The National Commission on Children and Disasters

1. The National Commission on Children and Disasters Hurricanekatrina.org Daniel A. Singer, MD, MPH, FACP June 22, 2011

2. Objectives • Describe the basic needs of children that were unmet in recent disasters, including Hurricane Katrina • Explain the role of an independent commission in advising Congress and the President • Identify three recommendations of the National Commission on Children and Disasters that have implications for HHS and its agencies

3. Disclaimers • No conflicts of interest to declare • The opinions expressed in this presentation are solely my own and do not reflect views or official policies of HHS, it employees, or its agencies.

4. Overview • Genesis of the Commission • Commissions, Advisory Committees, and FACA • Purposes of the Commission • Work of the Commission • Relationship with HHS • Recommendations • Subsequent Actions

5. Hurricane Katrina Hurricanekatrina.org Hurricanekatrina.org • Multiple needs of children were unmet • During the disaster • Immediate and long term aftermath People/AP Hurricanekatrina.org

6. Advocacy • Early concern for children post 9/11 and anthrax • Post-Katrina, multiple advocacy groups coalesced around both social and health issues • foster care, • early child development • pediatric EMS • etc.

7. National Commission on Children and Disasters • Authorized under the Consolidated Appropriations Act of 2008, signed into law by President Bush on December 26, 2007 (P.L. 110-161). • First public meeting - October 14, 2008 • Established under the Federal Advisory Committee Act (FACA)

8. Federal Advisory Committee Act (FACA) • Passed by Congress in 1972 • Ensures that advisory committees • Provide advice that is relevant, objective, and open to the public; • Act promptly to complete their work; and • Comply with reasonable cost controls and recordkeeping requirements • Congressionalvs Presidential Commissions • Selection of members varies widely • Members are special gov’t employees • Federalized for their term • Paid salary Whisky Rebellion - 1794

9. Purposes of the Commission • (1) conduct a comprehensive study that examines and assesses children’s needs as they relate to preparation for, response to, and recovery from all hazards, including major disasters and emergencies; • 2) identify, review, and evaluate existing laws, regulations, policies, and programs relevant to such needs; • (3) identify, review, and evaluate the lessons learned from past disasters relative to addressing such needs; and • (4) report to the President and Congress on its findings and recommendations to address such needs, including regarding the need for a national resource center on children and disasters, coordination of resources and services, administrative actions, policies, regulations, and legislative changes.

10. Commissioners • 10 members, 2 appointed by the presidents, 2 by senate majority, 2 by senate minority, 2 by house majority, 2 by house minority • Mark K. Shriver, Commission Chairperson, Vice President and Managing Director for U.S. Programs, Save the Children • Dr. Michael Anderson, Commission Vice-Chairperson, Interim Senior Vice President and Chief Medical Officer, University Hospitals • Ernie Allen, President & CEO, National Center for Missing and Exploited Children • Merry Carlson, Preparedness Chief, Division of Homeland Security and Emergency Management, State of Alaska • Honorable Assemblywoman Sheila Leslie, Nevada General Assembly, 2nd Judicial District Court • Bruce Lockwood, Public Health Emergency Response Coordinator, Bristol-Burlington (CT) Health District • Graydon "Gregg" Lord, Senior Policy Analyst and Associate Director, Homeland Security Policy Institute, George Washington University • Dr. Irwin Redlener, President & Co-founder, The Children’s Health Fund & Director of the National Center for Disaster Preparedness and Professor of Clinical Population and Family Health, Columbia University • Dr. David Schonfeld, Thelma and Jack Rubinstein Professor of Pediatrics, Director of the Division of Developmental and Behavioral Pediatrics, and Director of the National Center for School Crisis and Bereavement, National Center for School Crisis and Bereavement, Cincinnati Children's Hospital Medical Center • Lawrence “Larry” Tan, Chief of Emergency Medical Services, New Castle County (DE) Department of Public Safety

11. Commission Staff • Executive Director • Executive Deputy Director (ACF) • Designated Federal Officer • Policy Director • Policy Specialist • Communications Specialist • Executive Assistant • Budget ~ $1.5 million/year

12. Areas of Interest • Trauma, physical and mental health • Child welfare • Child care • Housing (sheltering, intermediate, long-term) • Evacuation and Transportation • Elementary and Secondary Education • Juvenile Justice • State and Local Emergency Management

13. Subcommittees • Education and Juvenile Justice • Pediatric Medical Care • Human Services Recovery • Evacuation, Transportation and Housing

14. Work of Commission • Met with most HHS agencies, FEMA, and others • state/local gov’t, • Non- governmental and professional organizations, • town hall meetings. • Three “Field Visits” • Public meetings were held on a quarterly basis. • An interim report was delivered to President Obama and Congress in October 2009. • The Commission delivered its final report on October 6, 2010.

15. Working with HHS • Commissioners • Have individual and group agendas • Can participate in federal meetings • Try to influence programs • Designated Federal Official • CAPT Juliana Sadovich • Supports Commission, but can’t have a stance on their recommendations

16. Final Report • Delivered on October 6, 2010

17. Recommendations • 31 recommendations in 11 categories • Most have numerous sub-parts • Includes a Model Executive Order or Resolution Creating a “Cabinet on Children and Disasters and Children and DisastersAdvisory Council”

18. Recommendation Categories • Disaster Management and Recovery • Mental Health • Child Physical Health and Trauma • Emergency Medical Systems and Pediatric Transport • Disaster Case Management • Child Care and Early Education • Elementary and Secondary Education • Welfare and Juvenile Justice • Sheltering Standards, Services, and Supplies • Housing • Evacuation

19. Recommendations – Examples • 3.1d - Within the HHS Biomedical Advanced Research and Development Authority, designate a pediatric leader and establish a pediatric and obstetric working group to conduct gap analyses and make research recommendations

20. Recommendations – Examples • 3.2c - HHS and DoD should establish a Pediatric Health Care Coordinator on each disaster medical response team and develop strategies to recruit and retain team members with pediatric medical expertise

21. Recommendations – Examples • 3.5a - Congress should establish sufficient fundingmechanisms to support restoration and continuity of for-profit and non-profit health and mental health services to children.

22. Recommendations – Examples • 6.1a - Congress and HHS should require States to include disaster planning, training, andexercise requirements within the scope of their minimum health and safety standardsfor child care licensure or registration.

23. Termination of the Commission • In accordance with Public Law 110-161 (2008), Sec. 611 (d) (1), the National Commission on Children and Disasters was terminated April 4, 2011

24. Children’s Interagency Leadership on Disasters (CHILD) Working Group • Chaired by • Dan Dodgen (ASPR) and Shannon Rudisill (ACF) • 4 committees • Child Care and Child Welfare • Mental health • Medical Countermeasures • Child Physical Health, Emergency Medical Services, and Pediatric Transport • Report in interagency clearance

25. Questions Daniel A. Singer, MD, MPH,FACP daniel.singer@nih.gov Daniel.Singer@nih.gov