1.4 billion, or 86 percent of that total.
GAO's recent report on the COVID-19 pandemic response and past work
on other disasters has identified potential challenges FEMA faces in
responding to the pandemic and any future Nationally-significant
biological incidents. These challenges may be further complicated by
the recent rise in COVID-19 cases and additional expected case
increases in the fall.
Contracting.--In December 2018, GAO found inconsistencies in
how FEMA coordinated and communicated with States and
localities on advance contracts--those that are established
prior to disasters and are typically needed to quickly provide
goods and services. GAO made recommendations to improve FEMA's
efforts and it is taking actions to address this issue.
Medical supply acquisition and distribution.--In June 2020,
GAO reported on concerns about the distribution, acquisition,
and adequacy of supplies from the Strategic National Stockpile
and other sources. GAO will continue to monitor these issues
through on-going and future work.
Deploying disaster workforce.--In May 2020, GAO reported on
staffing shortages and other workforce challenges FEMA faced in
recent disasters. The large number of declared COVID-19
disasters coupled with hurricane and wildfire seasons adds
other potential challenges. GAO made recommendations designed
to enhance the information FEMA officials have to manage the
workforce, which FEMA agreed to implement.
After-action reporting.--Analyzing lessons from the COVID-19
pandemic response may help FEMA and other agencies take
corrective action for the remainder of this response and for
potential future biological incidents. In May 2020, however,
GAO reported that FEMA had not consistently completed prior
after-action reports. FEMA agreed to implement recommendations
designed to improve after-action reporting.
Interagency planning for biological incidents.--In June
2020, GAO reported that the National Biodefense Strategy sets
goals and objectives to help the Nation prepare for and rapidly
respond to biological incidents to minimize their effect and
could drive interagency preparedness efforts. However,
implementation was in early stages at the start of the
pandemic, and in February 2020 GAO made recommendations
designed to address key implementation challenges, including
clarifying roles and responsibilities. As shown in the COVID-19
response, FEMA's role in these efforts will be critical. GAO
will continue to monitor preparedness and strategy
implementation.
Chairwoman Torres Small, Chairman Payne, Ranking Member Crenshaw,
Ranking Member King, and Members of the subcommittees: I am pleased to
be here today to discuss our work on the Federal Emergency Management
Agency's (FEMA) roles and responsibilities during the response to the
Coronavirus Disease 2019 (COVID-19) pandemic.\1\ While the COVID-19
pandemic continues to unfold and present new challenges, it also
demonstrates how biological threats have the potential to cause
catastrophic loss of life and sustained damage to the economy, societal
stability, and global security. We recently issued our first
comprehensive look at the overall Government response to the COVID-19
pandemic, in which we reported on the multiple Federal efforts to help
address the health effects and the spillover effects of the pandemic on
the economy.\2\ As of July 6, 2020, there were over 2.8 million
reported COVID-19 cases and over 129,000 reported deaths in the United
States, according to the Centers for Disease Control and Prevention
(CDC). In addition, from March 21 to May 30, 2020, there was an
increase of over 42 million unemployed Americans and an overall
downturn in the U.S. economy. The operational response to the pandemic
has required support from all of the Nation's existing systems and
structures designed to help manage the response to both public health
emergencies and natural disasters across multiple Federal departments.
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\1\ COVID-19 is a strain of coronavirus to which the public does
not have immunity. It was first reported on December 31, 2019, in
Wuhan, China. On January 31, 2020, the Secretary of Health and Human
Services declared a public health emergency for the United States,
retroactive to January 27. On March 13, 2020, the President declared
COVID-19 a National emergency under the National Emergencies Act.
\2\ GAO, COVID-19: Opportunities to Improve Federal Response and
Recovery Efforts, GAO-20-625 (Washington, DC: June 25, 2020).
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To help the Nation prepare for disasters regardless of origin, the
Department of Homeland Security (DHS) issued The National Response
Framework, which describes how the Federal Government, States and
localities, and other public and private-sector institutions should
respond to disasters.\3\ For example, State, local, Tribal, and
territorial governments are to play the lead roles in disaster response
and recovery. Federal agencies can become involved in responding to a
disaster, such as when the President declares a major disaster in
response to a request by the Governor of a State or territory or by the
chief executive of a Tribal government, pursuant to the Robert T.
Stafford Disaster Relief and Emergency Assistance Act (Stafford
Act).\4\ Such a request is based on a finding that the disaster is of
such severity and magnitude that effective response is beyond the
capabilities of the State and the affected local governments and that
Federal assistance is necessary. A Stafford Act declaration is a key
mechanism by which the Federal Government becomes involved in funding
and coordinating response and recovery activities. For example, FEMA
uses mission assignments and the Public Assistance and Individual
Assistance programs to support response efforts and obligated $5.8
billion for COVID-19 as of May 31, 2020.\5\ During the COVID-19
pandemic, 57 major disaster declarations have been issued
simultaneously for all U.S. States, the District of Columbia, and U.S.
territories--the first time in history this has occurred.\6\
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\3\ Presidential Policy Directive-8 National Preparedness (PPD-8)
establishes a National preparedness system made of an integrated set of
guidance, programs, and processes designed to strengthen the security
and resilience of the United States through systematic preparation for
the natural and human-caused threats that pose the greatest risk. This
system breaks preparedness activities into 5 different lines of
effort--prevention, protection, mitigation, response, and recovery--
each of which requires a separate planning framework.
\4\ 42 U.S.C. 5170.
\5\ Mission Assignments are work orders FEMA issues that direct
another Federal agency to utilize its authorities and the resources
granted to it under Federal law to provide direct assistance to State,
local, Tribal, and territorial governments. The Public Assistance
program provides assistance to State, Tribal, territorial, and local
governments. For example, for the COVID-related declarations, States
can use FEMA's Public Assistance program grant funding for actions that
lessen the immediate threat to public health and safety, like standing
up emergency medical facilities. In addition, FEMA's Individual
Assistance program, which provides assistance to help individuals and
households recover following a disaster, can also reinforce State and
local services provided to help individuals cope with the pandemic,
such as for crisis counseling.
\6\ Major disaster declarations include all 50 States, the District
of Columbia, 5 territories, and the Seminole Tribe of Florida. In
addition, 32 Tribal entities are working directly with FEMA under the
March 13, 2020, Nation-wide emergency declaration.
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In May 2020, we reported that the 2017 and 2018 hurricanes,
wildfires, and other recent disasters highlight the challenges that all
levels of government face in preparing for and responding effectively
to disasters--in terms of both immediate response and long-term
recovery efforts. Our prior work has identified FEMA's challenges in
preparing for, responding to, and recovering from major disasters and
also highlighted the need to ensure transparency for tracking Federal
contracting obligations for major disasters through proper accounting
mechanisms.\7\ In its 2017 Hurricane Season After-Action Report, FEMA
acknowledged that the agency must better prepare for sequential,
complex disasters and address logistical challenges that may complicate
efforts to deploy resources to remote areas.\8\ As the Nation continues
to battle the on-going pandemic, a recent spike in case numbers, and
additional expected increases in the fall, it also must maintain
nimbleness to address other likely concurrent disasters, such as
hurricanes and wildfires, that will rely on some of the same response
capabilities currently being used to address the pandemic, including
FEMA's workforce.
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\7\ GAO, National Preparedness: Additional Actions Needed to
Address Gaps in the Nation's Emergency Management Capabilities, GAO-20-
297 (Washington, DC: May 4, 2020); and GAO, 2017 Disaster Contracting:
Actions Needed to Improve the Use of Post-Disaster Contracts to Support
Response and Recovery, GAO-19-281 (Washington, DC: Apr. 24, 2019).
\8\ Federal Emergency Management Agency, 2017 Hurricane Season
After-Action Report (Washington, DC: July 12, 2018).
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My testimony today highlights key findings from our recent prior
work on: (1) FEMA's role in managing the response to the COVID-19
pandemic, including efforts to acquire and distribute critical medical
supplies, and (2) what our prior work suggests about potential
challenges going forward for this and any other responses to Nationally
significant biological incidents.\9\ The statement is based on our
prior work issued from August 2003 through June 2020 on various
preparedness and response issues, including those for biological
threats, as well as our on-going efforts to monitor contract
obligations.
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\9\ According to the 2018 National Biodefense Strategy, a
``biological incident'' is: (1) Any act of biological warfare or
terrorism; (2) a crime involving a biological agent or biologically
active substance; or (3) any natural or accidental occurrence in which
a biological agent or biologically active substance harms humans,
animals, plants, or the environment. By ``Nationally significant,'' we
mean biological incidents that have the potential for catastrophic
consequences, such as the potential to affect a large portion of the
United States or the potential for catastrophic economic consequences.
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To conduct our prior work, we reviewed relevant Presidential
directives, statutes, regulations, policies, strategic plans, and other
reports; and interviewed Federal and State officials, among others.
More information on our scope and methodology can be found in each of
the reports cited throughout this statement. As part of our work on
FEMA's contract obligations and use of Defense Production Act
authorities in response to COVID-19, we reviewed DHS and FEMA guidance
and information, and Federal Procurement Data System--Next Generation
data through May 31, 2020.\10\ We identified contract actions and
associated obligations related to COVID-19 using the National Interest
Action code, as well as the contract description. We assessed the
reliability of Federal procurement data by reviewing existing
information about the Federal Procurement Data System--Next Generation
and the data it collects--specifically, the data dictionary and data
validation rules--and performing electronic testing. We determined that
the data were sufficiently reliable for the purposes of describing
FEMA's reported contract obligations in response to COVID-19.
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\10\ For the purposes of this statement, ``contract obligations''
means obligations on contracts that are subject to the Federal
Acquisition Regulation, and does not include, for example, grants,
cooperative agreements, loans, other transactions for research, real
property leases, or requisitions from Federal stock.
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The work upon which this statement is based was conducted in
accordance with generally accepted Government auditing standards. Those
standards require that we plan and perform the audit to obtain
sufficient, appropriate evidence to provide a reasonable basis for our
findings and conclusions based on our audit objectives. We believe that
the evidence obtained provides a reasonable basis for our findings and
conclusions based on our audit objectives.
fema's role in managing the covid-19 response
Leadership of the whole-of-Nation response.--As part of the
interagency group with responsibility for leading the whole-of-Nation
response and the Federal official responsible for the operations of the
National Response Coordination Center (NRCC),\11\ the FEMA
administrator has a key role in managing the COVID-19 response. This
includes responding to States' needs for critical medical supplies.\12\
According to the FEMA administrator's June 2020 testimony before the
Senate Committee on Homeland Security and Government Affairs, on March
19, under the direction of the White House Coronavirus Task Force, FEMA
moved from playing a supporting role in assisting the U.S. Department
of Health and Human Services (HHS), which was designated as the initial
lead Federal agency for the response, to directing it.
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\11\ The NRCC is a multiagency coordination center located within
FEMA headquarters.
\12\ GAO-20-625.
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As with any emergency or major disaster requiring a coordinated
Federal response, the NRCC serves as the interagency coordination hub
for response actions and resources for the COVID-19 pandemic response.
According to FEMA officials, to help lead the response, the
administrator activated the NRCC to the highest level--which includes
full staffing of all key interagency functions--on March 19. The NRCC
can bring to bear the existing authorities, processes, resources, and
funding that the various Federal agencies can offer to meet response
needs.
The Unified Coordination Group--made up of the FEMA administrator,
the HHS assistant secretary for preparedness and response, and a CDC
representative--has responsibility for operational command, leadership,
and decision making for the COVID-19 pandemic response. The 3 leaders
are partners in operational decision making for the response and
provide input to the White House Coronavirus Task Force. According to
FEMA and HHS officials involved in the response and operational
documents used in response coordination, FEMA, the Assistant Secretary,
and CDC have complementary roles that correspond to their missions and
expertise. The FEMA administrator, for example, focuses on directing
Nation-wide operational needs--such as the logistics of moving
material, supplies, and personnel to meet emergent needs and tracking
the delivery of these supplies. We are conducting on-going work
reviewing FEMA's actions in response to the pandemic under the Stafford
Act, including any challenges FEMA faces in coordinating and providing
resources to States and Tribal entities.
Efforts to acquire and distribute critical medical supplies.--FEMA
has relied on various mechanisms to procure needed goods and services.
As part of the Federal response to the pandemic, FEMA has worked in
coordination with HHS and the Department of Defense (DOD) to increase
the availability of supplies for COVID-19--including purchasing and
distributing supplies to States and others. As part of the response led
out of the NRCC, task forces, representing different functional lines
of effort, provide operational guidance and secure resources to
coordinate the whole-of-Government response. We reported in June 2020,
that, according to FEMA officials, these task forces bring together
Federal departments and agencies with the relevant expertise,
authorities, and capabilities necessary to address unmet needs.\13\ One
of these is the Supply Chain Task Force, which is led jointly by
detailees from DOD and FEMA and has the objective of maximizing the
Nation-wide availability of mission-essential protective and life-
saving resources and equipment based on need.
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\13\ GAO-20-625.
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According to FEMA officials, the Supply Chain Joint Task Force's
efforts have largely been led by FEMA's Office of the Chief Procurement
Officer to address limited supplies of personal protective equipment,
ventilators, and other needed resources.\14\ FEMA has used various
contracting mechanisms to support its efforts.
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\14\ In May 2020, FEMA officials told us that HHS, FEMA, and the
Supply Chain Task Force would be transitioning some of the procurement
responsibilities previously led by FEMA to DOD.
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Based on preliminary observations from our on-going review of
Government-wide contract obligations, FEMA's contract obligations in
response to COVID-19 totaled about $1.6 billion as of May 31, 2020,
with obligations for goods accounting for $1.4 billion, or 86 percent
of that total. Our preliminary analysis of contract obligations
reported in the Federal Procurement Data System--Next Generation
indicates that over three-quarters of FEMA's obligations on goods were
reported as medical and surgical equipment, such as reusable surgical
gowns and N95 respirators or masks for medical professionals. See
figure 1 for the top categories of goods and services FEMA procured.
Our preliminary analysis also found that about $1.4 billion of
FEMA's contract obligations were awarded on new contracts, compared to
preexisting contracts established before the pandemic.\15\ We plan to
issue future products focused on agencies' planning and management of
contracts awarded in response to the pandemic, including a report later
this month that will describe, among other things, key characteristics
of Federal contracting obligations awarded in response to COVID-19.
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\15\ New contract obligations include obligations on new definitive
contracts (as reported in the Federal Procurement Data System-Next
Generation), purchase orders, indefinite delivery vehicles, and blanket
purchase agreements awarded after February 4, 2020--the date of the
first contract obligations in response to COVID-19--and all associated
orders, calls, and modifications to these awards. Preexisting contract
obligations include obligations on orders, calls, and modifications to
definitive contracts, purchase orders, indefinite delivery vehicles,
and blanket purchase agreements awarded prior to February 4, 2020. A
definitive contract means any contract that must be reported in the
Federal Procurement Data System--Next Generation other than an
indefinite delivery vehicle. This definition is only relevant for
Federal Procurement Data System--Next Generation reporting.
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In addition to contracting for goods and services, we further
reported in June 2020 that, as part of the Supply Chain Task Force,
FEMA has also been involved in the delivery of personal protective
equipment and supplies through Project Airbridge.\16\ This effort--
developed in coordination with 6 large medical supply distributors--was
intended to reduce the time it takes to receive needed supplies from
overseas manufacturers. According to FEMA, the agency pays for the air
transportation of supplies from overseas to the United States, 50
percent of which are distributed to areas of need based on CDC data.
The medical suppliers distribute the remaining 50 percent through their
normal commercial networks, although, according to FEMA officials, the
Federal Government has purchased some of these supplies to provide to
the States. In mid-June, FEMA reported that the Unified Coordination
Group is phasing out Project Airbridge, now that the supply chain for
personal protective equipment has stabilized across the United States.
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\16\ GAO-20-625.
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Use of Defense Production Act authorities.--Based on preliminary
observations of our on-going work on the use of the Defense Production
Act, FEMA has used Defense Production Act Title I authority to place
priority ratings on orders of personal protective equipment in response
to COVID-19.\17\ Specifically, FEMA officials told us they placed
priority ratings on 3 orders from 3M and received about 49 million N95
respirators from April 12, 2020, through May 20, 2020. According to DHS
Acquisition Alert Notice 20-13, DHS components must seek authorization
by the Unified Coordination Group and the White House Task Force before
placing a priority rating on a contract for COVID-19. Our on-going work
will further examine FEMA's role in procuring and distributing critical
goods and how Federal agencies used authority under the Defense
Production Act to obtain needed supplies.
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\17\ According to DHS guidance on the Federal Priorities and
Allocations System, a contract or order containing a priority rating
requires the contractor (and the contractor's supply chain) to provide
preferential treatment to fulfil the delivery requirements of the rated
contract or order. Department of Homeland Security, Office of the Chief
Procurement Officer, Federal Priorities and Allocations System: A Guide
for Placing Priority Ratings on Contracts and Orders (Washington, DC:
March 2020).
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potential challenges in this and future responses
Our prior work and the nature of this response suggest issues that
may present challenges for FEMA as this response continues and for any
future incidents. Monitoring known challenges and incorporating lessons
learned from the early phases of the COVID-19 response will provide
critical information to inform improvement efforts for the on-going
response. Moreover, as the Federal Government continues to take
necessary steps to protect the American public during the on-going
pandemic, we must not lose sight of the next potential threat. Our work
had identified challenges, and in many cases made recommendations, that
may be relevant for FEMA. Among these are challenges related to: (1)
Contracting, (2) medical supply acquisition and distribution during the
pandemic, (3) deploying the disaster workforce, (4) after-action
reporting, (5) interagency planning for Nationally significant
biological incidents, and (6) building and assessing non-Federal
capabilities for such incidents.
Contracting.--Our prior work has identified coordination challenges
between FEMA, other Federal agencies, and States and localities related
to the use of contracts following the 2017 disasters. In April 2019, we
found that FEMA's guidance lacked details on how FEMA and other Federal
agencies should coordinate contracting considerations as part of
mission assignments.\18\ We recommended that FEMA revise its mission
assignment policy and guidance to better incorporate consideration of
contracting needs and to ensure clear communication of coordination
responsibilities related to contracting. FEMA concurred with the
recommendation and stated it would work with other Federal agencies to
develop mission assignment tools, training, and guidance to address
these issues.
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\18\ GAO-19-281.
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We have also identified challenges with FEMA's coordination and
communication with States and localities over the use of advance
contracts. In December 2018, we found inconsistencies in how FEMA was
coordinating with States and localities and the information FEMA used
to communicate with States and localities on advance contracts.\19\ We
recommended that FEMA provide specific guidance to its contracting
officers to perform outreach to States and localities to encourage and
guide them on the use and establishment of advance contracts, and
communicate information on available advance contracts. FEMA concurred
with our recommendations and has taken some steps to update its
guidance and improve communication. Effective coordination between FEMA
and its Federal, State, and local partners helps ensure that
stakeholders have the tools needed to facilitate their emergency
response efforts.
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\19\ GAO, 2017 Disaster Contracting: Action Needed to Better Ensure
More Effective Use and Management of Advance Contracts, GAO-19-93
(Washington, DC: Dec. 6, 2018).
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Moreover, our prior work has noted that agencies, including FEMA,
can leverage contracts awarded in advance of a disaster to rapidly and
cost-effectively mobilize resources and that these contracts can help
preclude the need to procure critical goods and services
noncompetitively.\20\ In December 2018, we recommended that FEMA update
its advance contract strategy to clearly define the objectives of
advance contracts, how they contribute to FEMA's disaster response
operations, and how they should be prioritized in relation to new,
post-disaster contract awards. FEMA concurred with this recommendation
and has taken some steps to provide additional guidance on the use of
advance contracts, but its actions are still in progress. Our future
work will examine contracting lessons learned related to planning for
future public health emergencies.
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\20\ GAO-19-93.
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Medical supply acquisition and distribution during the pandemic.--
In June 2020, we reported on concerns about the distribution,
acquisition, and adequacy of supplies from the Strategic National
Stockpile and other sources.\21\ For example, in April 2020, the
National Governors Association--whose membership comprises State
governors, territories, and commonwealths--noted in a memorandum to
Governors' offices that Governors individually and through the
association had called for improved coordination in the Federal
response to enable States to obtain critical supplies.\22\
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\21\ GAO-20-625. The Strategic National Stockpile, which is
overseen by the HHS Assistant Secretary for Preparedness and Response,
is the largest Federal repository of critical medical supplies. When
FEMA was designated as the lead Federal agency for the pandemic
response, responsibility for allocation, distribution, and procurement
of supplies shifted from HHS to the Supply Chain Task Force.
\22\ National Governors Association, Governor Actions to Address
PPE and Ventilator Shortages (Washington, DC: Apr. 13, 2020), available
at https://www.nga.org/wp-content/uploads/2020/04/NGA-Medical-
Equipment-Memo.pdf.
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The National Governors Association further noted that a more
coordinated Federal role would help States to obtain personal
protective equipment, ventilators, and other critical supplies to
protect responders and save lives without competition between States
and with the Federal Government. Similarly, the Governors of Colorado
and Michigan testified before the House Committee on Energy and
Commerce in June 2020 that coordination of supplies between the Federal
Government and States needed to be improved. We previously raised
concerns about supply gaps. Specifically, in 2003, we reported that
urban hospitals lacked the necessary equipment, such as personal
protective equipment, to respond to a large influx of patients
experiencing respiratory problems caused by a bioterrorism event.\23\
Such an event would require a similar response to the naturally-
occurring COVID-19 outbreak.
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\23\ GAO, Hospital Preparedness: Most Urban Hospitals Have
Emergency Plans but Lack Certain Capacities for Bioterrorism Response,
GAO-03-924 (Washington, DC: Aug. 6, 2003).
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Officials from the HHS Assistant Secretary for Preparedness and
Response's office and FEMA officials told us that they did not consider
the views of the National Governors Association to be representative or
reflective of the entire response effort. Moreover, HHS officials noted
that many State stockpiles were inadequate and that public reporting
provides examples where Governors and mayors made unnecessarily large
demands for Federal resources. FEMA officials also noted that States
overestimated their needs for supplies, such as ventilators. Although
we requested information on the Strategic National Stockpile inventory
prior to the pandemic--such as the types and amounts of supplies that
States requested, as well as what the assistant secretary and FEMA
distributed from the stockpile in response to States' requests--HHS and
FEMA had not yet provided this information as of June 12, 2020. We plan
to continue to seek this information from the agencies.
In addition to the statements made by the National Governors
Association, in June 2020, a National Emergency Management Association
official testified before the Senate Committee on Homeland Security and
Government Affairs about the challenges States faced accessing the
Strategic National Stockpile. These challenges included limited
visibility into the availability of supplies and a failure to receive
items needed in a sufficient quantity or useable condition. For
example, some States reported receiving supplies that were past a
functional expiration date. In addition, this official noted that
States reported problems with receiving supplies from other sources
intended to fill the gap in the stockpile, such as long delivery times
(e.g., 46 days for a shipment of surgical gowns for one State),
shipments sent to the wrong locations, and supplies ordered that never
arrived.
We are conducting a comprehensive body of work on the Strategic
National Stockpile in response to the Pandemic and All-Hazards
Preparedness and Advancing Innovation Act of 2019 and the CARES
Act.\24\ As part of this work, we plan to review progress made in
restructuring the stockpile based on lessons learned from recent
pandemics, an effort the administration announced on May 14, 2020.
Further, we also plan to examine the alignment of supplies in the
stockpile with threat risks; coordination and communication with
States, territories, localities, and Tribes; and actions taken, if any,
to mitigate supply gaps. We are also examining the role that FEMA
played in distributing supplies in conjunction with HHS and others and
how Federal agencies used authority under the Defense Production Act to
obtain needed supplies.
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\24\ Pandemic and All-Hazards Preparedness and Advancing Innovation
Act of 2019, Pub. L. No. 116-22, 403(a)(5), 133 Stat. 905, 946-47;
CARES Act, Pub. L. No. 116-136, 19010, 134 Stat. 281, 579-81 (2020).
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Deploying disaster workforce.--FEMA may face challenges in its
ability to deploy its workforce in response to other disasters in
addition to COVID-19. In May 2020, we reported that FEMA faced staffing
shortages during the 2017 and 2018 disaster seasons, 2 years that were
particularly challenging due to the number and severity of disasters
experienced.\25\ We further reported that FEMA's qualification and
deployment processes did not provide reliable and complete staffing
information to field officials to ensure effective use of the deployed
workforce. We made recommendations on this issue, among others, which
FEMA agreed to implement.
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\25\ GAO, FEMA Disaster Workforce: Actions Needed to Address
Deployment and Staff Development Challenges, GAO-20-360 (Washington,
DC: May 4, 2020).
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Our prior work has also found that FEMA's ability to plan and
manage contracts during a disaster is also complicated by persistent
acquisition workforce challenges, including attrition and staffing
shortages. In April 2019, we found that FEMA had identified workforce
shortages as a challenge but had not assessed its contracting workforce
needs since at least 2014.\26\ We recommended that FEMA assess its
workforce needs to address these shortcomings and develop a plan,
including time lines. FEMA concurred with the recommendation and has
taken some steps to address it.
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\26\ GAO-19-281.
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The large number of declared disasters for the COVID-19 pandemic
and the lack of disaster management experience in this area add
additional layers of complexity to FEMA's response. Therefore, it is
critical that FEMA give leaders and managers in the field information
to help them respond flexibly and effectively. While continuing to
respond to the pandemic, FEMA and the Federal Government must also be
prepared to respond when the next disaster inevitably strikes. We will
continue to monitor Federal efforts to respond to the pandemic--
including FEMA's role in coordinating response and recovery efforts
Nation-wide and Federal efforts to prepare for large-scale biological
events--as well as challenges FEMA and other Federal agencies face in
ensuring that they are able to respond to major disasters and
emergencies effectively and equitably.
FEMA after-action reporting.--FEMA policy requires that after-
action reviews be conducted after Presidentially-declared major
disasters to identify strengths, areas for improvement, and potential
best practices of response and recovery efforts. However, we reported
in May 2020 that, as of January 2020, FEMA had completed after-action
reviews for only 29 percent of disasters since January 2017.\27\
Further, we reported that FEMA lacks a formal mechanism for documenting
and sharing best practices, lessons learned, and corrective actions
Nation-wide.
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\27\ GAO-20-297.
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Information collected and reported following a pandemic can inform
responses to future public health emergencies. Furthermore, the
National Response Framework specifies that evaluation and continual
process improvement are cornerstones of effective preparedness.
Ensuring that FEMA and all other agencies participating in the COVID-19
response are consistently identifying best practices and areas of
improvement will be critical to mounting an effective response now and
in the future. In May 2020, we recommended that FEMA prioritize the
completion of after-action reviews, document lessons learned at the
headquarters level, and develop guidance for sharing such reviews with
external stakeholders, when appropriate. DHS concurred with our
recommendations and stated that it is taking steps to address them,
including by implementing a new system for tracking best practices and
lessons learned, among other things.
Interagency planning for Nationally significant biological
events.--Since 2011, we have called for a more strategic approach to
guiding the systematic identification of risks, assessing resources
needed to address those risks, and prioritizing and allocating
investments across the biodefense enterprise.\28\ In September 2018,
the White House issued the National Biodefense Strategy (Strategy) and
characterized it as a new direction to protect the Nation against
biological threats. At the same time, the President issued the
Presidential Memorandum on the Support for National Biodefense/National
Security Presidential Memorandum-14 (NSPM-14), which details a
governance structure and implementation process to achieve the
Strategy's goals. For example, it established 2 governing bodies: The
Biodefense Steering Committee--chaired by the Secretary of HHS--and the
Biodefense Coordination Team, to support the efforts of the Steering
Committee. In our February 2020 report, we found that the Strategy and
associated plans bring together all the key elements of Federal
biodefense capabilities, which presents an opportunity to identify gaps
and consider enterprise-wide risk and resources for investment trade-
off decisions.\29\
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\28\ GAO, Opportunities to Reduce Potential Duplication in
Government Programs, Save Tax Dollars, and Enhance Revenue, GAO-11-
318SP (Washington, DC: Mar. 1, 2011). The biodefense enterprise is the
whole combination of systems at every level of Government and the
private sector that contribute to protecting the Nation and its
citizens from potentially catastrophic effects of a biological event.
It is composed of a complex collection of Federal, State, local,
Tribal, territorial, and private resources, programs, and initiatives
designed for different purposes and dedicated to mitigating both
natural and intentional risks.
\29\ GAO, National Biodefense Strategy: Additional Efforts Would
Enhance Likelihood of Effective Implementation, GAO-20-273 (Washington,
DC: Feb. 19, 2020).
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In February 2020, we reported that the Strategy and its associated
plans bring together the efforts of Federal agencies with significant
biodefense roles, responsibilities, and resources to address
intentional, accidental, and naturally-occurring threats and is an
important step toward the kind of enterprise-wide strategic decision
making we have called for. In June 2020, we also reported that the
Strategy sets goals and objectives to help the Nation prepare for and
rapidly respond to biological incidents to minimize their effect. As
such, implementing the strategy could help the Federal Government
prepare for Nationally significant events like the COVID-19 pandemic.
However, as we reported in February 2020, the Strategy efforts
under way represented a start to a process and a cultural shift that
may take years to fully develop. Given the timing of the COVID-19
pandemic, the Strategy had not had time to drive change in response
planning and other biodefense functions, and we identified multiple
challenges that could affect the Strategy's implementation, including
challenges in adapting to new procedures, a lack of clarity in roles
and responsibilities for joint decision making, and a lack of defined
resources to sustain on-going efforts. We made recommendations to the
Secretary of Health and Human Services, as the agency responsible for
coordinating interagency strategy efforts to address these
implementation challenges. HHS agreed to implement these
recommendations. Given the experience of the COVID-19 response, FEMA's
role and contribution to on-going interagency planning efforts for
Nationally significant biological incidents will be critical. We have
on-going work on preparedness for and response to COVID-19 and other
such Nationally significant events and expect to report in early 2021.
Building and assessing capabilities.--In our February 2020 review
of the National Biodefense Strategy, we reported that the initial
Federal effort to collect information on all biodefense-related
programs, projects, and activities focused on existing Federal
activities and did not include a complete assessment of biodefense
capabilities at the non-Federal level--capabilities needed to achieve
the goals and objectives outlined in the Strategy. We recommended that
HHS take steps to ensure that non-Federal resources and capabilities
are accounted for in the analysis of the Nation's biodefense efforts.
HHS agreed and described steps it is taking to address this
recommendation.
Capabilities at the non-Federal level are critical for supporting
key functions in biological incident response, and building them has
been an on-going challenge, as our prior work demonstrates. According
to Federal, State, and local officials, early detection of potentially
serious disease indications nearly always occurs first at the local
level, making the capabilities of personnel, training, systems, and
equipment that support detection at the State and local level a
cornerstone of our Nation's biodefense posture.\30\ In June 2019, we
testified that establishing and sustaining biosurveillance capabilities
can be difficult for a myriad of reasons.\31\ For example, maintaining
expertise in a rapidly changing field is difficult, as is the challenge
of accurately recognizing the signs and symptoms of rare or emerging
diseases.\32\ Additionally, we reported in October 2011 that funding
targeted for specific diseases does not allow for a focus on a broad
range of causes of morbidity and mortality, and Federal officials have
said that the disease-specific nature of funding is a challenge to
States' ability to invest in core biosurveillance capabilities.\33\ As
we testified in June 2019, implementation of the National Biodefense
Strategy offers the opportunity to design new approaches to identifying
and building a core set of capabilities for emerging infectious
diseases. However, implementation efforts are on-going and it is yet to
be determined how, if at all, implementation efforts will address this
long-standing challenge.
---------------------------------------------------------------------------
\30\ GAO, Biosurveillance: Non-Federal Capabilities Should Be
Considered in Creating a National Biosurveillance Strategy, GAO-12-55
(Washington, DC: Oct. 31, 2011).
\31\ GAO, Biodefense: The Nation Faces Long-standing Challenges
Related to Defending Against Biological Threats, GAO-19-635T
(Washington, DC: June 26, 2019). Biosurveillance, as defined by the
July 2012 National Strategy for Biosurveillance, is the on-going
process of gathering, integrating, interpreting, and communicating
essential information related to all-hazards threats or disease
activity affecting human, animal, or plant health, for the purpose of:
(1) Achieving early detection and warning, (2) contributing to overall
situational awareness of the health aspects of the incident, and (3)
enabling better decision making at all levels.
\32\ GAO, Biosurveillance: Efforts to Develop a National
Biosurveillance Capability Need a National Strategy and a Designated
Leader, GAO-10-645 (Washington, DC: June 30, 2010).
\33\ GAO-12-55.
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In our prior work in March 2011, we also recommended that FEMA
complete a National preparedness assessment of capability gaps at each
level of Government based on tiered, capability-specific performance
objectives to enable prioritization of grant funding.\34\ However, as
of March 2020, this recommendation has not been implemented.
---------------------------------------------------------------------------
\34\ GAO-11-318SP.
---------------------------------------------------------------------------
In summary, the response to the COVID-19 pandemic has relied on
both public health and emergency management capabilities, which are
often governed by different authorities and directed by different
agencies at the Federal and non-Federal level. As the Government looks
to the future and takes steps to plan, prepare, and respond to future
biological incidents of National concern, addressing the
recommendations we have made to better address capability gaps can help
better position the Nation for what comes next. We are planning
upcoming work on Federal efforts at DHS and HHS to support building
non-Federal capabilities to respond to and recover from Nationally
significant biological incidents.
Chairwoman Torres Small, Chairman Payne, Ranking Member Crenshaw,
Ranking Member King, and Members of the subcommittees, this concludes
my prepared statement. I would be happy to respond to any questions you
may have at this time.
Ms. Torres Small. Thank you for your testimony, Mr. Currie.
I deeply appreciate it.
I thank all of the witnesses for their testimony, and I
will remind each Member that he or she will have 5 minutes to
question the panel. Without objection, Ms. Jackson Lee will be
permitted to sit and question the witnesses as well.
I now recognize myself for questions.
We have heard, especially toward the start of this
pandemic, the market for PPE and other medical equipment was
difficult to navigate, to say the least, due to competition
from other States and little guidance from the Federal
Government.
Mr. Fugate, as the lead Federal agency, what do you think
FEMA's role should have been in providing a National
procurement strategy to avoid unnecessary competition and
bidding wars between States?
Mr. Fugate. Well, for FEMA this is brand-new. They don't
procure this type of equipment on these scales. So the learning
curve is very painful. I think probably the biggest problem I
saw early on is nobody was thinking a big number.
If you are going to use the Defense Production Act, you
have to use it early. The problem is, there was not certainty
it was going to get that bad. We can go back to H1N1 in 2009
where we prepared for a much worse pandemic, but the United
States was basically spared some of the impacts other country
did.
So we didn't have a big number, we didn't turn on things
early because the indicators, by the time it indicated a need,
were already behind the power curve, and then it was a mad
scramble. Everybody was trying to get PPE and it became a
competition.
I think we have to codify these rules ahead of time.
Ms. Torres Small. Thank you, Mr. Fugate.
Mr. Currie, do you have anything to add in terms of FEMA's
role in providing a National strategy?
Mr. Currie. Well, I agree with Mr. Fugate. I don't think
anybody at the Federal level expected the pandemic to be this
bad, and, as you said, this is why FEMA was called in late in
the game, because they were the only ones left that actually
had resources anywhere close to be able to handle something
like this.
I have to go back to preparedness. We have found over and
over, again, for example, in 2019, Crimson Contagion, the
exercise was conducted that was very similar to a pandemic
situation like this, one of the key vulnerabilities it
identified was that supply distribution and prioritization was
going to be a mess.
So we didn't take the steps and didn't devote the resources
to address it then. It is very difficult to address these
things before something like this actually happens. But we do
have the information to do it.
I think now, as I said in my opening, this response is
still on-going, so all is not lost. We are not just looking
back. We can address these issues now for the future.
Ms. Torres Small. Thank you, Mr. Currie.
Mr. Ghilarducci, California has an incredibly diverse
population in several rural communities, which is similar to my
State of New Mexico.
Can you talk about whether there are any inequalities in
the availability of supplies within the State and how you
ensure that rural areas are adequately equipped to combat
COVID-19?
Mr. Ghilarducci. Yes. Great question.
So one of the major efforts that we put forth and lean deep
into is to ensure that our rural communities in areas where
maybe communities that had a lack of direct access to these
kind of commodities were sourced and supplied efficiently and
effectively, particularly smaller hospitals.
We would wrap around those smaller health care systems with
not only PPE, but personnel, to ensure that they had the
capability they need to sustain themselves.
But look, it is a big State and part of the effort was to
initially decompress hospitals. So part of that was building in
these Federal and field medical stations and other kinds of
field alternative care sites to be able to help those
communities.
In rural California and in far north California, where we
have very diverse populations, those were primary areas to
ensure that we had enough resources.
Ms. Torres Small. Thank you, Mr. Ghilarducci.
To follow up on that, part of the diversity is Indian
Tribes, and right now FEMA assistance for COVID-19 requires a
25 percent match from States and Indian Tribes at a time when
the virus is also drying up State and Tribal revenues and
leading to budget shortfalls.
So in the limited remaining time, can you speak on the
disproportionate impact the virus is having, and start with
whether you believe waiving the cost-share would enhance
Tribes' ability to respond to the pandemic?
Mr. Ghilarducci. Well, certainly Tribes are unique in that
they have the opportunity to either acquire assistance from the
Federal Government directly or in some cases come to the State
for assistance.
But let me be clear, waiving the cost share in this
particular endeavor, this is such a massive, complicated event
that is long, really a marathon, the fiscal impact across the
board, as we have seen in the State, across other States in the
country, is massive.
So if any event would be required to waive the cost-share
really it would be this one and it certainly could be very
beneficial to Tribes and local governments and State
governments as well.
Ms. Torres Small. Thank you, Mr. Ghilarducci.
I yield the remainder of my time.
So I now recognize the Ranking Member of the Subcommittee
on Oversight, Management, and Accountability, the gentleman
from Texas, Mr. Crenshaw, for questions.
Mr. Crenshaw. Thank you, Madam Chairwoman.
Again, thank you, everyone, for being here.
This question is for Mr. Fugate. I just want to get a sense
of--we can always nitpick and Monday morning quarterback in
hindsight, but that is useful only to an extent. We have to
understand what is truly possible to change in a realistic way.
So along those lines, when it became clear that certain
items were needed as part of the response, Operation Airbridge
brought in and distributed PPE and other needed supplies. The
Defense Production Act was invoked to ramp up ventilator
production. On February 24, the President asked Congress for
money to fight COVID. It was, unfortunately, delayed at least a
week after requested.
Congress passed 3 COVID-related bills in March that were
signed into law, and the Federal Government, through the
Coronavirus Task Force, has continued to provide support.
What additional action should the Federal Government have
taken? I mean, when was there a fork in the road where we went
left and we should have gone right? That would be a critical
way to assess what we could have done better and maybe learn
lessons for the future.
Mr. Fugate. Well, my observations--and, again, this is my
opinion--we never looked at worst-case, big-number scenarios.
My experience has been we always try to make the disaster
fit our capabilities instead of looking at how bad something is
going to be and what would be the potential shortfalls and how
would we address it.
As you find with pandemics, if you are waiting for
certainty, you are too late. So it was we weren't looking at
big enough numbers to see what the delta was between what we
were doing and what the potential demand was.
Quite honestly, I would much rather testify to you that I
got too much stuff than I ran out. I think that is the thing we
have to really enforce here, is that we cannot right-size these
types of responses. We have to have too much or we are always
going to run out.
Mr. Crenshaw. Are you referring to--it seems like, as Mr.
Currie had stated before, you are not referring to a decision
made in the last few months; you are referring to decisions
made over the last few years of preparation.
Mr. Fugate. Absolutely.
Mr. Crenshaw. OK.
Mr. Fugate. We looked at our stockpile as a push package.
It was never designed to respond to a pandemic. It was only
designed to be the first things out the door. But we have to
also understand what the demand signal was, and with a novel
virus, there was no telling.
So essentially you can start taking what I call
[inaudible]. How many people in the health care industry are we
going to have to provide PPE for in every State simultaneously?
That is a big number. What is our delta between what we can do
now and what we can do to meet that number?
Mr. Crenshaw. Do you have any insight as to why, after
H1N1, our N95 mask depletion in the National Stockpile was down
75 percent, if the numbers that I am hearing are correct, and
that they were never replenished? Is there any good reason why
that is?
Mr. Fugate. Yes. It was called sequestration.
Mr. Crenshaw. Even though overall funding increased for the
National Stockpile?
Mr. Fugate. There were a lot of decisions made that it took
time to rebuild. But we identified that the stockpile was only
going to be a push package and that a pandemic would have to be
augmented by production, purchasing, and ultimately the Defense
Production Act.
Mr. Crenshaw. OK. Sticking with you Mr. Fugate, does FEMA
have the necessary authorities under the Stafford Act to
respond to pandemics? Is there something you would change?
Mr. Fugate. Yes. I would add pandemics to the definition of
a major Presidential disaster declaration. Senator Collins
actually tried to introduce this back in 2008, I believe.
There is also a Congressional Research report to Congress
on whether or not FEMA can declare pandemics under the Stafford
Act. Ultimately, it was always going to be a decision of the
President, but because it is not listed, it tends to be a
hindrance that it is not seen as FEMA's role to prepare for
this.
Mr. Crenshaw. One thing that has interested me as we sort-
of have this National debate over response is I hear from
States sometimes that they felt like there was not enough of a
National plan, and then I also hear that they weren't given the
flexibility they needed to, say, do their testing planning the
way they would have liked to.
So as far as the State-Federal relationship, are we still
basically on the right track? What lessons can we learn? What
should be shifted in that relationship?
Mr. Fugate. Having worked on both sides of this, I will
tell you, I see the Federal Government as the rules and the
tools and the funding. Then States, territories, and Tribes
implement it to their specific constituencies. What works in
Florida won't work in North Dakota. But we should be using the
same standards and guidelines to implement those programs
giving flexibility to the Governors and their teams for the
implementation.
Mr. Crenshaw. Would you say this? From my point of view
that seems to be how it is always supposed to have happened and
how it basically has been happening now, obviously, with some
[inaudible] here and there.
Mr. Fugate. Yes, I would agree. I think that I have heard
calls for a Federal czar to take over and run all this, and I
would defer to that. One person in the District of Columbia is
not going to be able to make this work, but we need to have
consistent guidance on the Federal side consistent with
increased forces so that States can implement this as it is
best for the States.
Ms. Torres Small. Thank you.
Mr. Crenshaw. I yield back.
Ms. Torres Small. Thank you, Ranking Member.
The Chair now recognizes the Chair of the Subcommittee on
Emergency Preparedness, Response, and Recovery, the gentleman
from New Jersey, Mr. Payne, for questions.
Mr. Payne. Thank you, Madam Chairwoman. I would like to
thank the gentlelady from New Mexico.
Mr. Fugate, it is once again good to see you. Always a
pleasure. We appreciate your service to our country. It has
been second-to-none.
As we all [inaudible] for disasters, do you believe that
FEMA should retain the lead of the Federal Government's
response to coronavirus, Mr. Fugate?
Mr. Fugate. Yes, I was always--I found it fascinating when
they put FEMA in that lead role, because if you think about
FEMA, they are the ultimate support agency. Either we are
supporting Governors in their response or we are supporting a
lead Federal agency that has jurisdiction. In FEMA's history,
this goes back to the Challenger disaster where FEMA was in
support of NASA.
By putting FEMA in the lead role, I think we lost a lot of
the expertise that CDC should have had that FEMA could have
supported.
So I think FEMA's role as the Nation's crisis manager
should be enforced, but I think it should also be seen that we
want to make sure that the lead agencies with the jurisdiction,
the legal authority, and the expertise are taking that lead and
FEMA is supporting it and hopefully making them more
successful.
Mr. Payne. Thank you.
Mr. Ghilarducci, same thing.
Mr. Ghilarducci. Yes, I will agree with Craig. I think that
the topic area is that not necessarily FEMA being the lead
agency but being the lead coordination agency at the Federal
level.
Obviously, much like we have done here in California, our
Health and Human Services is the lead agency dealing with the
pandemic, but my office is providing the overarching
coordination.
I bring all the other State agencies and departments
together. I interface between the State and Federal
Governments. I ensure that we are all rowing in the same
direction so that we are not wasting time and we are not
stovepiped in our effort or in our commitment of resources.
So that is really, I think, from the National perspective,
FEMA brings a great role and they understand emergencies on a
National scale. They have relationships with all the State
directors and they go down to the local.
All disasters are local, and we have to look at it from
that perspective, how these events are impacting local
governments and State governments.
So I think that FEMA has got that ability to look at the
big picture and make sure that action plans and the direction
of the Federal Government are in the best interest and support
of State and local governments.
Mr. Payne. Thank you.
Mr. Currie, what impact does constantly shifting who bears
responsibility for response activity have on the Federal
Government's ability to effectively manage a Nation-wide
emergency?
Mr. Currie. Well, I think the roles and responsibilities
being clear is critical in this case. I think, just to go off
some of the prior responses to your questions, I think we were
victims of past successes in other situations.
You know, typically in situations like H1N1 and Ebola and
Zika and everything we have had over the last 50 to 60 years,
HHS and CDC have been able to handle the response to those
public health emergencies.
So, because of that, the structures we have had in place to
deal with public health emergencies and pandemics is focused on
their role and their responsibilities, which is appropriate.
They have the medical expertise necessary.
But what is clear in this case is they did not have the
logistical capability that was required in a large pandemic.
So moving forward, I think the key is going to be for us to
figure out what new structures and new processes and roles and
responsibilities need to be in place to handle the rest of this
pandemic, and hopefully we don't have one, but one in the
future as well.
Mr. Payne. Thank you.
Also, Mr. Currie, how do you think deficiencies hindered
FEMA's ability to properly develop and execute procurement
strategy for COVID-19 given the scale of staff work on these
issues? What is the No. 1 outstanding recommendation you think
that FEMA needs to address?
Mr. Currie. Well, a couple come to mind in this case. The
first is I will throw out the contracting issue, which has been
a huge challenge. Chairman Thompson pointed this out in his
opening statement. After Hurricane Maria, we had challenges
trying to fill needs for tarps and other things.
So in a huge disaster this is very typical, where you have
exhausted all your preexisting advance contracts and so you go
out looking for anybody that can fill those things, and it is
not surprising that you come across contractors that don't have
the capability.
So I think we have got to get better in FEMA working with
the States on advance contracting and existing contracts to
handle these types of things, especially in a pandemic
situation where cases are going up and down in certain places,
more tests are needed in some places and less in others. It is
a constantly-evolving situation and unless we have advance
contracts that can scale where the need is [inaudible].
Mr. Payne. I know my time has expired. I yield back.
Ms. Torres Small. Thank you.
The Chair will now recognize other Members for questions
they may wish to ask the witnesses. As a reminder, I will
recognize Members in order of seniority, alternating between
Majority and Minority. Members are reminded to unmute
themselves when recognized for questioning.
The Chair recognizes for 5 minutes the gentleman from
Louisiana, Mr. Higgins.
Mr. Higgins. Thank you, Madam Chairwoman and the Ranking
Member and my colleagues on both sides of the aisle. It is
wonderful to see you all, and I look forward to return to
regular order where we can meet in person.
Madam Chairwoman, America's supply chains should be based
out of long-term dependable trade partners in the United States
or with stable, reliable nation-states based upon relationships
similar to USMCA.
The dependability of our supply chains, especially as it
regards to things like PPE in response to something like this
we have never seen before, this challenge that we are together
overcoming one way or another is going to make us stronger, and
I believe our supply chain is a primary example of that.
These supply chains should be multi-layered, in my opinion,
and many of my colleagues agree, established by the Federal
Government, by State and local governments, and by private
business end-users that have, generally speaking, established a
just-in-time, very efficient, economically efficient, but in
response to a pandemic, where Nation-wide we need untold,
previously-unimagined volumes of PPE, the just-in-time model
just doesn't work.
Now, I must say that there have been some rather ugly
things stated about our executive, who has responded, in my
opinion, by rebuilding the Federal infrastructure. It has been
incredibly re-envisioned and greatly enhanced over the last 6
months in a robust response to a new and aggressive virus born
of China and knowingly released across the world as the Chinese
Communist government concealed their actions.
President Trump and Vice President Pence have done an
incredible job to literally rebuild America's pandemic response
infrastructure. This is something we have never seen before.
May I say that our President inherited a system that was set up
by previous Presidents, not to blame President Obama and Vice
President Biden, nor President Bush. But previous
administrations had established a system that President Trump
inherited and we just didn't see this coming as a Nation.
So I think it is fair to be critical, and it is our job to
provide oversight, but let us take a step back from the
political abyss that we stare at and give a fair evaluation of
what our executive has done and how they have performed.
Ms. Torres Small. Mr. Higgins, I deeply apologize. I would
never want to interrupt your time normally, but due to
technical issues we need to recess.
Members, please remain on the platform. The committee will
stand in recess subject to the call of the Chair and your time
will be restored.
Mr. Higgins. Thank you, ma'am.
Ms. Torres Small. Apologies.
We are in recess.
[Recess.]
Ms. Torres Small. The committee will reconvene.
The Chair now recognizes for 5 minutes the gentleman from
Louisiana, Mr. Higgins.
Mr. Higgins. Thank you, Madam Chairwoman.
Let me say that I very much admire and greatly respect you.
You have been the face of calm and reason during this
technological challenge. It is very clear to me and to my
colleagues on both sides of the aisle, I am quite sure, why the
people of your district have placed their faith in you.
That being said, I am going to be submitting my opening
statement and question in writing. I am being pulled to another
Congressional obligation at this time. I will be yielding the
balance of my time to the Ranking Member.
But before I do so, let me say that, despite the best
efforts of our colleagues, I say again that I call upon the
Majority to consider allowing the House to return to regular
order and voting in person. Let's step away from proxy voting
and remote committee appearance. Because, again, despite the
best efforts, the technology is not quite there yet.
I would say that we need to be in person regardless, but
during a time of emergency, it could be foreseen that this is
required. We have learned a great deal.
However, I will be continuously calling for the return to
regular order. It is within the Constitutional parameters that
I believe we should serve.
You have been fantastic during this hearing and this
challenge. I apologize to our witnesses. I will be yielding the
balance of my time to the Ranking Member.
I yield now.
Mr. Crenshaw. Thank you, Representative Higgins. I couldn't
agree more. I think the way you presented your case is exactly
right. This not a hit on this subcommittee at all. This is a
hit on the entire Congress. It has to stop.
We all know full well, we are all common-sense people, we
all know that we could do this in person and show the American
people that we have just a modicum of courage, just a little
bit. It would be easy. We don't have to all congregate in there
at the same time. Usually we don't anyway. Most of us watch
from our office and then go in when it is our turn to ask
questions. We could easily socially distance. We could wear
masks. We could take all the proper precautions. We could
easily do this. Yet, our House of Representatives has chosen
not to.
This isn't the first time we have had technical problems.
Of course we are going to have technical problems. Many other
committees have it and we have had it in this committee as
well.
Again, this is not the Chairwoman's fault. This is
leadership from the top.
This is more than just about technical problems. It is
about the ability to demonstrate to the American people that we
have just a little bit of courage, just enough to actually show
them that we are willing to take the slightest amount of risk
just to do our jobs, so that we can actually hear our witnesses
instead of the garbled robotic mess that it sounded like at
times when I was trying to listen to them. We could actually do
our jobs.
But we have sort-of reversed what it means to have a sense
of duty in this country. Whereas it used to mean that we looked
up to our heroes who overcame adversity and looked back on
their hardship and said, ``Look what I did, look what I
overcame,'' now we seem to elevate victimhood as a virtue. We
say, ``Look at the problems we face. And look at us, we must
hide. And that is virtuous, that is heroic.''
It is not heroic. We look like fools. We need to stop. We
need to do better.
We can easily do this. We all know how. We all know we
could.
I think that we should be asking our leadership to put us
back into Congress, in person. Stop the vote by proxy. We know
we can do this safely. We have learned enough about this virus.
We can do this by now. We could demonstrate to the American
people that we are in this together and that we are willing to
do our duty and do our job. It really is as simple as that.
This is a highly unnecessary technical mess that we have
involved ourselves in and I hope we stop.
I yield back the remainder of my time.
Ms. Torres Small. Thank you, Mr. Ranking Member.
The Chair now recognizes for 5 minutes the gentlewoman from
Illinois, Ms. Underwood.
Ms. Underwood. Thank you, Madam Chair.
As a public health nurse, I have been disappointed and,
quite frankly, horrified by this administration's failure to
equip our health care professionals and others on the front
lines of this pandemic with the supplies that they need to stay
safe while doing their jobs.
Thirteen of my colleagues from the Illinois delegation
joined my letter to the President back in March urging the
administration to lead a coordinated National plan to procure
and deliver PPE where it was needed most. Even in March, we
were already getting tearful phone calls from Illinois nurses
who had worn the same single-use mask for 5 days straight. This
is unacceptable.
Yet somehow, 4 months later, we find ourselves still unable
to obtain and distribute essential supplies to meet our basic
needs. This is a colossal failure of leadership with truly life
and death consequences.
I am glad our witnesses are here today to help us figure
out what went so wildly wrong and to discuss improvements that
need to be made.
Mr. Fugate, as you know, one of the most important supplies
for health care workers is the N95 mask, which protects the
wearer from inhaling the virus. In March, the White House
promised to deliver 300,000 N95 masks to my State of Illinois.
When the shipment arrived, the boxes were found to instead
contain surgical masks, which are looser and do not provide
anywhere near the same level of protection for the wearer as
the N95 masks.
Based on your experience overseeing emergency management at
the Federal level, what concerns does this type of mix-up raise
for you about this administration's coordination of the
National response to this pandemic?
Mr. Fugate. Well, I don't think it is so much a mix-up, I
think it is what they had available.
It goes back to my original concerns that in facing a novel
virus, we never looked at how big the numbers needed to be. I
think that is why we were not making decisions early on, such
as increasing domestic production of N95 masks, reprioritizing
that system. We just never took the steps to know how big is
this.
We always, I think, adjusted based on what was available
and tried to increase that, but we never got to what was going
to be the big number, and so we still see those impacts today.
Ms. Underwood. OK. Thank you.
Illinois is currently in phase 4 of its data-driven
reopening strategy. As more and more local businesses resume or
increase their operations, and as we prepare to safely reopen
schools this fall, we need PPE, and it is only going to
continue to increase.
Mr. Fugate, how should the administration be preparing to
meet the increasing need for PPE across the country?
Mr. Fugate. Well, yes, I think it goes back to, what is the
number we are planning against? How much domestic production
can ramp up? What can our international supply chain supply?
What is the difference of that or delta? Then what would we do
to close that gap?
Again, we know that the N95s are most critical for health
care workers. But for others, surgical masks or lesser grade
protection is actually meeting the CDC guidance.
So it comes back to, what is the big number we have got to
plan against? What is our capability domestically? What is our
international supply capability? What is the difference? Then
what steps can we take to close those gaps?
Ms. Underwood. In addition to the administration's own
failure to provide the correct materials, another challenge our
front-line workers and State leaders have had to contend with
is fraud.
An investigative journalist at ProPublica broke a story
last month about an operation that repackaged non-medical grade
masks to remove the ``medical use prohibited'' warning and then
they sold those repackaged masks to a Texas emergency manager
for use in hospitals.
When the reporter contacted Homeland Security
Investigations to ask about this case, his replied only that
they are trying to, ``determine if any violations exist or
mishandling occurred''.
Mr. Fugate and Mr. Ghilarducci, can you each expand on why
the proliferation of fake equipment is so dangerous? What role
does a successful Federal response play in preventing this?
Mr. Fugate. Well, this goes back to when you have
shortfalls in critical supplies people will attempt to use that
to provide products that may not meet the standards.
As we saw with that investigation, in a grey market area it
is not always clear what the violations were. If we had a
better handle on domestic production and it was more regulated
I think we could address some of these concerns.
But at the time that FEMA and others were going out
procuring, there was not time to go out and do due diligence.
Almost all of that was done electronically. So it wasn't until
you actually had product showing up that in many cases you
found out that it wasn't what the teams thought they were
ordering.
Ms. Underwood. Well, at the end of the day scammers will
take advantage of unmet consumer needs. Right now we see
scammers providing everything from fake tests to useless PPE.
Especially in the middle of a global pandemic the
responsibility should not be on consumers to authenticate their
PPE or tests.
With that, I yield back. Thank you.
Ms. Torres Small. Thank you.
The Chair now recognizes for 5 minutes the gentleman from
North Carolina, Mr. Bishop.
Mr. Bishop. Thank you, Chairwoman Torres Small, very much.
I think I want to follow up, Mr. Fugate, on the questions
Ms. Underwood just asked. There seems to be--and I had occasion
to ask a question of Governor Pritzker about this--there seems
to be a sort-of a chorus of condemnation of the administration
for not having an overall coordinated response. It seems to be
mostly connected to the question of how much PPE has been
available.
But you can't just wish PPE into existence and put it in
the right spot. Isn't that correct?
Mr. Fugate. That is absolutely correct.
Mr. Bishop. You just explained in response to Ms.
Underwood's question that having a quantity of PPE to meet a
sudden huge need is a logistics problem, that you have got to
get production capacity in place. If it is not sufficient, you
have got to add to it. You have to figure out from a disparate
number of economic actors across our economy and maybe the
economy around the globe how to get items produced that don't
currently exist and then get them delivered to the right place,
correct?
Mr. Fugate. Yes, sir.
Mr. Bishop. Is it necessarily so that a Federal, any
Federal administration, yours or the current one, faced with an
unprecedentedly large demand that is sudden, is necessarily
going to get that problem solved faster by taking control of
the entire market through the Defense Production Act or the
like?
Mr. Fugate. When we war gamed what a pandemic looked like,
that turned out to be our only option. It is a drastic tool. It
has lots of disruption.
However, what we found was, because we had built a just-in-
time health care system, it was going to take a draconian tool,
like the Defense Production Act, to even begin to meet the
needs, and then there was not going to be a rapid response to
it.
So it would have to be turned on relatively early when
their numbers often wouldn't justify that action, but by the
time the numbers did, we were too far behind.
As we had explored this, this became one of the themes.
Failure to turn on Defense Production Act early, your strategy
now became one of hope you could meet demand. Turn it on early,
you could meet demand, but if there wasn't a need for it, it
caused a big disruption.
So it is not a precise tool. It goes back to the whole
issue of there is no slack in the system for health care. That
exacerbates what we are seeing now, that there wasn't even
reserves to start with in most of the health care industry
because everybody is just timing delivery, those stockpiles,
they don't prepare for this, and the Federal Government became
the default for this.
Mr. Bishop. I appreciate your candor in having described
that now a couple times, that the issue is one of many years in
the making. I think it is unfortunately very counterproductive
to go try to assess blame on that. The decisions are what they
are. It is a resource allocation issue. It has existed for
many, many years.
But let's take, for example, because it seems to persist,
the notion, as you say, that using the DPA would be your only
tool, but it wouldn't necessarily in the short term mean that
you could be sure from that decision point at the beginning of
the crisis that you were going to produce more in the short
term by using that than in allowing market mechanisms to
function. Isn't that so?
Mr. Fugate. No, sir. Market mechanisms are why we are in
the situation we are with a just-in-time delivery system. It is
the most cost-effective way to run it. It doesn't return to
shareholders. An inefficient system would have had a lot more
capacity to ramp up.
DPA actually does not start out with taking over
manufacturing. The first thing, which was early on, DPA gives
the Federal Government to go out and procure very large
quantities and also prioritizes those products being
domestically produced or coming into the country where they are
needed most.
That can happen immediately with DPA. We used it during
Superstorm Sandy to get interpreters.
So it is a tool that gives you immediate response if there
is product there, and that ultimately gives you the ability to
redirect industry to meet a strategic need that otherwise would
not have been met if you only went to a driven capital system.
It hasn't built that capacity. There is no reason why you
would have excess capacity unless you had some incentives,
either through tax credits or guaranteed markets that required
to you purchase that. It is not fair to industry to say you
should solve this problem if we are not going to build in the
tools to ensure production exists.
Mr. Bishop. So you are talking about a long-term incentive
solution, though, that would build more capacity to be in place
over the long-term, correct?
Mr. Fugate. Yes, sir. Pandemics are just one example of our
global supply chain, the vulnerabilities we have in critical
infrastructure when we depend upon global supply chains where
the suppliers may not always share our views or interests.
Ms. Torres Small. Thank you, Mr. Bishop.
The Chair now recognizes for 5 minutes the gentlewoman from
California, Ms. Barragan.
Ms. Barragan. Thank you, Madam Chairwoman.
Thank you to our panelists for being here today.
As I have heard the testimony, I am a little surprised to
be hearing so much of how wonderful the response was or how it
couldn't have been done better.
I have heard and have read a lot differently. I have read a
lot more about the administration's failures early on. In late
January, we had Dr. Bright warning about the lack of PPEs,
having to ramp it up quickly. Those calls went ignored. We had
the President basically saying this thing was going to go away,
it was going to disappear, making the mask very politicized.
So there have been a lot of failures with this
administration, which is why I think it is so critical that we
have these hearings and we make sure we don't repeat what has
happened here, and that we be honest with the American people,
because honesty will save lives. Even if we don't like what the
outcome is going to be or what people's fears are, we have to
address those.
I want to direct my first question to you, Mr. Fugate.
As part of the response to homelessness during COVID-19,
FEMA has committed to reimburse 50 to 75 percent of expenses
for shelter and temporary housing through the Public Assistance
Program Category B. However, some local governments and
agencies, like the Los Angeles Homeless Services Authority,
have expressed challenges with the FEMA program, such as not
knowing whether the program will be extended for the coming
months.
Along the same lines, they have been told that it could
take 4 to 5 years for localities to receive FEMA
reimbursements.
Mr. Fugate, in your experience as the former administrator,
is there anything FEMA could be doing to better notify
localities if programs will expire or be extended?
Mr. Fugate. Yes. This goes back to--and I am sure Director
Ghilarducci can amplify this--is if FEMA is given the authority
to extend this--again, these declarations are at the direction
of the President, so the White House would have to concur--they
could give guidance to States what the programs are, what the
likelihood of being extended are.
As far as reimbursement goes, yes, it can be a long time.
It can also be done in 2 weeks, which we did in Hurricane Isaac
in the city of New Orleans for their overtime.
So FEMA doesn't have to take forever to move the money, but
there has to be an understanding that the faster FEMA moves
money, the greater risk there will be of errors and the
potential that there may be a requirement to seek
reimbursements back.
I think the other thing is the cost share is something that
should be factored in, that it is 75 percent Federal, it is
never going less than 75 percent. But the cost share going up
to 100 percent may also be required in those jurisdictions that
are seeing both impacts of COVID-19 demand as well reduction in
income.
Ms. Barragan. Thank you, sir.
Along the same lines, last week the mayor of Tupelo,
Mississippi, testified that they are still waiting on
reimbursements from FEMA after a 2014 tornado caused major
damage to the city. That was 6 years ago.
Can we expect localities to wait this long for FEMA
reimbursements? How can we speed up the process to ensure that
local governments quickly receive their reimbursements?
Mr. Fugate. We were doing reimbursements and still doing
reimbursements for Hurricane Katrina in New Orleans. In fact,
in my last year at FEMA we were approving a million-dollar
grant on a waste water treatment system, a waste water system.
So the rebuilding process is reimburse, ask, and build
back. That can take a while.
I am more concerned about the immediate cost, which is
protective [inaudible] response cost, that FEMA should be
moving that money out very quickly. Congress has provided the
funding.
But this may be something our friends at the General
Accounting Office can weigh in on, is sometimes we get so
fearful of making mistakes we slow the process down with
bureaucracy instead of focusing on getting money out quickly
and cleaning up later with controls in place. Sometimes there
is just such a fear of making mistakes we end up holding so
much process we never seem to get the money out quickly.
Ms. Barragan. Thank you, sir.
Mr. Ghilarducci, California was one of the first States
faced with managing with the coronavirus, especially as it
received repatriation flights and returning cruise ships when
the outbreak began.
Can you tell us more about the evolution of your
coordination with the Federal Government on response efforts?
Did you notice a difference once FEMA took over as the lead?
Mr. Ghilarducci. Thanks for the question.
So California was engaged early on when the first
repatriation flights were brought back in. We worked with the
Department of State initially and then Health and Human
Services agency first to set up our repatriation center in one
of our airports in southern California, Ontario.
It became clear pretty quickly that that wasn't going to be
sufficient. We needed brick-and-mortar facilities to keep
people separated.
That was our first indication that the virus and the
[inaudible] were happening in China and the repatriation
members that were coming back could be potentially sick. So we
worked to get brick-and-mortar barracks at March Air Force Base
initially for the repatriation. That of course then extended
into Travis Air Force Base in northern California and then
Miramar Naval Air Station.
Ms. Torres Small. Mr. Ghilarducci, I appreciate it.
I apologize, the gentlewoman's time has expired.
The Chair now recognizes for 5 minutes the gentlewoman from
New York, Ms. Clarke.
Ms. Clarke. Thank you very much, Madam Chair.
Let me thank our Ranking Member, Mr. Crenshaw, and
Congressman Donald Payne, Jr. of New Jersey for the leadership
that they are showing.
Let me thank our expert witnesses as well.
Being a New Yorker, I think that I have a very unique lens
into the response of the administration. At the beginning of
the COVID-19 pandemic I signed a letter calling on the White
House to invoke the Defense Production Act to meet the
shortfall of PPE and other official supplies--other critical
supplies facing my district.
The people of New York City were hit first by this
pandemic. As we cried out for PPE and ventilators, our pleas
were met with a collective shrug from the administration.
By the time of the Defense Production Act, the limited way
in which it was utilized, was finally invoked, frankly, it was
too late.
As the case numbers begin to rise again across this Nation,
we are once again finding this administration, I believe,
asleep at the wheel.
We have had months to prepare, but comprehensive contact
tracing is still far from a reality, and even basic supplies
are once again in short supply.
For example, FEMA repeatedly touted Project Airbridge as a
success story in accelerating the importation of critical PPE.
FEMA has indicated that at least 50 percent of those supplies
were directed to hotspot areas.
But there has been a serious lack of transparency to
confirm this actually occurred. Despite repeated requests, we
have yet to receive information on where the supplies went and
other basic details, like how long it took to coordinate each
flight.
You know, I will tell you that it is important to have this
transparency, because we are getting word on the ground,
particularly in the height of the pandemic, that FEMA was
actually redirecting critically-needed supplies that were
intended for one portion of the Nation to other portions of the
Nation. I don't know whether that is true or not, but having
transparency about what took place would answer those
questions.
So my first question is for Director Ghilarducci.
How effective was the Airbridge in helping to meet your
State's supply needs? Were you given any insight into where
these supplies went or whether a county in your State was
deemed to be a hotspot for the sake of the program to better
coordinate the State's efforts to surge PPE into communities?
Mr. Ghilarducci. Thanks for the question.
So Operation Airbridge eventually became a helpful tool.
Initially it was not coordinated with the States. It was not
communicated effectively. We did not know where PPE would be
distributed to.
Quite frankly, the Airbridge effort actually enhanced the
competition by which the States were having to deal with. In
essence, Operation Airbridge cornered the market in any
available PPE that we could possibly get.
So I think in the end, if it was a more coordinated and
communicated effort and that PPE was brought in as a central
capability that we could have all benefited by, it would have
worked much better. But, unfortunately, it did not work that
way.
Ms. Clarke. All right.
Administrator Fugate, I want to echo the sentiments of my
colleagues. We appreciate your years of service, your
dedication, and your focus.
In many respects, as all of my colleagues have indicated,
you were sort-of blindsided by the scope and breadth and depth
of what we have had to deal as a Nation with respect to the
coronavirus and its spread.
But how does Project Airbridge compare to your experience
establishing public-private partnerships while at FEMA
throughout your tenure?
Mr. Fugate. Well, if you remember during Superstorm Sandy,
one of our challenges was getting utility trucks into the area
quickly. President Obama held a conference call with utility
companies. He said, if we have got equipment on the West Coast,
but it's going to take us a week or more to get it to the East
Coast, can you call us?
So FEMA coordinated with the Defense Transportation
Command. We used C-17s from the time of that call to the first
touchdown of those trucks. It occurred within 24 hours.
So we have worked with the private sector. In fact, we look
at the private sector as part of the team. We have used
[inaudible] assets, including DOD assets, to move equipment
from the private sector to achieve an outcome, which was
getting utilities turned on faster in Superstorm Sandy.
Ms. Clarke. Very well. I yield back. I thank you, Madam
Chair, for this very timely hearing. These important findings
will make a difference in life and death across this Nation. I
thank you, and I yield back.
Ms. Torres Small. Thank you Congresswoman Clarke.
The Chair now recognizes for 5 minutes the gentlewoman from
Texas, Ms. Jackson Lee.
Ms. Jackson Lee. Thank you very much, Madam Chair, for your
kindness and generosity in yielding to me. I am here in one of
the major hotspots of COVID-19, and we are not really seeing an
end, which I think is the uniqueness of COVID-19, is that both
science and medicine have now understood that it is not a virus
that they control. The virus controls us.
But we know that the basic elements of it are the
initiatives that we had, are cleanliness, sanitizing, gloves.
Eyewear has come into play, as I am wearing right now. Masks
and mandatory mask orders.
But we also know that in the system of logistics and
equipment we suffered greatly in being prepared. We suffered
greatly with no PPEs. We were fighting--and I really mean it--
fighting for masks. We were seemingly on markets that were
impossible to penetrate in terms of trying to get PPEs.
Of course the big one was test kits, test kits, test kits.
I would hear from my colleagues across the Nation: ``Where are
the test kits? I can't get any.''
Administrator Fugate, we have worked together in the past
over the years with hurricanes. I think, if I know you well,
your key definition is preparedness.
I would like to hear again, in light of Texas over 235,000
cases, now moving up to 6,000 deaths here in Houston, 60,000
[inaudible] and the number of deaths that we have as our
numbers continue to grow. I have a hospital right now where we
are getting the military team not in the hospital, but working
through a hospital where a military team will be coming to add
to our needs here in terms of staffing.
Administrator Fugate, can you speak to the absolute
crucialness of strategic plans, particularly on unknown
disasters like a COVID-19, and the importance of early on
developing a plan for equipment, which would include please
testing, which I understand that people in Florida right now
are fighting to get tests?
Mr. Fugate. Thank you, Congresswoman.
You know, it may sound trite, but what I have learned in
disasters is by the time you know how bad something is, it is a
little late to achieve the outcome. I learned this a long time
ago and it is a simple process. It may sound trite but it works
for me.
First thing is, define the disaster, think big. Don't try
to wait until you have all the information, just go, how bad
could it be? Then continue to go big. You have got to start
ordering your resources and personnel for that event and
looking at shortfalls and capacity. You need to go fast. The
more precision, the better you wait for information, the slower
you get.
The last part is be smart about it. As the numbers start
coming in, adjust. Hopefully you are adjusting downward. But
you never get time back in a disaster.
Again, as far as this being unforeseen and unprecedented, I
actually helped set up an exercise back in January in the State
of Florida, a no-notice exercise on COVID-19.
I think we have had a lot of missed opportunities. I think
this has gotten to a point where nobody wants to talk about
what didn't work.
I think we also need to consider something like a National
Transportation Safety Board-style committee that is standing,
that is not partisan, to review these types of events, to learn
lessons so they don't become lessons observed but are actually
then implemented in the changes to change future outcomes.
Ms. Jackson Lee. Administrator, if I could very quickly, my
research and testimony that I secured in the Homeland Security
Committee hearing was that the administration actually was
aware of COVID-19 as early as October 2019, which means we
should have long since had some kind of discernible plan.
But there are two issues that I would like your comment on.
I know already that you are not an educator but a great public
servant.
The issue of tests, test kits, that became almost of crisis
proportion with people really literally in the streets trying
to beg for test kits, trying to get States to get test kits. It
was unbelievable. We are now with lines of people in different
cities trying to get test kits.
It emphasized when you have something that is so
strategically important to fighting back the disaster which is
COVID-19, how important it is to get ahead of that.
Then any comment on what elements we should look at as
school districts across the Nation want to do the best thing
for their students in light of the circumstances that you see.
You are not a physician, I know that, but in terms of being
prepared.
Thank you. Thank you for your service.
Mr. Fugate. The test kits are really critical if we can get
containment. When we are seeing the infection rates we have
now, I don't think testing is going to change the outcome. If
we get containment and then we can test people and isolate
people that are exposed, we will get this under control.
But if we can again go back to [inaudible]. How big and how
much would you need in a worst-case scenario? Not what the plan
says, not what you think you are going to need, but just go,
``How bad could this be?'' and then start working backward.
Ms. Torres Small. Thank you, Mr. Fugate.
Ms. Jackson Lee. Thank you for the courtesy.
Ms. Torres Small. Thank you, Congresswoman.
I so appreciate everyone's patience in the midst of all of
this. I know we have a hard out at 12:30.
So I just want to close by thanking the witnesses for their
valuable time, patience, and testimony.
I want to thank all the Members for their questions,
patience, and dedication to serving their districts. I deeply
respect my colleagues and I do not judge any differences we may
have in opinion for a lack of courage in the way they serve
during this crisis that we face together.
The Members of the subcommittee may have additional
questions for the witnesses and we ask that you respond
expeditiously in writing to those questions.
Without objection, the committee record shall be kept open
for 10 days.
Hearing no further business, the hearing stands adjourned.
[Whereupon, at 2:28 p.m., the subcommittees were
adjourned.]
[all]