SEC. 2. METROPOLITAN MEDICAL RESPONSE SYSTEM PRO-
GRAM. 
(a) AMENDMENT.—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: 
‘‘SEC. 525. METROPOLITAN MEDICAL RESPONSE SYSTEM 
PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary shall conduct a 
Metropolitan Medical Response System Program, that 
shall assist State and local governments in preparing for 
and responding to public health and mass casualty inci-
dents resulting from natural disasters, acts of terrorism, 
and other man-made disasters. 
‘‘(b) FINANCIAL ASSISTANCE.— 
‘‘(1) AUTHORIZATION OF GRANTS.— 
‘‘(A) 
IN
GENERAL.—The 
Secretary, 
through the Administrator of the Federal 
Emergency Management Agency, may make 
grants under this section to State and local gov-
ernments to assist in preparing for and re-
sponding to mass casualty incidents resulting 
from natural disasters, acts of terrorism, and 
other man-made disasters. 
‘‘(B) CONSULTATION.—In developing guid-
ance for grants authorized under this section, 
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the Administrator shall consult with the Assist-
ant Secretary, Office of Health Affairs. 
‘‘(2) USE OF FUNDS.—A grant made under this 
section may be used to support the integration of 
emergency management, health, and medical sys-
tems 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; 
‘‘(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; 
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‘‘(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 such other activities as the Ad-
ministrator provides. 
‘‘(3) ELIGIBILITY.— 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (C), any jurisdiction that received 
funds through the Metropolitan Medical Re-
sponse System Program in fiscal year 2009 
shall be eligible to receive a grant under this 
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 Metropolitan Med-
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ical Response System Program in fis-
cal year 2009, or in which funding 
was received only through another 
State, the metropolitan statistical area 
in such State with the largest popu-
lation of all such areas in such State 
shall be eligible to receive a grant 
under this section. 
‘‘(II) LIMITATION.—For each of 
fiscal years 2010 through 2012, no 
jurisdiction that would otherwise be 
eligible to receive grants under sub-
clause (I) shall receive a grant under 
this section if it would result in any 
jurisdiction under subparagraph (A) 
receiving less funding than such juris-
diction received in fiscal year 2009. 
‘‘(ii) OTHER JURISDICTIONS.— 
‘‘(I) IN
GENERAL.—Subject to 
subparagraph (C), the Administrator 
may determine that additional juris-
dictions are eligible to receive grants 
under this section. 
‘‘(II) LIMITATION.—For each of 
fiscal years 2010 through 2012, the 
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eligibility of any additional jurisdic-
tion to receive grants under this sec-
tion is subject to the availability of 
appropriations beyond that necessary 
to— 
‘‘(aa) ensure that each juris-
diction eligible to receive a grant 
under subparagraph (A) does not 
receive less funding than such ju-
risdiction received in fiscal year 
2009; and 
‘‘(bb) provide grants to ju-
risdictions eligible under clause 
(i). 
‘‘(C) PERFORMANCE REQUIREMENT AFTER 
FISCAL YEAR 2010.—A jurisdiction shall not be 
eligible for a grant under this subsection from 
funds available after fiscal year 2010 unless the 
Secretary determines that the jurisdiction main-
tains a sufficient measured degree of capability 
in accordance with the performance measures 
issued under subsection (c). 
‘‘(4) DISTRIBUTION OF FUNDS.— 
‘‘(A) IN
GENERAL.—The Administrator 
shall distribute grant funds under this section 
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to the State in which the jurisdiction receiving 
a grant under this section is located. 
‘‘(B) PASS
THROUGH.—Subject to sub-
paragraph (C), not later than 45 days after the 
date on which a State receives grant funds 
under subparagraph (A), the State shall provide 
the jurisdiction receiving the grant 100 percent 
of the grant funds, and not later than 45 days 
after the State releases the funds, all fiscal 
agents shall make the grant funds available for 
expenditure. 
‘‘(C) 
EXCEPTION.—The 
Administrator 
may permit a State to provide to a jurisdiction 
receiving a grant under this section 97 percent 
of the grant funds awarded if doing so would 
not result in any jurisdiction eligible for a grant 
under paragraph (3)(A) receiving less funding 
than such jurisdiction received in fiscal year 
2009. 
‘‘(5) REGIONAL COORDINATION.—The Adminis-
trator shall ensure that each jurisdiction that re-
ceives a grant under this section, as a condition of 
receiving such grant, is actively coordinating its pre-
paredness efforts with surrounding jurisdictions, 
with the official with primary responsibility for 
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homeland security (other than the Governor) of the 
government of the State in which the jurisdiction is 
located, and with emergency response providers from 
all relevant disciplines, as determined by the Admin-
istrator, to effectively enhance regional prepared-
ness. 
‘‘(c) PERFORMANCE
MEASURES.—The Adminis-
trator, in coordination with the Assistant Secretary, Office 
of Health Affairs, and the National Metropolitan Medical 
Response System Working Group, shall issue performance 
measures within one year after the date of enactment of 
this section that enable objective evaluation of the per-
formance and effective use of funds provided under this 
section in any jurisdiction. 
‘‘(d) METROPOLITAN MEDICAL RESPONSE SYSTEM 
WORKING GROUP DEFINED.—In this section, the term 
‘National Metropolitan Medical Response System Working 
Group’ means— 
‘‘(1) 10 Metropolitan Medical Response System 
Program grant managers, who shall— 
‘‘(A) include one such grant manager from 
each region of the Agency; 
‘‘(B) comprise a population-based cross 
section of jurisdictions that are receiving grant 
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funds under the Metropolitan Medical Response 
System Program; and 
‘‘(C) include— 
‘‘(i) 3 selected by the Administrator; 
and 
‘‘(ii) 3 selected by the Assistant Sec-
retary, Office of Health Affairs; and 
‘‘(2) 3 State officials who are responsible for 
administration of State programs that are carried 
out with grants under this section, who shall be se-
lected by the Administrator. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated $75,000,000 to carry out 
the program for each of fiscal years 2010 through 2014.’’. 
(b) CLERICAL AMENDMENT.—The table of contents 
in section 1(b) of such Act is amended by adding at the 
end of the items relating to title V the following new item: 
‘‘Sec. 525. Metropolitan Medical Response System Program.’’. 
SEC. 3. METROPOLITAN MEDICAL RESPONSE PROGRAM RE-
VIEW. 
(a) IN GENERAL.—The Administrator of the Federal 
Emergency Management Agency, the Assistant Secretary, 
Office of Health Affairs, and the National Metropolitan 
Medical Response System Working Group shall conduct 
a review of the Metropolitan Medical Response System 
Program authorized under section 525 of the Homeland 
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Security Act of 2002, as added by section 2 of this Act, 
including an examination of— 
(1) the goals and objectives of the Metropolitan 
Medical Response System Program; 
(2) the extent to which the goals and objectives 
are being met; 
(3) the performance metrics that can best help 
assess whether the Metropolitan Medical Response 
System Program is succeeding; 
(4) how the Metropolitan Medical Response 
System Program can be improved; 
(5) how the Metropolitan Medical Response 
System Program complements and enhances other 
preparedness programs supported by the Depart-
ment of Homeland Security and the Department of 
Health and Human Services; 
(6) the degree to which the strategic goals, ob-
jectives, and capabilities of the Metropolitan Medical 
Response System Program are incorporated in State 
and local homeland security plans; 
(7) how eligibility for financial assistance, and 
the allocation of financial assistance, under the Met-
ropolitan Medical Response System Program should 
be determined, including how allocation of assistance 
could be based on risk; 
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(8) whether the Metropolitan Medical Response 
System Program would be more effective if it were 
managed as a contractual agreement; and 
(9) the resource requirements of the Metropoli-
tan Medical Response System Program. 
(b) REPORT.—Not later than 1 year after the date 
of enactment of this Act, the Administrator and the As-
sistant Secretary, Office of Health Affairs shall submit to 
the Committee on Homeland Security of the House of 
Representatives and the Committee on Homeland Security 
and Governmental Affairs of the Senate a report on the 
results of the review under this subsection. 
(c) CONSULTATION.—The Administrator of the Fed-
eral Emergency Management Agency shall consult with 
the Secretary of Health and Human Services in the imple-
mentation of subsection (a)(5). 
(d) DEFINITION.—In this section the term ‘‘National 
Metropolitan Medical Response System Working Group’’ 
has the meaning that term has in section 525 of the 
Homeland Security Act of 2002, as amended by this sec-
tion. 
SEC. 4. TECHNICAL AND CONFORMING AMENDMENT. 
Section 635 of the Post-Katrina Management Reform 
Act of 2006 (6 U.S.C. 723) is repealed. 
Æ 
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