The Doctors Next Door

H1N1 a National Emergency--What Does That Mean?!



So what does it mean that we're in a state of national emergency with the H1N1 outbreak? 

Here's Obama's statement:

"Pursuant to section 201 of the National Emergencies Act (50 U.S.C. 1621), I hereby report that I have exercised my authority to declare a national emergency in order to be prepared in the event of a rapid increase in illness across the Nation that may overburden health care resources.  

This declaration will allow the Secretary of Health and Human Services, if necessary, to temporarily waive certain standard Federal requirements in order to enable U.S. health care facilities to implement emergency operations plans to deal with the 2009 H1N1 influenza pandemic in the United States. ...Further, I have authorized the Secretary of Health and Human Services to exercise the authority under section 1135 of the Social Security Act to temporarily waive or modify certain requirements of the Medicare, Medicaid, and State Children's Health Insurance programs and of the Health Insurance Portability and Accountability Act Privacy Rule as necessary to respond to the pandemic throughout the duration of the public health emergency declared in response to the 2009 H1N1 influenza pandemic."

Upon this declaration, the healthcare community has the authority to operate under "crisis standards of care". This enables specific legal and regulatory powers and protections for healthcare providers and the action is deemed necessary since medical resources could become or are already becoming quite scarce. 

So for example, medical operations may need to be set up in non-traditional settings such as churches and schools.  Under ordinary circumstances such locations would not be allowed since they wouldn't meet facilities standards set by regulatory bodies like the Joint CommissionHealthcare workers can also short-circuit the amount of information gathering needed before administering care--like standard consents for example.

Another example of what would be allowable under "crisis" circumstances is that healthcare workers can operate slightly outside their usual scope of practice.  The term "scope of practice" defines the type of work that a person with a given level of training can engage in.  For example, in Illinois under usual conditions, a medical assistant is not able to assess a patient and give medical advice based on his assessment.  Since emergency conditions have been declared the medical assistant's scope of practice constraints can be relaxed. So say the doctor is swamped seeing patients and the registered nurse is out ill, the medical assistant can be given a protocol to follow for assessing a patient and giving medical advice over the phone. 

These are just a few of examples of ways that our healthcare system is now enabled to shift so that we can continue to care for our communities.  The Institute of Medicine just published a document entitled Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations.  This document addressing important subjects such as equity, ethics and privacy.  Let me assure you that these values remain important to us as we deliver healthcare services in all circumstances.

Now for some fun--go check out this H1N1 Rap! Dr. Clarke is the winner of a Health and Human Services sponsored national competition for developing a creative public service announcement about H1N1 and lives in Baldwin, New York.



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