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.

The 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:

Brief Letter of Introduction

Table of Contents

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

Universal Checklist for ESAR-VHP Legal and Regulatory Issues

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

Case Studies: (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 Minnesota

Other References: (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 Disasters, 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 here.