UNIFORM EMERGENCY VOLUNTEER HEALTHCARE PRACTITIONERS
ACT*
NATIONAL CONFERENCE OF COMMISSIONERS
ON UNIFORM STATE LAWS
MEETING IN ITS ONE-HUNDRED-AND-FIFTEENTH YEAR
HILTON HEAD, SOUTH CAROLINA
JULY 7-14, 2006
UNIFORM EMERGENCY VOLUNTEER HEALTHCARE PRACTITIONERS
ACT
WITHOUT PREFATORY NOTE OR COMMENTS
Copyright © 2006
By
National Conference of Commissioners
on Uniform State Laws
* The following text is subject to
revision by the Committee on Style of the National Conference of Commissioners
on Uniform State Laws.
ABOUT NCCUSL
The National
Conference of Commissioners on Uniform State Laws (NCCUSL), now in its 115th
year, provides states with non-partisan, well-conceived and well-drafted
legislation that brings clarity and stability to critical areas of state
statutory law.
Conference members
must be lawyers, qualified to practice law. They are practicing lawyers,
judges, legislators and legislative staff and law professors, who have been
appointed by state governments as well as the District of Columbia, Puerto Rico
and the U.S. Virgin Islands to research, draft and promote enactment of uniform
state laws in areas of state law where uniformity is desirable and practical.
•
NCCUSL strengthens the federal system by providing
rules and procedures that are consistent from state to state but that also
reflect the diverse experience of the states.
•
NCCUSL statutes are representative of state experience,
because the organization is made up of representatives from each state,
appointed by state government.
•
NCCUSL keeps state law up-to-date by addressing
important and timely legal issues.
•
NCCUSL’s efforts reduce the need for individuals and
businesses to deal with different laws as they move and do business in
different states.
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provides a legal platform for foreign entities to deal with U.S. citizens and
businesses.
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time and legal and drafting expertise every year as a public service, and
receive no salary or compensation for their work.
•
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process draws on the expertise of commissioners, but also utilizes input from
legal experts, and advisors and observers representing the views of other legal
organizations or interests that will be subject to the proposed laws.
•
NCCUSL is a state-supported organization that
represents true value for the states, providing services that most states could
not otherwise afford or duplicate.
DRAFTING COMMITTEE ON UNIFORM EMERGENCY
VOLUNTEER
HEALTHCARE PRACTITIONERS ACT
The Committee appointed by and representing
the National Conference of Commissioners on Uniform State Laws in drafting this
Act consists of the following individuals:
RAYMOND P. PEPE, 17 N. Second
St., 18th Floor, Harrisburg, PA 17101-1507, Chair
ROBERT G. BAILEY, University of
Missouri-Columbia, 217 Hulston Hall, Columbia, MO 65211
STEPHEN C. CAWOOD, 108 1/2
Kentucky Ave., P.O. Drawer 128, Pineville, KY 40977-0128
KENNETH W. ELLIOTT, City Place
Building, 204 N. Robinson Ave., Suite 2200, Oklahoma City, OK 73102
THOMAS T. GRIMSHAW, 1700 Lincoln St., Suite 3800, Denver, CO 80203
THEODORE C. KRAMER, 45 Walnut St., Brattleboro, VT 05301
AMY L. LONGO, 8805 Indian Hills Dr., Suite 280, Omaha, NE 68114-4070
JOHN J. MCAVOY, 3110 Brandywine St. NW, Washington, DC 20008
DONALD E. MIELKE, 7472 S. Shaffer Ln., Suite 100, Littleton, CO 80127
JAMES G. HODGE, JR., Johns
Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205-1996,
Reporter
EX OFFICIO
HOWARD J. SWIBEL, 120 S.
Riverside Plaza, Suite 1200, Chicago, IL 60606, President
LEVI J. BENTON, State of Texas, 201 Caroline, 13th Floor, Houston, TX 77002,
Division Chair
AMERICAN BAR ASSOCIATION ADVISORS
BRYAN ALBERT LIANG, California
Western School of Law, 350 Cedar St., San Diego, CA 92101, ABA Advisor
PRISCILLA D. KEITH, 3838 N. Rural
St., Indianapolis, IN 46205-2930,
ABA Section Advisor
EXECUTIVE DIRECTOR
WILLIAM H. HENNING, University of
Alabama School of Law, Box 870382, Tuscaloosa, AL 35487-0382, Executive
Director
Copies of this Act may be obtained
from:
NATIONAL CONFERENCE OF COMMISSIONERS
ON UNIFORM STATE LAWS
211 E. Ontario Street, Suite 1300
Chicago, Illinois
60611
www.nccusl.org
UNIFORM EMERGENCY VOLUNTEER HEALTHCARE SERVICES ACT
TABLE
OF CONTENTS
SECTION 1.
SHORT TITLE.......................................................................................................... 1
SECTION 2.
DEFINITIONS.......................................................................................................... 1
SECTION 3.
CONDITIONS APPLICABLE TO PROVIDING HEALTHCARE OR VETERINARY SERVICES 3
SECTION 4.
VOLUNTEER HEALTHCARE PRACTITIONER REGISTRATION
SYSTEMS........................................................................................................................... 4
SECTION 5.
INTERSTATE LICENSURE RECOGNITION FOR VOLUNTEER HEALTHCARE PRACTITIONERS............................................................................................................................................. 5
SECTION 6. PROVISION
OF VOLUNTEER HEALTHCARE OR VETERINARY SERVICES; ADMINISTRATIVE SANCTIONS...................................................................................................................... 6
SECTION 7.
EFFECT OF COMPENSATION ON VOLUNTEER STATUS............................... 7
SECTION 8.
RELATION TO OTHER LAWS............................................................................... 7
SECTION 9.
REGULATORY AUTHORITY................................................................................. 7
[SECTION 10.
CIVIL LIABILITY FOR VOLUNTEER HEALTHCARE
PRACTITIONERS; VICARIOUS LIABILITY.].................................................................. 8
[SECTION 11.
WORKERS’ COMPENSATION COVERAGE.].................................................. 8
SECTION 12.
UNIFORMITY OF APPLICATION AND CONSTRUCTION............................. 8
SECTION 13.
SEVERABILITY..................................................................................................... 9
UNIFORM EMERGENCY VOLUNTEER HEALTHCARE PRACTITIONERS ACT
SECTION 1. SHORT TITLE. This [act] may be cited as
the Uniform Emergency Volunteer Healthcare Practitioners Act.
SECTION 2. DEFINITIONS. As used in this [act]:
(1) “Comprehensive healthcare facility” means a healthcare facility that provides comprehensive
inpatient and outpatient healthcare services. The term includes tertiary care
and teaching hospitals.
(2) “Disaster relief organization” means an entity that provides emergency or disaster relief
services that include healthcare or veterinary services provided by volunteer
healthcare practitioners and that (A) is designated or recognized as a provider
of such services pursuant to a disaster response and recovery plan adopted by an
agency of the federal government or the [name
of appropriate state agency or agencies], or (B) regularly plans and conducts
its activities in coordination with an agency of the federal government or the [name of appropriate agency or agencies].
(3) “Emergency” means an event or condition that constitutes an [emergency,
disaster, or public health emergency] as defined by the [designate the appropriate laws of this state] and that may require
the provision of healthcare or veterinary services .
Legislative Note: The terms “emergency,” “disaster,” and
“public health emergency” are the most commonly used terms to describe the
circumstances that may lead to the issuance of an emergency declaration
referred to in this [act]. States that
use other terminology should insert the appropriate terminology into the first
set brackets. The second set of brackets
should contain references to the specific statutes pursuant to which emergencies are declared by the state.
(4) “Emergency
declaration” means a declaration of an emergency issued by a person
authorized to do so by the laws of this state [, a political subdivision of
this state, or a municipality or other local government within this state].
Legislative Note: References to declarations
issued by political subdivisions, municipalities or local governments should be
used in states in which these entities are authorized to issue emergency
declarations.
(5) “Emergency
Management Assistance Compact” refers to the mutual aid
agreement ratified by Congress and signed into law in 1996 as Public Law
104-321, and subsequently enacted by this state and codified at [cite].
(6) “Emergency
System for Advance Registration of Volunteer Health Professionals” means a registration system established by a state and
funded through the Health Resources Services Administration under Section 107
of the federal Public Health Security and Bioterrorism Preparedness and
Response Act of 2002, P.L. 107-188.
(7) “Entity” means a person other than an individual.
(8) “Healthcare facility” means an entity licensed by
the laws of this or another state to provide healthcare or veterinary services.
(9) “Healthcare
practitioner” means an individual licensed
in this or another state to provide healthcare or veterinary services.
(10) “Healthcare
services” means the provision of
care, services including advice or guidance, or supplies related to the health or
death of individuals, or to populations, to the extent necessary to respond to
an emergency, including (A) preventive, diagnostic, therapeutic,
rehabilitative, maintenance, or palliative care, and counseling, service,
assessment, or procedure concerning the physical or mental condition, or
functional status, of an individual or that affects the structure or function
of the body; (B) sale or dispensing of a drug, device, equipment, or other item
to an individual in accordance with a prescription; and (C) funeral, cremation,
cemetery, or other mortuary services.
(11) “Host
entity” means an entity in this
state that uses volunteer healthcare practitioners to respond to an emergency.
(12) “License” means authorization granted
by a state to engage in healthcare or veterinary services otherwise considered
unlawful without such authorization. The term includes authorization granted by
the laws of this state to an individual to provide healthcare or veterinary
services based upon a national certification issued by a public or private
entity.
(13) “Medical
Reserve Corps” means a local unit
consisting of trained and equipped emergency response, public health, and
medical personnel formed pursuant to Section 2801 of the Public Health Security
and Bioterrorism Preparedness and Response Act of 2002, P.L. 107-188.
(14) “Person” means an individual or a
corporation, business trust, trust, partnership, limited liability company,
association, joint venture, public corporation, government, or governmental
subdivision, agency, or instrumentality, or any other legal or commercial organization.
(15) “Scope
of practice” means the extent of the
authorization to provide healthcare or veterinary services granted to a
healthcare practitioner by a license issued to the practitioner in the state in
which the principal part of the practitioner’s services are rendered, including
any conditions imposed by the licensing authority.
(16) “State” means a
state of the United States, the District of Columbia, Puerto Rico, the Virgin
Islands, or any territory or insular possession subject to the jurisdiction of
the United States.
Legislative Note: Nothing prevents a state from expanding the
reach of this [act] by defining “state” to include a foreign country, political
subdivision of a foreign country, or Indian tribe or nation.
(17) “Veterinary
services” means the provision of care,
services including
advice or guidance, or supplies related to the health or
death of an animal, or to animal populations, to the extent necessary to respond to an emergency, including (A) diagnosis, treatment, or prevention of any animal
disease, injury, or other physical, dental, or mental condition by the
prescription, administration, or dispensing of any vaccine, medicine,
surgery, or therapy; and (B) the use of any procedure for reproductive
management; and (C) the monitoring and treatment of animal populations for
diseases that have or demonstrate the potential to spread to humans.
(18) “Volunteer
healthcare practitioner” means a healthcare
practitioner who provides healthcare or veterinary services in this state while
an emergency declaration is in effect and who, if employed is not precluded
from that status under Section 7.
SECTION 3. CONDITIONS APPLICABLE TO PROVIDING
HEALTHCARE OR VETERINARY SERVICES.
(a) This [act] applies to volunteer healthcare
practitioners only if they are providing healthcare or veterinary services for
a host entity while an emergency declaration is in effect.
(b) While an
emergency declaration is in effect, the [name
of appropriate agency or agencies] may limit, restrict, or otherwise
regulate (1) the duration of practice by volunteer healthcare practitioners, (2)
the geographical areas in which volunteer healthcare practitioners may
practice, (3) the types of volunteer healthcare practitioners who may practice,
and (4) any other matters necessary to coordinate effectively the provision of
healthcare or veterinary services during the emergency. Orders or directives issued pursuant to this
section are not subject to the requirements of the [State Administrative Procedures Act pertaining to the promulgation of
regulations].
(c) A host entity
that uses volunteer healthcare practitioners to provide healthcare or
veterinary services in this state must (1) consult and coordinate its
activities with the [name of the
appropriate agency or agencies] to the extent practicable to provide for
the efficient and effective use of volunteer healthcare practitioners, and (2)
comply with any other applicable laws relating to the management of emergency
healthcare or veterinary services.
SECTION 4. VOLUNTEER HEALTHCARE PRACTITIONER
REGISTRATION SYSTEMS.
(a) In order to
be a registration system, a system must:
(1)
accept applications for the registration of volunteer healthcare
practitioners prior to or during an emergency;
(2)
include information about the licensure and good standing of
practitioners that is accessible by authorized personnel; and
(3) be
capable of verifying the accuracy of information concerning whether a
practitioner is licensed and in good standing prior to the time healthcare or
veterinary services are provided under this [act].
(b) This [act] applies to
volunteer healthcare practitioners only if they are registered with a
registration system that complies with subsection (a) and is:
(1) an
Emergency
System for Advance Registration of Volunteer Healthcare Professionals or a Medical Reserve Corps unit;
(2) operated by a disaster relief organization,
licensing board, national or regional association of licensing boards or
healthcare practitioners, comprehensive healthcare facility, or governmental
entity; or
(3) designated by [name of
appropriate agency or agencies] as a registration system for purposes of
this [act].
(c) While an
emergency declaration is in effect, the [name
of appropriate agency or agencies], a person or persons authorized to act
on behalf of the [agency or agencies],
or a host entity, are authorized to confirm whether volunteer healthcare
practitioners utilized in this state are registered with a registration
system. Confirmation is limited to
obtaining notification from the registration system of the identities of the
practitioners and determining whether the system indicates that they are
licensed and in good standing.
(d) Upon request of personnel in this state authorized by
subsection (c), or similarly authorized
personnel in another state, a registration system located in this state must
provide notification of the identities of volunteer healthcare practitioners
and whether they are licensed and in good standing.
(e) A host entity is not required to use the services of
a volunteer healthcare practitioner even if the practitioner is registered with
a registration system that confirms that the practitioner is licensed and in
good standing.
SECTION 5.
INTERSTATE LICENSURE RECOGNITION FOR VOLUNTEER HEALTHCARE PRACTITIONERS.
(a) While an emergency
declaration is in effect, a volunteer healthcare practitioner, registered
pursuant to Section 4 and licensed and in good standing in another state, may
practice in this state to the extent authorized by this [act] as if the person
had been licensed in this state.
(b) A volunteer
healthcare practitioner whose license is suspended, revoked, or subject to an
agency order limiting or restricting practice privileges, or who has
voluntarily terminated a license under threat of sanction, in any state is not
entitled to the rights, privileges, and immunities authorized by this [act].
(c) This [act] does not affect
credentialing or privileging standards of a healthcare facility, nor does it
preclude a healthcare facility from waiving or modifying such standards while
an emergency declaration is in effect.
For purposes of this subsection:
(1) credentialing means obtaining, verifying,
and assessing the qualifications of a healthcare practitioner to provide
patient care, treatment, and services in or for a healthcare facility, and
(2) privileging means the authorization
granted by an appropriate authority, such as a governing body, to a healthcare
practitioner to provide specific care, treatment, and services at a healthcare
facility subject to limits based on factors that include license, education,
training, experience, competence, health status, and specialized judgment.
(a) Subject to subsections (b) and (c), a
volunteer healthcare practitioner must adhere to the scope of practice for a
similarly licensed practitioner established by the licensing provisions,
practice acts, or other laws of this state.
(b) Subject to
subsection (c), nothing in this [act] authorizes a volunteer healthcare
practitioner to provide services that are outside the practitioner’s scope of
practice even if a similarly licensed practitioner in this state would be permitted
to provide the services.
(c) The [name of appropriate agency or agencies]
may modify or restrict the healthcare or veterinary care services that a
volunteer healthcare practitioner may provide pursuant to this [act]. An order
or directive modifying the services a practitioner may provide pursuant to this
subsection is not subject to the requirements of the [State Administrative Procedures Act pertaining to the promulgation of
regulations].
(d) A host entity
may restrict the healthcare or veterinary services that a volunteer healthcare
practitioner may provide pursuant to this [act]
(e) A volunteer healthcare practitioner shall not be found
to be engaged in unauthorized practice unless the practitioner had reason to know
of any limitations, modifications or restrictions under subsections (a), (c) or
(d) or that a similarly licensed practitioner in this state would not be
permitted to provide the services. For
the purposes of this subsection, a volunteer healthcare practitioner has reason
to know if the practitioner (1) has actual knowledge of a modification or
restriction, or (2) from all the facts and circumstances known to the practitioner
at the time in question, a reasonable person would conclude that a modification
or restriction exists.
(f) A licensing
board or other disciplinary authority in this state:
(1) may impose administrative sanctions upon
a healthcare practitioner licensed in this state for wrongful conduct in
response to an emergency that occurs outside this state;
(2) may impose administrative sanctions upon
a practitioner not licensed in this state for wrongful conduct in response to
an emergency that occurs in this state; and
(3) must report any administrative sanctions
imposed upon a practitioner licensed in another state to the appropriate
licensing board or other disciplinary authority in any other state in which the
practitioner is known to be licensed.
(g) In determining
whether to impose administrative sanctions under subsection (f), a licensing
board or other disciplinary authority shall consider any exigent circumstances
in which the conduct took place, the practitioner’s scope of practice, and the
practitioner’s education, training, experience, and specialized judgment.
(a) Subject to
subsection (b), the prospective, concurrent, or retroactive payment of monetary
or other compensation to a healthcare practitioner by any person for the
provision of healthcare or veterinary services while an emergency declaration
is in effect does not preclude the practitioner from being a volunteer
healthcare practitioner under this [act],
(b) Subsection (a) does not apply if compensation is provided to a
healthcare practitioner pursuant to a preexisting employment relationship with
the host entity or an affiliate of the host entity that requires the
practitioner to provide healthcare or veterinary services in this state.
(c) Subsection (b) does not apply to a healthcare
practitioner who is not a resident of this state and who is employed by a
disaster relief organization providing services in this state while an
emergency declaration is in effect.
SECTION 8. RELATION TO OTHER LAWS.
(a) This [act]
does not limit rights, privileges, or immunities provided to volunteer
healthcare practitioners by other laws.
Except as provided in subsection (b), this [act] does not affect
requirements for the use of volunteer healthcare practitioners pursuant to the
Emergency Management Assistance Compact.
(b) The [name of appropriate agency or agencies]
may incorporate into state forces pursuant to the Emergency Management
Assistance Compact a volunteer healthcare practitioner who is not an employee
of this state, a political subdivision of this state, or a municipality or
other local government within this state.
Legislative Note: References to other emergency assistance
compacts to which the state is a party should be added.
SECTION 9. REGULATORY AUTHORITY. The [name of appropriate agency or agencies] [is] [are] authorized to
promulgate regulations to implement the provisions of this [act]. In doing so, the [name of appropriate agency or agencies] shall consult with, and
consider the recommendations of, the entity established to coordinate the
implementation of the Emergency
Management Assistance Compact and shall also consult with, and consider the
regulations promulgated by, similarly empowered agencies in other states in
order to promote uniformity of application of this act and thereby make the
emergency response systems in the various states reasonably compatible.
RESERVED
Legislative
Note: Final action
regarding Section 10 of the Act has been deferred until the 2007 Annual Meeting
of the National Conference of Commissioners on Uniform State Laws. At
that time, the Drafting Committee will present to the Conference for
consideration its final recommendations relating to the limitation of civil
liability for damages for volunteer healthcare practitioners and organizations
that use and maintain registration systems for volunteer healthcare
practitioners. Because many States have existing laws pertaining to
liability limitations and a uniform approach to liability limitations may
play a critical role in promoting the use of volunteer healthcare
practitioners, States considering adoption of this Act prior to final action by
the National Conference regarding Section 10 should carefully review their
existing laws, the laws of other states, provisions of the Emergency Management
Assistance Compact, and the work of the Drafting Committee, which is available
at http://www.law.upenn.edu/bll/ulc/ulc.
RESERVED
Legislative Note: Final action regarding Section
11 of the Act has been deferred until the 2007 Annual Meeting of the National
Conference of Commissioners on Uniform State Laws. At that time, the Drafting Committee will
present to the Conference for consideration its final recommendations regarding
the provision of workers’ compensation coverage for volunteer healthcare practitioners
without other forms of workers’ compensation or disability insurance
coverage. Because the establishment of a
reasonably uniform system to compensate volunteer practitioners for injuries
sustained while responding to emergencies is critical to an effective system of
legislation to promote the use of volunteer healthcare practitioners, States
considering adoption of this Act prior to final action by the National
Conference regarding Section 11 should carefully review the laws of other
states providing workers’ compensation coverage to volunteers responding to
emergencies, provisions of the Emergency Management Assistance Compact, and the
work of the Drafting Committee, which is available at
http://www.law.upenn.edu/bll/ulc/ulc.
SECTION 12. UNIFORMITY OF APPLICATION AND CONSTRUCTION. In applying and construing the provisions of this
[act], consideration must be given to the need to promote uniformity of the law
with respect to its subject matter among states that enact it.
SECTION 13. SEVERABILITY. The provisions of this [act] are severable. If any provision of this [act] or its
application to any person or circumstance is held invalid, such holding does
not affect other provisions or applications of this [act] which can be given
effect without the invalid provision or application.
