Catastrophic Incident
Supplement
to the National Response Plan
September 2004
FINAL DRAFT
FOR OFFICIAL USE ONLY
Catastrophic Incident
Supplement
January 2005
FOR OFFICIAL USE ONLY
Homeland
Security
FINAL DRAFT
to the National Response Plan

January 2005 Catastrophic Incident Supplement | 1
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National Response Plan ? Catastrophic Incident Supplement
Implementation Instructions
This Catastrophic Incident Supplement provides the operational framework for implementing the strategy
contained in the National Response Plan Catastrophic Incident Annex, and is effective upon issuance.
Departments and Agencies with designated responsibilities under this Catastrophic Incident Supplement
(to include those specific response actions listed in the Catastrophic Incident Response Execution
Schedule) are authorized 120 days to establish and institutionalize processes and procedures necessary to
effectively execute those responsibilities, should the provisions of this Supplement be implemented.
Departments and Agencies will notify the Secretary of Homeland Security, in writing, when the necessary
processes and procedures are in place.
Should conditions so warrant, the Secretary of Homeland Security may implement the provisions contained
within the Supplement prior to the expiration of the 120-day process institutionalization period.
Within 1 year of its effective date, the Secretary of Homeland Security will conduct an interagency
review to assess the effectiveness of the National Response Plan Catastrophic Incident Supplement,
identify improvements, and provide modification and reissuance recommendations, as required.
The Department of Homeland Security will establish an operational review cycle to ensure regular
revalidation of the actions and capabilities listed herein.
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January 2005 Catastrophic Incident Supplement | 3
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National Response Plan ? Catastrophic Incident Supplement
Table of Contents
Implementation Instructions .........................................................1
Table of Contents ...................................................................3
List of Figures......................................................................4
List of Tables ......................................................................4
Basic Plan...........................................................................5
1. Purpose.......................................................................... 5
2.Premise........................................................................... 5
3. Concept of Operations............................................................ 7
5. Federal Execution Strategy....................................................... 9
6. Catastrophic Response Inhibitors ................................................ 15
Operational Annexes
Annex 1  Execution Schedule ........................................................1-1
Annex 2  Transportation Schedule....................................................2-1
Reference and Overview Appendices
Appendix 1  Basic Planning Assumptions .............................................A1-1
Appendix 2  Inventory of Federal Response Teams ....................................A2-1
Appendix 3  Mass Care Response Overview.............................................A3-1
Appendix 4  Search and Rescue Response Overview.....................................A4-1
Appendix 5  Decontamination Response Overview ......................................A5-1
Appendix 6  Public Health and Medical Support Response Overview.....................A6-1
Appendix 7  Medical Equipment and Supplies Response Overview........................A7-1
Appendix 8  Patient Movement Response Overview......................................A8-1
Appendix 9  Mass Fatality Response Overview ........................................A9-1
Appendix 10  Housing Response Overview ............................................ A10-1
Appendix 11  Public Information and Incident Communications Response Overview.......A11-1
Appendix 12  Private Sector Support Overview....................................... A12-1
Appendix 13  Acronyms, Abbreviations, and Terms.................................... A13-1
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National Response Plan ? Catastrophic Incident Supplement
List of Figures
Figure 1  NRP-CIS Resource Flow Concept of Operations.............................. 13
Figure 2  NRP-CIS Resource Flow with Assessment Points............................. 14
Figure 4-1  National Urban Search and Rescue Response System........................A4-4
Figure 5-1  HAZMAT Team Response Times .............................................A5-10
Figure 5-2  Ladder Pipe Decontamination System .....................................A5-12
Figure 5-3  Personnel Decontamination Station (PDS) ................................A5-12
Figure 5-4  Emergency Decontamination Corridor System (EDCS)........................A5-13
Figure 5-5  Decontamination Decision Tree Example...................................A5-14
Figure 6-1  Available Health/Medical Personnel Deployment Projections ..............A6-2
Figure 6-2  NDMS Medical Specialty Force Strength...................................A6-4
Figure 6-3  Operational (Type-I) Disaster Medical Assistance Teams and Management
Support Team ........................................................................A6-5
Figure 6-4  Medical Response Teams Under Development ...............................A6-6
Figure 6-5  Medical Specialty Response Teams .......................................A6-6
Figure 6-6  National Disaster Medical System Timeline of Care.......................A6-9
Figure 6-7  U.S. Public Health Service Commissioned Corps Force Strength............A6-9
Figure 6-8  Active U.S. Public Health Service Commissioned Corps Force Roster ......A6-10
Figure 6-9  Medical Reserve Corps Communities.......................................A6-12
Figure 6-10  Department of Veterans Affairs Staff ..................................A6-12
Figure 6-11  Federal Coordinating Center Locations .................................A6-14
Figure 6-12  Potential National Disaster Medical System Beds Available Through
Federal Coordinating Centers ........................................................A6-14
List of Tables
Table 1  Push Assets ...............................................................2-2
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National Response Plan ? Catastrophic Incident Supplement

Basic Plan

1. Purpose

The National Response Plan Initial Catastrophic Incident Supplement (henceforth, the NRP-CIS) outlines
a coordinated strategy for accelerating the delivery and application of Federal and Federally accessible
resources and capabilities in support of a jurisdictional response to a catastrophic mass victim/mass
evacuation incident. Such an incident may result from a technological or natural disaster, or terrorist
attack involving chemical, biological, radiological, nuclear, or high-yield explosive (CBRNE) weapons of
mass destruction (WMD). As part of the articulated Federal response strategy contained herein, the NRPCIS
outlines an aggressive concept of operations, establishes an execution schedule and implementation
strategy, and, in the supporting appendices, provides functional capability overviews and outlines specific
responsibilities of Departments and Agencies. The NRP-CIS provides the operational strategy
summarized in the National Response Plan Catastrophic Incident Annex (NRP-CIA).

2. Premise

A. An urban or metropolitan area, or more expansive geographical area encompassing a large
aggregate population, suffers a sudden, catastrophic incident resulting (either immediately or over time)
in tens of thousands of casualties (dead, dying, and injured) and producing tens of thousands of evacuees
and/or affected-in-place. The response capabilities and resources of the local jurisdiction (to include
mutual aid from surrounding jurisdictions and response support from the State) are profoundly
insufficient and quickly, if not immediately, overwhelmed. In addition, characteristics of the precipitating
event, such as contamination concerns or other public health implications, severely aggravate the
response strategy and further tax the capabilities and resources available to the venue. Life saving
support from outside the area will be required, and time is of the essence. It is expected that venue
capabilities will be exceeded in one or more of the following areas:

(1) Mass Care. The ability of State and local first responders to adequately manage and
provide mass care (food and shelter) to a large, displaced, and potentially contaminated evacuee
population numbering in the tens of thousands will be quickly exceeded.

(2) Search and Rescue. If the incident involves collapsed structures, organic and mutual
aid, search and rescue resources are likely to be extremely limited. If the search and rescue operations are
required in areas of contamination, the availability of properly trained and equipped resources will be
further reduced.

(3) Decontamination. A WMD incident may involve contamination, and will require State
and local first responders and reception centers receivers to organize, support, and conduct mass
decontamination of casualties (including animals), evacuees, vehicles, and facilities. In addition, it will
require the commencement of site characterization as well as monitoring of both air quality and for
contamination among members of the public. Given the potentially immense numbers of casualties,
evacuees, vehicles, and facilities resulting from such an incident, decontamination requirements will
immediately outstrip State and local capabilities.

(4) Public Health and Medical Support. There will be significant issues relating to
environmental health and public health needs, including mental health services. Medical support will be

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required not only at medical facilities, but in large numbers at victim collection and evacuation points,
evacuee and refugee points and shelters, and to support field operations. In addition, any contamination
dimension will increase the requirement for technical assistance. The situation will quickly tax the
organic public health and medical infrastructure.

(5) Medical Equipment and Supplies. Depending on the nature of the incident,
organically available supplies of preventive and therapeutic pharmaceuticals and treatments will be
insufficient or unavailable to meet the demand, both real and perceived. Additionally, there will be
insufficient numbers of qualified medical personnel to administer available prophylaxis to both the
affected and adjacent (but worried) populations. Timely distribution of prophylaxis may be able to
forestall additional people becoming ill and reduce the impact of disease among those already exposed.

(6) Victim and Fatality Management and Transportation. The number of dead, injured,
and exposed may number in the tens of thousands and immediately overwhelm State and local
transportation capabilities and infrastructure. In addition, the immense numbers of casualties are likely to
overwhelm the bed capacities of State and local medical facilities.

(7) Public Information. A catastrophic mass victim/mass evacuation incident resulting
from an act of terrorism may terrify the population, both in the incident area and nationally. If the State
and local Government is overwhelmed by the scope and dimensions of the event and unable to provide
quick, positive, continuous, consistent, and clear public information and guidance to the affected
population, mass confusion and panic may ensue. On a national scale, the Federal Government must be
prepared to immediately provide clear and coherent guidance and direction.

B. Recognizing that Federal and/or Federally accessible resources will be required to support
State and local response efforts in some or all of the preceding areas, the Federal Government has preidentified
resources (e.g., medical teams, transportable shelters, preventive and therapeutic
pharmaceutical prophylactic caches, Federal medical facilities, cargo and passenger aircraft, etc.) that are
expected to be needed/required at or in support of an incident venue. Upon NRP-CIS implementation, the
Federal Government will unilaterally and immediately push these predesignated resources to a federal
mobilization center or staging facility near the incident area, as well as push certain actions (e.g.,
activate or make available Federal facilities, such as hospitals). Upon arrival, these resources will be
redeployed to the incident area and integrated into the response operation only when requested/approved
by and in collaboration with state/local incident command authorities, in accordance with the NRP and
NIMS.

(1) The NRP-CIS recognizes that State and local authorities may or may not ultimately
require all of the resources that are initially pushed or made available to an incident venue in support of
response operations and in anticipation of projected needs. Nevertheless, these resources will be
deployed as rapidly as possible to ensure their timely availability, if and when needed. Additional
resources will be deployed (if available) as precise requirements are subsequently identified through postincident
needs assessments.

(2) The development of venue-specific plans that fully integrate and leverage the resources
and capabilities of all levels of Government and the private sector into a coordinated incident-specific
advance response strategy will further accelerate the delivery of support and reduce the ratio of unneeded
resources and capabilities within the pre-established push-packages.

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3. Concept of Operations

A. Local (Venue) Response

(1) Responsibility for immediate response to an incident typically rests with local
authorities and first responders, as augmented by inter-jurisdictional mutual aid and, when requested, the
State. Accordingly, immediately following an incident, local authorities will:
(a) Establish an Incident Command System (ICS) response and management
authority and structure (e.g., identify an Incident Commander, establish an inter-jurisdictional Unified
Command and, if necessary, Area Command) and initiate whatever response actions they are capable of
taking with organic and inter-jurisdictional mutual aid resources. All resources and assistance provided to
support the response (regardless of source) will be integrated within and employed through this incident
command structure.

(b) Commence assessment activities to determine critical support requirements that
cannot be met by organic (Governmental and non-Governmental) and mutual aid resources, and that will
require support and augmentation from the Federal Government. These requirements will be
communicated to inter-jurisdictional, State, Tribal, and Federal authorities through and within the incident
command structure, in accordance with the National Incident Management System (NIMS).
NOTE: While the Catastrophic Incident Supplement is designed to augment and support the State and
local response to a catastrophic incident, the Federal Government must be prepared to assume a more
robust incident management role should State and local incident command capabilities be profoundly and
adversely impacted by the catastrophic incident.

(2) The Federal Government recognizes that each State and major urban area possesses
varying levels of capability, organic resources, and mutual aid availability, as well as unique physical and
social characteristics that will influence a tactical response strategy. Accordingly, to facilitate the rapid,
coordinated, and seamless integration of Federal and Federally accessible resources into a localized
immediate response effort, States and jurisdictions should, as part of a comprehensive pre-event planning
strategy:

(a) Retool existing State and jurisdiction response plans to reflect a coordinated
advance strategy for receiving, deploying, and/or using the pre-identified resources contained in the
Catastrophic Incident Response Execution Schedule (or venue-tailored variation thereof).
(b) Identify Mobilization Centers, staging areas, receiving and distribution sites,
victim collection points, temporary housing sites, and other key operational support facilities and
necessary staffing.

(c) Identify projected priority support requirements that will not be met by the
Catastrophic Incident Response Execution Schedule or through existing local, mutual aid, and State
resources and capabilities.

B. State Response

(1) The State will fully activate its incident management/response support architecture and
coordinate, through the incident command structure overseeing the response, the provision of additional
resources to the extent that State capabilities permit.

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(2) The ability of the State to quickly and effectively augment local response operations
will be enhanced through participation in the retooling/development of venue-specific response plans to
include a coordinated advance strategy for receiving, deploying, and/or using pre-identified State
resources.

C. Federal Response

(1) The NRP-CIS assumes that a catastrophic mass victim/mass evacuation incident will
trigger a Presidential disaster declaration, immediately or otherwise. Accordingly, the NRP-CIS will be
implemented under and carried out within the framework, operating principles, and authorities of:

(a) The National Response Plan (NRP).
(b) The NIMS ICS organizational and relational structure.
(c) Homeland Security Presidential Directive (HSPD)-5, Domestic Incident
Management.
(d) The Robert T. Stafford Disaster Relief and Assistance Act (henceforth, the
Stafford Act).
(e) National Preparedness for Bioterrorism and other Public Health Emergencies,
42 United States Code (U.S.C.) Sections 300hh and 300hh-11.

(2) Federal support under the NRP is normally provided on an expressed-need basis.
Incident venues, through their State emergency management authorities and in accordance with the ICS,
identify life and property-saving requirements that cannot be met by organic and mutual aid resources,
and request and, following a Presidential disaster or emergency declaration, receive assistance from the
Federal Government. However, given the clear and compelling impacts and ramifications of a
catastrophic incident, the NRP-CIS provides a more proactive and aggressive approach to the provision of
Federal support. Immediately upon recognition that a venue has suffered a catastrophic mass victim/mass
evacuation incident as determined by the Secretary of Homeland Security, this NRP-CIS will be
implemented and the specific actions reflected in the Execution Schedule (Annex 1) initiated. Those
actions (both standard NRP and unique to this NRP-CIS) include, but are not limited to:

(a) Designating and deploying a Principal Federal Official (PFO) and support staff to
directly represent the Secretary of Homeland Security. Until the designated PFO arrives in the area of
response, the U.S. Department of Homeland Security (DHS)/Federal Emergency Management Agency
(FEMA) Regional Director will assume the role of and function as Interim PFO.
(b) Designating and deploying a Federal Coordinating Officer (FCO) and activating
and deploying a Federal Incident Response Support Team (FIRST) and National Emergency Response
Team (ERT-N) to the State Emergency Operations Center (EOC) and/or incident venue. The FIRST and
ERT-N will coordinate Federal support, through the State and incident command structure, to local
authorities.
(c) Identifying and rapidly establishing necessary support facilities (Mobilization
Centers, Joint Field Offices (JFOs), etc.) proximal to the incident venue.
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(d) Immediately activating and mobilizing incident-specific resources and
capabilities (e.g., pharmaceutical caches, search and rescue teams, medical teams and equipment, shelters,
etc.) for deployment to the incident venue.
(e) Activating national and Regional-level operations centers and field support
centers (e.g., teleregistration centers).
(f) Activating and deploying reserve personnel to augment and support organic
State/local response capabilities and requirements in critical skills areas.
(g) Activating and preparing Federal facilities (e.g., hospitals) to receive and treat
casualties from the incident area. Tribal hospitals and clinics in the area of the incident need to be
considered.
(h) Issuing timely public announcements to inform and assure the Nation about the
incident and actions being undertaken to respond. If the venue and/or State infrastructure are incapable of
providing timely incident information, warning, and guidance to the public in and around the affected
area, the Federal Government will provide the necessary communications.
(i) Activating supplementary support agreements with the private sector.
NOTE: The advance retooling of State and local response plans to specifically address and include the
pre-identification of projected victim and mass care support requirements, Regionally available private
sector capabilities, critical skill and resource augmentation requirements, and corresponding
deployment/employment strategies, will accelerate the availability, delivery, and integration of such
resources.

4. Federal Execution Strategy

A. The NRP-CIS will be implemented when the Secretary of Homeland Security determines that
a precipitating incident will or may result in a mass victim/mass evacuation situation. Upon an
implementation decision, relayed by the Homeland Security Operations Center (HSOC):

(1) All Federal Departments and Agencies (including the American Red Cross (ARC))
identified to initiate incident type-specific actions in the Execution Schedule (refer to Annex 1) will
implement/initiate those assigned actions within the directed timeframe(s), to include activating and
mobilizing teams and resources for deployment. Transportation of mobilizing resources will be in
accordance with the procedures beginning at paragraph C, below.
(2) All Federal Departments and Agencies (including the ARC) assigned primary or
supporting Emergency Support Function (ESF) responsibilities under the NRP will immediately
implement those responsibilities, as appropriate or directed. Refer to the NRP for a description of
individual ESF responsibilities.
(3) The incident command structure/organization managing the response at the incident
venue will prepare to receive and direct the integration of deploying/activated Federal resources into the
response.

B. Resource mobilization actions directed in the Execution Schedule will be initiated no later than
their corresponding initiation times. However, deployment of mobilized resources will depend on the
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availability of air and surface transportation and the availability of adequate reception capabilities at the
programmed destination.

C. Upon activation of the NRP-CIS, DOT (as ESF#1 lead) will:

(1) Fully mobilize the Crisis Management Center (CMC) at DOT HQ. This team will
immediately begin an assessment of the transportation system and infrastructure providing reports to the
DHS Homeland Security Operations Center (HSOC) and NRCC.
(2) Provide dedicated staff to the DHS HSOC and IIMG.
(3) Staff the ESF#1 desk at the NRCC.
(4) Activate the ESF#1 Emergency Transportation Center (ETC) in Atlanta, GA.
(5) Dispatch DOT Regional Emergency Transportation Representatives (RETREPs) to
appropriate Regional Response Coordination Centers (RRCCs) and, when established, the JFO and
Mobilization Center(s). If multiple incidents occur, DOT will support each venue in the same manner.
DOT has Regional Emergency Transportation Coordinators (RETCOs) and RETREPS in nine Regions
and Alaska. (One RETCO serves Regions 1 and 2.)
(6) Coordinate, with the NRCC, issuance of a Mission Assignment that authorizes the
deployment of DOT personnel and funds transportation of all appropriate Push Assets in Annex 2.
D. The Transportation response will be provided in two broad categories. The first is the
immediate movement of pre-identified teams, equipment, and personnel to a Mobilization Center or
centers. The second category involves the movement of specifically requested assets into or from the
affected area. Transportation services will continue until the affected infrastructure returns to selfsufficiency.

(1) Immediate  Push Items (Dispatched during first 48 hours of incident): Assets that will
be transported automatically without any request from State or local authorities. These include
Emergency Response Teams (ERTs), equipment, and other supplies. Movement of these assets will be
sequenced to arrive at the incident Mobilization Center(s) in an appropriate order and quantity. These
assets are summarized in Annex 2. DOT maintains a separate listing of all assets in Annex 2 that provide
detailed coordination, locality, cargo, and contact information to facilitate the movement of these assets.
(2) Mid-Term  Pull Items (Dispatched within first 10 days). Assets that are likely to be
needed at the incident site, but will not be transported until requested by appropriate authority at the
DHS/Federal Emergency Management Agency (FEMA) Region, Joint Field Office (JFO) (local response
cell), or DHS/FEMA Headquarters (HQ). A DOT transportation representative will be present at each of
these locations.
(3) Long-Term Operations. Transportation services will be sustained as long as necessary,
until normal infrastructure is self-sustaining, and there is no longer a need for ESF#1 to support Federal,
State, or local efforts.

E. Requests for transportation services will be made through the NRCC. The RRCC and/or JFO,
when established, can originate requests as well. DOT representatives are present at each of these
locations. Transportation of the asset(s) at the origination site will normally occur within 6 hours of
receipt of the request. ERTs with their own vehicles must notify the ESF#1 watch at the NRCC to
January 2005 Catastrophic Incident Supplement | 11
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facilitate coordination at the receiving location. Assets transported outside of DOT will not automatically
benefit from the unique capabilities offered through the DOT-shipped program. Assets in transit will not
be centrally tracked rerouting around damaged infrastructure, and special waivers and clearances must be
obtained individually. There will be no in-transit tracking of these movements.

F. Consistent with their functional responsibilities under the NRP, ESF#1 will coordinate the
movement of assets it is tasked to transport into, and out of, the incident scene. The primary source of
transportation services is the industry itself, administered through contracts. When necessary, the
Department of Defense (DOD) and other alternative transportation methods will be used.

(1) DOT will activate a 24/7 Emergency Transportation Center (ETC) that coordinates the
movement of supplies and resources via air, sea, and land transport. Movement of these materials
includes special handling of unique and unusually large size and quantities of equipment and
commodities. Types of items shipped include generators, automobiles, boom tucks, refrigerated trailers,
potable water tankers, construction equipment, medical supplies, hazardous materials (HAZMAT), utility
poles, support teams (e.g., Disaster Medical Assistance Team (DMAT), Disaster Mortuary Operational
Response Team (DMORT), Urban Search and Rescue (US&R)), passengers, and firearms for U.S.
Marshals. This service maintains a fully functional Continuity of Operations (COOP) site and regularly
participates in training and exercises.
(2) Shipments will be competitively contracted with a wide range of commercial
transportation operators based on the most cost efficient, effective, and productive mode and carrier.
Other Departments and Agencies possess their own transportation capabilities to meet their own
transportation needs or supplement the DOT-provided service as alternate resources. DOT will augment
response agency/activity capabilities, when and where necessary:

G. Assets will be picked up, in accordance with the Execution Schedule, at any location within
the mainland United States within 6 hours. Times will vary for operations outside the continental United
States (OCONUS) and for international movements.

H. DOT will provide emergency transportation services in all Presidential declared
emergencies/disasters or when it is determined to be in the Governments best interest to use these
services, including cases of an imminent threat or predeployment. Assets will be shipped to a
Mobilization Center or, when needed, shipped through to local distribution centers. When necessary,
DOT will expedite HAZMAT waivers and provide airspace clearances/waivers to facilitate transportation
of assets during emergencies.

I. Response efforts will require at least one Mobilization Center. Immediately upon
implementation of the NRP-CIS, an appropriate location for a Mobilization Center will be chosen.
FEMA Regions, in collaboration with their respective States, have identified tentative Mobilization
Center sites. Military bases may be available for use and, in most cases, possess adequate material
handling facilities. However, the types of incidents envisioned by the NRP-CIS may create conditions
that preclude the use of a nearby military installation as the Mobilization Center. Pre-identification of
acceptable Mobilization Center r sites in each State will result in speedier and more organized response
and logistical support activities.

(1) The NRCC, through its Movement Coordination Center (MCC), establishes and
maintains control of all logistics deployment operations until such control can be successfully transferred
to JFO. Until that point, logistics coordination will take place at the NRCC MCC.
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(2) Designated resources will begin flowing in accordance with the Execution Schedule
upon implementation of the NRP-CIS. Resource flow will be from the resource starting point/home
station to the Mobilization Center location identified by the NRCC, unless notified to proceed to Interim
Staging Area(s). An Interim Staging Area can be a formal site set up and staffed by logistics personnel,
or an informal location, such as a rest area along the route. The function of an Interim Staging Area is to
provide, as required, an intermediate, alternate deployment location in support of an organized and
efficient Mobilization Center reception operation. Resources arriving at the Mobilization Center will be
processed, but not released for employment until requested/directed by competent and appropriate
authority. Resources stopped at an Interim Staging Area will proceed to the Mobilization Center or
incident area, as appropriate, when directed by the MCC.
(3) Figure 1 reflects, in general terms, resource flow following NRP-CIS activation.
Figure 2 outlines the same flow information, but also reflects Assessment Points where the MCC (at
either the NRCC or JFO) will direct resources to the Mobilization Center, Interim Staging Area(s), or into
the incident area. Under this strategy:

(a) Resources will deploy in accordance with the Execution Schedule.
(b) Deployment will be to the Mobilization Center unless, at the first Assessment
Point, the resource is redirected by the MCC to an Interim Staging Area.
(c) If the resource has been stopped at an Interim Staging Area, the MCC will notify
that resource when and where to move to - either to the Mobilization Center or to another location in
direct support of the incident response.
(d) If the resource is at the Mobilization Center, the MCC will notify that resource
when and where to stage in direct support of the incident response.

(4) The Mobilization Center, including associated Interim Staging Areas, is an integral
component of the NRP-CIS concept of accelerated operations. DHS/FEMA Logistics maintains and
exercises overall responsibility for Mobilization Center operations, to include providing guidance and
direction regarding establishment, operations, and demobilization. ESF#7 (Resource Support and
Logistics Management) has the lead role for providing logistical team support and will mission-assign
necessary resources from supporting agencies (e.g., Incident Management Teams (IMTs) from the U.S.
Forest Service (USFS)). However, in accordance with the Execution Schedule, USFS will activate and
deploy IMTs to the designated Mobilization Center in advance of a direct mission assignment.
(5) The Mobilization Center Management Team (MCMT) provides the organizational
management structure for a Mobilization Center. Responsibilities include mission planning and direction,
coordination and liaison, external relations, safety planning and operations, and security planning and
operations. Upon NRP-CIS implementation, a MCMT will immediately activate and deploy (in
accordance with the Execution Schedule) to the designated Mobilization Center to bring it to operational
readiness as soon as possible.
(6) The Mobilization Center Group is a component of the MCMT; its organizational
structure (including associated Interim Staging Areas) will support the complexities and accelerated
response requirements of a catastrophic incident response, as outlined in the NRP-CIS. A heavy
Mobilization Center (with areas of responsibility assigned to the General Services Administration (GSA),
U.S. Army Corps of Engineers (USACE), and USFS) will be established at full staffing levels, with
augmented additional staffing at Interim Staging Areas. If necessary, a designated Interim Staging Area
site can be expanded into an additional Mobilization Center.

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Figure 1 ? NRP-CIS Resource Flow Concept of Operations
14 | Catastrophic Incident Supplement January 2005

Figure 2 ? NRP-CIS Resource Flow with Assessment Points
January 2005 Catastrophic Incident Supplement | 15
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(7) Standard resource flow is depicted in Figure 1. Figure 2 identifies assessment points
where the MCC (at either the NRCC or JFO) has the opportunity to make operational course adjustments
to deploying resources. The ability to execute flow adjustments at designated points during deployment
will ensure a smooth, organized Mobilization Center reception operation and ensure proper support of
arriving resources. Resource flow steps are listed below.

(a) The NRCC, through the MCC, will notify Resource Storage Centers to begin
deploying resources in accordance with the NRP-CIS Execution Schedule. The NRCC, in coordination
with Regional, State, and local officials will quickly determine the Mobilization Center location.
(b) The MCC will notify Federal Emergency Operations Centers (EOCs) of the
location of the Mobilization Center. Federal EOCs will notify Federal Resource Storage sites under their
control. Resources will subsequently be deployed to Mobilization Center(s) in accordance with the
Execution Schedule.
(c) The NRCC and MCC will continually monitor and assess resource flow
conditions to facilitate the safe, effective, and efficient movement of resources.
(d) Personnel, teams, equipment, and other resources will be deployed from starting
locations with instructions to proceed to the Mobilization Center. During this movement, the MCC will
decide whether conditions require a change in instructions. The MCC will contact the resource with
instructions to continue to the Mobilization Center or to proceed to an Interim Staging Area.
(e) Resources arriving at the Mobilization Center will be processed and prepared for
continued movement into the incident area. Resources arriving at an Interim Staging Area will await
further instructions from the MCC.
(f) Interim Staging Areas will be set up at primary points of arrival (e.g., specified
airports for resources traveling by air; primary ground transportation route sites to process resources
traveling overland). Transportation from both types of Interim Staging Area will be provided to the
Mobilization Center.
(g) Interim Staging Areas will also be set up along primary ground transportation
routes to handle incoming resources such as teams and equipment. There is currently no formal structure
for an Interim Staging Area; the only requirement is that staged resources have communication with the
MCC to receive further instruction. Once at an Interim Staging Area, the resource will not leave until
authorized by the MCC.
(h) MCC operational and logistical control will be transferred to the JFO as soon as
that activity is prepared to assume the mission.

(8) DOT, as lead for ESF#1 (Transportation), will assist in the assessment of transportation
requirements and provide transportation resources and authorities necessary to ensure the effective
movement of teams, equipment, and supplies. Refer to Appendix 11 for a detailed transportation strategy.

5. Catastrophic Response Inhibitors

A. The occurrence or threat of multiple catastrophic mass victim/mass care incidents may
significantly reduce the size, speed, and depth of the Federal response. If deemed necessary or prudent,
the Federal Government may:

16 | Catastrophic Incident Supplement January 2005
National Response Plan

(1) Reduce the availability or allocation of finite resources when multiple venues are
competing for the same resources.
(2) Withhold certain otherwise available resources in reserve as a hedge against additional
incidents.

B. Major disruptions to the transportation infrastructure, either at or near the incident venue or
occurring nationally, may significantly impede the timely deployment of Federal and Federally accessible
resources.

C. Large-scale civil disruption, either at or near the incident venue or occurring nationally, may
significantly impede the timely deployment of Federal and Federally accessible resources.
January 2005 Catastrophic Incident Supplement | 2-1
National Response Plan
National Response Plan ? Catastrophic Incident Supplement
Annex 1 ? Execution Schedule
Upon implementation of the National Response Plan Initial Catastrophic Incident Supplement (NRP-CIS)
by the Secretary of Homeland Security, responsible organizations will, unless specifically directed otherwise,
initiate the following actions appropriate to the Incident Type no later than the time indicated.

A. Unless indicated otherwise under the Action verbiage, the action reflects the time the action
will be initiated, not completed.

B. Bold actions/rows reflect resources that will deploy to or activate within or near the incident
area.

C. The term ALL when used under the Responsible Agency column refers to all Federal
Departments and Agencies to which the action applies, not necessarily all Federal Departments and
Agencies.

D. Where multiple but specific agencies are listed under the Responsible Agency column, the
corresponding Action Identifier is M.

E. Action Identification numbers are provided to facilitate quick reference.

F. Incident Types are as follows:
NH = Natural Hazards (Earthquake, Hurricane, Tsunami, Volcano, et al)
C = Chemical Incident
B = Biological Incident
R = Radiological Incident
N = Nuclear Incident
E = High-Explosive Incident

G. This annex contains two Execution Schedules. Schedule 1 is organized by time and
provides a sequential, chronological schedule of all actions to be taken. Schedule 2 is organized by
Responsible Agency.

A1-2 | Catastrophic Incident Supplement January 2005
National Response Plan

1. Schedule 1
Complete Execution Schedule Organized by Initiation Time
NH = Natural Hazards (Earthquake, Hurricane, Tsunami, Volcano, et al)
C = Chemical Incident, B = Biological Incident, R = Radiological Incident, 
N = Nuclear Incident, E = High-Explosive Incident
Incident Type
NH C B R N E

Initiation
Time
(no later
than)

Action

Responsible
Agency /

Support
Agency

Action
Identification

R N I+10
minutes Priority 4 activation of Emergency
Alert System (EAS). DHS DHS-1

NH C B R N E I+10
minutes
Activation of the Incident
Communications Emergency Plan
(ICEP).
DHS DHS-2

NH C B R N E I+10
minutes
Activate National Incident
Communications Conference Line
(NICCL).
DHS DHS-3

R N I+10
minutes
DHS Public Affairs coordinates first
release of information to public. DHS DHS-4

NH C B R N E I+10
minutes
Establish and maintain lines of
communication with State
authorities for incident venues.
DHS DHS-5

NH C B R R N E I+15
minutes
Activate and initiate deployment
actions for the on-alert Federal
Initial Response Support Team
(FIRST) and the on-alert National
Emergency Response Team
(ERT-N). Place all remaining
FIRSTs and ERT-Ns on full alert.
DHS DHS-6

NH C B R R N E I+15
minutes
Activate and initiate deployment
actions for the Mobilization
Center Management Team
(MCMT).
DHS DHS-7

NH C B R R N E I+15
minutes
Activate, at full staffing levels, the
IIMG, NRCC, all Headquarters
(HQ), and Regional Operations
Center(s) (ROCs) with incident
oversight. Activate all other ROCs
at watch staff levels.
ALL A-1

RN I+15
minutes
Implement protective actions that
correspond to a ?SEVERE?
condition under the Homeland
Security Advisory System (HSAS)
as directed by the Secretary of
Homeland Security.
ALL A-2

NH C B R R N E I+15
minutes
Activate the HHS Secretary?s
Emergency Response Team
(SERT).
HHS HHS-1

NH N E I+30
minutes
Activate Deployment of Urban
Search and Rescue (US&R)
Incident Support Team Cache.
DHS DHS-8

January 2005 Catastrophic Incident Supplement | 2-3
National Response Plan

Incident Type
NH C B R N E

Initiation
Time
(no later
than)

Action

Responsible
Agency /

Support
Agency

Action
Identification

NH C B R N E I+30
minutes
Activate Mobile Emergency
Response Support (MERS) to
deploy Life Support Vehicles and
MERS Emergency Operations
Vehicle to the affected area to
establish a temporary operating
location for the Principal Federal
Official (PFO) and support staff.
DHS DHS-9

NH N E I+30
minutes
If the incident involves collapsed
structures, activate and initiate
deployment actions for all onalert,
weapons of mass
destruction (WMD)-equipped
National US&R Task Forces and
Incident Support Teams (ISTs).
Activate and fully mobilize all
other WMD-equipped National
US&R assets in place. Place all
remaining National US&R Task
Forces and ISTs on full alert.
Deployment into the incident
area will be as directed by the
National Response Coordination
Center (NRCC).
DHS DHS-10

NH C B R N E I+30
minutes
Deploy appropriate Emergency
Support Function (ESF)#8
Regional resources (such as the
Regional Health Administrator)
to the Regional and State
Operations Centers.
HHS HHS-2

R N I+30
minutes
Close airspace in affected area (via
Temporary Flight Restrictions
(TFRs) and Notices to Airmen
(NOTAMs)). Coordinate ground
stops as necessary.
DOT DOT-1

NH C B R N E I+30
minutes
Activate on call roster of U.S Public
Health Service (PHS)
Commissioned Corps.
HHS HHS-3

NH R N  I+30
minutes
Initiate actions to immediately
deploy 1600 cots. DHS DHS-11

NH R N I+30
minutes
Initiate actions to immediately
deploy 3200 blankets. DHS DHS-12

NH R N I+30
minutes
Initiate actions to immediately
deploy 10,000 emergency heater
meals.
DHS DHS-13

NH R N I+30
minutes
Initiate actions to immediately
deploy 500 personal toilets with
privacy tents.
DHS DHS-14

NH R N I+30
minutes
Initiate actions to immediately
deploy 2200 daily restroom kits. DHS DHS-15

NH R N I+30
minutes
Initiate actions to immediately
deploy 500 personal wash kits. DHS DHS-16

NH R N I+30
minutes
Initiate actions to immediately
deploy 300 sleeping bags. DHS DHS-17

A1-4 | Catastrophic Incident Supplement January 2005
National Response Plan

Incident Type
NH C B R N E

Initiation
Time
(no later
than)

Action

Responsible
Agency /

Support
Agency

Action
Identification

NH R N  I+30
minutes
Initiate actions to immediately
deploy 100 tents (6-8 person). DHS DHS-18

NH I+30
minutes
Initiate actions to immediately
deploy 580 rolls of plastic
sheeting (20x100).
DHS DHS-19

NH R N I+30
minutes
Initiate actions to immediately
deploy 10,000 gallons of bottled
water.
DHS DHS-20

NH R N I+30
minutes
Initiate actions to immediately
deploy 16 mid-range generators. DHS DHS-21

NH R N I+30
minutes
Initiate actions to immediately
deploy 1million MREs. DHS DHS-22

NH R N  I+30
minutes
Initiate actions to immediately
deploy 180,000 gallons of water. DHS DHS-23

NH R N  I+30
minutes
Initiate actions to immediately
deploy ten 250-person Pre-
Positioned Disaster Supply
containers.
DHS DHS-24

NH R N E I+30
minutes
Initiate actions to immediately
deploy nine 500-person Pre-
Positioned Disaster Supply
containers.
DHS DHS-25

NH C B R N E I+40
minutes
Interagency conference call
develops initial communications
strategy and plan.
DHS DHS-26

NH C B R N E I+45
minutes
Activate the American Association
of Blood Banks Interorganizational
Task Force on Domestic Disasters
and Acts of Terrorism (AABB Task
Force) to assess current blood
supply levels throughout the
country.
HHS HHS-4

NH C B R N E I+1 hour
Designate a PFO, who will
assemble a support staff and
deploy to the affected area as
soon as possible.
DHS DHS-27

NH C B R N E  I+1 hour Activate Rapid Response Victim
Registry. HHS HHS-5

R N I+1 hour
Department of Energy (DOE)
Nuclear Incident Team (NIT)
Stands up at DOE Emergency
Operations Center (EOC).
DOE DOE-1

NH C B R N E I+1 hour Activate the National Disaster
Medical System (NDMS). DHS DHS-28

NH C R N E I+1 hour Activate the patient movement
portion of the NDMS.
DHS
HHS
VA
DOD
DOT
DHS-29

January 2005 Catastrophic Incident Supplement | 2-5
National Response Plan
Incident Type
N
H C B R N E
Initiation
Time
(no later
than)
Action
Responsible
Agency /
Support
Agency
Action
Identification

NH C B R N  I+1 hour
Coordinate stoppage of all noncritical
cargo and passenger rail,
maritime, and highway
transportation into affected
area/region.
DOT DOT-2

NH C B R N E I+1 hour
For each incident venue, designate
the nearest securable airfield
(military or civilian) unaffected by
the incident as the Federal
Mobilization Center.
DHS DHS-30

NH C B R N E  I+1 hour
Verify activation of Environmental
Protection Agency (EPA)
resources.
EPA EPA-1

NH C B R N  I+1 hour
Provide initial HHS-coordinated
public service announcement.
Coordinate and issue follow-on
announcements at frequent and
regular intervals.
DHS DHS-31

NH C B R N E  I+1 hour
Secretary DHS makes first senior
Federal announcement of incident
and response effort.
DHS DHS-32

NH C B R N E I+1 hour Activate Hospital Asset Reporting
and Tracking System (HARTS). HHS HHS-6

NH C B R N E I+1 hour
Activate a National Joint
Information Center (JIC) to
coordinate all response-related
press and media affairs.
DHS DHS-33

NH C B R N E I+1 hour DHS Public Affairs releases
updated nuclear incident advice. DHS DHS-34

 C B R N   I+1 hour Activate Public Affairs surge plans. DHS DHS-35

NH C B R N E  I+1 hours Establish Joint Information
Center (JIC) at incident site. DHS DHS-36

NH C B R N E  I+1 hours
Release updated incident and
information statement to general
public.
DHS DHS-37

NH C B R N E  I+2 hours
Commence transportation of
pre-identified Push Assets (refer
to Table 11-1).
DOT DOT-3

RN  I+2 hours Deploy Radiological Assistance
Program (RAP) Teams. DOE DOE-2

NH C B R N E I+2 hours
Activate and deploy Aviation
Resources as required by DHS,
USDA, or Department of the
Interior (DOI).
USDA USDA-1

NH C B R N E I+2 hours
Activate and deploy (through
coordination with the NRCC)
Incident Management Team(s)
(IMTs) to establish and
operationalize each Federal
Mobilization Center.
USDA USDA-2

A1-6 | Catastrophic Incident Supplement January 2005
National Response Plan

NH C B R N  I+2 hours
Inventory existing available shelter
space within a radius of 250 miles.
Inventory national food supply
stockpiles and their locations.
ARC ARC-1

NH C B R N E I+2 hours
Dispatch the Red Cross
(Internal) Critical Response
Team (CRT) to safe area near
affected area(s) to assist with
initial national response efforts.
ARC ARC-2

NH C B R N E I+2 hours
Assess mass care actions initiated
by local response entities and
determine additional resources
needed to provide necessary
services.
ARC ARC-3

NH C B R N E I+2 hours Activate all Red Cross disaster
response functions. ARC ARC-4

NH C B R N E I+2 hours
Activate WMD/T Response Guidelines
for all national HQ units, to
include Biomedical Services
Operations Center for blood
coordination.
ARC ARC-5

NH C B R N E I+2 hours
Place a significant number of Red
Cross Emergency Response
Vehicles (ERVs) on standby for
deployment to provide mobile
feeding.
ARC ARC-7

NH C B R N I+2 hours
Coordinate with Red Cross
Disaster Field Supply Centers to
begin movement of a significant
number of cots and blankets to
affected area(s).
ARC ARC-7

NH C B R N E I+2 hours
Coordinate with national voluntary
organizations and non-
Governmental organization (NGO)
partners to provide personnel and
equipment to support response
activities.
ARC ARC-8

NH C B R N E  I+2 hours
Deploy Red Cross kitchens and
other mobile feeding units to
Staging Areas, once identified in
safe area.
ARC ARC-9

NH C B R N E  I+2 hours
Activate and deploy Prepositioned
Equipment Program
Teams.
DHS DHS-38

NH C B R N E I+2 hours
Activate Deployment of ERT-N
Disaster Field Office (DFO)
equipment and support kits.
DHS DHS-39

NH C B R N E I+2 hours
Activate Deployment of one
NDMS Management Support
Team (MST) equipments cache.
DHS DHS-40

NH C B R N E I+2 hours
Begin Deployment of Emergency
Temporary Housing units into
affected area.
DHS DHS-41

January 2005 Catastrophic Incident Supplement | 2-7
National Response Plan

C B R N E  I+2 hours
Activate Deployment of
Domestic Emergency Support
Team (DEST) and equipment
cache.
DHS DHS-42

C R N  I+2 hours
Ascertain if decontamination
technical assistance resources
have been requested and are
engaged.
DHS DHS-43

C B R N E  I+2 hours
Obtain preliminary estimate of the
number of victims exposed to toxic/
hazardous substance(s),
preliminary material identification,
and source containment.
DHS DHS-44

NH C B R N E I+2 hours
Coordinate with the AABB Task
Force to identify supply levels at
the supporting medical facilities for
the incident. Activate supply
distribution plans for affected
region(s).
HHS HHS-7

NH C B R N E I+2 hours
Activate links to the private sector
(e.g., secure CEO COMLINK) and
request them, as appropriate, to
inventory and identify available
transportation assets, potential
mass shelter facilities, and medical
facilities, personnel, equipment,
and supplies.
DHS DHS-45

N I+2 hours Activate Continuity of Operations
(COOP) Plans. ALL A-3

NH C B R N E  I+2 hours
Deploy one (1) NDMS
Management Support Team
(MST).
DHS DHS-46

NH C B R N E I+2 hours
Deploy Defense Coordinating
Officer (DCO) and supporting
Defense Coordinating Element
(DCE) to JFO or Initial Operating
Facility (IOF).
DOD DOD-1

C B R N E  I+3 hours
Alert HQ Joint Task Force ? Civil
Support (JTF-CS) and
designated Initial Entry Forces
(IEFs). Deploy Command
Assessment Element (CAE) to
provide rapid mission
assessment in coordination with
Federal authorities. Pre-position
key IEF capabilities as required
based on assessment and
coordination with DHS.
DOD DOD-2

C B R N I+3 hours
Determine zones and boundaries
of contamination and advise all
response entities.
DHS DHS-47

NH C B R N  I+3 hours
Convene the NDMS Interagency
Planning Group and Medical Inter-
Agency Coordination Group
(MIACG).
DHS
HHS
VA
DOD
M-1

A1-8 | Catastrophic Incident Supplement January 2005
National Response Plan

NH C B R N E  I+3 hours
Send qualified representatives to
staff the IIMG at DHS HQ and/or
other interagency EOCs (e.g.,
Strategic Information and
Operations Center, NRCC, etc.), as
rostered or directed under the Plan.
ALL A-4

NH B R N I+3 hours
Review all non-critical cargo and
passenger aviation activities.
Inventory and make available cargo
and passenger aviation assets.
Report availability to the NRCC.
ALL A-5

NH C B R N I+3 hours
Provide assessment of
transportation system and
infrastructure to DHS HSOC and
FEMA NRCC.
DOT DOT-4

NH C B R N E I+3 hours
Alert ESF#3 Emergency Response
Teams and assets (water, power,
debris, housing, ice, deployable
tactical operations system).
USACE USACE-1

NH C B R N E  I+4 hours Activate deployment of IOF/DFO
equipment and support kits. DHS DHS-48

NH C B R N E  I+4 hours
Activate deployment of Federal
Mobilization Center Management
Team equipment kit.
DHS DHS-49

NH C B R N E  I+4 hours
Activate Deployment of
Individual Response Resource
(IRR) assets from all FEMA
Logistics Centers (includes cot,
tents, water, food and
emergency generators).
DHS DHS-50

NH C B R N E  I+4 hours Activate Deployment of NDMS
MST initial equipment cache. DHS DHS-51

R N I+4 hours Aerial Measurements System
(AMS) deployed. DOE DOE-3

R N I+4 hours
Nuclear Radiological Advisory
Team (NRAT) deploys with the
DEST.
DOE DOE-4

R N I+4 hours
Initiate FRMAC and deploy Consequence
Management
Response Team.
DOE DOE-5

C B R N EI+4 hours Deploy National Medical
Response Team (NMRT). DHS DHS-52

NH E I+4 hours
Activate deployment of field survey
support team and remote sensing
aircraft to incident area.
DOC DOC-1

NH C B R N E I+4 hours
Obtain Assistant Secretary for
Health (ASH) approval for the
AABB Task Force coordinated
public information announcement
regarding the adequacy and safety
of the Nation?s blood supply.
HHS HHS-8

NH C B R N E  I+4 hours Stand up Animal and Plant Health
Inspection Service (APHIS) EOC. USDA USDA-3

January 2005 Catastrophic Incident Supplement | 2-9
National Response Plan

NH C B R N E  I+4 hours Initiate/expedite actions to establish
a JFO. DHS DHS-53

NH C B R N E  I+4 hours Assess requirements for facility/
environmental decontamination. EPA EPA-2

NH C B R N E  I+4 hours Deploy the HHS SERT. HHS HHS-9

C B R N E  I+6 hours
Deploy three (3) NDMS Disaster
Medical Assistance Teams
(DMATs).
DHS DHS-54

C B R N E I+6 hours Activate Deployment of three (3)
NDMS DMAT equipment caches. DHS DHS-55

B I+6 hours
Activate and deploy EIS officers
and other staff to support epidemiological
investigations.
HHS HHS-10

NH C B R N I+6 hours Activate and deploy food safety
inspectors. HHS HHS-11

C B R N E I+6 hours Update estimates/actual reporting
of number of victims. HHS HHS-12

NH C B R N E I+6 hours Initiate action planning for facility/
environmental decontamination. EPA EPA-3

NH C B R N  I+6 hours
Update status of transportation
system and provide emergency
transportation management recommendations
to DHS. Continue
updates as necessary.
DOT DOT-5

C B R N E  I+6 hours
Ascertain extent of success of
initial/gross decontamination and
containment activities.
DHS DHS-56

NH C R N I+6 hours
Inventory and identify (to the
NRCC) all large-space facilities/
structures within 250 miles of the
incident venue(s) that could be
made available as temporary
shelters, temporary morgues, or to
support mass casualty medical
operations.
ALL A-6

C B R N I+6 hours
Ascertain extent of contaminated
victim access to medical treatment
facilities and impact on operational
status.
DHS
HHS M-2
C R N I+6 hours
Assess local emergency public
information activities regarding
victim decontamination and engage
consultation if adjustments appear
necessary.
DHS DHS-57

NH C B R N E  I+6 hours
Verify need for additional
monitoring equipment at medical
treatment facilities and shelters and
ensure necessary logistics actions
are initiated.
DHS DHS-58

A1-10 | Catastrophic Incident Supplement January 2005
National Response Plan

NH C B R N E  I+6 hours
Deploy ESF#3 Emergency
Response Teams and assets
(water, power, debris, housing,
ice, deployable tactical
operations system).
USACE USACE-2

C B R N I+12 hours
Deploy and deliver appropriate
Strategic National Stockpile
(SNS) initial push-packages to a
Federal Mobilization Center or
other designated reception
location.
DHS
HHS M-3

NH C B R N E  I+12 hours Deploy on-call roster of PHS
Commissioned Corps. HHS HHS-13

C B I+12 hours
Identify laboratories that could be
used to support diagnostic activity
for agent of concern.
ALL A-7

NH C B R N E  I+12 hours
Inventory and report on (to the
NRCC) the availability and
functionality status of all Plansupporting
teams and resources.
Identify any deficiencies or limiting
factors in planned capability.
ALL A-8

NH C B R N E I+12 hours
Activate all PHS Commissioned
Corps rosters. Deploy
environmental health officers from
the PHS Commissioned Corps as
liaisons to the HHS SERT.
HHS HHS-14

NH C B R N E  I+12 hours
All NDMS medical facilities
inventory and report bed availability
to Federal Coordinating Facilities.
DHS
HHS
DOD
VA
M-4

C B R N E  I+12 hours Deploy two (2) NDMS NMRTs. DHS DHS-59

C B R N E I+12 hours Activate Deployment of two (2)
NDMS NMRT equipment caches. DHS DHS-60

NH C B R N E  I+12 hours
Deploy two (2) NDMS Veterinary
Medical Assistance Teams
(VMATs).
DHS DHS-61

NH C B R N E  I+16 hours
Locate owners of, and available
apartments in Federally funded
multifamily housing to provide
shelter to emergency response
personnel proximal to the incident
venue.
USDA USDA-4

NH C B R N E  I+18 hours
NDMS hospitals prepare to begin
receiving evacuated patients from
affected areas.
DHS
DOD
VA
HHS
M-5

C B R N E  I+24 hours Deploy eleven (11) NDMS
DMATs. DHS DHS-62

C B R N E  I+24 hours Deploy two (2) NDMS DMORTs. DHS
HHS M-6

C B R N E  I+24 hours
Activate deployment of eleven
(11) NDMS DMAT equipment
caches.
DHS DHS-63

January 2005 Catastrophic Incident Supplement | 2-11
National Response Plan

C B R N E  I+24 hours
Activate Deployment of two (2)
NDMS DMORT deployable
morgue units.
DHS DHS-64

NH C B R N E  I+24 hours
Activate Deployment of one (1)
full NDMS MST equipment
cache.
DHS DHS-65

NH C B R N E  I+24 hours Deploy a medical regulating
team. DOD DOD-3

NH C B R N E  I+24 hours
Release public messages providing
information on how to apply for
individual assistance.
DHS DHS-66

NH C B R N E  I+24 hours
Department of Veterans Affairs
(VA) Primary Receiving Centers
(PRCs) within 500 miles of an
incident venue prepare to terminate
non-critical medical services and
redirect available resources for
receipt of patients at VA medical
facilities, as required and directed
by applicable authority.
VA VA-1

NH R N I+24 hours Deploy additional 1600 cots to
arrive within 48 hours. DHS DHS-67

NH R N I+24 hours Deploy additional 3200 blankets
to arrive within 48 hours. DHS DHS-68

NH R N I+24 hours
Deploy additional 10,000
emergency heater meals to
arrive within 48 hours.
DHS DHS-69

NH R N I+24 hours
Deploy additional 500 personal
toilets with privacy tents to
arrive within 48 hours.
DHS DHS-70

NH R N I+24 hours
Deploy additional 2200 daily
restroom kits to arrive within 48
hours.
DHS DHS-71

NH R N I+24 hours
Deploy additional 500 personal
wash kits to arrive within 48
hours.
DHS DHS-72

NH R N I+24 hours Deploy additional 300 sleeping
bags to arrive within 48 hours. DHS DHS-73

NH R N I+24 hours Deploy additional 100 tents (6-8
person) to arrive within 48 hours. DHS DHS-74

NH Deploy additional 580 rolls of
plastic sheeting (20x100) to
arrive within 48 hours.
DHS DHS-75

NH R NI+24 hours
Deploy additional 10,000 gallons
of bottled water to arrive within
48 hours.
DHS DHS-76

NH R N I+24 hours
Deploy additional 16 mid-range
generators to arrive within 48
hours.
DHS DHS-77

NH R N I+24 hours Deploy additional 1million MREs
to arrive within 48 hours. DHS DHS-78

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National Response Plan

NH R N I+24 hours
Deploy additional 180,000
gallons of water to arrive within
48 hours.
DHS DHS-79

NH R N I+24 hours
Deploy additional ten 250-person
Pre-Positioned Disaster Supply
containers to arrive within 48
hours.
DHS DHS-80

NH R N I+24 hours
Deploy additional nine 500-
person Pre-Positioned Disaster
Supply containers to arrive
within 48 hours.
DHS DHS-81

C B R N I+36 hours
Assess short-term medical
treatment needs of incident area
population and evacuees and
deploy follow-on medical support
packages from SNS.
HHS
DHS M-7

NH C B R N E  I+36 hours
Patient evacuation initiated.
Patient Federal patient movement
established through DOD
TRACES2 system.
DHS
HHS
DOD
GSA
DOT
ARC
M-8

NH C B R N E  I+48 hours Send veterinary team to evaluate
situation. USDA USDA-5

NH C B R N E  I+48 hours Determine animal/livestock
disposal options. USDA USDA-6

NH R N I+48 hours Deploy additional 1600 cots to 
arrive within 72 hours. DHS DHS-82

NH R N  I+48 hours Deploy additional 3200 blankets
to arrive within 72 hours. DHS DHS-83

NH R N  I+48 hours
Deploy additional 10,000
emergency heater meals to
arrive within 72 hours.
DHS DHS-84

NH R N I+48 hours
Deploy additional 500 personal
toilets with privacy tents to
arrive within 72 hours.
DHS DHS-85

NH R N  I+48 hours
Deploy additional 2200 daily
restroom kits to arrive within 72
hours.
DHS DHS-86

NH R N  I+48 hours
Deploy additional 500 personal
wash kits to arrive within 72
hours.
DHS DHS-87

NH R N  I+48 hours Deploy additional 300 sleeping
bags to arrive within 72 hours. DHS DHS-88

NH R N  I+48 hours Deploy additional 100 tents (6-8
person) to arrive within 72 hours. DHS DHS-89

NH I+48 hours
Deploy additional 580 rolls of
plastic sheeting (20x100) to
arrive within 72 hours.
DHS DHS-90

NH R N  I+48 hours
Deploy additional 10,000 gallons
of bottled water to arrive within
72 hours.
DHS DHS-91

January 2005 Catastrophic Incident Supplement | 2-13
National Response Plan

NH R N  I+48 hours
Deploy additional 16 mid-range
generators to arrive within 72
hours.
DHS DHS-92

NH R N  I+48 hours Deploy additional 1million MREs
to arrive within 72 hours. DHS DHS-93

NH R N  I+48 hours
Deploy additional 180,000
gallons of water to arrive within
72 hours.
DHS DHS-94

NH R N  I+48 hours
Deploy additional ten 250-person
Pre-Positioned Disaster Supply
containers to arrive within 72
hours.
DHS DHS-95

NH R N  I+48 hours
Deploy additional nine 500-
person Pre-Positioned Disaster
Supply containers to arrive
within 72 hours.
DHS DHS-96

NH C B R N E I+72 hours Deploy all PHS Commissioned
Corps rosters. HHS HHS-15

C B R N E I+72 hours
Begin backfill of Pre-Positioned
Disaster Supplies (PPDS)
containers.
DHS DHS-97

NH C B R N E  I+72 hours Activate all PHS Commissioned
Corps deployable assets. HHS HHS-16

NH C B R N E  I+72 hours Establish crisis-counseling plan. DHS DHS-98

NH C B R N  I+96 hours
The national response coordination
group will devise a national animal,
plant, and health surveillance plan.
USDA USDA-7

NH C B R N  I+96 hours Determine animal/livestock
treatment and vaccine options. USDA USDA-8

NH C B R N E I+96 hours Assess housing needs. DHS DHS-99

NH C B R N E I+96 hours Establish housing plan. DHS DHS-100
NH C B R N E I+96 hours Establish donations strategy and
voluntary agency plan. DHS DHS-101
A1-14 | Catastrophic Incident Supplement January 2005
National Response Plan

2. Schedule 2
Complete Execution Schedule Organized by Responsible Agency

NH = Natural Hazards (Earthquake, Hurricane, Tsunami, Volcano, et al)
C = Chemical Incident, B = Biological Incident, R = Radiological Incident, 
N = Nuclear Incident, E = High-Explosive Incident

Incident Type
NH C B R N E

Initiation
Time
(no later
than)

Action
Responsible
Agency /

Support
Agency

Action
Identification

NH C B R N E I+15
minutes
Activate, at full staffing levels, the
Interagency Incident Management
Group (IIMG), National Response
Coordination Center (NRCC), all
Headquarters (HQ) and Regional
Operation Center(s) (ROC) with
incident oversight. Activate all
other ROCs at watch staff levels.
ALL A-1

R N I+15
minutes
Implement protective actions that
correspond to a ?SEVERE?
condition under the Homeland
Security Advisory System (HSAS)
as directed by the Secretary of
Homeland Security.
ALL A-2

N I+2 hours Activate Continuity of Operations
(COOP) Plans. ALL A-3

NH C B R N E I+3 hours
Send qualified representatives to
staff the IIMG at U.S. Department
of Homeland Security (DHS) HQ
and/or other interagency
Emergency Operations Centers
(EOCs) (e.g., Strategic Information
and Operations Center (SIOC),
NRCC, etc.), as rostered or
directed under the Plan.
ALL A-4

NH C R N I+3 hours
Review all non-critical cargo and
passenger aviation activities.
Inventory and make available cargo
and passenger aviation assets.
Report availability to the NRCC.
ALL A-5

NH C R N I+6 hours
Inventory and identify (to the
NRCC) all large-space facilities/
structures within 250 miles of the
incident venue(s) that could be
made available as temporary
shelters, temporary morgues, or to
support mass casualty medical
operations.
ALL A-6

C B I+12 hours
Identify labs that could be used to
support diagnostic activity for agent
of concern.
ALL A-7

NH C B R N E I+12 hours
Inventory and report on (to the
NRCC) the availability and
functionality status of all Plansupporting
teams and resources.
Identify any deficiencies or limiting
factors in planned capability.
ALL A-8

January 2005 Catastrophic Incident Supplement | 2-15
National Response Plan

Multiple Responsible Agencies

NH C B R N I+3 hours
Convene the NDMS Interagency
Planning Group and Medical Inter-
Agency Coordination Group
(MIACG).
DHS
HHS
VA
DoD
M-1

C B R N I+6 hours
Ascertain extent of contaminated
victim access to medical treatment
facilities and impact on operational
status.
DHS
HHS M-2

C B R N I+12 hours
Deploy and deliver appropriate
Strategic National Stockpile
(SNS) initial push-packages to a
Federal Mobilization Center or
other designated reception
location.
DHS
HHS M-3

NH C B R N EI+12 hours
All NDMS medical facilities
inventory and report bed availability
to Federal Coordinating Facilities.
DHS
HHS
DOD
VA
M-4

NH C B R N E I+18 hours
NDMS hospitals prepare to begin
receiving evacuated patients from
affected areas.
DHS
DOD
VA
HHS
M-5

C B R N E I+24 hours Deploy two (2) NDMS DMORTs. DHS
HHS M-6

C B R N  I+36 hours
Assess short-term medical
treatment needs of incident area
population and evacuees and
deploy follow-on medical support
packages from SNS.
HHS
DHS M-7

NH C B R N E I+36 hours
Patient evacuation initiated.
Patient Federal patient movement
established through DOD
TRACES2 system.
DHS
HHS
DOD
GSA
DOT
ARC
M-8

A1-16 | Catastrophic Incident Supplement January 2005
National Response Plan

American Red Cross

NH C B R N  I+2 hour
Inventory existing available shelter
space within a radius of 250 miles.
Inventory national food supply
stockpiles and their locations.
ARC ARC-1

NH C B R N E I+2 hours
Dispatch the Red Cross
(Internal) Critical Response
Team (CRT) to safe area near
affected area(s) to assist with
initial national response efforts.
ARC ARC-2

NH C B R N E I+2 hours
Assess mass care actions initiated
by local response entities and
determine additional resources
needed to provide necessary
services.
ARC ARC-3

NH C B R N EI+2 hours Activate all Red Cross disaster
response functions. ARC ARC-4

NH C B R N E I+2 hours
Activate WMD/T Response
Guidelines for all national HQ units,
to include Biomedical Services
Operations Center for blood
coordination.
ARC ARC-5

NH C B R N EI+2 hours
Place a significant number of Red
Cross Emergency Response
Vehicles on standby for
deployment to provide mobile
feeding.
ARC ARC-6

NH C B R N I+2 hours
Coordinate with Red Cross
Disaster Field Supply Centers to
begin movement of a significant
number of cots and blankets to
affected area(s).
ARC ARC-7

NH C B R N E I+2 hours
Coordinate with national voluntary
organizations and NGO partners to
provide personnel and equipment
to support response activities.
ARC ARC-8

NH C B R N E I+2 hours
Deploy Red Cross kitchens and
other mobile feeding units to
Staging Areas, once identified in
safe area.
ARC ARC-9

January 2005 Catastrophic Incident Supplement | 2-17
National Response Plan

U.S. Department of Agriculture

NH C B R N E I+2 hours
Activate and deploy Aviation
Resources as required by DHS,
USDA, or Department of the
Interior (DOI).
USDA USDA-1

NH C B R N EI+2 hours
Activate and deploy (through
coordination with the NRCC)
Incident Management Team(s) to
establish and operationalize
each Federal Mobilization
Center.
USDA USDA-2

NH C B R N EI+4 hours Stand up APHIS EOC. USDA USDA-3

NH C B R N E I+16 hours
Locate owners of, and available
apartments in Federally funded
multifamily housing to provide
shelter to emergency response
personnel proximal to the incident
venue.
USDA USDA-4

NH C B R N E I+48 hours Send veterinary team to evaluate
situation. USDA USDA-5

NH C B R N E I+48 hours Determine animal/livestock
disposal options. USDA USDA-6

NH C B R N  I+96 hours
The national response coordination
group will devise a national animal,
plant, and health surveillance plan.
USDA USDA-7

NH C B R N  I+96 hours Determine animal/livestock
treatment and vaccine options. USDA USDA-8

Department of Commerce

NH E I+4 hours
Activate deployment of field survey
support team and remote sensing
aircraft to incident area.
DOC DOC-1

Department of Defense

NH C B R N E I+2 hours Deploy DCO and supporting DCE
to JFO or IOF. DOD DOD-1

C B R N E I+3 hours
Alert HQ JTF-CS and designated
Initial Entry Forces (IEF). Deploy
Command Assessment Element
(CAE) to provide rapid mission
assessment in coordination with
Federal authorities. Pre-position
key IEF capabilities as required
based on assessment and
coordination with DHS.
DOD DOD-2

NH C B R N E I+24 hours Deploy a medical regulating
team. DOD DOD-3

A1-18 | Catastrophic Incident Supplement January 2005

Department of Energy

R N I+1 hour DOE Nuclear Incident Team (NIT)
Stands up at DOE EOC. DOE DOE-1

R N I+2 hours Deploy Radiological Assistance
Program Teams. DOE DOE-2

R N I+4 hours Aerial Measurements System
(AMS) deployed. DOE DOE-3

R N I+4 hours
Nuclear Radiological Advisory
Team (NRAT) deploys with the
DEST.
DOE DOE-4

R N I+4 hours
Initiate FRMAC and deploy
Consequence Management
Response Team.
DOE DOE-5
Department of Health and Human Services

NH C B R N E I+15
minutes
Activate the HHS Secretary?s
Emergency Response Team. HHS HHS-1

NH C B R N E I+30
minutes
Deploy appropriate ESF#8
Regional resources (such as the
Regional Health Administrator)
to the Regional and State
Operations Centers.
HHS HHS-2

NH C B R N E I+30
minutes
Activate on call roster of PHS
Commissioned Corps. HHS HHS-3

NH C B R N E I+45
minutes
Activate the American Association
of Blood Banks Interorganizational
Task Force on Domestic Disasters
and Acts of Terrorism (AABB Task
Force) to assess current blood
supply levels throughout the
country.
HHS HHS-4

NH C B R N E I+1 hour Activate Rapid Response Victim
Registry. HHS HHS-5

NH C B R N E I+1 hour Activate Hospital Asset Reporting
and Tracking System (HARTS). HHS HHS-6

NH C B R N EI+2 hours
Coordinate with the AABB Task
Force to identify supply levels at
the supporting medical facilities for
the incident. Activate supply
distribution plans for affected
region(s).
HHS HHS-7

NH C B R N E I+4 hours
Obtain ASH approval for the AABB
Task Force coordinated public
information announcement
regarding the adequacy and safety
of the Nation?s blood supply.
HHS HHS-8

January 2005 Catastrophic Incident Supplement | 2-19
National Response Plan

NH C B R N E I+4 hours
Deploy the HHS Secretary?s
Emergency Response Team
(SERT).
HHS HHS-9

B I+6 hours
Activate and deploy EIS officers
and other staff to support
epidemiological investigations.
HHS HHS-10

NH C B R N  I+6 hours Activate and deploy food safety
inspectors. HHS HHS-11

C B R N E I+6 hours Update estimates/actual reporting
of number of victims HHS HHS-12

NH C B R N E I+12 hours
Deploy on call roster of U.S.
Public Health Service (PHS)
Commissioned Corps.
HHS HHS-13

NH C B R N E I+12 hours
Activate all PHS Commissioned
Corps rosters. Deploy
environmental health officers from
the PHS Commissioned Corps as
liaisons to the HHS SERT.
HHS HHS-14

NH C B R N E I+72 hours Deploy all PHS Commissioned
Corps rosters. HHS HHS-15

NH C B R N E I+72 hours Activate all PHS Commissioned
Corps deployable assets. HHS HHS-16

Department of Homeland Security

R N I+10
minutes
Priority 4 activation of Emergency
Alert System (EAS). DHS DHS-1

NH C B R N E I+10
minutes
Activation of the Incident
Communications Emergency Plan
(ICEP).
DHS DHS-2

NH C B R N E I+10
minutes
Activate National Incident
Communications Conference Line
(NICCL).
DHS DHS-3

R N I+10
minutes
DHS Public Affairs coordinates first
release of information to public. DHS DHS-4

NH C B R N E I+10
minutes
Establish and maintain lines of
communication with state
authorities for incident venues.
DHS DHS-5

NH C B R N E I+15
minutes
Activate and initiate deployment
actions for the on-alert Federal
Initial Response Support Team
(FIRST) and the on-alert National
Emergency Response Team
(ERT-N). Place all remaining
FIRSTs and ERT-Ns on full alert.
DHS DHS-6

NH C B R N E I+15
minutes
Activate and initiate deployment
actions for the Mobilization
Center Management Team
(MCMT).
DHS DHS-7

A1-20 | Catastrophic Incident Supplement January 2005
National Response Plan

NH N E I+30
minutes
Activate Deployment of Urban
Search and Rescue (US&R)
Incident Support Team Cache.
DHS DHS-8

NH C B R N E I+30
minutes
Activate Mobile Emergency
Response Support (MERS) to
deploy Life Support Vehicles and
MERS Emergency Operations
Vehicle to the affected area in
order to establish a temporary
operating location for the PFO
and support staff.
DHS DHS-9

NH N E I+30
minutes
If the incident involves collapsed
structures, activate and initiate
deployment actions for all
on-alert, WMD-equipped National
US&R Task Forces and Incident
Support Teams. Activate and
fully mobilize all other WMDequipped
National US&R assets
in place. Place all remaining
National US&R Task Forces and
ISTs on full alert. Deployment
into the incident area will be as
directed by the NRCC.
DHS DHS-10

NH R N I+30
minutes
Initiate actions to immediately
deploy 1600 cots. DHS DHS-11

NH R N I+30
minutes
Initiate actions to immediately
deploy 3200 blankets. DHS DHS-12

NH R N I+30
minutes
Initiate actions to immediately
deploy 10,000 emergency heater
meals.
DHS DHS-13

NH R N I+30
minutes
Initiate actions to immediately
deploy 500 personal toilets with
privacy tents.
DHS DHS-14

NH R N I+30
minutes
Initiate actions to immediately
deploy 2200 daily restroom kits. DHS DHS-15

NH R N I+30
minutes
Initiate actions to immediately
deploy 500 personal wash kits. DHS DHS-16

NH R N I+30
minutes
Initiate actions to immediately
deploy 300 sleeping bags. DHS DHS-17

NH R N I+30
minutes
Initiate actions to immediately
deploy 100 tents (6-8 person). DHS DHS-18

NH I+30
minutes
Initiate actions to immediately
deploy 580 rolls of plastic
sheeting (20x100).
DHS DHS-19

NH R N I+30
minutes
Initiate actions to immediately
deploy 10,000 gallons of bottled
water.
DHS DHS-20

NH R N I+30
minutes
Initiate actions to immediately
deploy 16 mid-range generators. DHS DHS-21

NH R N I+30
minutes
Initiate actions to immediately
deploy 1million MREs. DHS DHS-22

January 2005 Catastrophic Incident Supplement | 2-21
National Response Plan

NH R N I+30
minutes
Initiate actions to immediately
deploy 180,000 gallons of water. DHS DHS-23

NH R N I+30
minutes
Initiate actions to immediately
deploy ten 250-person Pre-
Positioned Disaster Supply
containers.
DHS DHS-24

NH R N I+30
minutes
Initiate actions to immediately
deploy nine 500-person Pre-
Positioned Disaster Supply
containers.
DHS DHS-25

NH C B R N E I+40
minutes
Interagency conference call
develops initial communications
strategy and plan.
DHS DHS-26

NH C B R N E I+1 hour
Designate a Principal Federal
Official (PFO), who will assemble
a support staff and deploy to the
affected area as soon as
possible.
DHS DHS-27

NH C B R N E I+1 hour Activate the National Disaster
Medical System (NDMS). DHS DHS-28

NH C R N E I+1 hour Activate the patient movement
portion of the NDMS.
DHS
HHS
VA
DOD
DOT
DHS-29

NH C B R N E I+1 hour
For each incident venue, designate
the nearest securable airfield
(military or civilian) unaffected by
the incident as the Federal
Mobilization Center.
DHS DHS-30

NH C B R N I+1 hour
Provide initial HHS-coordinated
public service announcement.
Coordinate and issue follow-on
announcements at frequent and
regular intervals.
DHS DHS-31

NH C B R N E I+1 hour
Secretary DHS makes first senior
Federal announcement of incident
and response effort.
DHS DHS-32

NH C B R N E I+1 hour
Activate a National Joint
Information Center (JIC) to
coordinate all response-related
press and media affairs.
DHS DHS-33

NH C B R N E I+1 hour DHS Public Affairs releases
updated nuclear incident advice. DHS DHS-34

C B R N  I+1 hour Activate Public Affairs surge plans. DHS DHS-35

NH C B R N E I+1 hours Establish JIC at incident site. DHS DHS-36

NH C B R N E I+1 hours
Release updated incident and
information statement to general
public.
DHS DHS-37

NH C B R N E I+2 hours
Activate and deploy Prepositioned
Equipment Program
Teams.
DHS DHS-38

A1-22 | Catastrophic Incident Supplement January 2005
National Response Plan

NH C B R N E I+2 hours
Activate Deployment of National
Emergency Response Team
(ERT-N)/ Disaster Field Office
equipment and support kits.
DHS DHS-39

NH C B R N E I+2 hours
Activate Deployment of one
NDMS Management Support
Team (MST) equipments cache
DHS DHS-40

NH C B R N E I+2 hours
Begin Deployment of Emergency
Temporary Housing units into
affected area
DHS DHS-41

C B R N E I+2 hours
Activate Deployment of
Domestic Emergency Support
Team (DEST) and equipment
cache.
DHS DHS-42

C R N I+2 hours
Ascertain if decontamination
technical assistance resources
have been requested and are
engaged.
DHS DHS-43

C B R N E I+2 hours
Obtain preliminary estimate of the
number of victims exposed to toxic/
hazardous substance(s),
preliminary material identification,
and source containment.
DHS DHS-44

NH C B R N E I+2 hours
Activate links to the private sector
(e.g., secure CEO COMLINK) and
request them, as appropriate, to
inventory and identify available
transportation assets, potential
mass shelter facilities, and medical
facilities, personnel, equipment,
and supplies.
DHS DHS-45

NH C B R N E I+2 hours
Deploy one (1) NDMS
Management Support Team
(MST).
DHS DHS-46

C B R N I+3 hours
Determine zones and boundaries
of contamination and advise all
response entities.
DHS DHS-47

NH C B R N EI+4 hours Activate deployment of IOF/DFO
equipment and support kits. DHS DHS-48

NH C B R N E I+4 hours
Activate Deployment of Federal
Mobilization Center Management
Team equipment kit.
DHS DHS-49

NH C B R N E I+4 hours
Activate deployment of
Individual Response Resource
(IRR) Assets from all FEMA
Logistics Centers (Includes cot,
tents, water, food, and
emergency generators).
DHS DHS-50

NH C B R N E I+4 hours Activate deployment of NDMS
MST initial equipment cache. DHS DHS-51

C B R N E I+4 hours Deploy NMRT. DHS DHS-52

NH C B R N E I+4 hours Initiate/expedite actions to establish
a JFO. DHS DHS-53

January 2005 Catastrophic Incident Supplement | 2-23
National Response Plan

C B R N E I+6 hours Deploy three (3) NDMS DMATs. DHS DHS-54

C B R N E I+6 hours Activate deployment of three (3)
NDMS DMAT equipment caches. DHS DHS-55

C B R N E I+6 hours
Ascertain extent of success of
initial/gross decontamination and
containment activities.
DHS DHS-56

C R N I+6 hours
Assess local emergency public
information activities regarding
victim decontamination and engage
consultation if adjustments appear
necessary.
DHS DHS-57

NH C B R N E I+6 hours
Verify need for additional
monitoring equipment at medical
treatment facilities and shelters and
ensure necessary logistics actions
are initiated.
DHS DHS-58

C B R N E I+12 hours Deploy two (2) NDMS NMRTs. DHS DHS-59

C B R N E I+12 hours Activate deployment of two (2)
NDMS NMRT equipment caches. DHS DHS-60

NH C B R N E I+12 hours
Deploy two (2) NDMS Veterinary
Medical Assistance Teams
(VMATs).
DHS DHS-61

 C B R N E I+24 hours Deploy eleven (11) NDMS
DMATs. DHS DHS-62

 C B R N E I+24 hours
Activate deployment of eleven
(11) NDMS DMAT equipment
caches.
DHS DHS-63

 C B R N E I+24 hours
Activate deployment of two (2)
NDMS DMORT deployable
morgue units.
DHS DHS-64

NH C B R N E I+24 hours
Activate Deployment of one (1)
full NDMS MST equipment
cache.
DHS DHS-65

NH C B R N E I+24 hours
Release public messages providing
information on how to apply for
individual assistance.
DHS DHS-66

NH R N I+24 hours Deploy additional 1600 cots to
arrive within 48 hours. DHS DHS-67

NH R N I+24 hours Deploy additional 3200 blankets
to arrive within 48 hours. DHS DHS-68

NH R N I+24 hours
Deploy additional 10,000
emergency heater meals to
arrive within 48 hours.
DHS DHS-69

NH R N I+24 hours
Deploy additional 500 personal
toilets with privacy tents to
arrive within 48 hours.
DHS DHS-70

NH R N I+24 hours
Deploy additional 2200 daily
restroom kits to arrive within 48
hours.
DHS DHS-71

A1-24 | Catastrophic Incident Supplement January 2005
National Response Plan

NH R N I+24 hours
Deploy additional 500 personal
wash kits to arrive within 48
hours.
DHS DHS-72

NH R N I+24 hours Deploy additional 300 sleeping
bags to arrive within 48 hours. DHS DHS-73

NH R N I+24 hours Deploy additional 100 tents (6-8
person) to arrive within 48 hours. DHS DHS-74

NH I+24 hours
Deploy additional 580 rolls of
plastic sheeting (20x100) to
arrive within 48 hours.
DHS DHS-75

NH R N I+24 hours
Deploy additional 10,000 gallons
of bottled water to arrive within
48 hours.
DHS DHS-76

NH R N I+24 hours
Deploy additional 16 mid-range
generators to arrive within 48
hours.
DHS DHS-77

NH R N I+24 hours Deploy additional 1million MREs
to arrive within 48 hours. DHS DHS-78

NH R N I+24 hours
Deploy additional 180,000
gallons of water to arrive within
48 hours.
DHS DHS-79

NH R N I+24 hours
Deploy additional ten 250-person
Pre-Positioned Disaster Supply
containers to arrive within 48
hours.
DHS DHS-80

NH R N I+24 hours
Deploy additional nine 500-
person Pre-Positioned Disaster
Supply containers to arrive
within 48 hours.
DHS DHS-81

NH R N I+48 hours Deploy additional 1600 cots to
arrive within 72 hours. DHS DHS-82

NH R N I+48 hours Deploy additional 3200 blankets
to arrive within 72 hours. DHS DHS-83

NH R N I+48 hours
Deploy additional 10,000
emergency heater meals to
arrive within 72 hours.
DHS DHS-84

NH R N I+48 hours
Deploy additional 500 personal
toilets with privacy tents to
arrive within 72 hours.
DHS DHS-85

NH R N I+48 hours
Deploy additional 2200 daily
restroom kits to arrive within 72
hours.
DHS DHS-86

NH R N I+48 hours
Deploy additional 500 personal
wash kits to arrive within 72
hours.
DHS DHS-87

NH R N I+48 hours Deploy additional 300 sleeping
bags to arrive within 72 hours. DHS DHS-88

NH R N I+48 hours Deploy additional 100 tents (6-8
person) to arrive within 72 hours. DHS DHS-89

January 2005 Catastrophic Incident Supplement | 2-25
National Response Plan

NH I+48 hours
Deploy additional 580 rolls of
plastic sheeting (20x100) to
arrive within 72 hours.
DHS DHS-90

NH R N I+48 hours
Deploy additional 10,000 gallons
of bottled water to arrive within
72 hours.
DHS DHS-91

NH R N I+48 hours
Deploy additional 16 mid-range
generators to arrive within 72
hours.
DHS DHS-92

NH R N I+48 hours Deploy additional 1million MREs
to arrive within 72 hours. DHS DHS-93

NH R N I+48 hours
Deploy additional 180,000
gallons of water to arrive within
72 hours.
DHS DHS-94

NH R N I+48 hours
Deploy additional ten 250-person
Pre-Positioned Disaster Supply
containers to arrive within 72
hours.
DHS DHS-95

NH R N I+48 hours
Deploy additional nine 500-
person Pre-Positioned Disaster
Supply containers to arrive
within 72 hours.
DHS DHS-96

C B R N E I+72 hours
Begin Backfill of Pre-Positioned
Disaster Supplies (PPDS)
containers.
DHS DHS-97

NH C B R N E  I+ 72 hours Establish crisis-counseling plan. DHS DHS-98

NH C B R N E  I+96 hours Assess housing needs. DHS DHS-99

NH C B R N E  I+96 hours Establish housing plan. DHS DHS-100

NH C B R N E  I+96 hours Establish donations strategy and
voluntary agency plan. DHS DHS-101

Department of Transportation

R N I+30
minutes
Close airspace in affected area (via
TFRs and NOTAMs). Coordinate
ground stops as necessary.
DOT DOT-1

NH C B R N  I+1 hour
Coordinate stoppage of all noncritical
cargo and passenger rail,
maritime and highway
transportation into affected
area/region.
DOT DOT-2

NH C B R N E  I+2 hours
Commence transportation of
pre-identified Push Assets (refer
to Table 11-1).
DOT DOT-3

NH C B R N E  I+3 hours
Provide assessment of
transportation system and
infrastructure to DHS HSOC and
FEMA NRCC.
DOT DOT-4

A1-26 | Catastrophic Incident Supplement January 2005
National Response Plan

NH C B R N  I+6 hours
Update status of transportation
system and provide emergency
transportation management
recommendations to DHS.
Continue updates as necessary.
DOT DOT-5

Department of Veterans Affairs

NH C B R N E I+24 hours
VA Primary Receiving Centers
(PRCs) within 500 miles of an
incident venue prepare to terminate
non-critical medical services and
redirect available resources for
receipt of patients at VA medical
facilities, as required and directed
by applicable authority.
VA VA-1

Environmental Protection Agency

NH C B R N E I+1 hour Verify activation of EPA resources. EPA EPA-1

NH C B R N E I+4 hours
Assess requirements for
facility/environmental
decontamination.
EPA EPA-2

NH C B R N E I+6 hours
Initiate action planning for
facility/environmental
decontamination.
EPA EPA-3

U.S. Army Corps of Engineers (DOD)

NH C B R N EI+3 hours
Alert ESF#3 Emergency Response
Teams and assets (water, power,
debris, housing, ice, deployable
tactical operations system).
USACE USACE-1

NH C B R N EI+6 hours
Deploy ESF#3 Emergency
Response Teams and assets
(water, power, debris, housing,
ice, deployable tactical
operations system).
USACE USACE-2

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National Response Plan ? Catastrophic Incident Supplement
Annex 2 ? Transportation Schedule

1. The Transportation response will be provided in two broad categories. The first is the immediate
movement of pre-identified teams, equipment, and personnel to a Mobilization Center or centers. The
second category involves the movement of specifically requested assets into or from the affected area.
Transportation services will continue until the affected infrastructure returns to self-sufficiency.
2. Immediate  Push Items (Dispatched during first 48 hours of incident): Assets that will be
transported automatically without any request from State or local authorities. These include Emergency
Response Teams (ERTs), equipment, and other supplies. Movement of these assets will be sequenced to
arrive at the incident Mobilization Center(s) in an appropriate order and quantity. These assets are
summarized in the following table. DOT maintains a separate listing of all assets in Table 2-1 that
provide detailed coordination, locality, cargo, and contact information to facilitate the movement of these
assets.

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TABLE 2-1 Push Assets

Appendix 1 ? Basic Planning Assumptions
1. A catastrophic event or attack may occur with little or no warning.

2. The nature and scope of a catastrophic incident attack will initiate an immediate Federal response.

3. The majority of deployment-dependent Federal response resources are not likely to provide
significant lifesaving or life-sustaining capabilities until 18 to 36 hours after the event. However,
Regional Federal capabilities (hospitals, specialists, etc.) can begin providing critical support almost
immediately.

4. State and local response capabilities will be quickly overwhelmed; movement of casualties
throughout the area of operations will pose a significant challenge.

5. There will be a significant shortage response and casualty/evacuee reception capabilities, equipment,
and pharmaceuticals.

6. Adequate water supplies (both potable and non-potable to drive air conditioning systems) will be
compromised. Similarly, loss of city power will be only partially met by auxiliary power sources.
Lack of adequate water and power will impose significant issues for the population and operational
limitations on hospitals and blood centers.

7. Depletion of medical supplies and pharmaceuticals will significantly stress the Nations industrial
base and its ability to rapidly meet national resource requirements.
8. Blood supplies will be severely taxed and significant Regional shortages could occur within short
order after an event has occurred. Blood manufacturing, infectious disease testing, and distribution
of tested blood will be problematic.

9. Due to potentially unforeseen delays in the identification of a non-naturally occurring
epidemiological event, detection of disease outbreaks may not occur until large numbers of victims
are affected, particularly when the agent has a long incubation period.

10. Patient transportation to and from airheads and medical treatment facilities (MTFs) will be
problematic due to excessive congestion on local roads and limited patient movement alternatives
(e.g., rotary wing lift).

11. Emergency protective actions recommended to the public will likely be without the benefit of
detailed assessment data.

12. There will be significant issues regarding environmental health (e.g., air quality and food safety) and
public health (e.g., sanitation, housing, animal health) needs, including mental health services.

13. Public anxiety related to the catastrophic incident will require effective risk communication and may
require mental health and substance abuse services.
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14. A non-detected/recognized biological release spares the physical infrastructure but results in a
uniformly exposed population that is likely to create an overwhelming demand on medical
resources. However, the physical infrastructure may require decontamination.

15. A nuclear detonation will significantly degrade and potentially destroy initial local emergency
response management, medical, and public health capabilities.

16. Non-Federal hospitals of the National Disaster Medical System (NDMS), as well as Department of
Veterans Affairs (VA) Primary Receiving Centers (PRCs) and Department of Defense (DOD) MTFs
are authorized to provide definitive care to casualties of a catastrophic mass casualty incident.

17. The assets identified in the response strategy may not be available at the time of a catastrophic event
due to needs at their home institutions, family requirements, etc.

18. Neighboring States/jurisdictions will be reluctant or resistant to accepting patients that are
contaminated or infectious.

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National Response Plan ? Catastrophic Incident Supplement

Appendix 2 ? Inventory of Federal Response Teams
Chart

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National Response Plan ? Catastrophic Incident Supplement
Appendix 3 ? Mass Care Response Overview
1. Mission
Mass Care coordinates Federal assistance in support of Regional, State, and local efforts to meet the mass
care needs of victims of a disaster. This Federal assistance will support the delivery of mass care services
of shelter, feeding, and emergency first aid to disaster victims; the establishment of systems to provide
bulk distribution of emergency relief supplies to disaster victims; and the collection of information to
operate a Disaster Welfare Information (DWI) system to report victim status and assist in family
reunification.
2. Planning Assumptions
A. The American Red Cross (ARC) is designated a primary agency for Emergency Support
Function (ESF) #6 (Mass Care, Housing, and Human Services) with the lead for mass care. In this role,
the ARC mission is to coordinate Federal mass care assistance and support when a disaster event exceeds
the resources and capacity of State and local responders.
B. ARC also independently provides mass care services to disaster victims as part of a broad
program of disaster relief, and as outlined in charter provisions enacted by Congress  Act of January
1905 (36 United States Code (U.S.C.) Section 3001, et seq.). The responsibilities assigned to ARC as the
co-primary agency for ESF#6 at no time will supersede those responsibilities assigned to the ARC by its
congressional charter.
C. The ARC is assigned support agency responsibilities for ESF#8 (Public Health and Medical
Services) by the National Response Plan (NRP). These responsibilities center on augmenting certain
health and medical service response activities as requested by the primary ESF#8 agency, the Department
of Health and Human Services (HHS). HHS also provides support to ARC for the mass care portion of
ESF#6.
D. Significant disruption of the affected areas infrastructure, particularly power, transportation,
and communications systems, may occur. This will hinder the ability of responders to initiate and
accomplish emergency, restoration, and recovery actions in a timely manner.
E. The U.S. Department of Homeland Security (DHS) will likely raise the Homeland Security
Advisory System (HSAS) to red status immediately following a terrorist attack for designated areas, if
not the entire Nation. Depending on the location, scope, and magnitude of the event, this elevated status
can prompt actions limiting the availability of air transportation within the United States. Such travel
limitations can negatively impact the timely convergence, at the disaster-affected area, of needed
personnel and material resources.
F. As a result of the incident, many local emergency personnelpaid and volunteerthat
normally respond to disasters may be dead, injured, involved with family concerns, or otherwise unable to
reach their assigned posts.
G. Depending on the nature of the event, a catastrophic disaster will cause a substantial need for
mass sheltering and feeding within, near, and beyond the disaster-affected area.
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H. State and local resources will immediately be overwhelmed; therefore, Federal assistance will
be needed immediately.
I. Extensive self-directed population evacuations may also occur with families and individuals
traveling throughout the United States to stay with friends and relatives outside the affected area.
J. Populations likely to require mass care services include the following:
(1) Primary victims (with damaged or destroyed homes)
(2) Secondary and tertiary victims (denied access to homes)
(3) Transients (visitors and travelers within the affected area)
(4) Emergency workers (seeking feeding support, respite shelter(s), and lodging)
NOTE: There will also be a need for interpreters to provide assistance in communicating with non-
English speaking populations.
K. In the initial phase (hours and days) of a catastrophic disaster, organized and spontaneous
sheltering will occur simultaneously within and at the periphery of the affected area as people leave the
area. Additional congregate sheltering may be required for those evacuating to adjacent population
centers.
L. The wide dispersal of disaster victims will complicate Federal Government assistance
eligibility and delivery processes for extended temporary housing, tracking, and need for registering the
diseased, ill, injured, and exposed.
M. More people will initially flee and seek shelter from terrorist attacks involving chemical,
biological, radiological, nuclear, or high-yield explosive (CBRNE) agents than for natural catastrophic
disaster events. They will also exhibit a heightened concern for the health-related implications related to
the disaster agent.
N. Long-term sheltering, interim housing, and the mass relocation of affected populations may be
required for incidents with significant residential damage and/or contamination. (Refer to Appendix 10
for information on catastrophic housing.)
O. Substantial numbers of trained mass care specialists and managers will be required for an
extended period of time to augment local responders and to sustain mass care sheltering and feeding
activities.
P. Timely logistical support to shelters and feeding sites will be essential and required for a
sustained period of time. Food supplies from the U.S. Department of Agriculture (USDA) positioned at
various locations across the country will need to be accessed and transported to the affected area in a
timely manner.
Q. Close liaison and coordination with numerous voluntary and non-Governmental organizations
(NGOs) will be necessary on the national, Regional, State, and local levels.
R. Service delivery to affected populations by voluntary agencies and NGOs will occur in
locations deemed safe by appropriate Government officials.
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S. Public safety, health, and contamination monitoring expertise will be needed at shelters
following CBRNE events. Measures to ensure food and water safety will be necessary following CBRNE
events, and the general public will also need to be reassured concerning food and water safety.
T. Immediately following major CBRNE events, decontamination facilities may not be readily
available in all locations during the early stages of self-directed population evacuations. Unaware
contaminated persons therefore may seek entry to shelters. These facilities may, as a result, become
contaminated, adversely affecting resident health and general public trust.
U. Public health and medical care in shelters will be a significant challenge as local Emergency
Medical Services (EMS) resources and medical facilities will likely be overwhelmed quickly. The
deployment of public health and medical personnel and equipment to support medical needs in shelters
will need to be immediate and sustained by HHS. (Refer to Appendix 6 for information on medical
support activities.)
V. Shelters will likely experience large numbers of elderly with specific medication requirements
and other evacuees on critical home medical care maintenance regimens. (Refer to Appendix 6 for
information on medical support activities.)
W. Significant numbers of special needs shelters will likely be required as nursing homes and
other similar care facilities are rendered inoperable and are unable to execute their evacuation mutual aid
plans and agreements with other local facilities. ARC will coordinate with HHS in these situations.
X. DWI may be a priority concern for family members throughout the United States.
Y. Family reunification within the affected area will be an immediate and significant concern as
many family members may be separated at the time of the event.
Z. Transient populations within the affected areas, such as tourists, students, and foreign visitors
will require assistance.
AA. There will be an immediate and sustained need for the bulk distribution of relief supplies.
Requirements will depend on the nature of and human needs produced by the incident.
BB. The DHS Private Sector desk will coordinate incident response and recovery support from the
private sector.
CC. Criteria for identifying and validating priority needs will need to be established immediately.
DD. Populations with the resources to help themselves will be encouraged to take independent
action.
EE. Spontaneous volunteers and donations management will require significant attention
immediately following the event. If not promptly and appropriately managed, attention to this activity
will demand the diversion of resources away from service delivery.
FF. Significant, additional logistical support and coordination and public information systems will
be required whenever a shelter in place or a quarantine order is implemented.
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GG. Coordinated, accurate, timely public information will be required immediately to inform the
public of appropriate protective and self-care actions. ARC will support activities at Joint Information
Centers (JICs).
HH. Accurate and timely information over time must be distributed to the affected populations to
control rumors and assuage anxiety related to the event. This activity will be particularly important
following CBRNE-related events.
II. Mental health services will be sought by victims and responders in and near the affected area,
as well as (on a lesser scale) throughout the Nation. ARC will coordinate activities with HHS.
JJ. If decontamination is ongoing during the early stages of a catastrophic incident, persons
undergoing decontamination will have logistical, medical, and mental health needs that will need to be
addressed quickly.
KK. Red Cross staff will have access to needed medications/vaccinations made available to other
response personnel providing services.
3. Catastrophic Response Strategy
A. Response Strategy: IMMEDIATE.
(1) Assumptions
(a) Immediate response activities will focus on meeting urgent mass care needs of
victims in safe areas. There will be an increased emphasis on contamination, safety, and security issues
for CBRNE events.
(b) In coordination with State, Tribal, and local officials, determinations will be
made on the scope of the event and need for additional resources to provide mass care services.
(c) Local ARC chapters and other entities, which provide mass care services at the
local level, will initiate shelter and feeding activities in or near the impacted area, depending on the nature
of the event. (Sheltering will include organized sheltering efforts as well as ad hoc shelters formed by
community organizations and groups and spontaneous shelters established by evacuating residents.)
(d) Adjacent communities need to be prepared to deal with significant numbers of
fleeing persons from the affected area. These host communities will also need significant mass care
support.
(e) ARC chapters will be immediately augmented (in the form of additional
personnel, materials, and equipment deployed to the disaster area) by Red Cross Service Areas and
national headquarters. (Refer to Annex 1  Execution Schedule.)
(f) ESF#6 (Mass Care, Housing, and Human Services) operational cells will be
established at the Federal Emergency Management Agency (FEMA) Regional Response Coordination
Center(s) (RRCC) and DHS/FEMAs National Response Coordination Center (NRCC). Assessments for
resource support to the disaster-affected area will be promptly conducted. The receipt of Federal
Government support in the form of personnel, material, and equipment will be in accordance with the
NRP.
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(g) Contact and coordination will immediately proceed with other voluntary
organizations and NGOs. Available resources will be numerated and promptly applied to identified needs
and requirements.
(h) HHS will ensure the provision of blood/blood products and public messaging
blood supply safety through coordination with the American Association of Blood Banks Task Force on
Domestic Disasters and Acts of Terrorism (AABB Inter-Organizational Task Force).
B. Response Strategy: FIRST 10 DAYS.
(1) Assumptions
(a) Mass care services are at peak activity and in coordination with other voluntary
organizations, NGOs, ESF#6 support Federal agencies, and State and local governments. The location
and related information for all actual and potential shelters within a 250-mile radius is determined (as well
as can be established) and communicated to appropriate authorities and the public. Additionally,
logistical support is in place to meet the mass care needs of persons in all shelters, those sheltered
in-place, and residents of quarantined quarters.
(b) Full coordination with DHS and other Federal Departments/Agencies related to
mass care services. Information flows uninterrupted between agencies at the Federal level. Problem area
and resolution action information is exchanged promptly and routinely.
(c) Planning is under way with DHS/FEMA and other agencies regarding the prompt
relocation of people beyond the affected area. This strategy will address the significant logistical
requirements of supporting thousands of sheltered people in an otherwise difficult environment for
prolonged periods of time. This will also allow the affected areas infrastructure to be repaired and rebuilt
without placing additional strain on severely stressed resources. Relocation outside the affected area may
also be required because of limited available local housing stock and the long-term decontamination of
the disaster affected area.
(d) Ongoing work with HHS and other Federal Agencies will continue to ensure that
public health and medical care personnel and equipment are on site where needed.
(e) Liaison and coordination continues at the national level with FEMA, HHS, and
the Department of Defense (DOD).
(f) Coordination is under way with the DHS Private Sector desk to draw upon
additional resources for mass care support from the private sector. (Refer to Appendix 13 for information
on private sector activities.)
(g) Public information is provided via the ARC National Call Center, ARC public
Web site, and local chapters across the Nation. Health information is coordinated closely with the
Centers for Disease Control and Prevention (CDC), HHS, and other agencies as appropriate.
(h) The Coordinated Assistance Network (CAN) client information sharing system is
initiated by non-Governmental relief organizations to support relief activities. This system will enable
sharing of client information among identified participating relief agencies, but only under the strictest
standards of confidentiality and only with appropriate client approval.
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(i) DWI and family reunification services continue; collaboration proceeds with
HHS and the National Disaster Medical System (NDMS) regarding casualty and patient information for
the DWI system.
(j) Support efforts for ESF#8 activities are underway, as required.
(2) Primary Areas of Concern
(a) Shelter
i. Additional sheltering capability at levels beyond which currently exists
within the Red Cross system will need to be identified immediately if information is not readily available
from partners and Government entities.
ii. The safety and integrity of shelters is of paramount importance in order to
ensure that victims will use shelters. If decontamination is required for an incident, Federal, State, and
local assets must work with the Red Cross and other entities providing shelter to ensure that persons
entering shelters are free from contamination. Additionally, persons must be free from communicable
diseases and not exhibiting symptoms of an agent-related sickness.
(b) Food
i. Distribution of food within the affected area will require a substantial
logistical effort and may be complicated by the disruption of transportation systems within the affected
area and/or raising the HSAS to red.
ii. Special dietary considerations will need to be integrated into meal planning
at shelters as soon as possible.
(c) Other Human Needs
i. Human needs will need to be met on a significant scale in a catastrophic
disaster. These include such items as showers, toiletry items, bedding, diapers, and clothing.
ii. The ability to obtain large quantities of these items may be affected by
just-in-time supply strategies of major manufacturers and the nature of the event.
(d) Medical
i. Persons in shelters requiring medical care must receive appropriate medical
assistance from appropriate medical entities as soon as possible.
ii. Special needs persons will be a significant challenge during a catastrophic
disaster.
(3) Strategies
(a) Shelter. To ensure all victims are sheltered quickly and safely in the immediate
aftermath of a catastrophic event, the Red Cross will use all sheltering capability in its jurisdiction to meet
initial needs, as well as work with partner agencies to ensure all sheltering needs are met.
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i. Experience indicates that many persons fleeing an affected area will seek
shelter with relatives or stay in a hotel/motel, depending on their financial situation. However, a
significant number of persons will seek shelter in traditional shelter facilities.
ii. Ad hoc or spontaneous shelters may be established in the immediate
aftermath of the catastrophic incident and will need to be integrated into the official mass care response
activities as soon as possible.
iii. Depending on the nature of the event, the safety and integrity of shelters
may come into play. If decontamination is required for an incident, Federal, State, and local assets must
work to ensure that persons entering shelters are free from contamination prior to entry. Additionally,
persons entering shelters must be free from communicable diseases and not exhibiting symptoms of an
agent-related sickness.
iv. The Red Cross will work with Federal partners to ensure that as many
persons as possible are moved from shelters to interim housing situations within 30 to 45 days of an
event. It is likely, however, that many shelters will not be able to close for up to 90 days (or longer) after
the event. Since all shelters are not necessarily suitable to be used for long-term sheltering, this may
prove a significant problem.
(b) Food. The Red Cross will use significant internal assets, as well as work with
partner agencies under existing Memorandums of Understanding (MOUs), to meet the significant feeding
requirements a catastrophic incident will entail. This includes reliance on feeding equipment, such as
large kitchens, being brought into or near the affected area by such organizations as the Southern Baptists
and Salvation Army. Additionally, work with the USDA and private sector vendors, under existing
Standard Operating Procedures (SOPs) and MOUs at the national, State, and local level, is anticipated on
a significant scale.
(c) Other Human Needs. Meeting the human needs of significant numbers of
people will necessitate close, timely, and sustained collaboration with private sector vendors during the
recovery phase.
i. Bulk distribution of items will need to be accomplished quickly at central
locations. Needed items will include shower accessories such as towels, washcloths, toiletry items,
bedding, diapers, and clothing. The management of donated goods will be coordinated with the DHS
Private Sector desk.
ii. Special dietary considerations will need to be rapidly integrated into meal
planning at shelters.
iii. Management of peoples expectations will need to be quickly addressed,
and include timely and frequent dissemination of accurate information about what is happening. Family
reunification issues and Disaster Welfare Inquiries will also need to be quickly dealt with.
(d) Medical. Ensure that persons requiring medical care receive appropriate medical
assistance as soon as possible to include evaluating requirements and developing strategies for coping
with special needs evacuees and providing medical support to emergency shelters. The Red Cross will
work closely with local EMS and Federal partners through HHS to address these needs and ensure that
proper medical care is given as soon as possible.
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C. Response Strategy: SUSTAINED and TRANSITION.
(1) Sustained Strategy
(a) Mass care services are provided as needed; ongoing collaboration and
coordination continues with Federal, State, and local officials.
(b) Efforts continue with DHS/FEMA to enable execution of interim, alternate longterm
temporary and permanent housing strategies, and the provision of other Federal assistance. (Refer to
Appendix 10 for housing strategy.)
(c) Family resettlement actions and services will take on an increased momentum.
(2) Transition Strategy. Within 2 weeks of the catastrophic incident, the Red Cross and
DHS/FEMA will jointly develop a plan for transportation of persons in shelters out of the affected area
and into interim housing situations. This will require close coordination with the Department of
Transportation (DOT). Shelterees requiring medical attention, or special needs shelter(s) populations,
will be given priority in leaving the area. This will involve close coordination with HHS.
4. Transportation and Logistical Requirements
A. Transportation needs include the ability to move mobile feeding units into and near the
affected area quickly. These units include Red Cross Emergency Response Vehicles (ERVs), large
kitchens, and feeding units from other voluntary organizations and NGOs. Additionally, communications
vehicles and logistical support trucks must be moved in a rapid manner.
B. The transportation of needed mass care and support workers from around the country must be
accomplished quickly and sustained over time.
C. Material requirements will include but are not limited to the procurement and transportation of
cots, blankets, and other feeding and shelter supplies beyond those available from Red Cross and other
NGOs; the procurement and transport of food, including USDA commodities; and bulk distribution of
relief supplies from various venders and points across the country.
D. Procurement and distribution of potable water and ice to support the individual shelters and
feeding sites. Potable water and ice distribution will also be required for individuals who are able to
continue residing in their homes, but are without safe drinking water.
E. Portable showers and sanitation units at the individual shelter and feeding sites.
F. Possible transportation of residents requiring relocation beyond the affected area.
G. In the event of electrical power disruption, power generation support will be required for the
shelters and particularly the food preparation, storage, and feeding sites.
H. Portable food containers will be required at the food preparation and feeding sites.
I. Public safety and security personnel will be required at the larger shelters and to routinely
patrol shelters, food preparation sites, and fixed feeding stations. The Red Cross may augment with
private security, if needed.
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J. Transportation and allied logistics systems will need to be established within the incident area.
Moreover, linkages would be required, outside the affected area, with adjacent staging and marshalling
sites.
K. Information on venders, products, and services will need to be available on a real-time basis.
L. Transportation and other linkages need to be established with in-kind donation sites and
warehouses and mass care facilities within and near the incident area.
M. Each shelter will need to provide residents with access to telecommunication services.
5. Response Limitations and Unique Concerns
A. Refer to planning assumptions in Section 2 of this appendix.
B. The lack of a real-time national database reflecting all potential shelters for geographic areas
around major metropolitan areas poses a significant problem for mass care response activities during a
catastrophic incident.
C. Many metropolitan areas view mass care activities, especially sheltering, as a short-term
problem and have not developed plans for potential long-term shelter situations or coordinated plans
across geographic areas. This will pose significant challenges for mass care response activities at the time
of a catastrophic incident.
D. Lack of significant numbers of trained mass care specialists and managers will hinder effective
mass care response activities, as it is estimated that 30,000 mass care staff will be needed to provide
services for 300,000 displaced persons over extended periods of time.
6. Response Capabilities
A. Organic. In accordance with its assigned responsibilities as the primary agency for ESF#6
(Mass Care, Housing, and Human Services), the ARC has an organizational structure to support mass care
activities, which includes:
(1) Formal liaison and coordination with Federal, Regional, State, Tribal, and local
authorities for disaster planning preparedness and response.
(2) Ongoing planning, collaboration, and operational relationships with the following
Federal Agencies and private sector organizations: DHS, Interagency Incident Management Group
(IIMG) and NRCC; HHS, including the CDC; and the American Association of Blood Banks (AABB).
The ARC also supports FEMA RRCCs.
(3) Nearly 900 chapters responsible for implementing initial disaster response activities in
collaboration and cooperation with their local Government disaster response counterparts.
(4) Regional Red Cross Service Areas that provide technical guidance and resource support
to disaster affected chapters in coordination with Red Cross national headquarters.
(5) The 24/7 Disaster Operations Center (DOC) at the ARC national headquarters in
Washington, DC, routinely initiates major relief operations in support of field units, and coordinates
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related ARC activities with Federal Departments and Agencies. The DOC directs the nationwide
movement of personnel, materials, and equipment to major disaster affected areas. This includes:
(a) Critical Response Team (CRT). Specialized all-hazards trained teams of ARC
personnel who deploy immediately to major disaster affected areas. These teams support and enhance the
efforts of affected ARC chapters and integrate the introduction and application of external personnel,
material, and equipment resources.
(b) Disaster Services Human Resources (DSHR). Over 26,000 trained disaster
response personnel, resident nationwide, who can assist with major disaster relief operations and support
initial local chapter response activities.
(c) Logistics Support Network. Features a fleet of more than 300 ERVs prepositioned
nationwide to provide mobile feeding; two large mobile kitchens; ten mobile satellite (voice
and data) communications vehicles; five Local Area Network (LAN)-based field deployable automated
systems, ten Disaster Field Supply Centers (warehouses) with more than 50,000 stored cots and blankets,
feeding equipment, disaster victim hygiene kits, and home cleanup kits.
(d) The ability to activate Statements of Understanding (SOUs) between ARC with
43 national organizations that have signed SOUs and MOUs with ARC to support disaster relief
activities.
(6) The Biomedical Services Operations Center (BSOC) in Washington, DC, coordinates
Red Cross Blood Services operations, handling approximately half the Nations blood supply. The BSOC
coordinates with the AABB Inter-Organizational Task Force and HHS concerning blood availability and
public messaging regarding the safety and availability of the Nations blood supply.
B. Non-Organic (Collaborative). Includes voluntary organizations, NGOs, and private sector
entities with which ARC has written MOUs/SOUs to provide assistance at the time of a disaster. Certain
organizations may provide services in more than one area. For example, the Teamsters assist with finding
facilities and also provide volunteers to work in shelters. The list of current MOU/SOU partners includes
but is not limited to the following:
(1) Food and Shelter Assistance
(a) North American Mission Board of Southern Baptists
(b) The Salvation Army
(c) Americas Second Harvest
(d) Church of Jesus Christ of Latter Day Saints
(e) Woodmen of the World Insurance Society
(f) National Restaurant Association
(g) American School Food Service Association
(2) Additional Mass Care Volunteer Assistance
(a) Corporation of National and Community Service (CNCS)
(b) National Urban League
(c) Faith-based partners, such as Catholic Charities and Church World Service
(d) U.S. Jaycees
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(3) Transportation Assistance
(a) Civil Air Patrol
(b) Amtrak
(c) Federal Express (FedEx)
(4) Child Care Assistance. Church of the Brethren
(5) Mental Health Assistance
(a) American Psychological Association
(b) National Mental Health Association
(c) American Counseling Association
(d) American Psychiatric Association
(e) Various Associations for Chaplains of varying denominations
(f) National Association of Social Workers
(g) Association of Marriage and Family Therapists
(6) Facilities Procurement
(a) International Brotherhood of Teamsters
(b) International Brotherhood of Painters and Allied Trades
(c) Faith-based partners
(7) Technical Assistance
(a) American Radio Relay League
(b) Humane Society of the United States
(c) American Veterinary Medical Foundation
(d) National Funeral Directors Association
(e) National Foundation for Mortuary Care
(f) American Society of Civil Engineers
(g) National Voluntary Organizations Active in Disaster (NVOAD)
7. Responsibilities
A. ARC Responsibilities as Coordinating Agency for ESF#6 (Mass Care, Housing, and
Human Services)
(1) Shelter. Provide temporary congregate shelters to displaced individuals or persons
denied access to their homes by the disaster incident. This will involve the use of the pre-identified
facilities and facilities secured during and immediately following the incident. Sheltering will occur both
within and outside the disaster-affected area.
(2) Feeding. Provide prepared meals and food items to the disaster-affected area residents
in need. This may include a combination of fixed feeding sites, mobile feeding units, and the bulk
distribution of food. While the feeding and other logistical support for emergency workers is the
responsibility of their employing agency or organization, emergency workers will have access to feeding
sites within the disaster-affected area.
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(3) Emergency First Aid. Provided to victims and workers at mass care facilities and at
designated sites within or around the incident area. This service will be supplemental to the emergency
health and medical care services established and managed by Government and medical authorities. This
service consists of basic first aid review and referral to appropriate medical personnel and facilities. The
ARC will not provide direct medical care to victims/workers. Direct medical care is addressed under
Medical Support in Appendix 6.
(4) Disaster Welfare Information. Information on well-being will be collected from
individuals residing within the affected area and provided, with their approval, to immediate family
members located outside the affected area. The DWI system, managed by the ARC, will also be used to
aid in reunification of family members separated at the time of the incident. A reverse DWI system
will also be deployed. It will allow affected area residents in shelters to directly contact immediate family
members outside the affected area using a telephone.
(5) Bulk Distribution of Emergency Relief Items. Sites will be established within or near
the incident area for the general distribution of relief items to meet urgent disaster victim needs.
B. Support Agency Responsibilities to ESF#6 (Mass Care, Housing, and Human Services)
(1) U.S. Department of Homeland Security (DHS). FEMA will identify temporary
housing, and provide NDMS assets to help assist with medical care in shelters. The Red Cross will also
work with the DHS Private Sector desk, State and local desk, Public Affairs desk, and others as
appropriate.
(2) Department of Health and Human Services (HHS). Specifically, U.S. Public Health
Service (PHS) Commissioned Corps deployable assets to provide medical care in shelters.
(3) Department of Defense (DOD). Provide requested logistical support, as approved by
the Secretary of Defense.
(4) U.S. Department of Agriculture (USDA). Coordinate food stockpile locations and
identify for movement to incident areas.
(5) Department of Housing and Urban Development (HUD). Coordinate temporary
shelter and long-term housing assistance.
(6) Department of Veterans Affairs (VA). Provide food preparation and storage in its
facilities nationwide; provide medical supplies, mental health practitioners, and other personnel to
shelters; and offer facilities as possible shelter sites. Provide professional mental health staff to augment
local and Red Cross resources.
(7) U.S. Army Corps of Engineers (USACE). Provide, via contract, potable water and ice
to incident area(s) in need; also, inspect shelters for structural suitability and provide assistance in
constructing temporary shelters, if necessary.
(8) General Services Administration (GSA). Provide procurement and contracting
services and assistance based on defined mass care requirements. Also provide communications links
between the Disaster Welfare Inquiry Center (DWIC) and incident area.
(9) U.S. Postal Service (USPS). Provide change of address cards for victims who are
relocating, as well as provide an electronic file of address change information.
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Appendix 4 ? Search and Rescue Response Overview
1. Mission
Search and Rescue provides technical support (personnel and equipment) to assist in the location and
extraction of individuals from collapse and water rescue events.
2. Planning Assumptions
A. Terrorist employment of nuclear or high explosive weapons of mass destruction (WMD) will
create catastrophic devastation of buildings and physical structures in densely populated urban areas. As
a result, there will be a need to conduct Urban Search and Rescue (US&R) operations to locate surviving
victims.
B. Given that US&R is extremely time sensitive, initial operations will be undertaken by State
and local responders and those volunteer personnel willing to assist in locating victims. If the
catastrophic incident involves collapsed buildings, national US&R task force response assets will
immediately deploy in accordance with the Catastrophic Incident Response Execution Schedule (Annex
1). The goal will be to have full task forces on the scene and operational within 24 hours of occurrence.
C. Federal US&R assets are under the control of the U.S. Department of Homeland Security
(DHS)/Federal Emergency Management Agency (FEMA) and will be activated and deployed to support
the US&R mission. This would include the activation of an overhead US&R Incident Support Team
(IST) to assist with the integration and coordination of national US&R task forces with the local incident
command system. Federal US&R assets possess organic supplies and equipment to conduct the US&R
mission, which includes conducting limited defensive operations and victim decontamination in a
chemical, biological, radiological, nuclear, or high-yield explosive (CBRNE) contaminated environment.
D. DHS/FEMA will, in coordination with the Department of State (DOS), U.S. Agency for
International Development (USAID), Office of Foreign Disaster Assistance, coordinate the use and
employment of international search and rescue assets/resources if the level of response will overwhelm
our national capability.
E. The doctrine of do no additional harm will apply to all US&R operations. Search and rescue
personnel will take into consideration the danger of contamination and unstable physical structures before
entering into an area that may contain surviving victims and will take appropriate safety and protective
measures before commencing operations.
3. Catastrophic Response Strategy
A. Response Strategy: IMMEDIATE. The National US&R Response System uses a defined
Activation Rotation Model (maintained by DHS/FEMA) for the selection and activation of US&R task
forces. The first three task forces usedin accordance with the timing established in the Catastrophic
Incident Response Execution Schedule in Annex 1will be the three geographically closest task forces
that are operationally ready.
(1) If more than three task forces are or will be required, the Program Office will refer to
the annual Task Force Rotation Model for resources using the following protocols:
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(a) Assuming that the three closest selected task forces have been activated, the
strategy will be to move to the 1st Rotation column and select the next closest task force in that column
for activation.
(b) All of the task forces in the 1st Rotation column will be activated before
moving to the 2nd Rotation column. This process is repetitive.
(c) Absent a compelling reason otherwise, the process will not involve horizontal
movement on the rotation model to find an operational task force. (This protocol balances the immediate
needs of the victimsby activating the closest task forces firstwith the need to maintain a fair system
of activations that will include all task forces.)
(2) It is estimated that one IST and three Type-I task forces would be able to address initial
and moderate scale incidents. For a catastrophic incident involving widespread collapses, a far larger IST
and task force response will be required and initiated. (A Type-I US&R task force has an estimated
useful operational period of 5 to 7 days, based on prior experiences.)
(3) US&R task forces will address activities and operations within contaminated areas.
This will include establishing perimeters and hot, warm, and cold zones, as well as ingress/egress and
decontamination points. These actions/determinations will be coordinated with the local first responders/
Incident Commander and other Federal resources on site.
B. Response Strategy: FIRST 10 DAYS. Additional task forces will be activated and deployed
(based on anticipated/emerging requirements and/or as requested by Incident Command Authorities or
ISTs) to provide continuous operations, usually on a 5 to 7 day basis.
C. Response Strategy: SUSTAINED. For extended operations, additional task forces will be
activated and rotated in to provide continuous operations, usually on a 5 to 7 day basis.
4. Transportation and Logistical Requirements
A. US&R task force sponsoring/parent organizations handle all immediate transportation needs of
their task force if the task force is required to move to the incident site by ground transportation. Parent
organizations arrange transportation for their personnel and supporting equipment cache to the identified
point of departure (airport/airbase) if transportation is by air. If necessary, ESF#9 will request air
transportation support from ESF#1.
B. IST personnel are activated directly by the US&R Program Office at FEMA Headquarters
(HQ) and are responsible for coordinating their own transportation reservations.
C. Task forces require minor to moderate logistical support on incident. Each task force arrives
with 72-hour self-sufficiency. Task forces that have an immediate need for large forklift capability to
assist in cache movement and management will request such support from the IST through local sources
and/or the Incident Command Logistics Branch.
D. ISTs have supporting administrative and on-site support equipment caches and will coordinate
through FEMA to have one or more of these transported to the incident site.
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5. Response Limitations and Unique Concerns
A. The program is limited to the 28 task forces in the national system. This resource size has
been able to address significant WMD/terrorist events to date (e.g., Oklahoma City, The Pentagon, World
Trade Center) when integrated with local/Regional resources. However, the system could be
overwhelmed by an extremely large catastrophic incident involving many collapsed structures or the
occurrence of multiple concurrent incidents involving collapsed structures.
B. The WMD task forces in the national system are capable of only limited/defensive hazardous
material (HAZMAT) operations.
6. Response Capabilities
A. Organic Federal
(1) Twenty-eight Type-I task forces, each comprised of a 70-person, WMD-capable task
force and full equipment cache (see Figure 4-1 for a system overview). Each task force is fully selfsufficient
for the first 72 hours of operation. A Type-I task force has an internal HAZMAT component
staffed by two HAZMAT managers and eight HAZMAT specialists. A Type-I task force is capable of
addressing limited, defensive HAZMAT operations in a contaminated environment to enable the rescue of
trapped victims or rescuers. In addition, WMD cache enhancements have been added to the traditional
equipment cache and include atmospheric monitors, personnel protective equipment (PPE), and
decontamination equipment for approximately 60 ambulatory or 20 non-ambulatory patients per hour.
(2) Three 21-person ISTs, each of which is activated with US&R task forces for mission
operation. The IST provides command, control, and coordination (C3) with the local Incident
Commander and first responders.
(3) Three National Disaster Medical System (NDMS) National Medical Response Teams
(NMRTs) for mass decontamination.
(4) U.S. Coast Guard (USCG) personnel and assets for assistance and movement of US&R
task force personnel, either by fixed or rotor wing, and/or boat operations in areas of still or open water or
areas of inundation.
B. Non-Organic Federal. Approximately 12 to 15 International Search and Rescue Teams of
varying sizes/configurations are potentially available through the USAID/U.S. Office of Foreign Disaster
Assistance and the International Search and Rescue Advisory Group (INSARAG).
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Figure 4-1 ? National Urban Search and Rescue Response System
Graph with map 
7. Responsibilities of Coordinating and Support Agencies/Organizations
A. Coordinating Agency  DHS/FEMA will:
(1) Serve as national-level ESF#9 coordinator.
(2) Establish, maintain, and manage the National US&R Response System. This
responsibility includes predisaster activities such as training, equipment purchase, and evaluation of
operational readiness.
(3) Dispatch ISTs and task forces to the affected area(s) upon implementation of and when
directed by the Catastrophic Incident Response Execution Schedule.
(4) Manage US&R task force deployment to, employment in, and redeployment from the
affected area.
(5) Coordinate logistical support for US&R assets during field operations.
(6) Develop policies and procedures for the effective use and coordination of US&R assets.
(7) Provide status reports on US&R operations throughout the affected area.
(8) Under the NDMS:
(a) Provide administrative support to US&R task force medical teams to:
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i. Ensure medical team personnel who are not Federal employees have
appropriate and valid licenses to practice in their States and they are provided Federal tort claims liability
coverage for the practice of medicine.
ii. Develop an appropriate pay scale for US&R task force medical team
personnel.
iii. Register medical teams of each National US&R Response System task
force as specialized teams under the NDMS.
(b) Provide operational support to US&R task force medical teams and IST from
ESF#8 (Public Health and Medical Services), as requested by DHS, to provide liaisons; medical supplies,
equipment, and pharmaceuticals; supporting personnel; and veterinary support.
(c) Provide NDMS patient evacuation and continuing care after trapped victims are
removed from collapsed structures by US&R task force personnel.
B. Support Agencies
(1) U.S. Department of Agriculture (USDA), U.S. Forest Service (USFS)
(a) Develop standby agreements with US&R task forces to provide equipment and
supplies from the National Interagency Cache System at the time of deployment.
(b) Develop contingency plans for use of National Interagency Fire Center contract
aircraft by ESF#9 during disasters.
(2) Department of Health and Human Services (HHS). Provide operational support to
US&R task force medical teams and IST from ESF#8, as requested by DHS.
(3) Department of Defense (DOD)
(a) Serve as primary source for the following assistance:
i. Fixed-wing transportation of US&R task forces and ISTs from base
locations to Mobilization Centers or Base Support Installations (BSIs). Target timeframe for airlift
missions is 6 hours from the time of task force activation.
ii. Rotary-wing transportation of US&R task forces and ISTs to and from
isolated, surface inaccessible, or other limited access locations.
iii. Through the U.S. Army Corps of Engineers (USACE), provide trained
structures specialists and System to Locate Survivors (STOLS) teams to supplement resources of US&R
task forces and ISTs.
iv. Through the USACE, provide pre-disaster training for US&R task force and
IST structures specialists.
(b) Serve as secondary source for the following assistance:
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i. Ground transportation for US&R task forces and ISTs within the affected
area.
ii. Mobile feeding units for US&R task forces and IST personnel.
iii. Portable shelter (i.e., tents) for use by US&R task force and IST personnel
for eating, sleeping, and working.
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Appendix 5 ? Decontamination Response Overview
1. Mission
In the immediate aftermath of a catastrophic incident involving nuclear, radiological, or chemical
contamination, provide technical advice and assistance to State and local governments regarding the
decontamination of persons, first responders and medical treatment equipment and facilities, and animals
in service. Thereafter, augment technical advice with expert personnel and equipment, supplies, and
systems to assist in the decontamination of buildings and equipment (especially those providing essential/
critical services), and the environment. In the recovery phase, assist in providing augmented/replacement
first responder decontamination resources and capability.
2. Planning Assumptions
A. Overview. For catastrophic incidents depicted in the planning scenarios related to this plan,
decontamination involves several related and sequential activities. Chief among these are (1) immediate
(or gross) decontamination of persons exposed to toxic/hazardous substances; (2) continual
decontamination of first responders so that they can perform their essential functions; (3) decontamination
of animals in service to first responders; (4) continual decontamination of response equipment and
vehicles; (5) secondary, or definitive, decontamination of victims at medical treatment facilities to enable
medical treatment and protect the facility environment; (6) decontamination of facilities (public
infrastructure, business and residential structures); and (7) environmental (outdoor) decontamination
supporting recovery and remediation.
B. Decontamination of victims exposed to toxic/hazardous substances is primarily a State and
local responsibility. Noting that Federal responders rarely arrive in time to provide such a service, the
Federal Government will provide the maximum support possible. The primary Federal roles in the
immediate aftermath of a catastrophic incident would be:
(1) Providing technical advice and assistance for local personnel managing
decontamination activities.
(2) Obtaining status/assessment information regarding the extent and effectiveness of local
decontamination activities in order to analyze their implications for ongoing medical treatment and
population protection.
(3) Ensuring that requirements for additional equipment and/or personnel to support local
decontamination activities to be provided by the Federal Government are obtained and acted upon
expeditiously.
C. Catastrophic incidents using credible threat scenarios could potentially affect people based on
an estimated population density of 2,000 people per square mile. These numbers will be much higher in
major downtown urban areas. In addition, special event situations such as sporting events, conventions,
and holiday events create situations where a very large number of people gather and could become
potential victims.
D. Given a nuclear/radiological or chemical incident, and in certain situations for biological
agents, decontamination may be required for:
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(1) People (victims, including affected responders/workers who are decontaminating
buildings and the environment will need their protective equipment decontaminated during response,
recovery, and remediation; viable patients with injuries, exposure effects, and potential contamination;
victims with no medically significant injuries or requiring only psychological support; and fatalities).
(2) Animals (working rescue and response service animals, companion animals, and
livestock).
(3) Equipment (equipment or apparatus required for or of potential use in response,
equipment or apparatus required for or of potential use in recovery, and non-critical equipment or
apparatus not meeting the first two criteria).
(4) Facilities (facilities and infrastructure required for or of potential use in response,
facilities and infrastructure required for or of potential use in recovery, and non-critical facilities and
infrastructure not meeting the first two criteria).
(5) Geographic outdoor areas requiring remediation.
E. Decontamination priorities will be set using the following priorities, in order of importance:
life safety, incident stabilization, and property conservation.
F. The following crosscutting issues must also be considered:
(1) Decontamination procedures to date have treated the public as a homogeneous entity
and have not differentiated needs of specific subgroups. For example, decontamination techniques for
adults may not be applicable to children and infants or the elderly who require a heated environment.
(2) Decontamination has been a humiliating and degrading experience for women and men
who are forced to strip off their clothing in front of other people. Accordingly, gender separation and
privacy draping by tarpaulins, etc., is a recommended practice, as is provision of expedient clothing (e.g.,
blankets, sweat suits, large plastic bags).
(3) It is very likely that a significant number of persons exposed to the plume cloud will
flee the scene before first responders arrive and therefore will not be present for gross decontamination.
This reinforces the requirements for (a) effective risk communications/emergency public information and
(b) monitoring and detection capability at medical treatment facilities, first responder facilities, and
reception centers/mass care shelters.
(4) Secondary contamination has been noted as a major concern. Hospital emergency
rooms have been closed when contaminated victims have been admitted without decontamination. This
was a major problem in the Tokyo subway sarin incident. Other secondary contamination issues of note
include control of runoff of fluids used in decontamination and the handling of contaminated remains
such as clothing and personal effects. Secondary contamination of first responders must be planned
accordingly, even if wearing personal protective equipment (PPE). Such contamination can occur during
the removal of a patient from a hazardous area, performing basic life support functions, or because initial
responders are unaware that a hazardous material (HAZMAT) is involved.
(5) Another significant national issue is the lack of hospital preparedness for handling
contaminated patients or performing decontamination operations. Although many have plans in place,
few actually have the necessary facilities. Those with facilities can only process a limited number of
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patients at a time. One of the critical issues in hospital preparedness is the availability and use of
appropriate PPE. Many hospitals are in the process of receiving PPE and the training associated with
how to put on, work in, and safely remove PPE. However, there still remains much education to do on
PPE and decontamination activities to be performed at the hospital level.
(6) The psychological dimension of exposure to a toxic chemical, biological, or radiological
substance and the subsequent decontamination is an important, but not fully understood, topic. Epidemic
hysteria has been associated with perceived exposure to toxic substances among adolescent groups.
Concerns exist that psychological stress triggered by an accident will result in symptoms resembling
actual exposure and people with such stress symptoms may report to medical facilities seeking treatment.
Little documentation exists, however, to support this concern. Of greater concern are the short and longterm
psychological consequences of people actually exposed to a chemical or biological substance that
experience negative health effects. The decontamination process may compound negative psychological
effects from such experiences. Short-term stress symptoms may, in some cases, lead to long-term
debilitating psychological effects, which are referred to as post-traumatic stress disorder (PTSD).
(7) The worried well is a significant population to deal with. Hundreds or thousands can
easily overwhelm healthcare facilities. Being able to provide assurances via monitoring and detection
equipment will yield highly positive results.
(8) A major question remains concerning the effectiveness of decontamination techniques
and determining if a building or person are clean. This is less problematic for buildings where time
allows for multiple actions and extensive testing. Some buildings and equipment may be decontaminated
in phases depending on intended use and nature of contamination. It should also be noted that it might
not be possible to decontaminate areas to clean. For example, following a nuclear incident, the source
area may be so contaminated that it is more realistic to constrain access than to attempt to decontaminate.
Determining if people are clean following decontamination is more problematic, due to the inability to
test for and verify levels of residual contamination following decontamination procedures.
(9) Internal contamination may be a significant threat in radiological or nuclear incidents.
Victims who have internalized significant amounts of radiological contaminants may themselves present a
radiological threat to those in their vicinity. Because of the foregoing information and considerations,
there exists an urgent preparedness imperative, particularly at the local Government/local mutual aid
partners level. As venue-specific catastrophic incident planning continues, it is vital that local first
responder, medical provider, public health, emergency management, business, and volunteer organization
leaders address in pre-incident preparedness activities, decontamination issues to include:
(a) Development and implementation of a modular approach to medical treatment
facilities, first responder facilities, and reception centers/mass care shelters, which includes designation of
those facilities and tasking of elements/units and required equipment and supplies to provide portal and
point monitoring/detection, human and animal decontamination, and physical security to each of these
locations, whose operating viability must be maintained in order to engage a minimally successful
incident response.
(b) Development and implementation of risk communications/emergency public
information capabilities to deliver, via robust and redundant means, timely and accurate information, on
an ongoing basis throughout the response phase, regarding the nature and extent of the incident and the
actions to be taken to reduce the risk of weapons of mass destruction (WMD) agent contamination, obtain
personal and facility decontamination support and/or conduct self-help decontamination, implement
shelter-in-place or evacuation procedures, establishment of exclusion/isolation/quarantine zones, and
related matters regarding human and animal health with respect to WMD agent dispersal.
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(c) Provision of personal, family, workplace, and institutional setting information,
awareness, and guidance on personal, animal, and facility decontamination.
3. Catastrophic Response Strategy
A. Response Strategy: IMMEDIATE.
(1) Local governments have the primary responsibility for initial response to catastrophic
incidents. Accordingly, local responders will be implementing mass decontamination of people during
the most crucial period where minutes matter regarding reducing or eliminating negative human health
effects of external exposure to toxic/hazardous chemicals/materials. Removal of clothing and thorough
washing with a copious flow of water is the most expeditious and effective mass (or gross) procedure.
Initially individuals, if properly prepared, could begin mass decontamination actions of people, followed
by mass decontamination procedures that are part of local level response. If a Metropolitan Medical
Response System (MMRS) team is available, it will immediately respond to the incident.
(a) Metropolitan Medical Response System (MMRS). The MMRS program
assists highly populated jurisdictions to develop plans, conduct training and exercises, and acquire
pharmaceuticals and PPE, to achieve the enhanced capability necessary to respond to a mass casualty
event caused by a WMD terrorist act, with their own resources, during the first hours crucial to lifesaving
and population protection, until significant external assistance can arrive. Gaining this capability also
increases the preparedness of the jurisdictions for a mass casualty event caused by an incident involving
HAZMAT, an epidemic disease outbreak, or a natural disaster.
(b) The MMRS approach requires linkages among first responders, medical
treatment resources, public health, emergency management, volunteer organizations, and other local
elements, to work together to develop the capability to reduce the mortality and morbidity that would
result from major terrorist acts. It also requires planning integration with neighboring jurisdictions, State
and Federal agencies, and emphasizes enhanced mutual aid. MMRS capacity requirements include
pharmaceuticals sufficient to provide care for at least 1,000 victims of a chemical incident and for 10,000
victims for the first 48 hours of response to a biological event.
(2) Reduce the potential for persons becoming contaminated (e.g., sheltering) by screening
these potentially contaminated individuals. Portal monitors and handheld detection instrumentation can
add effectiveness and efficiency in sorting priorities in the population prior to decontamination activities.
Using such capabilities as the Interagency Modeling and Atmospheric Assessment Center (IMAAC) may
minimize public exposures.
(3) Biological agents typically have delayed symptoms and lack easily recognizable
signatures such as color or odor. There will rarely be an on-site incident to respond to when a biological
agent is released unless there is a dissemination warning, a claimed or suspected dissemination device is
found, or a perpetrator is caught in the act of disseminating the agent. Healthcare facilities are the most
likely locations for managing a biological agent incident. If a biological agent is suspected, care must be
taken to protect current patients, staff, and faculty from infection. If there is an on-site response to a
biological incident, decontamination is necessary to reduce the risk of additional contamination. When
biological decontamination is performed, thoroughness is more important than speed.
(4) The full decontamination procedure should occur in the following order:
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(a) People known to be in the plume path/debris field and others seeking
decontamination and first responders engaged in incident response.
(b) First responder equipment and vehicles, medical treatment facilities, reception
centers, and mass care shelters (should contamination prevention fail).
(c) Working rescue and response animals are critical for continued response
operations.
(d) Transportation vehicles needed to move casualties and evacuees (should
contamination prevention fail).
(e) Critical infrastructure (e.g., water and sewer systems, electric power,
communications, banking, etc.).
(f) Pets and livestock. Depending on the type of incident, livestock (including
poultry) may need to be euthanized instead of decontaminated. Sheep, goats, and smaller animals will be
dead within minutes if exposed to a nerve agent. Animals with dense fur are almost impossible to
decontaminate, especially if they are exposed to a mustard agent.
(5) Local authorities will issue timely and accurate risk communications/emergency public
information, via multiple means, regarding decontamination and protective actions regarding shelter-inplace
or evacuation.
(6) In the initial hours after a catastrophic incident, the priority Federal roles will be to
provide reach-back technical advice/assistance to local responders and assess the effectiveness of
decontamination as an element of situation awareness and assessment.
B. Response Strategy: FIRST 10 DAYS.
(1) Decontamination of critical infrastructure will likely continue well into the first 10 days,
and into the sustained response after decontamination of people, animals in service, critical infrastructure,
State and Federal facilities, and businesses that are critical to defense/security and the national/Regional
economy.
(2) Medical monitoring of contaminated and potentially contaminated victims should be
under way.
(3) Federal resources on the ground will focus on supporting State and local authorities
with facility and environmental decontamination, contaminated debris removal, and monitoring/
assessment in support of recovery and restoration.
C. Response Strategy: SUSTAINED.
(1) Continued decontamination of people as needed.
(2) Monitoring and decontamination of buildings/facilities and equipment in support of
restoration and recovery. Federal assistance will be available as long as necessary.
(3) Local authorities must have predesignated locations for storage of contaminated debris.
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(4) Local authorities (with technical support from Federal and State governments) will
determine when buildings/facilities and areas are safe for reentry, other utilization, or are to be
condemned.
(5) Federal assistance will be available for contaminated debris removal, storage, and
monitoring.
D. Additional Considerations
(1) No Federal resources, other than off-site technical experts will be available for
approximately the first 4 hours of the incident. Significant quantities of Federal resources may not be
available for up to 24 hours.
(2) Lack of resources available to decontaminate all people, animals, facilities, and
equipment, or to contain contaminants and runoff will result in failure to contain the spread of some
hazardous materials. The Environmental Protection Agency (EPA) recognizes that actually saving lives
takes priority over protecting the environment from contaminated runoff and has addressed this runoff
issue in a policy letter.
(3) Decontamination requirements will immediately exceed State and local capabilities.
Additional response assets will be available from intra-State Regional sources, State resources, and
neighboring States under the Emergency Management Assistance Compact (EMAC) within several hours.
(4) Contaminated people and animals will not remain at any one contaminated location.
Public officials will direct victims to collection points, potentially directing those who can selfdecontaminate
to do so.
(5) A majority of victims will make their own way to their home or medical treatment
facility and disregard first responder instructions to undergo gross decontamination unless a significant
crowd control regimen is instituted by law enforcement. In a radiological or nuclear incident, it may be
better to allow victims to leave the area of contamination rather than waiting for decontamination, to
provide them an opportunity to remove themselves from exposure to ionizing radiation.
(6) Medical treatment facilities and mass care shelters need to be kept clean yet are at great
risk of contamination. Law enforcement is critical to maintain integrity at medical treatment facilities and
shelters.
(7) There is a significant lack of monitoring equipment necessary to ensure the
thoroughness of decontamination and to protect entries to medical treatment facilities and mass care
shelters.
(8) The reception center concept employed in the Radiological Emergency Preparedness
(REP) Program around commercial nuclear power plantswhere monitoring, decontamination, and
registration occurhas great merit for consideration as an intermediate victim processing step between
gross decontamination and entry to a medical treatment facility, shelter, or return home. This concept
needs to be integrated into existing State and local planning and preparedness for catastrophic incident
response.
(9) A positive identification technique needs to be employed for persons who have received
gross decontamination so that medical treatment facilities and shelter managers can readily identify them
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and take action for those without a decontamination marker. Some local governments already accomplish
this with plastic wristbands and a data field on triage tags.
(10) According to common practice, local responders will position resources at road network
choke points and hospitals according to common practice in order to control and handle the maximum
possible number of affected people.
(11) Public information and guidance on self-decontamination and shelter-in-place strategies
will be distributed as soon as practical. Local responders generally provide this information. In the rare
instance that State and local governments are not able to release such information, the Federal
Government may do so.
(12) Patient movement assets of the National Disaster Medical System (NDMS) will not
accept patients for evacuation out of the incident area unless decontaminated.
(13) Persons who have self-decontaminated will still need to be accounted for to verify and
tag them as decontaminated without processing them. Their action may allow authorities to handle them
last since they will not be exposed further unless they pass through a contaminated area.
(14) The principal Federal interagency reference for mass personnel decontamination is
Best Practices and Guidelines for Mass Personnel Decontamination, published by the Technical
Support Working Group in collaboration with the Chemical and Biological Defense Information Analysis
Center and the Department of Health and Human Services (HHS).
(15) Appropriate coordinating authorities focus Federal, State, and local efforts on the
containment of contaminants as soon as resources and the situation allow.
4. Transportation and Logistical Requirements
A. There are no transportation or logistical requirements for Federal decontamination assets in the
push package for the immediate response phase.
B. Follow-on Federal assets, including personnel and equipment assigned to support facility and
environmental decontamination and removal of contaminated debris, should be able to use the situationspecific
transportation and logistical arrangements.
5. Resource Limitations and Unique Concerns
A. In general, at the venue level, there will be insufficient firefighter apparatus and personnel to
conduct immediate gross decontamination due to incident impact on these resources, size of the
contaminated population, competing tasks, and possible disruption to municipal water supply.
B. In general, at the venue level, there will be insufficient quantities of detection and monitoring
equipment for first responders, reception centers, mass care shelters, and medical treatment facilities.
C. There may be inadequate, untimely, or competing plume modeling to support rapid decisionmaking
regarding population protection measuresprincipally shelter-in-place or evacuation.
D. Due to the site-specific nature of many cleanup issues, there is currently no universal definitive
guidance on how clean is safe in regard to returning to residences and resumption of businesses.
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Cleanup levels will be determined on a site-by-site basis by local governments working in tandem with
Federal and State technical experts.
6. Response Capabilities
A. Organic Federal
(1) The National Response Center (NRC) is designated by Federal statute as the single
mandatory point of reporting by the discovering party for HAZMAT spills. By interagency agreement,
the NRC is also the single point of contact (POC) for members of the public and industry to report
potential terrorist incidents. The NRC will notify other Federal agencies as appropriate and will assist the
reporting party with referrals for technical assistance.
(2) EPA and the U.S. Coast Guard (USCG) will respond to HAZMAT incidents, through
the authorities, organization, and procedures contained in the National Oil and Hazardous Substances
Pollution Contingency Plan.
(3) EPA is creating a National Decontamination Team (specific to structures, infrastructure,
and critical items; not people). This 15-person team will be located in Cincinnati, OH. This team will
augment existing EPA response capabilities and will be dedicated to decontamination and the research
and development of decontamination techniques and decontamination execution, technologies, and
engineering for WMD.
(4) EPA maintains Emergency, Environmental, and Radiological Emergency Response
teams comprised of Federal On-Scene Coordinators (OSCs) (250 individuals in 10 EPA regions in 26
locations), the Environmental Response Team (50 experts in three locations: New Jersey, Ohio, and
Nevada), and the Radiological Response Team (two locations: Alabama and Nevada). EPA has further
reach-back capabilities with programs dealing with enforcement, air, water, research and development,
and pesticides. EPAs Radiological Emergency Response Team (RERT) members serve as part of the
Federal Radiological Monitoring and Assessment Center (FRMAC) for radiological or nuclear incidents.
For the intermediate and long-term phases of a radiological or nuclear incident, EPA takes over leadership
of the FRMAC.
(5) The Department of Energy (DOE) will activate Radiological Assistance Program (RAP)
Teams, the National Atmospheric Release Advisory Capability (NARAC), a FRMAC, and the Radiation
Emergency Assistance Center/Training Site (REAC/TS), in accordance with the Federal Radiological
Emergency Response Plan (FRERP). RAP Teams respond to incidents involving radioactive materials
and provide resources, including trained personnel and equipment, to evaluate, assess, advise, and assist
in the mitigation of radiation hazards. NARAC provides real-time assessment advisories on nuclear,
biological, or chemical (NBC) releases into the atmosphere. The FRMAC coordinates, through the
primary agency, all Federal radiological monitoring and assessment activities during major radiological
emergencies. REAC/TS provides medical consultation on the treatment of radiation exposure and
contamination. DOEs Aerial Measuring System (AMS) capability is an important asset that will allow
the FRMAC to gather information about the site more quickly and safely than would be possible with
only individuals performing monitoring.
(a) RAP Teams: 27 teams in 8 DOE Regions, based at DOE facilities. RAP Teams
are on a 2-hour call up (packed and in transit to the incident location within 2 hours) during working
hours and on a 4-hour call up during non-working hours.
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(b) NARAC: Can provide initial dispersion plots, based on weather information, in
as little as 15 minutes. NARAC continues to refine calculations and provide updated data until the release
has been fully mapped and impacts assessed.
(c) FRMAC: The Phase I Consequence Management Response Team (CMRT)
keeps a readiness posture of wheels-up from Las Vegas in 4 hours, arriving on-scene in 6 to 10 hours
for most of the continental United States (CONUS). Phase II CMRT, enabling round-the-clock
operations, can be on-scene and running in 24 to 36 hours. The full FRMAC capability can be staffed
with up to 500 people (including RAP elements) in a catastrophic incident, and use fixed and rotary-wing
airborne assets for wide-area radiation monitoring. The full FRMAC capability is supported by DOE
personnel and assets but is an interagency team of Federal and State technical experts.
(d) REAC/TS: Radiation experts with REAC/TS are on-call 24 hours a day to
provide direct medical and radiological advice.
(6) The following Federal teams/organizations provide (or are a source for)
decontamination special assistance:
(a) Agency for Toxic Substances and Disease Registry (ATSDR) Emergency
Response Teams.
(b) U.S. Marine Corps (USMC) Chemical Biological Incident Response Force
(CBIRF).
(c) DOE Nuclear Emergency Support Team (NEST).
(d) EPA Environmental Response Team (ERT).
(e) EPA RERT.
(f) Federal Bureau of Investigation (FBI), Laboratory Division, Hazardous Materials
Response Unit (HMRU).
(g) USCG National Strike Force (NSF).
(h) Occupational Safety and Health Administration (OSHA) Health Response Team.
(i) U.S. Army Corps of Engineers (USACE) Rapid Response Program.
(j) U.S. Department of Agriculture (USDA).
(k) National Response Center (NRC).
(l) Medical Emergency Radiological Response Team (MERRT).
B. HAZMAT Teams Deployment Time. Figure 5-1 reflects the number of hours before team is
capable of departure from home unit or base. HAZMAT Response Team is defined as an organized
group of individuals trained and equipped to perform work to control actual or potential leaks, spills,
discharges, or releases of hazardous materials, requiring possible close approach to the material. The
team/equipment may include external or contracted resources.
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Type I Type II Type III
ATSDR
CBIRF 1 Hour 1 Hour 1 Hour
DOE NEST
EPA ERT 4 Hours 4 Hours 4 Hours
EPA Office of Enforcement Compliance, and
Assurance (OECA)/National Counterterrorism
Evidence Response Team (NCERT)
6 Hours 6 Hours 6 Hours
EPA RERT
FBI HMRU <1 Hour <2 Hours
National Oceanic and Atmospheric
Administration (NOAA)
National Pollution Funds Center (NPFC)
NSF 2 Hours 2 Hours
OSHA HRT
Supervisor of Salvage (SUPSALV)
USACE Rapid Response

NOTE: EPA OSCs are capable of departure from home unit or base within 1 hour.
Figure 5-1 ? HAZMAT Team Response Times
C. Inventory of Other (Federally Accessible) Capabilities. National Medical Response Teams
(NMRTs). NMRTs are private practitioners who are organized into teams and Federalized for activation
and deployment. Teams deploy to and operate within a HAZMAT environment providing physiciansupervised
advanced level medical services, human decontamination services, agent detection, and/or
assistance to response agencies.
(1) All NMRT personnel are minimally trained to the OSHA HAZMAT operational level
and some are at the technical level. All have specialized WMD medical training. The team is maintained
in a state of readiness and is prepared to deploy within 4 hours of notification, 24 hours a day/7 days a
week.
(2) The NMRT consists of 50 personnel as the standard deployed force, although
specialized missions can require as few as 12 personnel. It is designed to deploy by ground or air and is
self-contained (except for water for decontamination). Ground transportation may be needed at the
receiving site for personnel and equipment.
(3) The NMRT may be requested for planned events, after a WMD event has occurred,
when a credible threat exists or to assist with technological disasters.
7. Responsibilities of Coordinating and Support Agencies/Organizations
A. When requested by the Coordinating Agency, DOE will:
(1) Establish the FRMAC and coordinate monitoring and assessment of radioactive
contamination, as outlined in the NRP Nuclear/Radiological Incident Annex.
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(2) Provide advisory assistance on radiological decontamination and monitoring techniques.
(3) Assist in providing characterization of radiation deposition in affected areas.
(4) Provide medical consultation on the treatment of persons injured by radioactive contamination
or exposure and provide lists of all local medical personnel trained in the treatment of such
injuries by the REAC/TS.
B. EPA will:
(1) Assume primary Federal responsibility for coordinating structural and environmental
decontamination.
(2) Assume primary Federal responsibility for measuring and informing the public and
responders on air and environmental quality.
C. HHS/ATSDR will:
(1) Perform specific functions concerning the effect on public health of hazardous
substances in the environment. ATSDR primarily supports and advises EPA, and is also available to
States or local entities on request.
(2) Immediately initiate or support State/local initiation of a health registry for both victims
and responders.
8. Graphic Illustrations of Decontamination Operations
A. Figure 5-2 depicts the Ladder Pipe method of emergency decontamination. It requires
minimal resources, is quick to establish, and can process a large number of patients.
B. Figure 5-3 depicts an example personnel decontamination station configuration.
C. Figure 5-4 depicts the Emergency Decontamination Corridor method of emergency
decontamination. It takes additional time to establish and does not have the same throughput as the
Ladder Pipe method but provides some patient privacy and protection from the weather.
D. Figure 5-5 depicts a sample decontamination decision tree (the example is for a chemical
incident).

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Flow Chart showing victims' movement from contamination area to medical triage and staging

Figure 5-2 ? Ladder Pipe Decontamination System

Figure 5-3 ? Personnel Decontamination Station (PDS)
Map of Personnel Decontamination Station

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Figure 5-4 ? Emergency Decontamination Corridor System (EDCS)
Map of EDCS Layouts and EDCS Decontamination Area Setup

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Figure 5-5 ? Decontamination Decision Tree Example
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National Response Plan ? Catastrophic Incident Supplement
Appendix 6 ? Public Health and Medical Support Response Overview
1. Mission
Quickly augment the public health and medical support resources and capabilities of State, Tribal, and
local governments responding to a catastrophic mass casualty/mass evacuation incident.
2. Planning Assumptions
A. The Federal public health and medical response to a catastrophic incident will be coordinated
by the Department of Health and Human Services (HHS) as outlined in Emergency Support Function
(ESF)#8.
B. During a catastrophic incident, medical support will be required not only at medical facilities,
but in large numbers at casualty evacuation points, evacuee and refugee points, and shelters as well as to
support field operations.
C. Mass field triage will be required.
D. Public anxiety regarding the catastrophic incident will require effective public information and
risk communication and may also require appropriate mental health and substance abuse services.
E. The Federal medical assets that can be brought to bear in a catastrophic incident are organized
into four categories: Personnel (and their specific capabilities), Hospital Beds, Medical Countermeasures,
and Equipment/Supplies. This appendix discusses personnel and hospital beds. Appendix 6 discusses
equipment and medical supplies.
F. Federal public health assets that can be brought to bear in are organized into five categories:
Health Surveillance, Worker Health and Safety, Radiological/Chemical/Biological Hazards Consultation,
Public Health Information, and Vector Control.
G. Federal public health and medical assets are accessible through a wide number of components
within the Federal Government, as well as from volunteer programs administered by the Federal
Government. These assets may not always be available during the response to a catastrophic incident,
depending on needs at their home institutions, family requirements, etc.
H. U.S. Department of Homeland Security (DHS) National Disaster Medical System (NDMS)
and HHS U.S. Public Health Service (PHS) Commissioned Corps assets will be the first Federal health
and medical assets to arrive on the scene of a catastrophic event.
I. Epidemiologic Intelligence Service (EIS) officers and the Center for Disease Control and
Prevention (CDC) emergency response assets (including the Agency for Toxic Substances and Disease
Registry (ATSDR)) will be the first Federal public health assets to arrive on the scene of a catastrophic
event.
J. While civilian Federal employees cannot be ordered to respond to a catastrophic incident, it is
anticipated that a sizable portion will volunteer to assist with the response.
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K. Because of disparate systems for counting personnel, numbers in this appendix are likely to
overestimate the number of available personnel as a result of double counting.
L. Additional teams are currently being developed, such as the National Nurse Response Team
(NNRT) and the National Pharmacy Response Team (NPRT).
M. A State-based Emergency System for Advanced Registration of Voluntary Healthcare
Personnel (ESAR-VHP) is being developed.
N. The assets identified in the response strategy may not be available at the time of a catastrophic
event due to needs at their home institutions, family requirements, etc.
3. Catastrophic Response Strategy
A. Response Strategy: IMMEDIATE.
(1) The personnel that can be brought to bear in response to a catastrophic incident come
from various Federal Departments and Agencies and are coordinated through ESF#8 under the leadership
of HHS. Figure 6-1 approximates the personnel available to deploy the first week of a catastrophic
event. Each column represents the number of additional people who could be deployed.
			24 Hours 	48 Hours 	72 Hours 	Total
Physician 		48 		39 		240 		327
Nurse Practitioner
/Physician
Assistant 		37 		26 		188 		251
Nurse 			120 		146 		515 		781
Paramedic 		39	 	118		64 		221
Pharmacist/Technician 	74 		25 		432 		531
Administrative Support 	99 		117 		445 		661
Mental Health 		23 		13 		125 		161
Respiratory Therapist 	0 		0 		0 		0
Medical Staff Support 	219 		0 		1,331 		1,550
Total 			659 		484 		3,340 		4,483
			3 DMATs,
			1 NMRT and
			70 percent of
			1 PHS Roster
					11 DMATs
					and 2 NMRTs
							8 DMATs and
							70 percent of 6
							PHS Rosters
Figure 6-1 ? Available Health/Medical Personnel Deployment Projections
(2) In addition to the resources depicted in Figure 6-1:
(a) The American Red Cross (ARC) will deploy local assets immediately following
the incident. National ARC assets can be deployed within 72 hours. ARC assets include mental health
and nursing personnel. These assets are under the ARC command structure, but will work in coordination
with Federal, State, Tribal, and local efforts. Refer to Appendix 3 for more details.
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(b) Community Health Centers (CHCs) and Community Mental Health Centers
(CMHCs) are available in all States and many jurisdictions. These centers are responsible for providing
health and mental health services to their communities. While these centers typically receive the majority
of their funding from State and local governments, they also receive substantial Federal funding. During
a catastrophic incident, these centers could provide services to the injured and those needing mental
health services. The use of CHCs and CMHCs should be coordinated with Federal, State, Tribal, and
local authorities. The number of assets available will vary depending on local incident demands and preincident
staffing levels. In Fiscal Year (FY) 2004, there were more than 3,650 CHC sites and 915 to 920
grantees across the country. In FY00 (the most recent year with available data) there were 2,075 CMHCs.
(c) Memoranda of Understanding (MOU) between individual Department of
Defense (DOD) military treatment facility commanders and surrounding local authorities may allow
provision of medical treatment facility (MTF) and/or personnel support for emergency care under
immediate response authorities, or when requested by ESF#8 and approved for employment by the
Secretary of Defense (SECDEF).
(d) As provided for in local community emergency response plans, and as authorized
under applicable authorities, Department of Veterans Affairs (VA) Directors may provide emergency
medical care to victims in a mass casualty event.
B. Response Strategy: FIRST 10 DAYS.
(1) After the first week, there will be an additional 390 NDMS personnel (members of
augmentation and developmental teams) that can serve as relief for NDMS personnel deployed during the
initial response.
(2) In addition to the PHS Commissioned Corps officers listed in Figure 6-1, there are
more than 700 other PHS officers who could be deployed to support a mass casualty event.
C. Response Strategy: SUSTAINED. In accordance with the guidance and direction outlined in
the ESF#8 annex of the National Response Plan (NRP).
4. Transportation and Logistical Requirements
Movement of personnel, equipment, and (potentially) patients will require transportation and logistics
support.
5. Response Limitations and Unique Concerns
A. There is no unified database to inventory the health and medical personnel employed in
administrative and research jobs within the Federal Government. These personnel could be a valuable
resource in a catastrophic incident.
B. Systems required to move personnel, patients, and equipment require extensive review and
should be simultaneously exercised during national, State, and local exercises.
C. Federal planning efforts need to be tied more closely to the efforts of Regional, State, and local
planners.
D. Plans need to be developed for rotating staff and incorporating volunteers.
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6. Response Capabilities
A. Organic Federal Resources
(1) HHS Secretarys Command Center (SCC). The SCC serves as an information and
operations center providing a single focal point for the Federal health and medical response to a
catastrophic incident, including information sharing, command and control (C2), communications,
specialized technologies and information collection, assessment, analysis, and sharing. HHS Operating
Divisions (OPDIVs) will provide liaisons to the SCC, at the request of the Assistant Secretary for Public
Health Emergency Preparedness (ASPHEP), to facilitate coordination of the health and medical response
to a catastrophic incident.
(2) Secretarys Emergency Response Team (SERT). The ASPHEP, on behalf of the
HHS Secretary, directs and coordinates HHS efforts to prevent, prepare for, respond to, and recover from
the public health and medical consequences of a catastrophic incident. The SERT and/or SERT Advance
element acts as the HHS Secretarys agent at incident sites. The SERT directs and coordinates the
activities of all HHS personnel deployed to the incident site to assist State, Tribal, local and other Federal
and Government agencies, as applicable.
(3) DHS National Disaster Medical System (NDMS). NDMS medical response teams
will be activated in response to a catastrophic incident and includes various teams that can deploy to the
scene of the incident. Current NDMS medical specialty force strength is reflected in Figure 6-2. NDMS
teams include:
(a) Management Support Team (MST). There is currently one MST. The MST
serves as the operational interface between NDMS response teams and the local Incident Commander, as
well as with State and local governments.
Role 						Number
Physician 					574
Nurse Practitioner/Physician?s Assistant 	234
Registered Nurse 				1,159
Emergency Medical Technician (EMT)/Paramedic 	738
Pharmacist 					158
Mortician 					235
Veterinarians 					100
Mental Health Professionals 			48

Figure 6-2 ? NDMS Medical Specialty Force Strength
(b) Disaster Medical Assistance Teams (DMATs). A DMAT is a group of
professional and para-professional medical personnel (supported by a cadre of logistical and
administrative staff) designed to provide medical care in response to a disaster or other incident. The
DMAT mission is to rapidly deploy to a disaster site to provide primary and acute care; triage of mass
casualties; initial resuscitation, stabilization, advanced life support; and preparation of sick or injured
patients for evacuation. The DMAT structure includes specialized teams, such as the four National
Medical Response Teams (NMRTs), five Burn Teams, two Pediatric Teams, one Crush Medicine Team,
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two Mental Health Teams, and one International Medical/Surgical Response Team (IMSuRT), with two
additional IMSuRTs under development. The specific capabilities of the NMRT, IMSuRT, NNRT, and
NPRT are described in succeeding paragraphs. Figure 6-3 shows the location of the MST and
operational DMATs. Figure 6-4 shows the medical response teams under development.
Figure 6-3 ? Operational (Type-I) Disaster Medical Assistance Teams and
Management Support Team
Figure 6-4 ? Medical Response Teams Under Development
Figure 3 DMAT MEDICAL OPERATIONAL TEAMS

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Figure 6-5 ? Medical Specialty Response Teams
(3) DMAT Types and Strength
(a) Type-I (Fully Operational Teams)  9 total teams. Type-I teams consist of
required equipment caches and rostered personnel that have demonstrated the ability to pack their cache
and report to the teams duty station within 6 hours of activation (among other criteria).
(b) Type-II (Operational Teams)  13 total teams. Type-II teams consist of
required equipment caches and rostered personnel that have demonstrated the ability to pack their cache
and report to the teams duty station within 12 hours of activation (among other criteria).
(c) Type-III (Augmentation/Local Teams)  16 total teams. Type-III teams may
be used to supplement other deployed teams, or may be deployed by NDMS within their home State to
assist a Type I deployed team. Personnel can be deployed 24 hours after activation by NDMS.
(d) Type-IV (Developmental Teams)  17 total teams. Type-IV teams may be
used to supplement other teams during deployments to allow the members an opportunity to gain the
experience, training, and skills necessary to upgrade the team status. Team personnel can be deployed in
24+hours following activation by NDMS.
(4) DMAT Capabilities
(a) Deploy to an incident site within 6 hours, for a 14-day period.
(b) Provide emergent care within 30 minutes of arrival at an incident site.
MEDICAL SPECIALTY RESPONSE TEAMS

Map of the US divided into West, Central and East Border Teams

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(c) Be fully operational within 6 hours of arrival at an incident site.
(d) Sustain 24-hour operations for 72 hours without external support.
(e) Provide initial resuscitative care to victims.
(f) For a 24-hour mission, provide out-of-hospital, acute care to 250 patients
(including geriatric and pediatric patients).
(g) Provide sustained 24/7 care to 125 patients per day, including:
i. Limited laboratory and pharmaceutical services.
ii. Immediate referral, transfer, or evacuation for 25 patients.
iii. Stabilizing/holding a maximum of six patients for up to 10 hours.
iv. Supporting two critical patients for up to 24 hours.
(h) Provide sustained hospital ward care for 30 medical/surgical (non-critical)
inpatients.
(i) Provide primary response to a mass casualty incident resulting from a nonchemical,
biological, radiological, nuclear, or high-yield explosive (CBRNE) event.
(j) Triage and prepare 200 patients at a casualty collection point for evacuation or
transport in a mass casualty incident.
(k) Provide patient staging for up to 100 patients at a Federal Coordinating Center
(FCC) reception site.
(l) Augment or assist at a mass drug distribution, immunization, or packaging
center.
(m) Staff or augment alternate care facilities.
(5) National Medical Response Teams (NMRTs). The four 50-person NMRTs are
equipped and trained to perform the functions of a DMAT, but possess additional capabilities to respond
to a CBRNE event, to include operating in Level A protective equipment. Each NMRT is equipped
with its own chemical and biological monitors and detectors, used primarily for personnel and victim
safety. Additionally, each team carries medical supplies and medications, including sufficient antidotes to
manage 5,000 victims of a chemical incident. The team can deploy in 4 hours and can be fully
operational within 30 minutes of arrival on the scene of a catastrophic incident. A NMRT can perform
the following specific functions:
(a) Provide mass or standard decontamination.
(b) Collect samples for laboratory analysis.
(c) Provide medical care to contaminated victims.
(d) Provide technical assistance to local Emergency Medical Services (EMS).
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(e) Assist in triage and medical care of CBRNE events before and after
decontamination.
(f) Provide technical assistance, decontamination, and medical care at a medical
facility.
(g) Provide medical care to Federal responders on-site.
(6) International Medical Surgical Response Team (IMSuRT). There is currently one
operational IMSuRT, which is located in Boston, MA. The mission of the IMSuRT is to assist in
international disasters at the request of the Department of State (DOS) and to augment other U.S. disaster
assets outside the continental United States (OCONUS). Each team is comprised of 25 medical and 5
logistic personnel. The medical personnel include trauma and general surgeons, physicians assistants,
registered nurses (some with trauma expertise), anesthesiologists, and Emergency Medical Technicians
(EMTs)-paramedics. The IMSuRT provides triage and initial stabilization, definitive surgical care,
critical care, and evacuation capacity. The team can deploy in 4 hours and is self sustaining for 72 hours.
(7) Disaster Mortuary Operational Response Team (DMORT). There are currently 11
DMORTs. Each team is comprised of Funeral Directors, Medical Examiners, Coroners, Pathologists,
Forensic Anthropologists, Medical Records Technicians and Transcribers, Fingerprint Specialists,
Forensic Odontologists, Dental Assistants, X-Ray Technicians, Computer Professionals, Administrative
Support staff, and Security and Investigative personnel. During an emergency response, DMORTs work
under the guidance of local authorities by providing technical assistance and personnel to recover,
identify, and process deceased victims. Capabilities include temporary morgue facilities; victim
identification; forensic dental pathology; forensic anthropology; and processing, preparation, and
disposition of remains. The DMORT program maintains two Disaster Portable Morgue Units (DPMUs)
at FEMA Logistics Centers (one in Rockville, MD; the other in Sacramento, CA). The DPMU is a cache
of equipment and supplies for deployment to an incident site. It contains a complete morgue, including
workstations for each processing element and prepackaged equipment and supplies.
(8) NDMS Planning Assumptions and Timeline of Care
(a) Transportation routesground and airare available to move NDMS assets.
(b) Twenty-four hour post activation (day plus one (D+1)) teams will be in place,
setup, and providing care within their region (East, Central, and West).
(c) If an incident occurs in one region (East or West), only one third of assets will be
on site and providing care at D+1. All other activated teams will arrive and initiate care at D+2 to D+3.
(d) In the event of catastrophic incident, the standard of care will be minimal life
support and patient holding for 2 to 3 days.
(e) The NDMS timeline of care (Figure 6-6) is based on the following teams:
i. 12 DMATs
ii. 3 NMRTs
iii. 1 IMSuRT
iv. 3 Base Support Teams (BSTs)

Figure 6-7 US Public Health Service Commissioned Corps Force Strength
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Role 			Number
Physicians 		1,210
Dentists 		502
Nurses 			1,224
Engineers 		415
Science 		269
Environmental
Health 			375
Veterinarian		97
Pharmacists 		877
Dieticians 		82
Therapists 		117
Health
Services 		831
TOTAL 			5,999

Figure 6-6 ? National Disaster Medical System Timeline of Care

(D+3)

Care Provided		Single Team (D+0)		14 Teams (D+1)		Entire NDMS System
			35 Personnel			660 Personnel		(D+3) 1,080 Personnel

Treat and Release	250 patients per day 		2,500 patients per day 	5,000 patients per day
(Outpatient Facility)

Treat and Limited 
Holding
(Alternate Care 
Facility)		160 outpatients per day		2,250 outpatients/day	4,500 outpatients per day
			8 inpatients			112 inpatients		224 inpatients

Figure 6-6 ? National Disaster Medical System Timeline of Care
(9) PHS Commissioned Corps. The mission of the PHS Commissioned Corps is to
provide highly trained and mobile health professionals to carry out programs to promote the health of the
Nation. As one of the seven uniformed services of the United States, the PHS Commissioned Corps is
designed to attract, develop, and retain health professionals who may be assigned to Federal, State, Tribal,
or local agencies or international organizations to accomplish its mission. Figure 6-7 and Figure 6-8
illustrate the force strength and breadth of skill sets available among Commissioned Corps officers.
Commissioned Corps officers can provide a wide variety of public health and medical services (both
domestically and internationally), to include:
(a) Direct medical and dental care to disaster victims and/or responders:
(b) Mental health and social work services to victims and/or responders:
(c) Provision of occupational health support to responders. Corps officers can
provide occupational health support to include personal
protective equipment, environmental hazards, hygiene,
food, water, and sanitation:
(d) Providing general health educators
to provide information to victims and their families:
(e) Environmental health and industrial
hygiene officers to evaluate potable water, wastewater, and
sanitation issues.
(f) Environmental health, food safety,
and dietician officers to evaluate food safety and security
issues.
(g) Epidemiologists to work with local
public health departments to identify and evaluate morbidity
and mortality issues.
(h) Forensic dentists to support the
local medical examiner in mass fatalities.
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(i) Information technology (IT) and medical records experts to improve the
collection and communication of public health information:
(j) Veterinarians and epidemiologists to support animal health disasters and disease
control, which may or may not transfer to humans. Roles include supporting the U.S. Department of
Agriculture (USDA) and augmenting the VMATs.
(k) Engineers, Environmental Health, Industrial Hygienists, and Safety Officers to
evaluate buildings, roads, bridges, or water and sewer systems, as well as investigate and ameliorate
environmental hazards and airborne materials in support of State and local jurisdictions and the SNS.
			Deployment Time
Deployment Role
			24 Hours 	72 Hours 	Totals
Clinical Dietitian 	5 		32 		37
Clinical Veterinarian 	5 		31 		36
Communications Officer 	6 		40 		46
Dentist 		36 		226 		262
Emergency Coordinator 
Augmentee 		12 		70 		82
Emergency Medical 
Technician 		1 		4 		5
Epidemiologist 		48 		288 		336
Food Safety 		9 		51 		60
General Environmental 
Health Officer 		46 		279 		325
General Health Educator 38 		232 		270
General Nurse 		72 		435 		507
Hazardous Waste/
Materials 		5 		32 		37
Liaison Officer 	29 		159 		188
Medical Records 
Administrator 		3 		21 		24
Medical Technologist 
(Laboratory Technician) 6 		36 		42
Mental Health Provider 19 		117 		136
Occupational Health/
Industrial Hygiene 	9 		56 		65
Optometrist 		8 		46 		54
Pharmacist (General) 	65 		391 		456
Pharmacist (Strategic 
National Stockpile) 	5 		33 		38
Physical Therapist 	8 		50 		58
Physician Assistant 	11 		63 		74
Primary Care Nurse 
Practitioner 		18 		109 		127
Primary Care Physician 	36 		216 		252
Safety Officer 		6 		38 		44
Strategic National 
Stockpile Officer 	2 		13 		15
TOTALS 			508 		3,068 		3,576
70 percent 356 2,148 2,503
Figure 6-8 ? Active U.S. Public Health Service Commissioned Corps Force Roster
NOTE: In response to a catastrophic incident, all officers are potentially deployable. However, at any
given time, 50 percent of officers are fulfilling mission-critical roles and will not be deployable.
January 2005 Catastrophic Incident Supplement | A6-11
National Response Plan
(l) The PHS Commissioned Corps includes approximately 6,000 officers, divided
among seven rosters, on-call on a rotating monthly basis. Officers are categorized according to the 26
deployment roles outlined in Figure 6-8. Once the mission requirements and the category/discipline/
specialty of members are determined, the Office of the Surgeon General (OSG) will match the
requirement against the qualifications of officers on that months rotational roster. Realistically, 70
percent of the on-call officers can be deployed within 24 hours (Figure 6-8). Within 72 hours, 70 percent
of the people on the other six rotational rosters could be deployed.
(m) Fifty-five of the medical providers (e.g., physicians, nurses, dentists, nurse
practitioners, and physicians assistants) listed in Figure 6-8 participate in the Health Resources and
Services Administrations (HRSAs) Ready Responder program. These Officers annually receive 2
weeks of specialized training to respond to weapons of mass destruction (WMD) events.
(n) CDC has more than 200 public health professionals that are trained in incident
response and have been medically cleared and fit tested for respirators. In addition, it is estimated that
additional CDC staff will volunteer to assist with the response to a catastrophic public health emergency.
Specific capabilities include:
i. Health Surveillance. Assistance in establishing surveillance systems to
monitor the general population and special high-risk population segments, carry out field studies and
investigations, monitor injury and disease patterns and potential disease outbreaks, and provide technical
assistance and consultations on disease and injury prevention and precautions.
ii. Worker Health/Safety. Assistance in monitoring the health and wellbeing
of emergency workers, perform field investigations and studies addressing worker health and safety
issues, and provide technical assistance and consultation on worker health and safety measures and
precautions.
iii. Radiological/Chemical/Biological Hazards Consultation. Assistance in
assessing health and medical effects of radiological, chemical, and biological exposures on the general
population and on high-risk population groups; conduct field investigations, including collection and
analysis of relevant samples; advise on protective actions related to direct human and animal exposure,
and on indirect exposure through radiologically, chemically, or biologically contaminated food, drugs,
water supply, and other media; and provide technical assistance and consultation on medical treatment
and decontamination of radiologically, chemically, or biologically injured/contaminated victims.
iv. Public Health Information. Assistance by providing public health,
disease, and injury prevention information that can be transmitted to members of the general public who
are located in or near areas affected by a major disaster or emergency.
v. Vector Control. Assistance in assessing the threat of vector-borne diseases
following a major disaster or emergency; conduct field investigations, including the collection and
laboratory analysis of relevant samples; provide vector control equipment and supplies; provide technical
assistance and consultation on protective actions regarding vector-borne diseases; and provide technical
assistance and consultation on medical treatment of victims of vector-borne diseases.
(10) Medical Reserve Corps. The response to a catastrophic incident will begin locally.
The local response will vary depending on the level of preparedness in the area of the incident. The
Medical Reserve Corps (MRC) program is establishing teams of local medical and public health
volunteers to enhance and support existing local capabilities on a regular basis and during emergencies.
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The MRC program is headquartered in the OSG. This program is part of a national initiative involving
the U.S. Freedom Corps (sponsored by the White House) and Citizen Corps (sponsored by DHS). Joining
the MRC ranks are over 5,000 volunteers from 186 communities. The number of volunteers is expected
to double within the next 12 months. Figure 6-9 shows the locations of the 186 MRC units. Based on
the interest in this program and the preliminary data from MRC units, the MRC program could be
expanded to provide local staff for a catastrophic incident.

Figure 6-9 ? Medical Reserve Corps Communities
Map of US showing Medical Reserve Corps Units

(11) Department of Veterans Affairs (VA). The VA can ask available medical, surgical,
mental health, and other health service support people to volunteer to assist the primary Federal agency in
the prosecution of a catastrophic event. Refer to Figure 6-10 for a list of potentially available VA staff.
In addition, local VA Medical Directors are authorized, under applicable authorities, to provide
emergency medical care to victims of mass casualty events. Public Law requires that patients be billed
for services provided.

Role 			Total Number
Physicians 		14,529
Physician Extenders 	4,262
Nurses 			35,834
Pharmacists 		5,159
Respiratory Therapists 	98
Medical Support Staff 	39,717
Mental Health Providers 8,625
Administrative Support 	14,878
TOTAL 			123,102
Figure 6-10 
Department of
Veteran Affairs
Staff

January 2005 Catastrophic Incident Supplement | A6-13
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(12) Department of Defense (DOD). Under imminently serious conditions, when there is
inadequate time to seek the approval of higher Headquarters (HQ), the commanders of DOD installations
near the incident may provide necessary assistance to save lives, prevent human suffering, or mitigate
great property damage without prior approval of the SECDEF. Continuation of such assistance beyond
the short term will require DOD approval. Availability of further assistance will be determined by DOD,
based on priority military requirements of ongoing DOD missions.
(13) Hospital Beds. In the United States there are approximately 5,800 non-Federal
hospitals with a staffed bed capacity of approximately 1 million. Of these non-Federal hospitals, over
1,600 have signed MOUs with NDMS agreeing to serve as receiving hospitals in an emergency. The
NDMS system has designated FCCs that would determine the number of available beds among the
NDMS hospitals in their region and coordinate patient movement to these facilities. The locations of the
FCCs are shown in Figure 6-11. The FCCs and the potential hospital beds that would be available to
receive patients in a mass casualty event are provided in Figure 6-12. These hospital beds may/may not
be available due to existing circumstance in each facility. Thus real-time bed availability will be captured
through a contingency bed report. Available hospital beds are defined as beds vacant for 24 hours prior to
the day of the report and can immediately receive patients. They must be in a functioning medical or
psychiatric treatment facility ready for all aspects of patient care. They must include supporting space,
equipment, medical material, ancillary and support services, and staff to operate under normal
circumstances. Excluded are transient patient beds, bassinets, incubators, and labor and recovery beds.
FCCs will input the number of available hospital beds in their catchment area into the DOD U.S.
Transportation Command C2 Evacuation System (TRACES2) database.
(a) If the number of casualties exceeds the available beds in non-Federal NDMS
hospitals, non-Federal hospitals outside of the NDMS system will be contacted to determine their ability
to accept patients. Furthermore, the VA has designated 65 hospitals as Primary Receiving Centers
(PRCs) to receive, transport, and treat patients from DOD in time of war. DOD has Military Treatment
Facilities (MTFs) that maythrough local MOUs and within the vicinity of the incident siteprovide
necessary assistance to save lives, prevent human suffering, or mitigate great property damage under
imminently serious conditions without prior approval by the SECDEF.
(b) Tribal facilities may be called upon to assist in a catastrophic incident. Tribal
facilities can be Federally owned and operated, Federally owned but Tribally operated, and Tribally
owned and operated. These facilities can include hospitals and health centers. These facilities may or
may not be available during a catastrophic incident, but they should be considered as part of planning
efforts.
(c) The HHS SCC has a hospital resource tracking system known as Hospital Asset
Reporting and Tracking System (HARTS). This system can be used during a catastrophic event to canvas
American Hospital Association (AHA) hospitals in the area of the disaster regarding available assets.
This data is entered through a secure Web site by the hospital. Using Geographic Information System
(GIS) capabilities, the HARTS can provide direction for movement of patients and resources to best
support the medical needs during the response to a catastrophic incident.
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Figure 6-11 ? Federal Coordinating Center Locations
Map of US displaying Federal Coordinating Center Locations

Figure 6-12 ? Potential National Disaster Medical System Beds Available
Through Federal Coordinating Centers
Federal Coordinating 
Center (FCC)		Name/Identification State	# of NDMS Hospitals  	Minimum Beds	Maximum Beds
Birmingham/Montgomery 	AL 				17 			516 		819
Mobile (Keesler Air 
Force Base
Alabama) 		AL 				6 			396 		707
Phoenix (Luke Air 
Force Base) 		AZ 				25 			664 		1,444
Tucson 			AZ 				10 			145 		379
Little Rock 		AR 				14 			183 		417
Long Beach/Greater 
Los Angeles Area 	CA 				21 			421 		1,538
Oakland/San Francisco 	CA 				15 			825 		1,573
Orange County (Camp 
Pendleton Naval Base) 	CA 				28 			290 		1,048
Sacramento/Travis (Travis 
Air Force Base) 	CA 				15 			130 		961
San Diego (San Diego 
Naval Base) 		CA 				17 			319 		945
Denver/Boulder (Fort 
Carson Army Base) 	CO 				20 			720 		1,316
New Haven/Hartford 
(Groton Naval Base) 	CT 				31 			502 		2,304
Washington, DC/Maryland 
(Bethesda) 		DC 				6			163 		260
Wilmington/Dover (Dover 
Air Force Base) 	DE 				7 			126 		475
Jacksonville 
(Jacksonville Naval 
Base) 			FL 				11 			106 		269
Miami/Fort Lauderdale/
Tampa/Orlando FL
Miami 							35 			681 		1,403
Tampa 							35 			372 		1,229
Bay Pines 						6 			166 		375
Pensacola/Gulfport 
(Keesler Air Force Base 
 Florida) 		FL 				7 			182 		322
Atlanta 		GA 				32 			567 		1,100
Augusta (Fort Gordon 
Army Base) 		GA 				8 			144 		751
Honolulu (Tripler Army 
Base) 			HI 				N/A
Chicago/Gary/Hammond 
(Great Lakes Naval 
Base)			IL 				24 			863 		1,793
Indianapolis 		IN 				17 			372 		807	
Des Moines 		IA 				8 			145 		500
Wichita 		KS 				5 			240 		595
Louisville/Lexington 	KY
Lexington 						11 			98 		383
Louisville 						16 			127 		355
New Orleans/Baton Rouge/
Shreveport 		LA
New Orleans 						23 			595 		1,433
Shreveport	 					8 			154 		428
Baltimore (Walter Reed 
Army Base) 		MD 				32 			676 		1,729
Boston/Eastern MA/
Northampton/
Central & Western MA 	MA
Bedford 						60 			1,157 		3,803
Northampton 						22 			254 		779
Detroit/Flint/Ann 
Arbor/Grand Rapids 	MI 				36 			1,151 		2,747
Minneapolis/St. Paul 	MN 				26 			569 		1,338
Biloxi/Gulfport/Mobile, AL 
(Keesler Air Force Base 
Mississippi) 		MS 				9 			185 		435
Jackson/Vicksburg 	MS 				12 			221 		452
Kansas City, MO/
Kansas City, KS 	MO 				9 			380 		700
St. Louis (Scott Air 
Force Base) 		MO 				20 			377 		1,229
Omaha/Lincoln (Offutt 
Air Force Base) 	NE 				17 			219 		578
Newark/Northern/Central 
(Lyons) 		NJ 				71 			2,090 		3,758
Albuquerque/Santa Fe 	NM 				10 			216 		403
Nassau/Suffolk/Brooklyn/
Queens/Manhattan/Staten 
Island 			NY
Long Island 						25 			659 		1,132
Brooklyn 						18 			189 		463
New York 						19 			584 		1,120
Rochester/Buffalo/
Western NY/Syracuse 	NY
Albany 							19 			500 		850
Buffalo 						28 			648 		1,307
Syracuse 						25 			613 		1,102
Southern Tier/Mid-Hudson/
New York Northern
Metropolitan/Bronx 	NY 				42 			705 		1,447
North Carolina 		NC 				80 			2,085 		4,584
Cincinnati/Columbus/
Dayton/Toledo 
(Wright Patterson
Air Force Base) 	OH
Cincinnati 						22 			265 		485

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Toledo 							6 			75 		155
Dayton 							13 			130 		265
Columbus 						8 			120 		225
Cleveland/Akron 	OH 				38 			927 		2,070
Oklahoma City/Tulsa 	OK 				12 			340 		801
Portland/Vancouver, WA 	OR 				16 			511 		1,142
Philadelphia/Southern 
New Jersey 		PA 				75 			1,236 		2,837
Pittsburgh/Northern 
West Virginia 		PA 				51 			953 		3,260
Puerto Rico and 
Virgin Islands 		PR 				19 			193 		378
Providence (Newport 
Naval Base) 		RI 				18 			123 		544
Charleston (Charleston 
Naval Base) 		SC 				5 			55 		125
Columbia/Greenville/
Spartanburg (Fort Jackson 
Army Base) 		SC 				22 			341 		632
Nashville/Knoxville 	TN
Nashville 						31 			811 		1,823
Memphis as Patient 
Reporting Activity 
(PRA) Pending
Dallas/Fort Worth 	TX 				50 			1,082 		2,459
El Paso/Las Cruces, NM 
(William Beaumont 
Army Base) 		TX 				9 			216 		503
Houston 		TX 				59 			1,215 		2,530
San Antonio 		TX 				33 			472 		1,293
Salt Lake City 		UT 				23 			294 		839
Norfolk/Virginia Beach 
(Portsmouth Naval Base) VA 				16 			395 		726
Northern Virginia Suburbs 
(Andrews Air Force Base)VA 				7 			184 		353
Richmond/Central/Western
Virginia 		VA 				21 			758 		1,301
Seattle/Everett/Tacoma 
(Madigan Army Base) 	WA 				27 			767 		2,173
Milwaukee 		WI 				17 			358 		756
TOTAL 							1,656 			35,511 		83,560

January 2005 Catastrophic Incident Supplement | A7-1
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National Response Plan ? Catastrophic Incident Supplement
Appendix 7 ? Medical Equipment and Supplies Response Overview
1. Mission
This appendix will consider medical assets for a Federal response to a catastrophic incident, irrespective
of cause or hazard. These assets will include a description of various programs and their overall
capabilities and are not limited to post-exposure prophylaxis.
2. Response Capabilities
A. Organic Federal
(1) Strategic National Stockpile (SNS) Program
(a) 12-Hour Push Package. This is a 50-ton assortment of medical assets and
pharmaceuticals from the SNS. The 12-hour Push Package provides a broad spectrum of
countermeasures applicable to a broad array of threats. The dozen 12-hour Push Packages are identical,
pre-packaged in specialized cargo containers, and stored for prompt access by SNS program
transportation partners. The 12-hour Push Package is assured for delivery to any site in the United States
or its Territories within 12 hours of a Federal order to deploy. Transportation methodology (via ground
or air) is situationally determined by the SNS program.
(b) Vendor-Managed Inventory (VMI). VMI comprises the majority of medical
assets and pharmaceuticals in the SNS program (e.g., VMI can provide 12 million citizens with much of
the 60 days of anthrax prophylaxis). Nearly the entire VMI is maintained by manufacturers who rotate
various product lines to ensure current product dating. VMI is designed for a tailored response to provide
specific pharmaceuticals or medical assets to a suspected or confirmed agent.
(c) Department of Veterans Affairs (VA) National Acquisition Center (NAC).
The SNS program selected the VA NAC as its procurement partner. VA NAC annually procures more
than $3.5 billion in medicines and medical material for the VA medical system and allows the SNS
program to take advantage of economies of scale. The established relationship with the VA NAC also
allows the SNS program to rapidly procure products not contained within the SNS formulary that are
needed to respond to a specific event. The VA NAC also assists the SNS program in determining overall
market availability and production capacity of pharmaceuticals and medical assets.
(d) Treatment and Prophylaxis Capabilities of the SNS Program. The SNS
formulary is designed for both pediatric and adult populations. The baseline capacity for children is
based on the 2000 U.S. Census data and is applied to the SNS program requirements for prophylaxis or
treatment for threat agents. The SNS capability against various threat agents will change over time as the
formulary content is augmented, enhanced, or modified to respond to present or emerging threats.
Therefore, the capabilities report will need to be continually updated.
(e) SNS Formulary Content. A list detailing the specific formulary contents of the
SNS is provided to State and local emergency planners through the SNS program consultant to that State.
The list does not include quantities of the specific products available, as the SNS program considers this
information to be sensitive in nature. The SNS formulary content changes over time as the formulary is
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modified, enhanced, or augmented to respond to present or emerging threats. The SNS formulary content
may be divided in to various categories to include:
i. Airway management supplies (endotracheal tubes, manual resuscitators
(ambu bags)) and intravenous (IV) supplies, including catheters and solutions (normal saline, lactated
ringers).
ii. Pharmaceuticals (antibiotics, analgesics, sedatives, chemical nerve agent
antidotes, anti-epileptic drugs, anti-emetics and paralytics).
iii. Wound management supplies (bandages, ointments, laceration repair
supplies).
iv. Vaccines (smallpox, anthrax).
v. Antitoxin (botulism).
vi. Ventilators.
(f) Emergency Use Authorization (EUA). The National Defense Authorization
Act was signed into law in November 2003. Section 1603 adds Section 564 to the Food, Drug, and
Cosmetic Act (Authorization for Medical Products for Use in Emergencies), and states that the
Department of Health and Human Services (HHS) Secretary may declare an emergency justifying the
authorization, under this subsection, for a product (either an unapproved product or an unapproved use of
an approved product) to be introduced into interstate commerce. The Secretary may make such an
emergency declaration on the basis of the determination by the Secretary of Defense (SECDEF) that there
is a military emergency, or a significant potential for an emergency, involving a heightened risk to U.S.
military forces from an attack with a specified biological, chemical, radiological, or nuclear agent(s). The
Secretary of HHS may issue an authorization under this section with respect to emergency use of a
product only if, after consultation with the Director of the National Institutes of Health (NIH) and the
Director of the Centers for Disease Control and Prevention (CDC), the Secretary concludes that: (1) an
agent specified above can cause a serious or life-threatening disease or condition; (2) it is reasonable to
believe that the product may be effective in diagnosing, treating, or preventing such disease or condition;
(3) the benefits or using a product outweigh the risks; and (4) there are no adequate, approved, and
available alternatives. Under EUA, healthcare providers and patients are informed about the risk and
benefits and alternative interventions. The SNS program is currently working with the Food and Drug
Administration (FDA) to evaluate the impact of the EUA on pharmaceuticals currently requiring an
Investigational New Drug (IND) for distribution and use as well as the overall impact on the SNS
formulary.
(g) SNS Transportation of Assets. The SNS program has transportation
partnerships with the commercial sector. The SNS program will make the decision of whether to execute
a Federal order to deploy a 12-hour Push Package or VMI by air or by ground based on such factors as
the safety and physical condition of the closest airfield where it is possible to land a wide-body aircraft,
weather and road conditions, the likelihood of continuing terrorist activity, or other perils that may
threaten SNS material. In making this decision, the SNS program will invite input from State and local
officials from the affected area; Federal health, homeland security, intelligence, meteorology, and law
enforcement agencies; and the SNS program transportation partners who must carry out delivery.
(h) State Roles in Distribution. It is the States responsibility to formulate and
implement a distribution and dispensing plan for SNS medical assets, including antibiotics for postJanuary
2005 Catastrophic Incident Supplement | A7-3
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exposure prophylaxis. The resources required to implement each plan will vary by State and the
organization of their SNS preparedness plan.
(i) Cooperative Agreement Guidance. Sixty-two project areas receive funding to
develop the necessary plans and infrastructure to receive and distribute the SNS assets. The project areas
include 50 States, eight Territories, Commonwealth and Compact States, and four cities. Project areas
obtain guidance from three sources:
i. The CDC. The CDC program announcement sets forth the broad
expectations for using these funds and stresses the need for State-level infrastructure to help carry out
SNS preparedness; a need to fund Regional and local SNS preparedness infrastructure development; and
the need to develop these infrastructures based on CDC guidance.
ii. SNS Program Preparedness Branch. The SNS Program Preparedness
Branch offers technical assistance.
iii. CDC Guidance Documentation. The CDC guidance document,
Receiving, Distributing, and Dispensing the Strategic National Stockpile: A Guide for Planners, Version
9 details the functions that State and local planners need to have in place in order for an affected area to
effectively manage and use SNS assets in a deployment. This includes information and instructions on:
(i) Requesting SNS assets.
(ii) What State and local communities must do prior to arrival of the SNS.
(iii) State and local responsibilities under C2 function.
(iv) Receipt, storage, and staging of SNS assets.
(v) Controlling SNS inventory.
(vi) Distributing SNS assets from staging warehouse to dispensing sites,
treatment centers, or other distribution locations.
(vii) Dispensing medications at emergency prophylaxis sites.
(j) State Requirements to Request SNS Assets. The Governor of the State or
his/her official designee is expected to initiate any request for Federal assets in an emergency. This
request can be made to the President, to the Federal Emergency Management Agency (FEMA), or, in the
case of requesting the SNS, to the Director of the CDC. There are no other requirements for a State to
receive these assets. SNS assets can be deployed in the absence of Presidential or Public Health
Emergency Declarations, and will be deployed when appropriate under the Catastrophic Incident
Response Execution Schedule.
(k) Resources States May Use to Achieve the Distribution and Dispensing of
SNS Assets. States may use a variety of resources within their State to assist with the distribution and
dispensing of medical assets and pharmaceuticals. These resources are not limited to State and local
health professionals, law enforcement, Government workers outside of primary response agencies, and
the National Guard, but can include volunteers from the community and professional organizations. The
following U.S. Public Health Service (PHS) Commissioned Corps categories (and their proposed
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activities) are appropriate for assisting State and local personnel in the distribution of prophylaxis
medications to an affected population:
i. General Health Educator: Assist with preparation and distribution of
educational materials at distribution points.
ii. Pharmacist: Assist with packaging/labeling of medications and distribution
to affected population at community dispensing sites.
iii. Dentist: Medical screening or counseling and assistance with dispensing of
medications to affected populations.
iv. Emergency Medical Technician (EMT): Medical screening or counseling
and assistance with dispensing of medications to affected populations.
v. General Nurse: Medical screening or counseling and assistance with
distribution of medications to affected populations, including distributing SNS assets from staging
warehouse to dispensing sites, treatment centers, or other distribution locations, as well as dispensing
medications at emergency prophylaxis sites.
vi. Physician Assistant: Medical screening or counseling and assistance with
distribution of medications to affected populations.
vii. Primary Care Nurse Practitioner. Supervision of Federal personnel
assisting with overall medical screening and/or counseling activities and assist with distribution of
medications to affected populations.
viii. Primary Care Physician: Supervision of Federal personnel assisting with
overall medical screening and/or counseling activities and assist with distribution of medications to
affected populations.
NOTE: Other PHS Commissioned Corps personnel categories may be required to assist with
registration, information distribution, and other distribution site organization and support activities.
(2) Department of Veterans Affairs (VA)
(a) The VA maintains pharmaceutical caches at their medical centers to protect VA
patients, staff, and visitors in the event of a terrorist attack. In a catastrophic incident, these caches could
be employed as required to provide humanitarian medical assistance to non-veteran beneficiary
populations although these caches are primarily intended to treat veterans, staff, and other victims that
may present to a local VA medical center. These caches are designed to ensure short-term preservation of
the VA healthcare infrastructure until other resources can be made available in the immediate area and to
support the facilitys involvement in the local community disaster plan. They contain limited stocks of
pharmaceuticals, fluids, and other items needed for a terrorist attack. The VA pharmaceutical caches
come in two different sizes. The small cache will support 1,000 casualties for 1 to 2 days while the large
cache will support 2,000 casualties for 1 to 2 days. Each cache is color-coded to indicate its contents
based on type of attack, with the exception of the color yellow, which indicates that the contents are
supplies. Caches (and associated color) are available for the following incident types:
i. Biological (B)......................Blue
ii. Chemical (C) .......................Green
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iii. Explosion and Burn (E)....... Red
iv. Radiological (R).................. Orange
v. Supplies (S) .........................Yellow
(b) Of the 143 current caches, 89 are large (1,500 square foot) and 54 are small
(1,000 square foot) caches. All caches are on rollable carts secured by unbreakable, tamper-proof locks.
The two exceptions are IV fluids, which are located on pallets in same area where the cache is stored, and
all Class II and Class III items (controlled substances), which must be stored in a vault or safe in
compliance with Drug Enforcement Agency (DEA) regulations. Should mobilization of the cache be
necessary, operating procedures ensure that all Class II and Class III pharmaceuticals will be included
with the cache.
(c) The SNS program delivery goal is 12 hours from notification and approval of
request. Although the delivery time of SNS assets to hospitals or dispensing sites will vary from State to
State and is situation dependent, it is expected that assets will be delivered to the end user within 24 hours
of the approval for activation. In a mass casualty event, hospitals should plan to function with on-hand
stocks and limited resupply for at least 24 hours.
(3) Blood and Blood Products. In a catastrophic incident there will be a need for blood
and blood products. Currently, blood reserves for national emergencies consist of 500 units of pretested,
pre-positioned packed red cells held at two locations250 on the East Coast and 250 on the West Coast.
Another 750 units are held in geographically dispersed private blood collection facilities. Blood can be
ready for ground shipment within 4 to 6 hours. The responsibility for air shipment is dependent upon the
situation.
(a) The provision of blood/blood products will depend on the nature of the event;
however, local blood collections, processing activities, and testing capabilities may be suspended.
(b) Depending on the type of incident, blood collection centers and associated
activity locations (i.e., processing, testing, and distribution) may require decontamination. These facilities
should be given priority, as identified in Appendix 4.
(4) Additional Equipment and Supplies. National Disaster Medical System (NDMS)
Teams have their own caches of equipment and supplies.
3. Response Limitations and Unique Concerns
A. Regional and local healthcare facilities lack sufficient quantities of antibiotics, antidotes, and
other pertinent pharmaceuticals and medical countermeasures to effectively handle mass casualty incident
requirements.
B. Since most healthcare systems use a just in time inventory system for supplies, on hand
supplies could be depleted quickly during a large-scale event.
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Appendix 8 ? Patient Movement Response Overview
1. Mission
Coordinate the communication, transportation, and medical regulating system to evacuate seriously ill or
injured patients from the disaster site to reception facilities where they may receive definitive medical
care.
2. Planning Assumptions
A. Casualties requiring medical care following a catastrophic incident are expected to present
themselves or be taken to hospitals near the incident site for treatment. This includes hospitals not
participating in the National Disaster Medical System (NDMS).
B. Medical evacuation operations (through air, ground, or sea assets) that may occur in affected
areas within the first 96 hours following a catastrophic incident are limited.
C. State and/or local transportation assets, if available, will be used to transport casualties
requiring medical care to the designated patient collection point before further movement to a shelter or to
a hospital or other medical facility for care.
D. There is no preferred method of patient movement. Air, ground, and rail resources will be
used to support patient transportation.
E. Periodic reports of estimated beds available in the NDMS, Department of Veterans Affairs
(VA) Patient Reception Centers (PRCs), and Military Treatment Facilities (MTFs) represent the
approximate definitive medical capability available to accomplish continental United States (CONUS)
medical regulating and patient movement.
F. The Department of Health and Human Services (HHS) can help identify available hospital
resources that could potentially accept casualties.
G. Various asset-tracking systems need to be coordinated.
H. The Department of Defense (DOD) Global Patient Medical Regulating Center will serve as the
single patient movement manager when moving patients on U.S. Transportation Command Assets or
other Federal Departments (e.g., Department of Transportation (DOT)) and Agencies (e.g., General
Services Administration (GSA)) transportation resources. Federal patient movement operations will be
integrated into DODs information technology (IT) system, TRAC2ES (U.S. Transportation Command
Command and Control (C2) Evacuation Systemthe system of choice for casualty movement in response
to a catastrophic incident) to ensure visibility of patient movement to hospital-definitive care by the
Federal sector. Patients can be regulated to NDMS hospitals that have agreed to participate in NDMS.
I. The movement of casualties on non-DOD Federal assets will require:
(1) Medical crews and specialists to support ambulatory and non-ambulatory patient
movement.
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(2) Patient regulating teams to enter data into TRACE2ES and associated hardware/
software.
(3) Patient liaison teams to support patients placed in non-Federal, non-NDMS hospitals.
J. NDMS hospitals are authorized to provide emergency care to casualties of a catastrophic mass
casualty incident. If the number of casualties exceeds the available beds in NDMS hospitals, hospitals
outside the NDMS system will be contacted to determine their ability to accept patients. VA PRCs and
DOD MTFs are authorized to provide emergency care to casualties of a catastrophic mass casualty
incident. DOD MTFs may, through local Memoranda of Understanding (MOU) and if within the vicinity
of the incident site, provide necessary assistance to save lives, prevent human suffering, or mitigate great
property damage under imminently serious conditions without prior approval by the Secretary of Defense
(SECDEF). Subject to ongoing DOD missions and approval by the SECDEF, other MTFs may be
available to assist during a domestic incident.
3. Catastrophic Response Strategy
A. DHS/ FEMA will rapidly establish at least one Federal Mobilization Center (FMC), generally
at military bases/airfields, near each affected venue.
B. State and local authorities will collect and transport patients to designated transportation hubs
in coordination with FMCs for outbound and inbound patient movement operations.
C. A Medical Inter-Agency Coordination Group (MIACG), consisting of representatives from
DHS, HHS, DOD, and the VA will convene and assess national capabilities, including those of the
NDMS, to accept casualties into definitive, hospital-based care.
D. Patient care services at non-incident locations will generally be used only by specific affected
metropolitan areas. Destination facilities identified as being used by one affected metropolitan area will
not generally be considered for use by any other affected metropolitan area.
E. Patients will generally not be transported to facilities located near threatened metropolitan
areas.
F. DODs U.S. Transportation Command (TRANSCOM) will coordinate the movement of
casualties/patients from patient collection points, such as Mobilization Centers, to airfields or other
transporting sites, to hospitals for definitive care. This will be accomplished through DOT, GSA, and
available DOD transportation assets (aircraft, rail, bus, ship), to NDMS hospitals. All Federal missions
will be entered into DODs TRAC2ES IT system. Once the casualties exceeds the available capacity in
non-Federal NDMS hospitals, other non-Federal hospitals may be contacted to determine their ability to
accept patients. VA hospitals and DOD MTFs within the vicinity of the incident site may be able to
provide support, pursuant to ongoing missions and availability of resources. Subject to the approval by
the SECDEF, other MTFs may be available to assist during a domestic incident.
4. Transportation and Logistical Requirements
A. Available beds are beds considered vacant as of 24 hours prior to the day of the report, and
patients can be immediately transported to fill them. The beds must be in a functioning medical treatment
facility set up and ready for all aspects of the care of a patient. It must include supporting space,
equipment, medical material, ancillary and support services, and staff to operate under normal
circumstances. Excluded are transient patient beds, bassinets, incubators, and labor and recovery beds.
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B. Throughput is defined as the maximum number of patients (stable or stabilized) by category
that can be received at the airport, staged, transported, and received at the proper hospital(s) within any
24-hour period (including DOD/VA/NDMS hospitals). This is an estimate, subjectively derived from
considerations that include limitations on the reception site, local transportation, and personnel.
5. Response Limitations and Unique Concerns
The Federal sectors capability to transport non-ambulatory patients requiring medical care during transit
is limited. Additionally, resources to move contaminated and/or contagious patients are extremely limited
and, for planning purposes, it should be assumed that this capability does not exist within the Federal
sector.
6. Responsibilities of Coordinating and Support Agencies/Organizations
A. Coordinating Agency: HHS. When a catastrophic incident with significant numbers of
victims occurs, HHS will:
(1) In collaboration with DHS/FEMA/NDMS, through the VA Readiness Operations
Center, and the DOD Office of the Assistant Secretary of Defense for Health Affairs, alert local NDMS
Federal Coordinating Centers (FCCs) to obtain bed availability reports from the participating non-Federal
NDMS hospitals and report bed status to Global Patient Medical Regulating Center (GPMRC).
(2) Through VA, DOD representatives and appropriate VA and Military Services C2
systems, alert local NDMS FCCs to obtain bed availability reports from the participating hospitals and
report bed status to GPMRC.
(3) The concept of operation is for local authorities to operate Casualty Collection Points
(CCPs) that will feed into State-operated Regional Evacuation Points (REPs). Emergency Support
Function (ESF)#8 will coordinate the hand-off of patients from the REPs into the NDMS evacuation
system.
B. Supporting Agencies
(1) Department of Defense. DOD will provide health and medical services support as
outlined in the National Response Plan (NRP) Public Health and Medical Services Annex (ESF#8).
(2) Department of Veterans Affairs. The VA is responsible for supporting in-hospital
patient care services.
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Appendix 9 ? Mass Fatality Response Overview
1. Planning Assumptions
A. A catastrophic incident that produces mass fatalities will place extraordinary demands
(including tremendous religious, cultural, and emotional burdens) on local jurisdictions and the families
of victims. Accordingly, after a disaster, the timely, safe, and respectful disposition of the deceased is an
essential component of an effective response. Accurate, sensitive, and timely public relations are crucial
to this effort. A catastrophic incident involving mass fatalities will require Federal assistance to transport,
recover, identify, process, and store deceased victims. The actual work of identifying and processing the
victims can be lengthy and painstaking work, often complicated by the needs of investigative agencies.
Most local jurisdictions are not equipped to handle a mass fatality event and will experience profound
difficulties coping with the disaster.
B. During a mass fatality incident, local jurisdictions will lack sufficient personnel, equipment,
and storage capacity to handle significant numbers of deceased victims. Assistance from Federal, public,
and private agencies will be required to assist in the transportation, tagging, removal, processing,
identification, and final disposition of victims and remains. Advanced methods of DNA typing and
information management will be essential to effectively support mass fatality disasters.
C. In the event of a mass casualty event, mutual aid resources and Federal assets will be needed to
support local medical examiner/coroner activities, as well as to coordinate public and private assistance to
grieving families.
D. The mission of mass fatality management is to recover, transport, appropriately process, and
protect all human remains; establish victim identities and causes of death; preserve all property found on
or adjacent to the bodies; and maintain legal evidence for criminal or civil court action.
E. Catastrophic mass fatalities will present unique logistical challenges, including the need for
thousands of refrigerated trucks, disaster body pouches, and related supplies.
F. If the deceased have been contaminated with chemical, biological, radiological, and/or nuclear
agents, mortuary personnel will need to use special precautions to prevent cross contamination.
G. Refrigerated truck capacity is limited to 40 remains per vehicle, since stacking can cause
unnatural bruising or discoloration of the remains. Accordingly, the ability of the Federal Government to
quickly secure 3,000 or more refrigerated trucks to support transportation and long-term storage will
enable medical examiners/coroners time to identify, process, and hold remains until they can be
delivered to local funeral parlors.
H. Basic to a mass fatality response will be the identification and selection of a number of
Casualty Collection Points (CCPs), using a combination of refrigerated trucks, portable preparation and
storage sites (generally tents), the use of existing facilities such as National Guard/Reserve facilities,
Department of Veterans Affairs (VA) facilities, and/or abandoned or under-used and convenient
community structures. Collection sites will present significant challenges regarding access, traffic
control, security, access to power, loading docks, and air quality (related to diesel engines).
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I. Local medical examiners/coroners, State funeral associations, State and local emergency
management agencies, local and interState mutual aid, non-Governmental organizations (NGOs), local
hospitals and hospitals councils, the American Red Cross (ARC), Federal Emergency Management
Agency (FEMA), and Disaster Mortuary Operational Response Teams (DMORTs) will immediately and
actively respond to a mass fatality event. Additional Federal support will be coordinated in accordance
with National Response Plan (NRP) and National Incident Management System (NIMS) protocols, and
may include support from the Department of Defense (DOD), Department of Transportation (DOT), and
the VA.
2. Inventory of Federal Capabilities
A. Disaster Mortuary Operational Response Teams. There are currently 10 DMORTs; each
comprised of funeral directors, medical examiners, coroners, forensic pathologists, forensic
anthropologists, medical records technicians and transcribers, fingerprint specialists, forensic
odontologists, dental assistants, x-ray technicians, computer professionals, administrative support staff,
and security and investigative personnel. During an emergency response, DMORTsworking within the
incident command and management structure established by local authoritiesprovide technical
assistance and personnel to recover, identify, and process deceased victims.
(1) DMORT capabilities include:
(a) Temporary morgue facilities
(b) Victim identification
(c) Forensic dental pathology
(d) Forensic anthropology
(e) Processing, preparation, and disposition of remains
(2) In support of the DMORT program, FEMA maintains two Disaster Portable Morgue
Units (DPMUs) at FEMA Logistics Centers; one in Rockville, MD, and the other in San Jose, CA. The
DPMU is a cache of equipment and supplies for deployment to a disaster site and includes a complete
morgue equipped with designated workstations for each processing element.
B. DOD Mortuary Services
(1) Following a mass fatality incident, which is likely to occur without warning and result
in considerable confusion, there is generally a lack of sufficient personnel to handle the sensitive tasks of
caring for the deceased. The Federal, State, and local governments may request DOD assistance in a
mass fatality incident. In the event of mass disasters when the requirements for mortuary services
exceeds that available from the civilian community, available DOD mortuary services support that has
been approved by the Secretary of Defense (SECDEF) can be provided to support the Coordinating
Agency in responding to a mass fatality request. DOD military services have Mortuary Affairs (MA)
units that establish, operate, and maintain MA collection points and coordinate evacuation operations for
deceased military personnel throughout the military area of operations worldwide. Capabilities include:
(a) Search and recovery of remains
(b) Presumptive identification
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(c) Processing and evacuation of remains
(d) Storage of remains
(2) Military MA units or personnel can provide these services listed above at an incident
site in support of the Coordinating Agency or augment the local authorities within existing civilian
processing/storage facilities (morgue) by providing technical assistance, processing, administration, and
storage of remains. Each ServiceU.S. Air Force (USAF), U.S. Army, U.S. Navy (USN), and U.S.
Marine Corps (USMC)have MA teams comprised of Active Duty and Reserve personnel. They range
from nine to 350 member teams that are used for DOD missions, and if available and approved by the
SECDEF, may be used to provide MA support as part of the Federal response to a catastrophic event.
Some of these teams complement the Dover Air Force Base (AFB) mass disaster investigation processing
facility that is led by the Armed Forces Institute of Pathology. Others may augment remains search,
recovery, and presumptive identification services at or near the disaster site. Active Duty members of
DOD MA Teams can be deployed quickly; however, a full complement will require mobilization of
Reservists that could take up to 10 days.
(3) Mass casualty investigation technical assistance and processing for conventional
weapons or natural disaster incidents can be provided at the mass disaster investigation and remains
processing facility at Dover AFB. However, investigation for contagious or contaminated remains cannot
be processed by DODs mass disaster investigation and processing facility; their capabilities only include
victim identification through dental examination, Federal Bureau of Investigation (FBI) fingerprinting,
and x-ray and digital processing.
(4) Armed Forces Medical Examiner Teams can provide technical assistance and pathology
and identification services to local authorities at the disaster site. Additionally, the Armed Forces
Institute of Pathology can provide death investigation services and support activities for toxicology, DNA
testing, and forensic anthropology.
(5) The Joint Prisoner of War/Missing in Action (POW/MIA) Accounting Command
(JPAC), Oahu, HI, accounts for missing Americans from previous conflicts and could support a homeland
security incident to account for unaccounted victims. JPAC performs analysis, investigation, recovery of
missing persons, and identification of remains of deceased victims. JPACs Central Identification
Laboratory provides anthropological studies, DNA identification, and odontosearch (before and after
death dental comparison) to establish personal identification.
3. Response Strategy
A. Response Strategy: IMMEDIATE.
(1) National Disaster Medical System (NDMS) DMORT and Disaster Medical Assistance
Team (DMAT) assets will commence deployment actions in accordance with the Catastrophic Incident
Response Execution Schedule (Annex 1). Based on subsequent situational assessment information and
the judgment of local medical examiners/coroners, Emergency Support Function (ESF)#8 will:
(a) Deploy additional DMORTs, DMATs, portable morgues, and such rental units
that may be available.
(b) Initiate, in coordination with local authorities, selected mass disposal of human
remains.
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(c) Locate and establish 50 reception sites for human remains.
(d) Secure human remains retrieval staffing from Urban Search and Rescue (US&R)
Teams, National Guard, Reserve elements, American Red Cross (ARC), and available volunteers from
participating NGOs supporting various Federal, State, and local mutual aid resources.
(e) Secure as many as 3,000 refrigerated trucks to both transport and store human
remains.
(f) Provide information technology (IT)/DNA-typing support unit(s).
(g) Establish a transportation coordination and development unit to address logistical
issues and transportation requirements of human remains to and from local hospitals, reception sites,
medical examiner/coroner offices, and local funeral parlors.
(h) Provide, with support from NGOs, mental health and counseling services for
families of victims.
(i) Assign human remains retrieval teams to the larger reception sites.
B. Response Strategy: FIRST 10 DAYS.
(1) During this period, decisions will be made regarding mass disposition strategies,
storage, and processing at the reception sites and follow-on deployment of national DMORT assets. State
and local emergency management agencies will quickly experience staffing/resource limitations as local
funeral directors, the National Guard, and contractors begin exhausting existing inventories. Accordingly,
the Federal Government will approach a variety of Federal, State, and local governmentalas well as
privateentities to assist in the provision of additional personnel and equipment to search for, retrieve,
transport, identify, categorize, and otherwise process potentially tens of thousands of humans remains.
Staffing and equipment augmentation will be sought from the following organizations:
(a) Federal DMORTs
(b) National US&R Teams
(c) State Funeral Directors Associations
(d) Local and Federally recognized mutual aid providers
(e) National Guard
(f) DOD
(g) VA
(h) DOT
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C. Response Strategy: SUSTAINED.
(1) From Day 10 until the last victim has either been the subject of mass disposition or
released by the local medical examiner/coroner to a local funeral parlor, the emphasis will shift from the
location and retrieval of the remains to full functioning (staffing, securing, and equipping) of the
reception sites. Federal Coordination Centers (FCCs) will continue to work with the local medical
examiner/coroner offices and State and local emergency management agencies, though restocking and
rotation of personnel will continue to be heavily weighted as Federal assignments.
4. Transportation Requirements
A. For the first 10 days following a catastrophic incident, the location, retrieval, transportation,
identification, and processing of human remains will be the initial focus of mass fatality response efforts.
Depending on the characteristics of the situation, mass disposition may be implemented. DMORTs are
expected to play a major role in support of these initial response activities, to include acquiring several
thousand refrigerator trucks, staffing massive human remains transportation initiatives, and securing tens
of thousands of disaster pouches.
B. During Days 10 to 20 the focus of mass fatality response efforts will broaden to include the
staffing and equipping of 50 reception sites and the establishment of a transportation rotation between the
various sites involved with processing and storing remains.
C. From Day 20 forward, the response will focus on completing the staffing and equipping of
reception sites and ensuring the proper disposition of all remains.
D. Mass fatality-related transportation and logistics requirements may include:
(1) Deployment of up to 10 DMORTs and two DPMUs and related assets, including
portable morgues and associated equipment.
(2) Deployment of up to 10,000 pathologists, funeral directors, and additional mortuary
support personnel.
(3) Up to 3,000 refrigerated trucks (2,500 for storage and 500 for transportation) for storage
and transportation of human remains.
(4) Up to 10,000 personnel to load, drive, repair, and secure the trucks at reception sites.
(5) Between 50,000 and 120,000 disaster pouches for human remains.
(6) Up to 50 reception sites with appropriate security, privacy, loading docks, power
outlets, and dormitory facilities (for up to 5,000 personnel, based on a 12-hour shift schedule).
(7) Up to 100 Technical Information Specialists.
(8) Up to 100 qualified personnel to augment DMORT DNA-typing resources.
(9) U.S. Public Health Service (PHS) Commissioned Corps Forensic Dentists.
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5. Limitations
A. All potential or requested assets and resources may not be available to respond to a
catastrophic event due to competing requirements at their home institutions (e.g., DOD assets may not be
available due to primary mission priorities) or because of family concerns.
B. Logistics systems may be overwhelmed and unable to move, in a timely manner, the projected
volume of personnel, victims, and equipment.
C. Protocols on movement and MA and identification processing of biologically and/or
chemically contaminated remains are non-existent.
D. Lack of standards for decontaminated remains.
E. Storage area where remains can be processed for family members to help identify the remains.
Could be a large permanent structure; but would require refrigeration. Contracted refrigeration vans
would suffice.
F. Storage area needed for personal effects; local procedures for inventorying personal effects
may be incorporated into Federal inventory procedures.
G. Supplies and equipment (e.g., pouches and litters) will be needed for large number of
deceased.
6. Responsibilities of Coordinating and Support Agencies/Organizations
A. Coordinating Agency: HHS. As coordinating agency for ESF#8, HHS provides leadership
in directing, coordinating, and integrating overall Federal efforts to provide mortuary assistance,
equipment, and supplies in support of the incident response.
B. Support Agencies
(1) U.S. Department of Homeland Security. DHS assists, principally through the NDMS,
in providing victim identification and mortuary services (including DMORTs); temporary morgues;
forensic dental and/or forensic pathology/anthropology; and support for processing, preparation, and
disposition of remains.
(2) Department of Defense. DOD provides assistance in managing human remains,
including victim identification and disposition.
(3) American Red Cross. ARC provides support counseling for family members of
victims and provides personnel, if available, to assist morgue operations.
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Appendix 10 ? Housing Response Overview
1. Mission
This appendix outlines interim and long-term catastrophic incident housing requirements and strategy
using current capabilities.
2. Planning Assumptions
A. A large number of people are homeless. Primary dwellings are destroyed, heavily damaged,
unlivable, and/or inaccessible.
B. There will be significant disruption of infrastructure that impacts residential area and
endangers public health and safety.
C. The ability to reenter and reoccupy primary dwellings will be dependent upon the incident
hazard, event, and geography.
D. Existing emergency shelter and temporary housing resources will not be sufficient to address
the numbers of individuals in need.
E. The Emergency Management Assistance Compact (EMAC) will be activated and neighboring
States will be accepting disaster victims.
F. There will be significant public health, law enforcement, and transportation issues.
G. This housing strategy will be implemented in cooperation with the affected State, Tribal,
and/or local governments(s).
H. There will be other disaster events such as floods, tornadoes, or hurricanes elsewhere in the
country during this response and recovery operation.
I. Federal and voluntary agencies will be available under the National Response Plan (NRP) for
primary and support functions.
J. It will be necessary to register recipients of Federal assistance but there will be significant
impediments to the registration process. Registration is necessary to provide continued assistance as
victims become dispersed, to reunite families, and ensure program accountability. Using the standard
teleregistration and inspection process will not be feasible in all areas. The field registration intake
process will be concentrated in or near emergency shelters. Registrations will be taken in the field by
caseworkers.
K. Current means of disbursing and delivering disaster assistance will be inadequate to overcome
disaster-related disruptions in banking and/or mail delivery services.
L. Individuals will not have access to their homes, jobs, schools, stores, pharmacies, etc. There
will be a lack of health and medical care, sanitation and hygiene, and food and water.
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M. Most individuals and families will be able to find shelter or temporary housing that is
preferable to congregate shelters if they are given the financial means. This will require providing the
victims money and, in some cases, transportation. Individuals and families will occupy individual
dwellings such as apartments, hotels, motels, manufactured housing, or tents whenever possible.
N. Normal methods of information dissemination will be significantly impaired due to the
disruption of utility services.
O. Management of the influx of incoming workers (e.g., Federal, State, and local response staff;
insurance adjusters; and unsolicited volunteers and construction companies) is essential to prevent a
second housing disaster from occurring. Planning for housing of these individuals is not included in this
appendix.
P. Elevation of the Homeland Security Advisory System (HSAS) will impact transportation
alternatives for victims seeking shelter or being transferred from shelters to temporary housing.
3. Catastrophic Response Strategy
The core strategy for housing will be to provide people the financial and other assistance to move out of
emergency shelters and into temporary and/or long-term housing as rapidly as possible. This will include
encouraging people to temporarily leave the disaster area until local temporary housing becomes
available.
A. Response Strategy: IMMEDIATE.
(1) In coordination with voluntary agencies, identify traditional and non-traditional shelter
resources within the immediate vicinity of the impact area.
(2) Identify traditional and non-traditional shelter resources within 250 miles of the impact
area to shelter victims and recovery personnel.
(3) Identify available housing resources within a 100-mile radius of the impact area,
including potential sites for manufactured housing.
(4) Deploy housing component of the Emergency Response Team to the area to establish an
initial operating capability.
(5) Activate contract employees to begin processing applications for disaster assistance and
conducting residential damage inspections.
(6) Disseminate public messages informing victims of what to do and the kind of disaster
assistance to expect and the timeframes for delivery of services. Encourage people to temporarily
relocate to outside the disaster area.
B. Response Strategy: FIRST 10 DAYS.
(1) Receive individuals and families into emergency shelters. Rapidly convert existing,
structurally sound, accessible buildings for use as emergency shelters for meeting basic human needs.
Structures in this category include commercially owned warehouses, manufacturing plants, vacant
Federal facilities, stadiums, convention centers, and shopping malls.
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(2) Identify registration intake and damage inspection strategy.
(3) Identify strategy for disbursing and delivering disaster assistance payments to displaced
populations.
(4) Consider private site use of tents and the use of larger tent cities (and prefabricated
units) to house portions of the affected population.
(5) Register individuals and families and conduct pre-placement interviews (PPIs).
(6) Determine need and capabilities for expediting, postponing, or waiving residential
damage inspections.
(7) Identify housing resources within the disaster area and neighboring States.
(8) Identify existing vacant manufactured housing sites (trailer parks) within 100 miles of
the impact area.
(9) Establish contracts with existing trailer parks and receive and position manufactured
housing units there.
(10) Identify undeveloped sites for manufactured housing units within 100 miles of the
impact area.
(11) Establish housing plan.
(12) Establish and staff Disaster Recovery Centers (DRCs) in or near emergency shelters.
(13) Disburse appropriate financial and other assistance to victims who want to temporarily
leave the disaster area.
(14) Refer individuals to available temporary housing such as apartments, hotels, motels, and
manufactured housing, and provide them with appropriate financial and other assistance.
(15) Deploy inspection and repair teams to identify and repair homes with minimal damage.
(16) Identify neighborhoods with light damage that can be reoccupied if provided with water
and sanitation services (e.g., portable toilets).
(17) Deploy water and sanitation services to neighborhoods. (Mission would be tasked to
the U.S. Army Corps of Engineers (USACE) by the Federal Emergency Management Agency (FEMA).)
(18) Assemble Emergency Support Function (ESF)#14 to implement long-term recovery
planning process.
(19) Identify resources for the transport and relocation of individuals and families from
shelters to temporary housing in areas of their choosing within 30 to 45 days.
(20) Implement staff rotation plans for existing shelters.
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C. Response Strategy: SUSTAINED.
(1) Integrate hardcopy registrations into the National Emergency Management Information
System (NEMIS).
(2) Continue to identify available housing.
(3) Implement FEMA temporary housing strategy.
(4) Continue to disburse financial and other assistance to victims and refer victims to
temporary housing.
(5) Continue repair of minimally damaged housing.
(6) Coordinate procurement and delivery of temporary housing units.
(7) Continue set up of manufactured housing and temporary shelter sites.
(8) Place individuals and families in Federal or privately owned temporary housing.
(9) ESF#14 coordinates long-term recovery strategy.
(10) Convert and remodel available, structurally sound buildings to make the structures
suitable for longer term interim housing.
(11) Remove debris and remediate sites as appropriate to allow for reoccupation and/or the
building of temporary and permanent structures.
4. Transportation and Logistical Requirements
A. Victims from assembly points to emergency shelters.
B. Recovery workers in and to the disaster area.
C. Delivery of supplies to the DRCs.
D. Delivery of housing units to the housing sites.
E. Victims from shelters to temporary housing.
5. Response Limitations and Unique Concerns
A. Individual assistance caseworkers and other trained staff.
B. Existing shelter sites.
C. Trained housing inspectors.
D. Public/private partnerships.
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6. Response Capabilities
A. Organic Federal
(1) Staff from:
(a) FEMA National Processing Service Centers (trained).
(b) Internal Revenue Service (IRS) (trained and not trained).
(c) FEMA Headquarters (HQ) and Regions (trained and not trained).
(d) Other Federal Agencies (not trained).
(2) Materials:
(a) DRC Go Kits from Logistics warehouses.
(b) Temporary Housing Units stock and tent stock.
(c) Federally owned housing (U.S. Department of Agriculture (USDA), Department
of Housing and Urban Development (HUD), Department of the Interior (DOI), Department of Defense
(DOD)).
B. Non-Organic Federal
(1) Staff from:
(a) FEMA inspections services contract.
(b) USACE inspection, engineering, and construction contracts.
(c) Federal local hires.
(2) Materials:
(a) Temporary Housing Units procurement contracts.
(b) Temporary Housing Units hauling and installing contracts.
(c) Standby disaster procurement contracts.
7. Coordinating and Support Agencies/Organizations
A. Coordinating Agency: U.S. Department of Homeland Security (DHS)/FEMA.
B. Support: American Red Cross (ARC), DOD, Department of Labor (DOL), Department of
Transportation (DOT), Department of Health and Human Services (HHS), HUD, Small Business
Administration (SBA), USACE, USDA, U.S. Postal Service (USPS), Department of Veterans Affairs
(VA), and the Private Sector.
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National Response Plan ? Catastrophic Incident Supplement
Appendix 11 ? Public Information and Incident Communications
Response Overview
1. Mission
This appendix outlines how information will be communicated to the public in support of a catastrophic
incident response effort.
Interagency Coordination
The National Response Plan (NRP) Incident Communications Emergency Policy and Procedures
(ICEPP) is the primary incident communications plan for use by the Federal interagency. It is used
in conjunction with State and local authorities to manage incident communications and Public
Affairs activities during domestic incidents. The NRP-ICEPP incorporates specific incident
communications guidance on operations in support of weapons of mass destruction (WMD) or
catastrophic incident scenarios. This appendix will be used in conjunction with the NRP-ICEPP
during such incidents. It provides detailed information on Departmental and Agency incident
communications resources to support response contingency plans.
Each Department or Agency has respective emergency plans that are implemented as appropriate
subject to respective missions, the nature of the incident, and tasks. These authorities support the
NRP-ICEPP through implementation of their respective plans. These actions are incorporated in the
overall interagency planning effort that is developed in the first hours of the incident. This effort
uses the incident communications processes of control, coordination, and communications to unify
and synchronize the interagency effort.
2. Planning Assumptions
A. National Incident Communications Planning Assumptions
(1) Primary Communications Objectives. All weapons of mass destruction (WMD)
incidents. Direct communication from the Federal Government to the public will focus on lifesaving and
life-sustaining information.
(2) National Reassurance Objective. All WMD incidents. Reassuring and informing the
public in areas not affected by the incident is critically important to the stability of communities and
security of our population. Updated or available preparedness information must be reemphasized and
aggressively pointed out to the non-affected public. Progress reports on the incident and the Government
recovery plan must be provided to the public. Reassuring and informing the non-affected population is
critical to the overall success of the recovery effort.
(3) Pre-Incident Education. All WMD incidents. Public responsiveness following a
WMD incident will be significantly enhanced through increased pre-incident awareness of basic
preparedness and response measures. Resources such as Ready.gov, media threat education, and predeveloped
fact sheets all increase the ability of our citizens to better cope with or understand the nature of
a threat and incident.
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(4) Scientific Support. All WMD incidents. Immediate and follow-on scientific support
for Public Affairs and the public messaging effort is critical to saving lives, mass movement of people,
and emotional stability of our citizens in affected and non-affected areas. Public information must be
correct and consistent with scientific recommendations.
(5) Panic and Rumors. All WMD incidents. It is possible that panic and rumors about an
incident will occur and spread to non-affected areas of the Nation. The national incident communications
effort must anticipate this possibility and ensure that measures are incorporated to mitigate or inhibit the
spread of false information. Consistency among Federal, State, and local authorities in providing incident
information beginning in the initial moments following the report of an incident is critical, as well as
demonstrating that authorities do have plans and are working hard to implement them.
(6) Communications Infrastructure. All WMD incidents. The capability to immediately
and effectively communicate to the population in affected or damaged regions may be destroyed or
severely degraded. Rapid employment of the Emergency Alert System (EAS), National Oceanic and
Atmospheric Administration (NOAA) Weather Radio, maximum use of battery-powered radios, nontraditional
measures (two-way radios, HAM radios, etc.), and other alternatives will be essential to
communicating our messages until power and normal utilities are restored. The ability of the Joint
Information System (JIS)/Joint Information Center (JIC) to coordinate and communicate may be
significantly limited or precluded. In situations with severe loss of utilities, a battery-powered radio kept
by citizens provides a very effective means to receive timely public instructions and incident information.
(7) Control, Coordination, and Communication. All WMD incidents. A catastrophic
mass casualty/mass evacuation incident resulting from an act of terrorism may cause significant public
concern, both in the incident area and nationally. State and local authorities will retain the lead
responsibility for communicating positive, continuous, consistent, and timely public information and
guidance to the affected population and those citizens potentially at risk. Federal, State, and local
authorities must synchronize their efforts from the outset of an incident to reduce the development and
spread of panic and rumors. The Federal Government will immediately coordinate with and support State
and local public information efforts in the affected areas to ensure that communications at all levels are
synchronized and consistent. The Federal Government will coordinate with other non-affected States and
authorities to reassure citizens, disseminate preparedness guidance, and protective measures.
B. Federal Interagency Planning Assumptions
(1) Department of Veterans Affairs (VA)
(a) VA resources are distributed Nationwide and located in, or close to, major
population centers. It may be assumed that should such an incident occur near a VA medical center
without damaging or seriously diminishing its operational capacity, the facility will be a key asset in
providing medical support and expertise to State and local emergency response agencies. This is in
addition to maintaining all basic services to its constituent veteran population.
(b) Because VA facilities are organized into Regional networks, personnel and
material to support incident response activities would be directed through the network offices.
(c) Public Affairs Officers (PAOs), many of whom serve in an additional duty status,
are located throughout the VAs national networks in each of its three administrations. In some cases
these individuals provide support in overlapping geographic areas.
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(2) Department of Health and Human Services (HHS)
(a) Ensuring that accurate medical and public health information and guidance is
provided is of immediate paramount importance to protect and save lives of those who may be affected by
the incident. This should be a top priority of Federal-wide incident communications.
(b) HHS Public Affairs staff could be dispersed at the time of an event or could be
directly affected by the event. HHS communication plans include the use of Public Affairs staff at its
agencies in locations that would be unaffected directly.
(c) HHS would rely on its family of agencies, in particular the Centers for Disease
Control and Prevention (CDC), to assist in public information activities and to provide subject matter
expertise in all communications activities.
(3) U.S. Department of Agriculture (USDA)
(a) The safety of food and livestock may be jeopardized during an event.
(b) Public information about the safety of the food supply should be a top priority.
(4) Environmental Protection Agency (EPA)
(a) Will provide support in accordance with the National Response Plan (NRP).
(b) EPA Public Affairs will use its Crisis Communications Plan.
(5) Department of Transportation (DOT)
(a) Large numbers of people may be casualties. These could include Departmental
Public Affairs staff and news media representatives.
(b) When the incident occurs, offices will be evacuated and staff dispersed. If it
occurs after working hours or on a weekend or holiday, staff will be dispersed.
(c) Public Affairs staff and leadership will be unable to access normal logistical
support, such as the Departments information technology (IT) and local area network (LAN). Computer
networks and even personal computers (PCs) themselves will shut down.
(d) Transportation in the area will stop. Roads will be jammed by people leaving the
metropolitan area. In certain cases, cars, trucks, buses, subways, trains, aircraft, etc., will not operate
because of electronic interference from the attack.
(e) Demand for information about transportation facilities, roads, bridges, airports,
etc., from news sources outside Washington, DC, will be great. New York, Chicago, Los Angeles, or
other metropolitan areas will become news central.
(6) American Red Cross (ARC)
(a) The Public Affairs staff of the ARC will initiate communication strategies that
support the response activities of the Red Cross.
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(b) The ARC will also mobilize its resources and capacities in coordination with
Federal, State, and local governments, partner agencies, and other non-Governmental organizations
(NGOs) to disseminate preparedness, safety, security, and calming messages to the affected communities
and the general public.
3. Federal Public Affairs and Incident Communications Capabilities
A. U.S. Department of Homeland Security (DHS)
(1) Joint Information Centers (JICs). Following an incident of national significance or
domestic incident, JICs are established to coordinate the Federal, State, Tribal, and local incident
communications effort. A JIC is a central point for coordination of disaster information, Public Affairs
activities, and media access to information about the latest developments.
(a) National JIC. Initially, and at the national level, a virtual JIC led by DHS Public
Affairs coordinates information among Federal Departments and Agencies. If necessary, a national JIC
may be established at DHS/Federal Emergency Management Agency (FEMA) Headquarters (HQ) in
Washington, DC, or another designated location. If established, Federal Departments and Agencies may
be requested to provide representatives to the national JIC. A national JIC may be used when an incident
of national significance is anticipated to have an extended duration (i.e., weeks or months).
(b) Incident JIC. The JIC is a physical location where incident communications
professionals from organizations involved in the response work together to provide critical emergency
information and Public Affairs response functions. The JIC serves as a focal point for the coordination
and dissemination of information to the public and media concerning incident prevention, preparedness,
response, recovery, and mitigation. The JIC may be established at an on-scene location in coordination
with State, Tribal, and local agencies depending on the requirements of the incident. In most cases, the
JIC is established at, or is virtually connected to, the Joint Field Office (JFO), under the coordination of
DHS Public Affairs.
(2) Staff Organization. DHS Public Affairs personnel are managed by the DHS Assistant
Secretary for Public Affairs (ASPA). This centralized management of highly trained personnel is
particularly effective during incident management situations where additional assets can be surged from
one component to support another or the overall national effort. Moreover, these personnel assets are
distributed around the United States and provide depth or deployable support to other locations.
(3) Staff Incident Management. During a domestic WMD or incident, DHS Public
Affairs will support and manage the following elements:
(a) Press Office. Performs primary media response and management of Departmental
issues or queries, including changes to the Homeland Security Threat Status.
(b) Speechwriting. Performs drafting tasks in support of the Secretary DHS and
other senior leadership. They prepare statements for use during major announcements.
(c) Interagency Incident Management Group (IIMG). DHS Public Affairs
assigns a team of experienced incident management personnel to the IIMG. They coordinate and support
the IIMG on Public Affairs issues and provide liaison with incident communications decisionmakers.
They also assist in coordinating the interagency through the National Incident Communications
Conference Line (NICCL).
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(d) Principal Federal Official (PFO) PAO. The deploying DHS PFO(s) will be
assigned a DHS Staff PAO to provide coordination between the JIC, incident site Public Affairs
leadership, and PFO personal staff. The PFO PAO will stay in close consultation with the DHS Public
Affairs staff while deployed for an incident.
(e) Homeland Security Operations Center (HSOC). The DHS Public Affairs
Duty Officer (PADO) will remain on watch in the HSOC and liaise with the Press Office, IIMG, and
other components.
(f) Media Support. A media support staff assists the Press Office and interagency
coordination efforts.
(g) Web Support. The DHS Public Affairs Web team maintains close contact with
the Press Office and other key staff to ensure the Web site contains the most relevant incident
information.
B. DHS Component Agencies. DHS Public Affairs manages Public Affairs personnel in 22
component agencies throughout the United States. Additional specialized resources are noted below:
(1) Federal Emergency Management Agency
(a) Emergency Response Team (ERT). ERTs have a Public Affairs component
(full-time and reserve disaster cadre).
(b) Mobile Emergency Response Support (MERS). The primary function of
MERS is to provide mobile, self-sustaining telecommunications, logistics, operations, and administrative
support required by Federal, State, and local responders in their efforts to save lives, protect property, and
coordinate disaster operations. Assets include some 270 mobile units, from five detachments positioned
throughout the United States that provide emergency telecommunications, logistics and operations
support.
(c) National Emergency Response Team (ERT-N). The ERT-Ns are activated for
large disasters only. When disaster hits multiple States, each State gets its own ERT (or ERT-N if
needed) based on the severity and magnitude of the incident (for example, during Hurricane Isabel, only
Virginia got an ERT-N; the other affected States received regular ERTs, made up mostly of Regional
resources).
(d) Community Relations (CR). The CR function provides the vital information
link between DHS/FEMA, the State, local communities, and those affected by disasters. The information
link is designed to ensure the citizens of disaster-affected communities are aware of available Federal
disaster assistance programs and how to access them. The CR cadre includes 241 personnel who work
during times of a Presidential declared disaster or emergency to provide information and assistance to
disaster victims and their communities to increase understanding of disaster assistance and to increase
DHS/FEMAs disaster response and recovery efforts. CR works in close coordination with Response and
Recovery Divisions and the Regional Cadre Managers to ensure the CR Disaster Assistance Employees
(DAEs) are trained to provide accurate and timely information to the Federal Coordinating Officer (FCO)
and State Coordinating Officer (SCO), disaster victims as well as the State, local, and community
leadership. CR DAEs also are trained to understand the communities and their disaster related issues.
From this understanding, field reports are produced to reflect those concerns and a recommendation is
produced to resolve the issue. The Federal and State Coordinating Officers and the Headquarters Cadre
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Manager also use these reports to ensure a clear understanding of how DHS/FEMAs disaster assistance
programs assist the community analysis and victims of a disaster.
(e) Emergency Alert System (EAS). The EAS is activated for the President by
FEMA and is managed in coordination with the FCC. It is also available within minutes to provide
commercial broadcast resources to national, State, and local authorities in an emergency to transmit
critical information to the public. The EAS is activated by the FEMA Operations Center (FOC) or the
FEMA Alternative Operations Center (FAOC) to provide audio broadcasts at the direction of the
President and DHS Secretary.
(f) Broadcast Radio Teams. The Broadcast Radio Team and the Broadcast
Television Team are the remote broadcast assets that FEMA deploys and is staffed by DAEs. These
teams allow Federal response authorities and DHS/FEMA to set up an information broadcast in a
community where normal media has been rendered incapable of broadcasting or operating.
(2) Border and Transportation Security (BTS). DHS BTS Public Affairs retains a strong
surge force of Public Affairs personnel through the many staffs and/organizations they support. This
includes airports, seaports, border crossings, and other customs and immigration facilities.
(3) U.S. Coast Guard (USCG). The USCG has a similar range of Public Affairs personnel
and offices arrayed around the Nation. While they are mainly located in coastal areas, they can be surged
and deployed for contingency purposes to other incidents. Special response capability is provided by a
Public Information Assist Team (PIAT). This is a deployable specialized Public Affairs team skilled in
hazardous material (HAZMAT) and environmental response, capable of supporting conventional,
biological, and chemical incidents.
C. Department of Veterans Affairs (VA). VA maintains a large force of field Public Affairs
personnel to support the wide network of facilities around the Nation. Field PAOs are located at each VA
medical center (162), Regional office (57), and cemetery (120). VAs Regional offices of Public Affairs
are located in New York, Washington, DC, Atlanta, Chicago, Dallas, Denver, and Los Angeles (21), plus
the VAs central office compliment of PAOs (20) brings the total to 380 people.
(1) Field Capabilities. Each field location has, as a minimum, computer, telephone, and
fax capabilities while approximately 20 VA medical centers possess some level of medical media support
for documentary coverage capability.
(2) Regional Offices. Five of the seven Regional offices of Public Affairs have digital
cameras, two have 35mm cameras, and one owns a video camera.
(3) VA Central Office. Operates a fully operational three-camera television studio with
digital post-production editing capability and access to three satellite broadcast channels. A media
services office provides a full range of audiovisual recording and still photography.
D. U.S. Department of Agriculture (USDA). The USDA possesses the following Public Affairs
resources:
(1) Television and radio studio with satellite capabilities at the Washington, DC, HQ
Building.
(2) Agency Public Information Officers (PIOs) in regions, States, and many counties.
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(3) Virtual War Room plan would be implemented to support public information efforts.
(4) Remote computer database capability to access lists.
(5) Food and agricultural experts in U.S. embassies.
(6) Food and agricultural constituent outreach lists.
(7) Webcast capabilities.
E. Department of Health and Human Services (HHS). HHS ASPA maintains the following
team structure to be ready to respond to a catastrophic incident:
(1) HHS ASPA. Coordinates the overall HHS Public Affairs response, maintains close
liaison with the Secretary, White House, DHS, CDC Director, NIH Director, Food and Drug
Administration (FDA) Commissioner, Assistant Secretary for Public Health Emergency Preparedness
(ASPHEP), and other principals. HHS ASPA also directs all HHS/CDC Public Affairs Team operations
and meets regularly with team leaders.
(2) Media and Message Team. This team handles media inquiries to include coordinating
and fulfilling requests. The team also coordinates development of unified talking points for principals
and Public Affairs staff to use when speaking to the media or in other public venues.
(3) Materials Development and Writing Team. The team develops, writes, and produces
documents necessary to communicate emergency response information. Materials include news releases,
background papers, factsheets, question and answer papers, and secretarial speeches. The team maintains
and ensures all information is accurate and up-to-date.
(4) Outreach Team. The team oversees outreach of communication materials and
information to HHS partner organizations as well as all other interested organizations. This includes
outreach to other governments, the private sector, not-for-profit organizations, minority groups, and other
organizations affected by the crisis. The team will coordinate public information campaigns, public
service announcements, and look for opportunities to partner with organizations to educate the public.
(5) Go Team. The team is comprised of staff that deploy as Public Affairs representatives
at various locations to assist HHS ASPA in liaison and communications activities. Upon activation,
predesignated HHS ASPA personnel will report to the CDC in Atlanta, GA, the Secretarys Emergency
Operations Center (EOC) and the ASPHEP. A Public Affairs representative will also travel with the
Secretarys Emergency Response Team (SERT). Go Team members primary responsibilities are to
prevent communications failures, misunderstandings, ensure coordination in the release of information
and consult with HHS ASPA on all major media requests.
(6) Web Team. The team oversees prompt posting of all Public Affairs materials to the
HHS Web site. The team also assesses how the Internet can be best used to communicate with the public
with information on the crisis.
(7) Studio/Broadcast Team. The team ensures the HHS studio and auditorium are ready
for use in an emergency situation. Their duties include setting up for news conferences, taping messages
from the Secretary and other senior officials, establishing communications with CDC, handling
teleconferences and documenting, via video and still photo, activities of the Secretary and key HHS
response components during a crisis.
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(8) Support Team. The team handles all essential Public Affairs administrative and
technical support. Their duties include procuring supplies, posting and distribution of news releases,
handling incoming telephone calls, and maintaining and circulating news clips.
(9) Preparedness and Health Information. HHS and its agencies maintain a wealth of
medical and public health information on biological, chemical, nuclear, and radiological agents and
hazards on their respective Web sites.
(10) Emergency Web Support. HHS also maintains an emergency shell Web page that can
be populated and posted quickly with information relevant to the event.
F. Environmental Protection Agency (EPA)
(1) EPA Headquarters. The EPA HQ Public Affairs staff consists of media relations;
communications including Web posting on the EPA homepage; video and still photography, and public
liaison.
(2) EPA Regional Support. Public Affairs Offices in EPAs 10 Regional HQ and
laboratories.
G. Nuclear Regulatory Commission (NRC). In the event of a nuclear or radiological
emergency involving an NRC-licensed nuclear facility or materials, NRC would activate and fully staff
its EOC at its HQ in Rockville, MD, including Public Affairs, to issue press announcements and operate a
news center for press briefings, as needed. Briefings would be Webcast live and archived for future
viewing by the public.
(1) Regional Teams. Regional teams with Public Affairs staff would be deployed from
one of four regions to the site of the emergency where they would support a pre-established joint
information/news center provided by the facility operator. This facility accommodates Public Affairs
staff of the facility operator, NRC, FEMA, possibly the Federal Bureau of Investigation (FBI), and the
affected State and counties. Members of the media would be briefed periodically at this facility on the
status of the facility and the response.
(2) Headquarters Staff. NRC Public Affairs staff at HQ will handle incoming media calls
and monitor news coverage.
(3) Interagency Coordination. Coordination and communication with DHS and other
Federal agency Public Affairs personnel would be achieved through the IIMG and the NICCL. Other
communications would be coordinated with the JIC, affected States central news centers, and the plant
operators public information organization.
(4) NRC Incident Response Plan. Procedures and participants for responding to a
radiological emergency are identified in the NRC Incident Response Plan, which will be followed if an
event becomes an emergency in accordance with predetermined emergency classification levels. The
NRC would post all its press releases and other Public Affairs material relevant to the event to its home
page on the Internet as well as providing it directly to DHS, the JIC and media.
H. Department of Transportation (DOT)
(1) Office of the Secretary. Twelve Public Affairs supervisors and specialists.
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(2) Federal Aviation Administration (FAA). Thirteen Public Affairs supervisors and
specialists in Washington, DC; 12 Regional supervisors and specialists in locations outside DC.
(3) Federal Highway Administration. Three specialists in/four outside Washington, DC.
(4) Federal Railroad Administration. Two specialists in Washington, DC.
(5) National Highway Traffic Safety Administration (NHTSA). Ten specialists in
Washington, DC, and 10 Regional specialists competent in advertising and promotion.
(6) Federal Transit Administration. Five supervisors and specialists.
(7) St. Lawrence Seaway Development Corporation. Three supervisors and specialists.
(8) Maritime Administration. Two supervisory equivalents.
(9) Research and Special Programs Administration. One supervisor and two specialists.
(10) Bureau of Transportation Statistics. One supervisor and one specialist.
(11) Federal Motor Carrier Safety Administration. One supervisor and one specialist.
I. American Red Cross. The ARC maintains the following:
(1) Rapid Response Team. Fifty-member team of trained, national media spokespersons.
(2) Disaster Responders. Six hundred responders around the Nation to work with State
and local media.
(3) Web Support. Internet group for Web coding of both internal and public Web sites.
(4) Photographic Support. Staff photographers and video production experts.
(5) Nationwide Chapters. More than 900 local Red Cross chapters throughout the country
provide a tangible local presence in communities.
(6) Information Hotline. The Red Cross maintains a 24/7 public information hotline.
(7) National Disaster Education Coalition Partnership. The Red Cross has extensive
preparedness and safety messaging and collateral materials available in both printed and electronic
formats. Much of the material is readily available on the public Web site.
4. Inventory of Other (Federally Accessible) Capabilities
A. DHS and FEMA
(1) DHS Ready.gov Preparedness Program. Ready.gov is a specially developed package
of preparedness measures for the public. The measures and presentation are crafted to be easily
understood by the public, and are available on-line in English and Spanish.
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(2) DHS Subject Matter Experts (SMEs). DHS Public Affairs maintains a
comprehensive listing of available SMEs covering medical, radiological, nuclear, chemical, and
biological threats. These experts can be made available to the media for technical explanations and in
support of incident response leadership.
(3) DHS Public Affairs and Ad Council. DHS Public Affairs and the Ad Council have
established a contingency program wherein the Ad Council will develop and air preparedness and
emergency medical or health segments. This program can be activated and provide features on air within
24 hours.
(4) Strategic Partnerships. As part of the planning process, DHS and FEMA are
developing strategic partnerships with large media conglomerates (especially radio) that have access to
major markets in the United States. This would be beneficial during emergencies and facilitate mass
communications efforts.
(5) FEMA Radio Survey Effort. As part of the catastrophic planning process, FEMA is
identifying State and local radio frequencies that may be available for broadcast of disaster information.
B. Department of Health and Human Services. HHS is the lead Federal Department for
protecting and preserving the Nations public health. Through its many Agencies, (CDC, NIH, FDA,
HRSA, Substance Abuse and Mental Health Services Administration (SAMHSA), etc.), HHS has
immediate access to a wide range of SMEs on virtually every medical and public health facet of any type
of WMD incident. The Departments most senior and visible spokespersonsfrom the HHS Secretary
and NIH leadership to CDC Director and the Surgeon Generalwill be needed to quickly address the
Nations health concerns. The HHS Public Affairs Office has significant experience in quickly providing
the appropriate and needed SMEs to the media in any type of public health emergency, and would plan to
do so in the event of any WMD incident.
C. Department of Commerce (DOC), National Oceanic and Atmospheric Administration
(NOAA) Weather Radio. NOAA Weather Radio broadcasts National Weather Service (NWS)
warnings, watches, forecasts, and other non-weather related hazard information 24 hours a day. During
an emergency, NWS forecasters interrupt routine weather programming and send out a special tone that
activates weather radios in the listening area. Weather radios equipped with a special alarm tone feature
can sound an alert and give immediate information about a life-threatening situation.
D. Environmental Protection Agency. EPA maintains a contract with U.S. Newswire for
electronic distribution of press releases.
E. Department of Transportation. DOT maintains a contract for an Associated Press (AP) feed
with eight stations.
F. Department of Veterans Affairs. The VA maintains contracts for news monitoring, clipping
services, and videotape and photo duplication services at the central office. Three Regional Public
Affairs Offices have news clipping service contracts.
G. U.S. Department of Agriculture. The USDA maintains mass casualty incident telephone
support for 24/7 incident communications, as well as a satellite standby truck on call at Continuity of
Operations (COOP) sites.
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H. American Red Cross. ARC can call upon cooperative relationships with the National
Association of Broadcasters (NAB), the Public Relations Society of America (PRSA), and various
corporate partners.
5. Response Strategy
The Federal interagency Public Affairs effort is detailed in the NRP-ICEPP. It is integrated with the
NRP, NIMS, and IIMG Standard Operating Procedure (SOP). Incident communications is the primary
Public Affairs concept of operations used by DHS to manage domestic incidents. This concept
incorporates the following key processes and is used to immediately coordinate and execute an integrated
interagency, State, and local incident communications plan.
! Control. What are the lead Departments and Agencies, authority, and authorities for release?
Key non-Federal players?
! Coordination. How will the communications strategy be developed, coordinated, executed,
and through what plans and protocols?
! Communication. What is known? What are the health risk concerns, preparedness advice,
warning issues, incident information, information flow, message, and audience? Who will
deliver, them? When? How? Where?
A. Execution. DHS Public Affairs will respond to and support the HSOC and IIMG as they
coordinate the Nations management of a domestic incident. To this end, DHS Public Affairs executes
the following steps and measures:
(1) Response Strategy: FIRST 10 TO 60 MINUTES.
(a) HSOC notified of an incident.
(b) HSOC initiates procedures for a nuclear/radiological/biological incident.
(c) HSOC notifications to key DHS leadership.
(d) DHS Public Affairs activates the supporting Incident Communications
Emergency Plan (ICEP) of the NRP-ICEPP. This mobilizes the DHS Public Affairs response structure
and provides staff support to the IIMG.
(e) DHS Public Affairs initiates communications with the following:
i. White House Office of Communications.
ii. Senior DHS IIMG/HSOC leadership.
iii. Incident site (including State/local) Public Affairs leadership.
iv. Federal interagency Public Affairs team (via NICCL).
v. Media contact through pre-established emergency contact line.
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(f) DHS Public Affairs requires immediate scientific support as facts and statements
are collected and prepared for release. Nuclear and biological scientific and trend information is
extremely critical to the development and deployment of an accurate and timely message to the public.
(g) NRP-ICEPP execution follows with DHS Secretary public announcement within
1 hour, subject to known facts, security, and confirmation of threat.
(h) Immediate health and safety advisories from DHS (with interagency
concurrence) or State and local authorities may precede the announcement. This health and safety
advisory may be the first announcement by Federal, State, or local authorities. Consideration should be
given towards a basic statement of the best precaution or protective measure until more refined
information can be obtained, evaluated, and provided to the public. Specific examples could include:
i. Immediate sheltering in place.
ii. Immediate evacuation or avoidance of a specific area (e.g., fallout).
iii. Basic facts (e.g., an anthrax attack has occurred, a nuclear blast, etc.).
(i) Splash Web page (a Web page that can be immediately created with emergency
updates), posted on Ready.gov with basic precautionary guidance. DHS Web site also updated with the
same information, which must be coordinated through the Interagency Incident Communications Team to
ensure that other Cabinet and Agency Web pages post or contain the same emergency information and
guidance.
(j) NICCL brings key Federal interagency incident communications team together to
develop coordinated communications plan and unified message. Key issues addressed include:
i. Incident situation.
ii. Control, leads, and authority for release.
iii. Coordination, plans in use, and key team for incident management.
iv. Communications, facts, information already released or known, plans for
next official statements, and health or safety advisories.
v. Who will make the first releases and coordinate with State and local
including synchronization of releases and role of spokespersons.
vi. Key Point: DHS takes national leadership role; State and local take lead
for on-scene medical and messaging, if feasible.
(k) First release by the DHS Secretary. Additional cabinet members or technical
experts may accompany or support this formal announcement.
(2) Response Strategy: FIRST 10 DAYS. Sustaining messages coordinated by Federal,
State, and local team: (see Note)
(a) Protection of population from fallout and contaminated areas.
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(b) Evacuation guidance and support to State and local authorities.
(c) Sheltering guidance as necessary.
(d) Evacuation guidance as necessary.
(e) Medical guidance (treatment, antidotes, prophylaxis, etc.).
(f) Safety of food and water.
(g) Dangers and hazards.
(h) National situational and instructional communications to non-affected areas.
(i) Distribution of key instructions for print, Web, television, and radio
programming.
NOTE: DHS will lead and coordinate the national messaging effort while the affected State and local
incident communications authorities will lead and coordinate incident local public information.
(3) Response Strategy: SUSTAINING ACTIONS.
(a) Sustaining actions by the Intergovernmental Incident Communications Team:
i. JIC established to manage and coordinate incident site Public Affairs
activities.
ii. DHS engages with non-affected States and initiates aggressive public
preparedness and information communications effort. Emphasis on basic instructions, family plans,
rationale for medical treatment, and distribution of appropriate medicines.
iii. DHS deploys PFO and supporting Public Affairs team.
iv. HHS and CDC may deploy Public Affairs teams to affected incident site to
support State and local effort. Subject to incident and requests.
v. FEMA establishes radio station to deliver incident and response activity.
vi. FEMA distributes battery-powered radios.
viii. FEMA initiates other incident site communications recovery efforts in
support of normal ESF tasks.
ix. Ad Council national public service television advertisements are covering
threat, public instructions, and preparedness measures.
x. SMEs are briefed and available to support sustaining communications.
B. Department of Health and Human Services. The HHS ASPA has developed an emergency
operations plan for situations involving major public health emergencies. When HHS ASPA activates the
plan, designated personnel will staff the teams as outlined in preceding paragraphs. The plan relies on the
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use of all HHS Public Affairs Office staff. If events continue for an extended period of time, the HHS
Public Affairs Office would supplement/rotate staff from its Agency (CDC, NIH, FDA) Public Affairs
Offices to prevent staff burnout.
C. U.S. Department of Agriculture. The USDA has a virtual war room plan to access Public
Affairs assets and resources throughout the Department and includes media response, information
development, outreach, and coordination. This process will allow USDA to sustain an information center
for a long period of time and was most recently used during the mad cow disease outbreak in 2004 in
the United States. The plan includes daily briefings, regular written updates for distribution, and Web
posting and recorded messages on mass casualty incident line. The USDA also has an incident command
team capability through the U.S. Forest Service (USFS), which includes ground Public Affairs support
functions.
D. Department of Veterans Affairs. The VA immediate response strategy is to carry out
essential communications functions in support of VAs primary mission and communicate emergency
response and resource information to internal and external audiences in the affected incident area and
across the VA system. Appropriate Public Affairs assets will be deployed as needed from closest
available locations to assist with situational assessments and communications activities as directed by VA
facility director or on-site authority. For the 10-day and sustained periods, additional resources would be
deployed to the incident venue sufficient to provide necessary Public Affairs coverage and support with a
24/7 work schedule.
E. Environmental Protection Agency
(1) Immediate. Implement the EPA Public Affairs Crisis Communications Plan;
implement Public Affairs COOP Plan if needed; provide PIO to EPA EOC; support DHS ICEP including
EPA staffing at a JIC.
(2) First 10 Days. Support and follow DHS Public Affairs lead and continue to support;
provide environmental and public health information to the media and public.
(3) Sustained. Provide continued support to DHS Public Affairs.
F. Department of Transportation
(1) Immediate. Three managers will disperse in the following manner: One with the
Secretary of Transportation; another will go to another site in accordance with the COOP Plan; and the
third will go to the DOT Crisis Management Center (CMC), also likely off-site. These managers will
supervise and control the DOT Public Affairs response to the catastrophe.
(2) First 10 Days. This configuration will continue for the first 10 days. Available local
and, if needed, Regional Public Affairs staff will be called upon to execute the Departments response and
messaging.
(3) Sustained. Public Affairs managers, supervisors, and staff will be called to an
appropriate central location where they will set up an office and function as a team.
G. American Red Cross. ARC response actions to support first hour to sustaining actions are
detailed below:
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(1) Staffing. Immediately deploy Public Affairs staff and officer to the incident site. Rapid
Response Team members will also be sent to the area to provide an ARC response to national news
media. Red Cross representatives will be dispatched to staff JICs and other messaging coordination
centers.
(2) Messaging. National HQ Public Affairs staff will begin collecting information and
messages for dissemination. Talking points and frequently asked questions (FAQs) will be written for
use by ARC spokespersons. SMEs within the organization will be identified and recruited to speak when
possible.
(3) Call Center/Hotline. Preparedness, safety, security, and calming messages and
information will be provided to Call Center staff for use in responding to public inquires. When
available, specific response information is also sent to the Call Center to respond to inquiries from the
affected area.
(4) Internet Information. The Web team will receive information from the Public Affairs
staff for posting to the public Web site. Web team members will also activate template pages of links to
information pertinent to the specific emergency. Talking points and FAQs are also posted on the internal
Web site for use by Red Cross State and local communicators, ensuring a coordinated message.
(5) Senior Leadership. Additional staff from the Communication and Marketing
department will coordinate information, messaging, and media presence for the President/CEO of the
American Red Cross, when necessary and appropriate.
6. Transportation and Logistical Requirements
A. U.S. Department of Homeland Security. Transportation and logistical requirements will be
assessed by the interagency during conference discussions and incident communications strategy
planning. Additional issues are noted below:
(1) Transportation. Transportation will be required to deploy the various surge personnel
and response teams to the incident site or Regional area. The scope of the incident will determine this
requirement. FEMA and USCG response teams have pre-established transportation plans and should be
able to respond if the infrastructure has not been severely degraded.
(2) Logistics. Logistics requirements will also be determined by the nature and scope of
the incident and available surviving infrastructure. Logistical support and facilities for temporary Public
Affairs operations may be available at Regional DHS component agency sites. This may also include
afloat vessels or large aircraft that could deploy to affected areas and provide power and utilities to run
incident communications recovery operations.
B. Department of Veterans Affairs. Depending on distances to be covered, transportation for
deploying or incident support Public Affairs personnel would be by personal vehicle or commercial
carrier using existing Government credit cards or purchase agreements. Temporary lodging would be
provided through commercial hotel facilities in or near the affected area or deployment location.
C. Environmental Protection Agency. Transportation of EPA personnel to JIC site would be
required if the catastrophic incident disrupts normal transportation. If the incident forces closing of hotels
and other lodging facilities, lodging of EPA JIC staff would also be required.
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D. Department of Health and Human Services. Upon activation of the HHS ASPA Public
Affairs emergency operations plan, pre-designated HHS ASPA personnel will report to the CDC in
Atlanta and also travel with the SERT to the incident jurisdiction.
E. U.S. Department of Agriculture. This is addressed through the USDA COOP Plan. If
USDA is needed to support another agency, transportation will be required.
F. American Red Cross. Public Affairs staff responding to an emergency would work through
existing channels and procedures within the Red Cross response plan to travel to the affected areas, and
for housing need on site. In the event that common carriers are not available, the Red Cross would work
with partner Government Departments and Agencies and private groups to facilitate alternate means of
travel.
7. Limitations
A. U.S. Department of Homeland Security. DHS Public Affairs has assessed the potential
limitations during a WMD or catastrophic incident. Specific limitations are contained in the initial
planning assumptions in paragraph one of this appendix. Briefly, these limitations focus on the following
components:
(1) Developing the Message. The process to develop the interagency message has been
refined and exercised. However, the nature of a catastrophic incident will likely inhibit or restrict the
timeliness of this effort. This will be exacerbated if relocation or COOP by DHS or other Federal
leadership has been initiated.
(2) Delivering the Message. Delivering the message may be problematic for some
audiences. Loss of power by the audience, the nature and threat of the incident, loss of media broadcast
capabilities in and around the affected region, and other limitations will inhibit and restrict the delivery of
the message. This will be more apparent in a nuclear incident where infrastructure and destruction or
damage is widespread. Delivery of a message during a biological incident may be less problematic, but
normal access and movement will limit communications opportunities and delivery.
(3) Receiving the Message. The audience and the public, especially those who require
evacuation or other guidance, must have the capability to receive the message. This may also be
problematic if they do not have electrical power or battery-powered communications capability. These
limitations and message options are addressed in the NRP-ICEPP and supporting annexes.
(4) DHS/FEMA. The FEMA on-site Public Affairs response will be limited by how
quickly teams could get to the affected area based on health and safety considerations. Other issues
include:
(a) Staffing. Considering the national and Regional teams that FEMA PAOs
requires, Public Affairs leadership has few remaining incident communications resources. This will
present a concern if multiple venues or incidents occur simultaneously.
(b) New Resources. A mobile broadcast unit would be useful for emergency
broadcast capability in or near the incident locations.
B. Department of Veterans Affairs. Given the distribution of resources across the country, it is
reasonable to assume certain VA assets may be diminished or lost due to any significant manmade or
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natural disaster, or terrorist attack involving chemical, biological, radiological, nuclear, or high-yield
explosive (CBRNE) WMD.
C. U.S. Department of Agriculture. Standby satellite facilities and time as well as
communications equipment that would take precedence on airtime is always needed.
D. Department of Transportation. Transportation Public Affairs will be severely limited by the
anticipated inability to communicate with both staff and news media. The demand for information about
the safety and operation of transportation facilities will be great and urgent.
8. Responsibilities of Coordinating and Support Agencies/Organizations
A. U.S. Department of Homeland Security. As Stated in the Basic Plan to the ICEP, when
operating in support of catastrophic incidents, the Secretary of Homeland Security will coordinate the
Federal incident communications response effort. This will involve execution of the ICEP, higher
authority guidance, interagency plan execution, incident updates, and delivery of a consistent and unified
message to the public. Other Departments, Agencies, and authorities may, however, retain incident
communications roles for respective tasks and speak for these areas. Coordinating agency issues will be
assessed and identified during initial conference call discussions and as necessary throughout the incident.
Notional lead assignments for incident communications may include the following:
(1) Incident Management.
(2) Law Enforcement.
(3) Medical or Health.
(4) Environmental.
(5) Protective Measures.
(6) Search and Rescue.
(7) Preparedness.
(8) Mass Care, Housing, and Food Safety.
(9) Recovery Assistance.
B. Department of Health and Human Services. In a public health emergency, the HHS Public
Affairs Office assumes the lead in media response for public health, coordinated with and through the
JIC. Depending on the nature of the event or incident, HHS Public Affairs may designate one of the HHS
Agencies (e.g., CDC, NIH, FDA) to take the lead on Public Affairs activities with the responsibility of
consulting with HHS Public Affairs as they move forward to manage the incident communications. In
addition, HHS Public Affairs would rely on its Agency Public Affairs Offices to supplement the office
with additional staff if events continue for an extended period of time.
C. U.S. Department of Agriculture. USDA would likely take the lead in animal and plant
health related emergencies as well as food-related emergencies involving meat and poultry. Food-related
activities would be coordinated with HHS. USDA and HHS have met to work through scenarios on foodA11-
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related issues and the appropriate response. USDA has also drilled internally with Agencies to address
food and animal-related activities and have several written plans in place for scenarios.
D. State and Local Authorities. Since most domestic terrorist incidents will occur within the
jurisdiction of State or local authorities, integration and teamwork between Federal and non-Federal
players is absolutely critical. State and local authorities retain their leadership role in assuring the health
and safety of their citizens. To this end, they may make statements or provide preparedness instructions
to their citizens at the onset of an incident. DHS Public Affairs and the Federal IIMG will use the ICEP
to engage with these authorities as soon as possible to synchronize the overall incident communications
effort and to provide support and assistance where State and local capabilities have been destroyed or
degraded. State and local incident communications authorities are requested to contact DHS Public
Affairs as soon as possible following a domestic incident.
E. Environmental Protection Agency. EPA Public Affairs would provide staff and other
support to the overall Federal effort and environmental and public health information via the media and
the Internet.
F. Department of Transportation. Following an incident, the Department of Public Affairs will
look to DHS as the lead agency in coordinating a message. The Transportation Public Affairs message
will, in turn, be managed solely by the Transportation Director of Public Affairs in coordination with
other appropriate Federal agencies.
G. American Red Cross. Will work in cooperation with DHS in the coordination of public
messaging following a major disaster incident. The Public Affairs team at the Red Cross would take the
lead in crafting and disseminating messaging that relates to the specific relief activities conducted by
ARC, including mass care sheltering, feeding, bulk distribution of supplies, recovery assistance, and
disaster welfare inquires. The Red Cross will also coordinate messaging related to preparedness, recovery
assistance, protective measures, and health and safety with other lead agencies.
H. Deparatment of Veterans Affairs. Public Affairs will follow the DHS lead in
communicating the incident response message as well as supporting HHS regarding health and medical
services as outlined in the Federal Response Plan (FRP) ESF#8. At the incident site(s), VA PAOs will
assist in communicating appropriate medical and emergency response messages in coordination with local
representatives of DHS, HHS, and State and local emergency response authorities whenever possible.
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National Response Plan ? Catastrophic Incident Supplement
Appendix 12 ?? Private Sector Support Overview
1. Mission
This appendix addresses how the private sector will be engaged to assist and support a catastrophic
response effort.
2. Planning Assumptions
A. Comprehensive response and recovery capabilities will be expanded and enhanced if private
sector support is quickly involved and engaged.
B. Many firms and/organizations within the private sector will work directly within existing
volunteer organization structures to provide goods, services, building space, and trained personnel to
assist in the response and recovery effort.
C. State and local governments will create systems for donations receipt/prioritization and needs
collection that will be staffed by State and local officials to ensure that needs and wants are coordinated
and met.
D. Some portion of what the private sector will provide will be made available without charge and
the balance will be available under varying compensation arrangements. Any discussions of
compensation to private organizations, instead of disaster victims, will be reviewed first with the agency
providing the funding.
3. Catastrophic Response Strategy
A. Private Sector Response Support Strategy: GENERAL.
(1) Initial and immediate emphasis will be placed on supporting existing donation
management frameworks, such as Federal Emergency Management Agency (FEMA) National Response
Coordination Center (NRCC) and National Volunteer Organizations Active in Disasters (NVOAD), and
linking potential donors (regardless of whether they are donating housing space, search and rescue
assistance, or other assistance) with identified resource needs.
(2) The U.S. Department of Homeland Security (DHS) Private Sector Office (PSO) will
identify local donations coordination centers as soon as possible and establish a system for determining
their needs and providing that information to the private sector contacts through an information sharing
system, described below, with recommendations that the private sector firms work directly with the
donations coordination centers to satisfy their needs.
(3) The DHS/PSO will rapidly identify points of contact (POCs) from each Emergency
Support Function (ESF) for inventorying the need for additional goods and services and for receiving
donations of goods and services.
(4) The DHS/PSO will obtain compensation information from lead agencies and provide it
to the private sector and/or advise prospective donors to enter into written agreements with the recipient
Federal, State, or local agency to cover issues of compensation.
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(5) The DHS/PSO will maintain an information sharing system to facilitate the submission
of offers by private sector organizations and the transmittal of such information to those sector specific
agencies or the donations centers. This will include a link/page on the Homeland Security Information
System (HSIN) allowing ESF POCs to list specific needs (goods or services). The link/page will also
advise companies or organizations to list information, including contact information, about the goods or
services that the organizations are willing to donate and/or sell. The DHS/PSO will regularly validate the
list and confirm, as necessary, the offers. At least daily, the DHS/PSO will share information about offers
with the various ESF POCs and relevant donations centers organized by State and local governments.
B. Private Sector Response Support Strategy: MASS CARE.
(1) If a mass casualty incident occurs, the mass care response will look to non-Government
entitiessuch as NVOAD, the American Red Cross (ARC), and other such groupsto augment Federal,
State, and local efforts.
(2) The mass care response will require existing and temporary facilities of varying kinds,
equipment, food, other consumables, and trained or quickly trainable personnel.
(3) DHS/PSO will coordinate with FEMA, ARC, NVOAD, the Citizens Corps, and other
organizations to determine their short and long-term resource and augmentation needs and rapidly
communicate those needs to private sector organizations. DHS/PSO will provide information about
response needs and donation protocols to private sector organizations and facilitate donations or provision
of needed goods and services.
(4) Shelters, cots, blankets, and related items are likely to be insufficient to meet the
tremendous demands of a catastrophic mass casualty/mass evacuation incident. Potential sources for such
needs, within industry associations and other private sector organizations, include (but are not limited to)
the following:
(a) The Business Roundtable
(b) The National Association of Manufacturers
(c) The U.S. Chamber of Commerce
(d) Veterans of Foreign Wars
(e) Fraternal Organizations (e.g., Shriners)
(f) Associations of Social Organizations (e.g., country clubs)
C. Private Sector Response Support Strategy: HOUSING.
(1) If a mass casualty/mass destruction event occurs, temporary housing will be required.
Several types of private sector assistance could be tapped in addition to that identified in the Housing
appendix. DHS/PSO will coordinate with FEMA, ARC, NVOAD, the Citizens Corps, and other
organizations to determine their short and long-term resource and augmentation needs and rapidly
communicate those needs to private sector organizations. DHS/PSO will provide information about
response needs and donation protocols to private sector organizations and facilitate donations or provision
of needed goods and services.
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(2) Potential industry association sources for addressing housing needs include:
(a) Existing Rooms/Space Available
i. Association of Hotels and Motels
ii. International Association of Convention and Visitor Bureaus
iii. Association of Mobile Home Builders
iv. Association of Rental Buildings
v. Association of Universities
vi. Association of Cruise Ships
vii. Association of Apartment/Housing Rental Agents
(b) Space Convertible to Temporary Housing (includes sanitary/feeding facilities)
i. National Association of Manufacturers
ii. U.S. Chamber of Commerce
iii. Association of Universities
iv. Association of Public Schools
v. Associations of Churches
vi. Association of Summer Camps
(c) Rapid Repair of Damaged Housing
i. National Association of Home Builders
ii. Association of General Contractors
iii. Association of Lumber Yards and Home Supplies
iv. Carpenters Union
v. Habitat for Humanity
D. Private Sector Response Support Strategy: SEARCH AND RESCUE.
(1) If a catastrophic incident occurs that includes a mass destruction component, search and
rescue operations will be required. Several types of private sector organizations (e.g., mining and
construction companies) may have employees likely to have useful skills for such operations and may be
willing to volunteer their assistance. Other organizations may have heavy construction equipment or steel
working equipment that could be needed and transported to the incident site.
(2) DHS/PSO will coordinate with ESF#9 (Urban Search and Rescue), FEMA, and other
appropriate organizations to determine their short and long-term search and rescue resource and
augmentation needs and rapidly communicate those needs to private sector organizations. DHS/PSO will
provide information about response needs and donation protocols to private sector organizations and
facilitate donations or provision of needed goods and services.
(3) Potential industry association sources for addressing search and rescue needs include:
(a) National Mining Association
(b) Association of Builders and Contractors
(c) Association of General Contractors of America
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(d) National Council of Erectors, Fabricators, and Riggers
(e) Association for Bridge Construction and Design
(f) Mechanical Contractors Association of America
E. Private Sector Response Support Strategy: DECONTAMINATION.
(1) If a catastrophic mass casualty/mass evacuation incident occurs that includes a
contamination component, decontamination of well, injured, and deceased individuals and facilities,
equipment, and property will be required. Several types of private sector organizations (e.g., nuclear
power companies, service companies to the nuclear power industry and chemical industry) possess skills
and experience in various decontamination situations and may be willing to volunteer to assist in the
decontamination effort.
(2) DHS/PSO will coordinate with appropriate organizations to determine their short and
long-term decontamination resource and augmentation needs, and rapidly communicate those needs to
private sector organizations. DHS/PSO will provide information about response needs and donation
protocols to private sector organizations, and facilitate donations or provision of needed goods and
services.
(3) Potential industry association sources for supplementing decontamination needs:
include:
(a) Laboratory Services
i. American Chemistry Council
ii. Pharmaceutical Research and Manufacturers Association
iii. Nuclear Energy Institute
iv. American Chemical Society (Universities Section)
v. Center for Chemical Research
vi. Cosmetic and Specialties Manufacturers Association
vii. The Food Processing Association
(b) Decontamination Services
i. Nuclear Energy Institute.
ii. Chemical Transportation Emergency Center (CHEMTREC).
iii. Private sector hazardous materials (HAZMAT) cleanup contractors.
(c) Contaminated Transport
i. Alliance of Auto Manufacturers
ii. Used Car/Truck Sellers Association
F. Private Sector Response Support Strategy: MEDICAL SUPPORT.
(1) If a catastrophic mass casualty/mass evacuation incident occurs, various private sector
organizations will be identified and/or contacted regarding response readiness, patient care, treatment,
isolation and recovery to complement resources already identified by the National Defense Medical
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System (NDMS) and other Governmental health organizations. Many hospitals are not included in those
already identified as part of the NDMS. Many large companies have medical facilities at their locations
with staff with varying degrees of medical training. It is anticipated such hospitals/facilities will want to
assist in the medical response to a mass casualty event.
(2) Several types of private sector organizations have facilities, skills, and experience that
would allow them to provide temporary care facilities in relative proximity the impacted area. Many
factories, universities, schools, churches, fraternal or social organizations, and other organizations have
large facilities with both feeding capabilities and space that could be converted for patient use. It is
anticipated such companies/facilities will want to assist in the medical response to a mass casualty event.
(3) DHS/PSO will coordinate with ESF#8 (Public Health and Medical Services) and other
appropriate organizations to determine their short and long-term medical support resource and
augmentation needs and rapidly communicate those needs to private sector organizations. DHS/PSO will
provide information about response needs and donation protocols to private sector organizations, and
facilitate donations or provision of needed goods and services.
(4) Potential industry sources for providing supplementary medical support include:
(a) National Business Group on Health
(b) The Business Roundtable
(c) The National Association of Manufacturers
(d) American Hospital Association
(e) Business Executives on National Security
(f) Associations of Medical Equipment/Medical Care Consumables Suppliers
(g) Veterans of Foreign Wars
(h) Fraternal Organizations (e.g., Shriners)
(i) Associations of Country Clubs (and other social organizations)
G. Private Sector Response Support Strategy: MASS FATALITY.
(1) If a catastrophic mass casualty/mass destruction incident occurs, assistance in
recovering, identifying, and processing deceased victims will be required. Several sources of private
sector assistance could be tapped to augment those capabilities identified in the Mass Fatality appendix.
(2) DHS/PSO will coordinate with ESF#8 (Public Health and Medical Services) and other
appropriate organizations to determine their short and long-term mass fatality management support
resource and augmentation needs and rapidly communicate those needs to private sector organizations.
DHS/PSO will provide information about response needs and donation protocols to private sector
organizations, and facilitate donations or provision of needed goods and services.
(3) Potential industry association sources for providing supplementary medical support
include:
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(a) National Funeral Director Association
(b) National Cemetery Association
(c) American College of Forensic Examiners
H. Private Sector Response Support Strategy: TRANSPORTATION.
(1) The Department of Transportation (DOT) and its 10 major operating administrations
maintain strong and historic relationships with the transportation industry. During periods of defense
mobilization, DOT plays a vital coordinating role with private sector transportation providers and
suppliers in order to meet emergency requirements. During a catastrophic mass casualty/mass evacuation
incident requiring additional, extraordinary transportation resources, DOT, as the lead for ESF#1
(Transportation), will facilitate the rapid acquisition of additional specialized transportation related
resources in coordination with State and local counterparts. Requirements would likely extend beyond
those resources described in the Transportation appendix.
(2) In response to a catastrophic incident, DOT would work closely with DHS/PSO to
facilitate the identification of donated services. The transportation industry has a history of volunteer
contributions to our nation during times of unprecedented need. It is imperative that any voluntary
donation of transportation services be coordinated through ESF#1. This will ensure that donated services
can be effectively organized to match nationally identified priorities; duplicative donations reduced or
minimized; and ensure that donated services and equipment are documented, tracked, and free from
controversy. ESF#1 can quickly validate the need for specific transportation services and equipment.
(3) In the event of multiple major incidents, and under the most extreme circumstances,
DOT will use allocation or prioritization authority under the Defense Production Act (DPA) of 1950, as
amended. This authority is available if domestic emergency conditions required civil transportation
materials, services, or facilities that are not available through the marketplace. For example, airlift,
sealift, trains, or trucks may be needed to support the mass and sustained movement of personnel,
casualties, equipment, or other resources into and away from the incident area. After identifying
appropriate resources that could be used and confirming that they will not be provided voluntarily, DOT
would seek a determination and concurrence from DHS. The DPA would only be used as a last resort.
(4) Each of the Operating Administrations within DOT maintains extensive industry contact
lists, which would be immediately accessible to DHS/PSO through ESF#1. These contact lists would be
used by DHS/PSO to reduce conflicting or duplicative requests going to private sector organizations.
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National Response Plan ? Catastrophic Incident Supplement
Appendix 13 ? Acronyms, Abbreviations, and Terms
1. Departments and Agencies
APHIS Animal and Plant Health Inspection Service (USDA)
ARC American Red Cross
ASPA Assistant Secretary for Public Affairs (DHS & HHS)
ASPHEP Assistant Secretary for Public Health Emergency Preparedness (HHS)
ATF Bureau of Alcohol Tobacco and Firearms
ATSDR Agency for Toxic Substances and Disease Registry
BOR Bureau of Reclamation
BTS Border and Transportation Security (DHS)
CBP Customs and Border Control (DHS & BTS)
CDC Centers for Disease Control
CMC Crisis Management Center
DHS Department of Homeland Security
DOC Department of Commerce
DOD Department of Defense
DOE Department of Energy
DOI Department of the Interior
DOJ Department of Justice
DOS Department of State
DOT Department of Transportation
DS/OFM Diplomatic Security Office of Foreign Missions (DOS)
EPA Environmental Protection Agency
FBI Federal Bureau of Investigation
FCC Federal Communications Commission
FDA Food and Drug Administration
FEMA Federal Emergency Management Agency (DHS)
FERC Federal Energy Regulatory Commission
GSA General Services Administration
HHS Department of Health and Human Services
HUD Department of Housing and Urban Development
ICE Immigration and Customs Enforcement (DHS)
IRS Internal Revenue Service
JS Joint Staff (Office of the Chairman of the Joint Chiefs of Staff, DOD)
NASA National Aeronautics and Space Administration
NIH National Institute of Health
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NIST National Institute of Standards and Technology
NNSA National Nuclear Security Administration
NOAA National Oceanic and Atmospheric Administration
NORTHCOM U.S. Northern Command
NRC Nuclear Regulatory Commission
NWS National Weather Service
OASD(HA) Office of the Assistant Secretary of Defense for Health Affairs
OASD(HD) Office of the Assistant Secretary of Defense for Homeland Defense
OSHA Occupational Safety and Health Administration
S&T Science and Technology
TRANSCOM U.S. Transportation Command
TREAS Department of Treasury
USACE U.S. Army Corps of Engineers
USAID United States Agency for International Development
USCG U.S. Coast Guard
USDA U.S. Department of Agriculture
USFS U.S. Forest Service
USGS U.S. Geological Survey
USPS U.S. Postal Service
VA Department of Veterans Affairs
2. Key Acronyms and Terms
AABB American Association of Blood Banks
AHA American Hospital Association
ARF Action Request Form
ASH Assistant Secretary of Health
BSOC Biomedical Services Operations Center
CAE Command Assessment Element (DOD)
CBIRF Chemical Biological Incident Response Force (USMC)
CBRNE Chemical, Biological, Radiological, Nuclear, or High-Yield Explosive
CCP Casualty Collection Point
CCRF Commissioned Corps Readiness Force
CHC Combined Health Center
CIS Community Information System
CMC Crisis Management Center
CMHC Community Mental Health Centers
CONOP Concept of Operations
CONUS Continental United States
COOP Continuity of Operations
CRT Critical Response Team
DCE Defense Coordinating Element
DCO Defense Coordinating Officer
January 2005 Catastrophic Incident Supplement | A13-3
National Response Plan
DEMPS Disaster Emergency Medical Personnel System
DEST Domestic Emergency Support Team
DFO Disaster Field Office
DMAT Disaster Medical Assistance Team
DMORT Disaster Mortuary Operational Response Team
DOC Disaster Operations Center
DPMU Disaster Portable Morgue Units
DRC Disaster Recovery Center
DSHR Disaster Services Human Resources
DWI Disaster Welfare Information
EAS Emergency Alert System
EIS Epidemiologic Intelligence Service
EMAC Emergency Management Assistance Compact
EOC Emergency Operations Center
ERT Emergency Response Team (DHS/FEMA)
ERT Environmental Response Team (EPA)
ERT-N National Emergency Response Team
ESF Emergency Support Function
EST Emergency Support Team
FCC Federal Coordinating Center
FCO Federal Coordinating Officer
FIRST Federal Incident Response Support Team (DHS/FEMA)
FRERP Federal Radiological Emergency Response Plan
FRMAC Federal Radiation Monitoring and Assessment Center
FRP Federal Response Plan
GIS Geographic Information System
GPMRC Global Patient Movements Requirement Center
HARTS Hospital Asset Resource Tracking System
HMRU Hazardous Materials Response Unit
HRSA Health Resources and Services Administration
HRT Health Response Team
HSAS Homeland Security Advisory System
HSOC Homeland Security Operations Center
HSPD Homeland Security Presidential Directive
ICEP Incident Communications Emergency Plan
IEF Initial Entry Forces (DOD)
IIMG Interagency Incident Management Group
INRP Initial National Response Plan
INSARAG International Search and Rescue Advisory Group
IOF Interim Operating Facility
IRR Individual Response Resource
IST Incident Support Team
JFO Joint Field Office
JIC Joint Intelligence/Information Center
JTF-CS Joint Task Force  Civil Support
A13-4 | Catastrophic Incident Supplement January 2005
National Response Plan
LIDAR Light Detection and Ranging (System)
LNG Liquefied Natural Gas
MATTS Mobile Air Transportable Telecommunications System
MCMT Mobilization Center Management Team
MERS Mobile Emergency Response Support
MIACG Medical Interagency Coordination Group
MMRS Metropolitan Medical Response System
MOU Memorandum of Understanding
MRC Medical Reserve Corps
MST Management Support Team
MTF Military Treatment Facility
NARAC National Atmospheric Release Advisory Capability
NCP National Disaster Medical System
NEIC National Earthquake Information Center
NEMIS National Emergency Management Information System
NEST Nuclear Emergency Support Team
NGO Non-Governmental Organization
NGS National Geodetic Survey
NH Natural Hazard
NICCL National Incident Communications Conference Line
NIMS National Incident Management System
NIT Nuclear Incident Team (DOE)
NLT No Later Than
NMRT National Medical Response Team
NOTAM Notice to Airmen
NRAT Nuclear Radiological Assessment Team
NRC National Response Center
NRCC National Response Coordination Center
NRP National Response Plan
NRP-CIA National Response Plan  Catastrophic Incident Annex
NRP-CIS National Response Plan  Catastrophic Incident Supplement
NSF National Strike Force (USCG)
OPDIV Operating Divisions
PADO Public Affairs Duty Officer
PAO Public Affairs Office (or Officer)
PFO Principal Federal Official
PHS Public Health Service
PIAT Public Information Assistance Team
POE Point of Embarkation
PPDS Pre-Positioned Disaster Supplies
PPI Pre-Placement Interviews
PRC Primary Receiving Center
PSO Private Sector Office
RAP Radiological Assistance Program
REAC/TS Radiation Emergency Assistance Center/Training Site
January 2005 Catastrophic Incident Supplement | A13-5
National Response Plan
REP Regional Evacuation Point
RERT Radiological Emergency Response Team
RHS Rural Housing Service
RNA Rapid Needs Assessment
RRCC Regional Response Coordination Center
SAR Search and Rescue
SCC Secretarys Command Center (HHS)
SCO State Coordinating Officer
SERT Secretarys Emergency Response Team (HHS)
SNS Strategic National Stockpile
SOP Standard Operating Procedure
SOU Statement of Understanding
STOLS System To Locate Survivors
TLC Territorial Logistics Center
TRAC2ES TRANSCOM Command and Control (C2) Evacuation System
TRF Temporary Flight Restriction
US&R Urban Search and Rescue
VA NAC Veterans Affairs National Acquisition Center
VMAT Veterinary Medical Assistance Team
VMI Vendor-Managed Inventory
WMD Weapon(s) of Mass Destruction
A13-6 | Catastrophic Incident Supplement January 2005
National Response Plan
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