When a US hospital system is overwhelmed by disaster, Crisis Standards of Care guide the triage teams forced to choose which patients receive scarce life support treatments in the Intensive Care Unit (ICU). Most US State Crisis Standards of Care rely on the Sequential Organ Failure Assessment (SOFA) score, but SOFA is inaccurate and racially biased. This project will 1) use structural equation modeling to develop an equitable life support allocation (ELSA) score with place-based disadvantage indices and 2) create the ICU Crisis Simulation Model (ICSM), open-source simulation software that evaluates the efficiency and equity of proposed life support allocation protocols.