Th ere are three separate areas of consideration in the question of government
support in disaster management: pre-disaster appeals, concurrent funding, and
post-disaster appeals. Each area has its own requirements and challenges. Since the
timetable for government action is not always what an organization would desire,
the need to be preemptive and strategic in the requests for assistance is essential.
Further, the need for supporting documentation and logical argument is key to
success in acquiring funding.
Th e fi rst area of consideration is the Federal or state help requested beforea disaster
scenario. Th is preplanning stage is the most advantageous in disaster preparation
because it is a proactive step. Th e strategy is to upgrade resources before they are needed,
thus being more effi cient and eff ective in the future management and mitigation.
Th e diffi culty is that there are no direct precedents upon which to base the
arguments for the need for funding. Th e disaster has not yet happened, and may
or may not happen to that particular hospital. Th erefore, it is diffi cult to make the
need compelling and immediate in the face of other budgetary priorities that are
more concrete and persuasive.
Be aware that preplanning requests are no diff erent than post-disaster responses.
Both involve the request for upgrading of systems, infrastructure, or equipment.
Both involve the delineation of future risk and the likelihood of a mass casualty
event occurring. And both have the challenge of convincing an authority that a need
exists when there is no immediate activity to illustrate the issues.
Th e discussions of both of these areas, therefore, can actually be combined
and will augment each other, if not specifi cally, then generally. However, to avoid
redundancy and duplication, there will be an attempt to consider in each section
only those aspects most germane to the individual period.
Th e diffi culty arises in that projected need is diffi cult to codify and quantify,
and even harder to justify. It is always diffi cult to persuade a funding source that the risks to the institution justify the potential fi nancial contributions requested.
If it were easy, everyone would have it. Th e key is in presentation, logic, and blind
luck, though graphs, charts, and tables help with the impact.
Th e most daunting task is to demonstrate future risk. Presently, the federal
government employs a system of hazard mapping to identify the geographic areas
with the greatest potential of terrorist targeting. Th e calculations revolve around
the characteristics of a particular geographic area that would encourage terrorist
activity and attack. Th e topic of hazard mapping is discussed in Chapters 20 and 21.
Also, the presentation of a slightly diff erent system of target risk score, which is not
employed presently by any agency, is presented for comparison and consideration.
However, for purposes of this discussion, it is only necessary to know that such
a system exists and, through contact with local senators and congressmen, the scoring
of a hospital’s location can be obtained. Should that score be suffi ciently high,
then the potential to obtain funding for mitigation increases.
Unfortunately, while such considerations would seem automatic, meaning that
when an institution or area is deemed high risk by the hazard mapping, funding
would be funneled in that direction, it does not work that way. Th e hospital must
take the initiative to identify itself as a target facility and use the statistics as a club
to acquire the funding. And each hospital must compete with all other hospitals
and institutions in the country doing the same.
Bear in mind also that when it comes to seeking funding, veracity is the fi rst
casualty. Many institutions have learned the art of stretching the truth better than
a worker in a taff y factory. Th e author does not advocate stooping to that level to
gain funding. However, being able to tactfully point out that the arguments of the
other hospitals have more holes than Swiss cheese, and that their logic is worthy of
a great work of fi ction, is an excellent defense. Th e struggle to place one’s hospital
at the top of the feeding chain is absolutely an uphill battle.
Th e second hurdle in the acquisition of federal or state funding for disaster management
is the question of predicting potential losses and expenditures in the event
of a disaster. Since there is no way to show conclusively what the actual expenditures
will be, the hospital must rely upon anecdotal reports from other institutions that
have faced such catastrophic situations and extrapolate those fi gures to their own
institution. Supporting documentation must be supplied to justify the calculations
of need.
Furthermore, each mass casualty event is very diff erent. Even beyond the obvious
categories of concussive, biologic, chemical, radiologic, and nuclear, each scenario
will play out diff erently depending on circumstances surrounding the disaster and
cooperation of other agencies and institutions.
Th us, the wisest choice is to present a range of possibilities for the potential
utilization of equipment and supplies, as well as the needs for modifi cation of the
hospital’s present structural elements to adequately care for patients and protect
staff in the event of a mass casualty event. Finally, translate that risk into a dollar
fi gure.