Despite new concerns about bioterrorism and steps to address them, local and state authorities lack a uniform system to assess their ability of detecting or combating the intentional spread of a disease or any other attack, officials told a House panel Wednesday.

"We've got to have a similar message, devised by experts, coordinated across the land; to do less is not appropriate," said Frank Young, former chief of the federal Office of Emergency Preparedness.

Since the Sept. 11 terrorist attacks, lawmakers have proposed adding $1.4 billion to the $350 million in the budget for bioterrorism.

Members of the House Energy and Commerce investigations subcommittee, concerned about the lack of a universal standard for checking readiness, had questions about how well bioterrorism funds are being spent.

"Every one gives lip service to the idea that our local communities are, and will remain, the principal responders to terrorist events, yet most of the billions spent each year never find" their way beyond Washington, said Rep. Jim Greenwood, R-Pa., the subcommittee chairman.

More money is needed to train health workers, shield them from infections and help them provide medicines to treat potential outbreaks, officials said.

Ronald Peterson, president of The Johns Hopkins Hospital and Health Systems, said his hospital would buy 1,000 respiratory masks at $300 each and protect just one-seventh of its employees from an airborne disease.

Fifty ventilators, meant to help sick patients breath, would cost $1.5 million, he said. Other steps would push the total cost above $7 million.

While some experts raised the possibility of fights over jurisdiction when responding to an attack, other officials welcomed the autonomy from Washington.

"We cannot assume one single model will work. These things can happen anywhere, in large cities, in rural areas," said Dennis O'Leary, president of the Joint Commission on Accreditation of Healthcare Organizations, which regulates hospitals, nursing homes and other health care facilities nationwide.

Dr. Lew Stringer, medical director of North Carolina's Division of Emergency Management, said federal emergency officials have given local agencies needed leeway.

"Each city is allowed to do it the way they think is best for them," Stringer said of plans to react to bioterrorism. "They do have the right to decide what's best for them."

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