The Acute Care Hospital Emergency Surge Project (ACHES) Jane Richter ACHES Project Coordinator 1

Emergency System for Advance Registration of Volunteer Health Professionals and the Medical Reserve Corps Deborah S. Derrick ESAR-VHP/MRC Coordinator Office of Public Health Preparedness (803)

ESAR-VHP Program A national program to help health professionals volunteer during emergencies Consists of an interoperable network of systems across the U.S. and maintained by the states to verify credentials BEFOREHAND! States must build their systems to a single set of Emergency Credentialing Standards and definitions so that volunteers can be shared and utilized across state lines. 3

Goal of the ESAR-VHP Program Resolve in advance significant problems encountered when utilizing the services of volunteers in complex emergency response situation. 4

The ESAR-VHP Program in South Carolina Here known as the South Carolina Emergency Registry of Volunteers (SCSERV) 5

South Carolina Emergency Registry of Volunteers (SCSERV) Now that SCSERV has been established..., how do we organize the volunteers? 6

Medical Reserve Corps (MRC) MRC mission is to engage volunteers in order to strengthen public health and medical response and community resiliency. Each MRC is designed to meet local community’s needs. MRC units undergo training, participate in exercises, and help educate the local community. 7

SC Medical Reserve Corps 8

MRC Training Requirements Orientation to MRC Unit IS 100 and IS 700 (formerly ICS 100 & 700) DHEC OSHA training DHEC HIPAA training Specialized trainings, for example: ◦ Special Medical Needs Shelters ◦ Points of Dispensing ◦ Epidemiology Teams 9

Volunteer Health Requirements SCSERV functions as a screening tool to ensure volunteers are assigned appropriately. Asks about: ◦ Medical History ◦ Allergies ◦ Bloodborne Pathogens & HIPAA trainings ◦ PPE Fit testing ◦ Vaccinations ◦ TB testing 10

ONGOING… Badging/IDs for volunteers Recruitment especially for volunteers willing to support hospitals Training & Exercising Policies & Procedures Legal Protections IT Development of SCSERV webpage and database 11

So we’ve got it going for public health, now what about hospitals? Grant written in spring, 2010 and funded in fall, Gave rise to the Acute Care Hospital Emergency Surge Project. 12

ACHES Project I. Goal Expand SC ESAR-VHP Program to facilitate acute care hospitals’ ability to utilize volunteers to increase hospital surge capacity II. Objectives Identify and address surge capacity needs of: 1) acute care hospitals 2) individual volunteers 3) ESAR-VHP database system III. Outcome Registered volunteers verified, credentialed, and prepared to augment hospital surge capacity! 13

ACHES Progress to Date Year 1: we planned! Year 2: we divided and conquered in order to problem-solve! ◦ Training Workgroup (to prepare volunteers) ◦ SCSERV Workgroup (to prepare database to accept volunteers willing to support hospitals) ◦ Volunteer Protections Workgroup (to prepare hospitals to mobilize & use volunteers) Year 3: we will continue to problem solve and we will test our plans and processes. 14

Training Workgroup (to prepare volunteers) With representation from hospitals, SC Hospital Association and DHEC, developed a training matrix. Used levels of volunteers as the “x-axis” Identified trainings online that are reputable and current Made as few trainings “REQUIRED” as necessary to align with public health training requirements. 15

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Levels of Volunteers Level 1: actively employed in a hospital or has hospital privileges Level 2: clinically active in any setting other than a hospital Level 3: meets basic qualifications necessary to practice in the State in which registered Level 4: healthcare experience/education in an area useful in providing basic healthcare not controlled by scope of practice laws Level 5: passes the Inspector General check (this is a DHEC-generated level) 18

SCSERV Workgroup (to prepared website & database to accept “hospital” volunteers) Added hospital photos to collage on opening page of website Changed verbiage to include willingness to volunteer in support of hospitals and other healthcare entities, in addition to public health. Added information to Frequently Asked Questions sidebar differentiating legal protections available when volunteering for public health versus those provided (or not) by hospitals 19

SCSERV Workgroup Added the following occupations to the SVSERV database: Biomedical Engineer Certified Nursing Assistant Emergency Management staff Environmental Services staff Facility Management staff Infection Control staff Language Interpreters Material Management staff Occupational Therapist Physical Therapist Plant Operations staff Safety staff Security staff Speech Therapist 20

Volunteer Protections Workgroup We operated with the assumption that there are 3 major concerns of individuals when volunteering: 1.If I am injured, whose policy will take care of me? 2.If I am sued, whose professional liability policy will cover me? 3.If I am unable to work, who will cover my lost wages? 21

This Has Been Worked Out for A DHEC Volunteer The volunteer must sign a volunteer agreement that specifies that liability coverage will be provided while acting exclusively on behalf of DHEC and within the scope of practice as a volunteer No Workers’ Compensation provided No mention of treatment for injury or sickness 22

If A Hospital Mobilizes a Volunteer May or may not provide treatment for injury or sickness May or may not provide professional liability coverage Possibly/probably won’t provide reimbursement for lost wages 23

Volunteers Need to Be Aware! Check with your health insurer and other appropriate insurers to determine if they will cover you should you volunteer to assist during an emergency response. Check with your personal professional liability insurance carrier to determine if they will cover you should you volunteer to assist during an emergency response. 24

Ask Questions, Demand Answers The initial contact from the hospital, clinic, etc. offering you (begging you???) the opportunity to volunteer will be the time for you to ask questions as to whether or not any legal protections will be provided. Make an informed decision based on knowledge of risks and benefits. 25

ACHES Year 3 Tasks Convene a workgroup comprised of: ◦ Hospital Human Resources staff ◦ Hospital Risk Managers ◦ Hospital Emergency Managers ◦ SC Hospital Association staff ◦ SC DHEC staff to design an educational campaign directed at hospitals so that they determine what coverage/protections they will provide to volunteers before an event happens. 26

ACHES Year 3 Tasks Recruit volunteers interested in providing support for hospitals Work with an urban hospital & a rural hospital to exercise: ◦ Calling DHEC and requesting volunteers ◦ Obtaining the listing from DHEC and calling volunteers in to provide hospital support ◦ Badging, credentialing and privileging (as appropriate) the volunteers ◦ Assigning volunteers to roles 27

ACHES Year 3 Tasks Based on the After Actions Reports of the hospital exercises, revise: ◦ The training matrix ◦ The SCSERV website/database ◦ The educational information provided to hospitals about:  the process of working with DHEC to access a listing of volunteers, and  the need to determine beforehand what legal protections will be provided for volunteers serving on their behalf during emergencies. 28

Dr. Jane Richter USC Center for Public Health Preparedness 1233 Washington Street, Suite 700 Columbia, SC