to sending our military to fight an enemy without a secondary weapon in their arsenal. while in afghanistan for the majority of 2011, my unit served in the home province. i was faced lebanon but since sometime with the british is your market on royal airbase. my physical injuries as a result of military service our insignificant relative to my fellow veterans. but like many veterans today who showed little signs of physical injury, there are many stars that beneath the surface. during the last few months of my deployment, our replacements were starting to arrive and takeover the operational capabilities of our unit , i felt i wasn't doing enough to help the cause of our war fighters. i started volunteering my time largely during sleep hours at a severely understaffed trauma center. it was there, mentally unprepared for the new volunteer role i assume that has affected me most in my post appointment transition. upon returning stateside, veterans post appointment

health assessment which indicated i needed to seek treatment for posttraumatic stress. i started to utilize the va system and eventually i met with a psychologist who confirmed the preliminary results of the health assessment. i was then prescribed sleep aids and antidepressants and told utilize what is called a veterans center in my local area for counseling. a little less than two yearson this path , the symptoms to stagnate or get worse. upon discharge from the marine corps into early 2014, interpersonal relationships were harder to maintain the necessary along with not having the support system of my fellow marines and the chain of command. i didn't have a civilian job, was not in school yet and simultaneously was experiencing a divorce. in the same few months i would experience what most veterans now are all too familiar with. a loss of military friends to preventable suicide. many of these veterans had gotten addicted to the slew of pills prescribed to them and

lost even a glimmer of hope in their lives. some of these men and women have spouses. had children, mothers , fathers and friends. they left behind because the status quo of treatment for posttraumatic stress failed. life as i noted had been ripped away and one might alone i decided to end it all. it is only for the timing of friends and fellow marines arriving on my doorstep at that exact moment that i am here right now. separate the dallas in the. the next day i quit my medication cold turkey not wanting to continue down the dark path of opiate addiction. i saw another way and found that a trained this dog was an option but not one provided either va. further inquiry to other local

nonprofits similar to canines for warriors resulted in wait times over a year with the demand being as high and nonprofit budgets being what they are. a few months after searching myself, i got kia was at my feet today. quite literally pounced into my life. i had her obedience trained and subsequently trained for posttraumatic stress symptoms by assistance dogs international accredited trainer. after roughly $10,000 all told, with my family's assistance of my own money, i got the help i needed. yesterday, many veterans still don't have those resources. i still have my bad days but with kaiya at my side i am largelyin a different phase. i call it recovery , retired

marine general james matus calls a posttraumatic growth. the bad days are less frequent than they've ever been and they mainly come when i get news of another friend has committed suicide.since starting this quest, more of the veteran community have come forward to impart upon my the stories of their brothers and sisters who have taken their lives. just last week a close friend of mine in texas lost a marine he served with two suicide. a month ago, one of my best friends who i deployed with and the father of my goddaughter admitted to me that he had gotten close and also would have succeeded had another marine not step in. they all come to me pleading, in fact begging to use what voice i have in this chamber and in the call halls of congress to give you all this message.service dogs will save lives. and with the current epidemic of veteran suicide, it is unconscionable to keep the status quo and wait any longer

to institute this change we all know is a viable solution to reduce the academic of veteran suicide. i do very much for the opportunity to testify and i look forward to answering your questions. >> thank you. mister feldman, you're up for five minutes. >> mister chairman, ranking member lynch, members of the subcommittee thank you for the opportunity to testify. i'm steve feldman, executive director of the human animal bond research initiative. we are a nonprofit research and education foundation that funds research on the benefits of companion animals to human health and specifically we are looking at children with autism, looking at show victims of domestic violence and how we can use these animal assisted interventions for veterans with posttraumatic stress. in addition to funding this research we also have built and maintained the world's largest research library on human

animal interaction and that's free and online and available and searchable to anyone doing research in this area. we also support commonsense public policies that should reflect a definitive body of science to show significant positive health impacts that companion animals have on human health.the va says it doesn't have enough evidence to support service animals for veterans with ptsd. we respectfully disagree and that's why we support hr 4764. we believe there is significant scientific evidence support the efficacy of service dogs for veterans with pts. we funded the first systematic review of research on animal assisted interventions for victims of trauma that was conducted at purdue university with doctor allen's alma mater and it was published less than a year ago and what it found was preliminary evidence that animals provide unique elements to address pts symptoms. i think it's also important to note as mister simon said,

what's the harm? this systematic review of published and unpublished research found no negative effects for many of these studies so no harm was found in any of the research we looked at. we think this supports the conclusion that service dogs for trauma survivors including veterans with pts can positively affect depression, anxiety, social outcomes, sleep quality of life. we are currently funding a pilot study on the effects of service dog on mental health and wellness in military veterans with pts. scientists are measuring psychological and psychosocial functioning including symptoms of ptsd, depression, life and relationship satisfaction and quality of life in 137 military veterans diagnosed with ptsd who either have a service dog or are waiting to receive one and the ones waiting to receive one is our scientific control group. so the preliminary unpublished results indicate military veterans with service dog have significantly lower overall

severity and that includes their ability to cope with flashbacks and anxiety attacks, reduce frequency of nightmares and less sleep disturbance, less anger, higher levels of companionship and social reintegration, increase overall psychological well-being and higher levels of life satisfaction and resilience and we have to wait for the final results of this study to be published in a peer-reviewed scientific journal which we expect to happen later this year but we wanted to bring you these preliminary outcomes because they are so encouraging and important to the discussion today. i also urge the committee and the va to look probably at research studies that really look at several key measures of mental health and well-being like depression, anxiety, stress and social integration. all of which are associated with pts. by written testimony covers these in great detail and you can find more studies in our database. that's why an organization like having can be helpful because we're looking at the broad

spectrum of research, not just one slice of it and that broad-spectrum is definitive. for example, we're looking at what's happening in a person's brain when they interact with an animal. the level of oxytocin which is a good hormone goes up, the level of cortisol which is a stress hormone goes down and so when fingers meet her there is something really fantastic happening and i think we've heard about some of those specific examples today. if you combine the scientifically documented therapy effects with the trained actions of a service dog you get a powerful combination. the american disabilities act recognizes service dogs for ptsd and their regulation and states are increasingly updating their definition of service animals. last year the state of florida passed a law to expand protections of service animal statutes to include traumatic brain injury and ptsd.

and the inclusion of these protections allows veterans have a disability that may not be outwardly visible to have access to public accommodations with their service dogs. and sometimes these symptoms manifest themselves in public so while at an emotional support animals can provide some of the benefits we've been discussing, it's only a train service dog that has for public access to provide that animal assisted interventions wherever and whenever it's necessary for a veteran with ptsd. what about the doctors in all this question mark we did a survey last year which showed that of 1000 doctors which showed 69 percent have worked in hospital medical centers for medical malpractice and 80 percent of doctors saw improvement in a patient's physical condition and 97 percent saw an improvement in the patient's mental health condition as a result of animal assisted interventions so doctors are likely to be really supportive if we can get this program going and really willing participants as we provide service veterans with pts.

so i just want to conclude by saying there is a growing body of research that demonstrates widespread positive mental health impacts from human animal bond and we hope you and the va will take this broad evidence into consideration when shaking public health policy with relation to 4764 and beyond . and i hope the members of the subcommittee and the va will rely on habri as a resource for anyone who is interested in this. with pts affecting so many of our veterans, we need to make sure everyone has access to service dogs and hr 4764 really is a step in the right direction and that's why we support the legislation. so mister chairman, ranking member lynch, members of this committee i want to thank you i want to thank for hard-working staff and especially mister chairman, thank you for your leadership on this issue and i'm happy to answer any questions you may have. the chair now recognizes himself for five minutes.

doctor fallon, why does the va reject pairing of veteran suffering from pts with service dogs? >> we don't mister chairman. the va is thrilled service dogs help veterans. it's just as a large medical organization we have to rely on evidence-based medicine . the veteran population is very heterogeneous, what helps one veteran is not going to help all. >> have any of the preliminary results pointed to by the witnesses at purdue, has that changed any of the thinking within the va? >> mister chairman i would point out that in the publication that was funded by habri, doctor lemaire published in 2015 one of the main conclusions was more research needs to be done. that's right out of the paper. she also documented a number of deficiencies in literature. she also was quoted on military times article on her work. it's nonbiased research needed to be completed, this is in

2015 that said, the va's approach to pts, is it fair to say it relies heavily on pharmaceuticals? >> i'm a veterinarian mister chairman, >> you're not familiar with how these veterans, basically you are here is a veterinarian. you don't have as much knowledge on pts generally? >> no mister chairman, my role here is to update you on our study. i would not pretend to be an expert in human clinical medicine. >> i think all the indications we've received from witnesses, from veterans are that you get counseling, you get drugs. that's the two things and that's effective for some people but there are other people and i think colonel weil is one who will say that's not good so maybe you can answer this but are there dangers associated with providing veterans opioids and other pharmaceuticals to deal with pts question mark. >> i can comment on that mister chairman. >> what would you say to that, mister diamond?

>> if you look at the wikipedia entry for some of these opiates, they clearly set down an entire list of side effects including increased suicide. in our opinion the dog is not going to cause any harm and yet we see every single month our classes, the warriors are transforming. they come in and they are a correct. there overmedicated, they're frightened to leave their homes and we see them over three weeks working with our staff, working with service dogs as that bond kicks in. they become different people and they are able to go to a store again. they're able to go to the beach in florida again and these are things they could not do without their service dogs. it opens the door, it lowers barriers to getting otherhell. they become more like the people they were before they went off to war . >> mister feldman , the opioids.is there a dangerous side effects with that, that accurate to see that that's the case? >> i think everyone knows that but i do want to respond something that dr. fallon said.

we are here in washington so there's a lot of regulations. you're not never going to meet a regulator who says we have enough regulations. you're never going to meet a researcher who says we have enough research. we need to do more research and that's what we're finding right now when you added up, we really do think there's enough research to substantiate this program. >> has there been any research that substantiates dangerous side effects with parent of veteran with a service dog? >> no sir, there is an absence of that. >> lyle, have you had any negative side effects since you've been paired with your service dog? >> that's a strong negative, mister chairman. >> i think we all agree that veteran suicides are a major problem. we do everything we can to prevent them and i think it makes sense that the va should explore all possible ways that this can be dealt with and i understand there may not, people can say well, we need more literature but you have enough evidence there that i think it's something that is

long overdue. let me ask you this. mister feldman, how is the va's opposition to providing service to arm veterans with pts? >> well, i guess i will speak as a citizen on this one. i just don't think were veteran and waiting list along in the same sentence. and while canines for warriors and other organizations like it are doing their best to put as many calls on the ground as they can, the only way we are really going to get this done is if we have the va providing that kind of support. >> what about mister diamond mark what's your judgment about the va's posture? how has that affected veterans. >> it cost lives, there's no question that there are thousands of veteran suicides that could have been prevented had they had the access to the service dog . >> and while, i know you have been involved in advocacy on this issue. you've gone through the halls

of congress and spoken with people. what's been the reception from members of congress on both sides of the aisle so far? >> mister chairman, the response has been overwhelmingly reported. we have bipartisan support on hr 4764. this is not a partisan issue. everybody knows we need to take care of our veterans. of course, we had different ideas about how to go about that but i personally walking the halls of congress and speaking with democrats, republicans, conservatives, liberals, everybody agrees that this is a good idea. and that we should do it. >> well you've done a good job. as this bill progresses and we have different steps, some of these guys on casey may be coming out to save your success in congress and mister diamond, i think canines for warriors has done a great job. it's the heart of the district and i'm privileged to represent

and i know you guys have expanded and you are there to help but i mean, you can only do so much. i wish you guys that have unlimited numbers but, you guys are part of it but i think we need to have a broader awareness here but i appreciate all witnesses for their testimony and i think thank you guys for coming and i recognize the ranking member, mister lynch. >> thank you mister chairman. i for the record, we got some hearings over in the senate on veterans and opioid addiction and this is a 2015 hearing. and in response to questions around opioid disorder by senator joe donnelly of indiana, the va indicated that about 60,000 veterans today or in 2015 had opioid use disorders. i think it represents about 13 percent of the total population

of veterans currently taking opioids according to the va so that's a lot of veterans. it's 60,000 have opioid use disorders and that's 13 percent of the veterans on opioids. that's a huge problem. couple of the witnesses have mentioned the costs and we just had a opportunity to go to iraq last week and and bar province and they had a couple of dogs they trained but those are trained for bomb detection. and but i ask, i asked the dod, i said what does it cost for us to train a dog, in that context and they said $65,000 each but that dod. i'm not surprised that the private sector doing it for a heck of a lot less and it's probably apples and oranges, they get trained for something

entirely different but col. lyle, first of all thank you for your service to our country and your help with veterans still. is that what, that can thousand you mentioned, is that what it cost you. >> yes sir, that's what it cost me to acquire kaiya, to pay for her training and initial veterinary care for her. i would note that $10,000. >> is that acquisition as well? >> yes. i would note that $10,000 is quite frankly she for. >> for the life of a dog and the benefit that it pays, you are right, absolutely. >> the $10,000 i would pay 10 more times if i had to do it over again.>> don't let the dod hear you say that. >> but it has paid dividends in

how i'm able to overcome specific symptoms associated with military experience and i would recommend it highly to anybody who feels as though opiates and traditional therapies just not working. >> thank you. mister diamond and mister feldman, mister diamond first. 17,000 square feet, you mentioned your facility in florida. and obviously there are efficiencies of scale because you are training so many dogs. how many dogs you probably train at a time? >> right now we have capacity for about 30 dogs in our campu . in a couple months will have capacity for 60. >> and what you see in terms of the costs of your more professionally doing it 30 times the wax, what do you see

your cost on the average question mark. >> we are finally seeing economies of scale. two years ago we were in the 40s. his staff here we were $32,000, this year $27,000 and we expect next year for the entire three week program was all the lifetime wraparound services to be about 22, $23,000 that we finally economies of scale and i would echo mister liles statements, that is the reduction of use of va services generally speaking and higher quality of life, the better human being you get at the end is a huge cost savings for the country.>> what's the lifespan, the average lifespan of one ofthe dogs? >> is between eight and 12 years . >> mr. lyle, you have something else? >> i would note that 8 to 10 years , kia started helping me within weeks. it does not take 12 years for these dogs to really assist veterans. >> know, i mean their training

well that 10 years of soda so that the servicing being rendered, you divide the cost of training and acquisition over the 10 years and advertise it i guess. mister feldman, you have anything else you'd like to add? >> you mentioned cost. i can tell you the pilot study looking at hundred 37 veterans which we announced the funding for last year and which will be completed next month and probably published later this year, that will study cost us upwards of $50,000 and we are getting results within a two-year period so yes, we need to do more research but it doesn't have to take that long or cost that much. >> you know, you see the number of veterans that we are treating with opioids and there's just no happy ending their with the addiction rate we have so we've got to try something different. my time is expired. thank you for your indulgence mister chairman. >> thank you gentlemen and the

chair recognizes the vice chairman of the committee, mister russell five minutes. >> thank you mister chairman and thank you for being here today. >> doctor alan, i noticed that he served in the military, thank you for your service. when you did serve, you served in a veterinary capacity as i understand it, is that correct question mark. >> yesterday, i was a technician. >> in that time did you develop a bond with the animals under your care? >> absolutely sir, yes. >> and would you say that now as a doctor of veterinary medicine you develop a nurturing bond with the animals in your care? >> absolutely. >> did you see dangers associated with parent service dogs with veterans? >> well, as the chairman mentioned i have seen problems with dogs, particularly dogs that are not properly trained. for instance we had those two children that were bitten which was a tragedy. it didn't help those veterans. also there are things to take into consideration. if a dogbecomes sick , and up with a chronic illness, that

could be huge veterinary bills associated. the veteran can actually become quite depressed, we've seen this anecdotally. >> how do you compare that to say veterans suffering from opioid abuse? harming their families, their own children, maybe harming others around them and getting in a depressed state? which would you say is more of a danger. >> i couldn't comment on that server. i'm a veterinarian. clearly all those things are terrible things though. >> you personally believe veterans would be harmed by their care and association with service dogs? >> i do not know the answer to that question. >> but you have a lot of experience. you served in the military, you're dealing with animals, you're a doctor of veterinary medicine. you have a lot of animals in your life, i just want to know and you came as a expert testifying before congress, i'm just curious of your personal opinion.

do you believe veterans would be harmed by their care and association with vertebrate service docs. >> i be reluctant to give my opinion because it could affect thestudy so i would prefer not to do that . >> i think that's telling and i appreciate you for being loyal to veterans administration but i think we have a greater responsibility as a nation to be loyal to our combatveterans and those that have suffered a great deal . i handled the flesh and blood a file on many battlefields to include iraq and afghanistan. as a combatinfantryman i've dealt with a lot of the issues that we are discussing here today . as a utterance advocate before entering a career in politics i guess if you call a career, i've even assisted in help place service dogs with veterans and see dramatic results. you know, whether that is a placebo effect or whether it's reality, i can tell you the

results have been remarkable. but here's what i also note. opioid abuse is a tragic indictment on the veterans administration. i would also tell you that on many veteran suicides i think are misdiagnosed. it's not unlikely for a soldier maybe drink a beer and now he's prescribed on oxycontin or percocet. he diminishes himself to a very low state, he doesn't breathe anymore and then the family finds him in the morning it's like g, russell didn't have any indication that he had any problems. in fact he was talking about going fishing this weekend and now he's dead and they talk them up as a suicide. here we have an opportunity to do a great deal of good with very low risk and if the price of that is to dog bites, i think we can do that. and i also think that the expense of a dog is far cheaper then years and years of opioid

addiction. we are legalizing heroin in this country and we are using our veterans as the number one scientific lab of opioid abuse. it really angers me and i've been prescribed percocet. oxycontin. floated around for several days and i'll tell you this, i quit cold turkey on it because i would rather have a clear head and pain then deal with a drug addiction and depression. i think intellectually honest here today and whether doctor crow would like to give his professional opinion if you can't the medical side or yourself, give me one good reason why we should not implement this

>> thank you very much for the question. first of all i think we are mistakenly confusing a couple of issues. opioids are not used to treat ptsd. a lot of folks with ptsd also a chronic pain conditions and they may have started opioids to treat the pain. but opioids are not used by va to treat ptsd. we also monitor prescribing practices and sent in experts to facilities where we think there's some miss practice going on in an attempt to crack that.

we also, as you know, we have the opioid rescue kits that now are being put in the hands of every veteran who's been prescribed opioids. this is also very personal issue for me. my sister died of an unintended opioid overdose. i take this very seriously. but it's not part of our ptsd discussion. >> and i appreciate that, and thank you, sir, for your insight. >> can you just state your full name for the record so we have it? >> doctor chris crowe. >> thanks. intertidal? >> senior mental health consultant, centers of excellence for psychological health. >> thank you. i appreciate your patience we've been put on the spot but understand you did come here as well today. look, this is a real issue and i don't let anyone sitting don't let anyone sitting after or a.

doesn't have concern and care to do the right things your but which also in your professional opinion acknowledged that those who feel more than likely with ptsd issues are also liable to be suffering from some sort of pain due to their service? of these to our associate together, would you agree? >> not necessarily. i think they cope occur in many people, folks have been deployed have many opportunities for injury and come back with lots of moscow skeletal pain -- moscow skeletal pain. then they. opioids are never used to treat ptsd. >> i will take you at your word for that but i'm also absolutely put it to you that people suffering from ptsd are often

drugged in a great deal of medication. so with a basket load of issues and problems, and think of soldiers or sailors or airmen and marines they take their medications. they fall the doctors orders. mr. chairman, i exceeded my time on it would like to say these programs come this far for evidence that they work than they don't and there's an awful lot of evidence that we are not doing a very good job with our treatment of ptsd and that we have a lot of veteran suicides, i believe, personally just an observation, i only come as a combat veteran. i'm not a doctor. i just fought for the. so what we tell you is we are not meeting those types of issues and we are trying to drug our veterans, send them off to some clinic rather than get them engaged in something productive. with your indulgence, thank you, mr. chairman. i yield back. >> the gentleman's time has expired. time done.

now recognize the gentleman from georgia mr. hice for five minutes and will have dr. fallon come back and resume his spot on the witness stand. >> thank you very much, mr. chairman. dr. fallon, do you have any idea how the va is recruiting qualified veterans for the study? >> that in participants? the folks at -- >> correct. >> they are recruited to each of the three medical centers through fliers and presentations to mental health clinicians. >> is there currently a waiting list of qualified veterans would like to participate? >> there is a waiting list at one of our sites. the portland, oregon, site because we found particular problems in recruiting both by doctrine for the site. how would we know have one trainer that is working now. spirit how large is the waiting list?

>> i cannot say for sure i would say it is probably in the range of maybe 20 people perhaps. >> this is at one facility? >> yes, sir. >> so are you saying that the personnel at va medical centers are unaware of this study and are actively engaged in in forming veterans of the potential of having a service the? >> yes, i would definitely say that. it's a very popular topic of interest with our veterans. >> does the va currently have any way to gauge the demand for the service dog's? >> we do not, sir. we do not have message of gauging for service dogs. >> is that under consideration? >> that would be outside of my purview. i couldn't say. >> mr. diamond, let me come to you. how are qualified veterans refer

to your organization's? >> we've never advertised for a veteran to come to our organization. they find us the word of mouth, there's a very tight veterans committee. when they apply with a 22 page application. we did interviews, criminal background checks, a thorough vetting process. by the time to do it comes to our camp perhaps a year after they've applied we know about the about the moderated to bring them into our program. >> so you don't get any advertising per se. it's all word-of-mouth? >> absolutely. if we advertise we would get inundated. we are pushing a two are pushing a two year wait list now. >> that's why was going. the va doesn't seem to have a lot of information. of course, it's not in the program but you're actively involved in providing service dogs to veterans and you have a two-year waiting list. how many, i mean, do you have any weight of gauging what the

need is? >> i wish we had a good measure. sense of under oath are not going to venture a guess but i do know this for sure, that the number of veterans that refer to us on the va because of the va because the va treating physician says i write anything else that will help you come is increasing come every single -- >> sure, absolutely. mr. lyle, first of all, thank you for your service come for your testimony, both are powerful and we deeply and an heartfelt way say thank you for what you've done for our country. how did you find out that service dogs were an option for ptsd in? >> i actually had a personal friend of mine who had a service dog that he also to acquire on his own and train. i'm not quite sure which organization he received his dog, well, where he got his dog trained.

but i knew that that was something that was an option, that veterans could utilize. and then when i went out to organizations specifically, i went to the organizations in texas it has that's were i am currently living. i got pretty much the same result, and the wait times were at least a year. i didn't feel as though i had the time to wait. >> okay. so you're introduction came through a personal friend of? >> that's correct. >> mr. diamond, let me come back to you and my time is almost up. twofold question. do you find that veterans struggle with affording service dogs as a general rule, and how does your organization enable them to pair up? >> two pieces to that.

the first is that some our veterans have reported back to us that they would rather make personal sacrifices than to not have him to forego having a service doctor they are on fixed incomes and, therefore, they do difficulty paying for it. most of the veterans we get cannot independently take to get a service dog out on their own. we've made a lot of partnerships with our corporate supporters, for example, better health is the together a network of documents to give free health care for the dogs, working with pet store to get free dog food for the better. we do everything we can to make it free or almost free for the veterans but the overwhelming message from them is they would forego their own personal comfort to make sure that they have a service dogs. >> very good. thank you, mr. chairman. >> thank the gentleman. mr. lyle, will your experience with the drugs? how did you get prescribed by the va? >> well again, trinity when i took the post-deployment health assessment which was the

preliminary, what they give you, i'm give you, i'm not sure that timeline but there is a timeline that the va is required to give that once you return stateside. i then went to a va facility in fort worth, and tried to use their system. i eventually met with a psychologist at the the hospital in fort worth and was prescribed the sleep aids and antidepressants. >> why did they do that? wawas it because of your sympto? >> correct. when i returned i was suffering from recurring nightmares and i would have a cute anxiety attacks. i also just do difficulty with close interpersonal relationships. as i've mentioned previously, one of the side effects that goes largely unnoticed as result of post-traumatic stress, there's a high divorce rate

amongst military members. but that also have affected me. it was at the direct cause of the divorce but it definitely did not help in any way, shape, or form. so it was affecting my personal relationships. the nightmares specifically. she will jump up in bed and lick my face to look me up so that's what of the ways that she has assisted me and my symptoms. i would further note that a dog indeed a sense of purpose that a pill just will not ever do. in the sense that were many days i did want to get out of bed. i didn't have really anything to do. as i said i didn't have a job at the time, wasn't currently enrolled in school. i didn't have any reason to you, but a service dog needs to be taken outside. they need to be fed. they give you reason to get up and be productive on a day-to-day basis and keep a

small sense of purpose again that you can go a. and again i reiterate that that's something that tells just did not do for me. >> because my testimony before this is not something that he is doing, providing drugs to i guess you disagree with what was said in your case? >> could you repeat the question? >> was a previous witness limited musical chairs who said that was not something drugs for ptsd are not something the va does. but in your instance is that what they did? >> well, my issues as result of post-traumatic stress were recurring nightmares. i got a sleep aid as a result of those nightmares. so i would disagree with that. >> and mr. diamond, the bill that we have done if it out of 22000, that's even more than what we are doing so that's good. you are confident you will be able to continue to reduce the

costs of each dog? >> yeah. i would hate for our donors do that but yes. we have hit economy of scale sufficiently that our efficiencies are in the low 20s for next year. >> okay, good. mr. feldman, what do you, i mean i guess, what is your recommendation for makin makinge case quick you are familiar with the research that is going on. what more in congress do we need to find and presenting, or did you think there's enough facts already in existence to justify moving forward? >> will continue to do research and we will come back and share the published research that we gave you a preview of the today. a pilot program as you have written in to this bill is a really good way to go because you built in some evaluation, built in a report on the program as part of the legislation. it's a chance to continue studying but also to a lot of

folks. so that's why we support it. >> great. look, at the end of the day there has been a lot of anecdotal evidence. there's some evidence coming out in some of the literature but here's the thing. i can understand why that would be a cautionary tale if there was somehow a negative side effect to this, but there's not. so the worst case scenario we are talking about is we've made some veterans happy with service dogs as companions. that's like the worst-case scenario and, obviously, if there's a positive effect you are actually giving veterans a sense of purpose. i believe saving life. i will just argue, since we -- i will just tell you i have had multiple veterans come up to me and tell me that they would've probably committed suicide but for being paired with a service dog. it's not often people look you in the eye and tell you that they probably would have done that. the really, really registers when you hear that. mr. lyle. >> mr. chairman, i would also

note that just being a veteran come any better and will probably tell you that they have come any better of a rock or afghanistan were publicly they either have a friend or a friend of a friend that has committed suicide and has been effected by this suicide epidemic the this study that was done by the va, i've also note back in 2013, that indicated that 22 veteran a day average committing suicide, that study was based on 21 states. so the number tragically is higher than 22 veterans by day. that was just a side note, but i will also say that since i have been doing this and, you know, i've been talking to members of congress, friends of mine specifically in texas, because the cost barriers are so hard to getting on service dog and many veterans join the military to get fm innocents is committed when they get out they don't have it anymore. they don't have the family

support i had to financially support their endeavor. and then they get told that the our way to over year and they don't feel they have that time. they go out and they just get a dog. and i went out, as i believe it was mr. russell who had, congressman russell, who had said earlier that just being around a dog, dr. fallon as a veterinarian, has said he has made personal connection with animals he has been around. i would argue that if you don't think or believe that a dog can be therapeutic and a service dog specifically can treat certain symptoms specific to the post-traumatic stress, then you probably have never owned or been around a dog. >> appreciate that. do you want to go real quick? i'm going to recognize the gentleman from massachusetts. >> thank you, mr. chairman. the way this is structured under the bill is that they keep

relationship will be the va and the contractor, mr. diamond and k9s for warriors or any other group. the 2016 the report said there was a problem with the va not getting out to the contractor location where the train was going on, or to the home of the veteran with the dog. and that broke down. are we able to cure that effect in further studies come in existing study speak was yes, ranking member. the problem was we rely on service dog organizations trainers to interact with our veterans and that resulted in us not getting timely information about problems that have developed with dog pairs which is why we hired our own dog trainers. >> okay. thank you. >> that chair that recognizes

the gentleman from texas for five minutes. the votes have started with 13 minutes, and so if there's other questions come we may have time for other members. >> thank the chairman and i want to thank the distinguished gentleman from florida for having this panel. and i would like to thank mr. lyle for being here. he's from my alma mater, texas a&m university, which have long history of working with animals, everything from texas task force one which one of the most active urban search and rescue teams you have a student organization called guide dogs, service dogs which promotes the use of service dog. we are also part of the texas that network which includes the operation k-9. mr. lyle, first of what you think you for service and dedication to the safety of americans. as a former officer in the cia, i have the honor of serving

alongside members of the military and then they with the sacrifices that you and your family make, and i know this is a life-changing experience, and has inspired you to give back to your community. i appreciate you for doing this. my first question is though is to mr. fallon. has the va reached out to any other organization to conduct studies of? >> after the difficult as we had with a pilot study we did site visits -- >> a pilot study from 2006? >> the one stored in 2011. it was suspended finally in 2012. we realized we had to change our study protocol. we visited major organizations like canine companions for independence speed is my question is actually, let's start before that. why did the va decide to reinvent the wheel rather than relying on some other organizations that have a

history i of doing this kind of think? >> for the pilot we relied upon the organizations themselves, all of them profess to be breakthroughs in to be able to produce high quality doctor unfortunately that did not turn out to be true. >> i don't even know where to go. there's so many questions. why not reach out to dod and leverage some experience they have? they have world-class trainers and world-class activities using dogs for all kinds of services? >> admittedly, we were not familiar enough with the service dog community when we embarked on the pilot study. there's no question we have made mistakes. >> say that again. >> we were not adequate for me with a service dog community and the pitfalls in that community when we embarked o on her pilot studies, no question about that spirit how much money did the va

spending face want to develop a today's standards? i've been told are no longer in use. >> i'm not sure of the exact figure. it's somewhere above 1 million for the pilot study spent about 1 million or 10 million? >> 1 million. at 12 million figures for the entire phase one and phase two. >> could that money had been saved a city initially adopted the uk's veterinary standards? >> no, sir it wasn't just the veterinary standards. it was training standards involved and also follow-up by the organizations dog trainers. all those things ended up to be a major problem. >> you are the chief veterinary medical officer? >> yes, sir. >> what the polls have you suggested i had to make sure we incorporate this into the va? >> into the study or in -- >> they va so that more veterans can get more access to this type of care. >> we were directed by congress

to do this study and that has been my focus to do this research study. for other portions -- >> what's the best next action? >> to complete the study successfully spin at what's the next next step to tak take to gt his complete its because we are doing it now. we have retooled and -- >> when is it going to be done in? >> we expect the data collection to be complete violate 2018. and then the paper will be published thereafter. >> mr. lyle, i have a look at less than a minute but you can go over a little bit. hopefully the chairman indulges my prerogative. anything that has not been discussed during this hearing today that you think is important to get out of there? >> thank you, congressman. i think it's important to understand and to reiterate what i said, that a service dog not

only will combat specific symptoms like kia does for me and waking up from nightmares, et cetera, et cetera, but there is an effect that they give to you of providing a sense of purpose. when veterans get out they lose their military community. they lose their chain of command. they get their mission, their purpose with away from them very, very quickly. there's nonprofits have done admirable work in trying to assist veterans transitioning, but they are still struggling. i think the main reason is that they lose their sense of purpose and they lose their mission to fail at anything driving them anymore. i think the service dog also provides that. i will just further note very quickly that i spent the last year doing this, trying to raise awareness about the issue, talk to members of congress, have been received very well and it's taken me a year to do this

funding all of this myself. we don't have until late 2018 to have the study completed, and didn't understand the results and then try to have a program initiated at that point. 22 veterans a day are committing suicide. anybody that is okay with that number, i wouldn't say that anybody of that he is okay with that number, but we have something that we know works. we have evidence that works now. and with 22 veterans and a committing suicide, i return to a second opening statement, that it is unconscionable that we don't explore alternative methods of treatment. >> mr. lyle, thank you. mr. diamond, thank you for your service. mr. chairman, i yield back the time i do not have. >> the gentleman's time has expired. i'd like to thank all of our witnesses for taking the time to appear before us today. if there's no further business

without objection the subcommittee stands adjourned. [inaudible conversations] >> [inaudible conversations] [inaudible conversations]

[inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations]

[inaudible conversations] >> republican presidential candidate donald trump is campaigning in connecticut today. c-span wildlife coverage of his rally in hartford at 7 p.m. eastern. connecticut holds its primary april 26. >> our live coverage of the presidential race continues tuesday night for the nuke state primary. join us at night user for election results, candid speeches and your reaction. take you on the road to the white house on c-span, c-span radio and c-span.org.

>> booktv is 40 hours of nonfiction works of authors every weekend. here's some programs to watch for this coming weekend. >> we wanted to raise early money and we thought if we gave women credibility by raising early money, then they could go on and raise the additional money they needed to win. so we were like little political venture capitalist. we were going to go out there.

in today's term we were the kickstarter for women. immolate stance or early money is light yeast. we make the dough rise, and we've been doing that ever since. >> go to booktv.org for the complete weekend schedule. >> several federal agency leaders testified yesterday before the senate homeland security and governmental affairs committee of the state of the nation's defense against biological threats such as the zika virus. blue ribbon study panel on biodefense says that the u.s. is dangerously horrible to biological events. this hearing is just under two hours. [inaudible conversations] >> good morning. this hearing will come to order. i want to thank all the witnesses for taking the time to

attend, taking the time to write your thoughtful testimony. we appreciate it will all be in the record. this is an important hearing. this is our second hearing on this subject. we had governor ridge and senator lieberman here earlier with their blue ribbon panel on biodefense. kind of very well thought out document. a lot of detail. problem is an important take away from it was the fact we just have no central authority to kind of a team late all the data, accumulator the budgets and really direct potential activity, particularly in the event of a significant outbreak. whether, and, of course, we dealt with ebola, avian influenza. we've had hearings on both of those. now the zika virus. in wisconsin we have something come i can't pronounce it, elizabeth -- it's taken come it's been affected about 59 people, already teaching people

in our state that i appreciate the work the cdc is done of that, responding quickly to a letter i sent. sounds like you are taking every citizen in trying to find what is the common cause your very interesting i guess, troubling in many respects. anyway, this is an important hearing. i'd ask consent that might open a written statement be entered into the record number but as any hearing, the main goal of these things is to lay out a reality so we all understand really what we are facing and when it comes to the different types of bio threats. .. the same type of procedures and processes and management structure can be put in place to respond just too about any of them because the threats are always changing as we see the

different types of pathogens and biological threats but i just listed out. so again appreciate all o of yor work and efforts on this and coming here and with that i will turn it over to senator carper. >> i understan understand undere of 10:30. do you want to keep rolling or do you want us to recess for the vote? >> it would be nice to keep going if we could. >> when the vote starts, i will leave and go vote and come back right away and you can keep talking and then we will start asking questions. thank you for coming and for bringing us together. this is an even more important hearing given what is going on with the zika virus. we have a hearing on the blue-ribbon panel chaired by a couple good friends and one of

the main points was the senior person to lead it an deleted ane president with the pretty good so we had a meeting with the vice president and see where that leads. but there's a lot more to be done and the panel provided recommendations to further answer to prevent to detect, respond to and recover from a biological incident and today we had the opportunity for senior people in several agencies will be responsible for implementing some of the recommendations in the earlier pan. eager to hear how you could improve the country's bio defense systems. this is an important conversation to have in the recent global events including as we speak.

it continues to threaten west africa and after killing thousands of the virus is declining significantly thanks in no small part to the investment in health systems in the country that were the hardest hit by the opportunities. it's one of the proudest chapters in the nation history as of late and i'm proud of the work that was done by some of you and the folks that you lead. but outside of the recent cases underlining the need for the partners and their efforts to combat this disease, we are almost one year removed from the pathogenic avian flu and the chairman and state was affected and a number of others were in the midwest and while infections have been limited in a number so far, we must remain vigilant and continue to enforce good biosafety practices across the

countries safeguard against another epidemic. meanwhile we are quickly approaching the beginning of mosquito season in most part of the unite united states and in s presents us with a new threat. it is another form that we are hearing a whole lot about. the virus has spread throughout central and south america and has already reached puerto rico and other territories and is expected to spread further. the world health organization estimates as many as 4 million people could contract zika by the end of the year. researchers continue to learn more about the virus every day. but it's clear that the impacts can be devastating particularly for pregnant women and their unborn children. we have heard they just recently confirmed this week that if other folks speculated for a while but the virus is the cause of severe birth defects. while most of the cases diagnosed in the citizens today have been traced to travel abroad we must be prepared for it to present itself locally to

us. so it has been encouraging to see a proactive coordinated response from the administration to this threat. for example federal agencies helping the state and local governments enhance the capacity to contract the virus and the mosquito control efforts underway and areas that most risk. we also know that the measures in the development of being rigorously pursued. to help fund these efforts the administration now redirects the most $600 million from other programs including fund originally designated for ebola on response efforts and i believe the president made the right call on this instance. all these efforts continue to carefully consider the presidents request for additional resources to combat this threat and we must ensure that the public health officials have the tools they need to protect us from and to prepare us from the future threats but

at the same time we shouldn't let our foot off the gas when it comes to our efforts to contain dangerous diseases and with that we welcome each of you and thank you for your service and testimony today. >> it is the tradition to swear in the witnesses said he would rise -- raised your right hand. do you swear the testimony you will get before the committee will be the truth, the whole truth and nothing but the truth so help you god? please be seated. somebody has a snappy tune. the first with mrs. doctor richard hatchett, the acting director of the biomedical advanced research and development authority and the acting deputy assistant secretary in the office of assistant secretary for preparedness response in the department of health and human services. that's a good title. among his many past roles, doctor hatch served as the national institute of allergy and infectious diseases, the

white house national security staff and homeland security council as the director of bio defense policy. >> chairman johnson, ranking member carper, distinguished members of the senate committee on homeland security and governmental affairs, good morning and thank you for inviting me to testify on the bio defense. i am doctor richard hatchett of the biomedical research development authority. my testimony today will focus on the steps taken by the office of the assistant secretary for preparedness and response to strengthen the nation's health security and the contributions of my own office towards the e end. we've made substantial progress to advance the state of the national bio defense and thanks to the support of this committee and others in congress we have established brda and continue to make critical investments in bio defense in the health care system. however, as highlighted by the recent challenges, such as a

ebola and zika their remaining gaps and as we are aware a recent report by the blue-ribbon study panel in bio defense indicated that the united states is under prepared for biological threats and that the nation is dangerously vulnerable to biological events, whether natural, intentional or unintentional in origin. what are the civilian public health responses to such concern is charged by statute to play a strong leadership role. it serves as the principal adviser to the secretary of health and human services on all matters related to federal preparedness response for public health emergencies. thethe chair dhhs disaster leadership group which convenes in response to complicate emergencies and the public health emergency countermeasures enterprise which coordinates medical countermeasures development efforts across the interagency. it is the author and custodian of the national health security

strategy which focuses on protecting public health during an emergency. and aspr oversees the critical response. first, the hospital preparedness program enhances medical preparedness and resiliency at the community level through the support of healthcare coalitions. the second, the national disaster medical system deploys medical personnel and related assets from sources that are overwhelmed. the fimsi has countermeasures for chemical, biological, radiological and nuclear threats, pandemic influenza and emerging infectious diseases. fimsi coordination and decision-making encompass all stages of the medical countermeasure lifecycle from identifying requirements into developing target profiles through product development to distribution and dispensing. there is an outstanding record of success and is now being studied as a model for the global preparedness against emerging infectious diseases.

to date at least 23 medical countermeasures barda has supported have been approved and cleared by the fda under the purview. of these, 15 have been approved since 2011 and five been approved in the last 12 months. 17 products ranging from anthrax and smallpox vaccines to the therapeutics for acute radiation syndrome and an array of products for the management of thermal burns have been added to the strategic national project bio shield. with another seven anticipated between now and the end of fy 20, overall since the year 2000 the fda has approved 89 medical countermeasures for the threats and pandemic influenza as well as 17 supplemental changes to already approved applications into 71 modifications to the diagnostic devices. this investment and preparedness has already paid dividends

because of the workforce and capabilities we've developed over the last ten years, we are better prepared to respond quickly to the emerging threats. the fimsi perk simple facilitated the rapid development and deployment of vaccines, therapeutics and diagnostics during the ebola epidemic it is fully engaged in the response to zika. we know from experience that a well coordinated fimsi response is a critical enabler of a rapid science and industry response. the fimsi succeeds not because of a set of government offices succeed is because response efforts across the whole of society are supported and coordinated. to respond effectively to threats as diverse and unpredictable as the biological threats we face, nothing less than a whole of society response would work. thank you again for the invitation to speak with you and at this time i would be happy to address any questions that you may have. >> the next witness is doctor stephen redd, the director of office of public health

preparedness response at the centers for disease control and prevention. he's been part of the public health service for over 30 years and is responsible for all of the public health preparedness response activities. the doctor read? okay, great. thank you. >> chairman johnson, ranking member carper and distinguished members of the committee, i'm the director of the office of public health preparedness and response at the cbc and it is my pleasure to appear today to discuss the work we are doing to prepare and respond to threats and health to the public. as you know, the cdc works to protect the public's health by helping communities improve readiness and response. this is for chemical, biological, radiation emergencies whether those are intentional, naturally occurring like the ebola epidemic or the zika epidemic or accidental.

there are two programs at cdc that enable us to prevent, detect and respond to public health threats. the public health emergency preparedness program and their strategic national stockpile. most programs have their origins before september 11 and the anthrax attacks of 2001. they were greatly expanded after those events in recognition of the need to improve the ability of the public health system to respond in scale and in speed. the public health emergency preparedness program's overall theme to prepare the nation to respond to public health emergencies. since 2002, $10 million has been devoted to this effort. the program funds 62 awardees to all states for large cities and eight territories, and what it actually funds our staff epidemiologists, laboratory experts, risk communication experts come emergency operation

centers, laboratory equipment, planning and exercising in efforts to respond or to correct things that are identified in the natural. the strategic national stockpile is the national repository of life-saving medicines vaccines and medical supplies such as mechanical ventilators, currently the stockpile holds over $7 billion in assets. it operates as part of the public health emergency medical countermeasure enterprise which you heard about. the stockpile stores and delivers supplies in times of emergencies. both the public health emergency preparedness program and the strategic national stockpile rinsed her mental in the ebola response and are being used as part of the fimsi response -- zika response. what we nolet me now turn to zi. as of yesterday, 41 countries reported local transmission of

the zika virus. in the continental united states, over 300 cases of travel associated cases have been reported. about one in ten of these are in pregnant women. seven have been acquired through sexual transmission. there is currently no local transmission by mosquitoes that the problem exists because the travel associated cases into sexually transmitted cases. in puerto rico there is transmission for mosquitoes over 300 cases about one in six of these are in pregnant women. as you heard to talk about some of the things that we are doing in tha response, you heard from senator carper of yesterday the cdc offered a publication that concluded that the virus infection causes severe birth defects. that article also identified a membenumber of the outstanding scientific questions. on april 1, we convened at the action plan summit in atlanta.

this put together state and local health officials to review the latest scientific information and jumpstart planning at the state and local level. we've also issued travel guidance for women who are pregnant within 72 hours of identifying the virus in the brain of children and fetuses that have died. we have developed laboratory tests. we are working closely with local health departments and we are implementing mosquito control measures with the government of puerto rico to present transmission took pregnant women. the public health threats are forever present due to the investments from congress the nation is better prepared to detect and respond to health emergencies than we were before the events of september 2001. and at the cdc, we are on the front lines to protect americans

from health threats wherever they occur. from recent experience we know what we call will respond in the future. thank you. >> the next witness is mr. kevin shady administrator of the u.s. department of agriculture's animal and plant health inspection service. mr. shea carries the prohibition of protecting and promoting american agriculture, regulating genetically engineered organisms come administrating the animal welfare act and carrying out wildlife damage management activities. >> thank you mr. chair. i appreciate you all being here today to hear us. over 8,000 men and women work around the world to protect american agriculture and natural resources against plant and animal pests and diseases. we want to keep them out of the country if they do get into the country, we have the expertise and the tools to detect and

control them and hopefully eradicate them. although our mission is planned and animal health, we understand there is a crucial link with human health. our partnerships with other federal and state emphasize this one health approach. animal health can affect human health and human health can affect animal health. that's why it's so important that we communicate and coordinate with each other and why the emphasis on oneself in the nationaone's healthand the r bio defense is so important and why we strongly support and appreciate that they emphasized it. i want to highlight a few examples of what this does with our partners. number one, we created within our veterinary service program in one health coordination center that works closely with our internal bits to make sure that they are considering human health aspects of animal health programs. at the same time they work with their counterparts in the human

health arena to make sure those agencies have an understanding of how what they do can affect agriculture and animal health. because the communication is so important, we have embedded a veterinarian in atlanta with the cdc to exchange information literally every day. we always share information with our partners about our well-established disease efforts and when we have information about potentially damaging diseases, we share them quickly. of course this committee knows as the chai chairman and the ser eluded to earlier, you noted that devastating impact last year on the producers could also the impact it had on the availability and price of eggs and turkey. 1,000 employees and thousands of contractors and state employees did the important for them find work to control the disease but behind the scenes, the partnerships with us today were there and we were very important.

our scientist shared information about the avian influenza virus. we have no reason to think that it was going to be a human health threat but given the viruses mutate and so we were constantly supplying information to the cdc sai so they could dep the vaccines if the need ever showed jumped to be a human health problem. we are also working closely with our colleagues in the fish and wildlife service to test wild birds and the good news is we tested 43,000 wild birds over the last nine months and have found no more examples of the influenza in those birds so that is some helpful information. we spent a lot of time assessing our efforts in controlling the last year and in our capability to detect it be compiled very substantial, very large new planning documents on what we

can do to prevent it from becoming a huge problem again. and we had a chance to test that out already in indiana in january. there was indeed one case of highly pathogenic influenza and nine cases of low pathogenic influenza associated with that. we were able to get onto that immediately come wife that out and we've had no cases other than that since last june 17. something we learned in all of the review is that we need to rebuild our capacity to respond to large animal health emergencies. we have 200 fewer animal health professionals, veterinarians and technicians then we had ten years ago. we need to rebuild that workforce and the secretary certainly recognized that in the president's budget request for fiscal year 17. there is a proposed 30 million-dollar increase for animal health emergency response because we realized just how lucky we were to get on top of

the avian after all the damage that it did do. mr. chairman this concludes my testimony and i appreciate the opportunity to be here and am happy to answer any questions. the next witness. it's kind of pronounced whatever. the director for god kyocera valence integratio integration n the officcenter andthe office ot the department of insecurity. he previously served as the senior bio defense adviser to the assistant secretary for health affairs and chief medical officer of the department. >> we have generations of people being called firebug in my family. [laughter] joanne johnson, ranking member carper, members, others in the

kennedy i want to thank you for inviting me to speak with you today. i appreciate the opportunity to testify on the department's role in bio defense in the honor from the hhs, usda and gao. i'm the director from the cent center. i'm a microbiologist by training and i've done some work with anthrax at the national security health and i understood the bio defense policy for the services of the committee so i want to thank you. these experiences have given me a broad understanding of the threat tthreats to the homelanda strong commitment to help improve the nation's bio defense progress. the threats and risks posed by the emerging infectious diseases and the use of biological like terrorist organizations, the extremists and rogue states will continue to challenge the ability to prepare and protect the homeland. in the wake of the threats the department of homeland security remains fully engaged in a proactive and characterized the threats providing the warming of the emerging diseases and

ensuring that critical missions in the department will continue should a biological events occur. for example, during the recent virus disease outbreak in west africa, the dhs provided intelligent analysis to the agency's in the state and local governments and first responde responders, directed research to better characterize the threat of the persistence and fill the gaps in public health and operational responses and coordinated and implemented the screening for more than 42,000 international passengers at five airports. today, we continue to build upon the lessons learned from the responses to ebola as we tackle the reemergence of the viruses like ebola where we are ensuring they continue to have timely information into the workforce is invoked to protect measures and the health interests of the detainees in the custody is provided for. we must remain vigilant and

innovative as biological threats continue to evolve and new threats emerge. the dhs office of health affairs coordinates the department's bio defense activities to understand and meet the threats today and be ready for the threats that will emerge tomorrow. they emphasized the biological threat information from multiple sources and takes up in one health approach to the bio defense emergency response. for large-scale biological events, knowledge as quickly as possible allows the decisions that could save american lives and to this end to prevent operational bio detection surveillance programs are critical to the nation's bio defense. the national surveillance integration center is uniquely situated within the dhs to provide the human health and animal health and environmental data to ensure the decision-makers have timely accurate action information.

with comprehensive biosurveillance integration. we are creating methods and greater stakeholder engagement. program provides with actionable information on detection of a biological agent to coordinate effective response. one importantly and frequently benefit is how we work with each local jurisdiction to ensure that the decision makers are familiar with how the

coordinated is unfold should a detection occur. there's no other program that provides this layer of biological defense. da is cooperating with doh as well as address other capability needs. one of our most critical roles, law enforcement, intelligence community partners, one initiative we are developing in coordination with hhs is the first-responder vaccine initiative. scheduled to rotate out of strategic national stockpile. i want to thank this committee for moving f1915, senator authorizing this pilot program. i thank you for your time and i look forward to answering your questions.

>> thank you, doctor. our final witness. mr. chris currie, he leads the agency's work and management and national preparedness and critical infrastructure issues. this this role he had led efforts to prevent and plan for natural and man-made disasters and natural attacks. mr. carrie. >> i really appreciate the opportunity to be here and today i would like to talk about work's on biodefense. leadership and coordination are critical to such a large fragmented effort not only local level but across federal government and private sector. the number demonstrate this is point. in a hearing last fall your committee heard the findings and

recommendations of the blue-ribbon study panel. today i would like to talk about this work ranging from coordinating the entire biodefense enterprise down to improving programs. at the highest level the blue-ribbon panel concluded that there's no leader and no strategic plan. our work has found that there's no national strategy or foecal point for biodefense. there's over two dozen officially appointed presidential officials. they did issue a strategy in 2012 and designated offices within the white house as focal points and this is progress and shows commitment to coordinating biodefense efforts.

however, it just doesn't go far enough. the strategy does not identify resears and -- research and investment needs in such enterprise. we heard the security staff implemented plan to the strategy. thus, we don't know if it will operation as coordination as we think it should. we've also identified challenges with specific agency biodefense programs within dhs. 12 years after the biowatch program there's still not reliable information about its capabilities. this is because a foot in the field so quickly without performance requirements. we also found that because of biowatch is not tested it's unknown.

we recommend that dhs not pursue upgrades. i would also like to talk about our work in national biosurveillance integration center also in dhs. it was set to be innovator of biosurveillance across the whole federal government. however, it's never fully met this bar. however, we reported last year that persistent challenges still get in the way. for example, most of its primary federal partners, those like cbs and hhs told us that products didn't add value and did not provide new meaning or didn't help them identify biological events quicker. the challenges are not easy to

face alone. however, these options may require changes in law and it's not clear that even these would address the challenge. this brings me back to the bigger issue, as we in the blue-ribbon panel noted programs should be evaluated in terms of cost and benefit but also be prioritized against other programs across government as part of a national biodefense strategy. another critical part is using the most recent threat and information to guide decisions. this is important to ensure that our limited resources are directed to the most important areas. without a strategy that bridges across departments, it's difficult in congress and those in executive branch to make decisions above the traditional agency approach.

i would be happy to answer your question. >> thank you, mr. currie. i want to go back within the specific agencies, talking about just sort of an update of exactly where we are. i want to talk to the the usda. mr. shea, the last outbreak occurred between december and june, basically migratory birds flying south and also in june flying back. to what extent have we dodged this bullet? have we gone throu basically two additional patterns without this hitting us again? >> mr. chairman, it's still too soon to say, what ended up being the final end to the outbreak last year really was the onset of warm weather. once the temperatures get to 70-degrees, the virus won't survive. >> similar to human flu then.

temperatures got to a point and that outbreak ended? >> exactly. also what happens with migratory birds, they have a clear path, they just keep going. when they are heading north, they can slow down. for example, what happened last year and the reason we thought it was so bad in iowa and wisconsin was that the birds were heading north but the weather was still too cold and got to a spot where the lakes were still frozen. >> yeah, okay, i got it. that's pretty good news though. the outbreak in indiana, is that typical? we just on occasion see the small outbreaks and stuff and we can respond quickly or is that -- >> it's typical to find influenza outbreaks. a virus that may have mutated.

the local surrounding areas were all low pathogenic. >> that was not spread by migratory birds but the local flock, hopefully? >> it may have started with the migratory birds as you suggest. >> i want to go to ebola. has that been totally wiped out, has that been contained? is there any active cases in africa that we are unaware of? >> unfortunately we have seen cases reem earlyerging. >> tell me what happened there. did we get to a level of zero and it's coming back or what? >> the wide-spread transmission that was seen in 2014 and 2015 has been contained. that we have seen repeatedly in

liberia and sierra leon rapid response that brought disease wide under control. unfortunately, this is not expected. the latest case, we believe, is from sexual transmission, a person that had ebola in the past, transmitted that disease through the route, sexual transmission and then a small cluster occurred. i think that this outbreak is now being worked very hard both in ghini and liberia. the cases in liberia are connected to the ones in ghini. the response is very vigorous. large numbers of contacts being traced that if one of those people come sick, they will put into isolation and given treatment very quickly. >> because of the tragedy that

occurred there, is the general population that is far more educated in this as well in addition to the public health and safety officials now how to respond? is there a combination of that? is -- tell me what worked? what lessons we learned? >> i think to go back to the lessons, the situation that's occurring right now is not that different than what occurred in march-april of 2014 in terms of where the disease is occurring and the location. the thing that's different is that we have a much more vigorous response. so both in ghini and liberia there's the capacity to identify those cases quickly and respond and there's an international presence that's able to respond. and to go back to 2014, the things that didn't happen that needed to happen were the ability of those governments to rapidly identify cases to respond effectively to them and when the response wasn't going to well, to call for help and

for the international community to be able to respond. that is basically the structure of the global health security agenda which is being implemented in those countries and in other countries in africa, asia and the americas. >> so you're basically describing a real, you know, real progress in terms of public health officials. has there been progress in terms of information to the general population where these things -- ebola breaks out in african countries? >> i think that there has been. i think particular at that inflation point in -- depending on the country 2014-2015, it's likely that a lot of the control was actually implemented outside of official channels that communities understood the risk that ebola caused and took measures into their own hands in terms of isolation facilities, local care, i think this is

actually a really important question that we need to have better hard data on but it appears that that was an important part of the response in addition to the community mobilization and communication efforts that took place. >> do you -- i hate to ask this, what was the final mortality rate? how many people -- when this first broke out, we were projecting a million people? >> yes, sir. >> how did we finally contain this? >> it didn't reach a million people. even though the number was massive, it wasn't what -- >> didn't hurt to get the public's attention so we can respond. tens of thousands? >> tens of thousands of cases, ten thousand or so deaths and just for context, the total number of cases in all the outbreaks up to that point was

2500. so around 10 time more cases that had ever occurred and one of the things just thinking about the sexual transmission side of it, we probably have twice as many male survivors as there were total cases before this outbreak. >> is that pretty unusual? was that because of additional treatment, hydration? we did -- so how many people were infected and how many people died? >> roughly, i can give you the exact number. 25,000, 12,000 deaths something like that. >> from how many people infected? >> 25,000. about 50% mortality rate. when i give those numbers i have to say that the quality of that information particularly early in the outbreak when medical services were overrun many deaths -- >> i understand. >> of that magnitude. >> where are we at in

development, ebola has been around. it wasn't a top priority. image it's been a priority. >> i will answer that question specifically and then turn to colleagues from barta. there were trials that were undertaken of different vaccines, the one in liberia and sierra leon. they were not able to show effectiveness. they were able to measure the safety of the vaccine a trial conducted and to measure itself effective and this was a containment strategy where a case was identified and then cluster of contacts and the contacts of the contacts were

vaccinated. >> so what level of effectiveness? i realize just a ballpark. >> i think that there's some questions about whether a person was exposed or not, it wasn't tested to be effective before a period of six days after -- after exposure, so after that period of time it did demonstrate effectiveness. i can come back to you with the exact number on that. >> i actual have the luxury because i'm here by myself. the infection of those nurses in texas, we were assuming that we kind of had this understood and precautions and yet we still had -- did we ever solve the mystery? >> i'm not sure that we totally solve it. what we did put in place a different plan for personal protective equipment which included very specific guidance on what types of protective

equipment were needed and also put in place a strategy to train, to use that personal protective equipment before needing it, additional specificity of when persons being treated for ebola including things like observers to make sure that a person didn't accidentally when they are taking the equipment off, kind of a risk period, something didn't happen. and then also following the individuals after the person was gone. similar to the returning travelers that the doctor had mentioned. >> so from started the outbreak to, you know, kind of the final conclusion of it, it seems that certainly the procedure was, we can have hospitals to the point now let's do it in specialized hospitals. is that -- is that kind of the process and procedured in place now that we are going to have

and maybe -- they have to respond properly but then transport individuals that prove positive? >> so for ebola that's the system that's in place. a lot of the discussion is about other diseases that there might be more cases and adopt the system so that we have the right care for people who have these very severe, severe effects. >> by the way, ebola is obviously unique disease but the procedures in place, those are good procedures for a number of types of situations? >> yes, sir. i think there are a couple of characteristics of ebola that are different. probably the main one is the small number of cases and the need for a very rigorous infection-control procedures. if there were large number of cases, the cases level of capability.

>> you speak to the vaccine and effectiveness but ability to produce it? >> of course, would you like me to touch on the ebola treatment center? >> sure. >> to answer that question and go to vaccine question, through preparedness program with the assistance of funding that was provided by congress and ebola supplemental, we have established a tier system nationally of ebola treatment centers. there are now nine regional ebola centers, there are three education and training centers at the system. i believe it's 73 state or local ebola treatment centers that can manage patients temporarily before they can be transferred to the noncenters that are fully equipped. as a larger system of assessment hospitals, i believe 200 nationally. >> okay, thank you. i have to go vote. i'm going to turn it to senator,

hopefully i can get back here and follow up. >> mr. currie unfortunately i had to leave as soon as you start today speak and wasn't causing effect but we trade off like this. we usually have 15 minutes in which we can vote so we can keep things rolling and don't delay you on doing. but just take a minute and give me -- in the house of representatives people get one-minute speeches, and so give us your best one minute. >> ly do my best, -- i will do my best, sir. one i called the 60,000-foot level and the second piece was looking at some of the specific programs at dhs that we looked at. obviously, we have done a lot of work at dhs and usda as well. one of the problems that we have identified through the years and so has the blue-ribbon panel is

the lack of a unified strategy at the top, at the federal level to guide all departmental efforts and resources and all of the departments work really hard and do a very good job of doing their individual missions. the problem is there's no one above that have the authority or ability to drive resource decisions and priorities. and so that makes it very difficult to know for addressing the top priorities. and so that was a key point from my opening statement. >> all right. as you know, we talked a little bit -- i mentioned the blue-ribbon study panel and the recommendation, the recommendations attempt today speak to the point that you just made. what -- let me just ask you all of you, with respect to the recommendations, i think they made 33 recommendations, the vice president should personal

lead on this, and what current plan activities are each of you taking or planning to take to address the recommendations contained in the report? what do you think about the recommendations of either vice president in the case, joe biden, and then presumably whoever succeeds him? >> i can start. >> please. >> we have not taken a formal position whether the vice president is the right place to place to responsibility or not. i understand why blue ribbon made the recommendation because it needs to be somebody in authority to do things and spend money a certain way. we made our initial recommendations along those lines to the national security staff and so i think -- and our goal there was again to try to put it at a level that was above the departmental level.

so far i think we have been a little underunderwhen he-- >> what the right entity is, i'm not sure, but the problem is consistent across our work and the pabl's -- panel's work. >> thank you so much. what plans are y'all taking to address recommendations contained in the report. >> thank you, sir, for the question. >> we certainly participated in the process that led to the development of the report. we participated in the meeting and read the report with interest when it came out. we feel that we have actually undertaken activities that address or parallels some of the recommendations in the report. i just mentioned the establishment of the ebola treatment centers and the national hospital system for managing diseases that require

high containment, that in some ways is similar to one of the recommendations within the report. we are not responding directly to the report, but we certainly feel that it's been a valuable contribution on this national issue. >> do you think the point, mr. currie the blue-ribbon panel recommended the vice president be to follow up or implement recommendations of the report, if not the vice president, how about the junior senator from maybe new jersey? [laughter] >> doesn't have much doing on. he just finished his book, finished his book tour. looking for stuff to work on. i'm just kidding. >> so we feel that we have effective cross-government mechanisms in place and respond appropriately within the

statutory for preparedness and respond, we actually have mechanisms in place which were used and coordinateing bodies and department of defense. the first is disaster leadership group. responds to complicated emergencies. that addresses policy issues that will arise. in recent months, two different groups, one to address the flint crisis and the other the emerging zika crisis. we have a very effective coordinating body, public health measures enterprise. i cited some of the successes that we have demonstrated. that entity has really -- >> i'm going to ask you to hold it right there otherwise these

guys will never have a chance to say a word. >> dr. redd. >> there are a number of recommendationations, i could submit now. just quickly recommendation 15 is a collaboration with the department of homeland security with anthrax vaccination. we are working with state partners through the countermeasure enterprise to implement improvements on the distribution and dispensing of the stockpile. there's a recommendation to allow for deployment of assets.

we are working closely with new york city on really kind of a project-management formula that when they're ready to administer product from a stockpile that we get it there that quickly. so watching the delivery from the stockpile to the local capacity, we will be working with other health jurisdictions to marry their capability and our capability. there's a recommendation to overhaul agent program, i think that would kind of fall into the overall category of high-level policy decision. we are doing a lot of work to improve the select agent program within our authority, improving the inspection process, the process to report incidents that are identified at the facilities and to improve the communication and transparency aspects of that. there actually have been three recent --

>> dr. redd i'm going to ask you to hold it right there. each answer the status of implementation, those who have begun implementation and those completed implementation and those who have no intention of implementing, and you could also use as an opportunity to respond as to whether or not the vice president is a better person to oversee the implementation or senator booker suggested as a possibility. when he asked his questions, maybe you can -- how many do you think we need somebody like the vice president to oversee the implementation that would otherwise not make the progress that we need. if you don't, raise your hand. all right. thank you. let the record show booker 2, joe biden zero. i saw several people leaning

towards joe as well. senator booker. >> i lost many votes before. this one i'm very happy to not win if possible. i want to thank you very much for holding this. i think it's an urgent hearing and i want to thank the folks before me because your dedication to the health safety strength and security of our country is really admirable. perhaps i can start with dr. dr. hatchet on the end. the hospital preparedness program is one that recently new jersey has seen a significant cut in, now it's a little incongruent to me because as callulated by the homeland security, we've actually seen

increases in some areas, for example, in fiscal year 2016, the department of homeland security recognizes new jersey's vulnerability to a targeted violent attack and heightened the attack and urban area security initiative from 11 to 7 on the risk index. so we see that new jersey when it comes to risks, paris attacks, bioattacks and the like are getting more severe. somehow in the formula we are being cut from the program. so i'm just wondering what's the reason for the cut given that the department of homeland sees us and i live 10 miles from manhattan, we are serious -- in fact, manhattan is moving back

offices to new jersey, which again as dhs heightening our risk. and so i'm wondering is this in your opinion problematic, do you see it in a different way? >> so i can't speak to the particular case of the new jersey allocation, but i can say that the urban area security initiative risk scores are figured into the hpp, the hospital preparedness program formula and those allocations are reviewed annually and so they are adjusted annually. there aren't many other factors which go into the formula, certainly population, et cetera. given that i am not myself personally responsible for the preparedness program, we can certainly get back with you with response. >> critical infrastructure, we

have the most dangerous, they say couple miles. there's chemical companies, you name it. specially when other areas, the federal government are seeing as such a higher and higher risk. i would really appreciate. >> we would be glad to do that. >> thank you very much. let me go just my concerns in general about zika and some of the other elements. so first, dr. reed. is it redd or reed? >> redd. >> the program, because cdc is looking for additional money to allocate for zika that, you know, we've seen money being taken away from the states including new jersey, which

raises concerns that we are moving around a finite pool and that that might be weakening our preparedness. can you explain for cuts, were they sort of blunt cuts across the board or are we looking at the crises and concerns for safety and security? >> let me start by saying that i agree with your underlying -- your underlying point, which is this is a new threat. that would address the problem in the way that it needs to be addressed. >> that's a very profound statement that i want to repeat one more time. you agree that this is a new threat and should be making supplemental funding as oppose to taking needed dollars from currently existing programs? >> yes, sir. >> that is a definitely important statement, thank you. >> in the absence of that, there is a very difficult decision that the administration had to make, whether we would respond

to the current threat or not and the only way to respond to the current threat was to identify funds that could be used now. i think your description of a blunt instrument is correct, that there was an across-the-board cut in preparedness program. it's a little bit complicated how each dollar was arrived but every grantee lost funding. >> we seem to be reactive to crisis. do we have analytics to know better about what's coming before it dominates the headlines? could we be doing a better job heading the crises off? >> i think it's a big challenge and one we continue to work on. to take a particular case of zika