I 

111TH CONGRESS 

2D SESSION H. R. 4492 

To amend the Homeland Security Act of 2002 to ensure continuation of 

the Metropolitan Medical Response System Program, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 21, 2010 

Mr. BILIRAKIS 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 ensure 

continuation of 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 Program Act of 2009’’. 

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1 SEC. 2. METROPOLITAN MEDICAL RESPONSE SYSTEM PRO2 GRAM. 

3 (a) AMENDMENT.—Title V of the Homeland Security 

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

5 at the end the following: 

6 ‘‘SEC. 525. METROPOLITAN MEDICAL RESPONSE SYSTEM 

7 PROGRAM. 

8 ‘‘(a) IN GENERAL.—The Secretary shall conduct a 

9 Metropolitan Medical Response System Program, that 

10 shall assist State and local governments in preparing for 

11 and responding to public health and mass casualty inci12 dents resulting from natural disasters, acts of terrorism, 

13 and other man-made disasters. 

14 ‘‘(b) FINANCIAL ASSISTANCE.— 

15 ‘‘(1) AUTHORIZATION OF GRANTS.— 

16 ‘‘(A) IN GENERAL.—The Secretary, 

17 through the Administrator of the Federal 

18 Emergency Management Agency, may make 

19 grants under this section to State and local gov20 ernments to assist in preparing for and re21 sponding to mass casualty incidents resulting 

22 from natural disasters, acts of terrorism, and 

23 other man-made disasters. 

24 ‘‘(B) CONSULTATION.—In developing guid25 ance for grants authorized under this section, 

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1 the Administrator shall consult with the Assist2 ant Secretary, Office of Health Affairs. 

3 ‘‘(2) USE OF FUNDS.—A grant made under this 

4 section may be used to support the integration of 

5 emergency management, health, and medical sys6 tems into a coordinated response to mass casualty 

7 incidents caused by any hazard, including— 

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

9 ‘‘(B) to strengthen mass prophylaxis capa10 bilities including development and maintenance 

11 of an initial pharmaceutical stockpile sufficient 

12 to protect first responders, their families, and 

13 immediate victims from a chemical or biological 

14 event; 

15 ‘‘(C) to strengthen chemical, biological, ra16 diological, nuclear, and explosive detection, re17 sponse, and decontamination capabilities; 

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

19 and pre-hospital treatment plans and capabili20 ties; 

21 ‘‘(E) for planning; 

22 ‘‘(F) to support efforts to strengthen infor23 mation sharing and collaboration capabilities of 

24 regional, State, and urban areas in support of 

25 public health and medical preparedness; 

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1 ‘‘(G) for medical supplies management and 

2 distribution; 

3 ‘‘(H) for training and exercises; 

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

5 activities and capabilities of public health per6 sonnel and medical care providers with those of 

7 other emergency response providers as well as 

8 other Federal agencies, the private sector, and 

9 nonprofit organizations, for the forward move10 ment of patients; and 

11 ‘‘(J) for such other activities as the Ad12 ministrator provides. 

13 ‘‘(3) ELIGIBILITY.— 

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

15 subparagraph (C), any jurisdiction that received 

16 funds through the Metropolitan Medical Re17 sponse System Program in fiscal year 2009 

18 shall be eligible to receive a grant under this 

19 section. 

20 ‘‘(B) ADDITIONAL JURISDICTIONS.— 

21 ‘‘(i) UNREPRESENTED STATES.— 

22 ‘‘(I) IN GENERAL.—Except as 

23 provided in subparagraph (C), for any 

24 State in which no jurisdiction received 

25 funds through the Metropolitan Medmstockstill on DSKH9S0YB1PROD with BILLS

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1 ical Response System Program in fis2 cal year 2009, or in which funding 

3 was received only through another 

4 State, the metropolitan statistical area 

5 in such State with the largest popu6 lation of all such areas in such State 

7 shall be eligible to receive a grant 

8 under this section. 

9 ‘‘(II) LIMITATION.—For each of 

10 fiscal years 2010 through 2012, no 

11 jurisdiction that would otherwise be 

12 eligible to receive grants under sub13 clause (I) shall receive a grant under 

14 this section if it would result in any 

15 jurisdiction under subparagraph (A) 

16 receiving less funding than such juris17 diction received in fiscal year 2009. 

18 ‘‘(ii) OTHER JURISDICTIONS.— 

19 ‘‘(I) IN GENERAL.—Subject to 

20 subparagraph (C), the Administrator 

21 may determine that additional juris22 dictions are eligible to receive grants 

23 under this section. 

24 ‘‘(II) LIMITATION.—For each of 

25 fiscal years 2010 through 2012, the 

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1 eligibility of any additional jurisdic2 tion to receive grants under this sec3 tion is subject to the availability of 

4 appropriations beyond that necessary 

5 to— 

6 ‘‘(aa) ensure that each juris7 diction eligible to receive a grant 

8 under subparagraph (A) does not 

9 receive less funding than such ju10 risdiction received in fiscal year 

11 2009; and 

12 ‘‘(bb) provide grants to ju13 risdictions eligible under clause 

14 (i). 

15 ‘‘(C) PERFORMANCE REQUIREMENT AFTER

16 FISCAL YEAR 2010.—A jurisdiction shall not be 

17 eligible for a grant under this subsection from 

18 funds available after fiscal year 2010 unless the 

19 Secretary determines that the jurisdiction main20 tains a sufficient measured degree of capability 

21 in accordance with the performance measures 

22 issued under subsection (c). 

23 ‘‘(4) DISTRIBUTION OF FUNDS.— 

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

25 shall distribute grant funds under this section 

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1 to the State in which the jurisdiction receiving 

2 a grant under this section is located. 

3 ‘‘(B) PASS THROUGH.—Subject to sub4 paragraph (C), not later than 45 days after the 

5 date on which a State receives grant funds 

6 under subparagraph (A), the State shall provide 

7 the jurisdiction receiving the grant 100 percent 

8 of the grant funds, and not later than 45 days 

9 after the State releases the funds, all fiscal 

10 agents shall make the grant funds available for 

11 expenditure. 

12 ‘‘(C) EXCEPTION.—The Administrator 

13 may permit a State to provide to a jurisdiction 

14 receiving a grant under this section 97 percent 

15 of the grant funds awarded if doing so would 

16 not result in any jurisdiction eligible for a grant 

17 under paragraph (3)(A) receiving less funding 

18 than such jurisdiction received in fiscal year 

19 2009. 

20 ‘‘(5) REGIONAL COORDINATION.—The Adminis21 trator shall ensure that each jurisdiction that re22 ceives a grant under this section, as a condition of 

23 receiving such grant, is actively coordinating its pre24 paredness efforts with surrounding jurisdictions, 

25 with the official with primary responsibility for 

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1 homeland security (other than the Governor) of the 

2 government of the State in which the jurisdiction is 

3 located, and with emergency response providers from 

4 all relevant disciplines, as determined by the Admin5 istrator, to effectively enhance regional prepared6 ness. 

7 ‘‘(c) PERFORMANCE MEASURES.—The Adminis8 trator, in coordination with the Assistant Secretary, Office 

9 of Health Affairs, and the National Metropolitan Medical 

10 Response System Working Group, shall issue performance 

11 measures within one year after the date of enactment of 

12 this section that enable objective evaluation of the per13 formance and effective use of funds provided under this 

14 section in any jurisdiction. 

15 ‘‘(d) METROPOLITAN MEDICAL RESPONSE SYSTEM

16 WORKING GROUP DEFINED.—In this section, the term 

17 ‘National Metropolitan Medical Response System Working 

18 Group’ means— 

19 ‘‘(1) 10 Metropolitan Medical Response System 

20 Program grant managers, who shall— 

21 ‘‘(A) include one such grant manager from 

22 each region of the Agency; 

23 ‘‘(B) comprise a population-based cross 

24 section of jurisdictions that are receiving grant 

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1 funds under the Metropolitan Medical Response 

2 System Program; and 

3 ‘‘(C) include— 

4 ‘‘(i) 3 selected by the Administrator; 

5 and 

6 ‘‘(ii) 3 selected by the Assistant Sec7 retary, Office of Health Affairs; and 

8 ‘‘(2) 3 State officials who are responsible for 

9 administration of State programs that are carried 

10 out with grants under this section, who shall be se11 lected by the Administrator. 

12 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

13 is authorized to be appropriated $75,000,000 to carry out 

14 the program for each of fiscal years 2010 through 2014.’’. 

15 (b) CLERICAL AMENDMENT.—The table of contents 

16 in section 1(b) of such Act is amended by adding at the 

17 end of the items relating to title V the following new item: 

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

18 SEC. 3. METROPOLITAN MEDICAL RESPONSE PROGRAM RE19 VIEW. 

20 (a) IN GENERAL.—The Administrator of the Federal 

21 Emergency Management Agency, the Assistant Secretary, 

22 Office of Health Affairs, and the National Metropolitan 

23 Medical Response System Working Group shall conduct 

24 a review of the Metropolitan Medical Response System 

25 Program authorized under section 525 of the Homeland 

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1 Security Act of 2002, as added by section 2 of this Act, 

2 including an examination of— 

3 (1) the goals and objectives of the Metropolitan 

4 Medical Response System Program; 

5 (2) the extent to which the goals and objectives 

6 are being met; 

7 (3) the performance metrics that can best help 

8 assess whether the Metropolitan Medical Response 

9 System Program is succeeding; 

10 (4) how the Metropolitan Medical Response 

11 System Program can be improved; 

12 (5) how the Metropolitan Medical Response 

13 System Program complements and enhances other 

14 preparedness programs supported by the Depart15 ment of Homeland Security and the Department of 

16 Health and Human Services; 

17 (6) the degree to which the strategic goals, ob18 jectives, and capabilities of the Metropolitan Medical 

19 Response System Program are incorporated in State 

20 and local homeland security plans; 

21 (7) how eligibility for financial assistance, and 

22 the allocation of financial assistance, under the Met23 ropolitan Medical Response System Program should 

24 be determined, including how allocation of assistance 

25 could be based on risk; 

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1 (8) whether the Metropolitan Medical Response 

2 System Program would be more effective if it were 

3 managed as a contractual agreement; and 

4 (9) the resource requirements of the Metropoli5 tan Medical Response System Program. 

6 (b) REPORT.—Not later than 1 year after the date 

7 of enactment of this Act, the Administrator and the As8 sistant Secretary, Office of Health Affairs shall submit to 

9 the Committee on Homeland Security of the House of 

10 Representatives and the Committee on Homeland Security 

11 and Governmental Affairs of the Senate a report on the 

12 results of the review under this subsection. 

13 (c) CONSULTATION.—The Administrator of the Fed14 eral Emergency Management Agency shall consult with 

15 the Secretary of Health and Human Services in the imple16 mentation of subsection (a)(5). 

17 (d) DEFINITION.—In this section the term ‘‘National 

18 Metropolitan Medical Response System Working Group’’ 

19 has the meaning that term has in section 525 of the 

20 Homeland Security Act of 2002, as amended by this sec21 tion. 

22 SEC. 4. TECHNICAL AND CONFORMING AMENDMENT. 

23 Section 635 of the Post-Katrina Management Reform 

24 Act of 2006 (6 U.S.C. 723) is repealed. 

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