Transcripts For CSPAN3 Politics Public Policy Today 2014111

CSPAN3 Politics Public Policy Today November 12, 2014

Instead of an effective response, what we have witnessed, i believe these past few months from various agency has been confusing and at times contradictory plans. For example, the cdcs guidance to hospitals has been a moving target. This uncertainty may have exposed Health Care Professionals to unnecessary risks. The administration also has sent mixed messages on the issue of quarantine. While the president has discouraged straight quarantine rules, defense secretary hagel has prudently put in place a 21day mandatory quarantine for troops returning from west africa. In addition, the administration did not call for enhanced airport screenings for travelers entering the u. S. From west africa until months after the epidemic became severe. It still remains to be seen whether these cursory screenings will be effective. Not surprisingly, americans have been frustrated by the lack of clarity and coordination within their government. Even though the president has named a socalled ebola czar to coordinate a response, all reports indicate that he has no Actual Authority to direct Government Agencies here. From the beginning of this outbreak, the administration has appeared to be preparing for only the best Case Scenario. Competent crisis planning must include contingencies for the worst Case Scenario as well. Therefore, i think we should not rule out any reasonable options to prevent the reintroduction of ebola in the u. S. , including travel and visa restrictions. If the history of disease outbreaks has taught us anything, it is that things can change quickly and without warning. Therefore, federal agencies must be ready to aggressively implement a clear and organized strategy. It is my hope that todays witnesses can assure this committee and the American People that the president has a plan, that the funds he has requested are necessary to execute it, but we will wait our testimony. Thank you, madam chair. Some of the responses to the Ebola Committee we will show you that coming up here on cspan3. A live look at the capital on the first day of the lame duck session of the 113th congress. Taken day got under way in senator Mitch Mcconnells office as he welcomed new senators to washington and talked to reporters as well. One newly elected senator not in this group is the newly elected senator from alaska, senatorelect stevens who has won that race in alaska. Heres this mornings event. Ready, stu . All right, leader go ahead. This is a lot happier occasion than after the 2006 election when we had president , secretary and treasurer, bob corner. We hope the new bunch will be joined, dan sullivan and bill cassidy shortly. We are here to make the place function again. And to begin to make progress for the American People. You said you are ready to work with the president if he moves to the middle. Does that mean you plan to move to the middle too . The problem is the president continues to send signals he has no intention of moving toward the middle. I was particularly distressed about a deal that apparently he reached with the chinese on his current trip, which is as i read the agreement, requires the chinese to do nothing at all for 16 years, while these carbon emission standards are ruining our environment. I hope the president can move to the middle and i hope to do some business on trade and tax reform. Mr. Leader how do you expect to deal with the china issue . Are you going to try to roll back well be discussing all that with our colleagues here in the next few days before we get ready to take over the new majority. Thank you everybody. Thank you very much thank you thank you thank you, everybody senator what about using a cr to block thank you, everybody lets go. Boom mic. How does it feel to be here . Great. Thanks, folks. Thank you very much lets go thank you mics, everybody, lets go. Thank you, everybody you did a great job. Thank you. Some of the newly elected senators in Mitch Mcconnells office earlier today on capitol hill on this the first day of the 113th congress. That group didnt include dan sullivan of alaska who was announced the winner in the Alaska Senate race. Really just one senate race out there that is left to resolve. That is the race in louisiana between senator landrieu and bill cassidy, the republican. And on that , senator landrieu has been speaking on the senate floor about the keystone xl pipeline. The house will take up a bill on the pipeline tomorrow. House rules is meeting in about ten minutes or so. Look for that bill on the house floor tomorrow. Follow the house on cspan and the senate on cspan2 and on cspan3 well show you the Senate Appreciation hearing today looking at the funding for the u. S. Response to the Ebola Outbreak. About domestic preparedness and thank everyone for the gallant and generous and dedicated work of Health Care Workers here. But i was also really wore rained wasnt only really worried but so were the National Nurses united i received a letter from them that really articulated my concerns. What they said to me, and now i quote them, is that the president needs to invoke his executive authority to maintain uniform National Standards and protocols, that all hospitals must follow safetyprotected patients or Health Care Workers and the public. They then go on to talk about the personal protective equipment needed, particularly hazmat equipment, and they identified the actual osha standard number. My question to you, secretary burrell, is do you feel confident that now in the way we are responding that the doctors and the nurses who are actually touching patients have the protective equipment that they need, that these are National Standards for not only the equipment but the training so that we have a National Response regardless of where someone might appear that needs help . Could you share with us and did you respond or did the president respond to the National Nurses united request . So, with regard to the issue of making sure that our Health Care Workers are prepared i think we need to think about in the a number of different levels. The first is in that screening and monitoring and thats what state and local Health Care Workers are doing, with then checking on the people who have come from these countries. Second is that that initial front line worker, in a Health Care Institution that needs to be able to detect and isolate, ask the right question. If you have a fever, what is your travel history . The next is the level where treatment will occur and as we describe in our submission, this will be in a more state by state basis and where the cases are in terms of treatment. The question i think the nurses were posing was on the category that had to do with that front line. As i mentioned in both my oral and written testimony, at this point, we have trained over 250,000 people. What we need to do now, and thats part of what this request is about, is to make sure that that training continues and extends and we need to measure it, what we are hearing when we hear from the nurses, we want to make sure we respond. Do they know . Is the training working . Do they feel confident . Right now, we are working with the association of state and Tribal Health Care Organizations to make sure that we are going to put in place a measurement so we can understand they have what they need with regard to training much the second part the nurses mention is ppe, the protective equipment. Yes. We have provided guidelines through the cdc in terms of whats needed in training and what to do. The second issue is access to that and through the assistance secretary assistance and sport, barta, working with the manufacturers producing 24 7 now working with them and work with the states to make sure that those who have the greatest need and will most likely treat get that equipment. Well, madam secretary, let follow up on this. So do you feel confident that we have that if ebola appears, you used on page four of your testimony, the maryland case example, a young lady came in, she took her temperature, she thought she might have it, she wasnt gonna go to nih, she was going to go either to maryland or hopkins. That those who would be once identified with the high temperature, et cetera, that they would have the equipment and that they would know how to use the equipment, but regardless of whether they are at a hightech urban hospital, like a hopkins or a maryland, an academic center, but could be a communitybased hospital in a rural area, that you would be ready to respond to see that they had the equipment and the training . That is why we are doing the aggressive training that we are going. Do you feel confident that we have it now or in process . Right now what we are seeing in all the cases that you articulated and all those who have come through. We are providing at the border a kit. Any individual coming through, which is where the case would originate, gets a phone number that they are supposed to call. They get a thermometer to take their own temperature. What i need to get is for that nurse to feel that if she has to walk into a room and provide the care that she has taken an oath to do, along with the doctors and others that are the support staff that theyre going to have what they need to do the job and that they also have what they need to protect themselves. That is what we are working to do with all the training. At this point weve trained 250,000 and the funds that were isnt this what your money is for . Yes. Really . Its to continue that effort. Isnt that part of the Public Health infrastructure . It is. This is the basic and its not just for ebola. I have to put the publics minds at east and i have to put the nurses minds at ease not just to put them at ease but to cover their back and their arms and legs, et cetera. A question for our constituents that go towards the military. The calls i got is were sending our military in harms way to protect us against terrorism. But now were sending them to get ebola. My constituents were deeply concerned that in deploying our military to do the excellent task that youve just identified, mr. Lumpkin, that they were going to be exposed to ebola and they were being put in harms way to get ebola. Do you believe in your employment and if the good general needs to respond, are our military actually going to come in contact with people with ebola and our are military at risk of getting ebola . And are we sending them in harms way in the same way we are doing it with a bullet, but here were doing with the a disease . Thank you very much for the question. I think one of the key aspects here is what i mentioned in my opening remarks is that d. O. D. Personnel are not doing direct patient care of those that are infected with the ebola virus. Weve taken great steps to ensure that our military and civilian personnel receive training before they go. Comprehensive training. We make sure that we monitor them while theyre there. And we make sure that we have a controlled monitoring situation when they return. Ill defer to my joint staff counterpart who can go into the specifics about it. Thank you. General, welcome. Thank you very much. The personnel who are going to be deployed, as the assistant secretary said, will not be doing direct patient care. Weve instituted four levels of predeployment training for all the personnel who are going. From the lowest levels of transient peoples, think about air crews flying in, not getting off the airplane, and flying out. Graduating up to personnel who will be in country, who will have to interact with liberian nationals as they go about their daytoday business. Those personnel will receive training in how not to come in close contact with those personnel and will be issued ppe that they will carry with them in the case its necessary. Up to higher levels of training for our Health Care Professions who will be in country at the two rural hospitals, one in monrovia and one in dakar, senegal, who will be there to treat our military personnel both for regular injuries and be able to treat them if they somehow do come in do contract ebola. And, finally, to the highest level of training for our lab workers who are there now, testing blood samples as part of the support there. Yes, weve got a complete protection package for those personnel. Thank you very much. Im now going to turn to senator shelby. I could have asked about the protection of our border people and state Department People and i look forward to you perhaps submitting an answer to that. So we protect those who are trying to protect us. Senator shelby . Thank you, madame chair. On october 17th, president obama named ron clain to a white house post responsible for coordinating our response to the ebola crisis. How many times have you met with this is a question for all our witnesses. How many times have you met with mr. Clain since his payment and what has he brought to the table, to the effort, in other words, that was missing. Madame secretary, start with you. Ive been in touch with mr. Clain every day since he has begun, face to face, by phone or by email. In terms of what he has brought to bear its been my experience and my experience last time when i served in government, the importance of policy coordination, i was there at the beginning of the National Economic council where we did much consultation. Its a very Important Role in terms of when a whole of government effort is occur. And mr. Clain has stepped into that role and added value to our coordination. He had been working with folks before but it is helpful to have someone in the white house daytoday to do that function. What has mr. Clain brought to the table . I cant say ive been in touch with him every single day. Ive been in touch with him countless times. Okay. I believe that the critical value that ron has brought to this is coordinating the federal response between and among all the agencies, components you see represented here and having somebody who is dedicated full time in the white house to doing exactly that. Secretary . My first meeting with mr. Clain was within 24 hours of him assuming duties and not daily but nearly every day in contact with him and he has done an outstanding job of doing just that, coordinating and singular focus for the administration of coordinating across interagency. Ive just been back from Maternity Leave for two weeks, senator. Ron was appointed to his position prior to my returning. Youll be excused. Since then weve had frequent interactions. Its the policy coordination thats so key to our response. To your knowledge, does mr. Clain have the authority or power to direct your agencies to perform any specific actions or is it mainly trying to bring you together . Policy coordination with regard to the execution of the agencys responsibilities, those sit with me and with the heads of our operationing divisions like dr. Frieden. Secretary burrell, on october 28, president obama was issued more stringent rules for returning Health Care Workers stating we dont just react based on our fears. We react based on facts. As weve all known, secretary hagel has approved mandatory quarantine for troops who have been deployed to the ebolaaffected areas. Forum, most military personnel, as weve learned are charged with building facilities and will have limited, we hope, patient contract. While civilian medical workers will have direct patient contact. What facts, that was the word the president used, should we base quarantine guidelines on madame secretary . I will start but turn to dr. S frieden and fauci. Weve determined level of risks. Quarantine base system based on their level of risk. And thats based on the epidemiology which is years of experience, i think dr. Fauci has been work on this for well over 30 years. In terms of the experience that we see. Thats how we determine whats done with each and every group of people and different groups fall into different categories. Thats how we base the decision. Thats an individual basis often which is why we monitor directly and actively every day those Health Care Workers that return. Is the assessment ill direct this to you, too, doctor, since youll be in on this. In the assessment of risk difficult when people are coming from various countries and perhaps dont divulge where theyve been . I know you can keep up with it to some extent. Who theyve been exposed to, all of this . Is the assessment tough to come by . We do several levels of assessment, first to assess the fever, to see if someone is ill. And then to assess them if they do have a fever to determine the cause. Second to see what exposures they may have had working in an ebola unit or are being a Health Care Worker otherwise or having potential exposure to someone who may have had ebola. But for every one of the individuals who returns, we ask the states to undertake an active monitoring process and we facilitate that process, as secretary burwell said so theyre taking their own temperature and if they develop fever, they are rapidly contacting the Health Department of their state, where they can be safely transported to a facility that is ready for them. Ebola, as far as everything weve seen only spreads from someone who is ill. It doesnt spread from someone who is not ill. If you can find that illness quickly and isolate them, then you can stop them from transmitting to anyone else. That, essentially, is the way of protecting not only their health but also the communitys health. Doctor, you want to add yeah. So in some circumstances when we have a high risk, when we strat fie risk versus the movement, there is a functional equivalent of a quarantine if someone is at a high risk. It isnt as if its all or none, but not saying theres a blanket quarantine were being somewhat reckless of making everyone have the same sort of movement. We dont do that

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