Which entity is responsible for activating the disaster plan during a mass casualty incident (MCI)?

The Federal Emergency Management Agency (FEMA) typically serves as a coordinating body at the federal level during significant disaster response efforts, but it is the local entities that usually take the immediate lead in activating a disaster plan during a mass casualty incident (MCI). The activation of a disaster plan is often initiated by local emergency services or public health departments, as they are the ones first on the scene and have the most direct knowledge of the incident and its implications.

In the context of a mass casualty incident, local health departments play a critical role in the initial assessment and activation of emergency response protocols, working closely with other local entities, including fire, law enforcement, and emergency medical services. State emergency services may provide support and coordination, but primary authority and responsibility typically lie at the local level, especially when it comes to the immediate response to an MCI.

While the International Red Cross is involved in humanitarian efforts, it is not the entity that activates disaster response plans for MCIs in most domestic contexts. Therefore, the most effective answer should focus on the role of local health departments or other local agencies rather than FEMA, which coordinates at a broader level after local response efforts are underway.