Topic Collection Cover Page

Coalition Response Operations (including Mutual Aid)
Topic Collection
October 16, 2019

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. 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. 

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. 

 

Must Reads


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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This presentation discusses how planning for and responding during mass gatherings can serve as proxy for a real response, and describes how healthcare coalitions can be involved in mass gathering planning and execution. A link to the archived webinar is included.
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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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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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Central Maine Regional Health Care Coalition. (2016). All Hazards Emergency Operations Plan: November 2016.
This plan describes the roles and responsibilities of the Central Maine Regional Health Care Coalition (CMRHCC) in responding to a healthcare emergency. It is comprised of a Base Plan and Annexes (e.g., communication plan, medical surge, responder health and safety) and concludes with appendices that include a list of acronyms and forms that can be downloaded and printed (e.g., volunteer request form, resource request form).
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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 3:32:22 PM
DC Emergency Healthcare Coalition. (2010). Appendix C: MOU for Hospitals in the District of Columbia.
This Mutual Aid & Cooperative Assistance Memorandum of Understanding describes the relationship and the associated procedures which participating healthcare organizations can use to share resources in supporting each other during response to potential or real emergencies or disasters. It may be used as a reference by other healthcare coalitions for developing coalition-specific memoranda of understanding.
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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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Fisher, S., Biesiadecki, L., and Schemm, K. (2014). Responding to Medical Surge in Rural Communities: Practices for Immediate Bed Availability. National Association of County and City Health Officials.
This report highlights the promising practices being used by healthcare coalitions to plan and increase immediate bed availability in rural communities.
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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, Capability 3, Objective 2 is focused on Continuity of Operations for healthcare facilities, and Capability 3, Objective 7 is focused on coordinating healthcare delivery system recovery. These four capabilities can help the healthcare delivery system better understand their roles in preparing for and responding to emergencies that impact the public’s health and adjust their EMP and EOP accordingly.
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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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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 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. (n.d.). From Hospitals to Healthcare Coalitions: Transforming Health Preparedness and Response in Our Communities. (Accessed 11/20/2017.) U.S. Department of Health and Human Services.
This report provides an overview of the Hospital Preparedness Program (HPP), shares profiles of grant awardees, and includes a chapter on the future of HPP.
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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). Hospital Preparedness Program.
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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


Center for Domestic Preparedness. (n.d.). Healthcare Leadership for Mass Casualty Incidents. (Accessed 10/16/2019.) Federal Emergency Management Agency.
This four-day course for healthcare leaders focuses on critical disaster emergency preparedness decision making, management of different facets of the hospital response, and considerations for the community. The course applies to any incident with multiple casualties requiring surge capacity implementation and emphasizes the importance of incident command in thehospital
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Center for Domestic Preparedness. (2017). Healthcare Coalition Response Leadership Course. (Accessed 11/20/2017.)
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 7/23/2019.)
This four-day (32-hour) course is geared towards people responsible for emergency management in healthcare facilities. It covers standards AND regulations; the Incident Command System; 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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General Guidance


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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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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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.
Rate:
Favorite:
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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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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, Capability 3, Objective 2 is focused on Continuity of Operations for healthcare facilities, and Capability 3, Objective 7 is focused on coordinating healthcare delivery system recovery. These four capabilities can help the healthcare delivery system better understand their roles in preparing for and responding to emergencies that impact the public’s health and adjust their EMP and EOP accordingly.
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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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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. (n.d.). From Hospitals to Healthcare Coalitions: Transforming Health Preparedness and Response in Our Communities. (Accessed 11/20/2017.) U.S. Department of Health and Human Services.
This report provides an overview of the Hospital Preparedness Program (HPP), shares profiles of grant awardees, and includes a chapter on the future of HPP.
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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). Hospital Preparedness Program.
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Guidance: Coalition Medical Surge


This presentation discusses how planning for and responding during mass gatherings can serve as proxy for a real response, and describes how healthcare coalitions can be involved in mass gathering planning and execution. A link to the archived webinar is included.
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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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Fisher, S., Biesiadecki, L., and Schemm, K. (2014). Responding to Medical Surge in Rural Communities: Practices for Immediate Bed Availability. National Association of County and City Health Officials.
This report highlights the promising practices being used by healthcare coalitions to plan and increase immediate bed availability in rural communities.
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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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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, which focused on situational awareness of capabilities and assets among members; exercising of plans across the region; augmentation of mutual aid agreements; development and strengthening of partnerships among members; ensuring NIMS compliance; and development and testing of a volunteer plan.
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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. (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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Plans, Tools, and Templates


(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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American Hospital Association. (n.d.). Model Hospital Mutual Aid Memorandum of Understanding. (Accessed 7/11/2019.)
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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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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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 health care coalitions 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 healthcare coalitions assess, create, and improve their pandemic preparedness and response plans.
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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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Central Florida Disaster Medical Coalition. (n.d.). Healthcare Coalitions in Florida: Frequently Asked Questions. (Accessed 11/20/2017.)
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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Central Maine Regional Health Care Coalition. (2016). All Hazards Emergency Operations Plan: November 2016.
This plan describes the roles and responsibilities of the Central Maine Regional Health Care Coalition (CMRHCC) in responding to a healthcare emergency. It is comprised of a Base Plan and Annexes (e.g., communication plan, medical surge, responder health and safety) and concludes with appendices that include a list of acronyms and forms that can be downloaded and printed (e.g., volunteer request form, resource request form).
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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 3:32:22 PM
DC Emergency Healthcare Coalition. (2010). Appendix C: MOU for Hospitals in the District of Columbia.
This Mutual Aid & Cooperative Assistance Memorandum of Understanding describes the relationship and the associated procedures which participating healthcare organizations can use to share resources in supporting each other during response to potential or real emergencies or disasters. It may be used as a reference by other healthcare coalitions for developing coalition-specific memoranda of understanding.
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This document provides guidance on the specific processes, procedures, and technology related to the communication systems utilized by the DC Emergency Healthcare Coalition during incident response. The information management needs during response require the ability to share information within the Coalition as a group of healthcare organizations, with jurisdictional agencies, with other external partners (e.g., Suburban Maryland Hospital Communication Center), and potentially federal entities (e.g. HHS, DHS).
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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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DC Emergency Healthcare Coalition. (2014). Public Information Functional Annex.
This annex to the DC Emergency Healthcare Coalition (DCEHC) EOP provides guidance to Healthcare Coalition public information officers (PIOs) and/or their staff during a pre-planned event or no-notice incident of significance to assist in providing timely, accurate, and consistent information to hospital personnel, external response partners (police, fire, EMS, public health, and emergency management), and the public.
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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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Fox Valley (Wisconsin) Healthcare Emergency Readiness Coalition. (n.d.). Base Hospital, Area & Regional Medical Coordination Plan. (Accessed 10/16/2019.)
This plan is intended to provide concepts, considerations and assumptions in a coordinated area or regional medical response to ensure the continuity of care from the event trigger to the opening of the county Emergency Operations Center (EOC) or serve as a method of resource management when an EOC is not opened. It defines triggers for activation of regional medical coordination, and includes checklists for affected facilities to assist them with managing their response and requesting assistance.
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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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Greater Cincinnati Disaster Preparedness Coalition. (n.d.). Memorandum of Understanding for Mutual Aid. (Accessed 7/19/2019.)
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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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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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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This plan describes the structure, functions, and planning frameworks of the Louisiana ESF-8 Health and Medical Preparedness and Response Coalition. Coalition membership is primarily those that have a preparedness and response function under ESF-8 such as public health, pre-hospital, and hospital assets. This plan includes sections such as ESF-8 Network Information Sharing; communication hardware/ modalities; planning framework; and cross-cutting activities/processes.
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Northern Utah Healthcare Coalition. (n.d.). Resource Management & Sharing. (Accessed 11/20/2017.)
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 healthcare coalition. Links to other resources (e.g., active shooter, pandemic influenza, and Ebola) are also included.
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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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Office of the Assistant Secretary for Preparedness and Response. (2017). Health Care Coalition Surge Test Tool. U.S. Department of Health and Human Services.
This training video provides an overview of how to use the HHS ASPR Health Care Coalition Surge Test Tool. The tool can be found at https://www.phe.gov/Preparedness/planning/hpp/Pages/coaltion-tool.aspx.
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Office of the Assistant Secretary for Preparedness and Response. (2019). 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 plan, an overview, the NHSS Implementation Plan, the NHSS Evaluation of Progress, and an NHSS Archive.
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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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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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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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SouthEast Texas Regional Advisory Council. (n.d.). Catastrophic Medical Operations Center. (Accessed 11/27/2017.)
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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Southeast Texas Regional Advisory Council. (n.d.). Regional Plans. (Accessed 11/5/2018.)
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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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 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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This county-specific pediatric disaster surge plan supports the Stanislaus County Healthcare Emergency Preparedness Coalitions’ (SCHEPC) Medical Health Surge Plan. This plan is intended to support, not replace, any agencies’ existing policies or plans by providing uniform response actions in the case of pediatric emergency.
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Uintah Basin Region Healthcare Preparedness Coalition. (n.d.). Inter-Healthcare Provider Master Mutual Aid Agreement. (Accessed 11/20/2017.)
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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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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Specialty Plan, Education, and Training Topics


* 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 health care coalitions 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 healthcare coalitions assess, create, and improve their pandemic preparedness and response plans.
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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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DC Emergency Healthcare Coalition. (2014). DCEHC Acute Care Facilities Decontamination Planning Template.
This planning template can help acute care facilities prepare for and respond to a hazardous material incident.
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DC Emergency Healthcare Coalition. (2014). DCEHC Disaster Behavioral Health Planning Template.
This template provides planning guidance that allows healthcare facilities prepare for and respond to the behavioral health needs of patients, staff, and loved ones impacted by a disaster or other emergent situation.
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DC Emergency Healthcare Coalition. (2014). Healthcare Facility Evacuation Incident Specific Annex.
This annex to the Washington, DC Emergency Healthcare Coalition Emergency Operations Plan provides guidance to personnel supporting an incident in which a single or multiple healthcare facilities in the District of Columbia require evacuation.
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This template was designed to provide guidance to healthcare coalition member organizations that provide residential healthcare services (e.g., acute care, long, and short term care) regarding effective management of mass fatality situations.
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This document serves as a planning guide for healthcare coalition member organizations wishing to establish response plans for an active shooter incident (defined as any individual with a firearm threatening harm or engaged in the process of causing harm in a facility or on a campus; other definitions are included in the plan).
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This plan contains documents that fully detail the St. Louis Area Regional Response System (STARRS) approach to Alternate Care Sites (ACS). It highlights how ACS can be used to alleviate the burden caused by a surge of patients entering the healthcare system.
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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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South Dakota Department of Health. (2015). ESF #8 Sturgis Rally Plan.
This plan incorporates various stakeholders from healthcare and related agencies and was developed in advance of the 75th Sturgis Motorcycle Rally.
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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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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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Agencies and Organizations


ASPR TRACIE. Select Health Care Coalition Resources. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
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U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. Hospital Preparedness Program.
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