FEMA notes that mutual assistance agreements do not require agencies, organizations, or jurisdictions to provide arrangements or assistance, but provide a needs-based tool in the event that the incident dictates the requirement. These agreements ensure the effective use of standardized and interoperable equipment and other services or resources in the event of an incident during incident operations. However, emergency managers should consult with their company`s legal representative before entering into an agreement. Even if approved and implemented by law, mutual assistance agreements will generally not be fully effective unless the necessary follow-up is carried out to ensure that the agreements serve their purpose. States should cooperate and coordinate with other competent jurisdictions by organizing table-top exercises and other planning and implementation measures to ensure that mutual assistance agreements deliver on their promises as effective tools for public health preparedness and response. Analyses by the judicial authorities of States on the exchange of information, equipment, supplies and personnel and on the conclusion of mutual assistance agreements with other States or across international borders are under way throughout the country. Attorneys from the 10 states of the Mid-America Alliance (MAA) – Colorado, Iowa, Kansas, Missouri, Montana, Nebraska, North Dakota, South Dakota, Utah and Wyoming – conducted a preliminary assessment of legal authority. The MAA`s mission is “to establish a framework for mutual assistance between states in a situation that strains the resources of a single state but does not initiate a governor declaring a state of emergency.” MAA aims to “establish a system that allows neighboring states to exchange services, resources and information to effectively meet the needs of citizens during a public health emergency.” 14 The results of the assessment shall be compiled and coordinated in order to identify the activities that can be carried out without delay by the MARKETING authorisation in accordance with the applicable laws and to identify the activities which must await the adoption of legislation which confers the necessary authority. An obvious method of compliance is the creation of cooperation agreements that would not constitute “agreements or pacts” within the meaning of the constitutional prohibition. To the extent that they are empowered by their own laws, States are free to conclude “non-binding” agreements beyond their borders.

The guidelines for coordination between the United States and Mexico on epidemiological events of mutual interest are not binding and serve as an example of this type of approach.19 Non-binding agreements can be useful to states, especially if they are interested in sharing information. Intergovernmental Agreement: Non-state support through formal state-to-state agreements such as the Emergency Management Assistance Pact or other formal state-to-state agreements that support response efforts. Intergovernmental cooperation is sought and facilitated by the interim national preparedness objective established under Presidential Directive 8 on Internal Security, which makes enhanced regional cooperation through mutual assistance agreements a national priority (Table 1?). The Cooperation Agreements of the Centers for Disease Control and Prevention, which aim to improve and improve the preparedness of states and local communities for public health, promote the development of mutual assistance agreements as a preparatory tool. Finally, Congress provided funding and referred the Secretary of DHHS to establish a program to develop an emergency system for the pre-registration of volunteer health professionals (ESAR-VHP) (Table 1?).13 Although the DHHS Health Resources and Services Administration provides funds for the development of EsAR-VHP, States are responsible for the design, development and maintenance of a national system of State emergency volunteer registries. Responsible.. .