By Lois M. Collins
Deseret Morning News (Salt Lake City)
Copyright 2006 The Deseret News Publishing Co.
Utah now has a Medical Reserve Corps in at least preliminary stages in each of its 12 local health districts.
The goal of the MRCs is to provide backup for disasters or just massive undertakings — an earthquake or a large flu-shot clinic, for example — to help the existing system avoid overload.
Across the nation and even across the state, they’re as distinctive as the topography and the people they’re forming to serve.
The MRC concept started with demonstration projects under the oversight of the Surgeon General’s Office in the U.S. Department of Health and Human Services, where the nearly 600 MRCs now registered will remain. They’re part of the Citizens Corps.
The Summit County corps in Park City had the honor of being the 500th MRC registered with the federal government.
Utah’s oldest MRC, formed by the Bear River Health Department, is now 3 years old and has about 85 volunteers. The baby of the Utah group, Wasatch, just got started. Several do not yet have any volunteers on the books, but they’ve got steering committees and timelines and big plans. They have one thing very much in common: They’re all trying to determine what they need to become to best serve their own communities, says Mike Weibel, coordinator of Bear River MRC’s Cache County unit (there’s also a Box Elder unit under Bear River) and the state MRCs’ unofficial dad.
When Katrina hit, FEMA, the American Red Cross and others were bombarded with offers of help. Most of them had to be turned away because there was no way to check backgrounds of the huge numbers of people. A large part of the corps’ value, says Bucky Whitehouse, coordinator of Tooele’s MRC, is they’ve been pre-identified, had background checks and are who they say they are. Everyone fears an event like the anecdote circulating after Katrina of the guy flying the helicopter in and out who, it turned out, just thought that would be “cool.”
“Clearly the strength and opportunity for MRC is a system where we pre-identify, pre-train and pre-credential volunteers to be able to respond during times of emergencies,” says John Librett, manager for Salt Lake Valley Health Department’s MRC. “It’s important that the MRC is a corps used to feed in, complement and fill gaps within the incident command structure.” The mandate, they all agree, is to enhance what each county or hospital or emergency crew is doing, not duplicate it.
In a disaster, about 85 percent of the folks who rush to the emergency room don’t need to be there, so Weibel and several other MRC coordinators say they hope their teams can provide triage and reduce that burden. Their plans call for a happy mix of medical professionals (including some not too-long retired) and nonmedical people. Weibel’s MRC signed up a group of contractors, which came in handy when they set up tents and generators at a mass flu shot clinic not long ago.
Something smaller, he says, might be an E. coli outbreak. Trained reservists could do the interviews of the sick that are part of the epidemiological investigation, freeing up the professionals for other tasks.
Or the MRC could play a huge role in planning and vaccinating a community if needed. Remember all that talk of smallpox? Or pandemic flu? They could distribute individual doses of antivirals or antibiotics from the national stockpile if needed, he says.
Unlike most Utah teams, Bear River’s has gone beyond just planning a couple of times. Five of their reservists went to Katrina, including Weibel, who served as a temporary public information officer there following the hurricane. Three members also helped an Idaho MRC with a national stockpile exercise.
The Davis County MRC forged alliances with local churches and others to use their buildings if needed as mass medicine distribution points or even, perhaps, shelters. Others, like Bear River and Utah County, have since forged similar agreements.
The goal isn’t to take over provision of medical services but to provide whatever cooperation and backup existing services would need in order to make it through a calamity. After Katrina produced thousands of displaced pets, one MRC nationally was made up of veterinarians. A few nationally revolve around medical schools and would use faculty and students to the degree they could help to fill gaps in the health-care system.
Most of Utah’s MRCs have picked particular areas they consider their first job. In Southwest MRC based in St. George, for instance, infectious disease outbreaks are the top target. A few weeks ago, the MRC was part of a larger effort to vaccinate more than 2,000 people against influenza, said Paulette Valentine, emergency response coordinator for the Southwest Health Department. It now has 12 reserve members but plans to reach at least 100.
Utah has a law that will provide an emergency medical license to a medical reservist who stopped maintaining a valid one in the past 10 years. Other laws protect the reservists from liability for things that go wrong during good-faith efforts to help. The reservists themselves determine how big a role they want to play and how much time to commit, from folks who are willing to help out any time the health department needs them to those who want to be called out only in a big emergency.
The Weber-Morgan MRC is not quite 2 years old but has recruited close to 50 people already, says George Chino, a health-department staffer who, with department nurses, is splitting coordination duties for now. Like many of the state’s MRCs, they hope at some point to have a VISTA member working to recruit and coordinate.
Some Utah MRCs, including Central MRC and Southeastern, have VISTA volunteers as coordinators, although Central’s Mandy Christensen will stay when her VISTA stint ends.
Weber-Morgan’s volunteer recruits are paramedics, doctors, nurses, veterinarians and people who are just willing to staff whatever needs to be done. For all the MRCs, in fact, nonmedical reservists are apt to outnumber the medical staff, just as support staff in a hospital outnumbers the medical teams, Chino says.
Recruiting’s a tough thing for the very rural Southeast MRC. “We have to re-evaluate our strategy,” says coordinator Kody Black (another VISTA volunteer), “because most of our skilled medical professionals are involved” with their own previous medical commitments. So they’re looking for pilots and radio operators and others to help with communication and transportation, two huge issues in rural areas in a disaster.
Central MRC has focused so far on designating roles its volunteers will fill — in triage, in shelter, as vaccinators or their assistants. As their ranks expand, so will the job list. When hospitals and agencies ask for help, they will be expected to provide job action sheets that show what they want volunteers to do, Christensen says.
MRCs serving two of the most populous parts of the state, Utah County and Salt Lake County, are barely getting started, although they’re moving pretty fast.
Utah County’s board meets twice a month, and it’s currently getting some supplies together and plan to start recruiting in a couple of weeks. It wants veterinarians, medical people, child-care workers and anyone who could help out, says coordinator Jan Rogers.
As they plan, says Rogers, “We hope we’re thinking of everything. But only in a true emergency will we know. We want to think ahead and be prepared before the fact, instead of bungling after the fact. And one of the most important things is we want to be a support and not a hindrance in an emergency.”
More information on the MRC, including links to Utah’s corps, is online at www.medicalreservecorps.gov and at www.deseretnews.com.