Dollars for disaster readiness, bioterrorism tricky to spend

OIG audits find unspent money and trigger calls for more oversight. States respond that problems result from growing pains.

By Victoria Stagg Elliott, AMNews staff. Jan. 2/9, 2006.

Victor Freeman, MD, an internist and past president of the Medical Society of the District of Columbia, is frustrated with the local efforts regarding bioterrorism and disaster preparedness. He knows that physicians are a key element of any such response plan, but the local public health department has proven so difficult to work with that he and other MSDC members have considered disbanding their emergency preparedness committee.

"We're quite disappointed, almost to the point of being demoralized," said Dr. Freeman.

His frustration results from an emerging reality that, despite increased federal support for shoring up public health readiness, this money has not always been easy to spend.

According to a series of eight reports issued in the past year by the Dept. of Health and Human Services Office of Inspector General, a significant portion of the billions of dollars directed to the public health system since the 2001 terrorist attacks was unspent as of August 2004.

More OIG reports analyzing how states used money from the Centers for Disease Control and Prevention and from the Health Resources and Services Administration for disease surveillance, laboratory capacity, and upgrades to hospitals' disaster response ability are expected in the coming months.

For now, though, what is clear is that each state along with the District of Columbia has its own unique set of issues in utilizing these newfound riches and most feel the hurdles faced thus far are a result of the difficulties that come with rapid growth. CDC preparedness funding, for example, was $40 million in 1999 but jumped to $982 million in 2002.