Travelers Hired Under EMSA

Has it happened at your institution yet? Emergency Medical Services Authority (EMSA) has adopted policies and procedures governing the use of out-of-state medical personnel to respond to the COVID-19 outbreak pursuant to the Governor’s Emergency Proclamation on March 4, 2020. Under this policy, facilities are bringing healthcare workers licensed in other states in to California to work. I imagine other states are doing the same. At the LA Surge Center, many nurses were brought in under this policy as well as one of the pharmacists I hired. This policy is so a medical facility that is unable to secure sufficient staffing from California certified and licensed healthcare professionals or a staffing agency may seek out-of-state healthcare professionals to fill the gap with approval from the EMS Authority1.

When diversion is identified or suspected for a healthcare worker licensed in a different state, what is the process for reporting? Recently, I was involved in suspected diversion of a Traveler Nurse licensed out of state. I did not realize she was part of the EMSA Policy until I saw the Board of Nursing Complaint that was filed where it stated she was hired under the EMSA Policy and mentioned the state of her licensure. New territory for me. Do we report to the California Board of Registered Nursing (BRN) or the BRN holding licensure? Both would be a good answer, but sometimes it takes a fair amount of follow through to confirm the report is filed at all, let alone in two states. After reaching out to a contact at the CA BRN, I was told the ideal process is to report directly to the state who holds the license. The complaint may be passed on fairly quickly, but typically the CA BRN will report to the NURSYS database and to the licensing state only after the CA case has been adjudicated. To ensure the more expedient reporting, it seems best to report directly. I also asked if the CA BRN requires they be notified of an out of state nurse’s activities or could the facility simply report to the licensing state only. The response from the CA BRN was “We do not currently have reporting requirements.”

The EMSA Policy states “the medical facility will be responsible for monitoring the healthcare providers hired based on this approval and will notify the EMS Authority of any unusual occurrence within 24 hours of the event occurring.” In addition to notifying the BRN, there must also be notification sent to the EMSA.

https://emsa.ca.gov/wp-content/uploads/sites/71/2020/03/MHPAuthorizationPolicyAndProcedure.pdf

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Terri Vidals

Terri has been a pharmacist for over 30 years and is a drug diversion mitigation and monitoring subject matter expert. Her years of experience in various roles within hospital pharmacy have given her real-world insight into risk, compliance, and regulatory requirements, as well as best practices for medication and patient safety.

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