An event that exceeds the resources of a single jurisdiction will require the use of a tiered approach beginning with the local community hospital and engaging a broad array of regional and national stakeholders depending on the scope of the incident. This document identifies the key roles of state and local responders, and those of the American Burn Association (ABA) and the U.S. Department of Health and Human Services (HHS) Assistant Secretary for Preparedness and Response (ASPR) during a BMCI.