The Metropolitan Medical Response System

The system, which serves 127 of the largest jurisdictions in the country, is built upon a template that can be adjusted to fit large and small communities.


The Metropolitan Medical Response System (MMRS) traces its origin to the Metropolitan Medical Strike Team (MMST) concept created by the Washington D.C. Metropolitan Area in 1995. The MMST was a joint effort by Washington D.C., Arlington County in Virginia and Prince George's and Montgomery Counties in Maryland.

The MMST was primarily a glorified hazardous materials team designed to respond to a terrorist event involving weapons of mass destruction. Based on the success of the MMST, a similar team was formed in order to defend against a possible terrorist attack at the 1996 Summer Olympics in Atlanta.

The MMRS was created in 1996 primarily in response to the Alfred P. Murrah Federal Building bombing in Oklahoma City and the Sarin gas attack in Tokyo, both of which occurred in 1995. Also playing a part in the decision was the first attack on the World Trade Center in 1993. A series of Congressional actions in the late 1990's laid the groundwork for the MMRS as it is known today. The original authorization for the program came from Public Law 104-201, National Defense Authorization Act for Fiscal Year 1997.

Funding the System
The Secretary of Defense was mandated to enhance the capabilities of the nation's first responders and to support improvements to their programs by the Defense Against Weapons of Mass Destruction Act of 1996. The Nunn-Lugar-Domenici Amendment to the National Defense Authorization Act for Fiscal Year 1997 authorized funding for "medical strike teams". These medical strike teams evolved into the current MMRS program. There are currently 127 MMRS jurisdictions across the country. The program is funded by Congress every year with current funding of approximately $30 million. This has been reduced from the initial allocation of $50 million.

Funds for the MMRS are distributed through the states where they are located. DHS allows up to 5 percent of the total allocation to be used for management and administrative needs. DHS also encourages the individual states to pass the entire allocation to the MMRS, but the state may retain up to 20 percent of the allocation in order to fund strategy assessments and capability integration projects between the state and the MMRS.

The Meat of the Team
The First Responder community is generally thought to consist of fire, law enforcement and emergency medical services (EMS) personnel. The MMRS takes these traditional first responders and adds a public health and hazardous materials component in taking an all hazards approach to mitigating a large scale incident. While the MMRS was initially designed to counter a terrorist event, it can also deal with any large scale mass casualty event such as a natural disaster or a large scale building collapse.

The system currently covers 127 of the largest jurisdictions in the country, leaving many jurisdictions at risk. The template can be adjusted to fit large and small communities. In fact, the MMRS was not designed to be a one size fits all solution. Individual jurisdictions are actively encouraged to tailor it to their individual needs in order to make it more effective. Regionalization is also encouraged. The MMRS is designed for high population areas. This does not necessarily mean large cities only. Several areas throughout the country have a MMRS based on a region as opposed to a single jurisdictional entity.

Federal disaster planning suggests that all jurisdictions be prepared to be self sufficient for 48 to 72 hours after an event occurs, be it a terrorist attack or a natural disaster. While federal assets will be on the way as soon as they are requested, it will take time for federal teams to marshal their staffing and resources and deploy to the incident site. While the response to Hurricane Katrina immediately comes to mind, even events that saw federal response teams on the ground quickly (Murrah Federal Building, September 11 attacks, etc.) took at best several hours to arrive on scene. The MMRS is designed to assist local agencies with mitigating the incident prior to the arrival of federal assets.

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