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FY 20061IOMELAND SECURITY GRANT PROGRAM DECEMBER 2, 2005 Advise and assist MMRS jurisdictions with HSPD -8 preparedness assessments and reporting. States are reminded that MMRS funds must be expended to support efforts to establish and sustain enhanced local capabilities in MMRS jurisdictions so that those jurisdictions are prepared to respond to any mass casualty incident, including terrorism, disease outbreaks, natural disasters, and large scale hazardous materials accidents. The intent of the MMRS program is to enhance these capabilities at the local level so that these jurisdictions can manage the aftermath of an incident until significant external assistance can arrive. MMRS jurisdictions may choose to allocate funding to the State to assist them in developing these capabilities. The MMRS Steering Committee Chair must provide written concurrence for the State to retain funds for these program purposes. Further, the MMRS jurisdictions have discretion to determine what level of funding, if any, they will allow the States to retain. As such, the MMRS jurisdictions are not constrained by the 20 percent cap on State retention of MMRS funds indicated in the program guidance. C.2. Revised Capability Focus Areas (CFA The listing constitutes revised MMRS Capability Focus Areas (CFAs) and reflects the correlation of the Goal, National Priorities and TCL, and updates the FY 2004 and 2005 MMRS CFAs. The Target Capabilities constitute the primary guidance for the MMRS activities engaged in achieving these capabilities. Reference to previous and continuing MMRS program guidance is also incorporated. MMRS jurisdictions have the option of using grant funds to improve capabilities in any of the other Target Capabilities listed in the MMRS column of Appendix G. MMRS jurisdictions must also sustain enhanced capabilities achieved through the implementation of prior years' program guidance and funding. CFA 1 - Strengthen Medical Surge This CFA links to the Medical Surge Target Capability. MMRS jurisdictions are strongly encouraged to develop, in conjunction with State and Urban Area officials, altered standards of care authorities and guides, based on the information provide in the AHRQ report, "Altered Standards of Care in Mass Casualty Events" (pub. No. 05 -0043, April 2005). Elements of the MMRS baseline capabilities apply to this area, including the WMD CBRNE plans and Local Hospital and Regional Healthcare Systems Plan. The provisions of FY 2004 and FY 2005 CFA 2, "ensure operational viability of mass care shelters and medical treatment facilities" are incorporated into this CFA: Revise or update current plans to include the provision of hazardous /toxic substances portal and point detection and monitoring, decontamination and public safety support to mass care shelters and medical treatment facilities by designated personnel and equipment. Consider the establishment of reception centers, which consolidate monitoring, triage, decontamination, and registration of affected persons. PREPAREDNESS DIRECTORATE'S OFFICE OF GRANTS AND TRAINING 96