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 de-
termined 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Metropolitan Medical 
Response System Act of 2010’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) In its January 2010 report card, the Com-
mission on the Prevention of Weapons of Mass De-
struction Proliferation and Terrorism stated that the 
Federal Government must ‘‘become a stronger advo-
cate for citizen, community, state, and regional pre-
paredness to effectively respond’’ to both natural 
disasters and man-made events. 
(2) The Metropolitan Medical Response System 
(MMRS) is the only program at the Federal level 
that supports the integration of local emergency 
management, law enforcement, and health and med-
ical systems into a coordinated response to a mass 
casualty event caused by a weapon of mass destruc-
tion, an incident involving hazardous materials, an 
epidemic disease outbreak, or a natural disaster. 
(3) The MMRS program was established in the 
wake of the 1995 deadly release of sarin nerve gas 
in a Tokyo subway, and the 1995 bombing of the Al-
fred P. Murrah building in Oklahoma City. 
(4) The MMRS program aims to improve med-
ical response systems, by enhancing the existing 
local response systems and capabilities of a commu-
nity before an incident occurs. 
(5) The MMRS program provides tangible ben-
efits in the form of increased operational capacity 
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and communication, improved personnel training, 
stockpiled pharmaceuticals, and adequate supplies of 
personal protective equipment and other specialized 
response equipment. 
(6) The MMRS program supports a number of 
other existing Federal programs, such as the Hos-
pital Preparedness Program, the Cities Readiness 
Initiative, the State Homeland Security Program, 
and Urban Area Security Initiative. 
(7) The MMRS program provides funding to 
124 local jurisdictions in 43 States, covering ap-
proximately 70 percent of the United States popu-
lation. 
(8) The MMRS program has become an in-
creasingly vital part of our homeland security infra-
structure in the wake of recent influenza outbreaks, 
renewed terrorists threats, and severe weather emer-
gencies. 
SEC. 3. METROPOLITAN MEDICAL RESPONSE SYSTEM PRO-
GRAM. 
(a) IN GENERAL.—Title V of the Homeland Security 
Act of 2002 (6 U.S.C. 311 et seq.) is amended by adding 
at the end the following new section: 
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‘‘SEC. 525. METROPOLITAN MEDICAL RESPONSE SYSTEM 
PROGRAM. 
‘‘(a) IN GENERAL.—There is in the Department a 
Metropolitan Medical Response System Program (in this 
section referred to as the ‘Program’). 
‘‘(b) PURPOSE.—The purpose of the Program shall 
be to support State and local jurisdictions in preparing 
for and maintaining all-hazards response capabilities to 
manage public health and mass casualty incidents result-
ing from natural and man-made disasters, acts of ter-
rorism, and epidemic disease outbreaks, by systematically 
enhancing and integrating first responders, public health 
personnel, emergency management personnel, and other 
participants in mass casualty management. 
‘‘(c) PROGRAM
ADMINISTRATION.—The Assistant 
Secretary, Office of Health Affairs shall develop pro-
grammatic and policy guidance for the Program in coordi-
nation with the Administrator of the Federal Emergency 
Management Agency. 
‘‘(d) PERSONNEL COSTS.—The Program shall not be 
subject to an administrative cap on the hiring of personnel 
to conduct Program activities. 
‘‘(e) FINANCIAL ASSISTANCE.— 
‘‘(1) AUTHORIZATION OF CONTRACTS.— 
‘‘(A) 
IN
GENERAL.—The 
Secretary, 
through the Administrator of the Federal 
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Emergency Management Agency and subject to 
the availability of appropriations, may enter 
into contracts under this section with local ju-
risdictions to assist in preparing for and re-
sponding to mass casualty incidents. 
‘‘(B) CONSULTATION.—In developing guid-
ance for contracts authorized under this sub-
section, the Administrator shall consult with the 
Assistant Secretary, Office of Health Affairs. 
‘‘(2) USE OF FUNDS.—A contract entered into 
under this subsection may be used to support the in-
tegration of emergency management, health, and 
medical systems into a coordinated response to mass 
casualty incidents caused by any hazard, including— 
‘‘(A) to strengthen medical surge capacity; 
‘‘(B) to strengthen mass prophylaxis capa-
bilities including development and maintenance 
of an initial pharmaceutical stockpile sufficient 
to protect first responders, their families, and 
immediate victims from a chemical or biological 
event; 
‘‘(C) to strengthen chemical, biological, ra-
diological, nuclear, and explosive detection, re-
sponse, and decontamination capabilities; 
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‘‘(D) to develop and maintain mass triage 
and pre-hospital treatment plans and capabili-
ties; 
‘‘(E) for planning; 
‘‘(F) to support efforts to strengthen infor-
mation sharing and collaboration capabilities of 
regional, State, and urban areas in support of 
public health and medical preparedness; 
‘‘(G) for medical supplies management and 
distribution; 
‘‘(H) for training and exercises; 
‘‘(I) for integration and coordination of the 
activities and capabilities of public health per-
sonnel and medical care providers with those of 
other emergency response providers as well as 
other Federal agencies, the private sector, and 
nonprofit organizations, for the forward move-
ment of patients; and 
‘‘(J) for activities aimed at increasing the 
awareness of the Program to Federal, State 
and local governments for purposes of further 
integrating the Program into existing capabili-
ties. 
‘‘(3) ELIGIBILITY.— 
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‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (C), any jurisdiction that received 
funds through the Program for fiscal year 2009 
shall be eligible for a contract under this sub-
section. 
‘‘(B) ADDITIONAL JURISDICTIONS.— 
‘‘(i) UNREPRESENTED STATES.— 
‘‘(I) IN
GENERAL.—Except as 
provided in subparagraph (C), for any 
State in which no jurisdiction received 
funds through the Program for fiscal 
year 2009, or in which funding was 
received only through another State, 
the metropolitan statistical area in 
such State with the largest population 
of all such areas in such State shall 
be eligible for a contract under this 
subsection. 
‘‘(II) LIMITATION.—For each of 
fiscal years 2010 through 2014, no 
jurisdiction that would otherwise be 
eligible to receive a contract under 
subclause (I) shall be eligible for a 
contract under this subsection if it 
would result in any jurisdiction under 
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subparagraph (A) receiving less fund-
ing than such jurisdiction received for 
fiscal year 2004. 
‘‘(ii) OTHER JURISDICTIONS.— 
‘‘(I) IN
GENERAL.—Subject to 
subparagraph (C), the Administrator 
may determine that additional juris-
dictions are eligible for contracts 
under this subsection. 
‘‘(II) LIMITATION.—For each of 
fiscal years 2010 through 2014, the 
eligibility of any additional jurisdic-
tion for contracts under this sub-
section is subject to the availability of 
appropriations beyond that necessary 
to— 
‘‘(aa) ensure that each juris-
diction eligible for a contract 
under subparagraph (A) does not 
receive less funding than such ju-
risdiction received for fiscal year 
2009; and 
‘‘(bb) provide contracts to 
jurisdictions eligible under clause 
(i). 
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‘‘(C) PERFORMANCE REQUIREMENT AFTER 
FISCAL YEAR 2010.—A jurisdiction shall not be 
eligible for a contract under this subsection to 
be funded with amounts available after fiscal 
year 2010 unless the Secretary determines that 
the jurisdiction has met the performance meas-
ures issued under subsection (f). 
‘‘(4) DISTRIBUTION OF FUNDS.— 
‘‘(A) IN
GENERAL.—The Administrator 
shall include in each contract under this sub-
section with a local jurisdiction a defined list of 
performance objectives for which funds will be 
distributed to the jurisdiction. 
‘‘(B) PAYMENTS.—Funds shall be distrib-
uted by the Administrator under each contract 
under this subsection directly to the local juris-
diction that entered into the contract. 
‘‘(5) MUTUAL AID.— 
‘‘(A) AGREEMENTS.—Local jurisdictions 
receiving assistance under the Program are en-
couraged to develop and maintain memoranda 
of understanding and agreement with neigh-
boring jurisdictions to support a system of mu-
tual aid among the jurisdictions. 
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‘‘(B) CONTENTS.—A memorandum re-
ferred to in subparagraph (A) shall include, at 
a minimum, policies and procedures to— 
‘‘(i) enable the timely deployment of 
Program personnel and equipment across 
jurisdictions and, if relevant, across State 
boundaries; 
‘‘(ii) share information in a consistent 
and timely manner; and 
‘‘(iii) notify State authorities of the 
deployment of Program resources in a 
manner that ensures coordination with 
State agencies without impeding the ability 
of Program personnel and equipment to re-
spond rapidly to emergencies in other ju-
risdictions. 
‘‘(f) PERFORMANCE
MEASURES.—The Adminis-
trator, in coordination with the Assistant Secretary, Office 
of Health Affairs and the National Metropolitan Medical 
Response System Working Group and within one year 
after the date of enactment of this section, shall issue per-
formance measures for each local jurisdiction that enters 
a contract under this section to allow objective evaluation 
of the performance and effective use of funds provided 
under the contract. 
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