Medical Aspects of Chemical Warfare (2008) - The Black Vault

Domestic Preparednessefforts led to the formation of a senior interagencygroup on terrorism, chaired by the Federal EmergencyManagement Agency (FEMA). This group coordinatedfederal policy issues among agencies and withstate and local governments. 4 At this time the Departmentof Defense (DoD) outlined its responsibilities,oversight, and execution plan aimed at preparednessand response.Section 1412 of Title XIV directed and equipped thesecretary of defense to carry out a program providingcivilian personnel of federal, state, and local agencieswith training and expert advice regarding emergencyresponses to the use or threatened use of a WMD orrelated materials. 3 This policy became known as the“120 Cities Program” and focused on improving coordinationbetween emergency response planners andexecutors at the 120 largest metropolitan centers in theUnited States. Section 1413 directed and equipped thesecretary of defense to coordinate DoD assistance tofederal, state, and local officials when responding tothreats involving biological or chemical weapons (orrelated materials or technologies) and to coordinatewith the Department of Energy for similar assistancewith nuclear weapons and related materials. 3 Section1415 directed and equipped the secretary of defenseto develop and carry out a program for testing andimproving federal, state, and local responses to emergenciesinvolving biological weapons and relatedmaterials. Section 1416 directed limited DoD supportto the attorney general and civilian law enforcementin emergency situations involving biological or chemicalweapons. 3 The preexisting Federal Response Planassigned specific emergency support functions (ESFs)to the DoD in the event of a local incident of sufficientmagnitude to involve federal assets. Public Law104-102 therefore expanded and clarified the DoD’sresponsibilities to prepare the nation’s emergencyresponse assets for a chemical, biological, or radiologicalincident and also clarified the nature of the DoD’scooperative relationships with other agencies. In 1999many of those responsibilities transferred to the USDepartment of Justice.Domestic Preparedness After September 11, 2001By September 11, 2001, many domestic preparednessinitiatives and programs were already in place,but a coordinated response effort was lacking. 3,5,6 Theresponse following September 11, 2001, demonstratedgaps in existing policy and practice as well as the needfor a more expanded approach, more unified structure,and closer coordination. Creating the White House Officeof Homeland Security on Oct 8, 2001, was the firststep toward improving the US emergency responseposture. The office published the National Strategy forHomeland Security in July 2002. This strategy providesguidelines and a framework by which the federal, state,and local governments, as well private companies andcivilians, can organize a more cohesive response networkfor the nation. As part of the strategy, PresidentGeorge W Bush established the US Department ofHomeland Security (DHS) in June 2002 to unite effortsacross different agencies involved in homeland securityand “clarify lines of responsibility for HomelandSecurity in the Executive Branch.” 7National Strategy for Homeland Security andHomeland Security Presidential DirectivesOn October 29, 2001, Homeland Security PresidentialDirective 1 was issued, becoming one of the first directivesto increase the security of US citizens by organizinga homeland security council. 8 The homelandsecurity council’s overarching role is to ensure there iscoordination between all executive agencies (eg, secretaryof defense, US Department of Health and HumanServices [DHHS], US Federal Bureau of Investigation,DHS, etc) involved in activities related to homelandsecurity. Homeland Security Presidential Directive 3 wasissued in March 2002, directing the homeland securityadvisory system to provide a comprehensive means todisseminate information regarding terrorist acts. 9 Thissystem, administered by the DHS, provides currentinformation related to threats and vulnerabilities andprovides the information to the public. The DHS communicatedthis information by means of a color-codedthreat condition chart (Figure 23-1). 9With more than 87,000 distinct jurisdictions, theUnited States faces a unique challenge when coordinatingefforts across federal, state, and local governments.In February 2003 the president issued Homeland SecurityPresidential Directive 5. 10 This directive established theDHS as the lead federal agency for domestic incidentmanagement and homeland security. The secretaryof homeland security coordinates the federal government’sresources to prevent, prepare for, respond to,and recover from natural and human-made disasters.The National Strategy for Homeland Security provides thedirection and framework for all government agenciesto follow that have roles in homeland security. 7National Incident Management System and theNational Response PlanIn 2003, under Homeland Security Presidential Directive5, the secretary of homeland security was taskedto develop and administer the National Incident755