Combating Gun ViolenceWhat is Gun ViolenceGu.docx

Combating Gun Violence
What is Gun Violence
Gun violence includes homicide, violent crime, attempted
murder, suicide, school/mass shootings, armed robbery, etc
Gun violence is violence committed with the use of firearms,
for example pistols, shotguns, assault rifles or machine guns.
Gun violence can also have a mental impact on people
The Impact of Gun Violence
Item 3
In just one year 45,222 people died from gun related injuries in
the US
Firearms cause 85,000 injuries
With more than 25% of children witnessing an act of violence in
their homes, schools, or community over the past year, and
more than 5% witnessing a shooting, it becomes not just an
issue of gun regulation, but also of addressing the impact on
those who have been traumatized by such violence (Finkelhor et
al., 2009).

<a href="https://www.pewresearch.org/fact-
tank/2022/02/03/what-the-data-says-about-gun-deaths-in-the-u-
s/ft_22-01-26_gundeaths_1/"><img
src="https://www.pewresearch.org/wp-
content/uploads/2022/02/FT_22.01.26_GunDeaths_1.png?w=40
0"></a>
Program: Pulling Levers
Pulling Levers is program that attacks the problem of gun
violence head on
Pulling Levers includes problem-oriented policing strategies
that follow the core principles of deterrence theory. The
strategies target specific criminal behavior committed by a
small number of chronic offenders, such as youth gang members
or repeat violent offenders, who are vulnerable to sanctions and
punishment. The Pulling Levers Program is very Promising for
reducing crime.
Corsaro and colleagues (2012) found that the High Point (N.C.)
Pulling Levers had a statistically significant impact on reducing
violent incidents in the target areas. Targeted census blocks
(treatment group) experienced a 7.9 percent decrease in violent
crime
Analysis
In the US this program is currently implemented in the
following cities: Oakland, Chicago, Rockford, Indianapolis,

Boston, Philadelphia, Nashville and the closest being in High
Point/NC
This program has been proven to work in all of these cities
having an impact on gun violence and drug related crimes
So all though Pulling levers is implemented in High Point, why
is it not in our big cities where crime rates are high as well?
One of the highest rated cities for crime in NC is Durham and
so far they do not have a program like Pulling Levers to combat
gun violence and other crime that stems from impoverished
areas.
Why Durham
Durham is the 2nd most dangerous city in NC
Durham had a murder captia of 21.5 per 100,000 which is
double the national average
Why Pulling Levers?
Pulling Levers has been used in multiple cities around the
nation and has been successful in targeting crime
It is also a non violent way of dealing with criminals and
changing their mindset so they don’t get more involved in gang
life and commit more serious offenses such as homicide or
drive-bys.
If the offender chooses to be compliant with law enforcement
then they will get help and treatment services. The term Pulling
Levers actually comes framing a response to offenders and
groups of offenders that uses a varied set of sanctions (“pulling

levers”) to change offenders’ behaviors.
How Pulling Lever Works: Phase 1
Identification Phase
During the identification phase, high-density crime areas that
had a strong prevalence of drugs were identified through
mapping drug arrests, calls for service, reviewing serious
crimes in hot spots to determine a drug connection, and finally
analyzing information from various criminal justice agencies.
Once these areas were identified, the police worked with the
community, narcotic investigators, probation officers, and
parole officers to add additional surveillance in the areas and
began carefully identifying dealers in these neighborhoods.
Further, the police reviewed every report associated with
potential dealers and their known associates. Once these
individuals became known cases were made up against each one
of them
Notification :Phase 2
During the notification phase, collaboration between agencies
and community groups is central to making a change. In the
case of offenders who commit nonviolent and non-felony
offenses, identified offenders were invited to a ‘call in’
community notification session where key police and
prosecution officials notified such offenders of the sanctions
that were available to criminal justice personnel. Additionally,
community members spoke to the offenders regarding the need
for community change and desistance from future offending.

Resource Delivery: Phase 3
Law enforcement speaks with offenders also while offenders
complete a needs assessment. The law enforcement officers
would inform offenders that if they continued dealing they
would be arrested immediately. Since the odds are stacked
against the offender they are more than likely going to be
compliant. After the results from the needs assessment come
back the offender will be connected to what they need such as
education, drug/alcohol treatment, jobs, and even housing.
Combating Gun Violence in Stockton ,Ca
The intervention of Pulling Levers was associated with a
statistically significant 42 percent decrease in the monthly
number of gun homicides, compared with pre-intervention
trends
The Stockton Pulling levers used mostly the same phases as the
one in Highpoint
The authorities and community would let the gangs in the area
know that they are under a microscope and should be cautious
because they could soon be arrested
Also letting the younger members know there is another way
and finding places and treatment for these juveniles
With the removal of younger gang members and the older ones
under scrutiny these youth members were less likely to become
killers or even victims
All of this resulted in less homicides and gun violence

Who is it going to
The letter will be addressed to the Mayor of Durham ( Elaine
O’Neal) and Police Chief (Patrice Andrews)
The letter will outline the Pulling Levers Program as well as
relate the specific goal of implementing such a program, it will
provide the outcomes from other cities that use Pulling Levers
program
Also in the letter I will bring up the amount of crime that is
being committed and vouch on how I think this program will
lower violent crime in the city like it had in other big cities.
Along with all that (even though its public knowledge) I would
attach a way to contact other police chiefs that have
implemented this program so Mrs. Andrews can get first hand
account of the success of such a program.
Funding
It can be costly to fund a program like pulling levers but since
it has been proven to work so well it should be a must.
The money will come from grants from the Department of
Justice (DOJ) who enjoys supporting law enforcement at all
levels and has given grants for Pulling Levers in the past so
should see how it is beneficial for Durham to have it
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CCJ 415 INSTRUCTOR’S REVIEW SHEET FOR
FINALCOMPOSITE PAPER WITH STRATEGIC PLAN
STUDENT: __________________
EVALUATION ELEMENTS
Yes/
No
Weight in Points
Points Taken
Score
NOTES
PAPER ELEMENTS SUBMITTED ON-TIME
10
1. Policy Analysis Draft 1
2
2. Policy Analysis Revisions
2
3. Management/Program Review

2
4. Policy/Program Proposal
2
5. Action Decision Document
2
ELEMENTS OF COMPOSITE PAPER
X
55
X
6.
Title Page
5
7.
Abstract
5

8.
Table of Contents
5
9.
POLICY ANALYSIS
· provides clear problem statement with empirical evidence
about its nature, scope and severity and importance of
addressing problem with researchable questions to be addressed
about stated problem(s)
[2 points]
· identifies and defines the scope of the policy(ies) that may be
causing the problem or seeking to remedy the problem, and
selects from among those policies which ones are most directly
associated with the problem and merit closer attention
[2 points
· defines the scope of policy(ies) involved, identifies specific
goals and program outcomes sought
[2 points]
· identifies “stakeholders” directly in policies and names
organizations/agencies and programs directly and indirectly
responsible for making and implementing policy(ies) and
programs intended to address/solve the problem(s)
[2 points]
· assesses whether and how well the programs,
agencies/organizations and their operational systems are
working to address the problem and determining what other
policy options may be warranted.
[2 points]
10

EVALUATION ELEMENTS
Yes/
No
Weight
Points Taken
Score
NOTES
10.
PROGRAM AND MANAGEMENT REVIEW
· identifies specific agencies/organizations most directly
involved in implementing these policies
[2 points]
· focuses on programs and operations of these
agencies/organizations to carry out policy and determines
whether these programs and operations are addressing the
problem(s) identified
[2 points]
· operationally defines expected/intended outcomes of these
programs and operations in measureable terms and explains how
these outcomes contribute to reaching policy goals and solving
the problem(s),
[2 points]
· presents findings/results of your review of the effectiveness of
efforts to implement these policy driven programs and
operations
[2 points]
· makes conclusions based on empirical assessments that have
been conducted that examined whether and to what extent
policy/program-design objectives have been achieved,
contributed to policy outcomes and addressed the problem
[2 points]
10

11.
PROPOSAL
· addressed to the executive, legislative or judicial leader with
the authority and means to adopt your proposed course of action
(usually a key stakeholder)
[2 points]
· summarizes the conditions found from the problem statement,
policy analysis and program management review
[2 points]
· identifies recommendations for one or more courses of action
which may require
[2 points]
• creating or developing a new policy/program,
• modifying an existing policy/program and/or
• terminating a policy/program with/ without replacement
· explains recommendations and arguments for adopting one
action over other possible courses of action
[2 points]
· identifies in summary fashion the costs and requirements to
implement the recommended course of action and comparing
them to other possible courses of action.
[2 points]
10
12.
ACTION DECISION DOCUMENT
Letter or memo to decision maker
· briefly summarizes problem and importance
[1 point]
· identifies policies, agencies and programs affected

[1 point]
· presents key findings from program and management review to
support need for action
[3 points]
· states proposed course of action in form of recommendations
and requests approval
[5 points]
10
EVALUATION ELEMENTS
Yes/
No
Weight
Points Taken
Score
NOTES
ASSESSMENT OF PLAN & CONSOLIDATED PAPER
X
35
X
13.
References and Bibliography
Included a research bibliography
[5 points]
Made appropriate use of research-based sources
[5 points]
10

14.
Concepts, Theory & Admin Practice
Incorporated
· Incorporated concepts, considered theories, and employed
organizational principles, administrative guidelines and
management ideas from the topics covered by text books
[5 points]
· Employed concepts and information from class presentations
and reading assignments
[5 points]
· Demonstrated creativity, insight, use of factual knowledge and
scientific problem-solving skills
[5 points]
15
15.
Writing Mechanics
Clarity of paper, proper sentence construction, grammar,
punctuation and spelling
[5 points]
Included charts, graphs, or other visual media to illustrate
points of strategic plan
[5 points]
10
COMPOSITE SCORE

100
Page 2 of 5
CCJ 415 FORMAT FOR COMPOSITE PAPER
FALL 2018
Your final composite paper must be organized and structured
using the following components You should use major and
minor side captions in the body of your paper to help
distinguish sections of your paper and address all the elements
specified for each component.
· Title Page (See next page for sample)
· Abstract (on a separate page by itself)
· Table of Contents (on a separate page identifying page
numbers where each section begins )
The body of the composite paper is organized in the following
sections
· STATEMENT OF THE PROBLEM
· provides clear and compelling empirical evidence about the
nature, scope and severity or the problem and the importance of
the addressing problem
· identifies researchable questions that need to be addressed
about stated problem(s)
· POLICY ANALYSIS
· identifies and defines the scope of the policy(ies) that may be
causing the problem or seeking to remedy the problem, and then
selecting from among those policies which ones are most

directly associated with the problem and merit closer attention
· identifies and clearly states what specific goals are/were being
sought by the policy(ies)
· identifies the “stakeholders” most directly involved with these
policies and names the organizations/agencies and programs
directly and indirectly responsible for making and implementing
derivative policy(ies) and programs that are intended to
address/solve the problem(s)
· assesses whether and how well the programs,
agencies/organizations and their operational systems are
working to address the problem and determining what other
policy options may be warranted.
· PROGRAM MANAGEMENT REVIEW
· identifies specific agencies/organizations most directly
involved in implementing these policies
· focuses on programs and operations of these
agencies/organizations to carry out policy and determines
whether these programs and operations are addressing the
problem(s) identified
· operationally defines expected/intended outcomes of these
programs and operations in measureable terms and explains how
these outcomes contribute to reaching policy goals and solving
the problem(s),
· presents findings/results of your review of the effectiveness of
efforts to implement these policy driven programs and
operations
· makes conclusions based on empirical assessments that have
been conducted that examined whether and to what extent
policy/program-design objectives have been achieved,
contributed to policy outcomes and addressed the problem
· PROPOSAL
· addressed to the executive, legislative or judicial leader with
the authority and means to adopt your proposed course of action
(usually a key stakeholder)

· summarizes the conditions found from the problem statement,
policy analysis and program management review
· identifies your recommendations for one or more courses of
action which may require
· creating or developing a new policy/program,
· modifying an existing policy/program and/or
· terminating a policy/program with or without replacement by
some other policy or program
· explains each recommendation and your arguments for
adopting one course of action over other possible courses of
action
· identifies in summary fashion the costs and requirements to
implement the recommended course of action and comparing
them to other possible courses of action.
· ACTION DECISION DOCUMENT
· letter or memo to the key decision maker summarizing the
problem, identifying policies, agencies and programs affected,
key findings from program and management review, summarizes
you proposal with your recommended course of action and
closing with your request for approval )
· REFERENCES (last page before Appendix, if any)
List all the sources and citations you applied in writing your
composite paper here using APA format for citations
NOTE: In considering a
strategic plan be sure to address/answer the following
questions or issues:
1. What is the first thing you would do to get started?
2. What steps would you take to institute reforms and who
would you involve in the process and why?
3. Assuming you have near total control over hiring and firing

decisions over personnel, what actions would you plan to
implement changes at the federal, state, and or local level
4. What measures would you recommend to affect needed
changes, build effective and productive relationships, and
strengthen the management and administration of special
operations functions and activities without disrupting positive
and effective activities damaging with state and local agencies?
5. What programs and strategies would you emphasize and why?
6. Describe the specific plan(s) you would pursue to create new
or strengthen existing programs and strategies.
7. How would you allocate resources to assure that you can
design and implement your plans for change?
8. What are the potential obstacles to your plan?
9. What steps would you take to overcome them?
10. How would you go about determining whether your
implemented plans will work?
11. What will you do with the evaluation information about how
your plan has or has not worked?
All papers must follow APA format and contain a running
header with the course number, title of the paper, and your
name in the illustration shown below
Header
CCJ 415 Preventing Recidivism via a Re-Entry Focused
Correctional System S.Smith
Body goes here
All papers must contain a footer with your name, page number
and date submitted as shown in the illustration below
Footer
R. Smith Page 1 of 43
11/20/18

See next page for sample title page
[Sample Title Page]
INCREASING FINANCIAL ACCOUNTABILITY AND
REGULATION
TO PREVENT
LARGE SCALE CRIMES INVOLVING VIOLATIONS OF
FINANCIAL TRUST
[Name of Student Goes Here]
Criminal Justice Policy and Administration
CCJ 415
Professors David Abeling-Judge and Suleyman Ozeren
Richard B. Groskin, PhD., Distinguished Professor and Director
Page 4 of 4 Criminology and Criminal Justice
Sciences
CCJ 415 Analysis of the Bioterrorism Act of 2002 Name of
Student
ANALYSIS OF THE BIOTERRORISM ACT OF 2002
Criminal Justice Policy and Administration
CCJ 415
submitted by ___________________
Professors Richard B. Groskin and David Abeling-Judge
December , 20XX
Abstract
After the September 11 attacks and the 2001 anthrax attacks, a
surge in bioterrorism research, planning, and preparation

occurred to improve on the weaknesses displayed in the United
States’ response to these attacks. One major piece of legislation
that occurred was the Public Health Security and Bioterrorism
Preparedness and Response Act of 2002. This act addressed the
lack of legislation, procedures, and policies for the federal
government to follow during a bioterrorism attack. Even though
the Bioterrorism Act did an excellent job of covering a variety
of issues, there are still areas not covered in the act such as
improving the failure in communication during the anthrax
attack. A proposal is recommended to fix these problems which
include the current leadership structure of the governmental
organizations involved during a bioterrorism attack and
communication abilities between the federal, state, and local
governments. Finally, a strategic plan is included which details
the best way to implement this proposal.
Table of Contents
Introduction/Statement of the
Problem……………………………………………………………4
Policy
Analysis………………………………………………………………
……………………5
Program and Management
Review………………………………………………………………1
2
Proposal………………………………………………………………
…………………………..19

Action Decision
Document……………………………………………………………
…………23
Strategic
Plan……………………………………………………………………
……………….26
References……………………………………………………………
…………………………..35
Introduction
According to the Center for Disease Control, “a bioterrorism
attack is the deliberate release of viruses, bacteria, or other
germs (agents) used to cause illness or death in people, animals,
or plants.”[footnoteRef:1] Even though bioterrorist attacks are
not as prevalent as other forms of terrorist attacks, they are still
extremely dangerous and can cause a large number of serious
injuries and fatalities. Terrorist may use biological agents
because “they can be extremely difficult to detect
and do not cause illness for several hours to several days,”[foot
noteRef:2] which can then spread and develop larger amounts of
cases, impacting more groups of individuals. An important part
of combating bioterrorism is to understand how exactly

prevalent the issue is. Worldwide, there has been 384 biological
and chemical attacks since 1970. Within the 384, 48 of these
attacks were in the United States. There was a known total of 9
fatalities and 841 injured people from the 48 attacks. After the
Bioterrorism Act of 2002 was implemented, there were 13
bioterrorism attacks in the United States between 2003 and
2015.[footnoteRef:3] [1: Centers for Disease Control and
Prevention 2006] [2: Centers for Disease Control and
Prevention 2006] [3: Global Terrorism Database 2017]
Background Information on Defining Bioterrorism Agents
Within the concept of bioterrorism, it is important to understand
how exactly the CDC defines the specific agents like anthrax
into three separate categories in order to understand the severity
and threat each agent poses. Category A includes high
priority agents due to the ease of transmission from person
to person, the possibility of higher death rates, and
the special action needed from public health preparedness.
Category B includes agents that are the second highest priority
due to the moderately easy way to spread it, the moderate
illness rates and low date rates, and the specific enhancements
required of the CDC’s laboratory capacity and enhanced disease
monitoring. Category C includes the
third highest priority agents which includes emerging
pathogens that could be engineered for mass spread due to the
availability of them, the ease of production, and the possibility
for high morbidity and mortality rates and major health
impact.[footnoteRef:4] [4: Centers for Disease Control and
Prevention 2006]
Problem Addressed in the Paper
The most current legislation focused on improving programs to
prevent bioterrorism in the United States is the Public Health
Security and Bioterrorism Preparedness and Response Act of
2002, also known as the Bioterrorism Act of 2002. Based on the
Bioterrorism Act of 2002, how can the United States improve

current policies and programs when preventing, researching,
and responding to bioterrorism?
Reasons for the Bioterrorism Act of 2002
After the 9/11 attacks and the anthrax attacks of 2001, the
United States discovered that they did not have the proper
legislation, procedures, and policies needed to address
bioterrorism attacks. The first reason for the creation of the
Bioterrorism Act was based on the absence of legislation or
federal statutes that focused specifically on federal bioterrorism
preparedness and response activities. This resulted in a lack of
focused funding for programs whose goals focused on the
prevention of bioterrorism.[footnoteRef:5] The second reason
was based on the flaw that the government agencies with the
most public health expertise were not in charge when attempting
to prepare for a bioterrorism attack. The third reason was based
on the disorganization and the lack of knowledge from the
federal organizations on how to properly respond to the anthrax
attacks. For example, a report by the U.S. Accountability Office
analyzed the CDC’s response during the anthrax attacks. The
report details how the CDC cannot lead in response to a
bioterrorism attack but can instead provide a key role in
supporting state and local responders, the CDC had major
difficulties when communicating with governmental agencies
and the general public during the attacks, and the CDC did not
have the necessary medical expertise to understand the anthrax
attacks.[footnoteRef:6] The fourth reason was based on the lack
of registration of dangerous chemical and biological agents to
the federal government. During the anthrax attacks, the CDC
only regulated the transfer of dangerous biological agents but
did not require individuals and laboratories to register the
biological agents they had.[footnoteRef:7] [5: Kemper 2005]
[6: Kemper 2005] [7: Kemper 2005]
Background Information on the Bioterrorism Act of 2002
The Bioterrorism Act of 2002, is a large, complex piece of
legislation which includes five titles focused on improving the

ability of the United States to prevent, prepare for, and respond
to bioterrorism and other public health emergencies. The policy
is written in five different titles which includes the major
problem that each part of the legislation is intending on
addressing. Title I is focused on improving national
preparedness for bioterrorism and other public health
emergencies. Title II is focused on enhancing controls on
dangerous biological agents and toxins. Title III is focused on
protecting the safety and security of the food and drug supply
for the United States. Title IV is focused on protecting the
security and safety of drinking water. Title V includes
additional provisions not found in other sections of the
legislation. For this paper, the focus will include Title I and
Title II since these sections of the Act focus on government
agencies and the overall improvement of the bioterrorism
policies. Titles III, IV, and V are all equally important but
mainly focus on the improvement of the food, drug, and water
supplies instead of establishing and improving specific
government functions.
IntendedImpact and Goals of Title I
Within Title I, there are several areas that the policy intends to
impact which includes improving the national preparedness and
response planning, coordinating, and reporting systems,
maintaining and improving the strategic national stockpile,
improving the current countermeasure research and development
for bioterrorism attacks, improving the state, local, and hospital
preparedness for and response to bioterrorism and other public
health emergencies, and analyzing current emergency authority
services when addressing a bioterrorism attack.[footnoteRef:8]
The goals of Title I include improving the ability of Centers for
Disease and Control and Prevention to address bioterrorism
attacks, analyzing current communication abilities between
public health agencies, improving the education of health care
personnel, researching more about antimicrobial resistance and
how this affects the way health care professionals treat strains.
More goals include creating grants based on shortages of certain

health care professionals, maintaining the strategic national
stockpile which consists of antibiotics, vaccines, chemical
antidotes, antitoxins, and other pharmaceuticals and medical
supplies used to address bioterrorist acts, evaluating new
technologies regarding bioterrorism attacks and other public
health emergencies, and making potassium iodide tablets
available to state and local governments through the national
stockpile to individuals living near a nuclear power plant. Also,
the Act focused on giving grants to help improve state, local,
and hospital preparedness and response to bioterrorism attacks,
improving the communicable disease quarantine provisions,
analyzing the current state public emergency announcement
plan, expanding research on worker health and safety and
improving the emergency preparedness of Department of
Veterans Affairs. [8: Public Health Security and Bioterrorism
Preparedness and Response Act of 2002]
IntendedImpact and Goals of Title II
Within Title II, there are several areas that the policy intends to
impact which include improving controls of biological agents
and toxins for the Department of Health and Human Services,
improving controls of biological agents and toxins for the
Department of Agriculture, improving interagency coordination
regarding overlap agents and toxins, and establishing and
improving current criminal penalties regarding certain
biological agents and toxins.[footnoteRef:9] The goals of Title
II include creating a regulation of certain biological agents and
toxins and addressing how the Department of Health and Human
Services can implement these regulations and creating a
regulation of certain biological agents and toxins and
addressing how the Department of Agriculture can implement
these regulations. [9: Public Health Security and Bioterrorism
Preparedness and Response Act of 2002]
Effectiveness of the Bioterrorism Act of 2002
The policy outcomes that were intended were to improve

national preparedness for bioterrorism and other public health
emergencies, enhance controls on dangerous biological agents
and toxins, protect the safety and security of the food and drug
supply for the United States, and protect the security and safety
of drinking water.
Effectiveness of Title I
Overall, title I vastly improved and clarified the roles for
federal, state, and local governments when responding to a
bioterrorism attack. Title I gives the majority of the
responsibility to local governments when dealing with a
bioterrorism attack since they are the mostly likely to detect and
respond to the release of a biological agent. State governments
are the next responders and rely heavily on police departments
and other first responders to help minimize the impact of the
terrorist attack. The federal government is mainly in charge of
planning for a bioterrorism attack through preparing the
National Preparedness Plan and will help when the national
security is compromised due to bioterrorism attacks on public
health.[footnoteRef:10] Based on these relationships between
the federal, state, and local governments, some confusion has
occurred over understanding exactly what each level of
government is responsible for and which level of government is
ultimately responsible for leading the response of a bioterrorism
attack. This confusion is an important problem that needs to be
addressed since a delayed response time to a bioterrorism attack
due to misunderstandings and unclear leadership could result in
more injuries and fatalities to individuals. The obvious choice
for leadership would be the federal government such as the
Department of Homeland Security due to its resources and
knowledge of bioterrorism but there are still issues that need to
be addressed due to fragmentation and unclear relationships
with the federal organizations that would be responsible for
helping during a bioterrorism attack. This fragmentation was
best highlighted during the anthrax attacks of 2001.
Unfortunately, the Bioterrorism Act of 2002 was inadequate in
addressing these issues. [10: Kemper 2005]

There are three major examples of fragmentation not addressed
within the Bioterrorism Act of 2002. The first example is that
there is no clear role outlined when the Assistant Secretary for
Public Health and Emergency Preparedness (who is formally in
charge when a bioterrorism attack occurs) interacts with the FBI
(who is leading federal agency in charge during any terrorist
attack). The second example is the Bioterrorism Act of 2002
does not clearly define the FBI and CDC’s relationship during a
bioterrorist attack, which caused problems with the federal
response during the 2001 anthrax attacks. Not defining this
relationship allows “the FBI to spearhead the response to a
bioterrorism attack and effectively “freeze-out” the CDC much
in the same way as it did in 2001.”[footnoteRef:11] The third
example focuses on the unified work group for all federal
agencies that was established under the Bioterrorism Act that
focuses on improving the United States’ response to
bioterrorism. Unfortunately, the Bioterrorism Act does not
require any reporting provisions for the group which results in
“little incentive to generate hard and fast solutions to
fragmentation problems.”[footnoteRef:12] [11: Kemper 2005]
[12: Kemper 2005]
Another important part of Title I was the requirement for the
CDC to improve their facilities. Congress provided the power
and funding to the CDC to improve the general organization and
to improve the security for their labs. The Act provides funding
for “facilities and communication networks” but the act does
not address, “the need for expanding the biodefense workforce
at the CDC.”[footnoteRef:13] Without the expansion of the
workforce, the CDC will be unable to complete the needed
research in biological agents that is needed. [13: Kemper 2005]
Effectiveness of Title II
Within Title II, the Bioterrorism Act of 2002 establishes a
complete regulation process for the possession and use of

specific biological agents. With this regulation in place, the
CDC can finally specify who has control of biological agents,
where those agents are located, and why that entity or
individual possesses that type of agent.[footnoteRef:14] In
addition, health officials may be better able to determine
whether a breach of laboratory security may endanger the
surrounding community because information on the types of
pathogens stored in particular labs will be readily available to
the government. Before the Bioterrorism Act of 2002, the CDC
had no record of which laboratories were conducting tests with
biological agents, and a security breach would have probably
gone undetected. [14: Kemper 2005]
One of the most important expansions of regulations under Title
II focuses on a reporting requirement by the CDC. Within the
Bioterrorism Act of 2002, an individual in possession of a select
biological agent is required to notify federal, state, and local
law enforcement agencies immediately if an agent is lost or
stolen.[footnoteRef:15] This is an important update to the select
agent regulations because it allows for an immediate response
by law enforcement and allows public health authorities to
known exactly what type of pathogen might be used in a
bioterrorism attack. Knowing which agent might be used in the
attack could lead to less fatalities and injuries since the public
health authorities could start requesting help from the CDC to
understand exactly what the specific agent is and what the best
treatment and prevention methods would be to use. [15:
Kemper 2005]
Other policies created to address bioterrorism
In general, the most recent legislation that is related to
bioterrorism is usually a broad piece of legislation that is
mainly focused on improving the health care system. For
example, the main objective of the Pandemic and All-Hazards
Preparedness Act of 2006 “is to improve the Nation’s public
health and medical preparedness and response capabilities for

emergencies, whether deliberate, accidental, or
natural.”[footnoteRef:16] Essentially, the act is mainly focused
on improving the ability of the public health sector to respond
to emergencies that occurs. Within the act, a small portion is
focused on improving the public health sector’s ability to
respond to emergency situations caused by bioterrorist attacks.
[16: Public Health Emergency 2014]
Organizations Involved in the Bioterrorism Act of 2002
There are many different organizations that try to address the
bioterrorism problem. One of the strengths to the Bioterrorism
Act of 2002 was tasking certain organizations like the CDC to
have a larger leadership role in preventing bioterrorism. This
has resulted in more organizations researching and developing
technologies to combat bioterrorism. However, the more
organizations involved without a strong, central leader to direct
efforts, the less cohesion and directed initiates there are to
focus on research in specific topic areas like the detection of
ricin.
Introduction to the Program Review
Before the 9/11 attacks and the 2001 Anthrax attacks, there
were many federal organizations that were responsible for
different aspects of terrorism prevention and response. Once
these attacks occurred, there were major flaws found within the
existing system, including major flaws in accountability and
understanding of how bioterrorism operates. After the
Bioterrorism Act of 2002, five main federal organizations were
tasked with improving bioterrorism research and defining what
each organization is responsible for in case of another
bioterrorism attack. These five federal organizations include the
Department of Defense, Department of Justice, Department of
Health and Human Services, Department of Veterans Affairs,
and Department of Homeland Security. Even though Homeland
Security was created after the Bioterrorism Act was passed,
there were key sections that later transferred authority to
Homeland Security. In the next sections, there will be an

analysis of what each department is now responsible for and
some of the major projects created to combat bioterrorism.
The Department of Defense Responsibilities
The Department of Defense plays a crucial role in supporting
other federal departments with resources during a terrorist
attack, especially bioterrorism attacks. The DOD is able to
provide technical and personnel support to the DHS and state
authorities during a declared biological or other terrorist attack.
This support includes the U.S. Army's Medical Research
Institute for Infectious Diseases (USAMRIID) Aeromedical
Isolation Team and the U.S. Marine Corps Chemical and
Biological Incident Response Force (CBIRF).[footnoteRef:17]
[17: Carafano 2003]
The Department of Justice Responsibilities
Within the Department of Justice, the FBI has a critical role
when addressing terrorist attacks. Even though the Assistant
Secretary for Public Health and Emergency Preparedness is
formally in charge when a bioterrorism attack occurs, the FBI is
still the leading agency for federal crisis management at a
terrorist scene for all types of terrorist attacks. This distinction
was outlined in the Federal Response Plan. The Federal
Response Plan was a significant project that was expanded due
to requirements in the Bioterrorism Act of 2002.
The Department of Health and Human Services Responsibilities
The Department of Health and Human Services is influential of
bioterrorism research and response since it houses key programs
such as the CDC and FDA. HHS is the federal agency that
handles public health responses to terrorist attacks and other
emergencies. The Bioterrorism Act of 2002 expanded HHS’
powers and created the position Assistant Secretary for Public
Health and Emergency Preparedness, which increased the
responsibilities of the department when responding to a
bioterrorism attack. One major development in the Bioterrorism
Act was to allow HHS to provide assistance to state or local
governments when dealing with a health emergency that is “of

such a nature as to warrant Federal assistance.”[footnoteRef:18]
[18: Carafano 2003]
Powers Given to the Newly Created Secretary Position
The Bioterrorism Act of 2002 gave the Secretary of HHS “broad
statutory powers to respond to a public health crisis and is
authorized to develop and take such actions as necessary to
implement a plan to control infectious
diseases.”[footnoteRef:19] The act also always the Secretary to
create federal quarantines to prevent the spread of cholera,
diphtheria, tuberculosis, plague, smallpox, yellow fever, viral
hemorrhagic fevers, and SARS. Also, when the United States is
at war, the Secretary can “detain persons who are infected with
a biological agent, are contagious, and pose a threat of infecting
any member of the armed forces.”[footnoteRef:20] [19:
Carafano 2003] [20: Carafano 2003]
Key Communication Efforts of the CDC
Within HHS, the CDC is one of the most powerful federal
organizations available to help prevent, research, and respond to
bioterrorism attacks. Within the department, a key role that the
CDC focuses on during a bioterrorism attack is communicating
between the numerous departments. The project created by the
CDC to improve the communication between organizations was
the Health Alert Network. The network transfers health alerts,
disease data, treatment guidelines, and secure disease
surveillance between the CDC and state and local officials
located at the bioterrorism attack sites.[footnoteRef:21] The
CDC used the network during the 2001 anthrax attacks to help
coordinate and provide information to local officials when
dealing with these attacks. Unfortunately, the system proved to
be “only marginally effective as many local jurisdictions
received incomplete data.”[footnoteRef:22] The Bioterrorism
Act of 2002 tasked the CDC with improving their capabilities,
including the ability to better communicate with state and local
governments during a bioterrorism attack. The CDC is still

working on the improvements but there has not been as much
research on improving the Health Alert Network. Improving the
communication efforts will help get information to state and
local governments faster, resulting in less loss of life. [21:
Carafano 2003] [22: Carafano 2003]
National Disaster Medical System
Another major project that was expanded due to the
Bioterrorism Act of 2002 was the National Disaster Medical
System. NDMS was a project created in 1984 by the HHS, VA,
and DOD to “help care for causalities that occurred in a
domestic disaster or an overseas conventional
war.”[footnoteRef:23] However, the system transformed into
focusing mainly on helping with domestic disasters but not with
terrorist attacks. After the terrorist attacks of 2001, the NDMS
mission was expanded to include medical response to terrorist
attacks, as well as pre-staging for national security special
events like political conventions. After the creation of the
Bioterrorism Act of 2002, Congress statutorily created the
National Medical System and transferred the control of the
system from HHS to DHS.[footnoteRef:24]
The NDMS components include deployable medical
response teams, a patient evacuation system, and definitive
hospital care. [23: Franco et al. 2007] [24: Public Health
Security and Bioterrorism Preparedness and Response Act of
2002]
Department of Veterans Affairs
The VA was another department that was impacted by the
Bioterrorism Act of 2002. The act required that the VA
“participates in the National Disaster Medical System, works in
collaboration with the States and other public or private entities
to provide health services and health-related social services, and
responds to the needs of victims of a public health
emergency.”[footnoteRef:25] The VA also assigned

preparedness and response functions to the nationwide system
of hospitals and clinics operated by the VA. Due to the
Bioterrorism Act of 2002, the VA created the Department of
Veterans Affairs Emergency Preparedness Act of 2002 in order
to help address the new requirements for the VA bioterrorism
research and prevention. [25: VA Office of Inspector General
2006]
Department of Homeland Security Responsibilities
The Department of Homeland Security was created in response
to the 9/11 attacks in order to oversee and coordinate the
comprehensive national strategy to safeguard the country
against terrorism.[footnoteRef:26] Homeland Security plays a
key role in bioterrorism research and response. After the
department was created, the responsibility of certain programs
was transferred to Homeland Security. DHS has general
oversight of the Strategic National Stockpile, while the CDC
manages the daily operations. DHS oversees the Metropolitan
Response System and the National Disaster Medical System
including the national Disaster Medical Assistance Teams,
Veterinary Medical Assistance Teams, and the Disaster
Mortuary Support Teams. DHS took over the managing
functions of the HHS’s Office of Emergency Preparedness. This
office “manages and coordinates federal health, medical, and
health-related social services for major emergencies and
disasters.”[footnoteRef:27] Responsibility was transferred to
DHS for the Department of Agriculture’s Plum Island Animal
Disease Center, (research conducted on animal pathogens), and
the Animal and Plant Health Inspection Service, (border
inspections). Another department that DHS gained oversight
was the Federal Emergency Management Agency. This agency
was formerly independent but control was shifted to DHS since
the agency handles bioterrorism threats and coordinates the
federal response to terrorism attacks or other major disasters. In
general, “FEMA manages national mitigation and disaster
assistance programs, including coordinating the types and levels

of support provided by all federal departments and agencies in
the response to and recovery from a terrorist
strike”[footnoteRef:28] [26: The Department of Homeland
Security] [27: Carafano 2003] [28: Carafano 2003]
Case Study of Anthrax Attack of 2001
The best way to illustrate the flaws in the federal response to
bioterrorism attacks is to analyze a case study to see how the
Bioterrorism Act of 2002 improved on the weaknesses of the
federal response and what currently still needs to be addressed.
An analysis of the 2001 anthrax attacks will provide important
insight to how the act fixed some of the issues that occurred
during the attack and what issues have still not been addressed.
The flaws discussed in this section are discussed in a report
prepared by the Center for Strategic and International Studies
and the Defense Threat Reduction Agency
titled Lessons from the Anthrax Attacks: Implications
for U.S. Bioterrorism Preparedness.
One major issue during the 2001 anthrax attacks was that a state
of emergency was not declared in any of the states that had
cases of anthrax like in Florida. As stated in the report, “The
strain on resources that communities faced during the anthrax
attacks evolved partially out of the fact that no local state of
emergency was ever invoked and no national of emergency was
ever declared.”[footnoteRef:29] If the state does not declare a
state of emergency and formally request federal governmentally
help, there is no way to get the resources and personnel needed
to address a bioterrorism attack. This resulted in the
Bioterrorism Act of 2002 giving authority to the Department of
Health and Human Services to aid local and state governments
if the department believes the specific emergency warrants
federal involvement. This helps fix the issue of the state of
emergency not being declared in the anthrax attacks since the
federal government can now help provide resources,
information, and personnel during a crisis without needing the

state to ask for federal involvement. [29: Heyman, Achterberg,
& Laszio 2002]
Another issue discussed was the confusion and lack of
organization in the command structure by the federal
government. The report discusses how the U.S. Capital Police
operated the Senate crisis without an incident command
structure until they hired an outside consultant to operate as the
incident commander to coordinate all the federal agencies
involved in the attack.[footnoteRef:30] Due to the time without
this commander, “initial confusion prior to retaining the
consultant about who was in charge and the roles, missions, and
capabilities of each agency tended to slow the
response.”[footnoteRef:31] Without a clear understanding of
which agencies and individuals are in charge during a
bioterrorism attack, the more confusion there is and more
resources are wasted. [30: Heyman, Achterberg, & Laszio
2002] [31: Heyman, Achterberg, & Laszio 2002]
A different report by the United States General Accounting
Office discussed more issues that occurred during the anthrax
attack. The titled of the report was the
Public Health Response to Anthrax Incidents of 2001
and was specifically created for Honorable Bill Frist, the
majority leader of the U.S. Senate. During the anthrax attack,
the CDC mainly used the HAN to provide information to state
and local governments. During the attack, all state health
departments used the HAN but only 13 states had connected all
of their local health jurisdictions to the HAN.[footnoteRef:32]
Overall, the CDC received mixed reviews of the HAN. Based on
the information provided by the HAN, “some states were
satisfied with the information they received via HAN, but others
claimed they did not get much information from HAN and what
they did get was incomplete.”[footnoteRef:33] More
improvement to the HAN need to be made in order to improve
on the current communication network used during bioterrorism

attacks. [32: United States General Accounting Office 2003]
[33: United States General Accounting Office 2003]
In the report, there were a few sections that discussed the
response of the FBI during the anthrax attacks. One example
focuses on the lack of information the public health officials at
an epicenter received from the FBI during the anthrax attacks.
The public health officials stated that “if they had received
more detailed information earlier about the nature of the anthrax
spores in the envelopes, it might have affected how their
agencies were responding.”[footnoteRef:34] During a
bioterrorism attack, the more information received, the better
chance of responding quickly enough to prevent more loss of
life. Most of the governmental reports do not discuss the failure
of the FBI to communicate with the CDC and other federal
organizations. There is one quote from the report that highlights
the need for better communication between the FBI and CDC.
The quote discusses how the “CDC has held joint training with
the FBI to discuss what they learned from their experience that
could facilitate working together in the future.”[footnoteRef:35]
Even though this quote is vague, it does demonstrate that the
FBI needs to work on their communication abilities. [34:
United States General Accounting Office 2003] [35: United
States General Accounting Office 2003]
Introduction to the Policy and Program Proposal
The Bioterrorism Act of 2002 was the first necessary step to
improving the United States’ response in the event of a
bioterrorism attack. The act assigned responsibility to federal
organizations, provided needed funding to improve current
bioterrorism research and response capabilities, and provided
basic legislation to address the major issues discovered during
the Anthrax attacks of 2001. However, as shown in the policy
and program analysis, there are several areas that need to be
addressed in order to improve the overall Bioterrorism Act and

the capabilities of responding to a bioterrorism attack. The
overall areas that need to be addressed are the current
leadership structure of the governmental organizations in
response to a bioterrorism attack and communication abilities
between the federal, state, and local governments.
Leadership Structure Issues
As stated in the policy and program analyses, there is an issue
of which individual and government agency is in charge during
a bioterrorism attack. The FBI is the leading agency during a
bioterrorism attack but the Assistant Secretary for Public Health
and Emergency Preparedness is the lead individual in charge
during a bioterrorism attack. As seen during the Anthrax
Attacks of 2001, the FBI did not use the valuable information of
other agencies like the CDC to their benefit. The FBI attempted
to lead the response alone, which caused more issues and
confusion between the different governmental organizations.
Unfortunately, the Bioterrorism Act of 2002 did not address this
major issue but instead created a conflict between the FBI and
the lead individual in charge during a bioterrorism attack. This
paper proposes a reauthorization of Title I for the Bioterrorism
Act of 2002 in order to restructure the current authority and
responsibilities of the different governmental agencies.
Reauthorization of Title I
The department of Homeland Security should be the leading
agency in charge during a bioterrorism attack. Even though the
most logical organization would be the Department of Health
and Human Services, they do not have the knowledge capable of
leading and organizing the response to a bioterrorism attack.
HHS is better suited to providing support, resources, and
knowledge to another leading agency since they do not have
enough experience to properly address a terrorist attack. The
mission of Homeland Security is to maintain the national
strategy to prevent terrorist attacks. Since DHS has knowledge
of bioterrorism attacks and some of the resources needed to
combat bioterrorism, they are the best suited to lead the
response of a bioterrorism attack. Also, DHS manages the

functions of the Office of Emergency Preparedness. This office
is focused on coordinating the federal medical and other health
related responses during a major emergency or disaster. Under
the oversite of DHS, this department would play a crucial role
during a bioterrorism attack. HHS, FBI, DOD, and VA will have
supporting roles in the event of a bioterrorism attack since each
agency brings a unique set of skills and resources that can best
help the US.
HHS and DHS
With DHS becoming the lead agency in charge during a
bioterrorism attack, some responsibilities of DHS should be
transferred back to HHS. One of the major programs that needs
to be transferred is the National Strategic Stockpile. The CDC
still manages the daily operations but DHS has general
oversight over the program. Having multiple agencies in charge
of major medical emergency response programs causes delays in
response to state and local governmental requests for assistance
from the federal government when dealing with bioterrorism
attacks. This could result in more fatalities since time is critical
in stopping and responding to a bioterrorism attack. In addition
to the National Strategic Stockpile, Congress should also give
responsibility of the Metropolitan Medical Response System
and National Disaster Medical System to HHS. This would
effectively switch the roles of HHS and DHS since HHS would
have a complimentary role to DHS during a bioterrorism attack.
HHS would be responsible for supplying the needed resources
and personnel to DHS while DHS would be responsible for
organizing and implementing the response of the federal
government during a bioterrorism attack.
Public Health Expert on the National Security Council
Even though there are many federal agencies involved in
bioterrorism research and planning, there is no representative on
the National Security Council for any public health department.
The members of the council include the President, Vice
President, Secretary of State, Secretary of Defense, Secretary of
the Treasury, and the Assistant to the President for National

Security Affairs. The Chairman of the Joint Chiefs of Staff is
the statutory military advisor to the Council, and the Director of
National Intelligence is the intelligence advisor. The Chief of
Staff to the President, Counsel to the President, and the
Assistant to the President for Economic Policy are invited to
attend any NSC meeting. The Attorney General and the Director
of the Office of Management and Budget are invited to attend
meetings pertaining to their responsibilities. The heads of other
executive departments and agencies, as well as other senior
officials, are invited to attend meetings of the NSC when
appropriate.[footnoteRef:36] [36: The White House]
Even though there are several departments on the council that
are partially responsible for bioterrorism response, there needs
to be an expert that is focused exclusively on public health,
including bioterrorism. This is a major issue since there is not
one expert to discuss with the president and other members of
the council about how to properly address situations concerning
public health but this information is instead tasked to other
council members to be addressed during the meetings. If there
was an expert that understood the complex health care system of
the United States on the council, they could save countless lives
in cases of public health emergencies. The expert would not just
focus on bioterrorism attacks but also any other health
emergencies such as nuclear weapon concerns or infectious
diseases control. Having a constant presence on the council will
allow for more information to be addressed to powerful decision
makers in the government and to help fix the current problems
that occur in the public health sector.
Improving the Health Alert Network
Another extensive topic that needs to be addressed is the
communication between the federal government and state and
local governments during a bioterrorism attack. Local and state
governments will be the first to be alerted to a bioterrorism
attack in their area. There must be an efficient way to distribute

information about how to address the specific agent used in the
attack and the best way to prevent the spread of the contagion.
The best way to address this communication error is by
improving the current Health Alert Network the CDC currently
uses. It would be cheaper and easier to improve a current
program rather than creating a new network that has not been
tested like the HAN was during the 2001 Anthrax Attacks.
During the Anthrax Attacks of 2001, this network was used to
coordinate information between local officials and the CDC
during these attacks. As stated earlier in the paper, the system
was proven to only be marginally effective since the local
governments only received incomplete data on anthrax and the
best way to treat the cases. If the local first responders and law
enforcement officials do not understand the best way to help
individuals suffering from different agents, they are unable to
effectively perform their job, leading to more injuries. Also,
this network would allow local and state governments to request
the needed resources and personnel from the different federal
agencies and programs like the National Strategic Stockpile.
With a bioterrorism attack, the less time it takes to understand
exactly what the pathogen is and to begin treatment, the less
fatalities may occur.
Action Decision Document
The next page includes the memorandum used to discuss
the proposal to improve current bioterrorism policies and
programs. In total, the memorandum will be addressed to
Speaker of the House, Assistant Secretary for Public Health and
Emergency Preparedness, the Domestic Policy Advisor,
Secretary of Homeland Security, Secretary of Defense, United
States Attorney General, Secretary of Health and Human
Services, Secretary of Veterans Affairs, and the Director of the
Centers for Disease Control and Prevention. However, each
memorandum will be individually addressed to each department
head, so a sample is provided on the next page to the Speaker of
the House as an example of the memorandum sent to each
department.

Memorandum
TO: Paul Ryan, Speaker of the House
FROM: Sarah Kirk
DATE: December 8, 2017
RE: Request to modify the current Bioterrorism Act of
2002
_____________________________________________________
_________________________
Introduction
According to the Center for Disease Control, “a bioterrorism
attack is the deliberate release of viruses, bacteria, or other
germs (agents) used to cause illness or death in people, animals,
or plants.” Even though bioterrorist attacks are not as prevalent
as other forms of terrorist attacks, they are still extremely
dangerous and can cause serious injuries and fatalities. The last
major piece of legislation that affected the prevention of and
response to bioterrorism attacks in the United States was the
Public Health Security and Bioterrorism Preparedness and
Response Act of 2002. The act was an important step in
improving the United States’ planning and response to
bioterrorism attacks. However, there are serious issues
concerning the federal government structure and communication
with state and local governments that needs to be addressed.
These issues can be fixed by reauthorizing Title I of the
Bioterrorism Act of 2002 to change the responsibilities of the
Department of Homeland Security and the Department of Health
and Human Services. The communication errors can be fixed by
creating a Public Health Expert position on the National
Security Council and improving on the current Health Alert
Network operated by the Center for Disease Control.
Reauthorization of Title I - DHS
In reauthorizing Title I, DHS needs to become the lead federal

agency in charge during a bioterrorism attack. The mission of
Homeland Security is to maintain the national strategy to
prevent terrorist attacks. Since DHS has knowledge of
bioterrorism attacks and some of the resources needed to
combat bioterrorism, they are the best suited to lead the
response of a bioterrorism attack. Also, DHS manages the
functions of the Office of Emergency Preparedness. This office
is focused on coordinating the federal medical and other health
related responses during a major emergency or disaster. Under
the oversite of DHS, this department would play a crucial role
during a bioterrorism attack.
Reauthorization of Title I - HHS
HHS is better suited to providing support, resources, and
knowledge to DHS as the leading agency and some
responsibilities of DHS should be transferred back to HHS. One
of the major programs that should be transferred is the National
Strategic Stockpile. The CDC still manages the daily operations
but DHS has general oversight over the program. Having
multiple agencies in charge of major medical emergency
response programs causes delays in response to state and local
governmental requests for assistance from the federal
government when dealing with bioterrorism attacks. This could
result in more fatalities since time is critical in stopping and
responding to a bioterrorism attack. In addition to the National
Strategic Stockpile, Congress should also give responsibility of
the Metropolitan Medical Response System and National
Disaster Medical System to HHS. This would effectively switch
the roles of HHS and DHS since HHS would have a
complimentary role to DHS during a bioterrorism attack. HHS
would be responsible for supplying the needed resources and
personnel to DHS while DHS would be responsible for
organizing and implementing the response of the federal
government during a bioterrorism attack.

Public Health Expert on the National Security Council
Even though there are many federal agencies involved in
bioterrorism research and planning, there is no representative on
the National Security Council for any public health department.
There needs to be an expert that is focused exclusively on
public health, including bioterrorism. This is a major issue
since there is not one expert to discuss with the president and
other members of the council about how to properly address
situations concerning public health. If there was an expert that
understood the complex health care system of the United States
on the council, they could save countless lives in case of a
public health emergency. The expert would not just focus on
bioterrorism attacks but also any other health emergencies such
as nuclear weapon concerns or infectious diseases control.
Having a constant presence on the council will help fix the
current problems that occur in our public health sector.
Improving the Health Alert Network
Improving the current Health Alert Network operated by the
CDC is the cheapest and easiest way to improve the
communication network between federal, state, and local
governments during a bioterrorism attack. Local and state
governments will be the first to be alerted to a bioterrorism
attack in their area. There must be an efficient way to distribute
information about how to address the specific agent used in the
attack and the best way to prevent the spread of the pathogen.
During the Anthrax Attacks of 2001, this network was used to
coordinate information between local officials and the CDC
during these attacks. Unfortunately, the system was proven to
only be marginally effective since the local governments only
received incomplete data on anthrax and the best way to treat
the cases. Improving this network would allow local and state
governments to request the needed information, resources, and
personnel from the different federal agencies and programs like

the National Strategic Stockpile. With a bioterrorism attack, the
less time it takes to understand exactly what the pathogen is and
to begin treatment, the less fatalities may occur.
I ask that you consider the previous proposal to improve the
current policies and programs focused on preparing,
researching, and responding to bioterrorism attacks.
Approved
_____________
_____________________________________
Date Signature Denied
Introduction to the Strategic Plan
As established in previous sections of this paper, there are
major issues with the Bioterrorism Act of 2002 that need to be
addressed. The three major recommendations in the proposal
included the creation of the public health expert position on the
National Security Council, re-authorization of Title I, and
improvements of the Health Alert Network. This section of the
paper will provide a specific plan on how to implement these
recommendations. Implementing these strategies will improve
the United States’ research and response to bioterrorism attacks.
Policy/Program Outcomes
Analyze the response of different federal government
organizations that are directly involved with the US’ federal
government’s response during a bioterrorism attack. Based on
these findings, determine new roles for each agency to improve
weaknesses in communication and response. For example,
authorizing Homeland Security as the leading federal agency
during a bioterrorism attack instead of the FBI. Improve the
ability of the current communication networks between the
federal government and state and local officials, such as first
responders, law enforcement, and hospital personnel, during a
bioterrorism attack. Create a new position focused on public
health awareness and improving the current bioterrorism
policies and programs by establishing a Public Health Expert

position on the National Security Council.
Program Design/Administrative “Blueprints”
Inputs
The inputs needed to implement the strategic plan include
financial resources, personnel, and time needed to implement all
components of the strategic plan. The financial resources would
contribute to the HAN, the creation of the mock training
exercises, and pay for the creation of the Public Health Expert
position and the HAN Strategic Network Operator. Key
personnel needed to implement the strategic plan include all
members of the working group such as the Assistant Secretary
for Public Health and Emergency Preparedness, the Domestic
Policy Advisor, Secretary of Homeland Security, Secretary of
Defense, United States Attorney General, Secretary of Health
and Human Services, Secretary of Veterans Affairs, and the
Director of the Centers for Disease Control and Prevention
Processes
The processes needed to implement the strategic plan
include creating a new position on the National Security
Council and establishing a working group to address changes in
bioterrorism policies and programs. These components are
crucial in implementing the strategic plan, since the Public
Health Expert will establish the working group. The working
group, including the Public Health Expert, will have the ability
to reauthorize legislation, leading to improvements in the HAN
and overall communication between different federal agencies
concerning bioterrorism research. The specific processes of how
to implement each step of the strategic plan are included below
in the implementation strategy section of the paper.
Outputs
The outputs of the strategic plan include researched
improvements in communication with the HAN between the
federal government, state, and local officials during a
bioterrorism attack, effective yearly mock training exercises,
which lead to better communication and response during a
bioterrorism attack. Also, two other outputs would include a

new position on the National Security Council titled the Public
Health Expert and a new position with the HAN titled the
Strategic Network Operator.
Outcomes and Impacts of the Strategic Plan
Overall, this strategic plan is focused on improving current
legislation and programs dedicated to preventing and
responding to bioterrorism attacks in the United States. One
major outcome of the plan is to improve general communication
between the federal, state, and local governments during a
bioterrorism attack. Specifically, improving the communication
between the five main federal agencies responsible for the
research of, response to, and prevention of a bioterrorism event.
One major impact that may occur will be more accurate and
faster responses to a bioterrorism attack, resulting in less
casualties and injuries. Another major outcome from the
strategic plan involves the mock yearly training exercises. The
outcome from these exercises includes improvements in the
response to bioterrorism attacks by all agencies involved in the
program. The more unique scenarios these agencies are exposed
to during the training exercises, the more experience the
agencies will have. The impact of this experience is for the
federal agencies to be better prepared to respond to a
bioterrorism attack, since they have dealt with a variety of
different scenarios.
Implementation Strategy
First, I would speak to the executive office to the president to
begin discussions for creating the Public Health Expert position
for the National Security Council. Creating the position first
would allow for direct access to high ranking governmental
officials to work on the re-authorization process for Title I and
providing necessary recommendations for the Health Alert
Network.
Establishing a Working Group

Once the public health expert is established, they can be the
leading agent to help address the problems in other areas of
bioterrorism. Next, the expert should establish a working group
to address the current bioterrorism policy and to implement the
changes that are proposed. Within this working group, the
Assistant Secretary for Public Health and Emergency
Preparedness will chair the group and include the newly
appointed Public Health Expert, the Domestic Policy Advisor,
Secretary of Homeland Security, Secretary of Defense, United
States Attorney General, Secretary of Health and Human
Services, Secretary of Veterans Affairs, and the Director of the
Centers for Disease Control and Prevention. One major
responsibility of this working group is to transfer authority to
homeland security to be the leading agency in charge during a
bioterrorism attack. Even though the FBI would not be in
charge, they would still have a key supporting role in providing
resources and field expertise that is vital during a bioterrorism
attack. Also, authority for the National Strategic Stockpile,
Metropolitan Response System and the National Disaster
Medical System should be transferred back in control of the
CDC.
Improving the Communication Network
Once this re-authorization occurs, the working group can then
focus on improving the current communication network used
during a bioterrorism attack. One major issue within this
communication is the number of different alert networks
available and the problem that occurs with multiple networks
competing to give information. For example, the CDC offers
multiple communication networks such as the Online Technical
Resource and Assistance Center and Epidemic Information
Exchange, which can cause confusion if multiple alerts are
being received from the different forms of communication
networks available. Multiple alerts may have conflicting or
redundant information that can delay decision making during a
bioterrorism attack.
Primary Communication Network

The working group should require that the Health Alert Network
be the main communication network between federal, state, and
local hospitals, first responders, law enforcement, and any other
official involved during a bioterrorism attack. The HAN is the
established network in the Public Health Emergency
Preparedness and Response Plan but it is not the only required
network for the program. The working group can establish
requirements for HAN to be the main source of communication
and to have another program like On-TRAC as the secondary
source of communication.
Creating HAN Strategic Network Operator
Next, the group should establish a new position called the
Strategic Network Operator. The purpose of this position is to
allow one individual to help address the confusion of multiple
messages. If all messages are cleared with one main individual
first before being sent through the HAN, it will decrease the
number of repeated and conflicting messages. Also, having one
individual in charge will ensure that messages are actually sent
during an emergency. One major issue from the anthrax attacks
of 2001 was the lack of information sent to local authorities.
Without the needed information to address the anthrax attacks,
more individuals became ill since they did not understand how
to properly handle the letters containing the anthrax.
Having a position dedicated to ensuring the correct information
is disseminated to local authority will help improve the overall
network, since some of the major issues with using the network
is the content of the messages being sent and the lack of
information being sent. More research needs to be conducted
once this position is established to determine other flaws within
the network. Hopefully decreasing the lack of conflicting
messages and increasing the amount of information provided
will fix the problems within the HAN. Also, more research
needs to be conducted to determine a way to evaluate all the
different communication networks. Having an evaluation tool
will provide more necessary feedback in order to improve the
HAN and any other networks used during a bioterrorism attack.

Budget
The major components included in the budget are the
salary for the Public Health Expert, salary for the Strategic
Network Operator, and the budget for the yearly training
exercises. The Government Management and Program Analysis
position in Homeland Security averages 102,475 per year. This
position focuses on “serving as analysts and advisors to
management on the evaluation of the effectiveness of
governmental programs and operations or the productivity and
efficiency of the management of Federal agencies or
both.”[footnoteRef:37] The Public Health Expert position would
have the same responsibilities as this current position, so both
positions should have the same salary. The Miscellaneous
Administration and Program position in Homeland Security
averages 91,847 per year.[footnoteRef:38] This position focuses
on mainly on managing systems or processes, which most
relates to the Strategic Network Operator. [37: Department of
Homeland Security 2016] [38: Department of Homeland
Security 2016]
Based on a mock terrorism training exercise conducted by the
Regional Domestic Security Task Force in Florida, the cost for
the training exercise is expensive based on the different
components to the study. In the Florida study, the task force
coordinated exercises between local, state, federal, and private
agencies, including 12 Emergency Operations Centers and 13
hospitals. In total, the task force spent approximately, “200,000
on planning staff, documentation, and staging the
exercise.”[footnoteRef:39] However, since this is a federal
program that will require more personnel and resources,
resulting in a budget of closer to 750,000 or more for the
planning and execution of the exercise. There was not a lot of
information available for terrorism training exercises for the
federal government, especially the budget used for these
program, but there was some information for state programs.
This is why the details for the state training exercise was used

as a general idea of how much the exercises may cost. [39:
Whitehead 2006]
Funding
Since the anthrax attacks of 2001, there are a large variety of
grants and funding resources available to different federal
agencies for improving the research and response functions of
the different departments. For example, some funding can come
from the Public Health Emergency Preparedness cooperative
agreement to help with improving the HAN. Other grants can be
requested from the National Institutes for Health to fund the
mock emergency training exercises. Also, since multiple
agencies will be represented in the working group, some
funding can come from these different federal agencies to help
with the cost of meeting and discussing improvements to current
bioterrorism research.
Timetable
In total, it will take approximately 5 to 8 years to fully
implement the proposal program. One difficulty in establishing
a timetable is not knowing an exact amount of time required
between each component of the proposal. For example, it may
take longer to achieve approval of the public health expert
position than anticipated. However, there is a general timetable
included that estimates the amount of time it may take to
establish each part of the proposal.
Within the first six months to one year of the proposal being
accepted, the new Public Health Expert position should be
created and a qualified individual for the position should be
hired. Since this position helps create the work group to fix the
problems in bioterrorism, it is necessary to have this position
created and filled as quickly as possible. Next, the working
group must be established and begin the reauthorization of Title
I. The working group should take approximately three months to
six months to be fully established. Within two and a half years
to three years, the reauthorization of Title I should be approved
by Congress. The creation of HAN position, improving the HAN

network, and planning the yearly mock exercise can occur at the
same time as the reauthorization process. This process may take
one year to two years to fully implement the HAN system
upgrades and the creation of the new HAN position. The yearly
mock exercise may take one year to two years to plan before the
implementation process can occur. The implementation process
can only occur once every other part of the proposal is
completed since it is the main evaluation component of the
proposal.
Monitoring & Evaluation
For the research evaluation component, a yearly mock
bioterrorism emergency event should be conducted to test the
newly created Public Health Expert position, the newly
improved HAN, and the newly established authority of the
different federal agencies. The mock events can include
different scenarios of possible bioterrorism attacks within
different areas of the country. For example, have a design one
year in the rural part of a southern state then the next year have
a mock design on the west coast in a busy metropolitan area.
The exercise should last a total of 72 hours. Within the first 72
hours of a bioterrorism event occurring is the most crucial time
to establish control of the event and provide necessary
information to decrease the harm caused by the attack.
Within the mock design, a key aspect is to allow the different
federal agencies to perform the normal tasks and procedures
required of them during a bioterrorism attack. This would allow
for a test of the new authority since Homeland Security would
be required to lead the activity while the CDC tested the new
resources that were re-authorized to them. This would allow for
the different federal departments to interact together and build
positive working relationships that are important to have during
a national emergency. The mock design would also test the new
public health expert since the new position would be key in
helping lead the response to a bioterrorism attack. Also, the
improved HAN system can be tested to see how well the system
is able to relay important information from the different federal

agencies to the local first responders. Through federal grants, an
outside research company should be hired to assess and analysis
the exercise to determine how well the federal organizations
worked together and the improvements each federal agency can
address to improve their overall response time and actions. The
research company can assess a variety of measures which
includes response times for the federal agencies to react during
a bioterrorism event, how well the different agencies work
together, general reactions to unexpected events that occur
during the exercise, simulated rates of fatalities and injuries,
and other measures to be determined.
References
Carafano, J. (2003). Improving federal response to catastrophic
bioterrorist attacks: The next steps.
The Heritage Foundation. Retrieved from
http://www.heritage.org/homeland-
security/report/improving-federal-response-catastrophic-
bioterrorist-attacks-the-next
Centers for Disease Control and Prevention (2006).
Bioterrorism Overview.
Department of Health and Human Services.

Centers for Disease Control and Prevention. (2017).
Public health emergency preparedness cooperative
agreement (PHEP) program. Office of Public Health
Preparedness and Response.
Department of Homeland Security (2015). Creation of the
Department of Homeland Security. Retrieved from
https://www.dhs.gov/creation-department-homeland-
security
Department of Homeland Security. (2016). Department of
homeland security headquarters salaries of 2016. Retrieved from
https://www.federalpay.org/employees/dhs-headquarters
Franco, C., Toner, E., Waldhorn, R., Inglesby, T. V., O’Toole,
T. (2007). The National Disaster Medical System: Past, Present,
and Suggestions for the Future.
Biosecurity and Bioterrorism: Biodefense Strategy,
Practice, and Science, 5(4), 319-326.
Global Terrorism Database. (2017). All terrorist incidents
involving weapon type as biological or chemical.
University of Maryland. Retrieved from
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ly=&end_yearonly=&start_year=&start_month=&start_day=&en
d_year=&end_month=&end_day=&asmSelect0=&asmSelect1=&
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b&casualties_max=
Grundmann, O. (2014). The current state of bioterrorist attack
surveillance and preparedness in the US.
Risk Management and Healthcare Policy, 7, 177-187.
Heyman, D., Achterberg, J., & Laszio, J. (2002). Lessons from
the anthrax attack: Implications for U.S. bioterrorism
preparedness.
Center for Strategic and International Studies and the

Defense Threat Reduction Agency. Retrieved from
https://biotech.law.lsu.edu/blaw/anthrax/dtra02.pdf
Kemper. R. R. (2005). Responding to bioterrorism: An analysis
of title I and II of the public health security and bioterrorism
preparedness and response act of 2002.
Washington University Law Review, 83(1), 384-415.
NDMS Federal Partners MOA. (2005). National disaster medical
system: Memorandum of agreement among the departments of
homeland security, health and human services, veterans affairs,
and defense. 1-12.
Public Health Emergency (2014). Pandemic and all hazards
preparedness act.
U.S. Department of Health & Human Services.
Retrieved from
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Public Health Security and Bioterrorism Preparedness and
Response Act of 2002, H. R. 3448, 117th Cong. (2002).
The White House. National Security Council. Retrieved from
https://obamawhitehouse.archives.gov/administration/eop/nsc
United States General Accounting Office. (2003). Public Health
Response to Anthrax Incidents of 2001.
Report to the Honorable Bill Frist, Majority Leader,
U.S. Senate. Retrieved from
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VA Office of Inspector General. (2006). Emergency
preparedness in veterans health administration facilities.
Department of Veterans Affairs. Retrieved from
https://www.va.gov/oig/54/reports/VAOIG-04-03266-
51.pdf
Whitehead, C. (2006). Mock terrorism exercises.
Hendon Publishing. Retrieved from

http://www.hendonpub.com/resources/article_archive/results/det
ails?id=3741
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