Nebraska Gov. Mike Johanns announced that Nebraska will designate a portion of next year's federal bioterrorism grant to begin an aggressive effort to develop a 10-state alliance to provide mutual aid in the event of an act of bioterrorism or other public health emergency.

"Mutual aid agreements would vastly increase our response capability by pulling our region together to share expertise and resources in the event of an emergency," Gov. Johanns said. "The interest expressed by our neighboring states leads me to believe the time is now to pursue this effort. Nebraska is already attracting national attention for our collaboration in the public health arena, now we'll extend that effort across state lines."

The governor made the announcement after speaking at a four-state meeting being hosted by Nebraska to discuss bioterrorism collaboration. The other states attending are Iowa, Kansas and Missouri. The 10-state alliance would also include North Dakota, South Dakota, Wyoming, Colorado, Utah, and Montana.

These mutual aid agreements would constitute the first large-scale, jointly coordinated regional public health agreements of their kind in the nation. The concept has been approved by state health officials in all ten states.

Charles A. Schable, Director of the Office of Terrorism Preparedness and Emergency Response in the federal Centers for Disease Control and Prevention (CDC), also addressed the four-state conference and met with bioterrorism preparedness officials from the Nebraska Health and Human Services System (HHSS). The CDC encouraged Nebraska to develop an interstate mutual aid prototype that could benefit other states.

"I am impressed by Nebraska's energetic approach to this project," Schable said. "Interstate mutual aid agreements could prove to be invaluable in the event of a public health emergency so we enthusiastically support their development. I applaud Nebraska for taking a leadership role and I will watch with interest this region's progress."

Key components of the mutual aid agreements would include sharing of qualified personnel, laboratory capacity, communications, and epidemiological capacity. Issues include cost sharing, liability concerns, deployment of resources, determination of priorities, and others.

Richard Dunn, the director of the Missouri Department of Health and Senior Services, said, "Public health emergencies do not respect geographical or political boundaries. It will take a united effort by state public health systems to effectively meet our legal and moral obligation to protect our citizens."

Gov. Johanns approved $200,000 of Nebraska's bioterrorism funding from the CDC to support the 10-state effort. The University of Nebraska Medical Center (UNMC) committed an additional $50,000. The proposal includes establishment of the Mid-America Demonstration Center for Public Health Preparedness at UNMC. The center would facilitate the establishment of the mutual aid agreements and develop a prototype for a public-health response system, based on Nebraska's model. A concept paper for the center has been drafted and additional funds will be sought to develop the center.

Emergency medical agreements currently exist for governor-declared emergencies that meet federal requirements, but there are no agreements or protocols that govern interstate cooperation in situations that do not rise to the level of federal emergencies.