Public Health Emergency - Leading a Nation Prepared
Three primary methods for interstate coordination during emergency or disaster response are information sharing, incident management coordination, and mutual aid. At a basic level, information sharing is critical because it allows States to stay up to date on how an incident is unfolding, how other States (Tier 4) or jurisdictions (Tier 3) are responding, and what resources have been committed or remain available. Incident management coordination builds consistency in regional strategies and promotes similarity in the development and application of operational tactics. Mutual aid maximizes MSCC by bringing materials, personnel, and/or services to areas where resources are insufficient to meet surge demands.
While the importance of sharing information and data with other affected States, in real time, is easily recognized, most efforts to address this issue have focused on communications technology. A major shortcoming of these efforts is that they neglect to first establish what type of information is important to share, where to obtain it, and who needs to receive it; these requirements should be set during preparedness planning. The types of information to share include the following:
Public health and medical disciplines face a unique challenge because of the complexity and quantity of information that must be shared during a major response. This is compounded by the presence of multiple information outlets, many of which provide unofficial data. For example, media trying to "break" news stories may provide situation assessments that misrepresent the actual severity of an incident or the progress of response. Therefore, information that is shared between States should be channeled first through formal mechanisms at the State level (Tier 4) to verify its accuracy. This is commonly done by releasing all information through the State public health agency or the Multiagency Coordination Center or MACC (i.e., State EOC).
Because of State sovereignty, the management processes for interstate coordination (Tier 5) differ appreciably from those used to manage the intrastate response (Tier 4), especially when multiple states are affected simultaneously. There can be no single command authority to oversee regional response and to promulgate incident objectives, strategy, and tactics. Instead, interstate regional response must rely on the coordination of State incident management and mutual aid. This is accomplished by comparing State IAPs and contingency or long-range plans while they are still in developmental phases. Regional management briefings between incident managers (conducted remotely via teleconference) could be held to ensure consistency in major strategic decisions and in the development of coordinated incident objectives and operational tactics.
Figure 6-1. Regional Management Coordination Between States
The key is to establish the regional management processes for interstate coordination during preparedness planning, and to develop the infrastructure required for coordination of incident planning under the stress of an actual incident. Infrastructure in this sense includes not just interoperable communications and other equipment, but also legislative and regulatory parameters needed for responders to work seamlessly together across State borders. Once established, these processes and infrastructure should be integrated into standard operating procedures.
Strategic mutual aid agreements between States address the "top-line" issues related to the transfer of materials, supplies, equipment, and personnel across State borders. Many of these issues are addressed through the EMAC guidance. Commonly listed strategic mutal aid guidelines include:
As noted in Chapter 5, information contained in strategic mutual aid agreements guides the development of tactical mutual aid agreements between States. Tactical agreements provide the specific operational processes (the "nuts and bolts") for how mutual aid will occur during an actual response. Resource typing, as discussed in Chapter 5, is important for clarity in making and meeting mutual aid requests. Issues commonly addressed in tactical aid agreements include the following:
How these issues are addressed will vary from State to State; however, basic information that should be included in any request for assistance is highlighted below.
Key Components of Mutual Aid Requests:
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