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2/10/2003

Medical Reserve Corps Pharmacists to Aid Communities

Donna Young

The federal government created the Medical Reserve Corps (MRC) last year to supplement local communities’ existing emergency preparedness plans and public health education and awareness programs.

This program was designed to provide organizational structure and training for licensed health care professionals—practicing, retired, or otherwise employed—who want to volunteer in their local communities.

MRC is coordinated by the Office of the Surgeon General and is part of the Bush administration’s Citizen Corps—introduced last year to complement other national service programs, including the Peace Corps, created by President John F. Kennedy in 1961, and AmeriCorps, established by President Bill Clinton in 1993.

USA Freedom Corps is the Bush administration’s umbrella organization for Citizen Corps, Peace Corps, and AmeriCorps.

Funding. Under the 2002 Supplemental Appropriations Act for Further Recovery From and Response To Terrorist Attacks on the United States, Congress appropriated $25 million last fall to the Federal Emergency Management Agency (FEMA) for Citizen Corps.

FEMA announced in December that $21 million of the funds would go to states to expand Community Emergency Response Teams—volunteers trained in basic response skills who assist emergency personnel in times of disasters—and for the creation and support of Citizen Corps councils—local community leaders who will be responsible for assessing possible threats, identifying local resources, and driving public participation in developing community action plans.

In November, the Surgeon General awarded 42 organizations in 27 states demonstration project grants of up to $50,000 apiece to establish an MRC unit in their local community.

MRC demonstration projects were not required to have a Citizen Corps Council in their community, said a policy adviser to the Surgeon General. But the MRC unit might act as an impetus for a community to organize a council, she said.

The Bush administration has proposed that Congress authorize $10 million in 2003 to fund new MRC demonstration grants and for the continued support of the 42 MRC units under way.

Without the $10 million, it is unclear how the MRC program will continue, according to the Surgeon General’s office.

National Citizen Corps Council. The White House also created a National Citizen Corps Council in December to advise the Bush administration about ways to promote safety practices and engage volunteers in homeland security and community preparedness.

The 43-member council consists of health care, firefighter, emergency management, and law enforcement associations; relief organizations, including the American Red Cross and the Salvation Army; intergovernmental groups, such as the National Governors Association and the National League of Cities; and various federal agencies.

The American Society of Health-System Pharmacists is the only pharmacy organization that was invited to be a charter member of the council.

Pharmacists’ role. Pharmacists are an essential component to any local MRC unit, said the Surgeon General’s policy adviser. By volunteering, she said, pharmacists can assist a local community’s emergency response during a public health crisis by helping to vaccinate residents against smallpox, providing medication information and counseling, or supplying information about antidotes used to counter a toxic substance that has been released.

Pharmacists can strengthen and sustain a community’s health care initiatives, she added, by helping to educate the public and engaging other health professionals in MRC training programs.

Demonstration projects. Since most of the demonstration projects received the funding in December 2002, MRC units are at various stages of development, the Surgeon General’s policy adviser said. MRC units will vary from community to community, depending on an area’s public health needs, leadership involvement, vulnerabilities, and population, she added.

Bayonne, New Jersey, a densely populated city located on a peninsula across the Hudson River from New York City, has a large potential for several hundred casualties if terrorists struck any of the many oil refineries, chemical plants, or factories in the area, said Lisa Catlin, Bayonne Medical Center director of grants administration.

Catlin’s medical center, one of the 42 MRC grant recipients, is developing a project to actively recruit medical health professionals, social workers, and clergy to be trained for any large-scale emergency.

The project will also use volunteers to help with health and wellness education, cancer and glaucoma screenings, and other health initiatives, she said.

Yale New Haven Health System in New Haven, Connecticut, is using its grant along with a state initiative to develop a statewide reserve of medical volunteers, said Christopher Cannon, director of the health system’s office of emergency preparedness.

Yale New Haven was one of two hospitals selected by the state to help coordinate and address emergency response planning, including set up stockpiles of medication and supplies and clinical protocols on their use.

“No one institution in an area can bear the brunt of an emergency crisis on its own,” he said. “You have to look to other institutions and medical volunteers.”

Yale New Haven’s MRC project includes identifying area colleges and universities with medical, nursing, public health, and pharmacy schools that could provide educators and students who would be trained to aid medical response teams in the event of a disaster.

The MRC project in Lane County, Oregon, is designed to work in conjunction with the local Disaster Medical Assistance Team (DMAT), a specialized group of volunteer health professionals that the federal government can mobilize within 72 hours to respond to an emergency in the United States or overseas.

Licensing. Unlike pharmacists deployed as part of a DMAT or National Pharmacist Response Team (NPRT), pharmacists volunteering for an MRC unit must be licensed by the state in which they volunteer.

Licensure and Liability Issues in Volunteer Emergency Response Groups

Emergency Response Group

Is State Pharmacist License Recognized Nationally?

Does Federal Government Protect Volunteers' Jobs?

Does Federal Liability Protection Extend to Volunteers?

National Pharmacist Response Teams

Yes

Yes

Yes

Medical Reserve Corps

No

No

No

Disaster Medical Assistance Teams

Yes

Yes

Yes

NPRTs are groups of volunteer pharmacists and pharmacy technicians that are deployed regionally to respond to an emergency.

Special populations. The elderly population in San Francisco, California, is an example of a group that poses a challenge for emergency responders and could benefit from a special cadre of volunteer pharmacists.

More than 238,000 residents in the Bay Area are Asian, many of whom are elderly, live in poverty, and speak no English, said Cecilia Lai, chief operating officer for Self-Help for the Elderly, a multiservice organization that provides assistance to more than 25,000 seniors in the San Francisco area.

“Many of our seniors live in single-room hotels that are not well equipped,” she said. “They are confined and have little contact with the outside world.”

Lai’s MRC unit is recruiting health care professionals who speak Chinese, Vietnamese, or another Asian language to assist if a crisis occurs in the area or to help with health care programs for seniors.

Pharmacists with language skills can contribute a great deal, she said, by providing seniors with medication counseling and health education and interpreting for other health professionals.

A community’s homeless population can also affect an area’s overall public health, said Ron Cookston, director of Gateway to Care, a service organization that helps the uninsured and underinsured in Houston, Texas, access health care. The group is also an MRC grant recipient.

“Have cities thought about what they are going to do about the homeless if or when we need to vaccinate for smallpox?” Cookston asked. “We are going to have to go out and find them.”

Pharmacists will be needed in every community when the smallpox vaccination process for the public begins, he said.

Houston learned a valuable lesson in emergency preparedness logistics when Tropical Storm Allison flooded the area in 2001, Cookston noted.

“Many of our hospitals were also flooded,” he said. “Allison showed us that hospitals cannot be command centers and sometimes end up being the places where emergencies happen. We had to evacuate patients from the hospitals. We thought we were prepared for emergencies, but Allison showed us that we weren’t.”

Opportunities for Volunteerism

Pharmacists and pharmacy technicians may volunteer their services and skills for any of the following groups:

National Pharmacist Response Teams, volunteer pharmacists and pharmacy technicians who respond to regional disasters and medical emergencies. Applications are available at www.oep-ndms.dhhs.gov/NDMS/Downloads/downloads.html.

Medical Reserve Corps, locally-based health care volunteers who can assist their community during a large-scale emergency, such as an influenza epidemica, a chemical spill, or an act of terrorism. Information is available at www.medicalreservecorps.gov/index.htm.

Disaster Medical Assistance Teams, a group of professional and paraprofessional medical personnel that provides emergency medical care during a disaster or other event anywhere in the nation or overseas. Information is available at www.oep-ndms.dhhs.gov.