# Presentation: 524518

## Collaboration in Ohio; Local and State Integration of the MRC ProgramApril 20, 2006

**Forrest Smith, MD,**** Ohio Department of Health**
**David O’Reilly,**** Ohio Citizen Corps**
**Paul Bender,**** Ohio Citizen Corps**
**Florence Drayden, RN, MHS,**** Montgomery County MRC Coordinator**
**Margo Schramm,**** Lucas County MRC Coordinator**
**Carol Jacobson, RN,**** Ohio Hospital Association**

- 2006 MRC National Leadership and Training Conference, Dallas, Texas

_**Overview**_
**Ohio Medical Reserve Corps**
**System and Infrastructure**
**Local MRC Units**
**Hospital-level volunteers (ESAR-VHP)**
**Future**
**Summary**

_**Objectives**_
**Learn about state and local collaboration for disaster planning in Ohio**
**Learn about the integrated medical and non-medical volunteer database in Ohio**
**Learn about the Ohio plan to develop and support local MRC units in each county**

_**Acknowledgments**_
**Ohio Department of Health, Chair**
**American Red Cross**
**Association of Ohio Health Commissioners **
**Infectious Disease Society of Ohio**
**Northeast Ohio Medical Association**
**Ohio Chapter, American College of Emergency Physicians**
**Ohio Community Service Council**
**Ohio Dental Association**
**Ohio Department of Agriculture**
**Ohio Department of Mental Health**
**Ohio Department of Public Safety,**
**Ohio Homeland Security Division**
**Ohio Emergency Management Agency**
**Ohio Emergency Medical Services**
**Ohio Emergency Nurses Association**
**Ohio Hospital Association**

**Ohio  Nurses Association**
**Ohio Osteopathic Association **
**Ohio Pharmacists Association**
**Ohio Psychiatric Association**
**Ohio State Medical Association**
**Ohio State Dental Board**
**Ohio State Medical Board**
**Ohio State Nursing Board**
**Ohio State Veterinary Board**
**Ohio local registered Medical Reserve Corps**
**Office of the Surgeon General **
**Office of the Surgeon General – MRC PHS Region V**

**State MRC Coordination**

_**Background**_
**September, 2001**
**OMRC Committee**
**HRSA, ESAR-VHP**
**State of Ohio Security Task Force (SOSTF)**
**Ohio Citizen Corps**
**June 27, 2005 - OMRC Formed**
**Local MRC development**

**State MRC Coordination**

_**Goal**_
**To develop an asset of pre-identified, credentialed healthcare professional volunteers to respond to an Ohio “event” –  independent of funding source – “umbrella” structure**
**“****CUSTOMERS”: Local health planners and future Incident Commander**

**State MRC Coordination**

## State MRC Coordination

_**Objective**_
**To facilitate state, regional and local planning efforts by development of consistent, state-wide parameters to assist in the deployment of physician/professional volunteers  **
**These parameters include:**
**Credentialing**
**Training**
**Identification and  resolution of legal issues**
**Other issues to be identified**

**State MRC Coordination**

_**Professions**_
**Physician/psychiatrist**
**Physician assistant**
**Registered nurse**
**Licensed practical nurse**
**Pharmacist**
**Pharmacy Intern**
**Psychologist**
**Licensed independent social worker**
**Licensed independent clinical counselor**
**Dentist**
**Emergency Medical Services**
**Veterinarian**

**State MRC Coordination**

_**State Roles**_
**Verify individual**
**Verify licensure**
**Follow HRSA ESAR-VHP credentialing**
**Facilitate registration of local MRC units in Ohio with the Office of the Surgeon General; June 27, 2005 **

**State MRC Coordination**

## Senate Bill 9
A registered volunteer is not liable in damages to any person or government entity in tort or other civil action, including an action upon a medical, dental, chiropractic, optometric, or other health-related claim or veterinary claim, for injury, death, or loss to person or property that may arise from an act or omission of that volunteer. This division applies to a registered volunteer while providing services within the scope of the volunteer's responsibilities during an emergency declared by the state or political subdivision or in disaster-related exercises, testing, or other training activities, if the volunteer's act or omission does not constitute willful or wanton misconduct. 

**A registered volunteer is not liable in damages to any person or government entity in tort or other civil action, including an action upon a medical, dental, chiropractic, optometric, or other health-related claim or veterinary claim, for injury, death, or loss to person or property that may arise from an act or omission of that volunteer. This division applies to a registered volunteer while providing services within the scope of the volunteer's responsibilities during an emergency declared by the state or political subdivision or in disaster-related exercises, testing, or other training activities, if the volunteer's act or omission does not constitute willful or wanton misconduct.**

**State MRC Coordination**

_**System and Infrastructure**_
**OMRC Committee – State **
**Local MRC units – County, Region**
**Statewide database -  Ohio Citizen Corps**
**Statewide program promotion**
**Volunteer recruitment**
**Training**
**Credentialing**
**Legislation – Senate Bill 9**

**State MRC Coordination**

_**Vision**_
**Strong local efforts**
**Infrastructure to assist and support**
**Systematic approach**
**Integration into Ohio’s homeland security****, ****disaster and emergency planning**

**State MRC Coordination**

_**Why MRC Units?**_
**Disasters could overburden local response capabilities**
**Streamline volunteer response efforts with pre-identified, pre-credentialed volunteers**
**Help with other community/public health activities**
**Local units can provide additional state support**
**Common names and procedures for volunteer management**

**State MRC Coordination**

_**MRC Unit Development**_
**Promote program to local health departments**
**Contact Ohio Citizen Corps **
**Letter of support from local health commissioner**
**Complete national MRC registration process**
**Ohio MRC Co-Coordinators review**
**Recommendation of approval to national MRC**
**Approval by national MRC**
**Start-up Kit**
**Support**

**State MRC Coordination**

## Slide 16

_**OMRC Volunteers**_
**Register at **_[www.serveohio.org](http://www.serveohio.org/)_
**Training**
**Verify credentials**
**Legislation – Liability & Privacy**
**Critical Responder IDs**
**Volunteer Reception Centers**

**State MRC Coordination**

_**Volunteer Recruitment**_
**Fall 2005 Campaign**
**Statewide TV and radio**
**7000 advertisements (3 months)**
**Ohio Association of Broadcasters**

**State MRC Coordination**

**State MRC Coordination**

_**Hurricane Katrina Recruitment**_
**Seize the opportunity**
**“****I want to help volunteer”**
**Media blitz**
**Governor’s Office coordination**
**Website (**_[www.serveohio.org](http://www.serveohio.org/)__)_

**State MRC Coordination**

_**Volunteer Recruitment**_
**Spring 2006 Campaign**
**Branding and Identity**
**Resources for locals**
**Website**
**Other publications**
**Direct mail**
**Fairs and festivals**

**State MRC Coordination**

## WEST CENTRAL OHIO MEDICAL RESERVE CORPS

**WEST CENTRAL OHIO MEDICAL RESERVE CORPS**

**Mission: **To establish teams of local volunteer medical and public health professionals and others  who can contribute their skills and expertise throughout the year and during times of community crisis to improving and maintaining the health of their community.

## WCOMRC

_**West Central Ohio MRC**_
**Volunteer group bringing health professionals **_***and others***_** together to support local public health, emergency and medical services in the event of a disaster.**

**WCOMRC**

## WCOMRC

_**History**_
**Awarded grant - October 2003**
**Coordinator hired - January 2004**
**Started attending State MRC meetings - Feb. 2004**
**Started reporting activities to the Citizen Corps Council - February 2004**
**Initial meeting of 8 county coordinators in WCO region - April 2004**
**Presented plan to health commissioners - May, 2004**
**Developed “Introduction to the MRC” course – June 2004**

**WCOMRC**

## WCOMRC

_**History**_
**Initiated training courses  for volunteers – July 2004**
**Developed “Infectious Diseases of the 21st Century” course – August 2004**
**Developed database to be used by all 8 counties – September 2004**
**Purchased ID Badge machine – October 2004**
**Developed ID Badge to be used by all WCO county volunteers – November 2004**
**Developed template for newsletter – January 2005**
**Held volunteer reception for 7 counties – Nov. 2005**

**WCOMRC**

## WCOMRC Organizational Chart

## WCOMRC

_**Organization**_
**All units in region are affiliated with the local health department**
**All units are assets of the public health department**
**Only one funded MRC in region due to receipt of a demonstration project grant from the federal government**

**WCOMRC**

## WCOMRC

_**Recruitment**_
**Word of mouth**
**Regional newsletter to be published by-monthly**
**Health fairs**
**Ads in local newspapers**
**Ads on public broadcasting stations**
**Participating in local talk shows**

**WCOMRC**

## WCOMRC

_**Training**_
**Locally developed courses**
**State developed requirements**
**National developed requirements**
**Ensure all training is related to operations in your community and is ICS compliant **

**WCOMRC**

## WCOMRC

_**Retention**_
**Training classes**
**Volunteer meetings at appropriate intervals**
**Use of volunteers to help promote the MRC and provide administrative support to the MRC**
**Use of volunteers to support various activities within the health department**
**Keep those volunteers that want to be involved busy**
**Continuously communicate with volunteers**
**Start a volunteer communication committee**
**Newsletter**

**WCOMRC**

## Lucas County Medical Reserve Corps

**Lucas County ****Medical Reserve Corps**

## Lucas County MRC

_**Structure**_
***Oversight Committee - Community Agencies***
**Toledo Lucas County Health Department**
**NWO Regional Medical Response System**
**Lucas County Emergency Management Agency**
**Lucas County Mental Health Board**
**Northwest Ohio Hospital Council**
**United Way of Greater Toledo **
**American Red Cross – Toledo Chapter**

**Lucas County MRC**

## Lucas County MRC

_**Structure**_
***Oversight Committee – Representatives of ***
***the Medical Professions***
**Physicians/Academy of Medicine**
**Veterinarian & Veterinary Tech/Disaster Animal Response Team**
**Dentist/Toledo Dental Society**
**Pharmacist/Area Pharmacists Associations**
**Psychologist/Toledo Academy of Psychologists**

**Lucas County MRC**

## Lucas County MRC

_**Recruitment**_
**Mail Campaign to Medical Professionals:**
**Personalized Letter**
**Key leaders, oversight committee members listed in margin**
**Three ways to apply**
**Brochure**
**Application**
**Business reply envelope**
**Business Card**

**Lucas County MRC**

## Lucas County MRC

_**Volunteers**_
**Physicians - 92**
**Physician Assistants - 4**
**Nurse Practitioners - 14**
**Midwives – 4**
**RN, CNS - 16**
**RN’s – 376**
**LPN’s - 85**
**Paramedics - 18**
**EMT’s - 45**
**Pharmacists - 27**

**Lucas County MRC**

**Respiratory Therapists - 19**
**Dentists - 18**
**Veterinarians - 6**
**Vet Techs - 6**
**Psychologists - 17**
**Social Workers - 93**
**Massage Therapists - 14**
**Nursing Assistants -  52**
**Other – 43**
_**Total = 949**_

## Lucas County MRC

_**Training**_
**What do volunteers need to know?**
**Incident Command**
**CBRNE**
**Natural Disasters**
**Mental Health in Disasters **
**Notification/Activation procedures**
**What will they attend (what’s the right # of hours?)**
**4 hours**

**Lucas County MRC**

## Lucas County MRC

_**Training**_
**Existing State approved courses did not fit our needs**
**Collaborated with other MRC’s to develop a “local” training**
**Created “Introduction to Medical Reserve Corps”**
**Obtained State of Ohio approval **
**Have held courses in each of our communities**

**Lucas County MRC**

## Hospital Integration

_**ESAR-VHP in Ohio**_
**OHA has adopted the AHA recommendations which will result in a more clearly identified pool of volunteers best qualified to assist in hospital setting**
**AHA prefers verify information up to Level 1 – Ohio is looking utilization of all levels within hospitals**

**Hospital Integration**

## Hospital Integration

_**How Does ESAR-VHP Relate to Hospitals?**_
**Use of volunteer services rest with hospitals**
**JCAHO vs. ESAR-VHP**
**Level of privileges will change over course of disaster**
**Large vs. Small Event**
**Depleting of hospital staff **

**Hospital Integration**

## Hospital Integration

_**ESAR-VHP Hospital Subcommittee**_
**Formed in July 2005**
**Subcommittee Membership**
**Hospitals (Medical Staff Credentialing and Physicians and Pharmacist)**
**Public Health and Public Health **
**MRC and Ohio Citizen Corp **
**Primary Function:**
**Ensure proper registration with proper authorizations**
**Resource Typing **
**Emergency Verification**

**Hospital Integration**

## Hospital Integration

_**ESAR-VHP Hospital Subcommittee**_
**Addressing Issues**
**Develop and distribute survey – determine hospital levels**
**Procedures for requesting privileged volunteers – Flow Chart**
**Develop strategies for recruitment of health care professionals**
**Credentialing/Privileging Issues**
**Develop Hospital Volunteer Management Plan****  **

**Hospital Integration**

## Hospital Integration

_**Volunteer Management Plan**_
**Volunteer Opportunities (Anticipate)**
**Need based on staffing plan/surge**
**Where volunteers will be needed**
**Specific skill sets (levels) or assignments**
**Recruitment/Selection Strategies**
**Training Strategies**
**Liability Issues **

**Hospital Integration**

## Hospital Integration

_**MRC / Hospital Relationships**_
**Planning **
**Standardized recruiting/registering format for MRC related to health care volunteer**
**Notification and Mobilization Issues**
**Integration of hospital volunteers into Volunteer Reception Centers**
**Hospital HR issues**
**Job Descriptions **
**Development of job descriptions based on pre-identified levels**

**Hospital Integration**

## State & Local MRC Coordination

_**Future**_
**Senate Bill 9 Rules**
**Position Descriptions – Target Capabilities**
**Local MRC Development**
**Exercises and Training**
**Strategic National Stockpile (SNS)**
**Medical Technical Advisory Committee (MEDTAC)**
**Pandemic Flu**
**Critical Responder IDs**
**Ohio Response Plan**
**Volunteer Coordinator Summit**

**State & Local MRC Coordination**

_**Summary**_
**Continued growth - Work in progress!**
**Local MRC efforts**
**System and Infrastructure**
**Database – Ohio Citizen Corps**
**Education**
**Recruitment**
**Hospital coordination, ESAR-VHP**
**Ready to respond**

## Questions

## Forrest Smith, MD, Ohio Department of Health
Forrest.Smith@odh.ohio.gov
David O’Reilly, Ohio Citizen Corps, OMRC
David.OReilly@ocsc.state.oh.us
Paul Bender, Ohio Citizen Corps
Paul.Bender@ocsc.state.oh.us
Florence Drayden, RN, MHS, WCO MRC Coordinator
FDrayden@chdmc.org 
Margo Schramm, Lucas County MRC Coordinator
Schrammm@co.lucas.oh.us 
Carol Jacobson, RN, Ohio Hospital Association
carolj@ohanet.org

**Forrest.Smith@odh.ohio.gov**
**David O’Reilly,**** Ohio Citizen Corps, OMRC**
**David.OReilly@ocsc.state.oh.us**
**Paul Bender,**** Ohio Citizen Corps**
**Paul.Bender@ocsc.state.oh.us**
**Florence Drayden, RN, MHS,**** WCO MRC Coordinator**
**FDrayden@chdmc.org**
**Margo Schramm,**** Lucas County MRC Coordinator**
**Schrammm@co.lucas.oh.us**
**Carol Jacobson, RN,**** Ohio Hospital Association**
**carolj@ohanet.org**

**Contact Information**

## Websites
Ohio Medical Reserve Corps: http://www.serveohio.org/citizencorps/mrc/mrc.htm
Medical Reserve Corps:  http://www.medicalreservecorps.gov/
Ohio Citizen Corps: http://www.serveohio.org/citizencorps/

**Ohio Medical Reserve Corps: **_[http://www.serveohio.org/citizencorps/mrc/mrc.htm](http://www.serveohio.org/citizencorps/mrc/mrc.htm)_
**Medical Reserve Corps:  **_[http://www.medicalreservecorps.gov/](http://www.medicalreservecorps.gov/)_
**Ohio Citizen Corps: **_[http://www.serveohio.org/citizencorps/](http://www.serveohio.org/citizencorps/)_

**Contact Information**