"We are way ahead of the game," said Judy Johnson, area manager for MDMC's emergency room.
Vendors of equipment for dealing with terrorist attacks say Missouri is "light years ahead of neighboring states," Johnson said. "We've taken the allocations of money and run with it."
Instead of simply spending Homeland Security funds as they come in, Missouri agencies have typically charted their course five years in advance. "So really Missouri is ahead because of planning," said Sharon Urhahn, MDMC's director of marketing.
Joy Cauthorn, safety and infection control officer at MDMC, said hospitals were first asked to prepare for bioterrorism attacks.
About 18 months ago, however, they were directed to expand to "CBRNE preparedness," which means being ready for a chemical, biological, radiological, nuclear or explosive event. "We have to develop plans for each of these," Cauthorn said. "It's getting extremely large - there's just so much to learn."
The amount of federal money from the Department of Homeland Security allocated to the state that goes to each hospital is based on the hospital's location with high-population urban hospitals getting more than those in rural areas. "We're a tier 3 hospital," Cauthorn said.
Over the past three years, the MDMC has received $30,000 in cash, equipment and training.
"The first year we purchased a portable hepafiltration system," Cauthorn recalled. When used with an air pressure monitor to create a negative pressure environment, the equipment enables staff to contain airborne diseases like smallpox and SARS.
Cauthorn said because the Department of Homeland Security is able to negotiate excellent prices for equipment, "the $10,000 really goes a pretty long way."
Although there is a lot of extra work involved, much of the preparation for terrorist attacks can also be used to deal with other emergencies, Cauthorn said, such as basic chemical decontamination procedures which can be applied to situations like farm accidents. "It doesn't have to be related to terrorism," she said.
Cauthorn said the hospital has about five or six staff members that are highly-trained in dealing with bioterrorism and other threats right now. "It just takes time to get the training," she said.
Johnson said most of it comes down to "train and practice, practice, practice."
Cauthorn said the hospital has always had a disaster team but before the 9/11 terrorist attacks the team was geared toward incidents such as mass casualties from car accidents, fires or natural disasters. "We didn't think about issues like bioterrorism," she said.
The 25-member team, which was restructured last summer to prepare for its expanded role, has four physicians and staff from various departments such as nursing, radiology, respiratory, lab and even security and maintenance. "They'll begin their chemical awareness training in the first part of February," Cauthorn said.
Hospital officials are also working on a memorandum of understanding with the Red Cross, the Missouri Hospital Association and the Department of Health and Senior Services.
"It's a plan for how to work together in a crisis," Cauthorn said.