Past collaborative experience was a key factor in interagency coordination. Agencies in areas that had been forced to respond jointly in the past were generally better positioned to work together, in large part because they had worked together before and knew each other's role. It was also found that the size of a country or jurisdiction affected coordination. Ireland, the United Kingdom, and even Canada all have the benefit of a smaller number of agencies requiring coordination. In contrast, the United States must coordinate responses with law enforcement, public health, and other first responder agencies, at Federal, State, and local levels. This study identified a number of promising models and mechanisms for interagency coordination. One of the basic principles of successful models is that communication among Federal, State and local agencies is a two-way street. One potential solution for improving the sharing of sensitive information is to give key public health staff a top secret security clearance. This can help eliminate the excuse that information cannot be shared because it is classified. Public health agencies need to develop written agreements with law enforcement that facilitates discussions in compliance with confidentiality laws and HIPAA. A third solution is to establish a common language for law enforcement officials and others in interagency planning and response development. Another solution is to engage as many concerned actors in the joint discussions as possible. Although significant communication and coordination gaps still exits, working together builds partnerships and promotes an understanding of each agency's requirements and roles. The coordination problem transcends subject matter areas as well as borders. The countries included in this study experienced a number of similar problems and successes. By examining coordination barriers and strategies across these countries, a wider range of solutions can be viewed. References
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