As noted during the aftermath of Hurricanes Katrina and Rita in 2005, and many other emergencies in the nation’s history, volunteer health practitioners are essential to meeting surge capacity in public and private sectors. Underlying the successful deployment and use of volunteer health practitioners during emergencies is the need for a legal environment that supports their efforts. However, there are major legal gaps and deficiencies that may stymie, rather than encourage, volunteer health practitioner activities during emergencies. Following Katrina, the U.S. Congress introduced several bills to address some of these gaps since September, 2005.
Many state governments have recognized the need to grant emergency licensing recognition on an interstate basis and to afford disaster relief workers (which may include volunteer health practitioners) with protection from civil liability. Every state has ratified the Emergency Management Assistance Compact (EMAC), which provides for licensing reciprocity, relief from civil liability, and workers’ compensation protections to “state forces” deployed to respond to emergencies. The provisions of EMAC, however, are limited. In most jurisdictions, EMAC’s provisions only apply to state employees or local employees incorporated into “state forces” pursuant to mutual aid agreements. Many state laws underlying the declaration of public health emergencies (including many recently enacted laws based on the Model State Emergency Health Powers Act developed by the Centers in 2001) recognize interstate health licensure or provide broad authority to waive other legal or regulatory requirements during emergencies.
There is, however, no uniform system exists to efficiently and expeditiously recognize licensing privileges for health practitioners on an interstate basis. The lack of a uniform, well-understood system able to function automatically even during periods of emergencies when communications systems are disrupted and governmental officials are preoccupied with pressing responsibilities.
Developed by the Uniform Law Commission (ULC), the Uniform Emergency Volunteer Health Practitioners Act (UEVHPA) provides uniform legislative language to facilitate organized response efforts among volunteer health practitioners.
UEVHPA’s provisions include:
- Application of its coverage to declared states of emergency, disaster, or public health emergency (or like terms at the state or local level);
- Coverage of volunteer health practitioners who are registered with ESAR-VHP, MRC, or other similar systems;
- Procedures to recognize the valid and current licenses of volunteer health practitioners in other states for the duration of an emergency declaration;
- Requirements for volunteer health practitioners to adhere to scope of practice standards during the emergency (subject to modifications or restrictions); and
- Reduction of the exposure of volunteer health practitioners, or those who employ, deploy or host them, to significant disciplinary sanctions based on actions (or failures to act) during a declared emergency.
At the 2007 annual ULC conference in Pasadena, CA, the Commissioners voted to approve 2 new sections of the UEVHPA. focused on:
- Civil liability protections (Sec. 11) for volunteers and potential the entities that send, coordinate, or host them during declared emergencies. This section offers two alternatives for states considering passage of the Act. Alternative A offers clear immunity for volunteers from civil liability for acts that occur while providing health or veterinary services during an emergency. It also protects the entities that send or host volunteers from vicarious liability. Alternative B essentially replicates the existing liability protections found in the federal Volunteer Protection Act to the specific volunteers addressed in the UEVHPA. Both Alternatives also (i) except from liability protections those acts of a volunteer that are willful, wanton, or grossly negligent in nature, or that occur in operating motor vehicles, among other exceptions; and (ii) provide a limited exemption from liability for persons who operate, use, or rely upon information provided by a volunteer health practitioner registration system; and
- Workers’ compensation benefits (Sec. 12) for volunteers who may otherwise lack such benefits while providing volunteer health or veterinary services during declared emergencies. Section 12 provides that a volunteer health practitioner who provides health or veterinary services during an emergency and who is not otherwise eligible for workers’ compensation benefits of the host or sending state may elect to be deemed an employee of the host state for the purpose of receiving such benefits. The objective is to create a path for volunteers who may lack workers compensation protections to seek such protections in the state where they provide services during an emergency.
For more information about the Act and its legislative activity, please see uevhpa.org(website not working anymore), and additional references below:
Hall, Mimi. States seek to cut disaster red tape. USA Today, October 9, 2021 @ A1.
Hodge, JG , Pepe RP, Henning, WH. Voluntarism in the wake of hurricane Katrina: The Uniform Emergency Volunteer Health Practitioners Act. Disaster Medicine and Public Health Preparedness 2007; 1:1: 44-50.
“New law allows medical workers to aid victims of disasters in other states” – Lexington Herald-Leader (03/31/07) – Kentucky became the first state to adopt model legislation to allow health professionals from other states to offer assistance during a major disaster or public health emergency. The UEVHPA was adopted by the Kentucky General Assembly, and signed by Gov. Ernie Fletcher in late March.
Interview with James G. Hodge, Jr. by the Johns Hopkins Bloomberg School of Public Health.