The inability to utilize qualified medical volunteers in the wake of the attack prompted Congress to pass the Public Health Security and Bioterrorism Preparedness and Response Act of 2002, which established the Emergency System for Advanced Registration of Volunteer Health Professionals (ESAR-VHP). The ESAR-VHP is helping states implement a national system to help emergency responders manage medical volunteers during disasters.
"One of the issues we've had is that when you have health-care professionals show up at a mass casualty site, there has been no way to identify or verify that individual is a nurse or physician," said Jennifer Hannah, acting team leader of the ESAR-VHP. "The reason for these systems is so you can verify people's identity and credentials."
The Health Resources and Service Administration (HRSA) provides national standards and guidelines for volunteer registration systems. HRSA guidelines mandate that states have a system that holds current, verifiable volunteer information -- such as identity, licensing, credentials, accreditation and privileging -- in hospitals. Yet electronic database systems are only part of the federal equation.
Registration systems must also include volunteer recruitment, statewide planning to coordinate all necessary constituencies, state capacity for managing credential information and procedures for linking these systems to state emergency management. The ESAR-VHP program provides technical assistance for states to develop effective volunteer registry systems, with higher priority given to states with larger populations.
A Better Way
During hurricanes Rita and Katrina in 2005, several states' ESAR-VHP programs deployed more than 8,300 health professionals to the Gulf Coast despite their programs' infancy.
However, after the 2005 hurricane season, federal officials concluded that high priority should be placed on a better coordinated response between federal and state agencies.
On Dec. 4, 2006, the ESAR-VHP program initiated a pilot involving four states to develop state and federal protocols for the deployment of state volunteers in a federal emergency response. Connecticut, Michigan, Minnesota and Oklahoma participated in the 48-hour exercise to test both federal and state protocols developed by the pilot group.
"We embarked on this project," Hannah said, "because after Katrina and Rita, what was found in the White House report on lessons learned was [that] there needed to be a better coordinated response between federal and state governments."
The exercise, which involved a hypothetical 7.2 magnitude earthquake, tested response times, communication processes, chains of commands, as well as how the system performed and how the staff managed it. It was the first volunteer exercise conducted that focused on hundreds of nationwide volunteers that could help in a large-scale disaster like Katrina. Hannah and executives at the ESAR-VHP division are still examining the after-action report to determine the exercise's success.
Registry Management Simplified
Michigan has been a pioneer of electronic volunteer registration, beginning in 2003 when it partook in a pilot for Global Secure Systems, a company that provides technology-based products and services to the homeland security industry.
Michigan helped mold and shape the Global Secure Volunteer Mobilizer platform, a secure, Web-based application for registering, credentialing, mobilizing and communicating with large groups of volunteers, said Virginia Ball, project coordinator at the Michigan Volunteer Registry.
"Before we had this program, we relied on spreadsheets," Ball said. "We had to figure out a way to document the people who wanted to volunteer, which is complex with that amount of information. Now in an emergency, we can pinpoint a volunteer we need instead of looking through spreadsheets."
The registry now has approximately 2,000 volunteers ready to assist in large-scale emergencies.
Volunteers register on the Michigan Department of Community Health Web site, where they're categorized in one of nine groups based on their qualifications, skill levels, specialties and availabilities. Once volunteers register, their qualifications are verified by Michigan health officials, and they are placed in appropriate categories.
In the event of a disaster, volunteers are automatically notified via phone and e-mail. Michigan officials can then select volunteers -- by ZIP code, skills and/or deployment preferences -- to supplement existing emergency response at the local level.
The Technology
The Global Secure Volunteer Mobilizer platform is tailored to states, counties and cities, and conforms to federal ESAR-VHP guidelines. States that currently subscribe to the platform include Tennessee, Ohio, Kentucky, South Dakota, Colorado, Michigan, Vermont and Nevada.
"We started to develop this product because we saw a need in our government agencies -- that we had exceptional need for the management of volunteers," said Steve Wood, vice president of exercises and training at Global Secure Systems.
Wood said he hopes the platform will expand beyond municipal use to include other organizations, such as the Red Cross. Other vendors that organize similar services include Disaster Help, Collaborative Fusion and Credential Smart. Some states are implementing their own ESAR-VHP solutions.
After Hurricane Katrina, more than 5,000 Louisiana and Mississippi residents sought refuge in Colorado, taxing the state's ability to notify, manage and deploy volunteers to assist the displaced Gulf Coast residents. The state had hundreds of nurse volunteers, but Colorado officials had no way of verifying credentials, or any means of deploying out-of-state volunteers.
However, Colorado now says it's prepared for another such incident. In March 2007, the state launched the Colorado Public Health and Medical Volunteer System to improve its ability to handle large-scale public health emergencies and manage volunteers.
"This tool we have certainly gives us an opportunity to not only verify medical licenses that volunteers have, but check the background and individuals volunteering throughout the state," said Mike Moreland, coordinator of the Colorado Public Health and Medical Volunteer System at the Colorado Department of Health and Environment. "I think it's very important. I think it will bolster Colorado's ability to respond to all-hazards emergencies."
In two month's time, Colorado's volunteer repository enrolled approximately 500 volunteers in nine groups: administration and logistics, medical reserve corps, dentists, health professionals, physicians, nurses, veterinarians, prehospital professionals -- such as EMTs and EMS -- and mental health providers.
The goal is to increase the registry to 4,000-5,000 volunteers.
The ESAR-VHP program has been extended to individual counties nationwide, helping to secure a mobile volunteer force prepared for the next big disaster.
"Our hope," Hannah said, "is that we will be prepared in the event we have a large-scale emergency on the same scale as Katrina and Rita, and we have a way to use volunteers."
