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Metrolina Preparedness

Dedicated to organizing healthcare assets through planning, information sharing and coordination to ensure that healthcare organizations have the support they need in order to provide health care to residents and visitors of western North Carolina.

What We Do


In 2002, SMRS developed a system of State Medical Assistance Teams (SMAT). Clinical considerations for patients included the consequences of bioterrorism and weapons of mass destruction (WMD). Recognizing the need to increase medical surge capacity, local, regional, and state agencies in North Carolina concentrated their efforts on developing this important emergency response capacity. The SMAT framework focused on the development of hospital, EMS, and fire department-based teams capable of providing medical decontamination, medical triage, emergency medical treatment, and medical surge capacity in hospital and field settings. This framework identified three tiers of SMATs. These tiers were identified as SMAT I, SMAT II, and SMAT III.

The SMAT program saw it first major response during Hurricane Katrina. Members of the MAHPC SMAT, and several other SMAT IIs and SMAT IIIs deployed to Waveland, Mississippi to provide a mobile field hospital for the area for over eight weeks. Other SMAT II members from across NC responded to Charlotte to assist with the reception of people and patients who had been evacuated from the Gulf area. The lessons learned from this response showed that equipment for mobile treatment facilities was needed to ensure North Carolina could better support itself in the face of a similar event since the area is very prone to hurricanes. The result was the purchase and distribution of eight Mobile Response Trailer Systems that included a 53’ trailer, that came with six Western Shelter Gate Keeper 19×35 tent systems. The tent systems could be set up individually or interconnected , and included provisions for power, light, and HVAC. The trailer was also designed to double as staff billeting and a command post, and carries the generator for the tent system. The teams also received beds, medical equipment, and supplies to establish a 40-bed treatment facility. Over the years, each team has made additions and adjustments to its system, equipment, and supplies to improve their capabilities and more fully support their specific service areas.

SMAT I: State-level response entity that manages the Mobile Disaster Hospital (MDH). The MDH is owned by the state of North Carolina, and is an asset that has generally all of the capabilities found in a typical community hospital. The MDH has a primary mission to support North Carolina, but can be deployed to any disaster site across the country.

SMAT II: Eight region-level response entities developed across the state. Their mission is to provide rapid mass casualty medical management services during human-made or natural disasters.

SMAT III: 30 teams developed in various county EMS systems across the state, with a focus on improving local decontamination and triage capabilities. The MAHPC region is home to five such teams (Buncombe, Cherokee, Eastern Band of Cherokee Indians, Henderson, McDowell).

From a non-emergent perspective, the MAHPC SMAT and MRC participates in or assists with multiple local, regional, state, and national events and exercises. In many cases this included providing personnel, logistics, or both.

MAHPC SMAT equipment is also frequently used to support regional healthcare facilities and providers during mass gatherings, facility maintenance or outages, or other situations.