District of Columbia — special events health, medical and safety planning (MSETG framework)[1]
Summary
The District of Columbia requires every special event to have a Health, Medical and Safety Plan approved by the Special Operations Division of the Department of Health: "All special events that occur in the District are required to have a Health, Medical and Safety Plan that is approved by the Special Operations Division of the Department of Health." The 2026 MSETG Special Events Planning Guide sets out an asset matrix by event type and crowd size, marking each asset required or recommended. A medical aid station staffed by a physician is REQUIRED at 15,001 or more attendees for athletic and sporting events, and at 50,001 or more for concerts and music festivals, parades and outside venues, and conferences and conventions. Also required across event types: 911 and CPR access at every tier; a BLS aid station at the smallest tier; an ALS aid station at middle tiers; and mobile medical teams at upper tiers. Ambulance provision is specified as BLS at the smallest tier and ALS above it, with multiple units potentially required depending on event history and size. Any event with anticipated attendance of 100,000 or more requires a formal planning meeting with the Department of Health. Enforcement runs through permit approval: final District permits are valid only for the event elements approved by the MSETG.
So what
The District imposes the most detailed event-medical matrix of any US jurisdiction in MGMI's 51-jurisdiction survey — physician-staffed aid stations triggered by event type as well as crowd size, with an explicit required-versus-recommended distinction that no state draws. Its athletic-event physician threshold of 15,001 is lower than New York's statutory 30,000 and is exceeded in stringency only by Connecticut. But it sits outside the count of jurisdictions carrying an event-medical requirement in law, and the reason is formal rather than substantive: the requirement lives in agency guidance enforced at permit approval, not in statute or promulgated rule, and the District's special-events licensing statute (D.C. Code 47-2826) was repealed effective 1 October 2025. This is the cleanest illustration available of the survey's central finding — that US event-medical requirements are a patchwork not only in content but in legal form.