By Poorva Gaur, MPH, DAP Volunteer
The 2005 hurricane season, specifically Hurricane Katrina had disastrous effects on Louisiana. In the aftermath of the hurricane, over one million volunteers came to offer aid in the relief efforts. Many of those volunteers came to help rebuild the area and provide a number of services to those in need, including health care. However, volunteer health practitioners who traveled from other states to help Katrina survivors found they were severely limited in their ability to provide proper health care services.
Every state requires health practitioners to have proper state licensure to practice, which, in a disaster situation creates a barrier to those health practitioners. In response to this, the Uniform Law Commission, an independent, non-partisan organization that develops model legislation for all states, created the Uniform Emergency Volunteer Health Practitioner Act (UEVHPA). If enacted in a given state, volunteer health practitioners would not need same-state licensure to help during a disaster in another state. Since the creation of the legislation, only fourteen states have enacted the legislation plus the District of Columbia and U.S. Virgin Islands. A quick glance at the states who have not yet adopted the law shows that some of the most disaster prone states still would not be able to allow for volunteer health practitioners to provide aide at full capacity. According to this BusinessWeek post, the top ten most disaster-prone states are Rhode Island, Florida, Louisiana, California, Massachusetts, Kansas, Connecticut, Oklahoma, South Carolina, and Delaware. Of these top ten states, only two states – Louisiana (2009) and Oklahoma (2009) – have enacted the laws.
So why haven’t these other states adopted the UEVHPA?
The Uniform Law Commission provides numerous reasons for states to enact the UEVHPA. The legislation takes into account many concerns that states may have prior to adopting. The act requires advanced registration by public or private volunteers into a unified system to establish their qualifications for providing volunteer emergency health care. This accounts for the competency of the volunteers and its inclusion of private sector volunteers greatly expands the variety of help victims would need. Additionally, volunteers can register anywhere at any time and not just when and where a disaster happens, reducing the chances of a system overload at a disaster site. Furthermore, existing state systems would be required to coordinate all volunteer activities to ensure efficient use of available resources. Volunteer health practitioners would also have to comply with the disaster states’ regulations and health practitioners would be immune to professional malpractice suits and be eligible for worker’s compensation.
Currently, all 50 states have adopted the Emergency Management Assistance Compact (EMAC). This is a mutual aid agreement that provides for better and more efficient collaboration among states during a disaster or emergency. While government agencies like the CDC support EMAC and each state’s full cooperation and involvement with it, the Uniform Law Commission reported that due to the complicated application process, EMAC cannot efficiently provide the appropriate volume of volunteers needed in a disaster situation like Hurricane Katrina. Advance registration and better coordination outlined in the UEVHPA can provide better relief efforts and should be considered seriously by more states.
In an August 2012 post, DAP reported that Mississippi tried to enact the legislation in 2012 but the bill died in the Public Health and Human Services Committee. As of December 2014, Mississippi and 36 other states are still vulnerable to the lack of medical aid in the event of an emergency.