The Legal Framework for Meeting Surge Capacity Through the Use of Volunteer Health Professionals During Public Health Emergencies and Other Disasters

Hodge, James G.; Gable, Lance; Calves, Stephanie H.

doi:10.2139/ssrn.1016166

Cited by 14 publications

(24 citation statements)

References 22 publications

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“…For example, in the United States, states have passed laws allowing recognition of out-of-state HCW licenses during emergencies, and the Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP) system allows states to verify the licenses of other states’ HCWs that register with their state systems. 67–69 Hospitals can also develop emergency systems to verify qualifications and extend temporary credentials and privileges during an emergency or its aftermath; in the United States, an accreditation body requires hospitals to have such systems. 70 Following Hurricane Sandy (2012), for example, many New York City hospitals remained closed for months.…”

Section: Resultsmentioning

confidence: 99%

Legal Preparedness

Courtney¹,

Hodge

Toner

et al. 2014

Chest

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BACKGROUND Significant legal challenges arise when health-care resources become scarce and population-based approaches to care are implemented during severe disasters and pandemics. Recent emergencies highlight the serious legal, economic, and health impacts that can be associated with responding in austere conditions and the critical importance of comprehensive, collaborative health response system planning. This article discusses legal suggestions developed by the American College of Chest Physicians (CHEST) Task Force for Mass Critical Care to support planning and response efforts for mass casualty incidents involving critically ill or injured patients. The suggestions in this chapter are important for all of those involved in a pandemic or disaster with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. METHODS Following the CHEST Guidelines Oversight Committee’s methodology, the Legal Panel developed 35 key questions for which specific literature searches were then conducted. The literature in this field is not suitable to provide support for evidence-based recommendations. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process resulting in seven final suggestions. RESULTS Acceptance is widespread for the health-care community’s duty to appropriately plan for and respond to severe disasters and pandemics. Hospitals, public health entities, and clinicians have an obligation to develop comprehensive, vetted plans for mass casualty incidents involving critically ill or injured patients. Such plans should address processes for evacuation and limited appeals and reviews of care decisions. To legitimize responses, deter independent actions, and trigger liability protections, mass critical care (MCC) plans should be formally activated when facilities and practitioners shift to providing MCC. Adherence to official MCC plans should contribute to protecting hospitals and practitioners who act in good faith from liability. Finally, to address anticipated staffing shortages during severe and prolonged disasters and pandemics, governments should develop approaches to formally expand the availability of qualified health-care workers, such as through using official foreign medical teams. CONCLUSIONS As a fundamental element of health-care and public health emergency planning and preparedness, the law underlies critical aspects of disaster and pandemic responses. Effective responses require comprehensive advance planning efforts that include assessments of complex legal issues and authorities. Recent disasters have shown that although law is a critical response tool, it can also be used to hold health-care stakeholders who fail to appropriately plan for or respond to disasters and pandemics accountable for resulting patient or staff harm. Claims of liability from harms allegedly suffered during disasters and pandemics cannot be avoided altogether. However, appropriate planning and l...

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Section: Resultsmentioning

confidence: 99%

Legal Preparedness

Courtney¹,

Hodge

Toner

et al. 2014

Chest

Self Cite

View full text Add to dashboard Cite

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“…Besides the issue of impracticality in an emergency, it is unlikely that courts would look upon such documents any more favorably than the releases indigent patients were required to sign at UCLA Medical Center 26. An additional possibility is to establish compensation pools, which would provide payment to individuals wrongfully injured in the course of an emergency 27. Although such a system might be valuable under some circumstances, the terms of its implementation would have to be carefully designed.…”

Section: Alternativesmentioning

confidence: 99%

Currents in Contemporary Ethics

Rothstein¹

2010

J. Law. Med. Ethics

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There is widespread concern among public health and emergency response officials that there could be a shortage of health care providers in a public health emergency. At least the following three factors could cause an inadequate supply of physicians, nurses, and other health care providers: (1) the severity of the emergency might greatly increase the demand for health services and outstrip the available supply; (2) health care providers might become unavailable because of their own high rates of illness, as was the case in the SARS epidemic; and (3) many health care providers might not report for duty for personal, family, or professional reasons.One way of addressing the shortage is to encourage health care providers from unaffected areas or parts of the country to volunteer their services. A variety of measures have been enacted to facilitate the use of such volunteers.

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“…Immunity provisions triggered by the declaration of an emergency protect some health personnel from civil liability, but the impact of these laws varies depending on the status of responders as a public or private employee or volunteers, the method of deployment, and other factors. 33 Such legal protections for individuals, however, are rarely extended to entities such as hospitals, 31 although this is changing due to state legislative reforms. 34 Hospitals should take a proactive approach to limit their liability by developing plans and protocols, practicing their plans, having a transparent triage process, and adequately documenting triage decisions.…”

Section: Inevitable Mistakes By Personnel Conducting Triage May Leavementioning

confidence: 99%

Emergency Legal Preparedness for Hospitals and Health Care Personnel

Hodge¹,

García

Anderson³

et al. 2009

Disaster med. public health prep.

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During the past decade, hospital emergency preparedness has become a focus of local, state, and federal governments seeking to address emergencies or disasters that affect the public health. Integral to hospital emergency preparedness are numerous legal challenges that hospitals and their health care personnel face during declared states of emergencies. In this article, we evaluate legal requirements for hospital emergency preparedness, key legal concerns that hospitals should consider in emergency preparedness activities, and how the changing legal landscape during emergencies necessitates real-time decision making. We then analyze legal issues including negligence, discrimination, and criminal culpability that may arise during or after medical triage. Finally, we examine the legal risks of evading preparedness, specifically asking how a hospital and its personnel may be held liable for failing to plan or prepare for an emergency.

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The Legal Framework for Meeting Surge Capacity Through the Use of Volunteer Health Professionals During Public Health Emergencies and Other Disasters

Cited by 14 publications

References 22 publications

Legal Preparedness

Legal Preparedness

Currents in Contemporary Ethics

Emergency Legal Preparedness for Hospitals and Health Care Personnel

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