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2. Mutual Aid Agreements And Assistance Agreements

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An obvious method of compliance is the creation of cooperation agreements that would not constitute « agreements or pacts » within the meaning of the constitutional prohibition. If they have powers under their own laws, states are free to enter into « non-binding » agreements beyond their borders. The guidelines for coordination between the United States and Mexico on epidemiological events of common interest are not binding and serve as an example for this type of approach.19 Non-binding agreements can be useful to states, especially when they are interested in the exchange of information. However, in the absence of the protection offered by EMAC in the event of a declared emergency, concerns about legal liability, compensation and reimbursement would certainly require binding agreements prior to the sharing of equipment, supplies and personnel. Of course, states can go to Congress, individually or collectively, to seek approval for binding agreements that go beyond those currently approved by the EMAC. Alaska, Idaho, Oregon and Washington have received congressional approval for their Pacific Northwest Emergency Management Arrangement (PNEMA) with British Columbia and the Yukon Territory (Table 2▶). Six New England states signed an EMAC emergency management agreement with five provinces in eastern Canada in July 2000. , known as the International Emergency Management Assistance Memorandum of Understanding (IEMAC). 22 Despite the lack of authorization, IEMAC was actually used to share equipment during small events such as snow emergencies. The U.S. Constitution provides that « no state without congressional approval… to enter into an agreement or pact with another state or with a foreign power .

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. . . . . (Table 3▶).18 This provision clearly impairs the legal capacity of states to enter into mutual assistance agreements with each other or with Mexican states or Canadian provinces. In response to the growing recognition of the importance of mutual assistance agreements, the Public Health Law Program of the Centers for Disease Control and Prevention has made efforts to characterize the legal framework for mutual assistance. In particular, the programme collected information on mutual assistance and related laws for the categories of intergovernmental and international mutual assistance, systematically established and synthesized information, conducted basic complementary legal research, and evaluated and identified legal approaches to achieving effective mutual assistance. These efforts included meetings, follow-up and participation in the activities of several groups that participated, at the national level, in projects to improve state mutual assistance to other states or against other states in Mexico and Canada.

State cooperation and assistance across international borders is envisioned by the language of treaties in the United States,7 the Stafford Act,8 of funding from the U.S. Department of Health and Human Services (DHH) (S) for the development of international infectious disease surveillance systems,9 the structural involvement of states in the activities of the Mexican Border Commission10 and the Partnership for Security and Prosperity in North America (SPP). « 11 and the adoption of the International Health Regulations (Table 2▶-3▶).12 Following recent public health emergencies, many efforts have been made in the United States and in cooperation with officials in Canada and Mexico to identify and clarify legal issues related to the implementation of mutual assistance agreements and improve legal preparedness for public health emergencies.

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