Hospital plans often vary when it comes to the specific functional roles that are included in emergency and incident management positions. Bioterrorism coordinators and emergency managers for 31 hospitals in a seven-county region outside of a major metropolitan area, with urban, suburban, and rural demographics were surveyed to determine which specific functional roles were considered "essential" to their hospital's emergency operations plans. Furthermore, they were asked to estimate the percentage of their "essential" staff trained to perform the functional roles delineated in the hospital's plan. Responses were entered into a database and descriptive statistical computations were performed. Only three categories of hospital personnel were reported to be "essential" by all hospitals to their emergency preparedness plans: emergency department physicians, nurse, and support staff. Training for overall "essential" staff ranged by hospital 73.6-83.3%. Some hospitals reported that these staff members have received no training in their anticipated role based on the hospital emergency response plan. Allied health professionals and emergency medical technicians/paramedics (that are employed by hospitals) had the least amount of training on their role in the hospital preparedness and response plan, 33.3% and 22.2% respectively. Without improved guidance on benchmarks for preparedness from regulators and professional organizations, hospitals will continue to lack the capacity to effectively respond to disasters and public health emergencies.