[Senate Hearing 107-292]
[From the U.S. Government Publishing Office]
S. Hrg. 107-292
EMERGENCY PREPAREDNESS
FOR THE ELDERLY AND DISABLED
=======================================================================
FIELD HEARING
before the
SPECIAL COMMITTEE ON AGING
UNITED STATES SENATE
ONE HUNDRED SEVENTH CONGRESS
SECOND SESSION
__________
NEW YORK, NY
__________
FEBRUARY 11, 2002
__________
Serial No. 107-18
Printed for the use of the Special Committee on Aging
U.S. GOVERNMENT PRINTING OFFICE
77-851 WASHINGTON : 2002
____________________________________________________________________________
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SPECIAL COMMITTEE ON AGING
JOHN B. BREAUX, Louisiana, Chairman
HARRY REID, Nevada LARRY CRAIG, Idaho, Ranking Member
HERB KOHL, Wisconsin CONRAD BURNS, Montana
JAMES M. JEFFORDS, Vermont RICHARD SHELBY, Alabama
RUSSELL D. FEINGOLD, Wisconsin RICK SANTORUM, Pennsylvania
RON WYDEN, Oregon SUSAN COLLINS, Maine
BLANCHE L. LINCOLN, Arkansas MIKE ENZI, Wyoming
EVAN BAYH, Indiana TIM HUTCHINSON, Arkansas
THOMAS R. CARPER, Delaware PETER G. FITZGERALD, Illinois
DEBBIE STABENOW, Michigan JOHN ENSIGN, Nevada
JEAN CARNAHAN, Missouri CHUCK HAGEL, Nebraska
Michelle Easton, Staff Director
Lupe Wissel, Ranking Member Staff Director
(ii)
C O N T E N T S
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Page
Opening Statement of Senator Larry E. Craig...................... 1
Panel I
Hon. Benjamin A. Gilman, A Representative in Congress from the
State of New York.............................................. 3
Josefina G. Carbonell, Assistant Secretary for Aging, U.S.
Department of Health and Human Services........................ 6
R. David Paulison, U.S. Fire Administrator, Federal Emergency
Management Agency.............................................. 20
Stephen Ostroff, M.D., Associate Director for Epidemiologic
Science, National Center for Infectious Diseases, Centers for
Disease Control and Prevention, Department of Health and Human
Services....................................................... 22
Alexander Parzych, Assistant Chief of Fire Prevention............ 35
Richard Sheirer, Director New York City Office of Emergency
Management..................................................... 36
Wayne Osten, Director, Office of Health Systems Management....... 38
Igal Jellinek, Executive Director, Council on Senior Centers and
Services of New York........................................... 41
Michael Benfante, Employee of Network Plus....................... 44
Andrea Dale, Visiting Nurse Service of New York.................. 49
APPENDIX
Information on Emergency Evacuation Devices...................... 83
(iii)
EMERGENCY PREPAREDNESS FOR THE ELDERLY AND DISABLED
----------
MONDAY, FEBRUARY 11, 2002
U.S. Senate,
Special Committee on Aging,
New York, NY.
The committee met, pursuant to notice, at 2 p.m., at 5 Penn
Plaza, Room 302, New York, NY, Senator Larry Craig, presiding.
OPENING STATEMENT OF SENATOR LARRY E. CRAIG
Senator Craig. Ladies and gentlemen, if I could have your
attention. We will start this hearing on the Special Committee
on Aging of the U.S. Senate. First and foremost, let me thank
all of you so very much for being with us today. We view this
as a very special hearing to hear from New York City, and to
have you share with us some of the things that you have learned
in the last several months.
Five months ago today attacks on America began right here
in this city: First at the World Trade Center as, of course,
you all know. Many of you who are New Yorkers may well have
experienced it visually and in reality firsthand. Then, of
course, down in a city where I spend a fair amount of my time,
Washington DC., and the Pentagon. These attacks on America I
think changed all of our lives in some way and many lives and
many institutions in major ways. I suspect none of us will ever
forget that tragic day.
I came here shortly after the attacks with my friends and
colleagues from the U.S. Senate. We stood in shock and in awe
at Ground Zero and what we saw with the devastation that was
clearly evident there. I chose to come back here today so that
we could look at some of the expertise and some of the finest
emergency response that clearly went on during that time that
the world is now well aware of. I think New Yorkers learned
much about the tragedy of September 11, and I want to hear what
you have learned as it relates to the seniors, the elderly, and
the some of the infirm of America and what we might learn
better so that the Special Committee on Aging can turn to
people like Governor Ridge, who is now heading up homeland
security, and we might offer suggestions and even propose
regulation changes or law changes to some of our agencies as it
relates to all of that.
Well, there are all heroes, but there are some heroes here
today, Michael Benfante--there are many more just like him,
people who help strangers in a time of need, and I could go on
and on as it relates to some of the wonderful things that
occurred in this city.
Abe Zelmanowitz, we want to recognize him, the work he did
on behalf of a friend, a paraplegic in a wheelchair, and all
that is now part of the history of September 11. These were
heroes: The firemen who arrived at the scene, many who gave
their lives; we all know about that now, and we will never
forget it, and we will continue to honor it. They were and are
brave men and women who responded in the line of duty.
According to a poll commissioned by the National
Organization On Disability last November, 58 percent of people
with disabilities say they do not know who to contact about
emergency plans for a community in event of a terrorist attack
or other crises. In other words, we are just beginning to learn
that there is a whole community of people out there who find
themselves or feel increasingly vulnerable as a result of
September 11. Sixty-one percent say that they have not made
plans to safely or quickly evacuate their own homes, and it
goes on and on. Well, those are some of the issues that we will
talk about today with the panels that we have assembled, and I
want to thank you all so very, very much for coming.
The first person who is with us today, I am very proud that
he had the time to join us because he is a gentleman I got to
know a long while ago. I served in the House for 10 years, and
during that period of time I got to know and appreciate
Congressman Ben Gilman from here in your area.
Ben has been one of those great public servants who
constantly gives of his time and his talent to all of his great
State and now to the Nation, and I was extremely pleased that
Ben would join us today and to become a part of a panel not
only to give testimony, but to sit here at the dais with me
and, Ben, I will tell you that you can question and participate
just like this was a joint House and Senate hearing because
that is what we are going to make it with Ben's presence here.
Let me also thank my chairman, John Breaux of Louisiana,
for allowing me to bring the committee up here today for what I
think is an extremely valuable hearing. Then what we are going
to do because of the character of the way we set this room up
so that you are all a part of it in a somewhat roundtable
discussion, I am going to work my way around the room and
introduce you and receive your testimony and then, as I ask
questions this afternoon, while some of them might be specific
to you as an individual in your expertise, please feel free to
add to or join in as questions are asked and you feel you have
additional information to offer.
I would also tell you that all of your written testimony is
a part of the record and will be reviewed by the committee and
can be reviewed by all Senators because it is a part of our
committee record. So, we again thank you all so very much for
being with us this afternoon. We will keep our hearings on
schedule and on time; we will make every effort to do that.
Now let me turn to a good friend over the years and I know
one of your very best in Washington and here in New York,
Congressman Ben Gilman. Ben, thanks so much for being with us.
[The prepared statement of Senator Larry Craig follows:]
Prepared Statement of Senator Larry Craig
Good afternoon. Thank you for attending today's hearing of
the Senate Special Committee on Aging. I would like to thank
the witnesses for agreeing to testify on the critical issue of
emergency preparedness for the elderly and disabled. I know
that some of you have stories of personal experiences that may
be difficult to tell, and I especially thank you for being
here.
Five months ago today attacks on America began right here
in New York City--first at the World Trade Center and then at
the Pentagon. These attacks on America changed our lives
forever. No one will ever forget that terrible day.
I came here shortly after the attacks with my friends and
colleagues from the U.S. Senate. We stood in shocked awe at the
scope of the devastation at the site of the World Trade Center.
I chose to come back here today so that we can call upon
the expertise of the finest emergency responders in the nation.
New Yorkers learned much from the tragedy of September 11 and I
look forward to hearing your testimony, ideas and suggestions
about how we can address the needs of seniors and disabled
people in future times of crisis.
We will also hear from at least one hero today, Michael
Benfante--and there are many more just like him--people who
helped strangers in a time of need. There are other heroes we
will never hear from--people who laid down their lives for
others.
One of those heroes we will not hear from--but one we
should recognize--is Abe Zelmanowitz. He stayed by the side of
his friend, Ed Beyea, a quadriplegic who used a wheelchair.
When it came time to evacuate the World Trade Center, Abe
stayed with Ed and waited with him to be rescued. Abe lost his
life waiting with his friend Ed--Abe Zelmanowitz was a hero.
There were other heroes too--the firemen who arrived on the
scene, many of whom also gave their lives for others. These
brave men and women have always put their lives on the line. It
is critical to their safety, as well as for the safety of the
rest of us, that our nation's firefighters have access to the
equipment, training, and personnel they need--and I am working
hard in Washington, DC, to make that happen.
According to a poll commissioned by the National
Organization on Disability last November, 58 percent of people
with disabilities say they do not know who to contact about
emergency plans for their community in the event of a terrorist
attack or other crisis. Sixty-one percent say that they have
not made plans to quickly and safely evacuate their home.
Clearly we must highlight the need for greater preparation
in meeting these needs.
I'd like to thank each of the witnesses for being here
today and for sharing their insights into his complex problem.
I look forward to hearing your testimony.
STATEMENT OF HON. BENJAMIN A. GILMAN, A REPRESENTATIVE IN
CONGRESS FROM THE STATE OF NEW YORK
Rep. Gilman. Thank you, Senator Craig, for your kind
invitation to join the Senate Special Committee on Aging. It
has done so much good for so many of us and keeps us all
apprised of the needs of our aging in both the Senate and the
House. I want to thank our participating panelists who are here
from the Federal Government, and the State Government and the
City Government, as well as visiting nurses and some of the
other important dignitaries who we look forward to hearing from
today.
I represent a little, small part of New York State a little
bit north of New York City in Westchester, Rockland, Orange,
and Sullivan Counties. Regrettably we had over 90 families that
lost their next of kin in the World Trade Center tragedy. And
that is why this hearing is so important as we try to learn
from the lessons of what occurred at that time. As New York
continues to recover from the tragic events of 9/11, our Nation
continues to go through the process of discerning what best we
can learn from all of that experience. It is important we
discuss the issue of emergency responses for our elderly and
our disabled. I commend this Special Committee on Aging, for
moving forward so that we can put together some better thoughts
for the future. Hopefully we won't have to need those
preparations, but better to be prepared than not prepared.
Mr. Chairman, obviously emergency evacuation procedures
need to be reconsidered. While no one before September 11 could
have envisioned the massive brutal destruction or the speed in
which it occurred, we have to recognize the special and unique
challenges which exist for our elderly and our disabled. The
World Trade Center Tower Number One and Number Two burned for
102 minutes and 56 minutes, respectively, before the top floors
of each tower collapsed onto the lower floors. Even more
incredible is the fact that 8 seconds later, the entire second
tower collapsed, and in 10 seconds Tower One followed suit.
That means that more than 50,000 individuals employed or
visiting the towers had about an hour to walk down 104 smoke
and debris-filled floors and hallways--no small task for any
young person, relatively healthy individual, let alone someone
either elderly or disabled.
All of us from the New York metropolitan area and across
the nation are grateful for the heroism displayed by our
firefighters, our police, our rescue people and emergency
personnel. Those services were taxed to the maximum, the
maximum extent possible, more than anyone could have ever
imagined prior to 9/11. And while we need to proceed forward
and determine our best to reconfigure current emergency
preparedness plans, we should make certain that we pay careful
attention to addressing this specific and different needs which
exist for the elderly and disabled, and that is why I am so
pleased to join Senator Craig today as we address this problem.
However, it is also important that we realize that 9/11,
while unique in its once unthinkable occurrence, may not be the
last of such events as our nation engages in our war on
terrorism; and, as the President reminds us, this may not be
the last event. Accordingly, at today's hearing we need to hear
from the top City, State, and Federal officials on what we have
learned from September 11 and what is being done to correct any
lapses or inconsistencies which it may be found to exist with
regard to emergency preparedness and evacuation.
In an emergency situation advanced planning, of course, is
the key to safety and to piece of mind. This also rings true
for those elderly and our disabled. Without the assistance of
coworkers those individuals most often could be left behind.
Decisions and now what must be done during such an event must
be thoroughly reviewed to determine how best to meet those kind
of emergencies prior to any event happening. This includes the
obvious concerns that have come about in my own region
recently, when it comes to nearby nuclear power plants. I am
specifically referring to Indian Point, which is just up the
river within a 30-mile range from here, Senator Craig.
Let me read you two brief quotes with regard to that
problem. State and local governments are the first line of
defense in the event of a serious nuclear power plant accident,
and their ability to respond depends to some extent on the
adequacy of guidance and training provided by FEMA--and I am
pleased FEMA is here today--and other Federal agencies.
Further, more can be done to help state and local governments
to respond effectively to a radiological emergency.
Now, those quotes were taken from a 1984 U.S. Controller
General GAO report entitled Further Actions Needed to Improve
Emergency Preparedness Around Nuclear Power Plants. Proper
improvements to the emergency preparedness plan for any event
can be made when those responsible for public safety at all
levels of government effectively communicate with each other.
And that is why it is so good, Senator Craig, to have all of
these agencies represented here today. Hopefully this process
will enhance our preparedness to these kind of emergencies.
So, in closing, permit me to again stress my sincere
appreciation for all of the incredible heroism, the dedication
displayed by all of those that were involved in this tragic
event: Our firefighters, our police, our agency personnel,
emergency personnel, rescue personnel, and our good Samaritans.
And many of these true national heroes reside in my
congressional district. I have a number of our police and
firemen residing in my area, and many lost their lives
regrettably on that faithful day. So I look forward along with
Senator Craig to hear your testimony today and your good
thoughts of what we can do to prepare for any future event. God
willing, we will not have any such occurrence again. Thank you,
Senator Craig.
[The prepared statement of Rep. Gilman follows:]
Prepared Statement of Rep. Benjamin A. Gilman
I want to thank Senator Craig for the invitation to
participate at today's hearing. As New York continues to
recover from the tragic events of September 11, and our Nation
continues to go through the process of discerning what can be
learned from the experience, it is important that we discuss
the issue of emergency responses for the elderly and disabled.
I commend the Special Committee on Aging for proceeding forward
today.
Mr. Chairman and Ranking Member, clearly emergency
evacuation procedures need to be reconsidered. While, no one
before September 11, could have envisioned such destruction or
the speed in which it occurred; we must recognize the special
and unique challenges which exist for those elderly and/or
disabled.
World Trade Center tower number one and two burned for 102
minutes and 56 minutes respectively, before the top floors of
each tower collapsed onto lower floors. Even more incredible,
is the fact that eight seconds later the entire second tower
collapsed and in ten seconds tower one followed suit. This
means that more than 50,000 individuals employed or visiting
the towers had approximately an hour to walk down 104 smoke and
debris filled floors and hallways. No small task for a young,
relatively healthy individual, let alone someone either elderly
or disabled.
All of us from New York and across the Nation are grateful
for the heroism displayed by our firefighters, police, rescue
and emergency personnel. These services were taxed to the
maximum extent possible--more than anyone could have ever
imagined prior to September 11.
While we need to proceed forward and determine how best to
reconfigure current emergency preparedness plans, we must be
sure to pay careful attention to addressing the specific and
differing needs which exist for the elderly and disabled.
However, it is also important that we realize that
September 11, while unique in its once unthinkable occurrence,
may not be the last such event, as our Nation engages in the
war on terror.
Accordingly, at today's hearing we need to hear from top
City and State officials on what has been learned since
September 11 and what is being done to correct any lapses or
inconsistencies, which may be found to exist with regard to
emergency preparedness and evacuation.
In an emergency situation, advance planning is the key to
safety and peace of mind. This statement also rings true for
those elderly and/or disabled. Without the assistance of co-
workers these individuals most often would be left behind.
Decisions on how and what must be done during such an event
must be planned and determine now prior to its happening.
In closing, I want to again stress my sincere appreciation
for all of the incredible heroism displayed by our
firefighters, police, emergency and rescue personnel. Many of
these true national heroes reside in my congressional district
and many lost there lives on that fateful day.
Thank you.
Senator Craig. Ben, thank you very much. Ms. Gilman, thank
you for joining us today.
As far away as Idaho is, you would think that we were
relatively untouched by it. It is simply not the case.
Certainly we were touched emotionally, and Idahoans have
responded in a variety of ways. But uniquely enough, we have a
company that is homed in Idaho that was started in Idaho a long
while ago who had a division that was housed in the World Trade
Center and lost 13 employees, four of them native Idahoans.
That is something that oftentimes we don't realize, but I think
when we examine the magnitude of the loss of the Trade Center
that occurred here, that it truly was a national situation, an
incident, and I think the Congressman, as you know, and
certainly with your efforts has tried to respond in that
context.
Now, let us move around the table and hear from all of you.
As you know, the Special Committee On Aging in the Senate is
not an authorizing committee. In other words, we don't write
legislation. We hold hearings and oversight on those issues
that are of concern to the seniors and the elderly of our
country, and then we make recommendations to other committees.
Oftentimes Chairman Breaux or myself or members of our
committee will actually testify before other committees about
our findings. There are several committees in the Senate and
the House that are unique in this way. We are largely an
investigative oversight body. That is an uniqueness of the
Special Committee.
So, with that, let me introduce our first person to testify
with us today, Josefina Carbonell, the Assistant Secretary of
Aging at HHS. Again, thank you so very much for being with us.
We would like to ask all of you to stay within the 5 minute
rule if you could, please.
STATEMENT OF JOSEFINA G. CARBONELL, ASSISTANT SECRETARY FOR
AGING, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Ms. Carbonell. Thank you, Mr. Chairman, and members of the
committee. It is indeed a pleasure and an honor to discuss the
Administration on Aging's perspective on emergency preparedness
for the elderly and those within disabilities. We appreciate
your leadership in convening this very important hearing.
Working in partnership with our national aging network, all
the service providers that form part of this aging network, AOA
is charged with providing essential home community-based care
services to those elderly in most need, some of whom are frail
and disabled. The Administration on Aging was at the forefront
to serve this population on September 11 in New York City. We
were joined by the Centers for Medicare and Medicaid Services
and the New York Aging provider network to deliver critical
services during this crisis. The emergency help line put into
place by CMS and the Administration on Aging received thousands
of calls from all over the country, many of which were from
older persons and their caregivers. I have submitted written
testimony for the record, but I will confine my oral
presentation again to the lessons we learned from September 11.
Mr. Chairman, I am committed to ensuring that the aging
network and all of our providers through state, units on aging
and the local area agencies on aging and aging providers are
ready and better prepared for any future disaster. There are
five needs to be addressed that I would like to address in this
brief presentation. First, one of my priorities is to ensure
that our states, our area agencies and tribal organizations
have emergency and backup plans in place for natural or manmade
disasters; that they have timetables for updating and revising
these plans and that there also would be ongoing training
programs to ensure the timeliness of the training and the
implementation stages. The administration is currently updating
our disaster assistance materials and plans to conduct training
for all levels of the network at the state and local levels.
Second, there is the need for alternative and backup
communications systems and that is paramount at all levels of
government. Battery powered radios and other such devices need
to be made available in the even of land line and cell phone
failure, which was the case right here in New York. Third, up-
to-date emergency contact information needs to be available on
key aging officials with emergency protocols to follow.
Fourth, we must collect and maintain a special needs
roster. This information should be shared with all partners in
the different locations across the country and with our local
emergency preparedness network.
Fifth, the aging network resources need to be coordinated
and integrated with larger Federal, state, and local emergency
management operations not only to avoid duplication, but most
importantly, to ensure that the special needs of elders are
incorporated into the overall community preparedness response
action plans.
Every one who is involved in an emergency has to be
sensitive to the fact that some older persons, especially those
with disabilities, may become disoriented, may take longer to
evacuate, may need special equipment or may depend on others to
help them.
I want to also call to your attention the need for mental
health counseling. These services provide individuals impacted
by disasters with an opportunity to react to and talk about
what they have experienced. For older persons their day-to-day
existence is often fragile, meaning that even the most modest
changes may trigger a series of events that threaten or even
destroy their ability to continue independently. For example,
this happened right here in Chinatown at the City Hall Senior
Center.
We have learned much from the September 11 event,
especially that we cannot predict the future. We can, however,
be better prepared. The commitment of Secretary Thompson to
help our seniors and their families was put to the test of
September 11. HHS is one department that exemplifies the
capacity of all agencies to provide critical assistance during
crisis. I applaud the dedication of so many of our Federal
partners, such as the CDC, FEMA, CMS and others who have
answered the call that day and in the weeks and months that
followed. We are particularly humbled by the heroic work of the
New York Aging Service Provider Network including Igal
Jellinek, who you will hear from later. I want to thank you for
calling today's hearing. As responsible public officials we
must do everything in our power to help our communities be
better prepared.
Most areas around the country have emergency plans in
place, and it is critical that these plans cover the needs of
the elderly. Mr. Chairman, I salute your commitment to our
nation's older Americans and their characters and I would be
happy to respond to any questions.
[The prepared statement of Ms. Carbonell follows:]
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Senator Craig. Thank you very much, Josefina. In a little
while you are going to be hearing from Marion Anello.
Ms. Carbonell. Yes.
Senator Craig. Marion is one of those seniors who found
herself evacuated into an area that was somewhat ill prepared
to respond to her needs. So, following her testimony I want to
come back to you and get not only your reaction, but some of
the thoughts that you may have about those kinds of
circumstances.
Now let me turn to David Paulison, U.S. Fire Administrator
FEMA--that's the Federal Emergency Management Agency. FEMA is
well-known around the country and has developed really a first
class reputation in the last good number of years for its
ability to respond quickly and with a level of preparedness
that is a product of many years of refinement. I am not going
to suggest you do it perfectly yet, David. It means that you
are supposed to, though. With that, let us turn to your
testimony and thanks for being here.
STATEMENT OF R. DAVID PAULISON, U.S. FIRE ADMINISTRATOR,
FEDERAL EMERGENCY MANAGEMENT AGENCY
Mr. Paulison. Thank you, Senator Craig, and I appreciate
the fact you recognize that we are still working on making it
better. Also, Representative Gilman, I appreciate having both
sides of the Congress here.
I am also pleased to be here representing Joe Allbaugh, the
FEMA Director. He had previous commitments and could not be
here, but he reminds us on a regular basis that FEMA should be
about people helping people, and as a U.S. Fire Administrator,
I share the Director's commitment to the well-being of disabled
and our senior citizens.
Just a little background, I had 30 years of fire service
experience. I was also in my early years as a firefighter and a
paramedic.
Senator Craig. We need to have you pull it a little closer
and speak into it so our court reporter can hear you.
Mr. Paulison. As a young firefighter and paramedic, I
worked mainly in an area with many elderly. I learned some of
the needs that are there and to love the people that I worked
with during that time. I have also handled several major
incidents, particularly Hurricane Andrew, the Valujet crash
several large evacuations of elderly people during hurricanes,
and I will talk about those a little bit later.
The United States Fire Administration worked closely with
other branches of FEMA to understand, prepare for, respond to
and recover from all hazards with an eye toward loss of
property and loss of life. We lose 4,000 people a year to fire
in this country and 1,200 of those people are over 65, so the
United States Fire Administration has set a goal to reduce that
by 25 percent over the next few years. Just as a side note, we
also lose one firefighter every third day in this country,
which is totally unacceptable.
My testimony will focus mainly on what FEMA has achieved,
what actions we are currently undertaking, and what FEMA
intends to do in the future. The efforts by FEMA in this area
was originally spearheaded by FEMA's national community
relations cadres. The cadres were assigned the responsibility
to locate and assist special needs population in disaster
areas. Over the years, FEMA has taken a number of steps in this
area, and let me briefly cover a couple of those.
Since 1997 the disaster, field offices have included a
special needs section to provide further aid. FEMA's national
community relations operation in the New York disaster area
made an intense effort to locate and assist special need
populations. It is essential to provide this function. The
agency hired a local person knowledgeable not only about
emergency management and the disabled community. FEMA, in
concert with New York City, ensured that the Disaster
Assistance Service Center would be accessible to seniors and
the disabled.
We also prepared a special brochure for all service center
employees informing them of their responsibility to assist
those with special needs. It is important to remember that part
of dealing with this issue is education internally so that
people who are handling the disaster understand the needs of
the elderly and the disabled.
Right now we are developing another manual to aid first
responders in dealing with disabled persons. In Miami Dade
County, we put together a group called Elder Links, where we
train firefighters and paramedics and EMTs to recognize when
they go on calls of elderly people who are either abused or
neglected, and we have 24-hour call-in line. As soon as they
got back in the station, they called in the names and addresses
of those people. The next day, the next day we got those people
help and got the right agencies there. I think that is a model
program that should spread across this country, and it is easy
to put together through the local fire departments.
There is an emergency management education network; FEMA
has sponsored several video conferences on this subject over
the years to get the word out that the local emergency managers
and local fire departments have to be very responsive in
recognizing the needs of the elderly in their communities.
FEMA has also developed an innovative course that
introduces service providers to emergency management and
emergency management to the special needs population.
Protecting the disabled and elderly persons from disaster is a
major responsibility of the emergency management community, and
that includes FEMA; but that responsibility is shared with
others, with relief organizations like the American Red Cross,
with fire and EMS services, with state and local governments,
and with the media. We found a long time ago that we used the
media as the main form of communications during our hurricane
disasters. We hold four or five press conferences a day, and we
tell the public exactly what we expect of them and what they
need to do to prepare for these emergencies.
Warning systems need to include provisions for people who
are deaf and hard of hearing. Televisions stations must live up
to the FCC mandate to provide emergency information in caption
form and first responders they must become familiar with how to
deal with the special needs of this population, and that
involves training and education for our first responders.
Building evacuation plans must include provisions for
warning to deaf persons and special evacuation devices to
assist mobilely impaired persons, You can't simply tell people
that shelters are open. You have to provide services for them.
In Miami Dade County we do a bus transit system--and not just
regular buses, buses that can handle people with disabilities
and handle people in wheelchairs and often sometimes people who
are bedridden. That is what every community must prepare for.
One final point every member of the adult community or
disabled community must learn as much as possible what is
required of them to survive in a disaster. The disability
rights movement has stressed the dignity and independence of
the individual as its goal. It is consistent with that
philosophy that each disabled person, to the extent possible,
assures responsibility for his or her own safety. So, together
in a partnership with the local fire department, the state
agencies and other local communities and the individuals
themselves we can develop a plan to help elderly survive these
disasters. Thank you, Commissioner.
Senator Craig. David, thank you very much. You have someone
with you?
Mr. Paulison. Yes. This is Marko Bourne from the Fire
Administration also.
Senator Craig. Thank you. Thanks for joining us.
Mr. Paulison. Thank you for your time.
Senator Craig. Now, let me turn to Dr. Stephen Ostroff,
Center for Disease Control and Prevention, better known as CDC
to most of us at least. Doctor, we thank you very much for
being here. Please proceed.
STATEMENT OF STEPHEN OSTROFF, M.D., ASSOCIATE DIRECTOR FOR
EPIDEMIOLOGIC SCIENCE, NATIONAL CENTER FOR INFECTIOUS DISEASES,
CENTERS FOR DISEASE CONTROL AND PREVENTION, DEPARTMENT OF
HEALTH AND HUMAN SERVICES
Dr. Ostroff. Thank you, Mr. Chairman, and Representative
Gilman. Like all other Americans, we at CDC were horrified and
saddened by the events which took place in New York last fall.
As the Nation's disease control and prevention agency, however,
we were also immediately galvanized to action to provide
assistance to our partners in the City and State of New York
and in D.C.
During the bioterrorism-associated anthrax attacks last
fall, I was the lead field investigator of the CDC team sent to
New York City to assist the public health in emergency
response, so I had firsthand knowledge of the tremendous effort
which took place then and continues to take place to recover
from the events of last fall. In my oral comments I will
provide a brief overview of CDC's activities related to
September 11, but focus more on the subsequent anthrax attacks
and how we worked to better prepare our Nation's states and
cities for the threat of terrorism from biological agents while
assuring that we meet the needs of particularly vulnerable
populations such as the elderly and disabled.
Within hours of the September 11 attacks, CDC deployed
teams of responders to New York City to assist in monitoring
the impact of the event and deployed assets of the national
pharmaceutical stockpile to assure essential medical supplies
and drugs would be available. By the end of that first week we
had more than 70 personnel engaged in a range of activities
including monitoring and documenting the patterns of illness
and injuries in victims and relief workers measuring hazardous
exposures at the World Trade Center site and recommending ways
to protect rescue and cleanup workers.
We also assisted the City Health Department in maintaining
their high state of alert for other types of events. These
activities were ongoing when anthrax was first recognized in
Florida on October 4th and then here in New York City the
following week. In response we augmented our onsite presence to
assist in investigating the sources of infection and
populations at risk and in providing antibiotic prophylaxis to
thousands of affected persons at the various media outlets and
postal facilities. Accomplishing these tasks against the
backdrop of September 11 was an example of Federal-state-local
corporation at its best and a credit to the diligence of our
colleagues here in New York City.
Overall there were a total of 22 cases of anthrax with 11
being the cutaneous or skin variety and 11 being the
inhalational form. In New York City there were seven cutaneous
cases and one inhalation case, with the latter being the only
fatality. It is worth noting that the inhalation cases were on
average significantly older than the cutaneous cases. This
finding was noted even before the last case was detected in a
94-year-old resident of Connecticut. Since we have little
historical data on which to base our epidemiologic information,
we don't know if this difference really has a biological basis
or is simply a reflection of age difference in work forces in
the various locations.
At the peak of the anthrax response we had more than 200
personnel in the field assisting state and local partners and
hundreds more personnel at headquarters assisting the effort.
While we deeply regret each illness that occurred, we are very
encouraged by the fact that none of the approximately 10,000
persons who were given antibiotic prophylaxis developed
anthrax, despite significant exposure to spores in many
locations.
Last fall's events revealed serious gaps in our nation's
public health defenses against biological and chemical threats.
These include inadequate epidemiologic and laboratory search
capability and insufficient knowledge base concerning sampling
and remediation and lack of information concerning infectious
dose and post susceptibility.
In addition, the public health system needs to improve its
ability to convey information and provide treatment and
preventive measures to large numbers of persons and a way of
assuring compliance. This will require extensive preparedness
planning, cooperation across agencies, and between Federal,
state and local counterparts.
All states and localities must be prepared to address these
threats and mount an effective response. This is as true for
New York City as it is for rural Idaho, although clearly the
needs and solutions will be different.
In late January Secretary Thompson announced that a total
of $1.1 billion in funding would be provided to states and
large cities to assist them in their bioterrorism preparedness
efforts. Here in New York the state will receive $29.4 million
in funds and the city $22.8 million in funds from CDC.
Agents such as anthrax, smallpox, and botulism are prime
bioterrorism threats because of their extreme virulence and
ease of dissemination. If used, they would likely affect all
segments of the population. However, there are certain special
challenges for the elderly and disabled. One relates to the
drugs and vaccines used to treat and prevent these diseases.
Many have side effects such as dizziness and nausea which make
them particularly difficult to use for prolonged periods in
older persons. In addition, these persons are more likely to be
taking drugs which have known or unrecognized interactions with
our recommended therapies. These factors must be taken into
consideration as our state and local partners move forward with
their preparedness planning so that we can assure that we can
properly care for and protect our most vulnerable populations.
Additional research is also necessary to understand
infectious dose of agents such as anthrax and whether it is
lower in older individuals than in other age groups.
In conclusion, CDC is committed to working with other
Federal agencies and partners, state and local health
departments, and the health care community to ensure the health
and medical care of all of our citizens from terrorist threats.
Although we have made substantial progress in enhancing the
nation's ability to prepare for and respond to a bioterrorist
attack, the events of last fall demonstrate that we must
accelerate the pace of our efforts. Thank you very much.
[The prepared statement of Dr. Ostroff follows:]
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Senator Craig. Doctor, thank you very much for that
testimony.
Now, let me move to Assistant Chief of Fire Prevention.
Alexander, I work really hard at damaging names. Pronounce your
last name for me.
Mr. Parzych. Parzych.
Senator Craig. Parzych. Fine enough. Thank you for joining
us.
Mr. Parzych. Thank you for having me.
Senator Craig. Please proceed.
You will hold for just a moment.
Please proceed.
STATEMENT OF ALEXANDER PARZYCH, ASSISTANT CHIEF OF FIRE
PREVENTION
Mr. Parzych. I would like to thank the committee to have
the fire department to have a chance to say something at it. I
am reading a statement from our Fire Department New York City.
Although disabled rights, laws and increased community
awareness have removed some barriers to everyday life for
senior citizens and people with disabilities, barriers still
exist. They present an even more significant challenge during
emergency conditions. September 11, once again, raises our
awareness of the challenges presented to both the disabled and
those challenges to assist them in an emergency. In addition to
these physical barriers such as flights of stairs, change of
level, no use of elevators, barriers to the acquisition of
information also exist. Communication that is audible, such as
TV and radio is not available to people who are deaf or hard of
hearing, people who have low vision or all blind cannot get
information from print media or the web site. People who have
learning disabilities or developmental disability often cannot
understand information when it is presented rapidly.
As we review our emergency plans, we must ensure that to
the fullest extent possible the needs of the disabled are
considered. This includes but is not limited to: One, we must
do our best to remove physical barriers. Future designs should
be universal, including everything from web sites to
transportation systems to escape routes. Two, do not separate
the disabled from the plans, but determine how they can be
included in the planning process, assuring that different
disabilities are included in all emergency plans and that these
plans are practiced, practiced, and practiced again. Public
education can raise awareness. An example of an improved
procedure would have the building fire safety warden and floor
searches coordinate with a designated point of contact for each
organization located in a building such as the personnel
department to develop a plan along with the Fire Department to
both locate and evacuate people with disabilities in
emergencies.
This plan may be tailored to the person's disability and
effectively communicated to them. Such a plan would have to be
updated on a regular basis to keep up with the changes in
personnel, work status awareness, and new rescue technology.
The New York City Fire Department is working with the public-
private sectors to enhance its ability to serve all members of
society. We must be responsible to our ever changing world and
the new threats that the world may bring.
Senator Craig. Thank you so much for that testimony. You
are one now of several panelists who we are especially wanting
to hear from because you were all here and had to deal with the
circumstances of September 11 on a daily basis, Alexander, as
you know and as you are obviously telling us with some of your
experiences.
Now, let me turn to the Director of the Office of Emergency
Management, Richard Sheirer. Richard. Thank you.
STATEMENT OF RICHARD SHEIRER, DIRECTOR NEW YORK CITY OFFICE OF
EMERGENCY MANAGEMENT
Mr. Sheirer. Thank you, Senator, Representative Gilman. I
am Richard Sheirer. I am the Commissioner of the New York City
Office of Emergency Management, and I am pleased to appear
before you today at the request of Mayor Bloomberg. OEM's role
in New York City is to coordinate and oversee the preparedness
for response to and recovery from all emergencies and
disasters. Our mission includes the protection of proper and
the continuance of government in the face of disaster; but our
most important goal is the safety and preservation of lives.
OEM accomplishes its mission through the collaboration with
all city, state, and Federal agencies through the use of the
resources of the Mayor's Office of People with Disabilities,
the mayor's Office of Aging, the Department of the Buildings,
Housing Authority, Transit Authority to name a few. We work
very closely with the American Red Cross, the Salvation Army,
and are partnered with many advocacy service groups in the
special needs community.
New York City appreciates the opportunity to present
information during this hearing about the unique planning and
response needs of the special needs community which includes
persons with disabilities and seniors and, as these populations
might be impacted, language issues as well. My comments will
focus on pre-September 11 issues, what happened during
September 11, and where we are going after September 11.
Prior to September 11 OEM employed a full-time special
needs advisor since 1997 who was responsible for the
development and execution of preparedness initiatives, response
actions, and recovery efforts working with both the emergency
management and respondent community as well as with
representatives from the special needs community itself. We
developed and coordinated a 4-day conference on emergency
preparedness for seniors and people with disabilities held at
Lighthouse International. It was attended by 500 members of the
community, 25 city response and service agencies, various
advocacy groups. In addition, attendance was mandated by the
New York State Department of Health for all home-based agencies
and residential care facilities licensed within the city.
We developed and implemented the communications picture
board program. This is a low tech solution which fills the
immediate communication gap in emergencies between response
personnel and persons with disabilities and/or non-English
speaking persons. It was originally designed with special needs
community in mind, but the tool has served to have broader
applications and used for members of the general public. They
have been placed in every New York City ambulance, in every
police precinct, in every FDNY certified first responder engine
company, every hospital emergency department, and with the Red
Cross and Salvation Army.
We convene special needs advisory panels for emergencies to
advise and assist the city in emergency planning for the
special needs community with representatives from all relevant
agencies advocacy groups, service organizations participating.
We have convened task forces in the past and we will continue
to do so in the future.
We have ensured that all emergency information materials
produced and distributed presented or posted on the OEM web
site contain specific special needs messages which would also
be available in alternate formats such as braille, large type,
and audio when requested and translated. We do it in multiple
languages which 13 review so far.
During September 11, in addition to the door-to-door
searches conducted by the fire department, police department
and rescue workers, an additional search was held, a follow-up
search, with members of the Steel and Ironworkers, with
American Red Cross and medic representatives. These teams were
directed back to buildings known to have large numbers of
seniors or people with special needs residing in them. We
confirmed that 50 percent of all the emergency shelters that we
opened were accessible to people with special needs. We
confirmed that the dialysis network of which there are 90
locations was fully functional. We confirmed that the
residential health care facilities, all 185 of them, were fully
functional and executed all necessary parts of their internal
emergency plans. We confirmed that most of the home-based care
industry had initiated their internal disaster planning.
Once communication was reestablished it was learned that of
the city contracted agencies below 14th Street, seven operated
in the evacuation zone and moved their administration functions
out of the zone. These agencies continued to serve as clients
with a team of staff, and every last client was accounted for.
We ensured that access restriction policies in the frozen zone
exempted all Access-A-Ride, Paratransit, Meals on Wheels
deliveries and private ambulances. We also ensured that
properly identified health care workers were allowed reentry to
assist their clients and directly to provide medication.
We confirmed that pharmacies honored appropriate refills
from bottles without written scripts and/or insurance cards. We
oversaw the mental health and crisis response activities
initiated by various agencies and groups for the response
personnel to direct victims and the city at large, and we
worked with those groups involved to be certain that the
experiences of the special needs community are accounted for in
services.
Post-September 11. The horrific events of September 11
tested all New Yorkers. Not only New Yorkers, people from
throughout our region as Congressman Gilman has said, and
people throughout the country who came here to help. There are
a lot of lessons we learned from our individual experiences and
from those of others. We are in the process of drafting a
proposal for a comprehensive special needs emergency plan and
mitigation that incorporates everything we learned.
We have begun additional research into how additional
notifications, communications, evacuation technologies and
policies can be implemented. We will continue to convene the
various task forces for the special needs community that we
started long before this incident. And We are committed to
reviewing existing emergency plans to incorporate the special
needs community at every level. We will continue to incorporate
the special needs community in each and every one of our
disaster drills and our planning for coastal storms which
incorporates the relocation of anywhere from 250 to 900,000
people has always included a special needs community and dogs
for that community.
Finally, there are a number of issues that can be looked at
right now by other emergency managers and ourselves. The
Federal mitigation funding available after a disaster that
formally was directed only to infrastructure initiative, we are
very hopeful that it is going be expanded to include more human
service measures. In my conversations with Joe Allbaugh, FEMA
appreciates all the problem that we have experienced and while
this has been an absolute horrible event, it has given us a lot
of insight into things that we can do, how we can do things
better, how we can help people better and, more importantly,
how we can better prepare our country working with the Governor
Ridge, Joe Allbaugh, and the other agencies. Emergency managers
in the public and private sector, whether they be the fire
safety director at a business or a person in a high-rise office
or residential building, all need to be very cognizant of the
special needs community, and we will continue to work with that
community to make sure that we get all relevant information out
and improve our processes based on our experience as much as
possible. Thank you.
Senator Craig. Richard, thank you. I will come back to you.
You mentioned in your testimony that you are in the process of
drafting a special needs proposal or proposals with special
needs elements in it. The question I will be asking you is what
would be your four top four or five recommendations within that
proposal. What do you see coming out of your experience that
you would elevate to a level of priority that either need to be
done or refined and improved. OK, Thank you.
Now, let me go to Wayne Osten, Director, Office of Health
Systems Management. Wayne, thank you for being with us.
STATEMENT OF WAYNE OSTEN, DIRECTOR, OFFICE OF HEALTH SYSTEMS
MANAGEMENT
Mr. Osten. Thank you, Senator, and thank you, Congressman
Gilman, for giving me the opportunity to speak with you today
on the subject of New York State's emergency preparedness for
elderly and disabled. The Department of Health's Office of
Health Systems Management is responsible for overseeing quality
of care in New York's hospitals, nursing homes, home care
agencies and clinics. We have been working to ensure that all
health care providers in New York State have emergency response
plans in place; and, since September 11, we have been in close
communication with the New York City Department of Health,
County Health Departments, the state and local emergency
management organizations, and the health care providers to
ensure our readiness in emergency situations.
Preparing our health care facilities to be able to respond
to a disaster is not a new activity. We took many steps in New
York State to develop strong disaster preparedness plans in
preparation for Y2K. We worked with health care providers,
including nursing homes and home care agencies, to ensure that
they all had up-to-date disaster plans in place. We made sure
they had adequate staffing, supplies, medication, and food, as
well as backup emergency generators. We saw clear evidence of
the success of these efforts in response to the events of
September 11 and in the days and weeks that followed. Hospitals
in Manhattan and throughout New York City immediately
implemented their disaster plans bringing in additional staff
and making beds available. Nursing home and home care agencies
in New York City also took immediate steps to ensure that those
in their care were getting the services they needed.
While we recognized that there were cases of individual
hardship, home care agencies did an outstanding job of
providing food, medication, and care to the home bound in lower
Manhattan in the days and weeks following the World Trade
Center disaster.
Since September 11 the Department of Health has been
working to update its emergency response plan, particularly as
they relate to nuclear, biological, and chemical events. We
have focused these activities on four functional areas: First,
surveillance and detection. How our health care providers can
quickly identify and report a potential event. Two, response.
How our health care providers should respond to an event both
individually and in partnership. Three, communication. How our
health care providers can maintain communications both during
and after a disaster; and finally, internal security what steps
our providers can take to improve their own organizational
security.
The model we are working on relies heavily on creating and
strengthening partnerships between state and local governmental
agencies and health care providers so that we can provide a
community-based response in emergency situations. The scope and
magnitude of September 11 terrorist attack has firmly
established the critical need for strong local public health
infrastructure to serve as the first line of defense in
responding to disasters whether they stem from natural or
manmade causes. We plan to use this model as a prototype. We
are meeting with county health departments, health care
providers, EMS representatives across New York State to assure
that they have emergency plans that meet the specific needs of
the communities. Nursing homes and home care agencies need to
be key components in this process.
We recognize that the elderly and disabled are particularly
vulnerable to the effects of a terrorist attack, and New York
will continue to work to provide for the needs of both of these
groups. New York State's current nursing home regulations
require that nursing homes have written disaster and emergency
preparedness response plans updated at least twice a year with
procedures to be followed for the proper care of residents and
staff. Nursing homes also must have plans in place for
receiving and treating victims of mass casualty. All nursing
homes must have plans in place for evacuating residents if it
becomes necessary. This plan must include plans to transport
residents to another facility or location. The plan must also
include preplanning for an evacuation with the local 911
system.
It should be noted that nursing homes, because they are
equipped with independent generators and supplies of food and
water, may be determined to be places to bring victims in the
event that area hospitals reach capacity. We were in a media
contact with nursing homes near the World Trade Center
following the September 11 attacks to determine their capacity
to handle overflow from area hospitals should that become
necessary. While this was not required, we did receive a very
positive and cooperative response from our nursing homes.
The anthrax threat that followed the World Trade Center
attacks, including the deaths of two older women in New York
and Connecticut who had no affiliation with the media or the
Postal Service seemed to indicate a greater vulnerability of
our elderly to agents used in bioterrorist attacks. The state
department of health has been in contact with nursing homes
about how to handle bioterrorist incidents so that they will be
prepared to protect the health of their residents and to alert
public health authorities should any suspicious incidents occur
within their facilities.
In conclusion, the New York State's disaster response plan
for the aging and the disabled will be part of our ongoing
collaborative effort between Federal, state, and local agencies
and health care providers to safeguard the health and well-
being of all New Yorkers. Our efforts emphasize the need for a
community-wide response beginning at the local levels and
involving partners in neighboring communities. Several weeks
ago we had the opportunity to meet with President Bush's
homeland security director, Governor Ridge to discuss our
emergency response plan. He was both encouraging and encouraged
by the cooperative efforts that we have embraced in New York
State. Governor Pataki and the Department of Health are
extremely proud of the way the city of New York and New York
State responded to the World Trade Center attack and the
ensuing bioterrorism incidents. Our response would not have
nearly been so effective without the strong leadership and
coordination among many agencies at the city, state, and
Federal levels. Thank you very much.
Senator Craig. Wayne, thank you very much. We will be back
to visit about some of those connective things that you see as
necessary between that local, state, and Federal partnership
that we are working on building at this moment.
Now, let me go to Igal Jellinek, Executive Director,
Counsel on Senior Centers and Services of New York. Igal,
welcome to the committee.
STATEMENT OF IGAL JELLINEK, EXECUTIVE DIRECTOR, COUNCIL ON
SENIOR CENTERS AND SERVICES OF NEW YORK
Mr. Jellinek. Thank you, Mr. Chairman and Representative
Gilman and members of the committee. I welcome the privilege of
appearing before you.
By way of background, the Council of Senior Centers and
Services is the premier professional nonprofit organization for
the city's senior service providers representing 265 senior
service organizations ranging from individual committee-based
senior centers to large, multipurpose city-wide organizations.
New York City's five boroughs are home to some 1.3 million
seniors. Regarding the problems our members and their seniors
face as a result of the most recent and horrific emergency
situation on September 11 of last year, I think the good news
is that we have all learned a great deal from how they coped
with these problems. As you will hear, their solutions are both
innovative and compassionate.
But you will also hear what we feel is the most important
solution of all; that is, that we as aging services providers
need to join with members of the communities, members of social
service agencies, with city, state, and Federal Government in
the private sector to pool our resources to truly prepare for a
unified integrated and effective response to emergencies. That
said, there are five overarching categories of need. Getting
services to the homebound person and people with disabilities,
ensuring that our clients have adequate food, water and
shelter, transportation of people, services, medications and
food. Three-hundred sixty degree communications with staff,
seniors, their families, and emergency organization and
addressing the mental health issues that arise for everyone.
Let me give you some examples beginning with the homebound
and disabled population. At Sunnyside Community Center in
Queens serving 1,500 seniors, they have an emergency planning
system in place that includes setting up a triage of client
needs from those who cannot function alone to those who can
function independently within their home. Part of the emergency
plan includes updating this information monthly and ensuring
that the client's levels of need has not changed.
In addition, Sunnyside keeps both a hard copy and a
computer file of their clients and shares both with the Fire
Department and Police Bureau Commander. Thus, in an emergency,
they immediately know which of their clients need help first.
When the problems arose on September 11 and in the following
days, that many of the home care workers could not get to their
clients because they didn't have official identification badges
to get through the blockades. These are the small but critical
issues that our members have alerted us to and that together we
can remedy.
At the Stanley Isaacs Neighborhood Center on the upper east
side of Manhattan, which also provides Meals on Wheels they
were serving congregate meals in their senior center on
September 11 when tragedy hit, and they continued to serve
their seniors that day making sure they were given their lunch.
But they could not carry out their Meals on Wheels program
because the trucks that brought in the food were stuck out in
Queens with the bridges and tunnels shut down. These are the
problems that occurred across areas of transportation issues,
communications issues and mental health needs arising from the
emergency. If a homebound person does not get his or her meal,
it is first a physical issue but quickly becomes an emotional
one as well as isolation, fear and panic set in, all with
terrible consequences for the homebound person. The solution in
this case a brace of some 24 corporate volunteers from
Bloomberg Communications delivered Meals on Wheels by going
door to door on foot, and two restaurants in the area; namely,
the world famous Le Bernardin and Daniel donated food to feed
the center's clients.
Transportation problems became the central issue preventing
people from receiving needed supplies of food and medications,
keeping people away from their homes and families, given the
city's need to close down all bridges and tunnels. It increased
safety for the island of Manhattan and the outer boroughs but
sent providers without local emergency backup scrambling to
cover the necessities that we took for granted before the
attack of 9/11.
On the issue of 360 degree communication, that means
communicating with staff, with clients, with emergency service
operations, with anyone else you need to reach or who needs to
reach you. Our members have asked us for help in creating a
redundant communications plan; that is, multiple ways of
communicating in an emergency that includes backup if one
method doesn't work. This is something we need to address going
forward, including the use of cell phones, backup land lines,
two-way radios, a special radio band for emergency
communications and broadcasting, and, of course, ensuring that
every person has a portable radio with fresh batteries.
Some of our members have created call down systems where
people can call in to them and they can try to contact
emergency services. But when the phone lines were down and cell
phones not working, this fell apart. Many are worried about
both what role they need to play in the event of a bioterrorist
attack and how to protect their seniors. Then there are the
mental health services which need to be offered in a 360 degree
manner as well. All our members told us that participation in
congregate facilities increased, sometimes double what it was
before 9/11. Senior centers became safe havens for our city's
older adults, as our members told us of the clear need seniors
had to be in touch with someone and not be isolated.
Each of the coping mechanisms our members designed to meet
the issue raised by the terror attack is ingenious, but therein
lies a larger problem. They should not have had to work on
their own to solve the problems they all shared. We need a
community-level preparedness plan where all stakeholders work
together. I would like to make some recommendations.
One develop a network of emergency pharmaceutical services
that includes the means both to fill medications and get them
to those who need them. Credit cards did not work for
prescriptions. We need to find a way to get prescriptions to
our community-based seniors as well.
Two, increase in-home services for the homebound including
in-home psychiatric mental health services and home health aide
providers.
Three, ensure that there is a team of restaurants
identified in the neighborhood as willing and able to provide
emergency food to a pooled resource.
Four, develop an emergency support system for the in-home
services including emergency respite care and communications
abilities for in-home caregivers.
Five, create a secure system of photo identification for
professional health care and senior service workers, even for
the Meals on Wheels providers and the drivers, that will enable
them to get through to their homebound clients in an emergency.
Ensure that each facility has done a risk assessment, audit of
its hardware, software, insurance coverage, and physical plant.
Develop a city-wide, statewide and national emergency
transportation plan. Each community needs a contingency plan
for moving people, including those in wheelchairs, emergency
supplies, and medication. Upgrade communications systems
including trunks of telephone lines and emergency response
systems and develop redundancy communication plans including
instructions on use of emergency communications products and
tools of backups. For Meals on Wheels programs, offer a sixth
meal or a shelf stable emergency pack in case of interruption
of service. Ensure that on an organizational level each
organization develops an emergency plan and that it is kept
updated, and teach them to remain flexible depending on the
nature and site of the emergency. Communicate with your clients
and staff immediately and continuously as possible. Ensure that
people do not feel isolated or abandoned. Understand that your
staff may feel a need to offer help and to be helped. Offer
group discussion sessions and if possible allow staff release
time for volunteer efforts.
One of the things that we found during this process is that
the seniors acted as a resource because they have gone through
this in World War II and other experiences, and they were
sometimes a resource to the staff who have never gone through
this before. In short, our message is that we never know what
natural or unnatural disaster will strike, but it is never too
soon to be prepared, especially for our nation's seniors. Thank
you.
Senator Craig. Mr. Jellinek, thank you very much.
Now I am going to turn to Mr. Michael Benfante. Michael is
unique in the sense that he was there, an employee of the
Network Plus Company, he worked on the 81st floor of Tower One
at the World Trade Center, and on September 11 Mr. Benfante
helped evacuate a woman with rheumatoid arthritis with the help
of an evacuation chair. So, we really do appreciate your being
here today. We look forward to your testimony.
STATEMENT OF MICHAEL BENFANTE, EMPLOYEE OF NETWORK PLUS
Mr. Benfante. Thank you, Senator. First I would like to
thank you Senator Craig and the other committee members for
inviting me to participate in this U.S. Senate Special
committee hearing regarding emergency preparedness for the
elderly and disabled. On the day of September 11 I consider
myself to be one of the fortunate ones, fortunate in many
regards which I am going to relay to you and to this committee.
First after the impact of the first airplane hitting the
north side of Tower One above my office, I was fortunate to
have the ability to stay calm to direct 28 of my sales reps out
of the office and into the stairwell, fortunate to be in the
highest office of the 81st floor of Tower One, to come away
from that day without a casualty, fortunate to have the
strength and composure to carry down Tina Hansen 68 flights,
fortunate to have that emergency evacuation wheelchair there to
assist me in doing so, fortunate to have my coworker John
Cerqueira along with me to help me carry her down 68 flights.
It was also very fortunate encounter firemen on the fifth
floor where we were stuck for a while who eventually directed
me out of Tower One and through the destruction and onto the
West Side Highway where they further directed me to an awaiting
ambulance where I was able to put Tina Hansen into, where she
eventually made it to safety. I was fortunate to have about 95
of those 102 minutes that Congressman Gilman mentioned earlier,
the time from the initial impact to the time of the eventual
collapse of the second tower. What I will do now is try to
explain to you what occurred in those 95 minutes from start to
end to see if it can assist you in this hearing, if that is
what you would care to listen to.
Like Senator Craig said, I was located on the 81st floor of
Tower One. The first plane hit above my office on the north
side of the tower. I was fortunate to be in the southeastern
corner of the tower, 7,000 square feet, where I had 28 of my
reps there. I don't know if you are aware that the actual
floors of the World Trade are about a acre large, so I actually
heard my reps screaming before I actually felt the impact
because I was on the south side of the floor. My office
actually overlooked the Statue of Liberty. So, I heard one of
my reps screaming from the impact before I actually felt the
impact, and I immediately rose from my desk and ran out to the
office and screamed for everybody to remain calm. I looked out
my window behind me and I saw debris and fire falling from the
building. And then I immediately ran out into the main office
through my reps and out into the hallway to see what the
destruction was like out there, and I saw that the stairwell
was clear. I did not know what was occurring at that time. I
thought it was a gas explosion or something, so I told everyone
to get to the center of the floor where, believe it or not,
they listened to me and came together and eventually made it to
the stairwell and began their descent down the stairs.
While I was directing them out, someone said that someone
was stuck in the bathroom, so I ran back into my office,
grabbed my cell phone and grabbed my bag, ran down to the men's
room in the main hallway, ran over some debris, did the
combination on the men's room door, opened it where there was a
lot of destruction in there, but there was nobody in there,
fortunately, ran back into my office and made sure everybody
had already left the office, so it was just myself and an
assistant branch manager. Everybody had already left and I
began my descent down the stairs.
I made it down about one flight and tried to assist two men
that were stuck in an elevator halfway between the landing. Me
and another gentleman, I don't recall who it was, we ran into
an office and tried to grab something to wedge the doors open
of that elevator. It was a bathroom key with a long stick at
the end of it. It was one of the devices we used--I think it
was a leg from a chair, and we tried to wedge the doors open,
but they were buckling front to back instead of opening
horizontally, so I felt that we were going to do more harm than
good, so I left those devices with those gentlemen and wished
them good luck. I don't know what actually eventually happened
to them, and I continued on down the stairs.
On my way down I passed many fire extinguishers in the
stairwell. People were screaming that there was fire on the
77th floor. People still--we did not know what was going on. I
grabbed the fire extinguisher on the 72nd floor and started
heading back up, but I was getting nowhere fast because of the
people coming down the stairs. So, I put down the fire
extinguisher and continued on down the stairs. On the 68th
floor I stopped out onto a floor and where there were people
and I was trying to direct them out into the stairwell. As I
looked down the hallway, there were large glass doors, and
there were these women just standing there behind the glass
doors. And it seemed to me kind of odd with all this hysteria
that they were just standing there, so I ran down the hallway.
I banged on the door where they eventually pressed the button
to open the doors. And as I was walking in to scream at them to
evacuate, one woman stepped aside and there was Tina Hansen in
her motorized wheelchair. I asked her if she needed help, and I
also noticed an emergency evacuation wheelchair still strapped
together on the floor besides the women. Nobody was doing
anything, and pretty much everybody had already evacuated
except for these women, and Tina was trying to calmly tell me
to use this chair, so I was frantically trying to open the
chair where I eventually saw a lever toward the back, flicked
the lever, the chair opened up, and I took, grabbed Tina from
her wheelchair and strapped her into this wheelchair where I
initially had her carrying her on the back and I had my
assistant manager carrying on the front and another gentleman,
and then I saw my coworker John Cerqueira and asked for his
help. He took one side of the front, I took one side of the
back and different gentlemen switched on and off on the back,
and we proceeded to carry her down 68 flights.
On the way down it was relative calm. Everybody was
helpful. For the most part it was clear. It did get backed up
from people evacuating the different floors and the flow of
traffic coming into the stairwell. We did switch stairwells a
couple of times to try and make better time.
There was a, I think, an emergency. We encountered the
firemen I guess around the forties full gear, tools and on
their way up trying to assist people in evacuation, exhausted
from climbing 40 flights with all that gear. There were people
trying to help them. They did not know what was wrong with
Tina. They thought maybe she was ill. They did indicate that on
the 21st floor there was a medic station set up where we could
set her down; maybe they could assist her.
As we got closer to the 21st floor, I asked her if she
would like me to put her down she was relatively calm and I
asked her again I will take you all the way out, and she said
OK, so we never let go, and I believe it was when we got down
to the tenth floor, around the tenth floor was maybe when Tower
Two was starting because we felt the rumble and some smoke
started to filter into the building.
Then we went into a floor landing. I believe--I don't know
if it was a Port Authority or some type of maintenance floor
because it was very dark. It was very narrow. There were
lockers and there were no lights, but the firemen were there to
assist us. They had lights and were trying to direct us. We
were going a couple of different ways, but I think because of
the collapse of the tower they could not find a safe way for us
to get out, so it started filling up with smoke, and there was
some panic there. Meanwhile we are lifting Tina and carrying
her over debris or trying to move the debris and carrying her
through and eventually a fireman tapped me on the shoulder and
said let's try this way again, and we were like, ``We already
went that way.'' We followed him and took us to a stairwell
where I barely remember going down the last four flights. At
that point it was myself and John Cerqueira and a firemen
carrying Tina from the back, and we made it down to the lobby
of Tower One on the West Side Highway side of the tower. So, if
you look to your right, it is where the turnstiles are to go up
the tower and the security desk to the left and massive
destruction where firemen directed us through the broken glass
of the tower out into the West Side Highway, where I put Tina
into the ambulance.
I as I was looking up trying to take in the enormity not
even realizing the enormity of the situation, I still did not
realize that Tower Two was down, I started to walk away and
heard an explosion and Tower One was collapsing behind me, so I
just ran for my life and dove under a truck. As the debris and
the smoke eventually subsided, I got up and walked away. I will
answer any questions that you may have regarding the hearing.
Senator Craig. Michael, you have answered all the
questions. You are obviously a very brave young man. We will
come back to you. There are a couple questions I would like to
ask you. I would like to hear from both Andrea and Marion here,
who are with us.
I understand, Josefina, you have to leave us to catch an
airplane in the somewhat immediate future. Is that right? Let
me come back then and ask you a question before we get final
testimony. I had hoped we could get to Marion before you left,
but I do want to ask you the question as it relates to
preparing the aging network and nursing homes for disasters and
the kind of coordination that is necessary.
You have had past experience in dealing with seniors in
emergencies. I guess my question really is what is the kind of
interagency coordination that you are participating in now that
is in part a direct response to the September 11 experience?
Ms. Carbonell. Thank you, Senator Craig. I think my
experience again goes back to, just like Mr. Paulison,
Hurricane Andrew in Florida, particularly working over 29 years
with the elderly community and disabled community in Miami. I
think many things changed after 1992, and we are working to
expand and to upgrade the material in our disaster preparedness
plan based on the recent experience.
But the most important thing is No. 1, that we need to do a
better job of ensuring that there is a special needs roster. We
developed the kinds of data that identify people that have
special needs and that in case of emergency that data base is
available in one location and could be spread into other areas.
So, it means that we work with 56 state units on aging. We also
work with 660 area agencies on aging. We have over 29,000
community providers throughout the country that work day in and
day out with individuals both in the congregate senior center
settings but also that serve homebound clients. So, we make
need to make sure that in the process of revising our disaster
preparedness manual, we take in recommendations from experts,
such as many around this table today, to incorporate those
recommendations into our technical assistance manual. We can
never be too prepared. We don't know where and when our next
emergency will hit, whether it is manmade or whether it is
natural disaster. So, definitely being able to have protection
in place and surveillance like we heard from Mr. Osten and
being able to have a response plan and a backup system, better
communications and ensuring that we work collaboratively like
we are doing at the department level right now with CDC, with
HRSA and CMS and other partners with FEMA and the local
emergency preparedness folks to integrate all of those plans
together. It starts at the Federal level, Senator Craig, and
that is what we are beginning to do right now, and we hope to
have a more up-to-date plan in place hopefully by the end of
this year that will address not only a manual on how to, but
will also increase the training of the individuals on the field
to the 660 AAAs throughout this country.
Senator Craig. Thank you very much. Let me turn to
Congressman Gilman. The Congressman is going to have to leave
us in a few moments, so I want him to ask any questions he
might want to and any comments he would want to make, and then
we will come back to you ladies for final testimony and the
balance of the questions I have to ask. Ben.
Rep. Gilman. Again thank you, Senator Craig, for conducting
this hearing on behalf of the Special Committee on Aging. I
think the recommendations coming out of this will be helpful to
every agency throughout our nation who is trying to prepare
properly for emergencies of this nature. I want to congratulate
Michael Benfante for his dedication and his heroism and what he
described to us of the method of saving one of the disabled. I
think that will stand out in our memory as we recall this
hearing, what we have to do to try to perfect our systems.
Please excuse me, our good nursing folks, Andrea and Marion.
But I have your testimony and I will look at it very carefully.
I have to go to another meeting very quickly, but I want to ask
just two quick questions, Senator, if I might.
Dr. Ostroff, you talked about all your recent initiatives
on behalf of the center, but I heard a report recently that
there was a toxicity found in the air following the 9/11
tragedy, and it had not been publicly released nor disseminated
to those who were in need, particularly our rescue workers. Is
there some substance to that.
Dr. Ostroff. I don't know all of the details of that,
Congressman. I work in the infectious part/disease part of the
agency. I know that there was an a hearing that took place this
morning that discussed many of those issues, and I know that
there are ongoing concerns about some of the air quality issues
around the World Trade Center.
Rep. Gilman. Well, then, let me ask Wayne Nelson from our
New York State Health Department. Wayne, can you tell us
anything about that toxicity and why the information was
disseminated to the rescue workers?
Mr. Nelson. No. Unfortunately, Congressman, I don't know
the details of that.
Rep. Gilman. I hope that maybe you can provide it to both
of us, Senator Craig and myself, and we would welcome knowing
more about it.
Mr. Sheirer, on behalf of the--with regard to the FEMA----
Senator Craig. Richard just stepped out.
Rep. Gilman. Oh, Richard stepped out? Well, I am sorry. I
would like to know just more about, and I will ask our FEMA
fire coordinator, what about the joint meetings of all of the
interested parties? How often do you get together to review
what our good Deputy Secretary was saying about coming together
to make plans? How often do you bring your agencies together?
Mr. Paulison. I don't know the answer to that. I have been
in FEMA a few months. But I can tell you that what I testified
before is absolutely accurate. It starts at the top with the
Federal Government. We have to get our act together first if we
are going to expect the local responders to act. That is the
message that we are taking back to the FEMA Director. FEMA
should take the lead in gathering some of these agencies
together to come up with some definitive plans.
Rep. Gilman. I hope you follow up on that.
Mr. Paulison. Absolutely.
Rep. Gilman. I think interagency communications and
planning is so important in what we are doing.
Mr. Paulison. It has to be. Everybody has to take ownership
in this. Everybody has to take ownership from the individual
all the way up to the top. If we do that--the ideas are out
there. Everybody around the table has the same message. We
listened very carefully. Laid out the same steps, the five or
six steps of what had to be done. We know what the issues are,
and I am sure we are going to have another testimony to tell us
very clearly what the issues are, what they see from their end
of it, and we just have to get together and resolve it. That is
a message that I am going to take back to the FEMA Director.
Rep. Gilman. Hopefully they will listen. I want to thank
you all for your recommendations, for being here today, Senator
Craig for conducting this hearing. Mr. Jellinek, you had good
recommendations. I hope there will be other good
recommendations of that nature passed on to us from both the
Senate and the House. Thank you very much. Please forgive me
for having to go to another meeting. Senator Craig, thanks
again for inviting me to participate. Thank you.
Senator Craig. Congressman, thank you very much. We are
pleased you could join with us today.
Let us now complete the testimony before I follow up with
some questions. I would like to ask Andrea Dale, a nurse with
the Visiting Nurse Service of New York to offer her testimony
at this moment. If you could pull that mike as close as is
comfortable. There you go.
Ms. Dale. Mr. Chairman and members of this committee, I am
Andrea Dale. I am a registered nurse.
Senator Craig. Andrea, we are going to ask you to hold
until the tape gets changed.
All right. Thank you.
STATEMENT OF ANDREA DALE, VISITING NURSE SERVICE OF NEW YORK
Ms. Dale. Mr. Chairman and members of this committee, I am
Andrea Dale. I am a registered nurse appearing before this
committee for myself and on behalf of the Visiting Nurse
Service of New York. I am joined today by Marion Anello, a
resident of lower Manhattan. I welcome the opportunity to join
you today along with the other witnesses in your efforts to
learn firsthand experience of the September 11 disaster and the
days that followed. I hope my experiences during those days as
a field nurse working in lower Manhattan will help the
committee better understand the environment and the challenges
at that time.
There are many things to be learned from September 11
terrorist attacks, too many to list here. I would like to take
a few minutes to highlight what to me are important lessons to
learn. First is that emergency preparedness planning must
recognize that homebound patients are spread throughout our
neighborhoods. As an example, VNSNY provides home care services
to over 24,000 patients each week throughout the five boroughs
of Manhattan, of New York City, and in Nassau County. Many of
our patients are homebound, chronically ill and elderly. Many
live alone. They are dependent on receiving services such as
wound care and medication administration on a daily basis. This
required home health aides to help them perform the activities
of daily living. Particular concern must be given to those who
are wheelchair bound and unable to leave home without
assistance.
Before September 11 I was one of 20 visiting New York
nurses assigned to see active home care cases in lower
Manhattan. My area extended from Canal Street to Battery Park,
from Church Street to the Hudson River. I care principally for
elderly patients and I recognize my responsibility to care for
them. Many of my elderly patients have few surviving family
members and small circles of friends. I must go to them. They
do not and cannot come to me.
VNSNY realized early on September 11 the challenges we
faced given our patient population and the fact that 1,600 of
our patients lived in the restricted area below 14th Street. I
was responsible for 30 of these patients. No public or private
transportation was available in this area for many weeks. Phone
lines, land and mobile, did not work or they were unreliable.
Stores, including grocery stores and pharmacies were closed.
Resident and emergency workers wore masks. People were
instructed to keep their windows closed due to the heavy smoke.
In the area below Canal Streets there was a lot of physical
damage and access was very limited. Essentially it was a war
zone. On September 11 many of my patients saw from their
windows the collapse of the World Trade Center buildings and
the devastation and chaos that enveloped the area. For many it
provoked memories of World War II and other traumatic events
they had experienced over the course of their lives. As my
colleagues and I continued to provide nursing therapy and other
home care services, we were struggling to meet the mental
health needs of our patients.
Second, emergency preparedness must include the resources
to transport care givers to their patients as well as being
able to transport patients to the medical care facilities. On
the morning of September 11 I was a few blocks north of the WTC
en route to my patients when the second airplane crashed into
the tower. I immediately contacted my team manager who advised
me to return home, and I was able to get home quickly, as my
home was a little more than a mile north, and I watched from my
balcony as the towers collapsed.
I contacted some of my patients living in Tribeca, and
hearing the distress in their voices as we talked, I decided I
needed to get back downtown I packed a backpack with some
supplies and I headed back downtown on foot to them as all
transportation had already stopped below 14th Street. After my
checking my patients door to door and caring for those who were
scheduled to be seen that day, I began to follow up on those
who had been evacuated. By the end of that first week a pattern
was established--miles of daily walking to care for the sick
and help provide for their basic needs such as food. Where
possible we contacted patients' relatives, passed along news of
their family members or arranged for patients who had been
staying in shelters to be brought to their family members'
home.
The point is that I was only able to get to my patients
because I could walk the distances that separated us and I knew
where they had been evacuated to or where they lived. Emergency
preparedness cannot always assume this will be the situation.
Three, emergency preparedness will depend on reliable and
predictable communications. My cell phone worked for a few
hours immediately following the attack and then became useless.
Our residential phone service lasted a little bit longer and
then became less and less reliable. Using these phones for a
while I was able to remain in contact with my team manager in
the hours following the attack. During these critical hours
immediately after the attack I was essentially operating
without depending on means of communicating with our central
office. This indicates I believe that it is such service be
made dependable and reliable in a time of crisis with a wider
use of radio communication be adopted for care givers.
A corporate lesson is to be prepared. VNSNY learned many
lessons from this tragedy. We are working with government
agencies to address public health issues that might arise in
the immediate future. For fine-tuning our disaster planning, we
have developed our comprehensive bioterrorism readiness plan.
Most important, out of our disaster recovery plan was done as
soon as the first plane hit, all our field staff knew their
first priority was to their patients. Management did turn to
the jobs to help the field staff do this. Senior management
communicated with the city, state, and Federal agencies to
request permission to enter the frozen area. New York City
Office of Emergency Management, Police Department Centers for
Medicare and Medicaid Services all offered greatly appreciated
assistance and support.
In the days after the attack it was essential to
communicate with field staff to make sure they had all the
necessary information on their patients, especially new ones.
Masks were obtained to wear in the ``frozen'' zone. Our
information technology unit had a backup system in place so
that no data were lost in communication. Patient information
was maintained with the staff through portable computers.
As noted, there were problems with communicating with
staffs since our phone lines broke down. In response VNSNY is
in the process of formalizing a business continuity plan. We
are developing policies procedures to ensure that business
operations can continue in the face of outside forces affecting
our buildings, our systems, our communications with staff. It
must include the assessment of the current environment,
development of business and technology requirements, strategy
and planned development and planned validation through mock
exercises. A dedicated VNSNY project team was formed in
November 2001. This practice was to provide project oversight
to represent all corporate entities. Contingency plans need to
be developed which show redundancy based on a variety of
scenarios: fires, floods, bomb scares, and bioterrorist
attacks.
Bioterrorism readiness--Home Care and VNAs must play a
role. As our nation begins a major readiness initiative in
anticipation of an unimaginable attack, it is important to
recognize the vital role to be played by home health agencies.
VNS and VNAs across the country have more than 100 years of
public health and immunization experience that should be
brought to bear on the local bioterrorism, readiness and
immunization planning process.
Home health care is not just an alternative to inpatient
care. It is a front line defense to any biological or chemical
threat this country may face and a key component to the public
health system. For over 100 years VNAs have immunized and
vaccinated hundreds of thousands of people in their homes and
at community sites. VNSNY under contract with the CDC screened
and immunized postal workers against anthrax in New York City.
In the event of a widespread epidemic VNAs and other health
agencies in each city can provide the experience and the
infrastructure to deliver care to every community.
During the days and hours following September 11 VNSNY
staff----
Senator Craig. Andrea, could you sum it as quickly as
possible. Thank you.
Ms. Dale: We have developed a bioterrorism readiness plan
as part of our overall disaster planning and will be doing
drills and regular correspondence as it will be periodically
updated. We thank you.
[The prepared statement of Andrea Dale follows:]
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Senator Craig. Well, thank you very much. I do want to get
Marion's testimony and then I have several questions I want to
ask and still try to keep us all on schedule here.
Next our last testifier and I must tell you, Marion,
certainly not our least. We thank you for your patience in
being with us. Marion Anello, an elderly patient of Ms. Dale's,
has her own personal experience to tell us out the very
experience and circumstances that Andrea Dale found herself
serving. So, if you would please proceed. There you go. Thank
you.
Ms. Anello. I thank you for having me. I am Marion Anello.
I am 80-years old. I live a block and a half away from the
World Trade Center. I was working that day on the Board of
Election in my building on the second floor. When the first
plane hit the tower everything shook: the windows, the blinds,
everything. We didn't know what happened. When the second one
hit, the maintenance man came downstairs and said the World
Trade Center was just hit. We have a 60-inch television
downstairs in the senior citizens room, pulled it out, and we
put it on. When we saw what happened, it was a terrible thing.
We closed up the Board of Election because there was nobody
coming down any more, so we got a phone call to close it. Put
everything in the back of the machines and we closed it and
went upstairs. I live on the fourth floor with my husband. When
I sat down on the chair I saw the second building come down. It
crashed right in front of my face. It was terrible. All I heard
was glass crashing, crunching. It was a terrible thing to see.
Not to see the other two buildings over there was more
disaster.
Well, my husband and I were talking about it. What could we
do. These are crazy people anyway. Two weeks later I landed in
the hospital with a lung infection from all the smoke and the
debris and everything from downtown. I was in the hospital for
8 days. I came home after the eighth day. Now my husband wanted
to come and see me in the hospital. I told him not to come
because he is blind. I told him I am coming home, but he came
anyway. He came home. He was on his way home in a taxi,
somebody got him a taxi downstairs. He got to Canal Street, the
cop wouldn't let him pass. So the tax driver said I have a
blind man here. He lives at 310. He's got to get home. So he
said, you are very fresh for a blind man. He said, ``What do
you want me to do? Walk? I can't walk.''
Anyway, another police car passes and says what is the
trouble? He said--the taxi man said I have a blind man over
here. he said he has got to get home. He lives at 310. He said
go ahead. Anyway, he called me in the hospital. I said how did
you get home. Why are you so late? He says they wouldn't let me
through beyond Canal Street so anyway, that is my story.
Oh, yes, excuse me. I am a little nervous, you'll have to
excuse me. OK. That night of September 11, getting back to my
story, they evacuated us from the house. All of us had to get
out. We had no hot water. We had no heat, no water. We all had
to get out of the building. Five hundred tenants had to get
out. They had three buses waiting for us outside to take us to
the Washington Irving High School. I lived in the shelter for 8
days. I tell you, it wasn't very nice and that is nothing like
home.
They brought us home after the eighth day, and I came home
I was so glad to have my house and to sleep in my own bed. I
slept on a cot for 8 days. I don't know how the homeless do it,
but God bless them anyway. That is all I have to say. I am just
happy to be home, that is all. I hope it doesn't happen again.
Senator Craig. Marion, thank you for your testimony. That
is extremely valuable because for those of us who attempt to
look at it through papers and reports and policies sometimes,
in all fairness, we miss the emotion, and it is very important
that we understand that as we work through these difficulties
and develop and coordinate programs.
Andrea, you obviously serve the area that Marion lives in,
and you talk about the preparedness or the efforts now at
greater levels of preparedness and coordination. If I were to
ask you what would be the top two or three lessons you have
learned and things would you want to change to improve the
circumstance you were in following September 11, what would
that be?
Ms. Dale. Well, of course we had difficulty with the
communication. I had two----
Senator Craig. My notes said communications right off the
top.
Ms. Dale. I had two phone services at home, one local, one
long distance, and the service at home is undependable. I had
my cell phone and that wasn't working downtown at all. My cell
phone worked the first day, so I wasn't able to make contact
with my office. We have computers. We communicate by phone
lines, and we also had trouble with the phones at my office, so
an alternative means of communication that would be more
dependable would be one thing I would consider very important.
Second, you know, I don't mind walking and I had it very
easy compared to a lot of people, but I had to walk miles and
miles every day just to get to the checkpoint, through the
checkpoint, and to my patients and back and then to go see some
who were evacuated. So, I got it all done in the course of a
day. I had some all the way over in the shelters on East 17th
Street because their care needed to be continued despite the
evacuations. I felt if there could be a better way to compile a
central list of knowing who had been evacuated. There were
certain people I had to put in more efforts to try to determine
whether or not they had actually been evacuated because they
had the right to refuse. It wasn't mandatory, and some had to
be persuaded. So as it turned out, there was one gentleman I
had in the Battery Park City area and Tribeca. I had a very
large area at that time. My resident in Battery Park City had
refused to be evacuated and I think it was probably because he
couldn't take his dog with him. He landed up on the floor and I
wasn't allowed to go down there, and I had been assured
everybody had been evacuated. He was eventually found on the
floor and he had sustained a fracture having fallen when it was
dark. Those would be three key items.
We have, of course, emergency disaster planning. I don't
think we had anticipated anything quite like this.
Senator Craig. Well, I doubt that any of us could possibly
have imagined this, and you are right. Although our planning
must encompass worst case scenarios as best the human mind can
create them and then develop systems for them. You mentioned an
elderly fellow staying behind because his dog could not go I
assume.
Ms. Dale. Pets were not allowed to go. They were not
brought to the shelters, although the ASPCA did establish a
plan to go around collecting pets if you could give them a
house key. Lots of people in New York City are so devoted to
their cats and dogs.
Senator Craig. We all are. I have pets and I am just
wondering in your recommendations where in the case of
evacuations not being mandatory and people not wanting to leave
because of their pets is there anything that mentioned that or
talks to that as to how we might be able to deal with that
sides of the dimension of people's willingness to participate?
Ms. Dale. No, there is nothing mentioned I just mentioned
because I did spend a lot of time just investigating after I
had determined where most of my patients were then I went to
look for people I had a harder time finding. I interviewed a
lot of people. I spoke to police officers and military police.
We were going to try to enter a locked building. The second day
I found a military policeman who was able to tell me that this
couple I was concerned about had been persuaded to leave
because they were going door to door as had been mentioned
earlier. They did a really good job. They went around and told
everybody you have 5 minutes to leave. Get your medicine and we
will be back for you. Well, they didn't state it was--I think
eventually it was mandatory in one of my buildings in that
building. I think they had mentioned something about it. They
suspected gas leaks or something.
Ms. Anello. That is right.
Ms. Dale. I think they mentioned suspected gas leaks.
Ms. Anello. That is why we were evacuated. We had gas
leaks. No water, no heat.
Senator Craig. Thank you both very much. That is valuable
testimony, to have firsthand testimony as to the actual area
itself and people your age and needs, Marion, and how they got
served. Thank you very much.
Ms. Anello. She was very helpful to me. That is right.
Bless her heart. She is a good girl.
Senator Craig. Michael, prior to your experience on
September 11 had you ever had any emergency training or any
kind of training within your office complex that assisted you?
Mr. Benfante. Other than routine fire drill to the extent
where you leave your office and you were shown where the
stairwells are on each level.
Senator Craig. Were those fire drills taken seriously by
your office and your staff?
Mr. Benfante. Yes. For the most part, we all followed the
procedure. I do remember that you are supposed to have a
designated fire marshal, so to speak, for each office and then
a secondary one. Just might want to consider where there are
offices with turnover, you might want to consider just someone
that is always there not so much as an outside sales office. I
happen to be one of those I think I was more of a secondary one
than a tertiary one, but other than just routine fire drills.
Senator Craig. The wheelchair that you used to bring Tina
out, obviously you could not have brought her out on her
electric wheelchair.
Mr. Benfante. She was actually adamant about bringing that
down, but it was too big. I just told her to leave it behind.
Senator Craig. Well, now was that portable or emergency
wheelchair part of the office or was it there because of her
situation? What caused that wheelchair to be there at the time?
Mr. Benfante. It was actually because of Tina. From what I
understand, Tina was also working at the World Trade Center
during the 1993 attack and as a result of that attack, there
were certain procedures put in place, I think one of them being
that emergency wheelchair.
Now, I think it should be mandatory that any person with a
disability that is confined to a wheelchair, whether they
remember to have one or demand to have one there or not should
be there, should be required. So I don't know if it was part of
a requirement or, if it was just part of Tina requesting it be
there.
Senator Craig. Well, I am sure it is fortunate for both
Tina and you and your partner that it was there.
Mr. Benfante. Yes, very fortunate. It just made the
evacuation a lot easier.
Senator Craig. Well, Michael, your testimony is special. I
am sure that many people have praised you, as they should, for
your help and persistence under those most difficult
circumstances. I think all of us when we hear of people like
you and testimonies given question ourselves over whether we
could have performed as well under those circumstances. My
congratulations to you.
Mr. Benfante. Thank you, Senator. Just one thing.
Senator Craig. Please go head.
Mr. Benfante. All things considered, I agree with
Congressman Gilman that it was a tremendous emergency response.
I know there were many lives lost, but I think just in the way
that our Fire Department and Police Department and rescue
workers responded there were more lives saved and it just
should be acknowledged.
Senator Craig. Well, I appreciate you for saying that.
Certainly I am not critical and I don't know of many who are.
We look at the circumstance and the magnitude of the situation
and recognize really how well everyone performed. What we are
in pursuit of now whether it is FEMA or CDC or others is where
do we go from here. Several of you mentioned our preparedness
for 2000 and a suspected problem, and there was a major
investment nationwide at that time for communications systems
and computerized systems as related to a potential shutdown
which did not occur. But it did create a preparedness that
obviously has helped us and helped this situation to some
extent. No, I don't think anyone is being critical, and I thank
you for saying that. The question is where do we go from here
to improve upon both services coordination and Federal, state,
local systems working together thank you.
Mr. Jellinek, you mentioned your experience with a private-
public environment. I guess my question to you is what
obstacles did you encounter as it relates to the cooperation
between the public-private sector?
Mr. Jellinek. I think overall it was a tremendous response
working together. I think New York is such a heavily populated
city and we are broken up into 59 different community boards.
There needs to be more of a community-based response. For
example, if you worked in programs in the community and
sometimes you don't--a lot of people don't live in that
community. Those people did not know where to go. They could
have gone to other communities and other programs to lend their
help. So I think there is also these informal relationships
where you have at the post office or you have with the
different businesses in the community. I think to begin to work
that a little more in terms of making sure the relationships
are there if things break down that you can work with a very
local level.
I appreciate the need to have Federal interagency responses
as well as state responses. But at the city level the action
occurs on a local level and unless the people on the ground
floor of the meal deliveries are trained as to what is going to
happen and who they go to--and nobody was prepared--at least I
wasn't prepared, let's put it this way, for this kind of
magnitude of tragedy. The thing that I raise is that as time
goes by that we keep diligent in terms of putting these
preparedness plans in place and take them seriously, and so I
would urge that there be some sort of mandate on a very local
level that people work together.
Senator Craig. Well, I appreciate you saying that. I come
from a very rural setting. I grew up. My nearest neighbor was
seven miles away in a rural ranching environment. While we
think of help coming in from the outside, it always would get
there too late. We really had to think locally and think
neighbor to neighbor and always did. I think that while I agree
that Federal, state, local cooperation is tremendously
important as it relates to training and communication and we
are finding out that the right hand in some instances on
September 11 did not know what the left hand was doing. There
is no question that those who are there if properly trained at
the moment the circumstance occurs can save lives as we know
and be that first line. Of course, fire departments certainly
were doing that in part immediately in the first instants. But
I think your admonishment or at least observation that local is
as critical as national is very true as we coordinate that.
Thank you.
Mr. Jellinek. May I say one thing.
Senator Craig. Yes.
Mr. Jellinek. It is not an admonishment but an observation.
Senator Craig. No, no, no, I appreciate that. It really
isn't. But it is a valuable observation and I agree with that.
Wayne, again, coordination state, Federal agencies, one or
two of your remaining thoughts. If you had the ability to say
tomorrow this would be different because I know it would
improve the circumstance I have to operate under, what might
that be?
Mr. Osten. Senator, I think the one area that needs to be
incredibly close coordination between Federal and state is on
responding to a biological event. I mean as bad as the Trade
Center was and the effects of that, the concerns of a
biological event going undetected for a period of time and how
you respond to that, that needs an--and I am sure Dr. Ostroff
would agree with that--that needs to be close corporation
between the Federal Government and state as well as the locals
because its the locals that will immediately deal with the
problem. That would be my No. 1 priority.
Senator Craig. Wayne, that is something we worry about.
Doctor, I am going to jump across the table to you with
this observation and I would appreciate your reaction from
where CDC is today versus where it was at the beginning.
I just got back into our office building 2 weeks ago. I was
in the Hart Building. My offices and some of the staff around
you were in the Hart Building. One of the things I observed is
that the best knowledge that was available after the anthrax
exposure in the Hart Building when there was a determination to
evacuate--and I say this as no criticism--the best information
that was available and the advice that was given us by CDC on
that day to communicate to our staffs was advice that was
invalid 30 or 40 days later as we began to pick up knowledge
and experience based on the woman here in New York and
certainly the woman in Connecticut. This tremendous change in
knowledge occurred based on the type of anthrax, the size of
the spores, the airborne character of them. Would you comment
not only in relation to what Wayne has just said but where CDC
is at this moment in cooperation with FEMA in not only better
coordination but programs in relation to new knowledge.
Dr. Ostroff. Thank you, Senator. I will start my comments
by saying that when the anthrax episode happened, an event like
this had never happened before. We were relying primarily on
scientific information that was in most cases decades old from
totally different types of settings. We were trying to use that
information and base our decisions on information that in some
cases turned out to be quite accurate and in some cases
certainly did not. I can tell you that here in New York, as
well as in Washington, DC. on a day-by-day basis as we went
through this episode, we learned every single day. We refined
what we were doing on a day in and day out basis as we acquired
more information. Here in the city of New York, certainly the
way we responded at the various media outlets, from NBC to ABC
to CBS and the New York Post was different each time. We
learned from each experience. If we don't do that, then I think
we are foolish because you have to learn from that experience.
Senator Craig. Would you hold for just a moment. We need to
change another tape.
Dr. Ostroff. So we did certainly learn a lot. I will also
say that we have a lot to learn. We will continue to try to
massage the experience that we had over the last several months
so that we can make the best informed decisions as we move
forward. I think the good news, and I will say this quite
frankly, is that most of the decisions that were made, in
retrospect, were the right ones. We did I think, by and large,
protect most people during this episode and I think that is
much to our credit.
I will say if I may, as opposed to some of the other
comments that were made, I am a bottom-up guy. I think that, at
least in public health, the responsibility as well as the
expertise is as much at the Federal level as it is at the local
level. The solutions and the infrastructure here in New York
City may be very right for New York City, and may be very wrong
for a place like Idaho. I think it is going to be quite
important for each place to come up with solutions that are
appropriate based on what they have to work with and what they
have to build. The one other thing I will mention is one of the
things we also learned: while it may be fine for New York State
to develop their plan and for Connecticut to develop their plan
and for New Jersey to develop their plan, many of these
episodes as we went through them were multistate; that was true
within Washington, DC., and certainly that was true here in New
York City. It affected people in New Jersey, it affected people
in Connecticut. While the facilities may have been here in New
York, the people were in a different state. The same was true
in New Jersey with people in Pennsylvania and Delaware. That is
why we need to be able to coordinate these types of activities.
Senator Craig. Doctor, thank you very much. FEMA is going
to have to leave us and catch an airplane. David, while we
always look at FEMA after the disaster to help, to bring in
resources, to direct and then, in some instances, to help
rebuild on a individual basis. One of the things that in a
previous hearing last week I heard from you all and Joe was
there speaking about his training and a substantial new role
for all of that and coordination, recognizing your time and you
can be very brief, I appreciate that because our time is up
here also, you just might broach that for a second as I think
it is a new role for FEMA to be participating in.
Mr. Paulison. That is an excellent observation. Three
things came out of the World Trade Center that we kind of knew
were out there, but it really came to a head: One, is
communications and interoperability, you know. One agency
couldn't talk to another agency, even through a command post,
and that is intolerable; we have to deal with that.
Two, is a nationwide instant command system. All of the
fire departments use the same instant command system, and it
has been nationally recognized as the one we want to use, but
other agencies are not on board yet. That creates some problems
when you have your command post set up where everybody is
participating and we have to deal with that.
Also mutual aid. What happened in New York is the same
thing that happened in Miami during Hurricane Andrew. We had
people coming from everywhere who were not asked to come in,
and it overwhelms the local system. You can't feed them, you
can't house them, you don't know what their credentials are,
whether they are really firefighters or whether they are really
paramedics or what their expertise is. They are just coming in
to help. We have to stop that. Somehow we have to be able to
deal with just an overwhelming response--people who want to
come in and help but may not be the right people to help.
Third, and I do agree with the doctor, that we have to have
more robust local planning or emergency plans at the local
level because that is where the rubber hits the road and that
is what FEMA's role is, to help with that, and we are going to
be doing that through training; the President's proposal on his
budget for three and a half billion dollars to go to first
responders is geared to deal with that, and that is where we
are in that, and we are ready to roll as soon as the Congress
approves that. Thank you.
Senator Craig. David, thank you and your associate for
being with us.
Alexander, let me turn to you before I conclude with
Richard. There are so many things that I would love to ask you,
and we have had some of your associates down and firefighters
from other departments around the country visiting with
Congress since the September 11 situation. But here in New York
is there any view of or do you sense a need as it relates to
training within your professional ranks to deal more with the
prioritizing of seniors as it relates to their needs and to
those people who are the disabled, any new stuff coming out of
the September 11 experience that you would suggest would become
a part of your training?
Mr. Parzych. Well, I think our training is adequate in that
we are staying with our standard procedures except for like a
September 11; that isn't standard procedures. In other words,
most of our procedures are if the people are not in danger in a
high-rise building or a fireproof building, we do not remove
them, you know, for a fire or some kind of an emergency. We
have had areas to be evacuated which were larger than just
let's say a whole building because of gas leak or something
like that, but nothing on the scale of September 11. I think it
is hard to be prepared for that. I think the Fire Department an
outstanding job getting so many people out with the help of the
people themselves, and I think the cooperation has to come with
the community, with the disabled and the aging to with not
having laws, but we do have procedures in a high-rise building,
as you say, and here is a problem: The Port Authority doesn't
have to comply with our laws because they are a state agency
that are in the city. So the bombing on 1993 sort of made them
open their eyes to comply with our laws, which made this time
much better. Having fire safety directors, having fire drills
and as fire safety directors fire wardens and our fire
marshals, but that is a minor point. But in my building I am a
fire warden, and we do take it very serious, especially--we
just had a drill. If I don't take it serious, no one will, and
it is important. So, the laws we have on the books now are very
good. There are improvements, but I think it is a cooperation
with in high rise buildings the fire safety plan, which is a
mandated plan for these hotels and office buildings to require
to give us the location of where the handicapped people are and
what shifts there are. There is no real coordination of
training or anything more specific than that. We are probably
going to look into that and maybe make that a little more
specific, but we are supposed to have when we arrive there a
list of who needs help and where they are. We may not know
exactly what the handicap is, we might have to refine that, but
again, depending on what the circumstances are, we may not want
to get 50,000 people out of a building. That is going to be
very unusual, and I think my only personal opinion is the next
one may be biological which you have 50,000 people just walking
out and spreading it further, which we are involved with with
hazmat, so hazmat and that training I think has to be beefed
up.
As far as mutual aid and recall, we had a system there. I
was not at the World Trade Center. Our command staff went
there. I had them be back, and we instituted our total recall
and we had mutual aid with every community we had, which is a
designed plan as OEM said; we didn't have people just coming in
and volunteering. They had to get approved to come in with our
dispatcher. At the World Trade Center, that was a different
circumstance. It was tough to control who was coming in. But
for the rest of the seven and a half million people we had a
system that came in to protect them at the time.
Senator Craig. Thank you very much for those thoughts,
those ideas and some of what you are employing.
Let me turn to you now, Richard, and we will ask you to be
our last as I ask this question. You had mentioned in your
testimony you are in the business of drafting a special report
or special proposals on special needs folks. If you could share
with us some of the three or four let us say top
recommendations that will be involved in that draft that
might--not only are they going to work here in New York, but
might be something that we would want to look at at a Federal
level whether it be with FEMA or the health and welfare, health
and human services and aging.
Mr. Sheirer. Well, as we went around the table today you
heard a lot of recurring: communications, the registry. It is
very, very important. One of the things we use almost every day
is those persons who could be affected by power outages and the
utilities in our town are mandated to have a list of anybody in
every building who would be affected if they lost power; so
when we do have a power outage, those are the first things we
check on are those what we call LSEs to make sure that they are
OK. How we expand that to include every person with special
needs in New York is going to be a real challenge, but it is a
real necessity to make sure people like Marion and her husband
get what they need and we know where they are; to try and be
able to get them their medication so they don't have to leave
their home if we can avoid it. In this instance there was no
way of avoiding just the enormous relocations that we had to
do. I mean, there were tens of thousands of people in Battery
Park City in north and south that we moved out and people north
of the Trade Center. We had no recourse in that; it was just
absolutely essential. But having a registry of those persons
with special needs like the man that Andrea spoke of who
refused to leave or didn't tell us that he wasn't going to
leave is very important so we can do a follow-up. A little
thing, a little aside, we do have a plan for pets and we have
tried to incorporate it, but no plan that we had could
encompass the numbers that we experienced. Even with our
coastal storm planning, we asked people ahead of time to start
thinking about what you will do with your pet because it is
going to be impossible for everybody to take their pet to a
shelter.
The communications issue is a critical one for everyone,
for people who live in the buildings and reside, the public
health community, the public safety community, and the number
of responders that we had at the World Trade Center and the
number of frequencies, there was frequency overload that just
could not be helped because of the number of messages. How you
address that, we don't have the answers yet. In terms of
telephone communications, this being Murphy's law, the one
building that was probably most affected other than the Trade
Center buildings themselves was the Verizon building which
knocked out virtually all communications in lower Manhattan
right away. We had to get them back to even get the financial
markets back. So, there were a lot of things that happened, and
we are all looking at that including Verizon.
The transportation issue, we had to close Manhattan and we
have to find a way to get people in and out. IDs are a problem.
There were a number of people that we had to have arrested with
false IDs who went into the site. We had a couple reporters who
posed, one as an ATF agent and one as a firefighter to try and
get in and get stories and pictures and there were just
individuals who were up to no good. We caught a few in the
access to the concourse, so it is a very difficult problem.
The need to identify caregivers, Meals on Wheels, people
have a universal identification is something we are going to
look at and hopefully will never have to use to the extent we
would have had to now.
The sheltering system. Marion's experience of being there
for 8 days, that is very difficult. We have done everything we
can to try to make it as habitable as possible, but it is
virtually impossible. These are the issues we want to look at.
We do have--I will leave you a copy of it--our all hazard plan
which specifically deals, has a section. It is web-based on
people with--seniors and special needs people planning. But
having it web-based alone is not enough, and we go further than
that. How we can expand it and get community involvement with
it is very important.
Many of the people around this table are the people that
sit on our task forces for various things, and we would like to
bring them all together on this particular issue. Liz Davis,
who is my special needs advisor, will probably reach out to
everybody. So, there are a number of things, many recurring.
One thing I just want to say about what Michael said. I was
at the bombing in 1993, and Chief Cowan, who was just here and
left, we were in the lobby of Number One on September 11. There
was a marked difference between the way people left that
building in 1993 and the way people left that building on
September 11. 1993 whether it be because the bomb was at the
base of the building or whether there wasn't adequate
preparation or training, there was a lot of panic, a lot more
chaotic. This time we didn't have the chaos. People were just
absolutely terrific. People like Michael will never know how
many people like Michael were there helping people get out of
that building. We know how many firefighters and police
officers and court officers and EMTs did what they did, but the
number of just average citizens who helped their fellow
citizens, an amazing number. It was just an amazing community
effort, and that is something that is lost in New York. New
Yorkers really--we may be eight million people, but we are all
very real communities, much like small towns. While Idaho may
be different being rural, you can go to York Village which has
its own character, you can go to the Village, you can go to Bay
Ridge, and these are all it communities are very much, very
similar, more like small towns, just happen to be part of a big
city.
On the issues for bioplanning, Dr. Ostroff and I spent a
lot of time together, much more than I had ever thought we
would these last few months. One of the things we have in New
York City that gives us a little bit of a heads up, we have a
syndromic surveillance system that monitors EMS calls by the
category they are and gives us an indication that something is
out of whack before it would be readily available. Then we have
CDC epidemiologists and Department of Health epidemiologists
work back to make sure that the operation we are seeing is not
bio, that it could be flu, it could be just whatever it is, but
we want to know what causes it. That works very well in New
York, and we have expanded it, but it would not necessarily
work in Idaho or other communities because you are not
ambulance based. But those surveillance systems in terms of
hospitals in terms of doctors. We worked now with the large
pharmaceutical chains. They cooperated and gave us--we knew the
sales of over-the-counter medications so if anything was out of
whack in terms of flu medications and then prescribed
medications with anonymity, we knew where the big sales of Doxy
and Cipro were going and what was going on. These type of
systems are worth their weight in gold. It is transferable, but
it takes a little work, and that is the way to go. But we will
be working on a lot of different issues for the entire special
needs and senior community because they're the most vulnerable
people in our town and we have the highest obligation to them
amongst all others.
Senator Craig. Richard, to you, to all of you, a very
special thanks for your time here today and your patience,
because none of us in Washington have an answer. We are in the
business of collecting those from all of you so that we can
help prioritize and hopefully supply what is necessary, whether
it be organization or resource that will assist you.
I truly agree with you; what will work in New York City
will not work somewhere else, but what you learn here may be
something that someone else won't have to learn by the sheer
experience that you have had. I think that is extremely
valuable as we work our way through this. This committee, as I
said at the beginning, is not an authorizing committee. But our
records and what we supply and what we can provide for other
members of the Senate or all of us who serve on this committee
also serve on authorizing committees. It will be extremely
valuable as we search our way through this, and we hope that we
can develop a system that can respond quickly to biological
kinds of terrorist attacks because I hope you are wrong,
Alexander. I hope that will not be our next one. But there is a
strong likelihood that at some time in the future that could
occur, and certainly preparedness will mean in the end less--
fewer of our citizens will lose their lives, more will be
prepared, and my guess is, you are right and Michael is right.
Something worked because from the initial attacks at the Tower
until the tragedy of the final numbers, within the first 24 to
48 hours those of us on the outside looking in were expecting a
much worse situation from the standpoint of human life lost
than did occur. To be able to evacuate that many people out in
the short time that was given before those towers came down
was, in itself, a remarkable thing. While I think it is missed
by some in the reports of aftermath, I remember at the time we
were talking of 25,000 or 30,000 potential lives lost, only to
have it now where it is, although that is tragic.
Ladies and gentlemen, thank you very much, and I will ask
that this committee stand in adjournment. I must tell you also,
and I forgot to thank staff for all the work, but I thank them
for working with you in preparing for this hearing and again
thank them.
[Whereupon, at 4:05 p.m., the committee was adjourned.]
A P P E N D I X
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