3
Federal Efforts to Increase State and Local Preparedness for Terrorism

The preceding chapter’s review of the Federal Response Plan makes it clear that the federal government is prepared to provide a substantial amount of diverse forms of assistance to communities stricken by a disaster. However, by even the most optimistic projections of the federal agencies themselves, none of this assistance will be available to the affected community until at least 12 to 24 hours after it is requested (and the request itself may not come for hours or even days after the initiating event, be it an earthquake, a flood, or the release of a chemical, biological, or radiological [CBR] agent). One of the distinguishing features of the Metropolitan Medical Response System (MMRS) program is that it is proactive. It is not just a new or better way of providing federal aid to stricken communities, but it is a way to help the communities themselves deal both with the initial stages of the disaster and with the subsequent influx of outside assistance. The MMRS program provides pre-disaster assistance; it is not a federal response. Chapter 4 provides details of the program, which provides funds for the purchase of special CBR agent-specific equipment, supplies, and pharmaceuticals for local law enforcement, fire department, and emergency medical personnel, but the program demands substantial integrated planning by the local partners. An important element of that planning involves knowledge of at least four other federal entities that provide additional equipment and CBR agent-specific training. These entities are the U.S. Department of Justice’s (DOJ’s) Office of Domestic Preparedness (ODP; formerly the Office of State and Local Domestic Preparedness Support [OSLDPS]), the Federal



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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program 3 Federal Efforts to Increase State and Local Preparedness for Terrorism The preceding chapter’s review of the Federal Response Plan makes it clear that the federal government is prepared to provide a substantial amount of diverse forms of assistance to communities stricken by a disaster. However, by even the most optimistic projections of the federal agencies themselves, none of this assistance will be available to the affected community until at least 12 to 24 hours after it is requested (and the request itself may not come for hours or even days after the initiating event, be it an earthquake, a flood, or the release of a chemical, biological, or radiological [CBR] agent). One of the distinguishing features of the Metropolitan Medical Response System (MMRS) program is that it is proactive. It is not just a new or better way of providing federal aid to stricken communities, but it is a way to help the communities themselves deal both with the initial stages of the disaster and with the subsequent influx of outside assistance. The MMRS program provides pre-disaster assistance; it is not a federal response. Chapter 4 provides details of the program, which provides funds for the purchase of special CBR agent-specific equipment, supplies, and pharmaceuticals for local law enforcement, fire department, and emergency medical personnel, but the program demands substantial integrated planning by the local partners. An important element of that planning involves knowledge of at least four other federal entities that provide additional equipment and CBR agent-specific training. These entities are the U.S. Department of Justice’s (DOJ’s) Office of Domestic Preparedness (ODP; formerly the Office of State and Local Domestic Preparedness Support [OSLDPS]), the Federal

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program Bureau of Investigation (FBI), the Centers for Disease Control and Prevention (CDC), and the Federal Emergency Management Agency (FEMA). ODP PROGRAMS As noted in Chapter 1, the Nunn-Lugar-Domenici Amendment to the National Defense Authorization Act for Fiscal Year 1997 (P.L. 104-201) designated the U.S. Department of Defense (DOD) as the head of an interagency program to assist civilian officials at all levels of government to better prepare for possible terrorist attacks with weapons of mass destruction (WMD). The law also gave the President the option of transferring responsibility for this “domestic preparedness” program to another agency any time after October 1, 1999, an option exercised by President Clinton in fiscal year 2000 by making DOJ the lead agency. DOJ was chosen at least in part because under the aegis of Title VIII of the Anti-Terrorism and Effective Death Penalty Act of 1996 (P.L. 104-32), DOJ, in conjunction with FEMA, had already begun a program to provide a 16-hour basic awareness course for fire and emergency medical services personnel through the National Fire Academy. DOJ assumed responsibility for this training in 1998 under P.L. 105-119 and organized OSLDPS to assist state and local response agencies (most often police and fire departments) in five interrelated areas: funding for special equipment, training, technical assistance, assessment, and exercise support. OSLDPS was renamed ODP in 2001. Equipment Grants of up to $300,000 are available for purchase of personal protective equipment (for example, chemical protective clothing and respirators), devices for field detection or identification of radioactive materials or selected military chemical or biological agents, equipment for mass decontamination of personnel or equipment, and communications equipment. In accordance with congressional direction, applications for these funds were initially taken from the 157 most populous metropolitan areas (unlike DOD and the U.S. Department of Health and Human Services [DHHS], which focused on the most populous core cities, DOJ used the Census Bureau’s most populous “metropolitan statistical areas,” 96 of which are counties rather than cities). All but a dozen of these jurisdictions have received training and associated equipment, and when the remainder of the 157 have been accommodated, DOJ will provide grants only to states and only contingent upon the state’s preparation of two documents for DOJ : a statewide needs assessment and a 3-year domestic preparedness strategy. These documents, developed in conjunction with

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program city, county, and other local jurisdiction emergency, health, and law enforcement agencies, will then guide both DOJ and the states in distributing the grant money to the appropriate agencies (U.S. Department of Justice, 2002a). Training Under the ODP emergency response training initiative, training courses are developed and delivered through a variety of venues and are directed at a broad spectrum of emergency responders, including fire, hazardous materials (hazmat), law enforcement, emergency medical services, public health, emergency management, and public works agencies (U.S. Department of Justice, 2002b). ODP draws upon a large number of resources to develop and deliver these training programs, including private contractors, emergency response organizations, the National Domestic Preparedness Consortium (NDPC), and other agencies from the local, state, and federal levels. All training and course materials are free to eligible jurisdictions, as determined by ODP, but to attend a training class delivered by one of the ODP training partners, a request must be provided to the designated training point of contact. The courses, the duration of which varies from several hours to 5 days, cover CBR materials at four levels: awareness-level courses, which are designed for the entry-level first responder to gain basic knowledge of agents of WMD and safe response practices; operations-level training, which is designed for those students who have a firm grasp of basic responses and who seek to further their knowledge of incidents involving WMD; technician-level training, which is designed for students who are well versed in all levels of the response to the use of a WMD and which uses practical knowledge through hands-on training and exercises; and command-level modules, which are designed for senior-level incident management personnel who have a strong background in coordinating emergency responses. All courses are described in a comprehensive on-line catalog (U.S. Department of Justice, 2002e). ODP’s course Emergency Response to Terrorism: Basic Concepts is available for on-site delivery to interested fire service and emergency medical services agencies. A limited number of positions may also be available for law enforcement personnel. This 2-day program is available as simple instruction, as a train-the-trainer course, or as a self-study

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program course. The training provided through this course is available at no cost, and more than 50,000 individuals have taken the course. ODP provides technical training in the handling of the equipment purchased through ODP programs that provide grants for the purchase of that equipment. This training is available upon the jurisdiction’s request either through on-site visits or long-distance learning or at training facilities around the country, including the Equipment Training Center at Pine Bluff Arsenal in Arkansas. Perhaps the centerpiece of DOJ training is the Center for Domestic Preparedness (CDP) in Anniston, Alabama, at the former Fort McClellan home of the U.S. Army’s Chemical Defense Training Facility. CDP is one of only two facilities in the United States where individuals can be trained in a contaminated environment by use of live agents (actual chemical warfare agents). Three 4-day courses are offered: WMD Specialist, WMD Advanced Operations, and WMD Command. Travel, meals, lodging, and training are provided at no cost to the organization or responder, but CDP trains only about 200 responders a month, and there is a waiting list for each of the three courses (a 60- to 90-day wait is about average). Other courses are available through NDPC, a partnership among DOJ, DOE, and three public universities. The courses provide training and run exercises on the operational and technical aspects of responding to terrorism involving WMD at its complex of consortium facilities, through regional courses, and via distance-learning technology. The National Energetic Materials Research and Testing Center of the New Mexico Institute of Mining and Technology provides field exercises and training with live explosives. The National Center for Bio-Medical Research and Training at Louisiana State University supplies training in biological agents and law enforcement. The National Emergency Response and Rescue Training Center at Texas A&M University specializes in training and field exercises on urban search-and-rescue techniques. The National Exercise, Test, and Training Center at the Nevada Test Site conducts large-scale field exercises using live agents, simulations, and explosives. Technical Assistance ODP provides free technical assistance of three types to state and local jurisdictions that request it. (1) General technical assistance provides assistance in such areas as development of a plan for responding to the use of a WMD and development and evaluation of exercise scenarios. (2) Technical assistance with state-level strategies helps states complete the required needs and threat assessments (see the next section on assessment) and the 3-year strategy that follows from them. (3) Equipment-related technical assistance provides training on the calibration, use, and

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program maintenance of specialized equipment used to respond to the release of CBR agents. Assessment As noted in the section above on equipment, ODP has created and supplied to each state’s designated administrative agency a multipart needs assessment that must be completed and returned as a prerequisite for the future receipt of equipment and training grants (U.S. Department of Justice, 2002c). The document instructs the state agency to gather data from all local jurisdictions with self-report forms and to then consolidate them into a document for the entire state. The forms include instruments developed by the FBI and the CDC to evaluate vulnerabilities, threats, and the performance of the public health sector. These are combined with assessments of required and current capabilities in the realms of fire services, hazmat services, emergency medical services, law enforcement, public works, public health, and emergency management. A 100-page “Tool Kit” is provided for use by the state and local personnel assigned to fill out the forms. Exercises As part of DOJ’s first responder training and domestic preparedness initiative, the conference report (U.S. House of Representatives, 1998b) accompanying the act providing appropriations to DOJ for fiscal year 1999 provides $3.5 million for situational exercises for state and local emergency response personnel. The language of the conference report further directs that a portion of these funds be used to comply with language found in the Senate report (U.S. Senate, 1998), which discusses two types of exercises. The first is a major national-level TOPOFF exercise involving TOP OFFicials from federal, state, and local governments. The other incorporates situational exercises as part of DOJ’s efforts to improve the capabilities of state and local emergency response personnel to incidents of domestic terrorism. Similar language is found in the House report (U.S. House of Representatives, 1998a, p. 13), which directs that the use of “confidence building exercises based on threat driven scenarios” be incorporated into DOJ’s training efforts. The 10-day TOPOFF exercise, which featured a simulated biological agent incident in Denver, Colorado, and a simultaneous chemical weapons incident in Portsmouth, New Hampshire, took place in May 2000. In addition to its National Exercise and State and Local Domestic Preparedness Exercise Programs, ODP, in collaboration with the U.S. Department of Energy (DOE), is establishing the Center for Exercise Excellence

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program at the Nevada Test Site. The Center for Exercise Excellence plans to deliver a Weapons of Mass Destruction Exercise Training Program for the nation’s emergency response community to ensure nationwide operational consistency in exercises related to incidents involving a WMD (U.S. Department of Justice, 2002d). FBI PROGRAMS The FBI is the lead federal agency responsible for crisis management, which includes “measures to identify, acquire, and plan the use of resources needed to anticipate, prevent, and/or resolve a threat or act of terrorism.” (Federal Emergency Management Agency, 1999b, p. 1). It employs almost 1,400 agents in counterterrorism activities, including WMD coordinators in 56 field offices whose responsibilities explicitly include antiterrorism and counterterrorism activities. Within the FBI, the two primary offices that support state and local domestic preparedness are the National Domestic Preparedness Office (NDPO) and the Hazardous Devices School (HDS). National Domestic Preparedness Office NDPO does not provide direct assistance to state and local jurisdictions; instead, it serves as an information clearinghouse for state and local agencies on all aspects of domestic preparedness and coordinates federal policy regarding the provision of assistance with domestic preparedness to state and local jurisdictions (National Domestic Preparedness Office, 2002). In concert with those roles, NDPO is actually an interagency office, even though it is housed in FBI headquarters and is funded by the FBI. Representatives from DOD, DOE, the Environmental Protection Agency (EPA), FEMA, FBI, DHHS, the National Guard Bureau, the Nuclear Regulatory Commission, DOJ, and the U.S. Coast Guard, along with state and local experts from a variety of disciplines, form the NDPO staff. The State and Local Advisory Group provides additional input. NDPO provides services in the following areas: Training. NDPO maintains a compendium of federal training courses in WMD and coordinates the establishment of emergency response training standards. Equipment. NDPO attempts to coordinate federal efforts to provide state and local governments with equipment for the detection of WMD, protection from WMD, and decontamination after the use of a WMD. Exercises. NDPO assembles a database of after-action reports from

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program federal, state, and local exercises, scenario templates, and other resources for state and local use. Planning. NDPO provides emergency responders access to federal, state, and local preparedness plans in the event of the use of a WMD. Information sharing. NDPO uses the Internet to provide information to the emergency response community on a wide variety of topics and formats, including a monthly newsletter, a secure network for emergency responders, and a toll-free help line. Most or all of these missions and services are scheduled to be transferred to the Office of Homeland Defense and FEMA in 2002. Hazardous Devices School Located at Redstone Arsenal in Alabama, the Hazardous Devices School (HDS) trains public safety personnel in technology used to render explosive devices safe and offers the only national certification program for state and local bomb technicians (Federal Bureau of Investigation, 2000). In 1998, the school developed a 1-week WMD-related emergency action course and integrated this training into its standard course in 1999. By July 2000, more than 2,000 bomb technicians, virtually all of the certified bomb technicians in the United States, had received the training. HDS also manages the State and Local Bomb Technician Equipment Program, which provides protective, diagnostic, and detection equipment to the roughly 435 state and local bomb squads that have received or that are in the process of receiving accreditation from the FBI. CDC PROGRAMS CDC’s Bioterrorism Preparedness and Response Program coordinates the efforts of eight different CDC offices and centers aimed at enhancing state and local capabilities to detect and respond to bioterrorism (Lillibridge, 2001). Unlike the DOJ and DOD programs, which primarily focus on fire and law enforcement actions in a chemical incident, the CDC programs target the public health infrastructure, that is, state health departments and local health departments, and terrorism involving biological agents. In fiscal year 2000, CDC devoted $155 million and 100 people to this effort in four core areas: pharmaceutical stockpiles, state and local capacities, CDC capacity, and independent studies. The National Pharmaceutical Stockpile involves rapid-response “push packages” that contain a wide variety of pharmaceuticals and other medical materials to control outbreaks of infectious diseases and other emergencies, plus a vendor-managed inventory (VMI) of the same materials.

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program Unlike the push packages, which are standardized packages that sacrifice specificity for speed, the VMI can supply large quantities of incident-specific supplies, albeit not so quickly. Governors, but not mayors, can make requests directly to CDC for supplies from either component. The push packages, located at 12 sites throughout the United States, are prepackaged collections ready for deployment anywhere in the United States via ground or air transportation in 12 hours or less. A single push package fills a Boeing 747 or seven 48-foot tractor-trailers and can treat 340,000 patients for 10 days. Supplies and equipment for repackaging of the pharmaceuticals are included, but everything comes in bulk form. CDC advisers accompany it; but the state is required to provide trucks, forklifts, security, personnel, electrical power, climate-controlled storage space, refrigerated storage space, and one or more licensed pharmacists to break down the package into single-dose-sized units and distribute them to health care providers. During the anthrax attacks from October 15 to November 29, 2001, CDC used the VMI instead of the push packages to provide antibiotics since the infectious agent was known and anthrax-specific shipments could be assembled. The NPS program accomplished this in response to 65 requests from 10 different states and the District of Columbia and provided treatment or prophylaxis for more than 30,000 Americans. One way in which state and local infrastructures are being strengthened is by the development of a national laboratory network to respond to bioterrorism. CDC now has dedicated laboratory space and rapid turnaround procedures to test for all six agents on its critical biological agents list; but more importantly, 72 state public health laboratories in 50 states now have some capacity to test for plague, tularemia, and anthrax, and 22 state public health laboratories can test for botulinum toxins. A second component of the CDC effort to build state and local capacities focuses on epidemiology: by providing funds for the hiring and training of epidemiology staff, providing local public health advisers and contacts from the Epidemic Intelligence Service trained to respond to bioterrorism incidents, developing enhanced communications and reporting mechanisms, and improving emergency notification procedures. Events like World Trade Organization meetings in Seattle, Washington, and Washington, D.C., the Olympics in Atlanta, Georgia, and Salt Lake City, Utah, and national political conventions have provided test sites where improvements in both epidemiological and laboratory procedures could be explored. However, the huge workload generated by a few anthrax-loaded letters in October 2001 and the imitations and false alarms that they spawned pushed the current system to its limits and demonstrated the qualitative and quantitative needs for the rebuilding of the nation’s public health system.

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program The CDC bioterrorism initiative has also built capacity within CDC itself by increased training of both laboratory and epidemiology staff and the development of communications technology like the Health Alert Network, which provides state and local health departments with essential computer hardware and software for interconnectivity, and expanded Internet access, which allows distance-based learning and access to the training institute at CDC. Another information technology initiative, the Epidemic Information Exchange program, provides epidemiologists with rapid access to information and advice from their peers. In the long term, a bioterrorism surveillance effort will be integrated into a National Electronic Disease Surveillance System covering a wide variety of activities and diseases. Other activities under way at CDC include a national bioterrorism training plan for public health staff in state and local health departments; provision of guidance to health departments on epidemic control and how to forge useful relationships with emergency management, law enforcement, and the other components of government necessary for epidemic control; and a comprehensive examination of federal, state, and local quarantine authorities. FEMA PROGRAMS Among the many disaster preparedness programs and initiatives that FEMA makes available to individuals and communities are several that are especially relevant for the planning of responses to CBR terrorism and the present study of evaluation tools (Federal Emergency Management Agency, 1997a, 1999c). Capability Assessment for Readiness In partnership with the National Emergency Management Association (NEMA), FEMA developed a comprehensive self-assessment instrument to evaluate the operational readiness and capabilities of state emergency management programs (Federal Emergency Management Agency and National Emergency Management Association, 1997). The 1,801-element survey was administered to all 56 states and territories in 1997 with the goal of eventually using the results to develop a national emergency management standard. The survey covers 13 functional areas, from knowledge of applicable laws and authorities and hazard management to public education and information and finance and administration. An “all-hazards” document (Federal Emergency Management Agency, 1997b, 2000a), Capability Assessment for Readiness (CAR), asks respondents about plans and activities common to most disasters (e.g., hazard assess-

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program ment, laws and authorities, communications and warning). It contains only a handful of CBR agent-specific items. CAR respondents are left to decide how to deal with local variations, but they are nevertheless asked to provide a readiness rating for each item (a five-point readiness scale ranging from fully capable to not capable is provided). In an effort to analyze the local capabilities more systematically, as well as to provide local officials with a useful means of self-assessment, FEMA, NEMA, and the International Association of Emergency Managers are creating a Local CAR that is undergoing pilot testing in selected counties. Comprehensive Hazmat Emergency Response-Capability Assessment Program The Comprehensive Hazmat Emergency Response-Capability Assessment Program (CHER-CAP) is an exercise-based program that assists local communities and tribal governments with obtaining a greater understanding of hazmat risks, identifying planning deficiencies, updating plans, training first responders, and stimulating and testing the system for strengths and needed improvements (Federal Emergency Management Agency, 2001b). CHER-CAP also assists jurisdictions in identifying ways in which hazmat prevention and mitigation measures can be implemented to reduce hazmat-related emergencies and protect the public. CHER-CAP is conducted in phases spanning 4 to 6 months. Communities interested in undertaking CHER-CAP notify their state emergency management agency. The state then selects jurisdictions for participation. To qualify for selection, a jurisdiction must have, at a minimum: an active Local Emergency Planning Committee (LEPC) with an emergency response plan, a commitment from a local industry partner in the jurisdiction to participate in the program, and the commitment and involvement of a key first responder agency in the jurisdiction to take the lead for the community. Most CHER-CAP initiatives eventually include fire and police departments, emergency medical services, public works agencies, health and environmental agencies, public officials, and hospitals, in addition to industry and the local emergency management office. After the state selects the participants, the FEMA CHER-CAP coordinator and LEPC hold an initial meeting to discuss the scope of CHER-CAP and the general time frame that will be needed to conduct the program. If the community then commits to undertake the program, it begins by gathering such information as the LEPC plan, existing mutual-aid

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program agreements, agency-specific standard operating procedures, existing data on hazardous substances in the community, documentation regarding training previously undertaken, and estimates of training needs. After discussions about the existing plans and procedures, communities then implement any suggested modifications that they deem appropriate. Local and state agency officials, industry, and the FEMA coordinator identify available training programs on the basis of identified needs. Tabletop exercises also may be conducted before the full-scale exercise. The full-scale exercise scenario and staging considerations are then developed with LEPC and other participating entities as a part of the training so that agencies prepare to test and demonstrate their skills in the final no-fault, full-scale exercise. The final phase of CHER-CAP, a full-scale hazmat exercise, is staged with live props, such as tanker trucks, railcars, or fixed facilities, simulated smoke and leaking liquid (dyed water), and simulated casualties. CHER-CAP exercises involve a mass-casualty scenario. As such, they also can be used to test a community’s ability to respond to a terrorist incident during the first critical hours. The CHER-CAP exercise, which typically involves 100 to 300 participants, is tailored to the specific hazmat risks that the community confronts. The evaluation is based on the objective criteria in 16 functional areas outlined in FEMA’s Hazmat Exercise Evaluation Supplement (Federal Emergency Management Agency, 2001a). These areas range from law enforcement, hazmat team, and emergency center operations to medical facility operations, population protection, and postexercise analysis. Peer evaluators observe the exercise and record their observations in a standardized format. Fire operations are observed by evaluators from other fire departments, police operations are observed by evaluators from other police departments, hospital operations are observed by evaluators from other hospitals, and so on. The exercise takes approximately 4 hours and is followed by a postexercise analysis. A final report based on the peer reviewers’ reports is submitted to the participants after the exercise. National Emergency Training Center FEMA’s National Emergency Training Center campus in Emmitsburg, Maryland, 75 miles north of Washington, D.C., is the home of two organizations offering short training courses relevant to emergency responses to the release of CBR agents. The National Fire Academy offers a wide variety of short courses at the Emmitsburg campus through a program of resident instruction and through a variety of off-campus programs. Any person with substantial involvement in fire prevention and control, emergency medical services, or fire-related emergency management activities

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program is eligible to apply for National Fire Academy courses. Among a number of hazmat and emergency services courses are several CBR terrorism-related courses developed with funding from DOJ. These are described above in the section on DOJ programs. The Emergency Management Institute (EMI) provides training in emergency management practices through a nationwide program of resident and nonresident instruction. Each year approximately 4,000 students attend courses while in residence at EMI, whereas 100,000 individuals participate in the nonresident program sponsored by EMI and conducted by state emergency management agencies. Additionally, tens of thousands of individuals use EMI distance-learning programs such as independent study courses and the Emergency Education Network in their home communities. Users can download different course materials that are intended to help senior local government officials prepare for and respond to terrorist incidents. Courses of relevance for MMRS program cities include those on radiological monitors and operations during radiological incidents, exercise design and evaluation, and incidents with mass fatalities. Of special note are several courses aimed at local government officials responsible for planning responses to incidents of CBR terrorism. Under the general title Terrorism Consequence Management: Weapons of Mass Destruction Courses, a series of five facilitator-led courses is intended to help senior local government officials prepare for and improve their abilities to manage and respond to mass-casualty terrorism incidents involving the use of WMD. Each course has the same five objectives, and each uses a different scenario (terrorism involving nuclear, radiological, sarin, VX, or anthrax agents) to enable participants to accomplish them (Federal Emergency Management Agency, 2001c). There are 1-day and 3-day versions of each of the five courses. There are no student manuals, and the facilitator must tailor the course for the specific community. At the completion of the training, local government officials should be able to exercise greater leadership in preparing for and managing the response to mass-casualty terrorism incidents involving a WMD through a better understanding of their jurisdiction’s response capabilities; analyze the appropriateness of the plans, policies, procedures, and other preparedness elements currently in place to respond to and recover from a mass-casualty terrorist incident; determine the adequacy of the level of training of jurisdictional disaster and emergency management staff; determine the adequacy of the jurisdiction’s resources (e.g., personnel, material, and personal protective and other equipment resources) to respond to and recover from a mass-casualty incident; and

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program identify the elements required to coordinate local, state, and federal government responses to terrorist incidents involving a WMD. Material from three of these courses (Federal Emergency Management Agency, 2001d,e,f) has been incorporated into the committee’s suggested evaluation activities (see Chapter 8 and Appendix F). Radiological Emergency Preparedness Following the 1979 Three Mile Island nuclear power plant malfunction in Pennsylvania, President Carter transferred the federal lead role in off-site radiological emergency planning and preparedness activities from the U.S. Nuclear Regulatory Commission to FEMA (the U.S. Nuclear Regulatory Commission retains responsibility for the oversight of safety at the actual sites of power plants and other licensees). FEMA established the Radiological Emergency Preparedness program to (1) ensure that the public health and the safety of the population living around commercial nuclear power plants would be adequately protected in case of a radiological incident at a nuclear power plant and (2) inform and educate the public about radiological emergency preparedness. The mission of the Radiological Emergency Preparedness program entails ensuring that adequate off-site emergency plans and preparedness programs are in place and can be implemented by state and local governments, a task which is carried out through the evaluation of scheduled biennial exercises (Federal Emergency Management Agency, 2000c, 2002c). Chemical Stockpile Emergency Preparedness Program For some years now, since the United States renounced the use of chemical weapons, certain kinds of chemical weapons have been stock-piled at eight U.S. Army installations in the continental United States while awaiting destruction. In the communities surrounding these installations, emergency plans and capabilities have been developed in recognition of the possibility of an emergency involving a chemical agent release. This effort, begun in 1988, is the Chemical Stockpile Emergency Preparedness Program (Federal Emergency Management Agency, 2001h). The U.S. Army, as the custodian of the stockpiles, and FEMA, as the lead federal agency in preparing for and dealing with emergencies of all kinds, provide funds, guidance, resources, training, and other support. Each community makes emergency plans on the basis of its own unique needs and considerations. Planners consider the specific agents stored at the installation that is nearby, potential stockpile incidents that could put

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Preparing for Terrorism: Tools for Evaluating the Metropolitan Medical Response System Program the off-post community at risk, various weather conditions, terrain, road systems, and other site-specific factors. Computers help community leaders evaluate and select the best protective measures for specific situations. Periodic exercises ensure that plans can be carried out rapidly and effectively.