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Nonurban HealthCare Coalition

Health care coalitions are promoted as a method to prepare for and respond to incidents among diverse health care organizations within a geographic region.

Nonurban Missouri Healthcare Coalition map

Tiered, scalable and flexible coordination among varied HCOs will facilitate more effective, efficient and timely situational awareness and coordination of resources, resulting in an overall improved health care emergency response. The role of HCCs is to communicate and coordinate; HCCs do not replace or interfere with official command and control structure authorized by state and local emergency management.

Through effective vertical and horizontal planning integration, each HCC aspires to be recognized by its regional partners as having a formally defined and exercised role that is integrated into the state emergency operations plan to facilitate the communication and coordination of health care response during a disaster.

MHA facilitates health care emergency preparedness planning efforts in Missouri Planning Regions B, D, E, F, G, H and I, through one nonurban healthcare coalition.

The Mid-America Regional Council serves the Kansas City Metropolitan Area, and the St. Louis Area Regional Response System serves the St. Louis region.

The Nonurban Missouri HCC has a 20-person board that provides oversight and is comprised of health professional volunteers. Additional information on the purpose and structure of the coalition board is available.

HCC Membership

Member Agreement

For individuals interested in becoming a member of the Nonurban Missouri Healthcare Coalition, a Member Roles, Expectations and Participation Agreement must be signed. The signed agreement should be sent to the respective region MHA HCC Liaison. Organizations are asked to select the type of participating agency and provided a primary and alternate coalition representative. The signature of the agreement confirms the select member agrees to the terms and the member is an active signatory or has not opted out of a discipline-specific mutual aid agreement.

Governance Document

New members are encouraged to review the Governance Document, which provides information regarding the HCC’s mission, scope, organization, coalition boundaries and demographics. It also provides information on the Nonurban HCC Board that provides oversight of the HCC.

HCC Plans and Annexes

Burn Annex

The Burn Annex provides the framework for the Nonurban Healthcare Coalition to respond to burn incidents among diverse health and medical entities supporting ESF-8 functions with the coalition’s boundaries.

Continuity of Operations

The Continuity of Operations Plan provides the framework to support the response plan and guide the Nonurban Missouri Healthcare Coalition to return to routine operations and response capabilities for all-hazard incidents among multiple disciplines supporting ESF-8 functions within the coalition’s boundaries.

Infectious Disease Annex

The Infectious Disease Annex provides the framework for the Nonurban Healthcare Coalition to respond to infectious disease incidents impacting ESF-8 organizations and their supporting partners in the nonurban HCC boundaries. This annex aims to improve the capacity and capabilities to manage a small number of patients with high-consequence pathogens or a large number of patients during a major epidemic or pandemic.

Pediatric Annex

The Pediatric Annex provides the framework for the Nonurban Healthcare Coalition to facilitate appropriate pediatric response measures and create a common operating picture, as well as coordinate and deconflict response strategies, support communication, and share information.

Preparedness Plan

The Emergency Preparedness Plan was drafted in 2018, and updated in June 2022, to provide a framework to guide the Nonurban Missouri Healthcare Coalition to prepare for and respond to incidents among diverse health and medical entities supporting ESF-8 functions.

Response Plan

The Response Plan provides the framework to support the preparedness plan and guide the Nonurban Missouri Healthcare Coalition to respond to all-hazard incidents among multiple disciplines supporting ESF-8 functions within the coalition’s boundaries.



MOSWIN is the statewide interoperable communications platform for mission-critical, life and public safety communications. MHA has developed a MOSWIN Standard Operating Guide for the health care coalitions.

The Statewide Interoperability Network serves two primary functions:

  • Providing internal communications capabilities for state agencies, including the Missouri State Highway Patrol, Department of Natural Resources and State Emergency Management Agency.
  • Providing a statewide interoperability platform and access for local agencies to achieve interoperable communications with local, state, regional and federal agencies.

For more information about MOSWIN, visit the official website of the Missouri Statewide Interoperability Network.


A complete list of the regional assets also are available on the MO Mobile Medical Assets View in EMResource.


MHA, through a subcontract with the Missouri Department of Health and Senior Services, serves as the fiduciary agent and program manager for the nonurban HCC of Missouri. In this role, MHA staff provide guidance and support for coalition planning, training and exercises to meet Hospital Preparedness Program performance measures.

HPP Coalition Medical Response and Surge Exercise

MHA facilitates the exercise planning for the HPP coalition medical response and surge exercise requirement. Taking into consideration that hospitals and other coalition members have individual exercise and training requirements, these coalition exercises are developed to reduce additional exercise burden where possible. The coalition chooses to expand their coalition surge exercise to assist members to meet individual regulatory or accreditation requirements, the additional exercise planning components would be the responsibility of the individual hospital or health care organization seeking those additional compliance metrics.

To assist all HCC members with further understanding the HPP coalition surge exercise that they may elect to participate in, the following guidance is available.

Redundant Communication Drills

MHA coordinates bi-annual redundant communication drills, which usually are conducted in February and August. The drills simultaneously test the functionality of MOSWIN radios, as well as the response through eICS. These drills allow the nonurban HCC to identify any necessary trainings based on identified gaps, as well as programming improvements for future mitigation. It is the goal to have all hospitals, public health agencies, emergency management directors and EMS who have MOSWIN radios to participate in the drills. For more information, contact Carissa Van Hunnik.

Annex Tabletop

MHA coordinates a yearly tabletop for a functional annex of the response plan. Below outlines the schedule for the development of the annexes, as well as the exercise time frame. Based on the annex, the appropriate subject matter experts and HCC partners are asked to engage in the planning and execution of the exercise. For more information, contact Keri Barclay.

  • Pediatric – June 2020 (Annex coming soon. The exercise was waived due to real-world COVID-19 event.)
  • Infectious Disease – Exercised by June 2021
  • Burn – Exercised by June 2022
  • Radiation – Exercised by June 2023
  • Chemical – Exercised by June 2024

Clinical Advisor & Northwest Region Liaison

Keri Barclay

Keri Barclay

Manager of Clinical Preparedness/Coalition Administrative Liaison

Send Email

573-893-3700 | ext. 1407

Northeast Region Liaison

Carissa Van Hunnik

Carissa Van Hunnik

Manager of Emergency Preparedness/Coalition Administrative Liaison

Send Email

573-893-3700 | ext. 1329

Central & Southeast Region Liaison

Kara Amann Kale

Kara Amann-Kale

Director of Hospital Preparedness Programs

Send Email

573-893-3700 | ext. 1402

Southwest Region Liaison

Robert Loseman

Robert Loseman, Jr.

Vice President of Safety and Preparedness

Send Email

573-893-3700 | ext. 1305

Decontamination Centers

MHA has facilitated the development of regional decontamination training centers in six nonurban Missouri communities to assist health care providers with meeting operations-level decontamination training for front-line staff.


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