I 

111TH CONGRESS 

2D SESSION H. R. 4580 

To amend the Homeland Security Act of 2002 to authorize the Metropolitan 

Medical Response System Program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 3, 2010 

Mr. MARKEY of Massachusetts (for himself, Mr. MORAN of Virginia, and Ms. 

LORETTA SANCHEZ of California) introduced the following bill; which was 

referred to the Committee on Energy and Commerce, and in addition to 

the Committee on Homeland Security, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions 

as fall within the jurisdiction of the committee concerned 

A BILL 

To amend the Homeland Security Act of 2002 to authorize 

the Metropolitan Medical Response System Program, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Metropolitan Medical 

5 Response System Act of 2010’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) In its January 2010 report card, the Com2 mission on the Prevention of Weapons of Mass De3 struction Proliferation and Terrorism stated that the 

4 Federal Government must ‘‘become a stronger advo5 cate for citizen, community, state, and regional pre6 paredness to effectively respond’’ to both natural 

7 disasters and man-made events. 

8 (2) The Metropolitan Medical Response System 

9 (MMRS) is the only program at the Federal level 

10 that supports the integration of local emergency 

11 management, law enforcement, and health and med12 ical systems into a coordinated response to a mass 

13 casualty event caused by a weapon of mass destruc14 tion, an incident involving hazardous materials, an 

15 epidemic disease outbreak, or a natural disaster. 

16 (3) The MMRS program was established in the 

17 wake of the 1995 deadly release of sarin nerve gas 

18 in a Tokyo subway, and the 1995 bombing of the Al19 fred P. Murrah building in Oklahoma City. 

20 (4) The MMRS program aims to improve med21 ical response systems, by enhancing the existing 

22 local response systems and capabilities of a commu23 nity before an incident occurs. 

24 (5) The MMRS program provides tangible ben25 efits in the form of increased operational capacity 


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1 and communication, improved personnel training, 

2 stockpiled pharmaceuticals, and adequate supplies of 

3 personal protective equipment and other specialized 

4 response equipment. 

5 (6) The MMRS program supports a number of 

6 other existing Federal programs, such as the Hos7 pital Preparedness Program, the Cities Readiness 

8 Initiative, the State Homeland Security Program, 

9 and Urban Area Security Initiative. 

10 (7) The MMRS program provides funding to 

11 124 local jurisdictions in 43 States, covering ap12 proximately 70 percent of the United States popu13 lation. 

14 (8) The MMRS program has become an in15 creasingly vital part of our homeland security infra16 structure in the wake of recent influenza outbreaks, 

17 renewed terrorists threats, and severe weather emer18 gencies. 

19 SEC. 3. METROPOLITAN MEDICAL RESPONSE SYSTEM PRO20 GRAM. 

21 (a) IN GENERAL.—Title V of the Homeland Security 

22 Act of 2002 (6 U.S.C. 311 et seq.) is amended by adding 

23 at the end the following new section: 


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1 ‘‘SEC. 525. METROPOLITAN MEDICAL RESPONSE SYSTEM 

2 PROGRAM. 

3 ‘‘(a) IN GENERAL.—There is in the Department a 

4 Metropolitan Medical Response System Program (in this 

5 section referred to as the ‘Program’). 

6 ‘‘(b) PURPOSE.—The purpose of the Program shall 

7 be to support State and local jurisdictions in preparing 

8 for and maintaining all-hazards response capabilities to 

9 manage public health and mass casualty incidents result10 ing from natural and man-made disasters, acts of ter11 rorism, and epidemic disease outbreaks, by systematically 

12 enhancing and integrating first responders, public health 

13 personnel, emergency management personnel, and other 

14 participants in mass casualty management. 

15 ‘‘(c) PROGRAM ADMINISTRATION.—The Assistant 

16 Secretary, Office of Health Affairs shall develop pro17 grammatic and policy guidance for the Program in coordi18 nation with the Administrator of the Federal Emergency 

19 Management Agency. 

20 ‘‘(d) PERSONNEL COSTS.—The Program shall not be 

21 subject to an administrative cap on the hiring of personnel 

22 to conduct Program activities. 

23 ‘‘(e) FINANCIAL ASSISTANCE.— 

24 ‘‘(1) AUTHORIZATION OF CONTRACTS.— 

25 ‘‘(A) IN GENERAL.—The Secretary, 

26 through the Administrator of the Federal 


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1 Emergency Management Agency and subject to 

2 the availability of appropriations, may enter 

3 into contracts under this section with local ju4 risdictions to assist in preparing for and re5 sponding to mass casualty incidents. 

6 ‘‘(B) CONSULTATION.—In developing guid7 ance for contracts authorized under this sub8 section, the Administrator shall consult with the 

9 Assistant Secretary, Office of Health Affairs. 

10 ‘‘(2) USE OF FUNDS.—A contract entered into 

11 under this subsection may be used to support the in12 tegration of emergency management, health, and 

13 medical systems into a coordinated response to mass 

14 casualty incidents caused by any hazard, including— 

15 ‘‘(A) to strengthen medical surge capacity; 

16 ‘‘(B) to strengthen mass prophylaxis capa17 bilities including development and maintenance 

18 of an initial pharmaceutical stockpile sufficient 

19 to protect first responders, their families, and 

20 immediate victims from a chemical or biological 

21 event; 

22 ‘‘(C) to strengthen chemical, biological, ra23 diological, nuclear, and explosive detection, re24 sponse, and decontamination capabilities; 


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1 ‘‘(D) to develop and maintain mass triage 

2 and pre-hospital treatment plans and capabili3 ties; 

4 ‘‘(E) for planning; 

5 ‘‘(F) to support efforts to strengthen infor6 mation sharing and collaboration capabilities of 

7 regional, State, and urban areas in support of 

8 public health and medical preparedness; 

9 ‘‘(G) for medical supplies management and 

10 distribution; 

11 ‘‘(H) for training and exercises; 

12 ‘‘(I) for integration and coordination of the 

13 activities and capabilities of public health per14 sonnel and medical care providers with those of 

15 other emergency response providers as well as 

16 other Federal agencies, the private sector, and 

17 nonprofit organizations, for the forward move18 ment of patients; and 

19 ‘‘(J) for activities aimed at increasing the 

20 awareness of the Program to Federal, State 

21 and local governments for purposes of further 

22 integrating the Program into existing capabili23 ties. 

24 ‘‘(3) ELIGIBILITY.— 


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1 ‘‘(A) IN GENERAL.—Except as provided in 

2 subparagraph (C), any jurisdiction that received 

3 funds through the Program for fiscal year 2009 

4 shall be eligible for a contract under this sub5 section. 

6 ‘‘(B) ADDITIONAL JURISDICTIONS.— 

7 ‘‘(i) UNREPRESENTED STATES.— 

8 ‘‘(I) IN GENERAL.—Except as 

9 provided in subparagraph (C), for any 

10 State in which no jurisdiction received 

11 funds through the Program for fiscal 

12 year 2009, or in which funding was 

13 received only through another State, 

14 the metropolitan statistical area in 

15 such State with the largest population 

16 of all such areas in such State shall 

17 be eligible for a contract under this 

18 subsection. 

19 ‘‘(II) LIMITATION.—For each of 

20 fiscal years 2010 through 2014, no 

21 jurisdiction that would otherwise be 

22 eligible to receive a contract under 

23 subclause (I) shall be eligible for a 

24 contract under this subsection if it 

25 would result in any jurisdiction under 


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1 subparagraph (A) receiving less fund2 ing than such jurisdiction received for 

3 fiscal year 2004. 

4 ‘‘(ii) OTHER JURISDICTIONS.— 

5 ‘‘(I) IN GENERAL.—Subject to 

6 subparagraph (C), the Administrator 

7 may determine that additional juris8 dictions are eligible for contracts 

9 under this subsection. 

10 ‘‘(II) LIMITATION.—For each of 

11 fiscal years 2010 through 2014, the 

12 eligibility of any additional jurisdic13 tion for contracts under this sub14 section is subject to the availability of 

15 appropriations beyond that necessary 

16 to— 

17 ‘‘(aa) ensure that each juris18 diction eligible for a contract 

19 under subparagraph (A) does not 

20 receive less funding than such ju21 risdiction received for fiscal year 

22 2009; and 

23 ‘‘(bb) provide contracts to 

24 jurisdictions eligible under clause 

25 (i). 


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1 ‘‘(C) PERFORMANCE REQUIREMENT AFTER

2 FISCAL YEAR 2010.—A jurisdiction shall not be 

3 eligible for a contract under this subsection to 

4 be funded with amounts available after fiscal 

5 year 2010 unless the Secretary determines that 

6 the jurisdiction has met the performance meas7 ures issued under subsection (f). 

8 ‘‘(4) DISTRIBUTION OF FUNDS.— 

9 ‘‘(A) IN GENERAL.—The Administrator 

10 shall include in each contract under this sub11 section with a local jurisdiction a defined list of 

12 performance objectives for which funds will be 

13 distributed to the jurisdiction. 

14 ‘‘(B) PAYMENTS.—Funds shall be distrib15 uted by the Administrator under each contract 

16 under this subsection directly to the local juris17 diction that entered into the contract. 

18 ‘‘(5) MUTUAL AID.— 

19 ‘‘(A) AGREEMENTS.—Local jurisdictions 

20 receiving assistance under the Program are en21 couraged to develop and maintain memoranda 

22 of understanding and agreement with neigh23 boring jurisdictions to support a system of mu24 tual aid among the jurisdictions. 


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1 ‘‘(B) CONTENTS.—A memorandum re2 ferred to in subparagraph (A) shall include, at 

3 a minimum, policies and procedures to— 

4 ‘‘(i) enable the timely deployment of 

5 Program personnel and equipment across 

6 jurisdictions and, if relevant, across State 

7 boundaries; 

8 ‘‘(ii) share information in a consistent 

9 and timely manner; and 

10 ‘‘(iii) notify State authorities of the 

11 deployment of Program resources in a 

12 manner that ensures coordination with 

13 State agencies without impeding the ability 

14 of Program personnel and equipment to re15 spond rapidly to emergencies in other ju16 risdictions. 

17 ‘‘(f) PERFORMANCE MEASURES.—The Adminis18 trator, in coordination with the Assistant Secretary, Office 

19 of Health Affairs and the National Metropolitan Medical 

20 Response System Working Group and within one year 

21 after the date of enactment of this section, shall issue per22 formance measures for each local jurisdiction that enters 

23 a contract under this section to allow objective evaluation 

24 of the performance and effective use of funds provided 

25 under the contract. 


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1 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

2 is authorized to be appropriated to carry out the Program 

3 $75,000,000 for each of the fiscal years 2010 through 

4 2014.’’. 

5 (b) PROGRAM REVIEW.— 

6 (1) IN GENERAL.—The Administrator of the 

7 Federal Emergency Management Agency, the Assist8 ant Secretary, Office of Health Affairs, and the Na9 tional Metropolitan Medical Response System Work10 ing Group shall jointly conduct a review of the Met11 ropolitan Medical Response System Program, includ12 ing an examination of— 

13 (A) the goals and objectives of the Pro14 gram; 

15 (B) the extent to which the goals and ob16 jectives are being met; 

17 (C) the performance metrics that can best 

18 help assess whether the Program is succeeding; 

19 (D) how the Program can be improved; 

20 (E) how the Program complements and en21 hances other preparedness programs supported 

22 by the Department of Homeland Security and 

23 the Department of Health and Human Services; 

24 (F) the degree to which the strategic goals, 

25 objectives, and capabilities of the Program are 


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1 incorporated in State and local homeland secu2 rity plans; 

3 (G) how eligibility for financial assistance, 

4 and the allocation of financial assistance, under 

5 the Program should be determined, including 

6 how allocation of assistance could be based on 

7 risk; and 

8 (H) the resource requirements of the Pro9 gram. 

10 (2) REPORT.—Not later than 1 year after the 

11 date of enactment of this Act, the Administrator and 

12 the Assistant Secretary shall submit to the Commit13 tees on Homeland Security and Energy and Com14 merce of the House of Representatives and the Com15 mittee on Homeland Security and Governmental Af16 fairs of the Senate a report on the results of the re17 view under this subsection. 

18 (3) CONSULTATION.—The Administrator of the 

19 Federal Emergency Management Agency shall con20 sult with the Secretary of Health and Human Serv21 ices in the implementation of paragraph (1)(E). 

22 (4) DEFINITION.—In this subsection the term 

23 ‘‘National Metropolitan Medical Response System 

24 Working Group’’ means a group of 10 local governVerDate Nov 24 2008 00:38 Feb 04, 2010 Jkt 089200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H4580.IH H4580

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1 ment agency managers of contracts awarded under 

2 the Program, that— 

3 (A) represents a population-based cross 

4 section of jurisdictions that are receiving con5 tract funds under the Program; and 

6 (B) includes one local government agency 

7 contract manager from each of the 10 regions 

8 of the Federal Emergency Management Agency, 

9 of whom— 

10 (i) 5 shall be appointed by the Admin11 istrator of the Federal Emergency Man12 agement Agency; and 

13 (ii) 5 shall be appointed by the Assist14 ant Secretary, Office of Health Affairs. 

15 (c) CONFORMING AMENDMENTS.— 

16 (1) REPEAL.—Section 635 of the Post-Katrina 

17 Management Reform Act of 2006 (6 U.S.C. 723) is 

18 repealed. 

19 (2) TABLE OF CONTENTS.—The table of con20 tents contained in section 1(b) of the Homeland Se21 curity Act of 2002 is amended by adding at the end 

22 of the items relating to title V the following new 

23 item: 

‘‘Sec. 525. Metropolitan Medical Response System Program.’’. 

Æ 


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