DATE: September 20, 1999

TO: The Subcommittee on National Security, Veteran Affairs

And International Relations

FROM: Edward P. Plaugher, Fire Chief – Arlington County

SUBJECT: Metropolitan Medical Strike Team

March 1995, after the attack on the Tokyo subway and prior to the Oklahoma City Federal Building bombing, the Washington DC Council of Government (COG) Fire Chiefs Committee requested assistance to better prepare the national capital area and the 1^st responder community for a weapons of mass destruction event. Efforts have been underway since that time and progress has been made in several important areas. Your community now has additional response services and a team that has received specialized training. Equipment has been designed and field exercises have been concentrated at several key facilities or targets such as the Pentagon. Some 1^st responder departments have received additional federal resources and in those communities, even more has been done to assist and prepare the 1^st responders.

In relation to the Metropolitan Medical Strike Team (MMST), the partnership with the Office of Emergency Preparedness (OEP), US

Chief Edward Plaugher

September 20, 1999

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Department of Public Health Services has been outstanding. With very limited resources, their program has made a difference in our ability to deal with critical life support issues such as immediate access to essential pharmaceuticals. The Metropolitan Medical Response System (MMRS) has and will continue with the support of OEP to improve our response capability and is a model program that utilizes the partnership approach to provide essential response capability to incidents of terrorism. Our partnership, which utilizes the resources and talents of local, regional, state and federal assets, developed well beyond our original expectations. Further development of the "System" is under way at this time and will with continued support of the partners continue to see improvements.

Several key areas however are very problematic and are to which I will focus the remainder of my remarks. Early in the development of the MMST/MMSR Team, the hospital/medical community was deemed critical. In the Tokyo incident, self-referral to a medical facility of the incident victims was a major issue and in most incident preplanning, has been

Chief Edward Plaugher

September 20, 1999

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deemed to be a major factor. Today’s hospitals, with few exceptions, have limited or no ability to manage the effects of a man-made or natural disaster with large numbers of casualties. Immediate 1^st response means hospitals and medical care, not just Law Enforcement, Fire and EMS response. We have not developed the necessary infrastructure to support this critical need. First responders will do their best to save lives only to see the lack of facilities equipment and trained staff fail to maintain or support that saved life. Managed care has streamlined the medical system for efficiency and is a system for which we have all benefited. Managed care and the fine-tuning of medical resources are however, the wrong approach to develop hospital-based resources. This resource is so critical that we must not allow the "corporate" bottom line to dictate the outcome. I propose that this need be viewed as similar to other infrastructure of critical importance to our nation such as interstate highways and air traffic control both, which I understand, are operated by federal trust funds. Trust funds, which can only be spent to support those program-specific needs for which we as the 1^st responder community/disaster preparedness community deem critical. I propose that two dollars per day be assessed per day per occupied hospital bed which

Chief Edward Plaugher

September 20, 1999

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would be used to fund the development of a hospitals based resources system. Every hospital could and would then have the financial resources to support the efforts of the 1^st responder in the event of a disaster.

Just in the last 30 days one of Arlington County’s three hospitals and its associated emergency room closed its doors. Almost 45% of our hospital based disaster response capability just vanished in less than 48 hours. This erosion of our emergency medical system must be stopped and reversed or the success of the world’s best emergency medical care will slide to an unacceptable level.

In addition, research and development must proceed on the development of a detector to aid the 1^st responders. Discussions with the Oak Ridge National Laboratory regarding this issue have produced positive preliminary results. However funding has prevented the concept from moving forward. The detector would vastly expand the early warning capability of today's smoke detector and could if applied to the 1^st responder protective clothing greatly

Chief Edward Plaugher

September 20, 1999

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enhance the protection of the response community and every occupation to which it is applied.