# Session No. 5

## Course Title: Homeland Security and Emergency Management

# Session Title: Response to Terrorist Attack

# Prepared by Frances L. Edwards, Ph.D., CEM

**TIME: 3 Hours**

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**Session**

**Objectives:** At the conclusion of the session the students should be
able to:

> 5.0 Describe the Lead and Support Roles in Homeland Security -- Who's
> in charge of what and when?
>
> 5.1 Describe the Federal, state and local (lead) roles in responding
> to terrorist events

5.2 Describe the professions involved in response to terrorist attack
and their roles and perspectives, and how their roles differ from
emergency response to natural and technological events

**Scope**

Brief overview of the catastrophic disaster response framework in the
U.S. Description of the varying roles of the Federal, state and local
roles in terrorism response. Professions that participate in the
response to terrorism, and their respective roles, including how they
differ from their roles in natural and technological disasters.

**Required Session Readings:**

City of San Jose, Emergency Operations Plan, Annex T,
<http://www.sanjoseca.gov/emergencyServices/pdf/EOP2004_3.pdf>,
p.112-158 (T-1 to T-47)

Hank Christen, Paul Maniscalco, Alan Vickery, Frances Winslow, "A
Overview of Incident Management Systems," *Perspectives on
Preparedness,* September 2001, No. 4.

<http://bcsia.ksg.harvard.edu/BCSIA_content/documents/An_Overview_of_Incident_Management_Systems.pdf>

Homeland Security Presidential Directive-5, February 28, 2003.
<http://www.nimsonline.com/presidential_directives/hspd_5.htm>

Homeland Security Presidential Directive-8, December 17, 2003.
<http://www.nimsonline.com/presidential_directives/hspd_8.htm>

National Response Plan Quick Reference Guide, 5/22/06,
<http://www.dhs.gov/interweb/assetlibrary/NRP_Quick_Reference_Guide_5-22-06.pdf>
(Accessed 6/30/06).

**Suggested Readings:**

Brian Michael Jenkins and Frances Edwards-Winslow, *Saving City
Lifelines: Lessons Learned in the 9-11 Terrorist Attacks*, San Jose, CA:
Mineta Transportation Institute, 2003.
<http://transweb.sjsu.edu/publications/Sept11.pdf>

Friedrich Steinhausler, and Frances Edwards, *NATO and Terrorism:
Catastrophic Terrorism and First Responders- Threats and Mitigation,*
Dordrecht, The Netherlands: Springer, 2005.

**Objective 5.0**

**Describe the Lead and Support Roles in Homeland Security -- Who's in
charge of what and when?**

Under the United States Constitution, the responsibility for disaster
management begins with the jurisdiction where the disaster occurred.

-   The National Response Plan (NRP) states,

    -   "A basic premise of the NRP is that incidents are generally
        handled at the lowest jurisdictional level possible."[^1]

-   The responsibility for public safety is a local government role
    under American federalism. The mayor and chief executive (city
    manager/county executive) retain responsibility for the health,
    welfare and safety of the community, even when other levels of
    government provide mutual aid[^2] or assistance of any kind.

-   If the emergency event is going to exceed the capacity of the local
    government (municipality, county) to manage it effectively, the
    municipal executive officer (mayor or city manager) and the city
    council must declare a "local disaster" to begin the request for
    state and federal assistance. Exact requirements for local disaster
    declarations are found in the state's Emergency Services Act. For
    example, see California's at
    <http://www.oes.ca.gov/Operational/OESHome.nsf/0/CB65D44B103E960D88256BC10079C3AF?OpenDocument>
    , article 3630-3634.

-   That local declaration is then passed up to the state with a request
    for a governor's declaration of a state of emergency. If the
    governor agrees that the event exceeds local government capacity,
    the governor declares a state of emergency, and the local government
    may then receive personnel, goods, services and funding from the
    state to deal with the disaster. These resources include the
    National Guard, which is a state resource.

-   If the governor believes that the disaster may overwhelm the
    capacity of the state to effectively manage the emergency, the
    governor then sends the President a request for a Presidential
    Disaster Declaration. Under the Stafford Act, only with the
    governor's request can the President declare an area a disaster, and
    begin to provide federal resources to the community.[^3]

-   This layered approach to local, state and federal relations mirrors
    the type of dual federalism built into the Constitution, called
    "layer cake federalism" or the "coordinated authority model" by
    Rosenbloom and Kravchuk.[^4] As the authors describe this model,
    "neither level (of government) is dominant and neither level should
    intervene in the affairs of the other."[^5] "Exclusive authority" is
    vested in the states for the management of natural disasters, while
    the federal government maintains its exclusive role in the
    prevention of invasion by a foreign power.

Following the attacks of 9-11-01, President George W. Bush issued
Homeland Security Presidential Directive 1 (HSPD-1) that described a new
set of relationships among local, state and federal government in the
event of a catastrophe.

-   Its stated purpose was "securing Americans from terrorist threats or
    attacks...."[^6] While natural and technological hazards were still
    viewed as the responsibility of the local and state governments,
    with federal assistance, HSPD-1 defined terrorism preparedness as "a
    critical national security function" requiring extensive
    coordination "across a broad spectrum of Federal, State, and local
    agencies to reduce the potential for terrorist attacks and to
    mitigate damage should such an attack occur. The Homeland Security
    Council (HSC) shall ensure coordination of all homeland
    security-related activities among executive departments and agencies
    and promote the effective development and implementation of all
    homeland security policies."[^7]

-   Under the Stafford Act, "All disasters are local." Under the HSPD-1
    concept, terrorism is now a national security responsibility to be
    handled with coordination among the local, state and federal assets.
    The new paradigm more closely resembles the "marble cake" approach
    of the New Deal Era, whereby the states and federal government would
    cooperate in certain critical areas, with the federal government
    playing a key coordinating role."[^8] This "marble cake model" or
    "overlapping authority model" can also be viewed as being "based on
    a sharing of power and responsibility, with the various participants
    working toward shared goals."[^9]

-   The role of the state as the \"service delivery arm" is the same as
    under the Stafford Act, and the federal government is providing "its
    vast resources,"[^10] but the mechanism for managing the four phases
    (preparedness, planning, response and recovery) is more intertwined,
    with federal HSPDs and grant documents dictating to locals exactly
    what steps they must take for preparedness, putting terrorism
    preparedness above all types of natural hazards, regardless of how
    frequently they occur or how likely they are to occur.

In 2003 additional guidance regarding disaster response relationships
came through Homeland Security Presidential Directive-5 (HSPD-5).
Although all disaster response starts at the local level, terrorism is
treated as a quasi-federal responsibility because it may be seen as an
attack on the United States, which is clearly a federal role under the
constitution.

-   "The Secretary shall coordinate the Federal Government\'s resources
    utilized in response to or recovery from terrorist attacks, major
    disasters, or other emergencies if and when any one of the following
    four conditions applies: (1) a Federal department or agency acting
    under its own authority has requested the assistance of the
    Secretary; (2) the resources of State and local authorities are
    overwhelmed and Federal assistance has been requested by the
    appropriate State and local authorities; (3) more than one Federal
    department or agency has become substantially involved in responding
    to the incident; or (4) the Secretary has been directed to assume
    responsibility for managing the domestic incident by the
    President."[^11]

The role of the local government and its integration with federal
resources was also further defined. While in the past FEMA was empowered
to work with the states to ensure that adequate emeregency response
plans were in place, the HDPS-5 mandate is now on the Secretary of the
Department of Homeland Security.

-   "The Federal Government recognizes the roles and responsibilities of
    State and local authorities in domestic incident management. Initial
    responsibility for managing domestic incidents generally falls on
    State and local authorities. The Federal Government will assist
    State and local authorities when their resources are overwhelmed, or
    when Federal interests are involved. The Secretary will coordinate
    with State and local governments to ensure adequate planning,
    equipment, training, and exercise activities. The Secretary will
    also provide assistance to State and local governments to develop
    all-hazards plans and capabilities, including those of greatest
    importance to the security of the United States, and will ensure
    that State, local, and Federal plans are compatible."[^12]

The Attorney General also has a specified role in terrorist prevention,
with the Federal Bureau of Investigation (FBI) as the lead agency.

-   "... the Attorney General, in cooperation with other Federal
    departments and agencies engaged in activities to protect our
    national security, shall also coordinate the activities of the other
    members of the law enforcement community to detect, prevent,
    preempt, and disrupt terrorist attacks against the United States.
    Following a terrorist threat or an actual incident that falls within
    the criminal jurisdiction of the United States, the full
    capabilities of the United States shall be dedicated, consistent
    with United States law and with activities of other Federal
    departments and agencies to protect our national security, to
    assisting the Attorney General to identify the perpetrators and
    bring them to justice."[^13]

The Department of Defense has long had a defined role in providing
logistical support to communities experiencing natural hazards.

-   Examples of domestic military deployments in support of disaster
    response include Hurricane Iniki and Hurricane Andrew in 1994.[^14]

-   Further, if civil unrest is involved, as during the Rodney King
    Riots in Los Angeles in 1992, the President can order the military
    to perform law enforcement under his authority to mainatin
    "tranquility" within the United States, and this authority
    supercedes the Posse Comitatus Act that generally prohibits the use
    of the military within the United States for law enforcement
    purposes.[^15]

-   "The Secretary of Defense shall provide military support to civil
    authorities for domestic incidents as directed by the President or
    when consistent with military readiness and appropriate under the
    circumstances and the law. The Secretary of Defense shall retain
    command of military forces providing civil support."[^16]

In each instance the HSPD mixes federal and state roles in a "marble
cake" fashion, blurring the lines of authority of the governor and the
president and his secretaries.

After 9/11 the President wanted the disaster response to be understood
as a more integrated approach among local, state and federal partners,
following the "marble cake" model. To that end the National Response
Plan (NRP) supeceded the Federal Response Plan, that was focused on
natuiral hazards. The NRP was defined as follows.

-   "The NRP, using the NIMS, shall, with regard to response to domestic
    incidents, provide the structure and mechanisms for national level
    policy and operational direction for Federal support to State and
    local incident managers and for exercising direct Federal
    authorities and responsibilities, as appropriate."[^17]

-   The NRP provides authority for the President to both assist local
    authorities, and to have federal assets assume responsibility for
    the management of outside resources.

-   The Federal Response Plan was clearly administered by FEMA, but the
    NRP places responsibility in the Secretary of Homeland Security,
    even though that agency has its focus in terrorism prevention and
    apprehension rather than disaster resource management.

HSPD-5, issued on February 28, 2003, enlarged the powers of the federal
aparatus to determine that a catastrophe of national proportions was
occuring, and to take initiative in responding to it. Considering that
local government might be overwhelmed by a terrorist attack, and that
state government might be unable to respond, HSPD-5 provided standards
for direct federal intervention into a disaster without the normal
disaster declaration pattern being followed.

-   "The Secretary shall coordinate the Federal Government\'s resources
    utilized in response to or recovery from terrorist attacks, major
    disasters, or other emergencies if and when any one of the following
    four conditions applies: (1) a Federal department or agency acting
    under its own authority has requested the assistance of the
    Secretary; (2) the resources of State and local authorities are
    overwhelmed and Federal assistance has been requested by the
    appropriate State and local authorities; (3) more than one Federal
    department or agency has become substantially involved in responding
    to the incident; or (4) the Secretary has been directed to assume
    responsibility for managing the domestic incident by the
    President.[^18]

Thus, if the state and local governments are unable to fulfill their
police power obligations to protect lives and property because of the
overwhelming nature of the event, the President has the opportunity
under section (4) to determine that the Secretary needs to take
responsibility for the incident.

Terrorist acts may be committed using "weapons of mass destruction,"
such as nuclear bombs, or "weapons of mass disruption," such as
chemical, biological, radiological, incendiary or explosive devises.
Disruption of critical infrastrusture or interference with the food
supply are also among the fifteen scenarios that the Department of
Homeland Security uses to test capability for response to terrorism in a
community.[^19]

Terrorism is defined by the U.S. Code as both international and
domestic. International terrorism occurs abroad. Domestic terrorism is
defined as follows:

-   "involve acts dangerous to human life that are a violation of the
    criminal laws of the United States or of any State;

-   appear to be intended --

    -   to intimidate or coerse a civilian population;

    -   to influence the policy of a government by intimidation or
        coersion; or

    -   to affect the cionduct of a government by mass destruction,
        assassination or kidnapping; and

-   occur primarily within the territorial jurisdiction of the United
    States.[^20]

## Objective 5.1 

## Describe the Federal, state and local (lead) roles in responding to terrorist events

Terrorist events include the use of weapons of mass destruction and
weapons of mass disruption. The use of some of the weapons is
immediately obvious, such as chemical and explosive-based weapons. In
that case the local first responders will become aware that something is
causing death, injury and property destruction within a short time of
the onset of the event, and begin an organized response to the scene or
scenes.

All disasters begin within someone's local community, either within the
boundaries of a municipality, or within a county.

-   Local government provides for the immediate needs of its residents

-   Local government hold the responsibility for the "police power"
    under the US Constitution, because the health, welfare and safety of
    the community is a power reserved to the states and to the people
    under the 9^th^ and 10^th^ Amendments to the Constitution.

Once an event begins that exceeds the ability to manage it is as a
day-to-day emergency, the local officials must use the National Incident
Management System to establish command and control.[^21]

-   An Incident Commander in the field will determine the type and
    extent of the emergency, and what professions are needed to resolve
    it. The Incident Commander will retain tactical control of the
    event.

-   Resources at the disposal of the Incident Commander will evaluate
    the scene from a safe distance, and determine which specialized
    units will be needed.

-   The Incident Commander will determine if specialized assets are
    needed as mutual aid assets from local, state or federal partners.
    Examples would be explosive ordinance disposal units, hazardous
    materials management units, urban search and rescue units, and
    mortuary units.

-   The jurisdiction will open its Emergency Operations Center (EOC),
    and use the Terrorism Annex of its Emergency Operations Plan (EOP)
    to manage the event from a strategic, resource management and
    information sharing perspective.

-   If the Incident Commander believes that terrorism is involved, the
    Federal Bureau of Investigation will be notified by the local chief
    of law enforcement (Police Chief or Sheriff).

-   The Planning/Intelligence Section will determine the size, scope and
    likely duration of the event, whether it is getting bigger or
    smaller, and whether other jurisdictions are, or are likely to
    become, involved. For example, if there airborne material that will
    travel to another jurisdiction.

-   The local chief executive officer will determine whether to declare
    a local disaster, and whether to request a Governor's declaration of
    a State of Emergency.

-   Local officials will continue to use all the resources at their
    disposal to save lives, protect the environment, and protect
    property.

If the Federal Bureau of Investigation (FBI) joins the Incident Command
structure they will typically do the following:

-   Confer with local law enforcement regarding existing evidence to
    support a terrorism assessment, such as threats, types of weapons,
    or methods of attack.

-   Establish a Joint Operations Center with the local jurisdiction

-   Establish a Joint Information Center with the local jurisdiction

-   Call on whatever federal assets the FBI needs to protect evidence
    and conduct the investigation

When the Governor receives the local disaster declaration, she/he
determines if the event can be managed by local resources alone, or
whether federal resources will be needed. If initial investigation
indicates that terrorism is involved, the governor may use state laws to
govern the investigation.

-   The Governor may declare a State of Emergency based on the statewide
    impact of the event, which may be physical, economic, or
    psychological.

-   The Governor may request a Presidential Disaster Declaration based
    on the initial analysis that the event is a terrorist attack, and is
    likely to overwhelm local and state resources. In cases of unusual
    events, such as a "dirty bomb" attack, local and state authorities
    may not have adequate detection equipment, adequate personal
    protection equipment, or adequate medical treatment capabilities, to
    care for the victims.

-   The Governor may respond to requests for resources from the local
    government EOC including

    -   Any assets of the state

    -   Any assets of the National Guard, including specialized units
        such as Civil Support Teams with chemical detection capabilities
        and augmented communications assets[^22]

The request for a Presidential disaster declaration may come from both
the Federal Bureau of Investigation and the Governor.

The staff members of the Department of Justice (on behalf of the FBI)
and the Department of Homeland Security will advise the President on the
issuance of the Presidential Disaster Declaration. Unlike natural
disaster, where extensive damage assessment information is usually
required to obtain a Presidential declaration, a terrorist event will
likely have the support of the FBI for a rapid issuance of a
Presidential Disaster Declaration. For example, President George W. Bush
issued a declaration for the September 11, 2001 attacks that same
afternoon.[^23]

Once the Presidential Disaster Declaration is issued, all the resources
and assets of the Federal government become available to the attacked
community. Critical assets would include:

-   National Disaster Medical System (NDMS) assets

-   Disaster Medical Assistance Teams (DMATs)

-   Veterinary Medical Assistance Teams (VMATs)

-   Urban Search and Rescue Teams (USARs)

-   Disaster Mortuary Teams (DMORTs)

-   U.S. Marine Corps Chemical Biological Emergency Response Force
    (CBERF)

-   Department of Energy Nuclear Emergency Support Team (NEST)

-   All the day-to-day resources of the various departments and offices
    of the Executive Branch of government

The National Response Plan provides for the organization of the Federal
government based on Emergency Support Functions, with a lead agency
assigned to coordinate each activity.

-   Joint Field Office will be established (NRP Quick Reference p. 8-13)

-   Joint Information Center will be established (NRP Quick Reference p.
    12)

The fifteen Emergency Support Functions will be activated as needed
based on the impacts of the disaster. For example, #8 Public Health and
Medical is managed by the Department of Health and Human Services
(DHHS). (NRP Quick Reference p. 14-15 for table of ESFs and lead
agencies).

Some disasters may not be immediately obvious and may require a
protracted period of recognition and response.

-   Biological agent attack

-   Animal disease attack

-   Cyber terrorism

In these cases the local jurisdiction may not be immediately aware of
the attack Cases or complaints may come in over a period of days or
weeks.

-   The local health officer would have initial jurisdiction over a
    disease outbreak

-   Section 304 of the Homeland Security Act allows the Secretary of
    DHHS "to issue a declaration of health emergency after concluding
    that an actual or potential bioterrorist incident or other potential
    public health emergency warrants" the delivery of mass medical care.

-   Department of Agriculture would have jurisdiction over an outbreak
    of animal disease

-   Law enforcement would have jurisdiction over attacks against
    infrastructure

## Objective 5.2 

## Describe the professions involved in response to terrorist attack and their roles and perspectives, and how their roles differ from emergency response to natural and technological events

1.  Law enforcement

-   Natural disaster role includes crowd control, traffic control,
    keeping the peace, preventing looting, VIP escort

-   Terrorism role places a high demand on site security, including
    establishing a reliable identification system rapidly for all first
    responders with legitimate business at the site, to exclude
    individuals who would tamper with potential evidence or victim
    remains

    -   Note the problems with identifying first responders at the World
        Trade Center site, safety issues related to "free lance" and
        volunteers workers who were not registered.

    -   WTC site had known perpetrators, so the focus was search and
        rescue; future events could turn on evidence pointing to the
        responsible parties

-   Terrorism demands the protection, collection and chain of custody
    over evidence, often taken from human bodies in the form of debris,
    shrapnel, or biological specimens

-   Terrorism requires building a case against the perpetrators, which
    requires interviewing and tracking witnesses, developing leads,
    using available close circuit camera videotape

-   Law Enforcement generally assumes Incident Command from Fire as soon
    as all victims are rescues, triaged, treated in the field and
    transported to definitive medical care, and all fatalities have been
    recovered. Law Enforcement Incident Commander oversees the
    processing of the site for evidence until the senior law enforcement
    person determines that the site can be released for restoration and
    reuse.

2.  Fire services

-   Natural disaster role includes putting out fire (urban and
    wildland), managing flood water rescues, urban search and rescue,
    managing utility-related dangers (downed power lines, flooded
    utility tunnels)

-   Natural disaster role include providing Incident Command until all
    rescues, triage and field treatments are completed

-   Many fire services provide emergency medical technician or paramedic
    level medical care

-   Terrorism response plans generally place Fire as Incident Commander
    until all victims are rescued, triaged and treated in the field and
    transported to definitive medical care, and until all fatalities are
    recovered

-   Terrorism role requires search and rescue in a hazardous materials
    environment, or unstable building environment, so extra personal
    protective equipment may be needed

-   Terrorism role requires caring for patients who may be contaminated,
    and whose symptoms may not be immediately recognizable as the result
    of a terrorist attack -- may look like exposure to an industrial
    hazardous material, or like a routine "flu-like" illness

-   Terrorism role requires that fire medical personnel consider whether
    shrapnel may be radioactive -- not many fire companies have real
    time radiation devices that can detect alpha, beta and gamma
    particles

3.  Hazardous materials units

-   Trained and equipped for responding to and mitigating hazardous
    materials accidents, and spills caused by natural events (floods,
    earthquakes, tornadoes, hurricanes)

-   Detectors focus on toxic industrial chemicals (TIC) -- can recognize
    organophosphates but not distinguish between a TIC and a weapon,
    such as sarin.

-   Usually only one trained team with Level A suit capability in the
    average community, and then only if there are TIC users in the
    community

-   Terrorism requires the development of an "index of suspicion" to
    consider that an event might be an attack

-   Terrorism requires the ability to rapidly identify agents of concern
    while still adequately protected against the toxics -- requires
    acquisition and practice with new detectors, including radiological
    detectors

-   Terrorism stresses the response time capabilities of hazardous
    materials teams

    -   as Occupational Health and Safety regulations require an on-site
        medical evaluation immediately before donning the Level A suit

    -   regulations require two team members to make entry together and
        two team members outside the hot zone available to rescue the
        entry team.

    -   after one air bottle the team member must go to "rehab" to
        rehydrate and stabilize body temperature before suiting up
        again. Practically speaking this means two people for every 15
        minutes of rescue time in a hazardous environment

4\. Public Works

-   Natural disaster role includes building damage assessment, based on
    known physical hazards

-   Natural disaster role includes shoring up buildings, clearing mud
    from roadways, repairing roadways, bridges and other access routes

-   Terrorism requires supporting fire search and rescue staff with
    heavy equipment, such as cranes and backhoes, in addition to
    providing shoring for safe work spaces and victim rescue

-   Terrorism requires rapid construction of temporary on-site
    facilities for rescue staff support and evidence protection

-   Terrorism requires coordinating with utility staff to safeguard
    community water, sewer and power supplies

-   Terrorism creates the need for personal protective equipment for
    much of the restoration work, based on not only the weapons
    released, but the materials released by the destruction of buildings
    and facilities, such as asbestos, which can raise labor issues,
    since working in a hazardous environment is not in their labor
    contracts

5\. Transportation

-   Natural disasters require rapid damage assessment of transportation
    infrastructure, and rapid restoration of damaged transportation
    infrastructure

-   Natural disasters require coordination with law enforcement staff
    for evacuation routes, street closures, and one way or contra-flow
    traffic routing to and from critical facilities, such as the
    disaster site and hospitals

-   Terrorism requires coordination with law enforcement to create
    traffic control points, erect barriers and barricades, and ensure
    rapid repair of critical facilities

-   Terrorism requires the same tasks as natural hazards, but often in a
    more dangerous environment that requires personal protective
    equipment against either the weaponized materials or the debris,
    such as asbestos. This can raise labor issues, since working in a
    hazardous environment is not in their labor contracts

6\. Office of Emergency Services

-   Natural hazards response involved opening the EOC, following the
    EOP, coordinating city staff for work outside their normal work
    space

-   Natural hazards response requires coordination with local, state and
    federal agencies for information sharing and resource requests

-   Risk assessments of natural hazards are usually accurate and provide
    a good basis for decision-making in the EOC

-   Terrorism plans usually place the Fire Chief as Operations Section
    Chief in the EOC until all victims are rescued, triaged, treated in
    the field and transported for definitive care, and until all
    fatalities are recovered

-   Terrorism plans usually place the Law Enforcement chief as
    Operations Section Chief in the EOC until all evidence is collected
    and the site is ready to be released for restoration and reuse.

-   Terrorism requires access to technical information about types of
    weapons, possible terrorist groups, and appropriate response from
    the EOC, with no specific information available in advance of the
    actual event -- time, place, impact area, population density and
    method will all be known only after the event

-   Terrorism requires cultural sensitivity in dealing with the
    community to avoid scapegoating

-   Terrorism requires a strong public information program to keep the
    public informed and reassured

    -   Mayor Rudolph Guiliani's frequent press conferences are an
        example of good public information for public reassurance

7\. Emergency medical services

-   Natural disasters require close coordination with fire EMT and
    paramedic staff regarding types of patients and treatment locations;
    and with law enforcement regarding access to treatment facilities

-   Natural hazards typically create patients with rapid onset illness
    or trauma

-   Terrorism requires coordination with law enforcement and fire
    regarding safe areas for emergency transportation vehicles staging,
    operations and access

-   Terrorism requires coordination with receiving treatment facilities
    to ensure that victims of the attack are identified separately from
    day-to-day event victims in the same facility

-   Terrorism requires personnel to develop an "index of suspicion"
    regarding the types of injuries that are unique to the CBRNE
    mechanisms

-   Terrorism requires personnel to consider shrapnel and debris removed
    from victims as evidence, and to develop a chain of custody with law
    enforcement

8\. Hospitals, e.g., surge capacity and trauma capacity

-   Natural disasters create a demand for hospital services through
    traumatic injury

-   Hospitals are also victims of a community-wide disaster, but are
    usually able to mitigate against the worst effects -- wind, water,
    flooding, shaking

-   Hospital staff members are trained to have home and family emergency
    plans since they will have to stay at work in natural disasters

    -   Note that Hurricane Katrina proved that only a minority of
        medical staff stayed at their hospitals in flooded areas of New
        Orleans

-   Terrorism requires hospitals to go to "lock down" to protect their
    staff and assets, and vulnerable in-patients, from possible
    terrorist attack, and from being overwhelmed by walk-in community
    members demanding care

-   The sudden demand for trauma care, shock care and cardiac care will
    overwhelm most community medical systems, requiring hospitals to
    change their admissions and retention policies, implementing plans
    for sending in-patients who are stable to skilled nursing facilities
    to make space of terror victims

-   Terrorism will require the implementation of alternate triage sites
    (parking lots, garages, alternate buildings), alternate treatment
    sites (walk-in clinics or physicians' offices) for those patients
    triaged Yellow (delayed) or Green (walking wounded).

-   Terrorism may require augmented medical resources. Community
    Emergency Response Teams, Medical Reserve Corps and other
    pre-registered local assets may be needed to supplement existing
    medical staff members. Disaster Medical Assistance Teams (DMAT) and
    Metropolitan Medical Task Forces (MMTF) from neighboring
    jurisdictions will be needed to supplement community resources.
    Military medical assets may be used if available.

-   Terrorism may generate large numbers of fatalities who may overwhelm
    the morgue, and require the mobilization of a Disaster Mortuary Team

-   Federal intervention will be required to resolve issues of
    cross-border operations by EMTs and paramedics that are licensed by
    county, and other medical personnel who are state licensed, in order
    to develop surge capacity to treat the community's existing patients
    as well as the terrorism-generated patients

9\. Public Health

-   Natural hazards generate concerns about safe drinking water that
    have to be addressed through public information releases

-   Natural hazards generate concerns about cleaning up after flooding,
    including what can be safely kept, how to clean it, and what
    immunizations to give people who were in the flood water; or about
    dust-borne molds, spores and diseases from earthquakes, tornadoes
    and dust storms

-   Natural outbreaks of disease may require immunization campaigns

-   Terrorism requires surveillance for the development of disease
    syndromes based on known weaponized chemical releases

-   Terrorism requires surveillance for disease outbreaks related to
    possible secondary devices that released a disease agent, such as
    anthrax, plague or smallpox

-   Terrorism requires coordination with hazardous materials and law
    enforcement staffs to determine the areas that require clean-up, and
    coordination with environmental protection organizations to
    determine what is an acceptable level of clean-up

-   Bioterrorism may require the isolation of diagnosed sick patients,
    and the quarantine of exposed patients

-   Bioterrorism with an infectious agent will require coordination with
    law enforcement to implement plans for community quarantine "snow
    days," including deliveries of essential good and the maintenance of
    essential services

10\. Clinical care

-   Natural hazards generate the demand for minor trauma care in
    physicians' offices and walk-in clinics

-   Natural hazards may disrupt clinical care when utilities or road
    systems are damaged

-   Terrorism will place demands on clinical care facilities, as
    hospitals become overwhelmed or unavailable

-   Most clinical facilities lack security, back up power, and large
    staffs, so most will probably choose to close unless they are
    related to a larger medical center that is using the clinic as an
    alternate care center

-   Clinical care facilities may become the care sites for day-to-day
    patients to free up hospital-based facilities for terrorism victims
    that need more extensive work-ups

**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

> Questions to ask students:

1.  What are Homeland Security Presidential Directives, and how do they
    impact terrorism response?

2.  "All disasters are local." How does this apply to terrorist attacks?

3.  What is the state's role in responding to a terrorist attack?

4.  What is the Federal role in responding to a terrorist attack?

5.  What professions participate in response to a terrorist attack?

6.  How is the fire response to injured people different at a terrorist
    attack then a natural disaster and why?

7.  What profession provides the Incident Commander at a terrorist
    attack with injured people? When does Law Enforcement become
    Incident Commander?

8.  Describe the functions of the following at a terrorist attack:

    a.  Emergency Medical Services

    b.  Hospitals

    c.  Public Health

    d.  Public Works

    e.  Transportation

    f.  Hazardous materials team

**CASE STUDIES**

**First World Trade Center Bombing, 1993: Facts**

On February 26, 1993 a radical Islamic organization led by Sheikh Omar
Abdel Rahman, parked a Ford Econoline van loaded with 1,500 pounds of
urea-nitrate explosives in the underground garage of the World Trade
Center. The mastermind of the attack was Ramzi Yousef, a man motivated
by a desire for revenge against Americans for the Palestinian lives
taken by Israelis with American sanction. The 110-story Twin Towers,
world's tallest building at the time of its construction, were home to
international business and banking firms from all over the world. At
12:18 pm while most of the offices were in full operation, the explosion
caused a gaping hole in the garage wall above the PATH underground train
station. The six people who died were in the PATH station when the
ceiling collapsed on them. The blast created a crater that was 200 feet
by 100 feet and seven stories deep.[^24]

100,000 people were estimated to be in the building when the attack
occurred, and about 1,000 of them were injured inside the World Trade
Center. The explosion went through three floors of concrete, and sent
smoke up one of the towers. It took out the building's power supply and
back-up generator, which was in the basement. People had to walk down
the fire stairs without light to escape the smoke inside the building.

**First World Trade Center Bombing, 1993: Issues**

New York City did not use the incident command system. A command post
was established, but overall coordination did not occur. No formal
staging area was established for first responder vehicles, resulting in
a chaotic disposition of vehicles as they arrived. Several hours into
the event the area around the towers was clogged with police and fire
vehicles and ambulances facing in every direction. The New York City
Fire Department did maintain command and control over their own staff,
and provided immediate care for the victims exiting the damaged
building. Law enforcement members coordinated at the scene with Fire to
provide assistance to victims as they exited the smoke filled building.

Then FBI Joint Terrorism Task Force collaborated with the New York City
Police Department to investigate the bombing, resulting in the
successful prosecution of the bombers. The attack did not have the
affect on counterterrorism activities that it should. James Kallstrom,
an FBI assistant director at the time, and later an adviser to Governor
George Pataki of New York, noted that law enforcement continued to build
walls between counterterrorism investigators and criminal investigators,
allowing the 2001 plot against the same building to go undetected.[^25]

**Long Island Rail Road Massacre: Facts**

Colin Ferguson was a New Yorker suffering from what his defense lawyers
called "Black Rage." On December 7, 1993 he took the 6:06pm train from
Penn Station. Just before it arrived at its Garden City, Long Island
stop he opened fire on the complete strangers in the train car. He fired
30 shots, hit 25 different people, killing six and injuring the other
19. He was alleged to be angry over the handling of a workers
compensation case, and developed racial hatred for white and Asian
people because of it.[^26] Ferguson was wrestled to the ground by 3
fellow passengers as he returned to his seat for ammumition to reload
the pistol for the third time! He left the dead sprawled across the
living trapping them in their seats for hours while they awaited law
enforcement assistance.

Ultimately Ferguson was sentenced to 6, 25-year-to-life sentences to run
consecutively (about 200 years in prison). He dismissed his defense
counsel, who wanted to argue an insanity defense, and instead insisted
that he did not do the killings. He left behind traumatized train
riders, some of whom have never gotten on a train again. Carol McCarthy,
whose husband Dennis was killed and son Kevin injured by Ferguson, win a
seat in Congress on a platform of gun control.[^27]

**Long Island Rail Road Massacre: Issues**

Medical control at the scene took a long time to develop. Uninjured
passengers were pinned in their seats by the bodies of the dead and
injured, awaiting assistance from overwhelmed fire and ambulance
personnel. Once triage of the injured was complete, lack of ambulances
forced all but the most seriously injured to wait in the death car or on
the cold and windy train platform. People with minor physical injuries
or psychological injuries were not transported at all, but waited for
relatives or public transit to take them away from the scene.

In this time before NIMS, New York state agencies did not use ICS. The
command post responsibilities were shared between fire, emergency
medical and law enforcement personnel, without adequate overall command
and control. One major problem was that access and egress for emergency
vehicles was not established early, resulting in a traffic jam of
commuters, community members and responders. Ambulances were forced to
park blocks away, and police could not clear roads because early
arriving first responders had parked anywhere, blocking in community
members in the shops below the train line. No staging area was ever
established, and the overall coordination of resources was not well
managed.

New York first responders learned the value of a more organized
response, especially the coordination of staging and transportation
assets.

**Bombing of the Murrah Building, Oklahoma City, 1995: Facts**

Timothy McVeigh was an American ex-Army man with ties to the militia
anti-government movement. On the morning of April 19, 1995 he parked a
Ryder truck containing ammonium nitrate and dynamite next to the
building, and detonated it at 9:02 am. At his trial he claimed it was
retribution for the deaths at Ruby Ridge and Waco at the hands of
federal agents. Children died in both of those events, and fifteen
children in the child care center died at the Murrah Building. 168
people were killed, including four child visitors, 26 adult visitors and
116 employees in the building, and one rescuer. 850 people were injured.
Four people were killed in surrounding buildings and outdoors.[^28]

The Oklahoma City Fire Department was the first on the scene, and
provided incident command for the event. In addition to Oklahoma City
police and fire personnel and ambulance service, mutual aid poured in
from around the nation. After the volunteer was killed by a debris fall,
a strict access control system was established to ensure tracking of all
workers on the site. Urban Search and Rescue teams from around the
nation assisted with the body recovery to bring closure to families of
those who died.[^29] 12,384 unpaid volunteers participated in the rescue
and body recovery at the bombing site, and in support of the rescuers
and victims.

**Bombing of the Murrah Building, Oklahoma City, 1995: Issues**

Good scene management enabled living people to be rescued within the
first 24 hours. On site triage and rapid movement to definitive care
saved many lives. The use of Incident Command System ensured overall
coordination of assets and resources, with staging established, media
briefings offered regularly, and post-shift medical and psychological
care provided to everyone working at the site.[^30]

The community impacts of terrorism were experienced for the first time
in the United States. People died or were injured in four surrounding
buildings. The federal courthouse was severely damaged and lost critical
case records to sprinklers activated by the building damage. Over three
hundred buildings were damaged or destroyed. 462 people were left
homeless.

Oklahoma City also marked a good cooperative effort between local first
responders and the media. Referred to as "Satellite City" by former
Assistant Fire Chief Jon Hansen, the media encampment became a conduit
for information between the first responder agencies at the bombing site
and the nation. "He details the relationship between the media and
public safety agencies. 'This proved that public safety agencies and the
media can work together at a common good.' "[^31]

**Bombing of the World Trade Center, 9-11-01: Facts**

On the morning of September 11, 2001 two planes headed from Boston to
west coast destinations, but were used as missiles to destroy the twin
towers of the World Trade Center. 60,000 people worked there every day,
with 90,000 daily visitors.[^32] Because the crashes occurred at 8:46
and 9:03 a.m. the buildings were not full, so fewer lives were lost
(2,752)[^33] than initially estimated.

Initially the event was treated as a high rise fire, and Fire Department
of New York set up the Incident Command Post in the lobby of Tower One
where they could monitor the annunciator box. Deputy Chief Ray Downey,
an internationally known search and rescue expert, was the Incident
Commander. Resources from throughout FDNY, Port Authority Police
Department, and New York City Police department arrived to assist with
fire suppression and victim rescue. The first collapse occurred at 9:59
a.m., 56 minutes after the plane hit the south tower.[^34] At 10:20 a.m.
the north tower collapsed, taking the command structure with it.[^35]
All the occupants of the towers below the crash floors evacuated safety,
but people were trapped above the fire floors and died, some inside
their burning offices, some from suicidal leaps from 80 or more floors
up, and some in the buildings' collapse.[^36]

**Bombing of the World Trade Center, 9-11-01: Issues**

Fire Department of New York (FDNY) was using the Incident Command
System, but it was not integrated with law enforcement, neither New York
Police Department nor Port Authority Police. All three agencies were
working at the site as a rescue team, but their efforts were not
coordinated through the Command Post. Further, they had no common
communication system, so messages regarding the conditions in the
damaged structures could not be passed rapidly to all responders.
Staging was established, but personnel discipline was overcome by the
size of the event. Individual off duty and retired members of FDNY
responded to the scene without being part of a command structure.[^37]
Medical assets were organized to receive trauma victims, but most local
hospitals were overwhelmed with the walking wounded, who had escaped
before the collapse but were covered in dust from the building
collapses, suffering from respiratory distress from the dust and debris
in the air, suffering from concussion injuries from the force of the
collapses. Water transportation resources were used to move 500,000
people out of downtown Manhattan after the subway system was compromised
by the tower collapses over several stations.[^38]

**Anthrax 2001: Facts**

Someone mailed highly refined anthrax to members of the media and
elected officials in the fall of 2001. The nation was barely recovering
from the attacks of 9-11 when a white powdery substance was discovered
in the office of a Boca Raton tabloid writer who had died on October 4
from inhalation anthrax thought to have been contracted on a wilderness
trip. Letters mailed to the intended media victims in New York City and
political victims at the United States Capitol created secondary disease
outbreaks in postal workers because spores escaped the envelopes in the
sorting and stamping machines, contaminating the work place, leading to
the deaths of two postal workers. A New York City hospital worker and an
elderly Connecticut postal customer also died from the disease from an
unknown source. The CDC reported that 32,000 people working at
contaminated sites received prophylaxis, while 10 contracted inhalation
anthrax and 12 contracted cutaneous anthrax.[^39] Federal office
buildings and postal facilities were anthrax was found were treated to
remove contamination, a difficult task since spores of anthrax are
resistant to most forms of sanitizing.

Although actual events were limited to one in Florida and several in New
York City, Washington, DC and New Jersey postal facilities, the anthrax
letters became a national psychological problem. People as far away as
San Jose, California were calling for emergency response to spilled
white powdery substances. In October 2001 the San Jose Fire Department
responded to 150 calls for white powdery substances, most of which were
clearly household products like coffee creamer and plaster dust. Two
events were investigated because of the circumstances of their delivery
and the threats attached, with one batch of material going to the State
Health Department for secondary confirmatory testing (and proved to be a
biological surrogate for anthrax).[^40]

**Anthrax 2001: Issues**

The FBI took the lead on the investigation of the anthrax attacks. They
determined that it was Ames strain from the Iowa veterinary school, and
that it was the most highly refined weaponized anthrax ever made.[^41]
They provided advisory posters for mail room personnel on avoiding
contact with suspicious mail.[^42] The CDC provided updates for the
public and the medical community. They conducted epidemiology and
surveillance nationally, reassuring the public that the anthrax attacks
were of limited scope. Their advice on medical prophylaxis and its
benefits saved thousands of people from illness who had been in areas
where anthrax was found. Their announcement that new cases ceased in
November helped to calm the community.[^43] The Postal Service began
placing anthrax detection devices in its main postal sorting centers in
2004.[^44]

[^1]: NRP Quick Reference Guide, May 22, 2006, p. 3.

[^2]: Mutual aid is personnel, equipment, goods or services provided to
    a jurisdiction at the time of a disaster based on a pre-existing
    agreement. Mutual aid agreements among jurisdictions within a state
    are common, and the national system is call Emergency Management
    Assistance Compact -- EMAC. For More information see
    <http://www.emacweb.org/>

[^3]: Note that HSPD-8 enlarges the scope of Presidential intervention
    capabilities, appearing to supercede the governor.

[^4]: David H. Rosenbloom and Robert S. Kravchuk, *Public
    Administration* (Boston, MA: McGraw-Hill, 2005), p. 109.

[^5]: David C. Nice, *Federalism: The Politics of Intergovernmental
    Relations* (New York: St. Martin's Press, 1987), p. 4-9, quoted in
    Rosenbloon and Kravchuk, p. 109.

[^6]: Pres. George W. Bush, Homeland Security Presidential Directive-1.
    A, October 29, 2001.

[^7]: HSPD-1, A.

[^8]: Rosenbloom and Kravchuk, p. 109.

[^9]: Nice in Rosenbloom and Kravchuk, p. 109.

[^10]: Rosenbloom and Kravchuk, p. 109.

[^11]: HSPD-5, (4).

[^12]: HSPD-5, (6)

[^13]: HSPD-5, (8)

[^14]:
    ##  Thomas R. Lujan, "Legal Aspects of Domestic Employment of the Army," *Parameters*, autumn 1997, p. 82. 

[^15]: Lujan, p. 88-89.

[^16]: HSPD-5, (9)

[^17]: HDPS-5 (16) (a)

[^18]: HSPD-5 (4)

[^19]: Department of Homeland Security, Office of State and Local
    Government Coordination and Preparedness, "Target Capabilities List:
    Version 1.1," May 23, 2005, p. 3. Complete scenarios are only
    available on a password protected government website.

[^20]: 18 U.S.C. para. 2331 (2004).

[^21]: "NIMS Compliance and Day-to-Day Emergency Operations," 8/17/05,
    <http://www.fema.gov/pdf/nims/compliance_emerg_op.pdf> (Accessed
    6/30/06).

[^22]: http://www.globalsecurity.org/military/agency/army/wmd-cst.htm

[^23]: http://www.yale.edu/lawweb/avalon/sept_11/press_briefing01.htm

[^24]: John V. Parachini, "The World Trade Center Bombers (1993)"
    Chapter 11 in Jonathan B. Tucker, (ed.) [*Toxic Terror: Assessing
    Terrorist Use of Chemical and Biological
    Weapons*](http://cns.miis.edu/research/cbw/toxterr.htm). MIT Press,
    Cambridge, MA. (2000), pp.185-206

[^25]: "!st Trade Center Attack:10 years Ago,"
    <http://www.cbsnews.com/stories/2003/02/12/attack/main540376.shtml>
    (accessed June 15, 2006).

[^26]:
    ###  The Long-Island Railroad Murder - \"Black Rage\" or \"So Crazy He Thinks He\'s Sane?\" Prepared by [**Michael Peil**](mailto:mpeil@lii.law.cornell.edu) for the [**Legal Information Institute**](../../../../../../../../). Last updated 21 December 1997 at 01:18.

[^27]: Jeffrey Zaslow, "Carolyn McCarthy", Straight Talk, May 1-3, 1998

[^28]: Oklahoma City National Memorial, A Look at Numbers,
    [http://www.oklahomacitynationalmemorial.org/docs/Murrah%20Bldg%20Numbers.pdf](http://www.oklahomacitynationalmemorial.org/docs/Murrah Bldg Numbers.pdf)
    (Accessed 6/9/06).

[^29]: Jon Hansen, Oklahoma Rescue, Ballentine Books, 1995.

[^30]: Lynne Engelbert, Report to Emergency Managers Association,
    August, 1995.

[^31]: CNN Interactive, "Firefighter details experiences in book on
    Oklahoma City bombing."
    <http://www.cnn.com/US/OKC/faces/Heroes/firefighter-book6-26/index.html>
    (Accessed 6/9/06).

[^32]: Brian Michael Jenkins and Frances Edwards-Winslow, *Saving City
    Lifelines*, San Jose, CA: Mineta Transportation Institute, 2003, p.
    15.

[^33]:
    #############  Phil Hirschkorn, "New York reduces 9/11 death toll by 40," CNN.com, 10-29-03, [**http://www.cnn.com/2003/US/Northeast/10/29/wtc.deaths/**](http://www.cnn.com/2003/US/Northeast/10/29/wtc.deaths/) (Accessed 6/15/06). {#phil-hirschkorn-new-york-reduces-911-death-toll-by-40-cnn.com-10-29-03-httpwww.cnn.com2003usnortheast1029wtc.deaths-accessed-61506. .unnumbered}

[^34]: Jenkins and Edwards-Winslow, p. 16.

[^35]: Jenkins and Edwards-Winslow, p. 51.

[^36]: Jarrett Murphy, "Open and Shut: Four Years Later We Still Have
    Ten Big Questions," 12/5/05,
    <http://www.villagevoice.com/news/0549,murphy,70685,6.html>
    (Accessed 6/15/06).

[^37]: Numerous accounts of "free lancing" are in Dennis Smith, *Report
    from Ground Zero*, New York:Viking Press, 2002.

[^38]: Kendra T. Wachtendorf and E. L. Quarantelli, Who Was in Charge of
    the Massive Evacuation of Lower Manhattan By Water Transport on
    9/11? No One Was, Yet it was an Extremely Successful Operation.
    Implications?, SEMP, 9/26/02, <http://www.semp.us/biots/biot23.html>
    (Accessed 5/15/05).

[^39]: CDC, MMWR, "Update: Investigation of Bioterrorism-Related Anthrax
    and Adverse Events from Antimicrobial Prophylaxis," November 9,
    2001, <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5044a1.htm>,
    (Accessed 7/15/06).

[^40]: San Jose Fire Department monthly activity report, October 31,
    2001.

[^41]: For a complete discussion see Richard Preston, *Demon in the
    Freezer*, New York: Random House, 2002, p. 161 ff.

[^42]: FBI Advisory poster, 2001, distributed through FBI field offices.

[^43]: CDC, MMWR, "Update: Investigation of Bioterrorism-Related
    Anthrax, 2001," November 16, 2001,
    <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5045a2.htm> (Accessed
    7/15/06).

[^44]: CDC, MMWR, "Responding to Detection of Aerosolized *Bacillus
    anthracis* by Autonomous Detection Systems in the Workplace," April
    30, 2004,
    <http://www.cdc.gov/mmwr/preview/mmwrhtml/rr53e430-2a1.htm>
    (Accessed 7/15/06).