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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)
4
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
5
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.
8
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)
9
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
11
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.
12
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).
13
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
15
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
17
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
19
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.
20
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.
21
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.
22
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/
23
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: [email protected]
APPENDIX
26
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
27
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
28
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
29
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
30
HIHIAKAK
CACA
OROR
WAWA
IDID
MTMT
TXTX
SDSDWYWY
NVNV
OKOK
KSKS
NENE
COCO
NMNMAZAZ
UTUT
NDND
SCSC
MNMN
WIWI
IOIO
MOMO
ARAR
LALA
VAVA
NCNC
GAGA
FLFL
ALALMSMS
ILILWVWV
KYKY
TNTN
NYNY
PAPA
ININ OHOH
MIMI
DEDENJNJ
CTCTRIRI
MAMA
MEME
DCDCMDMD
NHNHVTVT
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
31
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.