GUIDELINES FOR INTER-HOSPITAL MUTUAL AID RESPONSE

LETTER AGREEMENT

The below listed Participants, by affixing their signature to this letter, agree in principal to voluntarily coordinate mutual aid services with each of the signatories in a good faith effort to minimize risk to patient care and hospital operations in the event of a disaster.

Brattleboro Memorial Hospital
Brattleboro Retreat
Central Vermont Medical Center
Copley Hospital
Dartmouth Hitchcock Medical Center
Fletcher Allen Health Care
Gifford Medical Center
Grace Cottage Hospital
Mt. Ascutney Hospital & Health Center
North Country Hospital
Northeastern Vermont Regional Hospital
Northwestern Medical Center
Porter Medical Center
Rutland Regional Medical Center
Southwestern Vermont Medical Center
Springfield Hospital
V.A. Medical & Regional Office Center

I. SCOPE AND APPLICABILITY

The Participants agree that in the event of a disaster affecting hospital services as a result of natural or technological causes or a mass casualty incident (hereinafter "Disaster") which impacts the operational capabilities of any other Participant, the affected Participant may request assistance from the other Participants as is more generally set forth herein.

In the event of a disaster, an affected Participant should first contact ___________and ____________ (Partner Hospitals). If the disaster is broader than the Partner Hospitals determine that they can handle by working together, then they will contact the state Emergency Operations Center ("EOC"). The Partner Hospitals and the EOC will use the guidelines established herein to coordinate the care and services necessary to deal with the disaster.

Participants shall agree to take all appropriate actions during a disaster without regard to race, color, creed, national origin, age, sex, religion, or handicap, to assist its Partner Hospital and other Participants as necessary. No Participant shall be required to provide treatment, care, medical supplies, equipment, services or personnel over and above that which is necessary to meet its own needs, existing or anticipated, or beyond its own resources.

In the event of a disaster, each of the Participants agree to provide assistance as set forth herein, at their sole cost and expense for a period to be determined by the affected Participant’s Command Center based upon the needs of affected Participants.

In the event that the affected Participant is unable to continue patient care for some or all of its patients, the Participants agree to act as receiving facilities for these patients. The Command Center of affected Participants will coordinate the transfer of patients and will assign them to the other Participants’ facilities.

Each Participant agrees to follow the guidelines set forth herein to the extent possible. There shall be no cause of action or basis of liability for breach of this Agreement.

This Agreement is not intended to replace each facilities disaster plan or to adversely effect existing transfer agreements between facilities, but is intended to support those plans and agreement.

II. GUIDELINES

EMERGENCY TREATMENT CARE

Each Participant agrees to provide assistance to Partner Hospitals and other Participants, including:

  1. Accept as many casualties as possible.
  2. Accept as many transfers as possible.
  3. Provide emergency treatment/care within the capabilities of the facility.
  4. Provide emergency physician and medical support services.
  5. Provide diagnostic services as available.
  6. Assist in placing casualties/transfers in partner hospitals.
  7. Provide transportation as available and requested.
  8. Notify the Participants when vacancies no longer exist.
  9. Provide medical record for patient transferred/received (copy acceptable if time permits.)
  10. Provide other medical services that may be necessary and requested.

 

2.    EMERGENCY MEDICAL SUPPLIES AND EQUIPMENT

    Provide emergency medical supplies and equipment within resource capabilities.

3.    COST OF SERVICES, EQUIPMENT AND PERSONNEL

    A Participant receiving services, equipment and personnel, will reimburse the cost of same to the Participant providing services, equipment and personnel.

4.     COMMUNICATION SERVICES

In the event the Participants’ normal lines of communication are disrupted, each Participant will:

  1. Monitor Emergency Room Radios for emergency information transmitted.
  2. Notify local fire, police and other municipal services.
  3. Provide emergency communication equipment, if available, to the effected municipal services and/or Partner Hospitals.
  4. Request support from Emergency Operations Center.

5.    ADMINISTRATIVE SERVICES

Participants will provide the following administrative services for themselves and will assist Partner Hospitals by:

    1.    Maintaining a current listing of all casualties or transfers made.
    2.    Maintaining a current listing of all discharges, their assigned areas and location.
    3.    Maintaining a current listing of all deaths.
    4.   Maintaining a record of all treatment administered, including medical supplies, or charges made.
    5.       Contact family members of patient/personnel and inform them of the disposition of each.
    6. Other information or record keeping, as may be requested or deemed necessary


6. EMERGENCY MEDICAL INFORMATION

Participants experiencing a disaster and seeking assistance will:

   1. Notify Partner Hospitals of the disaster, and that casualties, if any, and/or transfers are being made, or will be made.
   2. Provide all medical information and/or records as necessary or requested.
   3. Coordinate emergency transportation as necessary or requested.
   4.   Maintain a current listing of all patients and/or personnel and the disposition of each.
   5. Assign medical personnel as requested.
   6. Notify the attending physicians of the disaster and the disposition of their patients.
   7. Notify Partner Hospitals when the disaster is over.
   8. Provide or coordinate other services/duties that may be necessary or requested.


7.    MISCELLANEOUS

1.    The Participants agree to notify the Partner Hospitals when patients or personnel can be returned to their facility.
2.    Transportation shall be provided by the Participant receiving assistance when transfers are being made to return patients to the Participant’s facility.
3.    Necessary supplies and equipment requested by the Partner Hospitals shall be coordinated by the Participants and delivered.
4.    Each Participant shall implement an individual disaster plan consistent with the principles agreed to herein.

8.    APPENDED MATERIALS

The materials attached in Tabs 2 through 8 provide additional information to assist each Participant in requesting or providing disaster aid services. Tab 8 provides definitions and clarification of procedures relative to this Letter Agreement.

 

III. EFFECTIVE DATE, FUTURE AMENDMENT AND CONSTRUCTION

This Letter Agreement shall become effective on ____________________, and shall continue in effect indefinitely, except that a Participant may terminate its participation in this Letter Agreement by giving a sixty (60) day written notice to the other Participants of its intentions.

This Letter Agreement shall be reviewed periodically. It may be amended upon the agreement of a two thirds majority of then current Participants.

This Agreement is in no way meant to affect any of the Participants’ rights, privileges, titles, claims, or defenses provided under federal or state law or common law.

IN WITNESS WHEREOF, we have set our hands and seals that dates below written.

___________________________________________

Health Care Institution

___________________________________________

Chief Executive Officer

____________________________

Date

Attest:

 

 

 

 

 

 

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