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1 Mr Hodge is the Lincoln Professor of Health Law and Ethics and the Director, Public Health Law and Policy Program, Sandra Day O’Connor College of Law, Arizona State University; Mr Anderson is Senior Legal Fellow, Center for Health Law, Policy and Practice, Temple University Beasley School of Law; Dr Kirsch is Associate Professor and Director of Operations, Department of Emergency Medicine, Johns Hopkins University; and Dr Kelen is Professor and Chair, Department of Emergency Medicine, Johns Hopkins University School of Medicine, Co-Director, National Center for the Study of Preparedness and Catastrophic Event Response (PACER), and Director of the Johns Hopkins Office of Critical Event Preparedness and Response.
* To whom correspondence should be addressed. E-mail: james.hodge.1{at}asu.edu.
Effective emergency response among hospitals and other health care providers stems from multiple factors depending on the nature of the emergency. While local emergencies can test hospital acute care facilities, prolonged national emergencies, such as the 2009 H1N1 outbreak, raise significant challenges. These events involve sustained surges of patients over longer periods and spanning entire regions. They require significant and sustained coordination of personnel, services, and supplies among hospitals and other providers to ensure adequate patient care across regions. Some hospitals, however, may lack structural principles to help coordinate care and guide critical allocation decisions. This article discusses a model Memorandum of Understanding (MOU) that sets forth essential principles on how to allocate scarce resources among providers across regions. The model seeks to align regional hospitals through advance agreements on procedures of mutual aid that reflect modern principles of emergency preparedness and changing legal norms in declared emergencies.
Key Words: hospitals, emergencies, health personnel, public health
