By Andrew Bates, CSG Research Associate
As it has for the past 25 years, when disaster strikes in the U.S., the Emergency Management Assistance Compact (EMAC) empowers its 55 member states and territories to share their emergency response resources and personnel across state lines to assist impacted communities.
Originally conceived following Hurricane Andrew’s devastation of Florida in 1992 and administered by the National Emergency Management Association (NEMA), EMAC facilitates rapid, collective responses to disasters by working around the bureaucratic wrangling that is typically involved in any agreement between governments. It allows for workers’ credentials to be recognized across state lines and frees responding states from legal or financial burdens associated with providing resources and services to the affected states.
The COVID-19 pandemic presents a new challenge to EMAC’s member states and territories: all 55 members are concurrently and significantly impacted by the virus, severely limiting states’ capacities to share resources and emergency personnel.
“We’ve had a Gulf Coast incident, plus [coinciding] flooding on another coast, or volcanoes in Hawaii … but we’ve never had an event that has impacted every single member state,” said Angela Copple, EMAC coordinator with NEMA. “And as a result of that, states are not able to share personnel because they are needed at home.”
NEMA Deputy Director Matt Cowles said several challenges contribute to a slower rate of assistance.
“It could be, ‘I don’t want to give up today what I might need tomorrow,’ plus you’ve got the practical aspect of equipment or personnel needing to go through decontamination and quarantine after being part of an EMAC mission.”
However, some states are working to share resources when possible. On April 9, NEMA announced that California plans to send 500 ventilators to support those states facing shortages due to COVID-19. Additionally, two other states have been able to share personal protective equipment (PPE) and a public health incident management team to other states harder hit by the pandemic.
“When those ventilators are used to save lives in those other states, we have the firm commitment from those states to send them back to the state of California,” said California Gov. Gavin Newsom. “But we can’t just sit on assets when we can save lives and help our fellow Americans.”
“Governor Newsom’s recent decision to share 500 state-owned ventilators through EMAC highlights the value of interstate compacts and their ability to provide states an efficient and effective structure through which to share available resources,” said Edgar Ruiz, director of CSG West. “In doing so, states are better equipped to harness the spirit of mutual aid and deliver resources to citizens in need during an emergency. CSG West is a proud supporter of interstate compacts and their ability to foster state-to-state assistance and collaboration.”
As more states begin to see some success in containing the virus, Cowles hopes to see an increase in interstate sharing of resources and personnel.
“The perception is that this is all handled at the national level, with all things being equal across the country, but when you really start to dig deeper into the status of each state — when they’re due to peak, when they’re due to start flattening the curve — it really varies across the country, so I do think that you’ll see a tick up in available EMAC assistance as states start to get a handle on their own internal needs.”
Beyond the sharing of PPE and medical equipment, EMAC’s provisions for telehealth practice are allowing states to assist one another in meeting increased demand for medical services.
“One of the innovative things that we are doing right now for the pandemic is to use EMAC for telehealth across state lines. Because EMAC has a really, really strong licensure reciprocity law, you can use EMAC for licensure reciprocity for telehealth,” Copple said, pointing the example of an executive order issued April 8 by North Carolina Gov. Roy Cooper allowing for out-of-state medical professionals to serve patients via electronic means.
Cowles added that other than states’ obvious needs for medical equipment and personnel, EMAC’s member states are also dependent on a reliable exchange of information between the states and the federal government.
“The greatest needs for states, up to this point, are for information. They’re on a constant quest for information from [the Federal Emergency Management Administration], from the White House, any number of angles, to make sure that they’re appropriately effecting all of the programs that they have access to. NEMA assists them by making sure federal agencies are aware of those needs for information.”