Depending on incident circumstances, the Tier 2 coalition may elect to write a comprehensive incident action plan (IAP) that summarizes each participant's HCO IAP (Figure 3-1).[7] This is most likely to occur when the response will be drawn out over an extended period of time (days or weeks).
The Tier 2 coalition IAP developed for each operational period requires approval by each coalition member. The HCO mutual aid memorandum of understanding (MOU) is commonly a voluntary commitment (not a legal agreement) by each participating HCO to share information and provide available assistance in a major emergency or disaster. Additional issues are addressed in the American Hospital Association's template, Model Hospital Memorandum of Understanding.
Additional information on the key components of an incident action plan is provided in Appendix C. Districts should have an Emergency Management Plan in place in accordance with Senate Bill 11. This "Concept of Operations" establishes specific roles for faculty, site based teams and the district administrative teams.
Is based on the Incident Command System, the same emergency management system used by public safety agencies nationwide.

Comes as a complete package that includes software, background literature, lesson plans, simulations and training materials. For example, an HCO may grant or deny a request for mutual aid based on perceived ability to adequately maintain its own operations. In other cases, the coalition IAP may simply aggregate action plans from individual HCOs into a pre-designated format. Examples could include HCO action plans, initial and updated bed counts, patient volumes, and status of personnel, supplies, and equipment. Historically, this agreement allowed for the provision of emergency services, on a reciprocal basis, when individual resources were inadequate to deal with a specific incident. All school personnel, students, and parents should be made aware of the district's plan, who the team members are, and the roles and responsibilities of all persons involved. The plan's all-hazards approach gets you moving in the right direction no matter what type of incident is occurring. Action Guides are a one-page consolidation of the plan which leads district personnel through their roles in a crisis.

For example, the Emergency Medical Services System Act passed by Congress in 1973 identified mutual aid as one of fifteen essential components in the formation of EMS systems in the United States. The mutual aid system is not a replacement for any individual hospital's emergency preparedness plan; rather, it is meant as a supplement that will augment an institution's capabilities. For example, the coalition EOP might provide instructions on such issues as how to request and integrate mutual aid assets into an HCO's incident operations, and what designated communication methods to use between HCOs during response. Any event requiring activation of the mutual aid system is expected to be of a magnitude that it also involves municipal emergency services and the jurisdiction's department of public health.

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