Emergency preparedness planning on a regional Level

Written by Dominic “Nick” Gragnani, executive director of the St. Louis Area Regional Response System

Since 2003, there has been a little-known emergency and disaster planning agency that has been diligently working to improve St. Louis disaster response capabilities of first responder and general healthcare agencies. The St. Louis Area Regional Response System, better known as STARRS, is a regional grants management organization, created to coordinate planning for response to large-scale critical incidents in the bi-state metropolitan region.

STARRS’s mission is to help local governments, businesses, and citizens plan for, prevent, protect against, respond to, and recover from critical incidents in the St. Louis region.

The St. Louis metropolitan region consists of Missouri Counties of Franklin, Jefferson, St. Charles, St. Louis, and the City of St. Louis; and in Illinois the Counties of Madison, Monroe, and St. Clair. Each of these jurisdictions possess different forms of local government, which range from local municipalities with their own services (police, fire, public works, etc.), to political subdivisions that include fire protection, school, and sewer districts.


Over two million people live in this region, which is home to national sports franchises, the Gateway Arch, and several multinational corporate headquarters. This region serves as a critical transportation hub for ground, air, rail, and shipping industries, as well as a heavily concentrated location for pipeline systems. This makes St. Louis an inviting target for both domestic and international terrorism, not only in terms of physical damage, but its economic, psychological, symbolic, and political impacts. Additionally, St. Louis lies in the New Madrid Seismic Zone, where scientists predict a moderate to major earthquake in the near future that has the potential to cause widespread damage.  St. Louis region is also very susceptible to tornadoes as it is within the area of the country known as “Tornado Alley,” with a yearly average of 24 tornadoes.

Because of its geographic location and size, the St. Louis region is in a vulnerable position for the occurrence of a major incident or catastrophic event. Adding to this vulnerability, the region is fragmented into many jurisdictions which have a large number of response agencies and organizations that are not interconnected by political default. As a result, there is a need for a regional planning agency that will identify all available emergency response resources across the region, and delineate a method that will mobilize these resources for response anywhere within the region. These resources can then also be mobilized regionally and statewide through compact agreements with Illinois and Missouri, or as a federal response to a Presidentially Declared Disaster within the United States. STARRS’s staff helps to identify resource gaps or shortfalls and make recommendations on improvements that will dictate future grant funding strategies used in the development of Homeland Security Investment Justifications.

STARRS was formed as a result of the U.S. Department of Homeland Security’s Urban Area Security Initiative (UASI) Grant Program, which directed a regional approach to Homeland Security funding. The name “STARRS” encompasses its role in regional disaster planning. STARRS cooperates with the eight governments that make up the St. Louis Urban Area through the East-West Gateway Council of Governments, which also serves as its fiscal agent.

The STARRS Board of Directors is comprised of appointed representation from the eight county elected leaders of the St. Louis Urban Area, the emergency managers from each of the eight counties, and operational subject matter experts from key disciplines including EMS, fire, police, hospitals and public health agencies. In addition, several technical committees have been established to determine the best application of grant funding and implement the important work of developing and maintaining regional plans and response capabilities. The various governments and agencies within the St. Louis Urban Area are better prepared to work together during disaster events as a result of the planning that takes place in these groups.

STARRS also manages the Hospital Preparedness Program (HPP) grant from the U.S. Department of Health and Human Services, Assistant Secretary of Preparedness and Response (ASPR). The ASPR funded projects are intended to help hospitals within twelve Missouri Region C counties (consisting of the independent City of St. Louis, and the Missouri Counties of Franklin, Jefferson, Lincoln, Perry, Pike, St. Charles, St. Francis St. Louis, Ste. Genevieve, Warren, and Washington) to prepare for mass casualty incidents through improved communication and coordination in the health care community and to provide funding for regionally shared medical response equipment and supplies. Representatives involved in the ASPR planning initiatives include emergency management, public health, mental/behavioral health providers, as well as community and faith-based partners which make up a community’s Healthcare Coalition (HCC). An overarching goal of HPP is to strengthen the capabilities of the HCC, not just one or more individual hospitals. Using the Healthcare Preparedness Capabilities: National Guidance for Healthcare System Preparedness as guidance, the HCC works to improve healthcare system response, recovery, multiagency coordination, fatality management, information sharing, medical surge, responder safety and health, and volunteer management.[1]

Over the past several years, STARRS has managed the distribution of more than $100 million dollars in grant funds to the entire St. Louis Urban Area in accordance with each grant program’s guidance. This funding has made vast improvements in disaster preparedness and response capabilities across the region and within both Illinois and Missouri. This critical work will continue as long as the Federal grant programs are made available to the region through the STARRS organization.

Examples of accomplishments completed with grant funding through STARRS committees include:

  • providing standardized equipment and training for urban search and rescue, hazardous materials, and law enforcement specialty response teams;
  • installing a region-wide digital land mobile communications network; providing the ability for public health agencies to foresee occurrence of pandemic outbreaks through regional health syndromic surveillance system;
  • providing medical equipment caches for EMS agencies and hospitals;
  • conducting multidisciplinary exercises to ensure response agencies continue to stay ready for the next disaster.

Quite simply, the greatest success of the STARRS program is bringing diverse response organizations together to work across jurisdictions as one unified region. That in itself, will ensure a better outcome for the citizens of St. Louis when disaster strikes.

[1] Hospital Preparedness Program Website: