Emergency Systems for Advance Registration of Volunteer Health Professionals (ESAR-VHP) – Legal and Regulatory Issues

Most state and local public health emergency response plans envision
the participation of significant numbers of medical and public health
volunteers to fill surge capacity and provide necessary expertise.
After complications arose in the use of medical volunteers following
9/11/01, Congress authorized DHHS’ Health
Resources and Services Administration (HRSA)
to develop
emergency systems for the advance registration of volunteer health
professionals (ESAR-VHP).
In December, 2006, the Pandemic and All-Hazards Preparedness Act
reassigned responsibility for ESAR-VHP to DHHS’ Assistant Secretary for
Preparedness and Response
(ASPR). These state-based systems are designed to assess
and register state and territorial VHPs to facilitate their interstate
and intrastate activities during public health and other emergencies.
Complex legal and regulatory issues underlie the provision of health
services by volunteers during emergencies.

Beginning September, 2005, the Center was asked to assess these legal and regulatory issues through written and other guidance to national and state partners. In response, the Center has researched and prepared the report, ESAR-VHP: Legal and Regulatory Issues (as of May 2006). This comprehensive report addresses many legal issues impacting the development of ESAR-VHP in all 50 states, including (1) state authority to declare public health or general states of emergency; (2) civil and criminal liability of volunteers and entities accepting or providing volunteers; (3) licensing/credentialing of volunteer health professionals; and (4) workers’ compensation. Though these issues are examined in their application to volunteers participating in ESAR-VHP, other medical volunteers (including those participating in the Medical Reserve Corps) may find relevance in the Report as well.

Center has also created an Advanced
Tool Kit

to provide prospective users with information, contacts, and resources
to help in the assessment of many of the legal issues that may arise. For
specific documents from the Tool Kit, please see the links below:

Letter of Introduction

of Contents

VHP Legal and Regulatory Issues Project: An Overview
– Power
Point Presentation

for ESAR-VHP Legal and Regulatory Issues

: (A)
Legal Best Practices Memo
; (B) Notice
of Rights and Responsibilities of Volunteer Health Professionals under
Volunteer Agreement
; and (D) Uniform
Emergency Volunteer Health Practitioners Act (UEVHPA): An Overview.

: (A) Case
Study 1
: Licensure Reciprocity for Volunteer Health
Professionals in Connecticut and Massachusetts; (B) Case
Study 2
: Hospital Liability for Volunteer Negligence in
Pennsylvania; (C) Case
Study 3
: Emergency Declaration Laws in Oregon; and (D) Case
Study 4
: Workers Compensation Coverage for Volunteers in

: (A) Center’s
Civil Legal Liability and Public Health Emergencies Checklist

(2004); (B) CDC
Public Health Emergency Response Guide for State, Local, and Tribal
Public Health Directors
(C) American Bar Association Section of State and Local Government Law
Task Force on Emergency Management and Homeland Security, Checklist
for State and Local Government Attorneys to Prepare for Possible
, and (D) U.S. Government Accountability Office, GAO’s
Preliminary Observations Regarding Preparedness, Response, and Recovery

In addition, the Centers
has also addressed legal issues related to the use of volunteer health
professionals in real time in response to the emergency circumstances
in the Gulf Coast region following Hurricanes Katrina and Rita. For
more information, click