The Acute Care Hospital Emergency Surge Project

(ACHES)

Jane RichterACHES Project Coordinator

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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) 898-4472 derricds@dhec.sc.gov

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ESAR-VHP ProgramESAR-VHP ProgramA 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.

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Goal of the ESAR-VHP Program

Resolve in advance significant problems encountered when utilizing the services of volunteers in complex emergency response situation.

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The ESAR-VHP ProgramThe ESAR-VHP Program in South Carolina in South Carolina

Here known as the South Carolina Emergency Registry of Volunteers (SCSERV)

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South Carolina Emergency South Carolina Emergency Registry of Volunteers Registry of Volunteers

(SCSERV)(SCSERV)

• Now that SCSERV has been established . . ., how do we organize the volunteers?

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Medical Reserve Corps Medical Reserve Corps (MRC)(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.

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SC Medical Reserve SC Medical Reserve CorpsCorps

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MRC Training MRC Training RequirementsRequirements

Orientation to MRC UnitIS 100 and IS 700 (formerly ICS

100 & 700)DHEC OSHA trainingDHEC HIPAA trainingSpecialized trainings, for example:

◦Special Medical Needs Shelters◦Points of Dispensing◦Epidemiology Teams

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So we’ve got it going for So we’ve got it going for public health, now what public health, now what about hospitals?about hospitals?Grant written in spring, 2010 and

funded in fall, 2010.Gave rise to the Acute Care

Hospital Emergency Surge Project.

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ACHES ProjectACHES ProjectI. Goal

Expand SC ESAR-VHP Program to facilitate acute care hospitals’ ability to utilize volunteers to increase hospital surge capacity

II. ObjectivesIdentify and address surge capacity needs of:1) acute care hospitals2) individual volunteers3) ESAR-VHP database system

III. OutcomeRegistered volunteers verified, credentialed, and prepared to augment hospital surge capacity!

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ACHES Progress to DateACHES Progress to DateYear 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.

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Training Workgroup Training Workgroup (to prepare volunteers)(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.

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Levels of VolunteersLevels of VolunteersLevel 1: actively employed in a hospital or

has hospital privilegesLevel 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)

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SCSERV WorkgroupSCSERV Workgroup(to prepared website & (to prepared website &

database to accept “hospital” database to accept “hospital” volunteers)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

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SCSERV WorkgroupSCSERV WorkgroupAdded the following occupations to the SVSERV

database:Biomedical Engineer Certified Nursing AssistantEmergency Management staff Environmental Services staffFacility Management staff Infection Control staffLanguage Interpreters Material Management staffOccupational Therapist Physical TherapistPlant Operations staff Safety staffSecurity staff Speech Therapist

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Volunteer Protections Volunteer Protections WorkgroupWorkgroup

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?

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This Has Been Worked Out This Has Been Worked Out forfor

A DHEC VolunteerA DHEC VolunteerThe 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 providedNo mention of treatment for injury

or sickness22

If A Hospital Mobilizes a If A Hospital Mobilizes a VolunteerVolunteerMay or may not provide

treatment for injury or sicknessMay or may not provide

professional liability coveragePossibly/probably won’t provide

reimbursement for lost wages

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Volunteers Need to Be Volunteers Need to Be Aware!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.

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Ask Questions, Demand Ask Questions, Demand AnswersAnswers

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.

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ACHES Year 3 TasksACHES Year 3 TasksConvene a workgroup comprised of:

◦Hospital Human Resources staff◦Hospital Risk Managers◦Hospital Emergency Managers◦SC Hospital Association staff◦SC DHEC staffto design an educational campaign

directed at hospitals so that they determine what coverage/protections they will provide to volunteers before an event happens.

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ACHES Year 3 TasksACHES Year 3 TasksRecruit volunteers interested in

providing support for hospitalsWork 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 roles27

ACHES Year 3 TasksACHES Year 3 TasksBased 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.

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Dr. Jane RichterDr. Jane RichterUSC Center for Public Health USC Center for Public Health PreparednessPreparedness1233 Washington Street, Suite 7001233 Washington Street, Suite 700Columbia, SC 29201Columbia, SC 29201803.606.1391803.606.1391jane.richter@sc.edujane.richter@sc.edu

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