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Coalition Response Operations (including Mutual Aid)
Topic Collection
February 2, 2023

Topic Collection: Coalition Response Operations (including Mutual Aid)

In addition to working together to prepare the local medical system for disasters, healthcare coalitions (HCC) must also plan to support and carry out effective, comprehensive, and coordinated response operations to a variety of emergencies. HCC response to emergencies differ vastly across the U.S.; this became more evident during the COVID-19 pandemic. It is recommended that healthcare organizations connect and collaborate with their local HCC to better understand response and resource capabilities in their area. In some areas, HCCs have a direct role in coordinating ESF-8 operations, while in others, they serve as information sharing and coordinating entities (e.g., patient tracking). In other areas, the coalitions themselves have the responsibilities for coordinating the response. In any case, all coalition partners have response roles, and the roles and the coordination between disciplines is what each coalition needs to define in its response plan, regardless of the degree of direct involvement by designated HCC personnel during a response. 

This Topic Collection was updated in October 2022. The resources in this Topic Collection include plans, checklists, and guidance specific to coalition response operations. Additional coalition-specific resources can be found in the Coalition Administrative Issues and Coalition Models and Functions Topic Collections. Access ASPR TRACIE's Select Health Care Coalition Resources page for links to related plans, tools, templates (including a coalition response plan template with links to “best practice” documents), Topic Collections, and webinars. The rest of our comprehensively-developed Topic Collections contain information on select threats and other public health emergency categories. 

 

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Must Reads

ASPR TRACIE. (2015). Strategic Development for Building Operational Healthcare Coalitions.
In this webinar, speakers share information on operationalizing healthcare coalitions and summarize requests for technical assistance received by ASPR TRACIE on healthcare coalition models and roles in response and recovery.
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ASPR TRACIE. (2017). Healthcare Coalition Response Plan. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
This template provides general headers and descriptions for a sample health care coalition (HCC) Response Plan Template. The resources used to develop this template includes sample HCC plans and the Health Care Preparedness and Response Capabilities.
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ASPR TRACIE. (2018). Healthcare Coalitions.
While ASPR TRACIE strives to ensure all of our resources are applicable to Healthcare Coalitions and other stakeholders, the resources on this page can be particularly helpful to coalitions in achieving the Health Care Preparedness and Response Capabilities. Resources on this page include ASPR TRACIE- and locally developed plans, tools, and templates.
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ASPR TRACIE. (2019). Healthcare Coalition Resource and Gap Analysis Tool. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
This tool is designed to help health care coalition (HCC) partners develop a common understanding of their resources and existing gaps, and strategies for prioritizing which gaps to close. Gaps may include inadequate plans or procedures, staffing, equipment and supplies, skills and expertise, and/or services. HCCs are encouraged to modify the template to reflect their coalition members, resources, and unique community attributes. A companion HCC Aggregator Tool allows information from multiple HCCs to be summarized to present an overall picture of a larger geographic area, including an entire state. (For a 508 compliant version of this tool, copy and paste this link into your browser: https://files.asprtracie.hhs.gov/documents/aspr-tracie-healthcarecoalition-resource-and-gap-analysis-pdf.pdf.)
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ASPR TRACIE. (2021). Healthcare Coalition Engagement in COVID-19 Assessment (Infographic).
This infographic highlights findings from a multi-phased effort that included an online survey open to all healthcare coalitions about various aspects of their response to the pandemic and eight focus groups with a subset of survey respondents.
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DC Emergency Healthcare Coalition. (2014). Emergency Operation Plan (EOP) for the DC Emergency Healthcare Coalition.
This plan describes the organizational structure and emergency response processes used by participating healthcare organizations in Washington, DC to collectively respond to and recover from an incident that severely challenges or exceeds normal day-to-day healthcare system management and/or healthcare delivery operations.
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Hanfling, D. (2013). Role of Regional Healthcare Coalitions in Managing and Coordinating Disaster Response.
The author provides an overview of the history of coalition development in the National Capital Region, describes the "optimal framework for coordinating response between existing healthcare coalitions and emergency management infrastructure," and explains how regional networks can bolster communications and situational awareness.
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  • Alan Dixon We need a hospital & clinic directory app for first responders with expertise stat analytics per hospital clinic with search tool find by expertise & availability ~Alan Tyler Dixon https://asprtracie.hhs.gov/technical-resources/25/coalition-response-operations-including-mutual-aid/21 Sent from my iPhone
    11/24/2017 3:32:50 PM
Healthcare Preparedness Coalition of Utah/Wasatch Counties. (2014). Regional Medical Surge Plan: Expanding Local Healthcare Structure in Mass Casualty Events.
This plan defines how healthcare and related organizations within this specific region will work together to prevent, mitigate, respond to and recover from a disaster that leads to a surge on healthcare facilities. It can be used by personnel in real emergencies and when conducting training, drills, and exercises.
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Office of the Assistant Secretary for Preparedness and Response. (2016). 2017-2022 Health Care Preparedness and Response Capabilities. U.S. Department of Health and Human Services.
This 70-page document describes the four capabilities that healthcare coalitions and individual healthcare facilities need to prepare for, respond to, and recover from emergencies. The capabilities are: foundation for healthcare and medical readiness; healthcare and medical response coordination; continuity of healthcare service delivery; and medical surge. For example, Capability 1, Objective 4 covers training and preparing the healthcare and medical workforce (Objective 4, Activities 3-5 also contain specific information about exercises within the HPP program) and Capability 3, Objective 7 is focused on coordinating healthcare delivery system recovery.
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Porth, L. and Gatz, J. (2013). Healthcare Coalitions: An Emergency Preparedness Framework for Non-Urban Regions. Missouri Hospital Association.
This guidance is targeted to non-urban communities in Missouri developing regional healthcare coalitions. It provides guidance on coalition membership, structure, governance, and roles/ responsibilities during a response (including coordination with city, county, regional, and state partners).
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Santa Barbara County. (2017). Santa Barbara County Disaster Healthcare Partners Coalition Governance Document.
This document spells out Santa Barbara County's healthcare coalition member roles and responsibilities during disaster response and recovery. Planners may be particularly interested in the table and accompanying narrative that detail agency/discipline roles and responsibilities during response.
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SE Minnesota Disaster Health Coalition. (2016). Healthcare Multi-Agency Coordinating Center (MACC).
This document can serve as a template for healthcare coalitions interested in creating a Healthcare Multi-Agency Coordination Center (H-MACC). The scope of this document involves H-MACC activities; information should be integrated within organizational and community operational documents as applicable.
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St. Louis Area Regional Response System. (2014). St. Louis Area Regional Hospital Evacuation and Transportation Plan.
This plan focuses on emergencies and disasters requiring immediate response from regional partners and the St. Louis Medical Operations Center. It outlines a system to coordinate patient evacuation and establishes an organizational structure to facilitate communication and cooperation between the evacuating facilities, the St. Louis Medical Operations Center (SMOC), receiving facilities, alternate care sites, and transportation resources.
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St. Louis Hospital Preparedness Committee. (2015). St. Louis Area Regional Hospital Re-Entry Plan.
This plan describes how the healthcare organizations in the St. Louis Area region will coordinate regionally to conduct re-entry operations following evacuation or operational interruption as a result of a disaster and includes the role of the medical operations center in coordinating this effort. It also includes information on managing identification, credentialing, and granting access management for healthcare facility personnel after an incident.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2009). The Healthcare Coalition in Emergency Response and Recovery.
This follow up to the landmark Medical Surge Capacity and Capability (MSCC) Handbook covers all aspects of a healthcare coalition and its role in response and recovery. Though slightly dated, this remains a “must read” for all coalition leaders and planners.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2012). 2.3 The Healthcare Coalition Response Team.
This webpage explains the composition, scope, management strategy, and requirements for a healthcare coalition response team.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2017). HPP Coalition Surge Test Webinar.
This presentation describes the Coalition Surge Test, an annual grant requirement for healthcare coalitions (HCCs) that tests a simulated evacuation for 20% of the HCCs acute care bed capacity. Lessons learned and best practices from HCCs that participated during a pilot phase, and guidance for using exercise tools, are also reviewed including the role of HCC in coordination of evacuation activities. A link to the archived webinar is included. (For post-webinar questions and answers, access: https://files.asprtracie.hhs.gov/documents/aspr-tracie-ta-coalition-surge-test-webinar-qa.pdf.)
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Education and Training

ASPR TRACIE and NETEC. (2017). Highly Pathogenic Infectious Disease Exercise Planning for Health Care Coalitions.
The speakers in this webinar discussed exercise templates designed to help manage patients with highly pathogenic infectious diseases; explained how exercises support ASPR's regional, tiered approach; and shared their experiences planning and executing exercises for Ebola and other special pathogens.
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Center for Domestic Preparedness. (n.d.). Healthcare Coalition Response Leadership Course. (Accessed 10/31/2022.)
This three-day course provides instruction and facilitated discussion in healthcare coalition preparedness, best practices, and lessons learned in establishing an effective healthcare-coalition framework and conducting healthcare-coalition planning. Participants will learn about developing indicators, triggers, and tactics for proactive coalition planning as well as strategies for leading coalition response and recovery.
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Federal Emergency Management Agency. (n.d.). Framework for Healthcare Emergency Management. (Accessed 9/30/2022.)
This four-day (32-hour) course is geared towards people responsible for emergency management in healthcare facilities and systems. It covers standards AND regulations; the Incident Command System and integration with emergency management; resource acquisition; plans/the planning process; facility and personnel preparedness; exercises and training; mass casualty and surge issues; recovery; and finances.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2017). HPP Coalition Surge Test Webinar.
This presentation describes the Coalition Surge Test, an annual grant requirement for healthcare coalitions (HCCs) that tests a simulated evacuation for 20% of the HCCs acute care bed capacity. Lessons learned and best practices from HCCs that participated during a pilot phase, and guidance for using exercise tools, are also reviewed including the role of HCC in coordination of evacuation activities. A link to the archived webinar is included. (For post-webinar questions and answers, access: https://files.asprtracie.hhs.gov/documents/aspr-tracie-ta-coalition-surge-test-webinar-qa.pdf.)
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response, and the Centers for Disease Control and Prevention. (2014). Ebola Training Webinar for Healthcare Coalitions and Healthcare Workers.
This webinar presents lessons learned and other best practices for healthcare workers and coalitions as a result of the Ebola epidemic.
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General Guidance and Research

ASPR TRACIE. (2015). Strategic Development for Building Operational Healthcare Coalitions.
In this webinar, speakers share information on operationalizing healthcare coalitions and summarize requests for technical assistance received by ASPR TRACIE on healthcare coalition models and roles in response and recovery.
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ASPR TRACIE. (2017). Learning More About the 2017-2022 Health Care Preparedness and Response Capabilities. U.S. Department of Health and Human Services, Assistant Secretary for Preparedness and Response.
Dr. John Hick and Melissa Harvey (NHPP) discuss the 2017-2022 capabilities, how they evolved over time, and what they mean for healthcare facilities.
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Brown, L., Feinberg, M., and Greenbert, M. (2012). Measuring Coalition Functioning: Refining Constructs Through Factor Analysis. Health Education Behavior. 39(4): 486-497.
This article aims to understand factors which lead to successful functioning of community coalitions, in particular those associated with drug use prevention but with applicability of findings to healthcare coalitions. The authors use factor analysis to examine how leadership, relationships, task focus, costs and benefits, sustainability, and community support affect coalition function.
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Central Florida Disaster Medical Coalition. (n.d.). Healthcare Coalitions in Florida: Frequently Asked Questions. (Accessed 9/30/2022.)
This document provides answers to some of the most commonly-asked questions about healthcare coalitions and serve as a checklist and help new coalition leaders in the early phases of their work.
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Courtney, B., Toner, E., Waldhorn, R., et al. (2009). Healthcare Coalitions: The New Foundation for National Healthcare Preparedness and Response for Catastrophic Health Emergencies. (Abstract only.) Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. 7(2):153-6.
The authors provide an overview of the Hospital Preparedness Program and the Center for Biosecurity of the University of Pittsburgh's research for the Assistant Secretary for Preparedness and Response. The authors define healthcare coalitions, highlight their structure and functions, and illustrate how they overcame challenges.
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Federal Emergency Management Agency. (2017). National Incident Management System Guideline for Mutual Aid. U.S. Department of Homeland Security .
This document supports the Resource Management component of the National Incident Management System (NIMS) and provides guidance on mutual aid agreements, and the main elements of a mutual aid and operational plans.
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Fraley, M. (2020). Healthcare Coalitions: The New Structure for Disaster Response. EMS1.
In this brief article, the author discusses the history of healthcare coalitions and roles they performed during the COVID-19 pandemic (e.g., patient and supply transfer, information exchange, meeting coordination, and standardizing testing and treatment protocols).
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Frogel, M., Flamm, A., Sagy, M., et al. (2017). Utilizing a Pediatric Disaster Coalition Model to Increase Pediatric Critical Care Surge Capacity in New York City. Disaster Medicine and Public Health Preparedness. 11(4): 473-478.
The authors describe the stepwise development of the NYC Pediatric Disaster Coalition as a model for other cities to replicate in planning for pediatric disaster patients. They also discuss how the coalition supported hospitals in planning for pediatric surge.
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Hanfling, D. (2013). Role of Regional Healthcare Coalitions in Managing and Coordinating Disaster Response.
The author provides an overview of the history of coalition development in the National Capital Region, describes the "optimal framework for coordinating response between existing healthcare coalitions and emergency management infrastructure," and explains how regional networks can bolster communications and situational awareness.
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  • Alan Dixon We need a hospital & clinic directory app for first responders with expertise stat analytics per hospital clinic with search tool find by expertise & availability ~Alan Tyler Dixon https://asprtracie.hhs.gov/technical-resources/25/coalition-response-operations-including-mutual-aid/21 Sent from my iPhone
    11/24/2017 3:32:50 PM
Hupert, N., Biala, K., Holland, T., et al. (2015). Optimizing Health Care Coalitions: Conceptual Frameworks and a Research Agenda. Disaster Medicine and Public Health Preparedness. 9(6): 717-723.
The authors provide an overview of the Hospital Preparedness Program and healthcare coalitions in general. This is followed by a description of two frameworks they created to give coalition leaders improved insight into “how different enterprises achieve similar ends relevant to emergency response.” The authors also provide a research agenda related to coalition contribution to the healthcare system.
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Medcalf, S., Roy, S., Bekmuratova, S., et al. (2020). From Silo to Coalitions: The Evolution of the U.S. Hospital Preparedness Program. (Abstract only.) Journal of Emergency Management. 18(2):163-169.
The authors of this article reviewed the Hospital Preparedness Program footprint, examining funding trends, the increase in the development and evolving role of healthcare coalitions, and sustainment of the program, which requires support from hospital leadership and adaptation of preparedness activities into daily operations.
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National Association of County and City Health Officials. (2017). Fact Sheet: The Role of Healthcare Coalitions in Emergency Response.
This resource aims to strengthen healthcare coalitions by identifying coalition response roles and providing strategies for building response capacity. Brief coalition response case studies based on the Boston Marathon Bombings and the Chimney Wildfire are included.
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National Association of County and City Health Officials. (2017). The Role of Healthcare Coalitions in Emergency Response.
This fact sheet provides a succinct overview of healthcare coalitions (HCC) and lists their response roles. Two examples of HCC response are included, as are links to tools and resources.
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Office of the Assistant Secretary for Preparedness and Response. (2016). 2017-2022 Health Care Preparedness and Response Capabilities. U.S. Department of Health and Human Services.
This 70-page document describes the four capabilities that healthcare coalitions and individual healthcare facilities need to prepare for, respond to, and recover from emergencies. The capabilities are: foundation for healthcare and medical readiness; healthcare and medical response coordination; continuity of healthcare service delivery; and medical surge. For example, Capability 1, Objective 4 covers training and preparing the healthcare and medical workforce (Objective 4, Activities 3-5 also contain specific information about exercises within the HPP program) and Capability 3, Objective 7 is focused on coordinating healthcare delivery system recovery.
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Porth, L. and Gatz, J. (2013). Healthcare Coalitions: An Emergency Preparedness Framework for Non-Urban Regions. Missouri Hospital Association.
This guidance is targeted to non-urban communities in Missouri developing regional healthcare coalitions. It provides guidance on coalition membership, structure, governance, and roles/ responsibilities during a response (including coordination with city, county, regional, and state partners).
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Terndrup, T., Leaming, J., Adams, R., and Adoff, S. (2012). Hospital-Based Coalition to Improve Regional Surge Capacity. The Western Journal of Emergency Medicine. 13(5):445-52.
The authors examined the effect of a newly developed regional healthcare coalition (in south Central Pennsylvania) on six surge capacity-related objectives. In a two-year period, the healthcare coalition improved areas under all objectives. The authors also found that designating and training a coordinator for the state healthcare volunteer database contributed to a significant increase in volunteer registrations from the participating hospitals.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2009). The Healthcare Coalition in Emergency Response and Recovery.
This follow up to the landmark Medical Surge Capacity and Capability (MSCC) Handbook covers all aspects of a healthcare coalition and its role in response and recovery. Though slightly dated, this remains a “must read” for all coalition leaders and planners.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2012). 2.3 The Healthcare Coalition Response Team.
This webpage explains the composition, scope, management strategy, and requirements for a healthcare coalition response team.
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Lessons Learned: COVID-19

ASPR TRACIE. (2021). Healthcare Coalition Engagement in COVID-19 Assessment (Infographic).
This infographic highlights findings from a multi-phased effort that included an online survey open to all healthcare coalitions about various aspects of their response to the pandemic and eight focus groups with a subset of survey respondents.
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Barnett, D. Knieser L., and Errett N.A., et al. (2020). Reexamining Health-Care Coalitions in Light of COVID-19. Disaster Medicine and Public Health Preparedness.
This article uses a strengths, weaknesses, opportunities, and threats analysis to understand healthcare coalition (HCC) models’ performance during COVID-19. The authors include concrete recommendations for stronger coalitions including better evaluation of HCCs, reexamining existing HCC administration, and supporting future healthcare preparedness efforts.
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Devereaux, A., Yang, H., Seda, G., et al. (2020). Optimizing Scarce Resource Allocation During COVID-19: Rapid Creation of a Regional Health-Care Coalition and Triage Teams in San Diego County, California. Disaster Medicine and Public Health Preparedness.
The authors describe the rapid development of a healthcare coalition in response to the COVID-19 pandemic with a crisis care committee and other workgroups focused on sharing scarce resources, developing and training triage teams, and providing situational awareness.
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Dominguez, D., Garcia, D., Martinez, D., et al. (2020). Leveraging The Power of Mutual Aid, Coalitions, Leadership, and Advocacy During COVID-19. American Psychologist. 75(7):909-918.
The authors propose that COVID-19 can act as a catalyst for the American Psychological Association to support mutual aid associations and prioritize underserved communities. They recommend a broad coalition between health associations, health experts, and policymakers to address the needs of these communities and mitigate disparities.
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Koch, A., Bohn, J., Corvin, J., and Seaberg, J. (2022). Maturing Into High-Functioning Health-Care Coalitions: A Qualitative Nationwide Study of Emergency Preparedness and Response Leadership. (Abstract only.) Disaster Medicine and Public Health Preparedness. 10(1-9).
The authors conducted a qualitative study and identified three factors related to "high-functioning" healthcare coalitions: (1) having an established and growing partnership, (2) being value-driven culture, and (3) being response ready.
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Lee, A., Upton, L., Denham, M., and Williamson, J. (2021). COVID-19 Data Driven Planning: The SouthEast Texas Approach. (Abstract only.) Journal of Emergency Management. 20(7):39-56.
The authors reviewed South East Texas Regional Advisory Councils' (SETRAC) collection, processing, and analysis of COVID-19 data "in the largest national medical setting in the United States." This case study highlights best practices in risk and crisis communications, emphasizes the need for cross-sector collaboration and standardization of data collection, and examines process that effect information sharing between the healthcare and homeland security sectors.
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The National Center for Disaster Medicine and Public Health. (2021). Collaboration during COVID-19: Healthcare Coalitions and Regional Assistance Committees.
Speakers from New York City, Southwest Texas, and Johns Hopkins School of Public Health discuss how a regional collaborative response involving healthcare coalitions supported and improved the COVID-19 response.
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Plans, Tools, and Templates

American Hospital Association. (n.d.). Model Hospital Mutual Aid Memorandum of Understanding. (Accessed 9/30/2022.)
Memoranda of Understanding are considered one of the most common cooperative arrangements for healthcare facilities in disasters. This model template can be used by those facilities looking for a way to address resource sharing with neighboring facilities as part of their EOP.
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ASPR TRACIE. (2017). Healthcare Coalition Preparedness Plan. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
This template provides general headers and descriptions for a sample health care coalition (HCC) Preparedness Plan Template. The resources used to develop this template include sample HCC plans and the Health Care Preparedness and Response Capabilities.
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ASPR TRACIE. (2017). Healthcare Coalition Resource and Gap Analysis Aggregator.
This tool was developed to serve as a companion to the Healthcare Coalition Resource and Gap Analysis Tool. This Aggregator Tool is intended to summarize the results from multiple HCC Resource and Gap Analysis to present an overall picture of a larger geographic area, including an entire state. To access the HCC Resource and Gap Analysis Tool and other select HCC resources, visit https://asprtracie.hhs.gov/hcc-resources. ASPR TRACIE welcomes feedback on how to improve these tools. The intent of releasing the initial version of the Aggregator Tool was to allow jurisdictions to use and test it and provide us with recommendations for enhancements to ensure our stakeholders get the most helpful results. For questions, comments, or assistance with this tool, contact us at askasprtracie@hhs.gov or 1-844-5-TRACIE (587-2243).
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ASPR TRACIE. (2017). Healthcare Coalition Response Plan. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
This template provides general headers and descriptions for a sample health care coalition (HCC) Response Plan Template. The resources used to develop this template includes sample HCC plans and the Health Care Preparedness and Response Capabilities.
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ASPR TRACIE. (2018). Healthcare Coalitions.
While ASPR TRACIE strives to ensure all of our resources are applicable to Healthcare Coalitions and other stakeholders, the resources on this page can be particularly helpful to coalitions in achieving the Health Care Preparedness and Response Capabilities. Resources on this page include ASPR TRACIE- and locally developed plans, tools, and templates.
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ASPR TRACIE. (2019). Healthcare Coalition Influenza Pandemic Checklist. U.S Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
This planning tool is intended to assist healthcare coalitions (HCCs) and their partners in assessing their preparedness for an influenza pandemic. It may also be used to orient the response as a pandemic begins. This checklist can help HCCs assess, create, and improve their pandemic preparedness and response plans.
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ASPR TRACIE. (2019). Healthcare Coalition Pediatric Surge Annex Template.
This template provides general headers and descriptions for a sample healthcare coalition (HCC) Pediatric Surge Annex Template. The resources used to develop this template include sample HCC plans and the Health Care Preparedness and Response Capabilities.
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ASPR TRACIE. (2019). Healthcare Coalition Resource and Gap Analysis Tool. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
This tool is designed to help health care coalition (HCC) partners develop a common understanding of their resources and existing gaps, and strategies for prioritizing which gaps to close. Gaps may include inadequate plans or procedures, staffing, equipment and supplies, skills and expertise, and/or services. HCCs are encouraged to modify the template to reflect their coalition members, resources, and unique community attributes. A companion HCC Aggregator Tool allows information from multiple HCCs to be summarized to present an overall picture of a larger geographic area, including an entire state. (For a 508 compliant version of this tool, copy and paste this link into your browser: https://files.asprtracie.hhs.gov/documents/aspr-tracie-healthcarecoalition-resource-and-gap-analysis-pdf.pdf.)
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ASPR TRACIE. (2020). Healthcare Coalition Burn Surge Annex Template.
The 2019-2023 HPP Funding Opportunity Announcement (FOA) requires Healthcare Coalitions (HCCs) to develop a complementary coalition-level burn annex to their base medical surge/trauma mass casualty response plan. This burn-focused operational annex template can be tailored by coalitions to complement their response plans.
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ASPR TRACIE. (2021). Step-by-Step Guide to Implementing the Coalition Infectious Disease Annex TTX Template (PDF).
This guide is part of a toolkit that can help emergency planners create an interactive, discussion-based exercise focusing on impacts to healthcare coalition and healthcare facilities caused by large numbers of patients seeking healthcare following exposure to an infectious agent.
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ASPR TRACIE. (2022). ASPR TRACIE Tools and Templates for Healthcare Coalitions.
This document includes links to ASPR TRACIE resources that can help healthcare coalitions plan for certain patient surge incidents and meet grant requirements.
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DC Emergency Healthcare Coalition. (2022). Washington, DC Emergency Healthcare Coalition Templates.
The documents in this resource were provided to ASPR TRACIE by representatives from the Washington, DC Emergency Healthcare Coalition (DCEHC). While these may not be the most current documents used by the coalition, they are still considered robust templates and can be used by other for emergency planning purposes.
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Eastern Virginia Healthcare Coalition. (2016). Continuity of Operations Plan (COOP): Guide for Disaster Avoidance, Preparation, and Recovery.
This plan describes the steps the Eastern Virginia Healthcare Coalition will take following a disaster to ensure that it is able to return to normal operations as quickly as possible in order to fulfill its mission of supporting its healthcare community in response and recovery. It may be used as a reference to assist other coalitions with developing their Continuity of Operations plans.
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Eastern Virginia Healthcare Coalition. (2016). Eastern Virginia Healthcare Coalition Emergency Operations Guide.
This Emergency Operations Guide addresses protocols, procedures, and organizational structure necessary for the healthcare entities in the Eastern Region to prepare for, respond to and recover from emergencies as a collective whole, in partnership with other emergency response agencies.
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Greater Cincinnati Disaster Preparedness Coalition. (n.d.). Memorandum of Understanding for Mutual Aid. (Accessed 9/30/2022.)
This MOU is between hospitals in the greater Cincinnati, OH area and defines the scope of a voluntary agreement “to provide mutual aid and coordinated response efforts to best meet the needs of the community in the event of a disaster or other large scale emergent event.” It may be referenced by other healthcare organizations in the development of their emergency management program.
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Healthcare Preparedness Coalition of Utah/Wasatch Counties. (2014). Regional Medical Surge Plan: Expanding Local Healthcare Structure in Mass Casualty Events.
This plan defines how healthcare and related organizations within this specific region will work together to prevent, mitigate, respond to and recover from a disaster that leads to a surge on healthcare facilities. It can be used by personnel in real emergencies and when conducting training, drills, and exercises.
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Illinois Department of Public Health. (2018). Illinois Department of Public Health Emergency Support Function (ESF) 8 Plan.
This plan describes concept of operations, roles and responsibilities, and command structures for ESF-8 members in Illinois that may be useful to coalitions in developing coordination structures and plans for their communities when integrated into ESF-8. This plan can be used as a guidance or template for regional healthcare coalitions. Illinois has seven Public Health and Medical Service Response Regions with a state-wide population of approximately 12.8 million.
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Indiana Department of Homeland Security. (2010). Indiana Department of Homeland Security District Mutual Aid Agreement Template.
This Mutual Aid Agreement template from Indiana consists of the template, instructions for using the template, and key steps for the mutual aid planning process that may be useful to coalitions. There are 10 Homeland Security Districts in Indiana, with a state-wide population of approximately 6.5 million.
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Kansas City Metropolitan Area. (2016). ESF 8: Public Health and Medical Services: Kansas City Metropolitan Area Regional Coordination Guide (contact ASPR TRACIE at askasprtracie.gov for this resource). (Contact ASPR TRACIE via email at askasprtracie@hhs.gov for access to this document).
This comprehensive (318 page) annex to the Regional Coordination Guide describes how public health and medical services capabilities from metropolitan areas surrounding Kansas City would be coordinated in the event of a natural or human-caused disaster. It details planning for every aspect of disaster medical response and may be a useful reference for metro area planners. It is not public but available on request for official use.
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Lis, R., and Resnick, A. (2018). Coordinated Communications and Decision Making to Support a Regional Severe Infectious Disease Response. (Abstract only.) Health Security. 16(3):158-164.
This article discusses coordination and information sharing during infectious disease outbreaks for the Northwest Healthcare Response Network in Washington State. The network developed a plan for the region and tested it through tabletop and webinar-based functional; the authors suggest other communities use these processes as a model for community infectious disease planning.
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Nevada Division of Public and Behavioral Health. (2016). Nevada Statewide Medical Surge Plan.
This state-level plan provides guidance for healthcare facilities in Nevada, allowing them to prepare to respond to planned and unexpected events that may necessitate a surge of hospital and other healthcare resources within the state. It outlines roles and responsibilities of each entity during the response phase.
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Northern Utah Healthcare Coalition. (n.d.). Resource Management & Sharing. (Accessed 9/30/2022.)
The Northern Utah Healthcare Coalition created this guidance to help members have the right resources available at the right time and place after an incident. It describes protocols for resource requests, as well as reimbursement among members.
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Northwest Healthcare Response Network. (2017). Plans and Resources.
This webpage includes links to plans, tools, and services provided by this Seattle-area healthcare coalition. Links to other resources (e.g., active shooter, pandemic influenza, and Ebola) are also included.
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NW Oregon Health Preparedness Organization. (2015). Memorandum of Understanding: Hospital/ Health System Facility Emergency Mutual Aid.
This Memorandum of Understanding (MOU) is a voluntary agreement among the hospital/health system facilities in Northwest Oregon Healthcare Preparedness Region 1 (and Southwest Washington) with the goals of: 1) coordinating emergency planning; 2) preparing for a coordinated response to large-scale emergencies; 3) facilitating communications; and 4) providing mutual aid during a medical disaster. It may be used as a reference by other healthcare coalitions for developing coalition-specific memoranda of understanding.
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Public Health-Seattle and King County, Washington. (2015). ESF 8 Basic Plan-Health, Medical and Mortuary Services.
This plan describes concept of operations, roles and responsibilities, and command structures for ESF-8 members in King County, Washington that may be useful to coalitions in developing coordination structures and plans for their communities. This plan includes concept of operations and roles and responsibilities that involve the Northwest Healthcare Response Network (healthcare coalition).
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Region 1 NW Oregon Health Preparedness Organization. (2015). Health/Medical Multi-Agency Coordination (MAC) Group Handbook.
This Health/Medical Multi-Agency Coordination (MAC) Group Handbook provides the framework for MAC Group activities during a public health emergency with significant regional impacts. The handbook also includes a section entitled “Ethical Framework and Criteria” and a facility mutual aid memorandum of understanding.
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Salt Lake, Summit, and Tooele County Healthcare Preparedness Coalition. (2014). SST Regional Mass Surge & Alternate Care Plan.
This comprehensive plan explains how alternate care facilities will be used in the Salt Lake, Summit, and Tooele County (UT) Region to help increase the capacities and capabilities of public health and healthcare facilities in the event of a mass casualty incident that leads to a surge in patients.
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Santa Barbara County. (2017). Santa Barbara County Disaster Healthcare Partners Coalition Governance Document.
This document spells out Santa Barbara County's healthcare coalition member roles and responsibilities during disaster response and recovery. Planners may be particularly interested in the table and accompanying narrative that detail agency/discipline roles and responsibilities during response.
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SE Minnesota Disaster Health Coalition. (2016). Healthcare Multi-Agency Coordinating Center (MACC).
This document can serve as a template for healthcare coalitions interested in creating a Healthcare Multi-Agency Coordination Center (H-MACC). The scope of this document involves H-MACC activities; information should be integrated within organizational and community operational documents as applicable.
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SE Minnesota Healthcare Coalition. (2013). Communications Guidelines.
The SE Region Healthcare Coalition Communications Plan provides information to support interoperability and effective communication among coalition partners during all phases of disaster.
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Sonoma County Department of Health Services. (2022). Healthcare Coalition Toolkit.
This webpage links to many tools which can be helpful to a healthcare coalition’s planning and response efforts. The toolkit includes links to a public health emergency operation manual, a multi-casualty incident management plan, a situation report quick sheet, an exercise after action report template, and other resources.
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Southeast Texas Regional Advisory Council. (n.d.). Regional Plans. (Accessed 9/30/2022.)
This webpage includes links to plans, templates, and tools that can help planners draft reports, conduct hazard vulnerability analyses, develop family reception centers, and the like.
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SouthEast Texas Regional Advisory Council. (n.d.). Catastrophic Medical Operations Center. (Accessed 9/30/2022.)
This webpage describes the Catastrophic Medical Operations Center (referred to as “the operational arm of the Regional Healthcare Preparedness Coalition) and highlights the four levels of activation. A link to frequently asked questions is located at the bottom of the page.
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St. Louis Area Regional Response System. (2014). St. Louis Area Regional Hospital Evacuation and Transportation Plan.
This plan focuses on emergencies and disasters requiring immediate response from regional partners and the St. Louis Medical Operations Center. It outlines a system to coordinate patient evacuation and establishes an organizational structure to facilitate communication and cooperation between the evacuating facilities, the St. Louis Medical Operations Center (SMOC), receiving facilities, alternate care sites, and transportation resources.
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St. Louis Hospital Preparedness Committee. (2015). St. Louis Area Regional Hospital Re-Entry Plan.
This plan describes how the healthcare organizations in the St. Louis Area region will coordinate regionally to conduct re-entry operations following evacuation or operational interruption as a result of a disaster and includes the role of the medical operations center in coordinating this effort. It also includes information on managing identification, credentialing, and granting access management for healthcare facility personnel after an incident.
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Stanislaus County Health Services Agency. (2019). Stanislaus County Healthcare Emergency Preparedness Coalition Pediatric Disaster Surge Plan.
This county-specific pediatric disaster surge plan supports the Stanislaus County Healthcare Emergency Preparedness Coalitions’ (SCHEPC) Medical Health Surge Plan. Integration of the hospitals with the State of California through multi-agency coordination mechanisms is demonstrated.
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Texas Trauma Service Area - B Regional Advisory Council. (2017). Regional Emergency Operations Plan.
This plan provides guidelines for coordinating the emergency response of health care system partners. Included in the plan are: general operational concepts; inter-agency communication protocols; and information on memoranda of understanding (e.g., acquisition of resources and staff sharing).
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (2021). National Health Security Strategy. U.S. Department of Health and Human Services.
The goal of the National Health Security Strategy (NHSS) is to strengthen and sustain communities’ abilities to prevent, protect against, mitigate the effects of, respond to, and recover from disasters and emergencies. This webpage includes links to the full text of the strategy, an overview, the NHSS Implementation Plan, the NHSS Evaluation of Progress, and an NHSS Archive.
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Uintah Basin Region Healthcare Preparedness Coalition. (n.d.). Inter-Healthcare Provider Master Mutual Aid Agreement. (Accessed 10/31/2022.)
This agreement facilitates the sharing of staff, equipment, supplies, and pharmaceuticals, and the transfer of patients during disasters affecting the rural Uintah Basin region. It may be used as a reference by other healthcare coalitions for developing coalition-specific memoranda of understanding.
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Upton, L., Kirsch, T., Harvey, M., et al. (2017). Health Care Coalitions as Response Organizations: Houston After Hurricane Harvey. Disaster Medicine and Public Health Preparedness. 11(6).
This article discusses the role of a healthcare coalition (HCC) in response to the 2017 landfall and flooding of Hurricane Harvey in Texas. The authors cover HCC operational and strategic planning, information sharing, and resource coordination during the disaster response.
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Washoe County, Nevada. (2017). Emergency Medical Services Regional Plans.
This webpage includes links to county-specific plans and annexes (e.g., multi-casualty incident plan; mutual aid evacuation annex; and family service center annex).
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Agencies and Organizations

U.S. Department of Health and Human Services, Administration for Strategic Preparedness and Response. Hospital Preparedness Program.
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This ASPR TRACIE Topic Collection was refreshed in October 2022. It was comprehensively reviewed in November 2017 by the following subject matter experts (listed in alphabetical order):

 

Eric Alberts, CEM, CHS-V, FPEM, FPEM-HC, CDP-1, CHPP, CHEP, SEM, CFRP, FABCHS, Corporate Manager, Emergency Preparedness, Orlando Health, Inc.; Patrick Ashley, MS, Virginia Department of Health; Craig DeAtley, Director, Institute for Public Health Emergency Readiness, MedStar Washington Hospital Center; Andrea Esp, MPH, CPH, CHES, KG7VXU, Inter-Hospital Coordinating Council, Washoe County Health District; Dan Hanfling, MD, Special Advisor, National Healthcare Preparedness Program, HHS/ASPR; John L. Hick, MD, HHS ASPR and Hennepin County Medical Center; Richard Hunt, MD, Senior Medical Advisor, National Healthcare Preparedness Programs, HHS/ASPR Office of Emergency Management; Mark Jarrett, MD, MBA, MS, SVP & Chief Quality Officer, Associate Chief Medical Officer, Northwell Health, Professor of Medicine, Zucker School of Medicine at Hofstra/Northwell; Brad Learn, CHEP, Emergency Preparedness Coordinator, Kentucky Hospital Association; Onora Lien, Executive Director, Northwest Healthcare Response Network; Mary Russell, EdD MSN, Emergency Services, Boca Raton Regional Hospital; Susan Snider, M.A.; Lori A. Upton, RN, BSN, MS, CEM, Director of Regional Preparedness and Operations, Southeast Texas Regional Advisory Council; and Virginia Zimmerman, BS, MA, Michigan Volunteer Registry and Medical Reserve Corps Coordinator, Division of Emergency Preparedness and Response, Bureau of EMS, Trauma and Preparedness, Michigan Department of Health and Human Services.

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