Health Resources and Services Administration Healthcare Systems Bureau

1. Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP)Program Overview and Benefits of Integrating ESAR-VHP and the Medical Reserve Corps2005 Annual Medical Reserve Corps National Leadership ConferenceApril 21, 2005 Health Resources and Services Administration Healthcare Systems Bureau Division of Healthcare Preparedness ESAR-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 Preparedness + + Training (NBHPP & BHPr) =

6. Building a State-based National System • StateESAR-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.

7. Guidelines—how they are being developed, tested and implemented.

8. ESAR-VHP Essential Partners • FEDERAL PARTNERS • Medical Reserve • Corps • Federal • CDC • HHS • DHS • FEMA • USPHS Readiness • Corps • Citizen Corps PROFESSIONAL ASSOCIATIONS & ORGANIZATIONS • Health Professional Assoc. (AMA, ANA) • JCAHO • AHA • NCSBN • FSMB • ABMS • Red Cross STATE NBHPPGrantees (62) STATE ESAR-VHP HRSA Technical and Policy Guidelines, Definitions & Standards

9. Issue Topic State Chair System Design and Content West Virginia Credentialing and NIMS Resource Typing Minnesota Security, Privacy, and Communications Wisconsin Authorities and Emergency Operations California Regionalizing and Nationalizing the ESAR-VHP Project Missouri Training Texas Recruitment and Volunteer Advocacy Connecticut Funding and Cost Illinois Data Definitions and Naming Conventions Ohio Operations and Maintenance Massachusetts National Working Group Chair District of Columbia The Guidelines cover the entire spectrum of advance registration, development and operation features. Each Issue Topic is supported by a national working group

10. 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.

14. 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.

18. 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. MRC Credentialing Portal Pilot Easy to use registration tool will allow MRCs to collect the information needed to verify credentials and assign resource types to volunteers. http://www.esarvhp.com/mrc/

23. MRC Credentialing Portal Pilot 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

24. 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

25. APPENDIX

26. Credentialing and Resource Typing High Priority Occupations Bold = Draft Resource Typing Completed

27. Timeline for State-Based ESAR-VHP2004-2006 Develop Guidelines and common definitions and assess hospital, liability, and other key implementation issues. NBHPP FY04 Supplement to 30 States to pilot guidelines and develop systems *Remaining NBHPP awardees supplemental approved but unfunded Complete Interim Guidelines, issue analysis & best practices 2nd ESAR-VHP Focus Group Meeting Develop baseline number of ESAR-VHP providers (update annually) ESAR-VHP Focus group meeting May 2004 Nov. 2004 Jan. 2005 Sept. 2004

28. Timeline for State-Based ESAR-VHP 2004-2006, cont’d Provide technical assistance to 20 States. Conduct regional focus and technical assistance meetings and refine Guidelines Pilot test Guidelines in 10 States and refine Guidelines ESAR-VHP Focus Group Meeting NBHPP FY 05 Award to 32 States to develop systems. 30 (Total) ESAR-VHPs initiated. Guidelines revised. 10 ESAR-VHP systems initiated Jan. 2005 Sept. 2005 July 2005 Dec. 2005 June 2005

29. 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 . Dec. 2006 Jan. 2006 June 2006

30. Phases of ESAR-VHP Development and Technical Assistance HI AK WA VT NH MT ME ND MN OR ID MA SD WI NY MI RI WY CT PA IO NJ NE NV DE OH IN IL UT MD CA CO WV VA DC KS MO KY NC TN AZ OK NM AR SC GA AL MS TX LA PHASE I FL PHASE II PHASE III PR - (Puerto Rico) VI - (U.S. Virgin Islands)

31. Credentialing, Privileging, and NIMS Resource Typing of Physicians 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.