What is a Regional State Medical Assistance Team (SMAT type II)?

An SMAT II is a State Medical Assistance Team that makes up the core of the North Carolina State Medical Response System (SMRS). There is an SMAT II in each of the eight (8) identified Trauma Regions of North Carolina.

What does an SMAT do?

The SMAT may respond as part of the SMRS within 6 hours in the region and within 12-24 hours in the state. The team maintains the capability to provide:

  • Advanced medical care in potentially austere environments.
  • Medical sheltering during an evacuation.
  • Mass patient decontamination after an industrial accident or terrorist event.
  • Mass immunization and/or pharmaceutical distribution.
  • Alternate care site operations for hospital surge. 

What kind of equipment and supplies does the SMAT have?

Our SMAT has medical equipment and supplies much like you would find in a hospital emergency department. The team also maintains trucks, trailers, tents, generators, tools and essential equipment necessary for deployment into an affected area. 

Where is the Mid Carolina SMAT?

The Mid Carolina SMAT is located about 14 miles from UNC campus in southern Durham County. The location provides space for offices, training activities, as well as indoor areas for the storage and maintenance of the SMAT assets. 

Who can join the SMAT?

Employees of the Mid Carolina region’s healthcare agencies can join the SMAT and any resident of a member county can join the Mid Carolina MRC as a volunteer. There are tasks for everyone to do regardless of your experience or skill level. There are over 200 medical and non-medical members currently registered on the team. Team members includes nurses, paramedics, doctors, EMTs, respiratory & physical therapists, mechanics, vehicle operators, administrative personnel, social workers, radio operators, as well as lay people and a handful of other skill sets.

What are members required to do?

Each member is required to register in and complete some online ICS training. Depending on your possible role with the team, team members will or may also be required to:

  • Provide and/or maintain North Carolina professional license/certification (as applicable).
  • Participate in two training sessions per year and one drill, exercise, or deployment every 2 years.
  • Maintain a personal pack (team uniforms are provided).
  • Provide evidence of employer Respiratory Health Surveillance Examination every 2 years.
  • Provide record of a Tetanus Toxoid vaccination within lasts 10 years, Hepatitis B vaccine with a positive titer, Tuberculin Skin Test every year or, if positive, a chest x-ray report. 

There are varying tasks and positions which create differing physical demands on a member. Support roles are available as part of the rear echelon for those members not physically or otherwise able to deploy. For those who aspire to deploy with the team, the following physical restrictions apply:

  • Hypertension (BP Systolic >150 Diastolic >90). May provide documentation that member is on medication maintaining BP within safe range (<150 systolic, <90 diastolic)
  • Seizure activity w/in last 5 years
  • Hypoglycemic (low blood sugar) events causing unconsciousness or altered mental status in last 5 years (not controlled by medication)
  • Pulse <60, >120, heart block, arrhythmia’s (irregular heart rates)
  • Morbid obesity
  • Shortness of breath climbing 3 flights of steps
  • Claustrophobia
  • Limited range of motion in any of the 4 extremities including fingers & toes
  • Any recently diagnosed serious medical condition that would place the team member in jeopardy while functioning as a member of the team
  • Inability to lift and carry 50 lbs. a distance of 100 feet 

Do I get paid for my time?

Most of the time spent is voluntary and all Medical Reserve Corp members are considered to be volunteers. There are several mechanisms in place to get team members paid for their deployment time. The first method is the Memorandum of Agreement between hospitals that was authored by the North Carolina State Hospital Association; essentially this agreement covers the utilization of personnel and equipment during times of disaster. Once a disaster is “declared” by the President, reimbursement for personnel, services and equipment falls under FEMA. This is typically a long, but usually an effective process. The salary for your training time is either voluntary or borne by your employer. Efforts are made to reduce or eliminate any expense on the part of team members whenever possible.

How do I sign up?

Every team in the SMRS utilizes, the NC registry for volunteer response personnel. Create your profile in and affiliate yourself with the Mid Carolina State Medical Assistance Team II (SMAT II) OR the Mid Carolina Medical Reserve Corps (MRC). This system is used to disseminate information and alert team members.

Obviously, SMAT II isn’t for everyone, it requires a strong sense of dedication and a commitment of time and energy. Team members will not only be providing a great service to the citizens of North Carolina, but will also be able to provide valuable expertise and guidance to their agencies on matters of bio-terrorism, disaster and healthcare preparedness.

For more information, please visit or contact Randy Hoffman, team leader, at:

919-883-8948 (m)