The Metropolitan Medical Response System (MMRS) program of the U. S. Department of Health and Human Services (DHHS) provides funds to major U. S. cities to help them develop plans for coping with the health and medical consequences of a terrorist attack with chemical, biological, or radiological (CBR) agents. DHHS asked the Institute of Medicine (IOM) to assist in assessing the effectiveness of the MMRS program by developing appropriate evaluation methods, tools, and processes to assess both its own management of the program and local preparedness in the cities that have participated in the program. This book provides the managers of the MMRS program and others concerned about local capabilities to cope with CBR terrorism with three evaluation tools and a three-part assessment method. The tools are a questionnaire survey eliciting feedback about the management of the MMRS program, a table of preparedness indicators for 23 essential response capabilities, and a set of three scenarios and related questions for group discussion. The assessment method described integrates document inspection, a site visit by a team of expert peer reviewers, and observations at community exercises and drills.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON EVALUATION OF THE METROPOLITAN MEDICAL RESPONSE SYSTEM PROGRAM
• Independent Report Reviewers
• [Dedication]
• Preface
• Acronyms and Abbreviations
• Executive Summary
• 1 Introduction
• 2. Community Emergency Management and Available Federal Assistance
  • EMERGENCY MANAGEMENT TERMINOLOGY
  • EMERGENCY MANAGEMENT IN THE UNITED STATES
  • LOCAL EMERGENCY MANAGEMENT
  • STATE ASSISTANCE
  • THE FEDERAL EMERGENCY RESPONSE PLAN
  • THE NATIONAL CONTINGENCY PLAN
  • THE FEDERAL RADIOLOGICAL EMERGENCY RESPONSE PLAN
  • TERRORISM-SPECIFIC FEDERAL SUPPORT TEAMS
  • CONCLUSION
• 3. Federal Efforts to Increase State and Local Preparedness for Terrorism
  • ODP PROGRAMS
  • FBI PROGRAMS
  • CDC PROGRAMS
  • FEMA PROGRAMS
• 4. Metropolitan Medical Response System Program Contracts
  • FUNCTIONAL AREAS COVERED
  • PRODUCTS DEMANDED
  • CONTRACT DELIVERABLE EVALUATION INSTRUMENT
• 5. Measurement and Data Collection in Evaluation
  • EVALUATIONS OF VARIOUS TYPES
  • MANAGEMENT FUNCTIONS OF EVALUATIONS IN THE MMRS PROGRAM CONTEXT
  • SUMMATIVE AND FORMATIVE USES OF VARIOUS EVALUATION TYPES
  • WHY AN ADEQUATE WRITTEN PLAN IS NOT SUFFICIENT ASSURANCE OF PREPAREDNESS
  • EVALUATION MEASUREMENT FOR LOW-FREQUENCY, HIGH-STAKES EVENTS
  • EVALUATION MEASUREMENT: PERFORMANCE MEASURES AND PROXIES
  • CRITERIA FOR SELECTION OF EVALUATION METHODS
• 6. Preparedness Indicators
  • EXISTING STANDARDS
  • EXISTING ASSESSMENT TOOLS
  • PERFORMANCE MEASURES VERSUS PREPAREDNESS INDICATORS
• 7. Feedback to Office of Emergency Preparedness on Program Management
  • OEP HELP TO MMRS PROGRAM CONTRACTORS
  • SURVEY FOR MMRS PROGRAM CONTRACTORS
• 8. Feedback to Office of Emergency Preparedness on Program Success
  • ESSENTIAL RESPONSE CAPABILITIES
  • PREPAREDNESS INDICATORS FOR EVALUATION OF WRITTEN SUBMISSIONS, ON-SITE INSPECTION, AND OBSERVED EXERCISES
  • PREPAREDNESS CRITERIA
  • EXERCISES AND DRILLS
  • SITE VISITS AND PEER EVALUATORS
  • SCENARIO-DRIVEN GROUP INTERACTION
  • SUMMARY
• 9. Closing Remarks
  • STRATEGIC USES OF EVALUATION DATA: IMPLEMENTING THE “LAYERING STRATEGY”
  • COMMITTEE CRITIQUE AND SUGGESTIONS FOR PROGRAM AMENDMENTS
• References
• A Committee and Staff Biographies
• B Selected Information About Federal Chemical, Biological, Radiological, Nuclear Consequence Management Response Teams (Appendix II, General Accounting Office Report GAO-01-14)
• C Metropolitan Medical Response System Program Cities
• D 2000 MMRS Contract Deliverable Evaluation Instrument
• E Preparedness Indicators for Metropolitan Medical Response System Program Contract Deliverables
• F Scenarios and Discussion Materials for Use on Site Visits

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for this report were chosen for their special competences and with regard for appropriate balance.

Support for this project was provided by the Office of Emergency Preparedness, U.S. Department of Health and Human Services (Contract No. 282-99-0045, TO#5). This support does not constitute endorsement of the views expressed in the report.