sure readiness in any given city. It also suggests that caution is called for in making changes in any part of the web of activities, for they may have unintended consequences far from the locus of change.

Third, although many of the pieces of a response plan may be thoroughly evaluated, evaluation of response capacity as a whole will, by necessity, be inferential; that is, assumptions must be made about how the component parts should work together.

Fourth, the wide variations in the resources and vulnerabilities of the MMRS program municipalities may preclude use of a single yardstick or measure that places all the MMRS cities along a single scale of readiness. As noted in the previous chapter, Washington, D.C., must anticipate attacks on numerous federal facilities and embassies, whereas Baton Rouge, Louisiana, has a variety of chemical plants that are vulnerable to attack. Some cities operate their own emergency medical services; others depend on private, county, or state assets. OEP has dealt with this variation by not attempting to impose a single model or acceptable plan on all its MMRS program cities, instead opting to encourage cities to build their own plans in conjunction with the available structures, resources, and vulnerabilities. This flexible approach results in a substantial reduction in the ability to impose universal performance measures and standards and a corresponding difficulty in devising fair and comparable evaluation tools.

Finally, the committee has been persuaded by both the first five observations and the written and oral explications of OEP that it should approach its tasks with a strong bias toward a formative rather than a summative evaluation. That is, the committee takes as a given that the primary goal of the proposed evaluation is constructive feedback both to OEP staff and to the MMRS program cities.

EXISTING STANDARDS

Many of the personnel, professions, organizations, and jobs referred to in the plans of MMRS program cities are governed by existing standards; some of these are legally mandated (Occupational Safety and Health Administration [OSHA] regulations), and others are voluntary. The following is a partial list of potentially relevant standards that the committee examined:

Joint Commission for Accreditation of Healthcare Organizations (JCAHCO)

Standard EC.1.4—Emergency preparedness management plan

Standard EC.2.9.1—Emergency preparedness drills

Standard EC.1.4 (1997)—Security management plan

Standard EC.1.5 (1997)—Hazardous materials and waste management plan



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