THE NATIONAL COMMISSION ON CHILDREN AND DISASTERS Daniel A. Singer, MD, MPH, FACP

June 22, 2011

Hurricanekatrina.org

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

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.

Overview

Genesis of the Commission Commissions, Advisory Committees,

and FACA Purposes of the Commission Work of the Commission Relationship with HHS Recommendations Subsequent Actions

Multiple needs of children were unmet During the disaster Immediate and long term aftermath

Hurricanekatrina.org

Hurricane Katrina

People/AP

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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.

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)

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

Congressional vs Presidential Commissions Selection of members varies widely Members are special gov’t employees

Federalized for their term Paid salary

Whisky Rebellion - 1794

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.

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

Commission Staff Executive Director Executive Deputy Director (ACF) Designated Federal Officer Policy Director Policy Specialist Communications Specialist Executive Assistant

Budget ~ $1.5 million/year

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

Subcommittees

Education and Juvenile Justice Pediatric Medical Care Human Services Recovery Evacuation, Transportation and

Housing

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.

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

Final Report

Delivered on October 6, 2010

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 Disasters Advisory Council”

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

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

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

Recommendations – Examples

3.5a - Congress should establish sufficient funding mechanisms to support restoration and continuity of for-profit and non-profit health and mental health services to children.

Recommendations – Examples

6.1a - Congress and HHS should require States to include disaster planning, training, and exercise requirements within the scope of their minimum health and safety standards for child care licensure or registration.

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

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

Daniel A. Singer, MD, MPH,FACPdaniel.singer@nih.gov

Daniel.Singer@nih.gov

Questions