Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP)

Program Overview and Benefits of Integrating ESAR-VHP and the Medical Reserve Corps

2005 Annual Medical Reserve Corps National Leadership Conference

April 21, 2005

Health Resources and Services AdministrationHealthcare Systems Bureau

Division of Healthcare PreparednessESAR-VHP Program

Marilyn Biviano, Director, ESAR-VHP

2

Presentation Overview

• Background of ESAR-VHP Program and Technical and Policy Guidelines Standards and Definitions (Guidelines)

• Guidelines – how they are being developed, tested and implemented

• ESAR-VHP Credentialing & Resource Typing– Benefits of Advance Credentialing

• Benefits of Integrating MRC and ESAR-VHP

• ESAR-VHP Reports, Papers and Tools

• Appendix

3

Background of ESAR-VHP Program and Technical and Policy

Guidelines, Standards and Definitions (Guidelines)

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ESAR-VHP Legislative Mandate

• Public Law—PL 107-188, directs the development of (State based) Emergency Systems for Advance Registration of Volunteer Health Professionals, or ESAR-VHP. 1/

• Health and Human Services (HHS) has delegated the ESAR-VHP development to the Health Resources and Services Administration (HRSA).

1/ Public Law—PL 107-188, Public Health Security and Bioterrorism Preparedness and Response Act of 2002, Section 107

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Health care personnel surge capacity is ESSENTIAL!

Physical Surge Capacity

(e.g. Hospitals)(NBHPP)

Health Care Personnel

Surge Capacity(ESAR-VHP and MRC)

+ =Health care

PreparednessTraining

(NBHPP & BHPr)

+

6

Building a State-based National System

• State ESAR-VHPs must be built to national standards and definitions so that they can be shared and utilized across State lines.

• Credentialing (verification of qualifications) and DHS National Incident Management System (NIMS) Resource Typing is at the core of developing a National system.

Guidelines—how they are being developed, tested and

implemented.

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STATE

ESAR-VHP

ESAR-VHP Essential Partners

PROFESSIONAL ASSOCIATIONS & ORGANIZATIONS

• Health Professional

Assoc. (AMA, ANA)• JCAHO• AHA • NCSBN• FSMB• ABMS• Red Cross

FEDERAL PARTNERS

• Medical Reserve Corps• Federal• CDC• HHS• DHS• FEMA• USPHS Readiness

Corps• Citizen Corps

HRSA Technical and Policy Guidelines, Definitions & Standards

STATE NBHPP Grantees (62)

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The Guidelines cover the entire spectrum of advance registration, development and operation features.

Massachusetts Operations and Maintenance

District of Columbia National Working Group Chair

Ohio Data Definitions and Naming Conventions

Illinois Funding and Cost

Connecticut Recruitment and Volunteer Advocacy

Texas Training

Missouri Regionalizing and Nationalizing the ESAR-VHP Project

California Authorities and Emergency Operations

Wisconsin Security, Privacy, and Communications

MinnesotaCredentialing and NIMS Resource Typing

West Virginia System Design and Content

State ChairIssue Topic

Each Issue Topic is supported by a national working group

ESAR-VHP Credentialing and Resource Typing

• Credentialing, Privileging and National Incident Management System (NIMS) Resource Typing

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Credentialing, Privileging, and NIMS Resource Typing

Credentialing is the process of obtaining, verifying, and assessing the qualifications of a health volunteer.

Resource Typing Within the ESAR-VHP program, resource typing is a uniform process of classifying a health care volunteer based on verified credentials and consistent with the NIMS credentialing system.

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Benefits of Advance Credentialing and Resource Typing of Emergency Medical

Volunteers

• Reduces credentialing burden for emergency care delivery, e.g., hospitals.

• Allows scarce specialist resources to be allocated according to need (e.g., orthopedic surgeon, anesthesiologist, thoracic surgeon).

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Benefits of Advance Credentialing and Resource Typing Emergency Medical

Volunteers, cont.

• Credentials standards and verification and resource typing will permit volunteers to be used at the highest possible level.– Building “hospital ready” volunteer workforce

• Resource typing (based on credentialing standards):– facilitates intra and interstate sharing of scarce

medical volunteers.

Benefits of Integrating the MRCs and State ESAR-VHPs

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Benefits of Integrating MRC and State ESAR-VHP

• Precious health profession volunteer resources are maximized and coordinated.

• Integration may reduce MRC operation cost, for example, cost of verifying volunteer’s credentials.

16

Benefits of Integrating MRC and State ESAR-VHP, cont.

• MRC volunteer may be eligible (through ESAR-VHP) for benefits under state declared emergency authorities

– malpractice liability protection

– workmen’s compensation

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Benefits of Integrating MRC and State ESAR-VHP, cont.

Integration provides for a seamless linking of State and local medical volunteer emergency response efforts that will:

– Reduce emergency response time,

– Increase capability to respond to bigger emergencies within a state, and

– Enable interstate responses—EMAC is a state-to-state response.

ESAR-VHP Reports, Papers, and Tools

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ESAR-VHP Reports, Papers, and Tools:

• Interim Technical and Policy Guidelines, Standards, and Definitions—A “Handbook” that provides a set of recommendations and approaches for developing, implementing, and maintaining an ESAR-VHP system. (Available Soon)

• Legal and Regulatory Issues—Examines and summarizes areas of law relevant to ESAR-VHP, such as emergency declarations, licensing, credentialing, liability and workmen’s compensation issues.

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ESAR-VHP Reports, cont:

• Hospital Implementation Issues and Solutions Focus Group Meeting Report—Identifies and assess hospital issues as they relate to the development and implementation of an ESAR-VHP system.

• Will the States’ ESAR-VHP Build Adequate Hospital Personnel Surge Capacity—A White Paper that discusses the options for credential verification of health professionals and the implications of not meeting hospital level verification standards.

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ESAR-VHP Reports, cont:

• ESAR-VHP Legal and Regulatory Issues Draft Toolkit – Provides information, contacts, and resources to help you assess of many of the legal issues that may arise during implementation of your States ESAR-VHP system. Includes, among other items, a checklist and model documents.

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Easy to use registration tool will allow MRCs to collect the information needed to verify credentials and assign resource types to volunteers.

MRC Credentialing Portal Pilot

http://www.esarvhp.com/mrc/

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Please visit the ESAR-VHP & MRC Project Table to learn more about:

ESAR-VHP & MRC integration plans MRC Credentialing Portal Project

ESAR-VHP will also be discussed in the following presentations later today:

Integrating MRC and ESAR-VHP across Minnesota Database and Reporting Options for Local MRCs, Jeff

Reilly, Westchester County MRC

MRC Credentialing Portal Pilot

Additional Information

Marilyn Biviano, Director ESAR-VHP

HSB, Division of Healthcare Preparedness

Room 13C-105

5600 Fishers Lane

Rockville, MD 20857

Email: mbiviano@hrsa.gov

APPENDIX

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Credentialing and Resource Typing High Priority Occupations

High Priority Health Occupations

Physicians and Surgeons Radiologic Technologists & TechniciansPsychologists Surgical TechnologistsRegistered Nurses Medical and Clinical Lab TechniciansAdvance Practice Nurses Medical and Clinical Lab TechnologistsPhysicians Assistants Diagnostic Medical SonographersDentists Marriage & Family TherapistsEMTs and Paramedics Medical & Public Health Social WorkersPharmacists Mental Health & Substance Abuse Social WorkersLicensed Practical Nurses Mental Health CounselorsRespiratory Therapists VeterinariansCardiovascular Techno. and Techni.

Bold = Draft Resource Typing Completed

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Timeline for State-Based ESAR-VHP2004-2006

ESAR-VHP Focus group

meeting

Develop Guidelines and common definitions and assess hospital, liability, and other key implementation issues.

May2004

Develop baseline number of ESAR-

VHP providers (update annually)

NBHPP FY04 Supplement to 30 States to pilot guidelines and

develop systems

*Remaining NBHPP awardees supplemental approved but unfunded

2nd ESAR-VHP Focus Group

Meeting

Jan.2005

Complete Interim

Guidelines, issue analysis

& best practices

Nov.2004

Sept. 2004

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July2005

Dec.2005

10 ESAR-VHPsystemsinitiated

Timeline for State-Based ESAR-VHP

2004-2006, cont’d

June2005

Pilot test Guidelines in 10 States and refine Guidelines

Sept.2005

NBHPP FY 05 Award to 32

States to develop systems.

Provide technical assistance to 20 States. Conduct regional focus and technical assistance meetings and refine Guidelines

30 (Total) ESAR-VHPs initiated. Guidelines revised.

Jan.2005

ESAR-VHP Focus Group

Meeting

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Jan.2006

Dec.2006

Timeline for State-Based ESAR-VHP

2004-2006, cont’d

Provide technical assistance to remaining (32) States and jurisdictions in development of their ESAR-VHP. Conduct regional focus and technical assistance meetings and refine Guidelines

.

June2006

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PR - PR - (Puerto Rico)(Puerto Rico)VI - VI - (U.S. Virgin Islands)(U.S. Virgin Islands)

PHASE IIIPHASE III

PHASE IPHASE I

PHASE IIPHASE II

Phases of ESAR-VHP Development and Technical Assistance

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Credentialing, Privileging, and NIMS Resource Typing of Physicians

Physician Type 1 Status Physician A Physician B Unencumbered License Verified New York Degree Verified M.D.—U. of IL Certification (ABMS Specialty) Verified Orthopedics Active Clinical Practice (Patient Care) Not Required Yes National Practitioner Databank Status Verified No Actions DEA License Verified Yes Inspector General Status Verified No CMS actions Active Clinical Privileges (Hospital) Verified Yes/ Montifiore Physician Type 2 Status Unencumbered License Verified Degree Verified Certification (ABMS Specialty) Verified Active Clinical Practice (Patient Care) Verified Active Clinical Privileges (Hospital) Indeterminate National Practitioner Databank Status Verified DEA License Verification Verified Inspector General Status Verified Physician Type 3 Status Unencumbered License Verified Degree Indeterminate Certification (ABMS Specialty) Indeterminate Active Clinical Practice (Patient Care) Indeterminate Active Clinical Privileges (Hospital) Indeterminate National Practitioner Databank Status Indeterminate DEA License Verification Indeterminate Inspector General Status Indeterminate Physician Type 4 Verification Unencumbered License Indeterminate VT--unverified Degree Indeterminate NYU-unverified Certification (ABMS Specialty) Indeterminate Unknown Active Clinical Practice (Patient Care) Indeterminate Unknown Active Clinical Privileges (Hospital) Indeterminate Unknown National Practitioner Databank Status Indeterminate Unknown DEA License Verification Indeterminate Unknown Inspector General Status Indeterminate Unknown

Initial Guidelines focus on credentialing requirements for physicians, registered nurses, and behavioral health professionals 1/. We will expeditiously add additional professions.

1/ Psychologists, medical and public health social workers, mental and substance abuse social workers, marriage and family therapists and clinical mental health counselors.