Health-Care Coalitions (HCCs) provide an important emergency response safety net function across the United States in preparedness and responses to disasters. A key challenge is the variation in the maturity and operational readiness of HCCs. The purpose of this study was to identify key tenets that define high-functioning HCCs and help mature HCCs into a higher-functioning state of operations.

This was a qualitative study based on grounded theory methodology using semi-structured interviews for data collection and thematic analysis. Participants were stakeholders (n = 39) of HCCs from across the United States at local, state, and federal levels.

Through an institutional logics lens, the 3 key attributes for high functioning-HCCs were identified as (1) having an established and growing partnership, (2) being value-driven culture, and (3) being response ready. In addition, 3 logics were deemed essential for guiding HCCs: sources of governance, sources of partner engagement, and sources of sustainability. Participant responses describe the importance of these attributes and logics in influencing decision-making processes, supporting a community’s resilience during a disaster, and fostering robust relationships among community partners.

Addressing these attributes and logics in planning and management of HCCs can help establish the foundation for partner collaborations and high-functioning HCCs.