White House health team not at 100 percent

[cnn-photo-caption image= http://i2.cdn.turner.com/cnn/2009/images/04/27/art.getty.obama.3.3.jpg caption="The White House declared a public health emergency Sunday, and briefed reporters on efforts the federal government's taking to confront the swine flu."]WASHINGTON (CNN) - A firm declaration from the White House: "I want to be very clear here. There is a team in place."

But while those comments Sunday from White House Press Secretary Robert Gibbs are accurate, it's also true that the Obama administration is dealing with its first medical outbreak with some key players missing from its health team.

The White House declared a public health emergency Sunday, and briefed reporters on efforts the federal government's taking to confront the swine flu. Department of Homeland Security Secretary Janet Napolitano led the news conference.

Missing from the Sunday news conference: the adminstration's Health and Human Services Secretary. That's because Obama's nominee for HHS secretary, Kansas Gov. Kathleen Sebelius, has yet to be confirmed by the Senate. Her confirmation could come as early as Tuesday. The President's first choice for the position, former Senate Majority Leader Tom Daschle, withdrew his nomination because of tax problems. Tax issues have slowed Sebelius's Senate confirmation.

But it's not just the top spot: There are no apointees in place in any of the department's 18 key positions.

Those positions are Deputy Secretary, Assistant Secretary for Resources and Technology, Assistant Secretary for Preparedness and Response, General Counsel, Assistant Secretary for Planning and Evaluation, Assistant Secretary for Public Affairs, Assistant Secretary for Public Health and Science, Surgeon General, Assistant Secretary for Legislation, Assistant Secretary for Aging, Assistant Secretary for Children and Families, Commissioner of the Adminstration for Children, Youth and Families, Commissioner of the Adminstration for Native Americans, Administrator for the Centers for Medicare and Medicaid Services, Commissioner of the Food and Drug Administration, Director of the National Institutes of Health, and Administrator of the Substance Abuse and Mental Health Services Administration, and Director of the Indian Health Service.

In most cases where a position is awaiting Senate confirmation, that job is currently filled by a career civil servant in an "acting" or interim capacity.

The Obama administration has named five nominees for the open positions.

"Obviously we would love to have all of our nominees confirmed but we are lucky to have a terrific team of career and political staff who have been working around the clock to respond to this swine flu outbreak and on all the critical work that the Department has done over the past 100 days," says HHS Spokesperson Jenny Backus.

"During this swine flu outbreak, HHS has worked to get out in front of the challenge, building on planning and preparation that HHS has been doing for years on flu issues, and taking steps that will allow us to respond quickly if the outbreak grows here in the United States."

Also not in place: a new head for the Centers for Disease Control and Prevention, which does not need Senate confirmation. Like the postions at HHS, the CDC also has a acting director running the show until the Obama administration installs its own person in place.

At Sunday's news conference, Gibbs made a point of saying that the Obama administration is more than equipped to handle the current crisis.

"The team is - part of it is standing behind me, and part of it is working as we speak to identify exactly what the doctor and others have talked about," said Gibbs. "I think this notion somehow that if there's not currently a secretary, that there's not the function that needs to take place in order to prepare for this either this or any other situation is just simply not the case."

The current situation is reminiscent of the early days of the adminstration, when Treasury Secretary Tim Geithner was dealing with the ever worsening global recession and implementing portions of the federal bailout of financial instutions and of the stimulus package, without most of his top deputies in place at the Treasury Department.

"Can the Obama administration deal with a public health emergency? Yes, but it will be more of a makeshift effort. And therefore a test of management skills in the new White House," says CNN Senior Political Analyst Bill Schneider.