Two decades later, the Department of Homeland Security continues to evolve

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It’s been 20 years since its creation and there are some aspects of the Department of Homeland Security that are still taking shape. In the latest change to its organizational chart, the department created a new Office of Health Security in its headquarters. In part, it’ll take the place of the former DHS Office of Health Affairs, but the new mission’s quite a bit broader. To find out more about this, Federal News Network’s Deputy Editor Jared Serbu talked with Dr. Pritesh Gandhi, DHS’ chief medical officer on the Federal Drive with Tom Temin.

Interview transcript:

Jared Serbu: Dr. Gandhi, thanks for being with us to talk a little bit more about this. Appreciate it. Let me start as broadly as possible and have you just describe a little bit what the mission of the new office is going to be? You know, obviously, DHS, famously, is involved in a whole lot of diverse mission areas across the department, many of which have health implications. So where do you start?

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Pritesh Gandhi: I mean, you’re exactly right. I mean, DHS over the past couple of years, has essentially been a nerve center for the public health and medical challenges that the country has faced that have a Homeland Security nexus, right. And so seemingly, almost every challenge that DHS faces, where there is a security issue, there is also a health security issue. And so whether you’re looking at you’re looking at Operation Allies Welcome, and our work to bring nearly 85,000 plus Afghans here safely over the past year, or the work that we’re doing on Ukraine, or, you know, having to manage border health, and ensuring that our workforce is safe in the midst of this pandemic, and many other challenges. All of these have a clear health security nexus. We have been this nerve center for the past couple of years. And now this new office will be able to move forward and institutionalize our efforts to build a best in class workforce health and safety and work life program for 250,000 plus employees to ensure that we’re actually able to do the oversight and coordination and standardization and accountability that we need to do for the department to be able to centralize our medical and public health and safety data. So all of these efforts are certainly in the mission of OHS. And I think lastly, and perhaps most importantly, to ensure that we are continuing to be engaged with our state and local partners and sharing our expertise and sharing our data, and sharing our best practices, as we have done so over the past couple of years. And so the mission set is broad, the portfolio is diverse, but I think there is real clarity in what the role of OHS is for the department and for the federal government at large.

Jared Serbu: Yeah, just to add some more to that clarity. I think DHS already had an organization called the Office of Health Affairs. It sounds like this is much more than just a name change. Can you talk a bit about how the new organization differs from that former Office of Health Affairs?

Pritesh Gandhi: Yeah, so I think that we have had the opportunity, if you will, to do some lessons learned, right. I think DHS, this is the third in frankly, what will have to be the final opportunity to get this right. Right, we had the Office of Health Affairs, which was the most recent iteration of this. And OHA also had a diverse portfolio and a diverse mission set. But in many respects, OHS differs. One, because we are very narrowly focused on health security threats and our role in response, coordination, standardization and accountability here for the department. Two, in that we are largely, largely unencumbered, or unburdened by complicated, massive programs. That is something that, you know, if you parse through how OHS is going to work with [the Countering Weapons of Mass Destruction Office], CWMD, is retaining some of those larger programs that OHA held, and our role is to provide clinical and technical expertise and consultation to CWMD, and we’ll continue to do so. But by not having those programs with us. It allows us to be frankly, much more agile and dynamic as we need to be to be able to face these crises, right. An example I’ll give is that when Operation Allies Welcome happened last fall, and Kabul fell, it didn’t take weeks or months for DHS to mount their public health and medical response. Within hours of those events occurring, we had mobilized our team and started our response. That’s the expectation that I have for this office. That’s the expectation I have for how we are going to respond to health security crises and emergencies as they come up is that we have got to yes, wear the head of coordinating for the department, standardizing for the department, having departmental oversight on all of the public health and medical activities yet, we will also have to be ready to respond in a moment’s notice to public health crisis when they, when they occur, when they have a security nexus. And I think we are equipped to do that. And we are building OHS to be able to do that.

Jared Serbu: On the matter of public health, the government, of course already has a Public Health Service. And I think they offer a lot of services within DHS components with a lot of folks detailed there. Can you say a bit about the interaction between your new office and PHS. And where, the relationships to the extent there are going to be relationships are going to be and what the sort of Homeland Security specific mission for OHS is?

Pritesh Gandhi: Right. We work very closely with our PHS colleagues. And in fact, right now, we have PHS officers that are detailed to our team for Operation Allies Welcome. We have PHS officers that are working with us at [Immigration and Customs Enforcement], and frankly, across the entire department. And so we are very connected with PHS, and frankly, we’re connected with our medical and public health partners across the federal government at CDC, at ASPR, at DOD and elsewhere. And so I see, we are in the midst of a what I think is a… assessments happening across the federal government in every department on how to do medicine and public health better after the lessons we have already learned from being in the midst of this pandemic and what we are facing in the pipeline. In that what we know is that we, there are a clear ESF-8, let’s say let’s just use this as an example. There are clear ESF-8 responses when there is a national public health emergency or a national public health crisis, the role that DHS plays in supporting HHS in that response, right. We are now going to be able to fulfill that role in a way that I don’t think we’ve been able to do prior to the last couple of years. And so development of OHS allows us to better fulfill those responsibilities that we have in a supporting agency role for HHS in the midst of a national public health emergency, while at the same time when there are public health issues that come up that are very clearly driven by Homeland Security equities. And the examples I’ll give, again, are Operation Allies Welcome, or the work that’s happening with Ukraine, or challenges on the border or in our airports. We fully intend to be able to play a leadership role on those items, which we have, and engage our partners in a way that is dynamic and in real time. Right. And, you know, we are, we’ve gotten into the habit now, during some of these major issues that we face over the last couple years. And we were having seven days a week, often twice a day meetings with the public health and medical leaders and public health and medical operators across the interagency. That’s how the federal government responds effectively in the face of crisis. We have modeled that out. And given examples of that in the work that we’ve done over the past couple of years and the work that we expect to do. But I think that we certainly know, you know, how to engage with our partners. And we’re excited for the direction that our partners are going in their work and their lessons learned from this pandemic, from the ongoing pandemic. And we’re looking forward to ongoing collaboration.

Jared Serbu: Dr. Gandhi since you’ve brought up Operation Allies Welcome a couple of times, I’m just curious, was there something about that specific mission that revealed capability gaps or capacity gaps in the department that showed that you needed this new office?

Pritesh Gandhi: I think that’s a good assessment. I bring up Operation Allies Welcome because it was a complicated interagency effort to an international emergency that became a domestic responsibility. And because the public health and medical issues were very contained within the Afghan population that we were, our allies, that we were moving here, but had the risk, if we didn’t do it right, to affect the health and well being of the American people. It very squarely fall, fell in our, in our lane. And now we took a leadership role. DHS, as you know, was named lead federal agency for the effort. And by default, our team, smaller at that time, was named to lead the public health and medical effort, we realized that we have got to build policies and protocols and processes to be able to better manage our emergency response in the future. A lot of how we responded, the daily syncs with the medical leads of the interagency, the nerve center that we built in the basement of our headquarters in Washington. The deployment of our technical experts from our office to airports and safe havens across the country and the engagements in collaboration with CDC, ASPR and other work were built outside of the normal kind of ESF-8 process, because this wasn’t a declared national public health emergency. But I think what your listeners know, and what we all know is that there are public health emergencies that occur that will occur that have occurred that are not national public health emergencies, but still have national equities at play. And so while there are clear roles for HHS as lead on on so many of these, monkeypox is a great example, when there is something as narrowly defined as an issue like Operation Allies Welcome, then there is a clear role for the health security team at DHS to lean in, which is what we did. And so, in many respects, the formulation of this office reflects so many lessons learned from going through that operation, having to work through the vaccination of our workforce through Operation Vaccinate our Workforce last January, having to ensure border security as we faced increased irregular migration last year, all of those lessons and events have helped shaped, have helped to shape the mission of this new office.

Jared Serbu: Last thing because I know time is short here, we’ve been pretty focused on the public health aspects of the mission so far in our conversation, what are your responsibilities is going to be related to the actual DHS workforce internally? You mentioned vaccination, but what else?

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Pritesh Gandhi: Yeah, this is I think, perhaps what I’m most excited by, is the opportunity to lean in to the health and well being of our workforce. I think, as you know, the DHS workforce is front and center for the American people. And often the average American interacts more with our agency, with our with our department than any other department. And our mission set is such that there are real, not just medical risks to our workforce, but also mental health challenges and others, given the diverse portfolio that we hold. And so we have a real opportunity here to improve our engagement as it relates to employee wellness, to employee mental health, to psychological resilience, to the health and well being of our working animals and their handlers. And so that’s where there are, where there are real opportunities. And I’ll give you just a brief example, you know, just reflective of where our priorities are, the department’s chief psychologist, I’ve moved up to directly report to me, and I’ve done so because in the face of so many challenges that our department is facing, from a mental health perspective, we need to build the kinds of programs and resiliency that our workforce deserves. And so I’m really excited about this opportunity to further build our services for our workforce who do so much on the front lines every day.

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