6.3 EMAC: A Model for Regional Coordination

The Emergency Management Assistance Compact (EMAC) is a congressionally ratified interstate mutual aid mechanism (Public Law 104-321) that is supported through legislation enacted by all 50 States, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. It provides a general framework (and legal basis) for interstate coordination and mutual aid during Governor-declared emergencies or disasters.^[2] It also provides for interstate cooperation and resource sharing in emergency-related training, drills, and exercises. Important preparedness and response issues addressed in EMAC include the following:

Review of State emergency plans and hazard vulnerability analyses
Provisions for temporary suspension of any laws or ordinances
Licensure and permit waivers for medical and other professionals
Assumption of liability risk for donated personnel rendering aid
Reimbursement for assistance (e.g., personnel, equipment, and supplies)
Compensation for workers killed or injured while rendering aid
Interstate evacuation of the civilian population.

EMAC was designed to apply only to the sharing of State resources and personnel. Therefore, coverage for such issues as professional licensure and liability risk applies only to State employees. Specific legislative or regulatory actions must be taken to address coverage of local government or private sector public health and medical personnel deployed to another State. For example, some States have enacted legislation allowing local government and private sector personnel to deploy as temporary State employees via EMAC during emergencies.

EMAC was a key mechanism used by States to deploy public health and medical personnel and resources following Hurricane Katrina. This was, in fact, the largest ever deployment through EMAC with an estimated 66,000 personnel (civilian and National Guard) deployed across all disciplines.^[3] One of the key lessons learned from Hurricane Katrina was the need for specificity in requesting resources via EMAC (e.g., clearly delineating specific qualifications or training for personnel or teams). Healthcare resource typing as a national initiative is underway but incomplete. Thus, it is important to carefully describe the type of assistance being requested.

Public health and medical planners should work closely with their State's EMAC coordinator to understand how EMAC is being implemented in their State. They should also be directly involved in establishing processes to ensure coordination of public health and medical assets obtained/deployed via EMAC in support of MSCC.

Additional information on EMAC is available at:http://www.emacweb.org.
EMAC Executive Briefing, August 16, 2006

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