Figure 5.1. The Decisionmaking Process for Resource Allocation and Policy Guidance

Flow chart depicts levels in the decisionmaking process.  At the top of the chart is a box labeled 'Federal response(regional and national),' connected by lines to two boxes below labeled 'State A' and 'State B'; a line between these two boxes also connects them to each other.  Beneath 'State A' is another box also labeled 'State A'; two lines connect this box to two boxes below it labeled 'Jurisdiction I (PH/EM/public safety)' and 'Jurisdiction II (PH/EM/public safety).'  'Jurisdiction I' is connected to 5 boxes beneath it; the first, on a level above, is labeled 'Medical Support' and in a row below it are 4 boxes labeled 'HCF A,' 'HCF B,' 'HCF C,' 'HCF D.'  Beneath 'HCF A' is another box also labeled 'HCF A' with an arrow pointing up between the two. Federal response
(support to State and locals)
Tier 6
Interstate regional coordination
(management coordination and mutual support)
Tier 5
State response and coordination of intrastate jurisdictions
(management coordination and support to jurisdictions)
Tier 4
Jurisdiction incident management
(medical IMS and emergency support—EOC)
Tier 3
Healthcare "coalition"
(info sharing, cooperative planning, mutual aid)
Tier 2
Healthcare asset management
(EMP+EOP using incident management)
Tier 1

Notes: EMP = Emergency Management Program; EOP = Emergency Operations Plan; PH= Public Health; EM = Emergency Management; EOC = Emergency Operations Center; IMS = Incident Management System.

Source: Medical Surge Capacity and Capability: A Management System to Integrate Medical and Health Resources During Large-scale Emergencies. CNA Corporation, under contract to the Department of Health and Human Services (August 2004). Available at Accessed November 27, 2006.

Return to Document