A Primer on Mutual Aid Agreements in NIMS

NIMS and Mutual Aid: An Overview

The National Incident Management System (NIMS) was developed to provide a systematic, proactive approach to guide all levels of government, private-sector companies, and non-profit organizations in their actions to prevent, prepare for, respond to, recover from, and mitigate the effects of domestic incidents, regardless of cause, size, or complexity. The basic premise of NIMS is that it provides a common framework for multiple and diverse organizations to work together, so that we do not have to re-invent the wheel every time we respond to an event. Conversely, much of this same philosophy can clearly be applied to mutual aid.
In this context, mutual aid can be simply defined as a program to assist the emergency response efforts of neighboring localities. In reality, however, mutual aid is much more complex than that. Mutual aid is often established and is often the means by which jurisdictions and mutual aid partners (jurisdictions in close proximity to one another) agree on pre-approved levels of assistance that will be provided "up front" and without each requesting a corresponding level of assistance in return . While mutual aid is often established and agreed upon in advance, at least by practice if not legal codification, mutual aid does not have to be established in advance. This is particularly true of large-scale response efforts where the notion of what constitutes "normal ongoing day-to-day operations" no longer controls the scale, scope, and magnitude of the response effort. In those instances, emergency mutual aid provisions spring into action.
Mutual aid assistance can take numerous forms including providing personnel, equipment, supplies, or other services and may be provided by any number of sources including private-sector businesses, private non-commercial entities, and various governmental entities. Importantly, since mutual aid may involve costs or expenses, mutual aid agreements or protocols are almost always formally memorialized by the parties involved in the agreement or protocol. When memorialized in a comprehensive and legally-sound manner, mutual aid agreements can serve to minimize disagreements between parties regarding their respective obligations and liabilities, including issues such as reimbursement for services or materials, legal liability, and the duration and scope of the assistance provided.

How It Works

Mutual aid agreements are based on the concept of sharing resources in order to more effectively control an incident. They are used to formalize the ability of organisations to assist each other in meeting their operational goals. NIMS provides a framework for information and communication systems that allow for the planning, coordination, and design of mutual aid agreements.
Once an agreement is in place, mutual aid is accomplished by using NIMS approved planning tools. In a practical sense, this involves the use of the resource management common standards and protocols established by NIMS, including the ICS and credentials required by the NIMS training and certification system.
The agreement can be signed by representatives of the following entities:
The agreement typically consists of the following components:
Any member of the mutual aid agreement can activate the agreement. Following the activation of a mutual aid agreement, the responding organisation or agency should ensure that it is integrated within the incident management structure of the requesting agency. Therefore, the appropriate NIMS forms and reporting structures should be used to track all personnel and equipment obtained through a mutual aid agreement.
If the requesting agency puts a request out for mutual aid services, this action alone does not mean that mutual aid has been activated.
Formal activation occurs when the requesting agency and the responding agencies enter into an agreement to share resources. This may occur verbally or in writing; however, the responding agency should immediately notify the requesting agency of its participation in the mutual aid agreement and the timeline for duration of the agreement. The duration of the mutual aid agreement may or may not be specified in the agreement. If the duration is not, it is agreed that once requested aid arrives on scene, the requesting party will continue to request, through the standard means for requesting external resources.
Therefore, both parties assume respective obligations until the original purpose of the requested services has been satisfied.
The overwhelming goal of mutual aid systems is to provide a framework for expansion of resources that are thereafter integrated with existing resources and with NIMS compliant approaches to emergency response.

Mutual Aid Agreements: The Key Elements

A mutual aid agreement (MAA) is an essential part of the strategic planning process under NIMS. An MAA complements a jurisdiction’s emergency response plan and is of primary importance to ensure adequate assistance in times of an emergency. An MAA consists of four key elements: The MAA is a voluntary action agency that allows for sharing manpower, equipment, and services in an emergency situation. The MAA is an agreement that supports numerous activities, which include operational support, technical assistance, or personnel support. A MAA is a cooperative effort with other jurisdictions and can be used in a variety of ways. The approach is flexible enough to allow jurisdictions to share resources with neighboring areas to help during an emergency. The MAA requires the requesting party as well as the supporting jurisdiction to determine the level of support, the scope of responsibilities, the type of personnel needed, the quantity of equipment necessary, the amount of supplies requested, the days of availability, the cost incurred, and who will be responsible for the costs. To facilitate timely assistance, the MAA should be developed before the emergency. The solicitor general, deputy attorney general, and county attorneys should coordinate to develop the terms used for the MAA. Prior to establishing an MAA, legal considerations must be assessed and addressed. The legal issues must include the following: liability of individual responders, signing authority for the MAA, worker’s compensation coverage, and the Federal Tort Claims Act. Once the MAA is established, the local jurisdiction’s emergency management coordinator and the Chief of Police in each municipality should have updated copies of the MAA. The MAA should be reviewed, signed, and voluntarily agreed upon by parties prior to an actual emergency. Review and evaluations should be conducted to keep the MAA current and effective. Furthermore, all parties involved in the MAA should embrace the principles of the agreement stated in the following section to ensure the MAA process is guided by the core beliefs of the document.

Legal and Practical Issues

The formation and operation of mutual aid agreements can lead to a variety of legal and operational challenges for agencies. This is especially true when there is a lack of sufficiently clear and effective internal policies governing a given agency’s authority to enter into and limit the terms of mutual aid. For example, a county fire chief had entered into an interagency agreement with another county for use of each other’s equipment. Later, that fire chief disbanded his county’s Emergency Services Team ("EST"), but did not actually terminate the interagency agreement. When a terrorist incident occurred in his county, the fire chief invoked the interagency agreement and called upon the other county to provide support personnel under the terms of the now-defunct EST Memorandum of Understanding. The Court of Appeal of California held the fire chief liable for funds spent under that agreement because he failed to properly secure approval of the county board of supervisors to invoke the agreement even though the emergency invocation of such an agreement is specifically authorized by state law.
On a more fundamental level, there are many practical considerations applicable to the coordination of mutual aid resources, i.e. the decision concerning whether to commit resources, the type of resources to commit, and the retention of the right to terminate or switch resources despite an overt commitment. These operational issues carry with them the potential for misuse or misunderstanding of jurisdictional authorities and may lead to enumeration and codification of the rights and duties among contributing and/or requested agencies in the event something goes wrong with the agreement and problems arise out of the interaction between each agency’s respective legal authorities. For instance, in Jarrett v. Town of Winchester, a contractor was injured while working to suppress a fire in another town as part of an emergency assistance mutual aid agreement ("M.A.A."). He was rescued by Firefighters from the requesting town, but fell from a roof as a result of a visible fire department unsafe practice, allegedly due to the Town of Winchester fire department. The contractor sued both the requesting town and the Town of Winchester, and the trial court dismissed the suit against the Winchester fire department. The Connecticut Supreme Court held that the Winchester fire department could be liable to the injured contractor for negligent acts or omissions relating to the "establishment, maintenance, and use of internal safety practices and procedures." Although a request for emergency assistance under General Statute § 7-308 cannot be construed as creating a private cause of action on behalf of an injured worker against the responding fire department, if the Town of Winchester exercised control over the manner by which the contractor was performing his work, the Town could be held liable for injuries resulting from this exercise of control; such liability would fall under the Rescue Doctrine. The Connecticut Supreme Court did, however, note that the Town of Winchester’s M.A.A. with the requesting town prohibited it from demishing the building without the requesting town’s authorization, suggesting that under the M.A.A. the Winchester fire department was prohibited from taking control over internal safety practices and procedures.
Here, it is evident that an M.A.A. may create enforceable obligations where the parties have contractually agreed to follow certain rules, regulations and procedures. With the increase in arbitrations, and with the proliferation of M.A.A.s for mutual assistance between government agencies, it is likely that new case law will gradually fill gaps concerning M.A.A.s, and judicial opinions will continue to inform, and possibly alter, the manner in which agencies form and implement their M.A.A.s.

Benefits of Mutuial Aid Agreements

Mutual aid agreements that are carefully thought out and constructed not only strengthen the understanding of all those involved, but also provide for more effective and efficient emergency responses. The bottom line is that mutual aid agreements can make a significant difference between success and failure under challenging conditions.
Well-planned and articulated mutual aid agreements enhance coordination and communication between emergency responders and resource providers. The level of experience, qualification, range of equipment types, and availability of resources among agencies can vary significantly. Effective mutual aid agreements ensure those agencies and entities know what is expected, and agree about what can reasonably be provided to support the response effort.
The short-term view of mutual aid agreements favoring only responding agencies and teams needs to be set against the long-term realization that at the conclusion of the response , those agreeing agencies and entities will become recovery partners as well. The enhanced relationship resulting from that understanding means that at the beginning of recovery phase, there is already a cooperative bond between the parties and that can provide immediate benefits.
A major advantage of mutual aid agreements is to advance an understanding between the parties of what equipment and resources the other agency can provide. The mutual aid agreement should provide the specific details on the type of equipment available, training and abilities of the teams providing the support. What other information would be helpful (i.e., number of local personnel that can be deployed, etc.) to have this information available in the field prior to deployment.

Real-Life Scenarios and Successes

Case Study 1: During Hurricane Sandy – The Immediate Impact of Neighbor to Neighbor Mutual Aid – New York, New Jersey and Connecticut
In the aftermath of Hurricane Sandy, the importance of having an existing mutual aid agreement was highlighted by municipalities working together. Even before the storm made landfall, the Port Authority of New York/New Jersey, a bi-state agency that operates city bridges, tunnels and airports, was making arrangements for possible disruption. The Port Authority has a long history of planning for possible disasters and has a working mutual aid agreement in place with the New York City Police Department (NYPD) and the New Jersey State Police (NJSP). Port Authority Police and NYPD officers traveled across the Hudson River through the Holland Tunnel to work on Staten Island, participating in search and rescue operations. Engineers employed by the Port Authority met with the Bureau of Engineering as part of its FDNY Engineering Support Team for structural damage assessments. Additionally, the NYPD and NJSP provided Port Authority officers, and NYPD officers provided traffic management and crowd control in the secure areas of local airports during peak travel periods.
The Department of Homeland Security (DHS) has released a report highlighting mutual aid done during Sandy in the New York tri-state area. One of the reports highlights the activities led by NIMS Integration Center staff during Hurricane Sandy to facilitate healthcare system mutual aid between New Jersey, New York, and Connecticut through fusing information, supporting situational awareness and supporting requests for needed resources. The New York and New Jersey healthcare systems experienced a large influx of patients due to Sandy. Several of them including the University Hospital, Brookdale, Coney Island and The City College of New York had their own challenges. In response to this mutual aid need, systems collaborated and coordinated joint requests to obtain additional personnel and equipment, as well as the relocation of patients from hospitals affected by the storm. The New Jersey Department of Health (NJDOH) supported the Public Health Emergency Certificate System (PHICS) containing information on available hospital beds and the New York State Department of Health (NYDOH) supported the Regional Medical Coordination Center (RMCC) to assist in the coordination of patient placement. Situational information about bed availability was shared, and mutual aid efforts were facilitated. With NYC hospitals struggling under patient surges, Nassau and Suffolk counties in New York offered assistance. For example, Northwell Health sent many of its Long Island hospitals’ emergency medical technicians to work at Kings County Hospital Center. Liberty Dialysis in Yorktown Heights, New York, sent a surge team to assist in cleaning and disinfecting rooms so that patients could be placed back into the dialyzer. It also deployed 13 registered nurses to hospitals. Similarly, CareMount Medical sent a team to offer assistance in New York, and South Nassau Communities Hospital sent 20 staff to Long Island hospitals. More than 150 patient beds were filled in New Jersey because of hospital operational challenges, according to NJDOH. By late Monday evening, over 250 mutual aid staff supported hospitals in New York. Additionally, CT CEO Network (C-3 Network), a nonprofit that includes 15 member hospitals in CT, worked with the CT Commissioner of Public Health to support the coordination of mutual aid. Also, the Connecticut Department of Public Health (CTDPH) integrated information and resources from neighboring state (i.e., Massachusetts, Rhode Island, and New York) into state and local Hospital Emergency Incident Command Systems (HEICS).
Case Study 2:
In California, a mutual aid system for healthcare has been established. This system provides immediate assistance and disaster response training to help healthcare organizations prepare for and respond to any type of hazard, including multiple casualty incidents, infectious disease outbreaks, natural disasters and terrorism. The Healthcare Mutual Aid System (HMAS) was formed in the wake of the 1994 Northridge earthquake in Los Angeles, when area hospitals quickly realized that they could not effectively respond to such a major disaster on their own. Since then, more than 1,300 healthcare organizations across the state have participated in the HMAS volunteer network, forging valuable partnerships across political jurisdictions and healthcare delivery systems.
The HMAS is a statewide disaster movement of like-minded professionals with a desire to foster relationships through mutual aid. Members include ambulatory surgery centers, acute care hospitals, clinics, emergency transport services and hospital systems. Each participating entity has committed to assisting each other’s facilities as needed in times of disaster. In addition to serving as a lifeline for hospitals during time-critical emergencies such as wildfires or earthquakes, the system has contributed to greater cooperation among hospitals during other operable emergency situations, including easily placing high-acuity patients, transferring a 350-lb critically ill patient by air, and aiding facilities with staffing issues in the wake of a shortage.

Creating a Mutual Aid Agreement

Both private and public organizations should take the following steps to develop and then maintain a successful mutual aid agreement.

• Identify Collaborating Organizations. The first step is identifying the other organizations that will be asked to join the mutual aid agreement. For mutual aid agreements that work well, the amount of prior collaboration and cooperation is often very high. Ideally, all organizations in a mutual aid agreement know each other in some way. Much of this can be accomplished through basic networking. A great resource for building relationships are community and regional emergency planning committees, which often have excellent ways to identify individuals and organizations with similar interests in mutual aid agreements.
• Determine Terms of the Agreement. A strong mutual aid agreement will generally provide specifics about the following:
• Identify and Resolve Concerns.
• Draft Agreement. A collaborative working group should draft a mutual aid agreement. Key issues to consider include:
• Review and Revise Agreement.
• Execute Agreement. The once the draft is complete, organizations need to execute the agreement, which constitutes a contract between the participating organizations. Signed copies should be widely distributed within all involved organizations so that everyone understands their legal responsibilities for providing their mutual aid to other organizations.
• Test Agreement. Every good plan needs a test and a mutual aid agreement is no different. A good way to test a mutual aid agreement is to hold a joint training or a tabletop exercise. It could be as simple as having representatives from each organization review the agreement and consider what the response would be if actually utilized.
• Revise and Update. Few documents last forever and memorandums of agreement are no different. Revisions should be made to address changes in state or federal laws, changes in the organizations, and changes in other issues that can impact the execution of the agreement. This also means the agreement should be reviewed at least every one or two years to determine whether it remains accurate and consistent with the goals and objectives of the organizations involved.
• Consider Legal Issues. The organizations will want to pay particular attention to liability issues when drafting a mutual aid agreement. In particular, a growing number of states have enacted so-called "Good Samaritan" laws. These laws protect individuals from liability when providing aid in an emergency. Organizations providing aid in an emergency should review whether these laws provide adequate protection against liability.

The Future

While the concept of mutual aid is not new, emerging technology is likely to transform how mutual aid agreements are created and implemented. For a small nonprofit, considering whether to enter into one or more mutual aid agreements could seem daunting enough, but such organizations are probably in the best position to benefit from forthcoming innovations in this area. Four key areas of innovation may have (or soon have the potential for) a significant impact on mutual aid agreements.
One area for innovation in future mutual aid agreements is in the area of data management. The technology and platforms that allow for the easy and efficient collection, storage, and retrieval of data are always evolving. As state and local governments promote the use of static templates designed to meet the needs of all potential mutual aid participants, the implementation of dynamic databases that take into account the specifically identified needs of individual participants may be needed. Tracking of resources requested and provided will be a crucial component of future post-incident reporting. Additionally, the administrative burdens associated with many of the current mutual aid agreements can likely be reduced by the availability of more streamlined platforms and forms for their creation and tracking. The increasing role of web-based programs and applications also has the potential to create greater transparency for mutual aid agreements that serve as conduits for non-profits receiving and administering public funds.
The second area for potential innovation is in the area of training. Because mutual aid agreements have the potential to create the expectation of reciprocity among participating jurisdictions and entities, it will be important for those entities to receive training on what to expect and (just as importantly) what not to expect from their counterparties and also to receive training on what is necessary to protect and defend themselves against claims of breach of contract or other liabilities .
A third area for innovation may lie in the realm of legal assistance itself. Attorneys have different levels of understanding, usually based on the particular jurisdictions in which they practice, of the obligations and enforceability of mutual aid agreements. While some are likely to provide mutual aid agreements for free or pro bono, others will need to be paid. The expertise of the attorneys serving as counsel for parties entering into mutual aid agreements can be paramount for avoiding wasteful litigation over the mutual aid agreements after disaster strikes. This expertise can be particularly important in non-profit contexts to avoid wasteful litigation over (as just mentioned) questions of whether a particular organization was "non-profit" for the purposes of the agreement. Providing training, materials, or pro bono assistance to non-profit organizations in particular may be one way to address this need.
The fourth area for innovation in the context of mutual aid agreements may be in envisioning new models for mutual aid relief. For example, while mutual aid agreements are typically between two or more entities, there has been a growing trend for creating mutual aid relief that involves numerous entities, such as a coalition of addictions treatment centers or coalitions of hospitals. These coalitions may respond to a specific need such as mental health or substance abuse treatment but are effective because they allow entities that might not otherwise have the capacity to assist one another to offer and receive help.
As for the future of mutual aid generally, organizations like the American Public Health Association have been supporting the development of providing for increased responsibility for non-profits to participate in mutual aid agreements, including with strategies for integrating capacity building and establishing and implementing mutual aid agreements into public health practice.