Originally intended as the operational element of the area's MMRS, the Advanced Local Emergency Response Team in Charlotte-Mecklenburg, N.C., has become a resource in its own right.

By Capt. Glen Neimeyer
Charlotte-Mecklenburg (N.C.) Police Department

Pick your favorite team sport and then imagine bringing together for the big game on Sunday a group of 15 to 20 professional athletes who've never trained together, perhaps never even met.

No seamlessly choreographed plays, no unified communication system, no real understanding of what the other players' responsibilities are, so each athlete is trying to play the game the way their team normally plays. There's no time to sort through these issues, and the coach can't fix them because he's burdened with a game already in progress. How long will it be before the fans figure out that something's seriously wrong?

In a game you can lose your pride, but failing to properly prepare for a mass-casualty chemical or biological event will cost lives, perhaps hundreds of them. So why do agencies in the same jurisdiction or geographic area sit idle and wait for the game to start? Until an event strikes our area, we have the luxury of time to get prepared.

Founding and funding
The City of Charlotte, N.C., was not among the initial 27 cities to receive a contract from the U.S. Public Health Service to establish a Metropolitan Medical Strike Team (later a Metropolitan Medical Response System), with funding under the Defense Against Weapons of Mass Destruction Act of 1996, aka Nunn-Lugar-Domenici. To remedy this, a delegation from the Charlotte-Meck­lenburg area traveled to Washington, D.C., and met with two U.S. Representatives from North Carolina to propose establishing a response team.

Federal funding of $1 million for the team was allocated in late 1998 under the Defense Department appropriations bill. Additional funding was received later from the DOD's Domestic Preparedness Program and the Justice Department's Office of Justice Programs.

The current configuration of the Charlotte-Mecklenburg Advanced Local Emergency Response Team was established in the spring of 1998 and became the operational element of the mmrs. As a result of several years of additional federal and local funding,  ALERT developed into a model program for terrorism response preparedness.

ALERT is organized around a team concept that builds on and supports the existing emergency resources that would be called on to respond to a mass-casualty incident, including law enforcement, fire and medical components. The team is currently composed of personnel from 11 agencies.

What makes ALERT unique is this multidisciplinary approach to comprehensive preparedness, rather than each agency preparing on its own. This team approach has worked through development, implementation, equipment purchasing and training exercises.

The single greatest advantage to this type of system is that all of the players who may be involved in a mass-casualty event have already worked and trained together as part of the team. Key operational personnel from all first responder disciplines can communicate on a first-name basis, and the turf and egos are left at the command post door. We're all on the same team, with the same goal in sight.

Probably one of the best decisions the team's command staff made was to have a standardized uniform for ALERT members. Each member, no matter what other uniform he or she wears on a daily basis, shows up at training exercises wearing the same team uniform. The only difference is that on the sleeves of the shirts, we have our own specific agency patches. This relatively inexpensive purchase has done wonders for enhancing the group's cohesion. When you look like a team, you'll act like a team.

Command and coordination
The command and control functions of ALERT are handled by two distinct groups. The Policy Group is made up of the executive-level managers from each first responder agency, such as the chief of police, fire chief, ALERT medical director, county health department director and so on.

Operational leadership for the unit comes from a group known as the Inter-Agency Coordinators. Although this group is also composed of representatives from all of the participating agencies, it's focused more at the operations-level personnel from each discipline.

Both groups hold regular meetings, and the information flow between the two elements is reciprocal. While the Policy Group develops the team's primary policy and procedures, the Inter-Agency Coordinators implement the plan and are responsible for the direction of their own agency's members, coordination of team training and recommending equipment purchases.

When the team, or an individual participating agency, purchases equipment we make sure we're thinking in terms of interoperability. Several years ago, I was obtaining bids for a possible purchase of a large quantity of respiratory protection equipment.

I brought up the topic at a meeting attended by ALERT members from the fire department and immediately learned that the type of mask I was looking to purchase couldn't interface with the rest of the equipment alert and the fire department already owned. Specifically, the masks couldn't operate with the powered-air respirators we were using and the filters weren't interchangeable.

Simply by sitting down at a table with individuals from another first responder agency, I was able to keep from making a very expensive error.

Emphasis on cross-training
ALERT members from the various disciplines function as an inter­agency cadre of experts, highly skilled and cross-trained in tasks and functions that may be needed to mitigate a WMD event.

Regardless of their regular expertise or discipline, all ALERT team members are capable of:

• Establishing disaster scene zones of operation for protection,
• Establishing decontamination corridors for ambulatory and nonambulatory patients,
• Performing patient decon procedures,
• Assisting in patient movement, and
• Assisting medical personnel with triage and treatment.

The system is designed to ensure that victims of a terrorist incident are properly cared for and that the community infrastructure is safeguarded.

Training for the team has gone through several transitions since its initial establishment. We first perceived a unit where, except for firearms training and specific paramedic skills, all of the members would be cross-trained in the other represented disciplines.

The team's command staff quickly learned, however, that without repetitive use on the job, most of the cross-trained skills were rapidly being lost. For example, if you trained a police SWAT officer to use a hazmat detection device, that knowledge was lost several months down the road, because the officer didn't use this type of equipment on a regular basis.

We realized that we needed to have team members maintain proficiency in their own specific areas while cross-training all of the team members on the more basic techniques, such as mass-decontamination procedures. These "gross" skills didn't diminish over time and didn't draw away from each element's primary function at a scene.

The first several years we conducted monthly training until the team members reached a plateau where they were proficient in the desired basic skills. The training was facilitated by a representative from each contributing response agency and focused primarily on mass-decon procedures; medical triage protocols; scene security; evidence preservation; and the identification, characteristics and symptoms of various chemical, biological and nuclear agents.

Currently we conduct training with the entire team quarterly and focus on exercise scenarios that test the team's overall deployment logistics. Maintaining the team members' skills and abilities is the responsibility of the individual agencies. Each response agency conducts regular training for their members, and then the whole team comes together quarterly for a training event. This arrangement seems to have delivered the desired results.

In addition, the Charlotte Fire Department has trained all of the firefighters assigned to engine companies in the procedures for setting up the mass decon tents and related equipment. This will expedite the decontamination of citizens at an nbc incident and free up the ALERT specialists to perform their specific incident mitigation tasks.

Similarly, in addition to their specific areas of responsibility, all two dozen of the CMPD officers on ALERT are cross-trained in the various tasks required at a mass-casualty/mass-decon incident. If the situation doesn't require the expertise of a SWAT officer or bomb technician, that officer can be placed into another role at the incident.

The activation protocols for ALERT have been drafted into a document that is part of the city and county's "all-hazards plan." This specifically describes the unit's scope and function and also recognizes that ALERT's unique expertise and equipment make it capable of responding to natural, manmade and technological hazards. 
This approach can be replicated in other cities across the United States, and in fact some cities have already done this. The allocation of resources is minimal, so the initial steps don't require additional funding.

By simply setting up a regular meeting schedule for all of the first response agencies in your community, you can start establishing and communicating response protocols that benefit all of the parties involved. If funding sources later become available, you'll already have a structure in place to determine how the funds should be appropriated, while ensuring that critical issues like interoperability are maintained.
Catastrophic incidents inherently involve a coordinated effort from first responder agencies, which can be successfully accomplished only if the groundwork has been set prior to the event.

The community has entrusted us with their safety. Don't wait till the game starts to put your team together.

About the author
Glen Neimeyer is a captain with the Charlotte-Mecklenburg (N.C.) Police Department, where he is the supervisor of the Special Services Division, which includes the SWAT Team, Aviation Unit, K-9 Unit and Civil Emergency Unit. He holds a bachelor's degree in justice administration.