What are Dayton MMRS and West Central Ohio RMRS?

  • Print

What are Dayton MMRS and West Central Ohio RMRS?





Stands for:

Metropolitan Medical Response System

Regional Medical Response System


Began in 1996 in selected cities.

Now 124 cities under FEMA/DHS.

Originally, a series of response teams, in the late ‘90’s, feds changed it to a contract program.  Contracts provided $$ to cities in return for Domestic Preparedness planning and preparation focused on B-NICE (Biological, Nuclear/Radiological, Incendiary, Chemical, Explosive) events, now called CBRNE events.

MMRS is now an “all-hazards” planning program, which includes, for example, PanFlu.

Our contract is complete, and we now receive grants each year

RMRS was a State of Ohio follow-on to the major city (MMRS) plans.

In 2009, the Ohio Department of Health opted not to fund RMRS.  However, selected regions, including West Central Ohio (WCO, aka, Homeland Security Region 3) are continuing RMRS with alternative funding.  Greater Dayton Area Hospital Association (GDAHA) is using a portion of their federal ASPR grant funds to maintain WCO RMRS.

Much of Ohio was not covered by MMRS cities, because of gaps between 25 miles circles.  There was no coverage in Southeast Ohio.

ODH divided state into regions, using (essentially) the Ohio Homeland Security Regions (see below).

Since RMRS was an ODH program, it was heavily focused on public health (PH).  Therefore the primary focus of RMRS was biological events.

There were three major components of RMRS, with three corresponding coordinators in each region:

Public Health



Oddly, ODH labeled the Public Safety component of RMRS as RMRS.


Administered by:

U.S. Department of Homeland Security (DHS)

Originally, Public Health Dayton & Montgomery County, using a pass-through grant from the Ohio Department of Health (ODH).

Those grants originated as Public Health Infrastructure Grants (sometimes referred to as a PHIG or PHI –pronounced “fy” - grant) from the Centers for Disease Control (U.S. Department of Health and Human Services.

The GDAHA grants originate as federal HHS Assistant Secretary for Preparedness and Response (ASPR) grants

State administration/oversight:

Ohio Emergency Management Agency (OEMA)

ODH (see above)


Originally a 25 mile radius from the center of Dayton.

Notified DHS that some of that radius is covered by Cincinnati UASI/MMRS, and that, instead of the strict 25 mile circle, we now cover the eight county West Central Ohio Region (see box to right).

Three terms refer to the same eight counties, depending on the state agency involved:  West Central Ohio Region (ODH terminology), Homeland Security Region 3 (OEMA term), and Regional Physicians Advisory Board or EMS Region 2 (ODPS).

Counties included in West Central Ohio Region/Ohio Homeland Security Region:









Dayton/West Central Ohio Coordinators:

MMRS:  David Gerstner, Dayton Fire Department (DFD)

RMRS three components:

Public Health:  Bill Burkhart, Public Health Dayton & Montgomery County

Hospitals/Healthcare:  Pat Bernitt, Greater Dayton Area Hospital Association (GDAHA)

RMRS:  David Gerstner, DFD


Key Deliverables:

Initial contract deliverables (completed):

Forward Movement of Patients Plan

Chemical, Radiological, Nuclear, Explosive WMD Plan

Managing human health consequences of a biological WMD Plan (anthrax, botulism, plague, smallpox, tularemia, and viral hemorrhagic fevers)

Levels of plan:

<100 victims

100-10,000 victims

>10,000 victims

Hospital Surge Capacity Plan

Pharmaceutical & Equipment Cache

Sustainment Plan

New deliverables with each grant year

Principle deliverable (completed):

Regional Biological Response Plan

Same six diseases as in MMRS Bio Plan.

Dayton MMRS Bio Plan used as initial template for RMRS Regional plan.

PH Infrastructure

Core Functions


policy development


Emergency Preparedness


outbreaks of emerging infectious diseases

other public health threats and emergencies

New deliverables with each grant year

DFD History with programs:

DFD efforts began in 1999: Department of Justice (DOJ) Terrorism Courses, Nunn-Luger-Dominici grant, DOJ grant

Awarded MMRS Contract in 2001

Received 1st Drug Cache in 2002

Began when ODH formed RMRS

Equipment/Pharmaceutical Mandate:

Pharmaceuticals sufficient for at least 1,000 victims for chemical incident, and 24 hours for biological incident.

The antibiotics for a bio incident are intended for First Responders (Fire, Law Enforcement, EMS, EMA) and their families, until the arrival of Strategic National Stockpile (SNS) resources


What MMRS/RMRS Offers:


Planning and preparation for major events and disasters

MMRS/RMRS Steering & Planning Committees

Multiple subcommittees (Exercises, Training, PR, Pharmaceuticals, Equipment, etc.)

Opportunity and resources for REGIONAL planning, cooperation, and procedures

Antidotes and Antibiotics

Treatments for Nerve Agents or Organophosphates (Atropine, 2-PAM)

Cyanide Antidotes (primarily Sodium Thiosulfate)

Seizure meds for CN, Nerve Agents, etc.

Albuterol cache, IV’s, etc.

Anti-radiation drugs under consideration

Antibiotics for Public Safety Personnel & families for Anthrax, Plague, etc.



Vibromycin Suspension

Sodium Thiosulfate in every GMVEMSC Drug Box

Mark I Kits, etc. for Drug Boxes

Nerve Agent Antidote Cache for each County

Coordination of MMRS Drug Cache

Accessed by contacting DFD at 333-USAR (333-8727) for:

Any suspected WMD Incident

Any MCI that may involve Cyanide, Organophosphates, or Carbamates

MCIs when other disaster equipment needed (BBs, IC equipment, etc.)

GMVEMSC & Ohio Region 2 Standing Orders Revisions

Antibiotics in Biowarfare section

Enables use of MMRS Cache of antibiotics for FFs, EMTs, PDs, and family members

Training and Exercises

Chemical Weapons Tabletop

Chemical Weapons Full Scale

Biological Tabletop

PanFlu (2007 & again in 2008)

CHEMPACK Full Scale Exercise

Multiple exercises and trainings in development

Respiratory PPE

Powered Air Purifying Respirators (PAPR’s) for major EMS agencies (22) in region

CD with Manual and Powerpoint

Draft SOP/SOG for departments to modify and adopt

N-95 Respirator Masks

Major purchase (1/4 million masks)

Shared purchase opportunity

Storage against Major Event (PanFlu, SARS, bioterror)

Additional support for partner agencies, e.g.:

Grant for trailer and mass fatality management supplies to Montgomery County Coroner’s Office (who responds to much of the WCO region)

Grant to American Red Cross to purchase cots for special needs populations

Grant to Medical Reserve Corps