The medical surge capability is the ability to provide adequate medical evaluation and care during incidents that exceed the limits of the normal medical infrastructure within the community. This encompasses the ability of healthcare organizations to survive an all-hazards incident, and maintain or rapidly recover operations that were compromised.

Medical Evacuation/Shelter In Place

The ASPR understands that not all scenarios will require a full or partial facility evacuation. In some situations, it may be safer and more medically responsible for healthcare entities to shelter in place versus evacuating patients and/or facilities.

Hospitals are encouraged to develop plans to ensure the safe and respectful movement of patients, and the safety of the facility healthcare workers and family members.

Alternate Care Sites

It is recommended that facilities identify multiple pre-determined locations for alternate care sites.

The alternate care sites may be a building that is already being used for medical purposes, such as a hospital, clinic or nursing home, or a structure with the capacity to shelter people and take care of their needs such as a hotel.

It is recommended to identify one geographically close alternate site and another being at least 50 miles away. Based on some lessons learned, disasters can affect a large geographical area so your closest site may not always be an acceptable option in an evacuation.

All planning should be based on the respectful care of those residing at the alternate care site. Planning considerations should include the identification of residents and communicating information to the resident and their families. Also, consider the supplies and staffing you will need during the transport and care of the resident. Other planning considerations should include transportation, communication, and operational processes, such as environmental services, feeding and care, medical records, hazardous waste, security, and staff training.

Conduct exercises designed to test your plan and alternate care sites to pre-identify any issues. Corrective actions should be taken with any identified gaps or needs.


Exposure to hazardous chemicals released during an accident, dirty bomb, or chemical attack poses a serious health threat requiring immediate response and treatment. Hospitals across the state were funded to purchase decontamination equipment establishing its decontamination capabilities. Competency-based training was provided to ensure staff had the knowledge and understanding to respond to such an event at their facility.

Mobile Medical Assets

In the event of an emergency, healthcare organizations rely on immediate access to medical assets. Medical equipment has been provided to hospitals to improve their surge capacity. In addition, mobile medical assets have been established when these supplies run low. The mobile medical assets have the ability to be quickly transported to an affected facility to maximize patient care.