As Nevada’s medical sector braces for the impact of the novel coronavirus, Gov. Steve Sisolak is hoping to attract a network of emergency volunteers to join in the fight.
The governor’s emergency directive last week provides lawsuit immunity for medical professionals providing COVID-19 care and temporarily loosens restrictions on certain health care workers who are retired or unlicensed in the state, allowing them to seek waivers and exemptions to assist in the effort.
Dubbed the Battle Born Medical Corps, the new initiative is already generating interest, but if the state sees a spike in severe cases, it will have to work to attract volunteer health care providers in a competitive national environment and in a state with a pre-existing shortage.
“We’re trying to loosen some of the licensing requirements, expand reciprocity with other states — the big problem with all of those efforts is you see 49 other states doing the same thing,” said John Packham, associate dean for the Office of Statewide Initiatives at the University of Nevada, Reno School of Medicine.
Since the governor’s directive was signed on April 1, the Nevada State Board of Medical Examiners has received a dozen or more calls from individuals interested in obtaining waivers, said Executive Director Edward Cousineau.
The office of the state’s chief medical officer, Ihsan Azzam, has also received multiple inquiries from interested volunteers educated and credentialed outside of the country who would like to assist, said Nevada Department of Health and Human Services Director’s Office spokesperson Shannon Litz via email.
Clark County has also released English and Spanish public service announcements to reach the state’s retired health workforce. But other states like Oregon, Alabama and hard-hit areas such as California and New York are also recruiting volunteers.
Ideally, volunteers could move from hotspot to hotspot, but that’s not the way health workforce staffing usually goes, Packham said. Across the Silver State, steady growth in the number of licensed medical professionals has not kept pace with the booming population.
“We’ve made progress, but I do think this crisis will underscore the price we pay for having those workforce shortages,” Packham said.
The state is making a push to recruit willing volunteers with licenses in good standing through the State Emergency Registry of Volunteers-Nevada (SERV-NV). Registrants can select their local Medical Reserve Corps, the Statewide Volunteer Pool or the Mental Health Crisis Counselors.
But the process of signing up for the Medical Reserve Corps isn’t just about filling out a sign-up form.
“Different organizations have their own processes for vetting volunteers,” Washoe County Health District program coordinator Raquel DePuy Grafton said via email. “The WCHD Medical Reserve Corps works with the State of Nevada and it is the process that allows us to keep a pool of vetted, affiliated volunteers that may be activated for emergency response efforts.”
Individuals who complete the process in Southern Nevada have trainings, background checks and licensure verification done by the state, too. The verification process can take time, which is why it’s important to recruit heavily now in case Nevada experiences a health emergency, said Jeff Quinn, manager of the Southern Nevada Health District’s Office of Public Health Preparedness. Quinn oversees the MedCorps of Southern Nevada.
Though the governor’s directive loosened some restrictions, it still prohibits individuals with suspended or revoked licenses from taking advantage of waivers and exemptions. The governor’s office did not respond to inquiries about whether health care providers under supervision after returning from a suspension would be considered in “good standing” and able to join the effort.
The order also does not clarify the extent of work authorized for medical students without their degrees versus those with degrees who are in their residencies.
Cousineau said he believes the governor made the order broad for a reason.
“The folks who are employing them would have to do their due diligence, and I think they are,” he said.
The Southern Nevada volunteer corps, which can deploy across Clark County, includes 18 physicians, 68 nurses, 22 emergency medical service professionals and a number of other volunteers including pharmacists, physician assistants and respiratory therapists. Nonmedical volunteers with no public health licensing make up about a quarter of the group.
The organization has generally limited participation to roughly 200 members in the past, but it has now ramped up recruiting.
The question of whether the volunteers will actually be put to work in the field with COVID-19 patients remains up in the air as hospitals, volunteers and state leaders carefully watch the severity and number of cases in Nevada.
“That is not out of the question,” Quinn said. “They really are on the frontlines and provide a valuable resource.”
Representatives for University Medical Center of Southern Nevada, Dignity Health-St. Rose Dominican Hospitals and HCA Healthcare told the Current on Tuesday that their Southern Nevada hospitals are currently fully staffed.
Dignity Health has made arrangements for travel nurses, while HCA has shifted staffing and has a surge plan in place, according the hospitals’ respective spokesmen.
UMC, meanwhile, has an overall low patient count due to the cancellation of nonemergent elective surgeries, public relations manager Scott Kerbs said.
In Washoe County, seven of their Medcorps members who are also registered nurses have been activated to assist with coronavirus testing, Grafton said.
Washoe has an activated pool of 34 volunteers, including 10 medical doctors, two respiratory therapists, three physician assistants, seven additional registered nurses and two paramedics. The group also includes a dietician, a certified nursing assistant and a licensed practical nurse.
The state’s rural areas have also had a chance to prepare thanks to a delay in the virus reaching those areas, Packham said.
But the real test will be if the regions experience multiple severe cases of COVID-19 requiring intensive care unit facilities, ventilators and other resources that are in short supply in the state’s rural and frontier regions.
“Don’t ask me to make any predictions,” Packham said.