 Myth
Federal terrorism response plans call for immediate assistance to sites of significant terrorist attacks.
Reality
The National Response Plan, through the National Incident Management System, provides for limited assistance for the first seventy-two (72) hours following a significant terrorist event. The timeliness of federal level assistance is a function of the nature of the incident, the national security estimates, and federal mission priorities. Multiple national incidents may delay federal assistance for unknown time frames. An organization's survival depends on its own vigilance and application of the Readiness elements of:
- Mitigation
- Preparation
- Response
- Recovery
Myth
According to our HVA experts, the probability of our area being a target is nil because “we are a small rural facility.”
Reality
Agro-Terrorism is a real threat; the first line of defense is small rural or critical care facilities. Their ability to detect and treat cannot be overstated. Rural areas have the highest probability of being the recipients of "crop duster" attacks, crop dusting being a familiar activity in those areas.
Myth
According to our HVA experts, the probability of our area being a target is nil because “we are a suburban facility; the large metropolitan facilities and local governmental planners are preparing for terrorist response; the probability of our direct involvement is unlikely.”
Reality
Clustered urban healthcare facilities are seen as soft infrastructure targets with high probability as "dirty bomb" victims. Destruction of these healthcare assets forces care to the suburbs and beyond. This strategy, whether the medical centers are the primary target or an attack in tandem with a high profile urban target in the vicinity, is designed to maximize lethality and deny treatment for victims.
Myth
We have not formally participated in local or regional planning or received any federal grant funds for CBRNE readiness so we are not obligated to have an emergency management plan that meets NRP/NIMS/ICS expectations.
Reality
Homeland Security Presidential Directives have designated all hospitals as Critical Infrastructure/Key Assets and medical staff as First Responders/First Receivers. DHHS's Center for Medicare and Medicaid Services (CMS) requires all-hazards (including CBRNE) preparedness as a Condition of Participation (COP).
Myth
Everyone knows that terrorists are looking for spectacular, high victim count, high profile targets. We don't meet any of those criteria so we have little to fear.
Reality
Recent intelligence estimates indicate that the likelihood terrorists would choose one large target has reduced by twenty-five percent (25%) and selection of multiple smaller targets has increased. Target selection is partially a function of access; as larger targets "harden," selection of "softer" more vulnerable targets are more likely. Recent insurance industry target modeling also reflects a shift away from larger targets.
Myth
Hospitals are unlikely terrorist targets, and if they were selected it would be large famous medical centers in urban settings. We don't fit that description. It is improbable that a small town healthcare facility would be targeted.
Reality
Recent highly suspicious activities involving fake federal and accrediting hospital inspectors appearing in the middle of the night asking for building tours have little common pattern relative to size, geography, ownership or specialty. A spate of unexplained intense interest in specific areas of healthcare facilities focused on pharmacy and radiology departments had little in common with facility characteristics. Theft and questionable purchases of used ambulances appear to be geographically random events. The use of vehicles as future terrorist delivery systems is commonly accepted, with VIP limos and ambulances heading the list. One unsettling aspect associated with the imposter inspectors centers on the commonly accepted hierarchy of threat recognition indicators (TRI). Many experts classify these indicators along a seven-stage continuum from "marking the target" to "attack." Stage three is characterized as "gathering information" and stage six as " rehearsal." The troubling question is, are these activities stage three? If so, it is early in a normally patient and protracted process. But if they are stage six, the next stage is "attack." The acquisition and short-term storage of ambulances would appear to be a late stage activity.
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