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A Menu of Suggested Provisions for Public Health Mutual Aid Agreements


Mutual aid agreements* can be effective tools to assist U.S. state and local governments, Tribes, Canadian provinces, First Nations, and Mexican states in sharing information, data, supplies, resources, equipment, or personnel for the purpose of protecting the public’s health.

Public health officials with an interest in developing mutual aid agreements have frequently approached CDC’s Public Health Law Program to request the creation of “model” agreements. In an effort to be of assistance in that regard, the Public Health Law Program, in cooperation with CDC’s Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER), gathered, reviewed, analyzed, condensed, and categorized provisions from numerous and varied mutual aid agreements. A workshop was then convened, comprised of public health attorneys and officials representing U.S. federal, state, and local governments, Canadian federal and provincial entities, and Tribes with a wide range of mutual aid responsibility, experience, and expertise. Workshop participants reviewed and analyzed the collected provisions, and provided valuable input concerning the types of provisions that could be considered for possible inclusion in agreements. This document is the product of those efforts. It is hoped that the document will be of immediate practical value to public health officials and their legal counsel in the development of mutual aid agreements involving a variety of jurisdictions.

While this document is intended to provide impetus for consideration of various mutual aid-related issues, and to suggest some possible approaches for addressing those issues, the suggested provisions must be carefully scrutinized and modified as necessary to accurately reflect the specific intent of the parties to an agreement. For example, the types of provisions to be included within a mutual aid agreement are necessarily dependent on the resources to be shared and the circumstances under which sharing may be contemplated. With varying degrees of specificity, resources to be shared may include information, data, supplies, equipment, or personnel. Some parties may wish to share resources only upon a declaration of emergency. On the other hand, resource sharing may be a method of providing surge capacity in response to smaller scale, non-declared emergencies. Resource sharing may even be an effective means of executing routine public health functions. Parties using the following provisions to assist in the negotiation and development of mutual aid agreements, therefore, must determine whether a particular type of provision is relevant to their contemplated agreement, and must then carefully tailor provisions to meet their specific needs.

Each section commences with a brief note describing the purpose and effect of provisions included within the section. Provisions in each section are in turn organized under sub-headings. Bulleted provisions within each section and under each sub-heading are mutually exclusive; i.e., a bulleted provision should be viewed as alternative to, rather than supplemental to, other provisions. As noted above, the suggested provisions are only examples intended to prompt negotiation and drafting of provisions that will comply with applicable laws and best meet the needs of the parties to a particular mutual aid agreement. The suggested provisions are followed by a Special Note Relating to Tribes.

*Parties intending to create informal or non-binding terms may choose to title the document a "memorandum of understanding" or a "memorandum of agreement" rather than a "mutual aid agreement."

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