Because the MAA and other states resolve state law issues related to the sharing of supplies, equipment and personnel in undeclared emergencies, they can also serve as mechanisms to determine the best way to meet federal constitutional requirements. Particularly in the intergovernmental context, prosecutors could examine the case law that defines the “Compact” clause with respect to interstate agreements, to determine whether states have more leeway in relation to such agreements than in the case of agreements with foreign governments. The case law suggests that binding agreements may be valid without congressional approval if they do not enter the power of the federal government or if they do not alter the political balance between states and the federal government25.25 The Stafford Act provides an abbreviated way to obtain congressional approval on intergovernmental agreements. Congressional approval is deemed granted 60 days after the transfer of an intergovernmental agreement to the two houses. Refusal or revocation of congressional approval is permitted at any time.23 Given that states conclude that their existing laws permit entry into mutual aid agreements or that they pursue new laws to obtain such authority, there should be a concerted effort to share and maximize the knowledge gained between states. Similarly, strategies to meet the constitutional requirements of the federal state should be pursued jointly. Non-binding agreements can be a convenient way to exchange health information. However, liability, compensation and reimbursement issues related to the distribution of supplies, equipment or personnel (in the event of an undeclared emergency outside the EMAC) can only be dealt with effectively in mutual assistance agreements that create binding obligations for the parties. States may be comfortable concluding binding agreements drawn up taking into account existing judicial interpretations of the compact clause or useful proposals from the Department of Foreign Affairs.
Or, like EMAC and PNEMA, states may decide to seek congressional approval for binding agreements. The Congress agreement on PNEMA (particularly if IEMAC subsequently obtains approval), coupled with the Confederation`s strong promotion of state mutual assistance, suggests that congressional approval of an international EMAC agreement covering all states along the borders between the United States, Canada and Mexico could be possible. In response to the growing recognition of the importance of mutual assistance agreements, the Public Health Law Program of the Centers for Disease Control and Prevention has made efforts to characterize the legal framework for mutual assistance.