Organizational Structures for Emergency Preparedness
There are many
organizational structures that have been developed to support emergency
response to environmental hazards. Three of the most important are the
Metropolitan Medical Response System (MMRS), Urban Areas Security Initiative
(UASI), and National Incident Management System (NIMS). MMRS and UASI are
federally funded programs that support interjurisdictional collaboration. NIMS
includes a standardized structure for emergency preparedness and response
titled the Incident Command System (ICS) that must link effectively to the jurisdiction’s
Emergency Operations Center (EOC). Each of these organizational structures is
discussed below.
Metropolitan
Medical Response System
The Metropolitan
Medical Strike Team program was initiated in 1997 by the Department of Health
and Human Services (DHHS), Office of the Assistant Secretary for Public Health
Emergency Preparedness. The program quickly changed its designation to the
Metropolitan Medical Response System to reflect both integration into local
incident management systems and the extensive involvement of multiple
governments, not just municipal agencies but also private sector organizations.
Of the original 26 MMRS cities established before 1999, only two (Atlanta, Georgia,
and Washington, D.C.) retained the strike team framework. In
March, 2004, 124 city and regional MMRS programs had been established. These
tend to be concentrated in high population density areas and other areas that
are high probability terrorist targets, but 43 states have at least one MMRS
program, yielding very broad geographic coverage and high levels of national
population coverage.
The initial
purpose of the MMRS program was to enhance local efforts to manage very large
mass casualty incidents arising from terrorists’ use of weapons of mass
destruction (Perry, 2003). In part the program mission was driven by the
realization that, for local governments, specialized federal assets for
terrorist attacks are 48-72 hours away even under the best of circumstances.
The MMRS program goal is to ensure cities can operate independently until
support arrives and develop a strong local incident management system that can
effectively and efficiently integrate specialized extra community (especially
federal) resources. Unlike many federal programs, the MMRS purpose statement has
evolved over time, largely in ways that emergency managers consider
constructive. The focus has come to include CBR agents as well as any other
agent (natural or technological) that could produce large numbers of
casualties; it has become firmly established as an all hazards program. Perhaps the two most distinctive features of
the MMRS program from a local government perspective are funding and
organization. DHHS allocated funds directly to cities, eliminating concerns
about funding losses to intermediate government levels and increasing
purchasing flexibility for municipalities. The organizational constraint is
that focal cities must create programs that include broad participation by
municipal departments (not just fire and police), as well as county and state
agencies and the private sector (e.g., hospitals). Although the funding
conditions are generally considered a blessing, the organizational issues have
been treated as (and undoubtedly are) significant challenges.
The most
significant feature of an MMRS is that it links multiple response systems.
Horizontal linkages involve first responders (e.g., firefighters, hazmat
technicians, technical rescue technicians, emergency medical personnel), public
health, emergency management, law enforcement, and medical and behavioral
health services. There also are vertical linkages; for example, public health
participation involves city, county, and state agencies. Also, private sector
organizations are included in the planning process to establish contact with hospital
emergency departments, environmental cleanup companies, ambulance systems,
funeral director associations, and similar organizations that provide critical
services in mass casualty incidents. MMRS cities must also plan for receipt and
integration of important federal assets by building a relationship with the
National Disaster Medical System (NDMS) and developing a capacity to receive
pharmaceuticals from the national stockpile, as well as other specialized
assets from a variety of federal programs.
Whether by design
or not, the MMRS program has imposed a comprehensive emergency management
process on recipient cities. Municipalities are required to operate an incident
management system; link it to a jurisdictional EOC; enhance mutual aid
agreements with surrounding communities; integrate county and state agencies;
and conduct joint planning, training, and exercises on a continuing basis. MMRS
program requirements address some mitigation and recovery issues, but emphasize
preparedness and response. As a condition of declaring an MMRS “fully
operational”, each city must conduct a full scale exercise with federal
evaluation. Achievement of operational status is treated at the federal level
as only one milestone in the continuing development—through planning, training,
and exercising—of an MMRS.
In March 2003,
responsibility for the MMRS program passed from DHHS to DHS. Ultimately—except
for the National Urban Search and Rescue Program—the MMRS program represents
the only federally devised model for disaster operations that has been tested
through repeated exercises and deployments. The challenge for the MMRS program
is sustainability; to maintain “adequate funding and effective management of
preparedness and efforts to keep domestic preparedness as a policy priority”
(Grannis, 2003, p. 210). Through the years of DHHS oversight, funds to sustain
established MMRS cities were made available, although on a highly variable
basis. An indicator of the strength of the program and proof of serious local
commitment is that cities kept their MMRS programs alive, even during years of
small federal allocations, by making hard choices about the distribution of
local resources. Funds to sustain the established MMRS programs have continued
under DHS, but future federal support is no more guaranteed for MMRS than for
any other program. No new MMRSs have been established since 2003, but this
program appears to be one significant success in a long history of federal
efforts to promote local emergency management where successes have been rare.
Interestingly, the FY2005 allocation for the federal MMRS Program decreased to
slightly more than $29 million, down from $50 million in FY2004. The 2005
allocation was also subject to retention of 20% at the state level, making the
federal commitment to the successful MMRS cities even more tenuous.
Urban
Areas Security Initiative (UASI)
In July of 2002,
President Bush approved the National
Strategy for Homeland Security as a framework for national efforts to
prevent and respond to terrorist actions. Beginning in 2003, the DHS Office for
Domestic Preparedness (ODP, formerly part of the Department of Justice)
inaugurated the Urban Areas Security Initiative as part of the National
Strategy for Homeland Security. In late 2003, President Bush approved the
FY2004 Homeland Security Appropriations Act, which continued and expanded UASI
at a funding level exceeding $4 billion. Seven urban areas were approved for
funding in 2003, and that number grew to 50 in 2004. For 2005, DHS added seven
new UASI jurisdictions while, without public explanation, discontinuing funding
for seven urban areas that had been funded in 2004. The financial awards were
substantial, ranging in FY2005 from a high of more than $207 million to New York City to a low of $5 million for Louisville, Kentucky.
In addition to these grants, 25 mass transit systems (heavy rail and commuter
rail systems) were funded in 2004 on the basis of ridership and total system
miles.
Former DHS Secretary Tom Ridge (U. S. Department
of Homeland Security, 2004d, p. iii) stated the purpose of UASI is to “create a
sustainable national model program to enhance security and overall preparedness
to prevent, respond to, and recover from acts of terrorism.” In launching UASI,
technical vulnerability assessments were used to identify high threat, high
population density areas to participate in the program. The level of funding
assigned to urban areas has been based in part upon the vulnerability
assessments and other needs assessments. UASI does not impose a generic response
model on participating urban areas, but requires local governments located
around a designated core city to cooperate in developing a strategic plan that
either creates anew or supplements existing disaster plans for terrorist
attacks anywhere in the urban area. UASI then authorizes program expenditures
across five areas: planning, equipment acquisition, training, exercises, and
management and administration (the latter is limited to 3% of the total
allocation). The funding mechanism is intergovernmental, with federal money
being allocated to states (which can retain up to 20%) that, in turn,
distribute funds to local governments. Local governments receive funds based on
the area’s strategic plan as well as agreements among the core city’s Urban Area
Administrator, participating municipal governments, and county and state
emergency management agencies. All expenditures are subject to federal review.
These general
funding rules for UASI continued through the FY2005 allocations, although DHS
has changed its approach to funding local government programs. The DHS Office
of State and Local Government Coordination and Preparedness (SLGCP) Office for
Domestic Preparedness has created a program that combines the application
process for six major federal programs and delegates the responsibility for
that process to state governments. The programs brought under this umbrella
application process are UASI, the MMRS Program, the State Homeland Security
Program, the Law Enforcement Terrorism Prevention Program, the Citizen Corps
Program, and Emergency Management Performance Grants. Some of the budget
allocations appear to have increased, whereas others decreased from previous
years. It is clear that this new process gives states additional resources
(programs like MMRS which were previously immune to the 20% funds retention by
the state under UASI are now subject to the retention), but also a considerably
greater administrative role and burden. It is not clear how effectively this
consolidation of programs will be implemented by the federal government and
states, nor how well it will be received by local governments.
For the most part,
emergency managers view UASI as promising. It provides substantial funding for
local needs (rarely accomplished by previous federal programs) and allows a
degree of local choice in planning, administration, and funding. Another
positive point is that 47 core cities of the 50 UASI urban areas already had
existing MMRS programs. This means they had already engaged in substantial
emergency planning and, therefore, possessed an existing structure on which to
build further capability. Complaints include concern that federal authorities
tightly define authorized expenditures within each predetermined budget
category and that local governments bear a substantial financial accounting
load. There is also concern that the pass-through mechanism from federal to
state and then to local agencies is complex and administratively demanding,
thus risking the diversion of funds from emergency preparedness to other uses.
Finally, if UASI is to succeed in creating a functioning local emergency
management capability, there must be high levels of continuing cooperation
among federal, state, county, and municipal governments—and particularly among
the municipal governments within each urban area. Sylves’ (1991) work on the
inherent difficulties with intergovernmental relations indicates the required
agreements on operational plans and budget allocations will prove to be serious
challenges.
At the present
time, there is little basis for judging the success of the UASI program. Not
only is the program new, but plans must be kept secure to avoid divulging their
contents to potential adversaries. When combined with the usual administrative
and operational hurdles to data collection, these obstacles inhibit the amount
of information available in the open literature that can be used to evaluate
the program. Most urban areas funded in the FY03 budget cycle obtained federal
approval of strategic plans, but implementation requiring such intense
intergovernmental collaboration and massive equipment purchases can be expected
to be slow under even the best of circumstances. There has simply not been time
to establish a capability that could be evaluated in functional or full scale
exercises. Although many of these urban areas have MMRS programs that provide
emergency management system models, it is not clear if the UASI strategic plans
build upon these capabilities, revise them, or change them entirely.
The
National Incident Management System
The concept of
incident management systems is neither new nor confined to traditional
emergency management. Incident management has military origins and law
enforcement agencies have long used the Incident Command System (ICS) for large
scale incident response. Both ICS and IMS (Incident Management System,
Brunacini, 1985) are preplanned organizational structures for emergency
response that will be treated here as interchangeable, although there are small
differences that will be discussed in the next section. In fact, an important
issue regarding IMS/ICS is the confusion about meaning; different professions,
different professionals, and different times have embraced different meanings.
Municipal fire departments use IMS and the National Fire Protection Association
adopted a standard (NFPA 1561) on emergency services IMSs in 2000. Similarly,
the Law Enforcement Incident Command System (LEICS) was systematized and
endorsed by the Police Officers Standards and Testing organization (Bartosh,
2003). The Hospital Emergency Incident Command System (HEICS), used in public
health organizations, originated with the Orange County, California, Emergency
Medical Services Agency and has diffused widely through the medical community.
In addition to the myriad systems currently available
for incident management, the federal government has now required NIMS. Homeland
Security Presidential Directive Number 5 (HSPD-5), a direct response to
multijurisdictional, multiorganizational problems arising in the response to
the September 11th attacks, established NIMS as part of the US
National Response Plan. The Department of Homeland Security (2004b) issued the
documentation for NIMS on March 1, 2004. HSPD-5 required all federal agencies
to adopt NIMS immediately and all state and local organizations to adopt NIMS
as a condition for federal preparedness funding by FY2005. The State of California negotiated
with DHS to retain SEMS (a standardized emergency management system it had
developed before NIMS), but the overall reception of the NIMS among other
emergency responders is currently unknown.
While all IMSs focus on the operational response to an
incident, NIMS addresses this issue and also many others that are considered to
be emergency preparedness rather than emergency response activities. There are
six components to NIMS (US Department of Homeland Security, 2004b). The first,
labeled command and management,
includes the traditional component of ICS (NIMS here uses ICS rather than the
more conventional IMS term), plus a definition of “multiagency coordination
systems” and “public information systems”. The ICS described here appears to be
almost identical to California’s
SEMS (which also is more comprehensive than a simple ICS) and similar to a
traditional fire service IMS. What DHS identifies separately as multiagency
coordination systems and public information systems overlap the structure of
traditional fire services incident management. The conventional version of IMS
structurally accommodates the need to link with incident management systems
operated by different classes of agencies and governments (e.g., public works,
EMS, law enforcement, hospitals) and includes joint information systems to
disseminate incident information to the public
(Brunacini, 2002). These same features also characterize all municipal
MMRS programs.
The second component of NIMS is labeled preparedness and “involves an integrated
combination of planning, training, exercises, personnel qualification and
certification standards, equipment acquisition and certification standards, and
publication management processes and activities” (US Department of Homeland
Security, 2004b, p. 4). Much of this component appears to be conventional
guidance that, to maintain any ICS (or IMS), one needs to engage in planning,
training, and exercising, as well as develop mutual aid pacts. The parts that
are both different and confining include the notion that DHS will issue
standards and test personnel to certify their ability to perform “NIMS-related
functions.” This certification process also will be applied to equipment.
Finally, this component specifies that forms used in ICS—including the incident
action plan, organization assignment list, and many others—be standardized by
federal fiat. Indeed Appendix A, Tab 9 of the National Incident Management System reproduces facsimiles of
appropriate form formats (US Department of Homeland Security, 2004b, p.
105-120).
The resource
management component of NIMS is complex and extensive. There is a
requirement for inventorying resources, along with a DHS supplied “resource
typing system”, that provides specific definitions of each type of resource and
how it is to be categorized. There are also rules for determining what
resources are needed for an incident, as well as how they are to be ordered,
mobilized, tracked, reported, and recovered. Finally, there is a section
requiring certification and credentials for personnel, but it is unclear from
the description whether this means resource management personnel must be
certified or whether they are charged with ensuring incident command personnel
and equipment are properly certified.
The final three components of NIMS are less well
defined than those just discussed. The “communication and information
management” component develops standards for communications (including
interoperability between responder organizations) at an incident and specifies
processes for managing incident information. The supporting technologies component exhorts locals to acquire and
continually review the availability of new technology for incident management.
The ongoing management and maintenance
component “establishes an activity to provide strategic direction for and
oversight of the NIMS, supporting both routine review and the continuous
refinement of the system and its components over the long term” (US Department
of Homeland Security, 2004b, p. 6)
It is difficult to evaluate NIMS at this stage of
implementation. With regard to its origins, “Both NRP [National Response Plan]
and NIMS have been developed in a top down manner, centrally coordinated by
DHS… [and] [v]iews differ on the scope and intent of stakeholder involvement in
developing NRP and NIMS.” (Hess & Harrald, 2004, p. 2). It appears that
disaster research was minimally considered, if at all, in the process of
generating NIMS. It is unclear how other guidance was solicited by DHS, from
whom, or how it was incorporated. Drafts of the NRP were widely distributed via
electronic mail along with requests for comment and many of these messages
reached municipal emergency managers. What appears to be an even greater
concern to municipal emergency management and response agencies is the detail
in which processes and protocols are specified within NIMS. In what could be
regarded as a significant understatement, Christen (2004, p. 96) states that,
in the fire service, “not everyone is happy with national standards and
protocols that supersede local preferences.” More important is the question of
whether such detailed specification promotes or retards the effective and
efficient management of emergencies and disasters.
On a practical level, the likelihood of successful
NIMS implementation is difficult to estimate. There is no doubt DHS can impose a
requirement for agencies accepting federal disaster preparedness funding to
adopt NIMS. However, effective implementation is quite a different matter from
official adoption. A veneer of nominal adoption sometimes substitutes for the
reality of an executable capability at the local level. The ICS component is
similar to the IMS that is used by most large fire services agencies in the United States,
although implementation by public works, hospitals, and law enforcement
agencies is difficult to estimate. To effectively operate an IMS, an agency
must address the planning, training, and exercising issues contained in other
NIMS components. There are serious practical challenges—including a reliance on
intergovernmental relationships that has plagued implementation efforts for
other federal programs. As another example, immense resources will be required
for DHS to produce standards and annually test and certify every command
officer in the United States.
If equipment must also be certified, the task will be even more daunting,
especially when one remembers NIMS is designed for federal, state, local, and
tribal governments (Ridge, 2004). The Phoenix Fire Department operates a Command Training Center
for certifying its own command officers (and others from the surrounding
region), but the simulation models, props, computers, and software require a
financial investment far beyond the resources of most fire departments. Hence,
even if the certification and testing were passed to local jurisdictions, many
would be overwhelmed and would likely see the process as another “unfunded federal
mandate”. For local agencies that do not routinely use some ICS or IMS or use
it infrequently, the additional resources required to comply with NIMS will be
substantial. DHS has created a “NIMS
Integration Center”
(with a Web site at www.fema.gov/nims) as part of
the federal effort to manage NIMS and answer questions regarding system
adoption. In addition, the DHS/FEMA Emergency Management Institute offers
multiple online classes that address both NIMS and basic ICS.
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