Is your agency prepared for a mass-casualty disaster response? Should such an incident occur, the Metropolitan Medical Response System can assist, but only if the program continues to exist.

MMRS is under an attack — not an attack led by a domestic or international terrorist, but by the federal government. MMRS has had its annual funding reduced each year since FY '05, and there's no funding at all for the program in the FY '07 budget. Not unlike the FIRE Grant program, MMRS is suffering collateral damage in a funding war and needs help in the fight.

Federal support

MMRS is the only Department of Homeland Security program that enhances preparedness of local governments for response to a mass-casualty event, whether natural or deliberate, making use of immediately available resources to manage the incident in those critical initial hours before federal resources arrive. MMRS currently consists of 124 jurisdictions covering about 80% of the nation's population. The system ensures that first responders, public health officials and health service agencies all participate in planning for an effective, comprehensive response to a mass-casualty event. As mandated by the National Incident Management System, MMRS maximizes the efficient use of regional resources to strengthen the response capabilities of our communities. Recent national disasters have reinforced this critical need at the local level of government.

The MMRS preparedness planning and response capabilities include:

• Planning and preparation to expand existing local health-care systems' capabilities to provide definitive health care.
• Provision and management of pharmaceutical and equipment caches.
• Identification of treatment protocols and enhancement of medical capabilities.
• Integration and coordination of MMRS plans with local, regional and state response capabilities, including early detection and recognition of disease, efficient mass immunization and prophylaxis, mass-casualty patient care, mass-fatality management, and environmental surety.

As previously noted, MMRS currently possesses plans for mass pharmaceutical distribution and mass vaccinations as developed through grant guidelines. The recently developed National Strategy for Pandemic Influenza Implementation Plan supports the need for the MMRS.

The plan states: “… The federal government will provide medical countermeasures, resources, and personnel, if available, in support of communities experiencing pandemic influenza, but communities should anticipate that in the event of multiple simultaneous outbreaks, the federal government may not possess sufficient medical resources or personnel to augment local capabilities. The development of medical and public health mutual aid arrangements through the Emergency Management Assistance Compact and other mechanisms is encouraged, but states and localities should anticipate that all sources of external aid may be compromised during a pandemic.”

The plan further supports MMRS by declaring: “…While a pandemic may strain hundreds of communities simultaneously, each community will experience the pandemic as a local event. In the best of circumstances, patients and health care resources are not easily redistributed; in a pandemic, conditions would make the sharing of resources and burdens even more difficult. [The Department of Health and Human Services] in coordination with [the Department of Defense and the Department of Veterans Affairs], and in collaboration with state, local and tribal governments and private-sector partners, shall assist in the development of distribution plans for medical countermeasure stockpiles to ensure that delivery and distribution algorithms have been planned for each locality for antiviral distribution. The goal is to be able to distribute antiviral medications to infected patients within 48 hours of the onset of symptoms within 12 months.”

MMRS will provide plans and distribution mechanisms for both situations mentioned in the plan if sustaining funding can be obtained. MMRS additionally could develop EMAC capability. However, without additional funding most MMRS jurisdictions cannot fund this program, and the system will dissolve.

Mutual aid request

A contingency from Arizona and California MMRS programs traveled again to Washington, D.C., in February to request congressional support for the lack of sustaining funding identified in the president's FY '07 budget. The congressional members and their staff elicited tacit support for the MMRS program, but they suggested that the MMRS contingent reinforce the request for sustaining funding by submitting additional local, county and state supporting documents to their respective congressional offices.

Mutual aid agreements are now being mandated if your agency is going to become NIMS compliant. The MMRS program is requesting mutual aid assistance throughout the United States. Chiefs can help by contacting their congressional representatives and advising them of the preparedness gap that will occur without the program and by soliciting local, county and state supporting documents and forwarding these documents to their congressional representatives.

The MMRS program is the foundation for local efforts in a disaster and will assist you in your time of need. Call your members of Congress and ask them to support the MMRS program and disaster preparation at the local level. For more information, e-mail cdechant@glendaleaz.com.

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Chris DeChant is the special operations division chief for the Glendale (Ariz.) Fire Department. He currently is the MMRS coordinator for the City of Glendale and was selected as chair of the state's MMRS Steering Committee in 2004. DeChant holds associate's degrees in fire science and advanced emergency medical technology and a bachelor's degree in public safety administration.