Leo Mackay

Meeting Report

"Reorganizing for Homeland Security"
July 25, 2002

Deputy Secretary of Veteran's Affairs, Leo S. Mackay, Jr.

Leo S. Mackay gave a luncheon address at Eisenhower Institute to a group of 40 senior policy-makers and experts on July 25, 2002, the second in a series of Whitman Domestic Studies Seminars on Homeland Security.  Mackay discussed the role of the Veterans Affairs Department in preparing the federal government to cope with a possible terrorist attack, focusing on the vital importance of the federal medical infrastructure in the event of a bioterrorist incident on U.S. territory.

Anne Whitman, who was President Eisenhower's personal secretary for twelve years, generously provided an endowment to the Eisenhower Institute to study how effectively agencies of the federal government are fulfilling their mandates. The monthly lunch seminars, which are the first product of the Whitman Domestic Studies Program, feature prominent speakers who have extensive experience in various aspects of homeland security.

Effective domestic governance has become more crucial as the nation organizes to prevent and protect against possible future acts of terrorism. The Department of Veterans Affairs is one of the key cabinet agencies that will actively contribute to national medical resources to protect Americans lives in the event of a disaster.

The VA is not slated to become part of the new, consolidated Department of Homeland Security, but it will continue to play a major role in the federal disaster response system. Among other leadership roles, the VA serves as a member of six policy coordinating committees that are part of the Homeland Security Council. These committees are coordinating the design and implementation of both the federal homeland security structure and its interaction with state and local governments.

Of the four core missions carried out by the Veterans' Affairs department (including administering veterans' health and benefits programs, overseeing the system of national cemeteries, and working with the Pentagon to provide veterans' health care), Secretary Mackay emphasized the vital importance of the VA's ability to provide prompt medical assistance in the event of a national emergency. The VA is currently prepared to augment the Defense Department's network of hospital and health care facilities in the event of crisis with 165 medical centers and 1300 other medical support facilities around the country. The VA also can rapidly procure emergency medicine and supplies and provide these to the Centers for Disease Control and the Department of Health and Human Services.

The department plays a critical role in the National Disaster Medical System, a federal program to coordinate and mobilize medical resources in an emergency. Managing more than two-thirds of the 74 national areas targeted, the VA is prepared to assist state and local authorities during either a major national disaster or in the event that large-scale casualties are evacuated to the United States following an overseas conflict. Additionally, the department has acquired supplies called, "Push Packs" for rapid distribution in a crisis (in less than twelve hours). Push Packs are pre-assembled packages of antidotes, pharmaceuticals and other medical supplies. The department also maintains radiological response teams and decontamination systems should radioactive materials ever be used in an attack.

The VA emphasizes the importance of containing and redressing public stress and panic should a disaster occur. As part of its programs to lend comfort to victims of September 11, along with those involved in rescue operations, the VA provided medical backup and psychological support for the National Guard units and civilians who were handling recovery operations. 

Mackay provided examples of how the Veterans Affairs Department has already been involved in preparations for a medical emergency. After reports of anthrax dissemination in Florida and Washington, DC, Veterans Affairs worked with the Centers for Disease Control to provide doses of Ciprofloaxin (commonly referred to as "Cipro") to people in high-risk areas, including the Hart Senate Office Building. During the 2002 Winter Olympics, the VA managed and operated a medical center and multi-agency command center just 1500 yards from the main stadium. The medical center, which also served as headquarters for the Secret Service, housed two decontamination units, as well as a fully functioning medical care facility prepared to treat victims of biological and chemical weapons attacks. From now on, large-scale public gatherings such as the Super Bowl and Independence Day celebrations will be considered National Special Security Events, situations requiring federal, state and local agencies to coordinate for the protection and medical care for all event participants.
As a model of the interagency and cross-disciplinary collaboration that is urgently needed for homeland security, the VA is already organized to work closely with several federal agencies, including the Secret Service, the Federal Emergency Management Agency and the Centers for Disease Control. Preparations for public events serve as excellent training missions for a national emergency preparedness plan.

During the discussion period following Mackay's formal remarks, he discussed the contingencies that the VA has considered in the event of a concerted terrorist attack. The VA has contemplated a serious, sophisticated biological weapons attack as the most severe scenario. In its support role, the VA would be in charge of handling casualties and the transportation of pharmaceuticals and medical personnel. However, despite some preparedness for this situation, the Federal Government does not have an existing plan that provides for coordination across all agencies. Mackay hopes that the Department of Homeland Security will address that problem. He also emphasized that concerns about a smallpox attack has compelled the VA and other agencies to think very hard about current options. Preparedness is constantly improving, but a smallpox outbreak would be especially worrisome given the shortage of vaccines and the length of time since there had been a national vaccination plan. With the ease of air travel and growing global public exposure, a pathogen like smallpox would quickly spread beyond the target area.

In response to a question about voluntary quarantine, Mackay explained that the VA has proposed the use of a so-called "ring strategy," in which successive "rings" of people who have been near a contaminated area would be inoculated against the disease. This method can work with smallpox as individuals can still be inoculated for a brief period after exposure, allowing medical personnel additional time to control further outbreaks and avert public panic.

Addressing a question about the possible use of a "dirty bomb" in a terrorist attack,  Mackay noted that while such an attack is feasible, it is unlikely. The radioactive material used to create a dirty bomb would be lethal to anyone carrying the explosive. For a "radiological dispersal device" to be effective, the weapon would have to be heavily shielded - so much so that the device would have to be transported by truck or heavy transport equipment. As such, the dirty bomb scenario is less likely than many believe. Responding to a final question about the importance of public awareness and education regarding weapons of mass destruction, emergency preparedness and civil defense, Secretary Mackay pointed to the large veteran's community as a resource for educating the public. Organizations like the Veterans of Foreign Wars (VFW) and the American Legion are well organized and have many motivated volunteers who have experience in survival and medical training. These groups are well suited to provide education and information to the public. He also noted that the USA Freedom Corps and its Citizen Corps Council - a network of civic groups provides training, awareness and community assistance on the local level, will spearhead the administration's major civic education program.

In conclusion, Mackay endorsed a unified plan to coordinate the many agencies and departments slated to be involved in Homeland Security. The process will be a difficult and there are a number of divergent areas that need to be properly coordinated, including intelligence analysis, emergency preparedness and crisis response, to name just a few. He expressed his confidence that that the Department will develop successfully over time, and that a slower process of consolidation could be beneficial, allowing more time to iron out legislative and other issues of coordination. In the end, the process will work and the benefits of the new Department of Homeland Security will outweigh the costs.

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Mackay, a former Pentagon official and senior executive of Lockheed Martin and Bell Helicopter, is a 1983 graduate of the U.S. Naval Academy. He completed pilot training in 1985, graduating at the top of his class, as well as the Naval Fighter Weapons School (known as "Top Gun"), compiling an impressive 235 carrier landings and logging 1,000 hours in an F-14. Over his military career, Mackay was decorated several times, including the Defense Meritorious Service Medal, the Navy Achievement Medal and the Armed Forces Expeditionary Medal. Secretary Mackay earned a master's degree in public policy from the Kennedy School of Government at Harvard and a PhD in political and economic analysis from the Graduate School of Arts and Sciences. He has taught at the Naval Academy and was a Special Guest Fellow at the Brookings Institution.

Meeting Report by Josh Kolchins and Janne Nolan 

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