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Irwin Redlener, M.D.

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America Unprepared: Are Budget Cuts Undermining National Disaster Readiness?

Posted: 07/19/11 03:16 PM ET

Improving the nation's state of readiness, response and recovery capacity has been a slow and painful process since the attacks of September 11, 2001. The establishment of an enormous new Cabinet-level Department of Homeland Security (DHS), along with major disaster response programs across the federal government, was nothing if not a legitimate expectation that 10 years following the largest terror attack ever on U.S. soil -- and five years after Hurricane Katrina and the flooding of New Orleans -- the country would be ready for some serious catastrophes delivered by dedicated terrorists or Mother Nature at her worst.

Under the cover of "other things to worry about," federal lawmakers and planners have managed to cut disaster readiness programs to the point of truly undermining U.S. disaster readiness well into the future. The all-consuming focus on the nation's economic crisis clearly is -- and should be -- a major priority. But this has truly overshadowed other critical areas where the nation's health and well-being is at serious risk. In addition to major cuts in DHS and FEMA funding for domestic preparedness and response funding for states and localities, Health and Human Services funding for preparing and training public health workers in disaster response has also been inexplicably slashed.

In fact, overall preparedness and response funding within the U.S Departments of Health and Human Services and Homeland Security dropped by nearly $900 million, from $5.3 billion in FY10 to $4.4 billion in FY11, a 17% overall reduction. And for 2012, even more cuts in disaster readiness programs are being proposed.

With the economy in dire trouble, no one is denying that austerity measures are essential. But diminishing the capacity of the public health system to respond to disasters is bad policy. Not only has there been a steady and dangerous erosion of the actual number of public health workers in the U.S., but training programs designed to improve disaster response capabilities are being cut to the bone.

As an illustration of this trend, a new program introduced just last year as a "five-year effort" to engage the nation's schools of public health in the training of disaster workers was drastically cut in the 2011 budget -- and scheduled for elimination in 2012.

This initiative, dubbed "Preparedness and Emergency Response Learning Centers" (PERLC) was established under the auspices of the Centers for Disease Control and Prevention. And for many of the country's health departments PERLC would be a substantial source of disaster response training for their front-line workers.

Ironically, the PERLCs actually ensure that local readiness is in-line with both the goals of the administration's own National Health Security Strategy's objectives on workforce readiness and the Presidential Policy Directive on National Preparedness. Yet, PERLCs are set to expire in 2012 -- three years short of the intended length of the program. With no proposed substitute, the PERLCs mandate will not be met and the capacity of states and local communities to respond effectively to a spectrum of disaster scenarios will be diminished.

Make no mistake about it, the loss of capacity to respond will be measured in lives affected or even lives lost in the disaster. Who thinks this is a good idea?

Note: New York's PERLC, the Columbia Regional Learning Center (CRLC) is based at Columbia University Mailman School. CRLC has trained 100,000 public health workers since inception ten years ago, convened first of its kind conferences on nuclear and radiological public health response, and created Web-based distance learning that serves public professionals from Hawaii to New York.