Go ahead and get its starting to i appreciate it. We are here to examine the Public Health fairness for and response to the 2017 Hurricane Season. Last two months, texas, florida, puerto rico, and the u. S. Virgin islands have been devastated by hurricanes. We first want to express our heartfelt sorrow to the millions of americans impacted by these devastating storms and to say that all members of this community on both sides of the aisle stand with those affected i these hurricanes by these hurricanes. I would like to thank the members of this subcommittee who visited puerto rico and says the impact and see the impact that these have on our americans. Has beenittee conducting oversight to the federal response to the hurricanes after harvey laid landfall. I expect our work will continue for years to come. The jurisdiction involves not just Public Health issues but also rebuilding the electrical grid, addressing environment of cleanup, and restoring telecommute occasion to name a few. Telecommunications to name a few. They are living without power and Running Water. I believe we are going to be joined today by Jennifer Gonzalez from puerto rico. Someone who knows all too well about the difficult challenges her home is facing. Thank you for being here. For coordinating the federal Health Care Response to ensuring individuals have medical treatment they need to protecting the blood and pharmaceutical supply. Granting emergency waivers and everything in between. Hhs has been working for for those individuals affected by the storms. They went above and beyond to protect and treat those in arms way. Some Health Care Providers failed to protect their patients. Atre was a tragic situation a nursing home in florida where 14 residents died after the and the federal Emergency Management or they might been working to provide care and help reestablish the infrastructure. Hhs has worked with puerto ricos department of health to resources needed for dialysis facilities and ensure critical supplies are delivered. Similar operations are going on at me Virgin Islands. Virgin islands. Are these calling delays and efforts . Are we utilizing resources in the most effective ways to assist . It is critical we understand Public Health challenges ahead. Mold formation is likely in nearly all the affected regions. As we seen after Hurricane Harvey, there is an increased risk for the spread of Infectious Disease due to contaminated water. After Hurricane Maria, one million americans are still without clean, safe Drinking Water. Rebuilding in the Virgin Islands will take years. Mostre condition, and facilities need some degree of assistance. The electrical grid has been devastated which has significantly hampered Recovery Efforts. We do not know the full extent of the damage, let alone when our fellow citizens will have Running Water restored. We are doing Everything Possible to address the short and longterm needs of those impacted by hurricanes harvey, irma, and maria. Thecially in the face of Public Health threats that have resulted from these storms. I think the Witnesses Today and look forward to your testimony. I will now yield five minutes for an opening statement. Much, mr. Ou so chairman. This Hurricane Season has been most one of the devastating on record. Southndated houston and texas. 51 inches of rain. Hurricane irma was the strongest atlantic hurricane on record before it hit the Virgin Islands and florida. While these storms have been devastating, Hurricane Marias impact on puerto rico and the u. S. Virgin islands has been nothing less than catastrophic. The scope of potential health risks caused by this ongoing crisis is still coming into focus. It is clearly considerable. Nearly a month after Hurricane Maria hit, the impact remains decimating. Nearly 80 of puerto rico still does not have power and hhs reported of substantial amount of hospitals are either not operational or require diesel to run generators to keep functioning. One third of residents lack reliable access to Potable Water. Contaminated water is spreading contagious diseases and while i certainly appreciate the effort by volunteers, including physicians and nurses volunteering their time with the teams, i am concerned that poor management of the hurricane response at a federal level may hinder response efforts. The federal government publicly picture have a complete of what Health Care Challenges exist because quite frankly, most of the island of puerto rico requires lacks adequate communication. Researche need to further to establish the status of these services. As time goes on, we should have filled hearings about puerto rico in and the Virgin Islands. But much of the recovery effort involves the jurisdiction of this committee. I cannot stress enough how important it is for us to send our staff down there to investigate this and how important it is for members to go and investigate this. I was part of a group of members who went after Hurricane Katrina to new orleans. Through years of oversight on the subcommittee was that washingtons understanding of the situation on the ground is very different than what we observed firsthand. Happenedirst saw what to those records, when we had our field hearings and we saw businessened to small people dont marry in new orleans, you just cannot substitute for that. Begin to think about our public responses, members of congress, we need to see what we are doing on the ground. Mr. Chairman, last week President Trump said the administration deserves a 10 fourths response to the devastation of Hurricane Maria. Given the fact that most residents lack power, nearly a million americans lack access to safe and reliable Drinking Water, i find that statement to be breathtaking. I hope that our Witnesses Today are better prepared than that to talk about what is really happening on the ground and what we can do to address this unfolding crisis. I hope it will be the beginning , concerted effort to understand what is going on and i would now like to yield the balance of my time to representative pastor, who wants to talk, appropriately, bob he Health Challenges facing her home state of florida. Pastor thank you for the time. We have many challenges ahead. I want to think the witnesses here today. I want to thank all of my colleagues. Hopefully this is the first of many hearings because his is going to be a very long recovery. , 75r 75 lives lost in texas including in florida, 14 related to a nursing home that were completely avoidable. We need to discuss that. We know that we have about 50 deaths in puerto rico so far with the threat of active role in infections growing. I am very concerned about puerto rico and the whole interplay between the folks that live there and the u. S. Virgin islands and their migration, and what that means for the health needs of everyone. On the island, the Drinking Water issue is simply critical. I look forward to your expert testimony today and the committees work in the days ahead. Thank you. We now recognize the chairman of the committee. I think the vicechairman for holding this important hearing. I want to express my deepest sympathy for those have been affected by these horrible storms, specifically our citizens in the u. S. Virgin islands and puerto rico. This committee stands ready to assist in whatever way we can. We will continue to be religion to in the oversight and the work that the agencies are doing and the needs of the people. I am pleased that dr. Burgess has already been to puerto rico, visited some of hospitals, and looked at the health care issues. We know we have much more work to do and we hope to hear from all of you today about what is out there and had an we need to uncover and get better solutions. Today we are examining continuing efforts to protect the Public Health in texas, florida, preorder rico, and the u. S. Virgin islands in the aftermath of hurricanes harvey, irma, and maria. This is the first of a series of meetings and in the coming weeks we will hold hearings before the energy and environment committees. The vicechairman stated this committee will be conducting rsight of the building rebuilding the of puerto rico and the u. S. Virgin islands for years and years to come. The Public Health risk typically associated with Natural Disasters very, including heightened incidents, diminished access to medical care and longterm Mental Health trauma. Risks can be particularly dangerous, especially for vulnerable populations such as infants, dialysis patients, and individuals who may be immunosuppressed. We saw this in the aftermath of Hurricane Irma, where 14 elderly residents lost their lives as a result of feet induced death issues after the facilities are conditioning system failed during the storm. Committees and a bipartisan letter to the Nursing Homes under requesting information on the facilities Emergency Preparedness plan, inspection history, and the steps it took to protect its residents after the airconditioning system stopped working. Will hear from three major many protocols necessary to conduct a fast the public immutable. E federal agencies responding to disasters must be able to communicate with each other ofectively to identify areas need, ensuring that individuals have adequate access to basic process of as food, water, and medical supplies critical in any of recovery. As we head into the recovery thats it is also important we carefully monitor patients as they transition from hospitals or under medical supervision back to their homes or places of residence. News reports indicate more than 60 of Puerto Ricans are now theless as a result of devastating hurricanes. We need to make sure when patients are discharged from hospital that they are safe places to go and do not end up on the streets are back in the hospital. Following Hurricane Maria, various me to reports called into question whether the federal government is adequately meeting its obligations protect health and welfare of american citizens. On this matter, look to gain perspective from witnesses who left than on the ground in the areas. Making sure the americans in need get the assistance they require cannot and should not be a partisan matter. Agencies are not pulling their weight, we want to know. If there are federal laws or policies that are impeding the Recovery Efforts, we want to know. About any best practices that can be gleaned from ongoing Recovery Efforts to utilize in response to future Natural Disasters. Thanks to you for being on the ground trying to do the best you can in these horrible circumstances. We need to know the facts. Are. At the Lessons Learned with that, yield back about some by time but before i do that i would like to welcome our newest member of the committee, mr. Duncan, who was just approved by the House Conference Committee this morning, the Steering Committee last night replacing dr. Murphy. Thank you for your today. I yield back. Thank you mr. Chairman. We now recognize the drinking member of the committee. Thank you mr. Chairman and thank you for holding this critical hearing. I hope this is the first of many meetings. Congress needs to hear further from hhs and others. To take also like moment to recognize the federal, state, local responders are working hard to address the many public issues which exist as response and recovery continues in all of the areas that work impacted by these three major hurricanes. I know firsthand of the tragic naturalion caused by disasters. My area was hit by Hurricane Sandy and i have ever seen worst storm damage. In many cases it was the worst case scenario. Homes lost. The fifth anniversary is coming up this weekend and we still have a lot of people are not back in their homes or businesses. Our nation is experiencing historic loss in the Virgin Islands and puerto ricos as well as on the gulf coast. While a to Natural Disasters are though results of these hurricanes call for unique help and have challenges. While Congress Continues to address the response in florida and texas, we must work to ensure that puerto rico and the u. S. Virgin islands received full and immediate support. I would like to recognize a number of ongoing challenges. The areas indicate hundreds of thousands of americans continue to struggle to meet daytoday needs. I am particularly concerned residents still do not have access to food or medicine. As many as one million americans lack access to clean water. Situations a dire that completely contradicts often rosy stories that come from the president and white house. Hurricanes are my end where caused widespread flooding and the u. S. Virgin islands including Critical Damage to electrical roads, Drinking Water systems, and transportation infrastructure. Virtually all residents of puerto rico on the u. S. Virgin islands have an impacted. Reportsseen and heard of death, dehydration, and desperation is residents continue to struggle in a postapoplectic landscape. Postapocalyptic landscape. FundaMental Health needs remain unaddressed even a month after Hurricane Maria and almost two months after Hurricane Irma. The list of serious needs and challenges is long. Many hospitals do not have reliable power. Many communities lack safe Drinking Water and people of resort into drinking questionable water sources. Are still unsure if the water is safe and a recent crewsiefing we learned going into communities to test for Water Quality were arriving to found that people still lacked adequate food and Drinking Water. Congress must provide ongoing support in the aftermath of these hurricanes to restore and rebuild. I hope our witnesses will help us understand what needs to me moreved so congress can effectively provide assistance in understanding impacts on Public Health not just today but in the months to come. My mayors and by elected officials locally are help or any kind of help for us because a lot of these people are coming or without a lot of money and they need support as well. This is something we need to look into. I like to yield the remainder of my time to mr. Green. Thank you. Our district in houston in harris county, texas, was heavenly impacted by Hurricane Harvey. We had at least eight deaths in our district alone. Ofhink the tireless work First Responders, Public Health professionals, and Community Members for helping fellow texans during the time of need. Forill be much more notches texas but for louisiana, florida, puerto rico, Virgin Islands, and a number of other disasters. Needtate of texas and cms to Work Together to make sure were taking advantage of every opportunity to help people in need, especially when comes to medicaid. I hope they will act expeditiously to get necessary resources to our local hospitals in texas to help uninsured disaster victims. We shifted recovery to houston and texas gulf cost and are responding to Public Health concerns related to harvey, including the spread of mold, the spread of disease carrying mosquitoes. We must be responsive to the Environmental Impact of harvey, including Community Members possibility of exposure to toxic chemicals and wastewater. Fromk forward to hearing federal Public Health agencies to address these pressing concerns. In our office in houston, we are still doing a lot of casework on social security, veterans, you name it. But now every staff member is working with fema because it goes through the process. We are working toward, again with our federal agencies helping us to make sure we can get people back to where they are. Where they were before the storm. I think my colleague again for yielding. I yield back the time. And i yield back as well, mr. Chairman. Consent, that our member statements be made available in the record. Without objection, they will be entered into the record. Energy andsent t