North Carolina has been working diligently to develop a State Medical Response System. Through collaboration with Regional Hospitals, Emergency Medical Services, Public Health, Long Term Care, Hospice and Home Health, as well as Community Health Care Services we are strengthening our readiness and our capacity to respond to incidents involving mass casualties, natural disasters or acts of terrorism which may overwhelm the local resources. Numerous local, state, and regional agencies are collaborating on multiple scenarios that exist now that the threat of terrorism is real. Three agencies have taken a lead role in a joint effort to consider the treatment and response phase of a terrorist event. They include: the North Carolina Office of Emergency Medical Services (NCOEMS); the North Carolina Division of Emergency Management (NCEM); and the North Carolina Division of Public Health - Preparedness & Response (NCPH). These agencies represent the management system responsible for coordinating a disaster response, ensuring that treatment and prevention strategies are implemented, as well as disease surveillance and medical preparedness. The goal of this effort is to assure the citizens and visitors of North Carolina will be able to obtain the medical care services they might need.