• James G Hodge, Evan D Anderson, Thomas D Kirsch, and Gabor D Kelen.
• ASU Sandra Day O’Connor College of Law, Armstrong Hall, Room 120E, PO Box 877906, Tempe, AZ 85287-7906, USA. james.hodge.1@asu.edu
• Disaster Med Public Health Prep. 2011 Mar 1; 5 (1): 54-61.

AbstractEffective 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.©2011 American Medical Association. All rights reserved.

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