Over one million americans are still without clean, safe Drinking Water. Rebuilding puerto rico and u. S. Virgin islands will take years. The Health Care Systems are in direcondition and most of the operational facilities need some degree of assistance. To make matters worse the electrical grid has been devastated which has significantly hampered recoveryefforts. We dont know the full extent of the damage let alone when we will have electricity and Running Water restored. We are trying to make sure we do Everything Possible to addressthe short and long term needs. Especially in the face of Thepublic Health risk that resulted and will continue to resultfrom these storms. I would like to thank the witnesses for testifying today and i look forward to hearing your testimony. I yield five minutes for Opening Statement to the Ranking Memberfrom colorado. This 2017 Hurricane Season has been one of the most damagingon record. Hurricane harvey broke the record for the greatestamount of rain recorded from a single Tropical Storm or hurricane in the United States. Hurricane irma became strongestatlantic hurricane on record. Hurricane marias impact on puerto rico and the u. S. Virgin islands has been nothing lessthan catastrophic. Mr. Chairman, as you said, the scope of potential health risks caused by this ongoing crisis is still coming into focus. The infrastructure on puerto rico and theVirgin Islands remains decimated. Nearly 80 of puerto rico still doesnt have power. Hhs reported that a substantial number of puerto ricos hospitals are either nonoperational or require diesel to run generators. Over a third of puerto ricoenresidents lack access to Potable Water. Contaminated water isspreading contagious diseases. While i certainly appreciate the effort by volunteers including physicians and nurses volunteering their time with the teams i am concerned that poormanagement of the hurricane response at a federal level may be hindering response efforts. The federal government i believe probably does not have a complete picture of what Health Care Challenges exist because frankly most of the island of puerto rico lacks adequate communication. I think that this committee needs to hold further hearings to address the status of all these Vital Services that you talked about. I think as time goes on we should have field hearings on puerto rico in particular but also the vergeant islands as much of the recovery effort as you accurately describe involves jurisdiction of this committee. I cant 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 that went after Hurricane Katrina to new orleans to observe the Recovery Efforts. What we found through years of oversight on this subcommittee was that washingtons understanding regarding the situation on theground was very different than we were able to observe firsthand when we went into the basement of Charity Hospital and we saw what happened to those records. When we had field hearings and we saw what had happened to small businesspeople down there in new orleans. You just cannot substitutefor that. As we 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 ten for its response to the devastation of Hurricane Maria. Given the fat thakt most residents lack power, nearly a million americans lack access to safe and reliable Drinking Water , i find that statement to be breathtaking. 14 related to a nursing home that were completely avoidable. We need to discuss that. We know we have about 50 deaths in puerto rico so far with the threat of bacterial infections growing. I am very concerned about puerto rico and the whole interplay between the folks that live u. S. Virgine 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 thank you. Now recognize the chairman of the full committee. I thank the vice chairman for the support. I want to express my deepest sympathy for those impacted by the horrible storms particularly fellow citizens in puerto rico and the u. S. Virgin islands. This committee stands ready to assist in whatever way we can. We will continue to be diligent in the oversight in 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 the hospitals and looked at the health care issues. We know we have much more work to do and we hope tohear from all of you today about what is out there ahead, we need to uncover and get better solutions. Today we are examining continuing efforts to protect the Public Health in texas, florida, puerto rico and u. S. Virgin islands in the aftermath of hurricanes harvey, irma and maria. This is the first of series of meetings and in the coming weeks we will hold hearings before the energy and environment these matters. As vice chairman stated this committee will be conducting oversight of the rebuilding of puerto rico and theu. S. Virgin islands for years to come. The Public Health riskstypically associated with Natural Disasters are vary skpdinclude heightened incidences, diminished access to medical care and Long Term Mental Health trauma. These risks can beparticularly dangerous especially for vulnerable populationssuch as infants, dialysis patients, individuals who may beimmuneo suppressed and the elderly. We saw this in the after math of Hurricane Irma where 14 elderly residents lost their lives as a result of heat induced death issues after the facilitys air conditioning system failed during the storm. Last week this committee sent a bipartisan letter to the Nursing Homes owner requesting information on the facilitys Emergency Preparedness plan, inspection history and steps it took toprotect residents after the air conditioning system stopped working. We will hear while three major hurricanes to impact United States in 2017 were distinct events that present and continue to present their own unique challenges, many protocols necessary to conduct effective Public Health response are immutable. Federal agencies responding to disasters must be able to communicate effectively with each other and local, state and territorial officials to identify areas of need, insuring that individuals have adequate access to basic necessities such as food, water and medical supplies. As we head into recovery phase it is important we also carefully monitor patients as they transition from hospitals or under medical supervision back to their homes. News reports indicate more than 60 of puerto ricoens are now homeless as a result of the devastating hurricanes. We need to make sure when patients are discharged from hospitals that they have safe places to go and dont end up on the streets and back into the hospital. FollowingHurricane Maria various media reports called into question whether the federal government is adequately meeting its obligation to protect health and welfare of american citizens. On this matter i look to gain perspective from witnesses whohave been 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. If certain agencies arent pulling their weight we want to know. If there are federal laws or policies that are impeding the Recovery Efforts we want to know. We want to hear about any best practices that can be gleaned from ongoing Recovery Efforts to utilize in response to future Natural Disasters. Thanks to you and your teams for being on the ground trying to do the best you can in these horrible circumstances. We need to know the facts. What are the Lessons Learned and where do you need additional help. With that i yield back the balance of my time and look forward to the testimony of our witnesses. Before i do that, i would also like to welcome our newest member to the committee. Mr. Duncan was just approved by the house conference thismorning. And we are delighted to have you on board the committee. Thanks for being here today. I yield back. Thank you, mr. Chairman. That i recognize Ranking Member of the full committee. Thank you, mr. Chairman and thank you for holding this hearing on this critical issue. I hope this hearing is the first of manyhurricanerelated hearings as Congress Needs to hear further from hhs and other agencies regarding ongoing response and Recovery Efforts in all of the effected areas. I would like totake a moment to recognize the federal, state and local responders who are working hard to address the many Public Health issues which exist as response and recovery continues in all areas that were impacted by the three major hurricanes. I know firsthand of the tragic devastation caused by such immense Natural Disasters. In 2012 my district was hit hard by hurricane sandy. For many the storm was a worst case scenario,lost lives, homes flooded and businesses lost. The fifthanniversary is coming up this weekend and we still have a lot of people not back in homes or businesses. Our nation is experiencing historic levels of destruction and loss in puerto rico and Virgin Islands as well as florida, texas and the gulf coast. While no two Natural Disasters are alike the areas have unique needs and challenges. While Congress Continues toaddress the response in florida and texas must work to ensure that puerto rico and u. S. Virgin islands receive full and mmediate support. I recognize a number of ongoing challenges facing the residents of south florida and the gulf coast but much of the hearing will likely teed 92 laely need to address thesituation in puerto rico and Virgin Islands. Hundreds of thousands of americans continue to meet day to day needs. Im particularly concerned of reports that residents do not have access to food or medicine. In the areas effected paint a dire situation that completely contradict often rosy stories from the president and the white house. Hurricanes irma and maria caused widespread flooding and destruction including Critical Damage to electrical grids, Drinking Water systems and transportation infrastructure. Virtually all residents of puerto rico and the u. S. Virgin islands have been impacted and these infrastructure failures create acute Public Health issues. We have seen and heard reports of death, dehydration and desperation as residents continue to struggle where 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 have resorted to drinking to questionable water services. Residents are still unsure if thewater is safe and recent epa briefing we learned crews goinginto communities to test for Water Quality were arriving to find 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 be improved so that congress can more effectively provide assistance and understand the impacts on Public Health not just today but in the months and years to come. I wanted to Say Something aboutthe fact that many are coming from the island to our states in particular new jersey in my district. You know, my mayors and myelected officials locally are saying is there any kind of help for us because a lot of these people come here and dont have a lotof money and need support, as well. That is also something we need to look into. I would like to yield the remainder of my time to mr. Green. Thank you. Our district in houston and harris county, texas was heavily impacted by Hurricane Harvey. We had at least eight deaths in our district alone. I thank the tireless work of First Responders, Public Health professionals, Community Members for helping fellow texans during the time of need. I would like to thank my colleagues. There will be much more for not just texas but louisiana, florida, puerto rico the Virgin Islands and a number of other disasters. The state of texas and cms need to Work Together to make sure we are taking advantage of every opportunity to help people in need especially when it comes to medicaid. Get necessary resources to our local hospital in texas to help uninsured disaster victims. We shifted to recovery in houston and texas gulf coast and are responding to Public Health concerns related to harvey including spread of moldand spread of disease carrying mosquitos. We must be responsive to the Environmental Impact of harvey including Community Members, possibility of exposure to toxic chemicals and wastewater. I look forward to hearing from witnesses and working with federal Public Health agencies to address these pressing concerns. In our office in houston we do a lot of case work on social security, health care, veterans. Now every staff member is case work with fema. We are working through it withour federal agencies helping us to make sure we can get people back to where they are. I yield back, as well. Well, mr. Ield back as chairman. Unanimous consent. Without objection they will be entered into the record. I ask consent that energy and commerce members be permitted to participate in todays hearing. Without objection soordered. Further, just so Everybody Knows what we are doing, mr. Dunkin has joined the committee and subcommittee. Until a formal motion is made on the floor the parliamentarians tell me we have to treat him as a member but not yet on subcommittee of oversight investigations. He will be treated like all othermembers in the circumstance which means he will go last. As newest member of the committee he would go last anyway. We are just rubbing it in. [laughter] i did want to let everybody else know what the status was so when they hear a motion on the floor they will understand that is what the parliamentarians told us we need to do. I assume he knows to as others getting us each coffee. [laughter] well make sure he is aware of those duties. We welcome members with us today pursue tonight house rules members not on the committee are able to attend our hearings. We are glad to have them but are not permitted to askquestions. I would like now to introduce our panel of witnesses for todays hearing. First we have the honorable robert, assistant secretary for preparedness and response at the department of health and human services. Welcome. Next is the honorable Scott Gotlieb who serves as commissioner of u. S. Food and Drug Administration and then we have ms. Kimberly brandt. Glad you are here. We have admiral steven red who is director of office of Public Health preparedness and response at centers for Disease Control. Thank you for beinghere. As a part of what we do in this committee we are holdingan investigative hearing. It has been the practice of this subcommittee to take testimony under oath. Do any of you have objection to testifying under oath . Seeing none the chair then advises you that under the rules of the house and the rules of the committee you are entitled to be accompanied by counsel. Do any of you desire to be accompanied by counsel during your testimony . Case ifone, in that youwill all rise, i will sear you in. Do you swear that the testimony you are about to give is the truth, the whole truth and nothing but the truth . Hearing affirmative answersfrom now i appreciate it. You are under oath and subject to penalties set forth in title 18 of the United States code. You may give a five minute summary of your written obviously we will begin