A counterterror medical team based in Denver is supposed to be able to launch in hours after an attack. But FEMA cuts may curb that capability.

A Denver-based federal counterterrorism team charged with saving
lives after nerve gas, nuclear or dirty-bomb attacks is facing its
own challenges that threaten its ability to quickly respond.

“If getting there early is going to save lives, we are not going
to save as many lives,” said Dr. Charles Goldstein, commander of
the 90-member unit.

The team of doctors, nurses and paramedics – a unique unit in the
107-team National Disaster Medical System – is supposed to be able
to mobilize within hours, then fly into chaos and work through the
crucial first few days after an attack to contain casualties.

But overspending has mired the system in debt, forcing the
suspension of funding for such teams while Federal Emergency
Management Agency supervisors scramble to sort out irregularities.

Team members say the problems threaten to compromise their work in
a disaster by impeding maintenance of equipment, limiting paid
training and increasing the time it takes to prepare to go.

The Denver team now requires eight hours to mobilize, two hours
more than the FEMA standard, for lack of a functioning centralized
pager-notification system, Goldstein said. He blames poor FEMA
oversight.

More than a year after Hurricane Katrina called FEMA’s management
into question, the agency’s stewardship of the disaster medical
system “is dysfunctional and complex,” Goldstein said.

The problems have shaken the entire National Disaster Medical
System, which was formed during the Cold War as a prized asset of
the Public Health Service.

FEMA took over the system after the Sept. 11, 2001, attacks amid
concerns that terrorists would launch more attacks inside the
United States. Congress gave it $34 million a year. It includes
teams with specialized capabilities ranging from handling heaps of
dead bodies to helping distressed animals.

Now – on orders from the White House – the U.S. Department of
Health and Human Services is poised to take back the system as part
of a post-Katrina reorganization.

Three teams in nation

Goldstein’s team operates out of a beige warehouse in north Denver
holding millions of dollars’ worth of equipment and vehicles. It is
one of three elite medical teams in the system. Others are
positioned in Los Angeles and Raleigh-Durham, N.C.

It is the nation’s only team configured to travel on short notice
by air using collapsible gear that fits into easily transportable
containers.

Its mission is responding to terrorist attacks involving weapons of
mass destruction, though all teams in the system can work after
natural disasters and other crises as well. The Denver team worked
in Houston for two weeks after Katrina.

But team spending on training and maintenance so exceeded the
system’s budget that FEMA supervisors shut down funding in
September. The deficit amount “is still being reviewed,” said
Jack Beall, chief of the system at FEMA, in response to written
questions from The Denver Post.

Goldstein said that he couldn’t say how much he spent this year but
that the total doesn’t exceed his roughly $800,000 annual budget
from 2005.

“They’ve never told me how much money I’m allowed to spend” in
2006, he said.

Team members are classified as “intermittent federal employees”
and until recently received from $13 to $50 an hour, depending on
their skill level, for work devoted to the team. As a doctor,
Goldstein, 59, said he has collected $50 an hour for 24 hours a
week of work outside his private medical practice to run the team –
about $57,600 a year.

If FEMA officials “tell me what the rules are, I’m going to play
by them,” he said. “But they are not telling us what the rules
are. And then they keep changing them midstream.

“We are doing things, utilizing our best judgment, to accomplish
the mission and keep our teams in a state of appropriate readiness
and alertness.”

Outside work questioned

Some units of the National Disaster Medical System, including the
Denver-based team, solicit additional outside funding. Goldstein
arranged a $75,000-a-year sponsorship from the Hospital Corporation of America. At FEMA headquarters, Beall said the sponsorship is illegal under federal rules to guard against conflicts of interest.

Said Goldstein: “We weren’t told we can’t do that. We were told
there were potential conflicts of interest. They said they were
going to investigate teams individually. That never went
anyplace.”

The Denver team formed a nonprofit foundation after the Sept. 11
attacks to raise money and do outside work. This nonprofit sought
and won a $600,000 state government contract to run a database and
train local medical volunteers.

FEMA officials said teams can do outside work like this and accept
payment as long as they are not acting in their federal capacity.
It’s unclear whether that means team members can work together and
use federally funded equipment.

Now the interruption of funding threatens response capabilities.
For example, Goldstein said, his 13 vehicles no longer are fully
maintained, and crews are hard-pressed to handle tedious but
crucial tasks such as charging more than 425 batteries that run
respirators, air-monitoring devices and other tools.

Limited funding resumed this month, but the Denver team now
operates at “a sub-optimal level,” Goldstein announced in a
recent memo to team members.

At FEMA headquarters in Washington, new managers hired after the
Hurricane Katrina debacle acknowledged problems with the disaster
medical teams. They say they’re investigating and scrambling to put
in order a system the nation could need any day.

Supervisors cut off funds in September because “a number of teams
had overspent their budgets,” said Glenn Cannon, director of
FEMA’s response division.

Team leaders “got in trouble because they tried to make it like
there were full-time positions when in fact there weren’t,” Cannon
said, declining to single out specific teams.

“Now,” Cannon said, “we will watch, much more closely, the
spending rates of the teams.”

U.S. Health and Human Services officials who will take over the
disaster-response system in January said they’ll have lawyers
review all FEMA decisions.

The system “needs strengthening,” said Public Health Service Rear
Adm. Dr. Craig VanDerwagen, an assistant secretary for public
health emergency preparedness.

Maintaining an elite team that can fly into a crisis within four
hours is essential, VanDerwagen said.

Team members around the country “are appropriately anxious,
perhaps frustrated, and somewhat angry because of the movement back
and forth (between agencies) over the past two years,” he said.

Where the cuts will hurt

Now, after the sudden suspension of funding, Denver team members
train on a volunteer basis. This month, managers were allotted a
combined total of 48 paid hours a week to coordinate training and
keep equipment ready, Goldstein said.

“There are things that are going to suffer,” he said. “I have 13
vehicles that are supposed to be driven 50 miles a month. I can’t
pay people to do that anymore. … Is fuel going to start leaking
from one of my trucks because it hasn’t been lubricated?”

Last Sunday, a dozen or so nurses, doctors and paramedics gathered
for training in their rented 16,600-square-foot warehouse, east of
Interstate 25, amid millions of dollars’ worth of gear, from drug
supplies to nerve gas detectors.

Clad in chocolate-colored protective overalls, lime-green rubber
boots and double gloves, they practiced inserting breathing tubes
into a mannequin while wearing gas masks that made their voices
sound pinched and faraway.

“Like working underwater,” said team member Dr. David Levine, 57.
“Cumbersome.”

Team members set up collapsible stretchers. They set up a
collapsible decontamination tent and an accordion-like apparatus
for moving unconscious victims on backboards through a scrubbing
zone. They reviewed procedures for jamming injectors filled with
atropine, a nerve gas antidote, into their thighs.

Now, with federal funding reduced and seemingly uncertain, some
team leaders seek new jobs to make up lost income.

“I can do this for a couple months, but then it will start getting
tight,” said team administrator Wendy Colon, whose paid hours were
cut from 40 a week to 24. “And there are some things that aren’t
being done.”

Yet despite uncertainties, every terrorism-related news bulletin,
such as the recent one about possible radiological bombs in
football stadiums, sends team member Edie Lindeburg, 40, bolting to
a spare room in her house, where her black duffel bag sits ready to
go.

“I run and check my equipment. I think: ‘Did I do the battery
check? Who do I have to notify if I go?”‘ said Lindeburg, an
18-year-veteran hospital and emergency room nurse.

“I’d be scared to death” to walk into the scene of a nuclear or
chemical attack, she said. “But I still am ready to do that.”