While an established MAA, such as EMAC or a model aid agreement, may require the inclusion of a specific language in an agreement, the U.S. Department of Homeland Security has identified, through NIMS, a number of important elements that should generally be included in MAAS1: these public health emergencies have reinforced the recognition of potential and real barriers to effective mutual assistance and have identified legal “gaps.” , both inside and outside the EMAC, this must be filled. Although EMAC facilitated the transfer of unprecedented mutual assistance to the affected areas affected by Katrina, response gaps have been improved. For this reason, many states have not been able or unsure of how they can use the services of volunteers (who were not protected from legal liability) 4. However, some states are trying to address this problem.5 In addition, the provisions of the EMAC are triggered only by a governor`s declaration, the sharing of small-scale resources, emergencies not declared by agreements separated by the EMAC, must take effect. The same applies to the exchange of epidemiological or laboratory data to detect endangered infectious diseases. In some circumstances, it may even be argued that routine public health functions would be more effective in concluding mutual assistance agreements for the exchange of relevant information, supplies or equipment. Other agreements are common in small towns that have no resources or have limited resources. In these cases, local crews are able to deal with small incidents themselves, but in the event of a major incident, surrounding communities and local resources are called upon for the first deployment.

For example, local fire and EMS services will generally handle fire alarms and car accidents, while fire reports result in automatic dispatches (automatic assistance) to surrounding cities. Texas assessed its legal capacity to enter into cooperation agreements with Mexican states for the exchange of epidemiological information and concluded that it had no legal jurisdiction over the cross-border exchange of confidential health information. It also found that, while the state authority exists to enter into mutual aid agreements on the border, a provision of the U.S. Constitution (previously discussed) has put in place an obstacle to entry into binding agreements.15 Lawyers in some Great Lakes states of Michigan, Minnesota, New York, and Wisconsin, in conjunction with The EWIDS Project, have verified and analyzed the privacy and confidentiality laws of each of these states.16 exchange information, equipment, supplies and personnel and enter into mutual assistance agreements with other states or across international borders are under way.