COMMITTEE ON HEALTH

BILL NO. 28-0071 Twenty-Eighth Legislature of the Virgin Islands

June 8, 2009

An Act amending title 23 Virgin Islands Code, chapter 12 to enact the Virgin Islands Uniform Emergency Volunteer Health Practitioners Act PROPOSED BY:

Senators Patrick Simeon Sprauve and Craig W. Barshinger Co-Sponsor: Louis Patrick Hill

Be it enacted by the Legislature of the Virgin Islands: 1

SECTION 1. Title 23 Virgin Islands Code chapter 11 is amended by adding a 2

subchapter III that reads as follows: 3

“SUBCHAPTER II I VIRGIN ISLANDS UNIFORM EMERGENCY VOLUNTEER 4

PRACTITIONERS ACT 5

§ 171. SHORT TITLE. This subchapter may be cited as The Virgin Islands 6

Uniform Emergency Volunteer Health Practitioners Act. 7

SECTION 2. §171a. DEFINITIONS. As used in this subchapter: 8

9

10

2

(1) “Director” means the Director of the Virgin Islands Emergency Management 1

Agency. 2

(2) “Disaster relief organization” means an entity that provides emergency or disaster 3

relief services that include health or veterinary services provided by volunteer health 4

(A) is designated or recognized as a provider of those services pursuant to 5

a disaster response and recovery plan adopted by an agency of the federal 6

Government or the Virgin Islands; or 7

(B) regularly plans and conducts its activities in coordination with an 8

agency of the federal government or VITEMA. 9

(3) “Emergency” means an event or condition that is an emergency or major 10

disaster as defined in section 1124 subsections (a) paragraphs (1)&) (2). Of this chapter. 11

(4) “Emergency declaration” means a declaration of emergency issued by 12

proclamation of the Governor pursuant to section 1125 (c) of this chapter. 13

(5) “Emergency Management Assistance Compact” means the interstate compact 14

approved by Congress by Public Law No. 104-321,110 Stat. 3877 and established in 15

subchapter II of this chapter. 16

(6) “Entity” means a person other than an individual. 17

(7) “Health facility” means an entity licensed under the laws of the Virgin Islands 18

or the laws of another state to provide health or veterinary services. 19

(8) “Health practitioner” means an individual licensed under the laws of the 20

Virgin Islands or another state to provide health or veterinary services. 21

(9) “Health services” means the provision of treatment, care, advice or guidance, 22

or other services or supplies, related to the health or death of individuals or human 23

populations, to the extent necessary to respond to an emergency, including: 24

25

3

(A) the following, concerning the physical or mental condition or 1

functional status of an individual or affecting the structure or function of the body: 2

(i) preventive, diagnostic, therapeutic, rehabilitative, maintenance, 3

or palliative care; and 4

(ii) counseling, assessment, procedures, or other services; 5

(B) sale or dispensing of a drug, a device, equipment, or another item to an 6

individual in accordance with a prescription; and 7

(C) funeral, cremation, cemetery, or other mortuary services. 8

(10) “Host entity” means an entity operating in the Virgin Islands which uses 9

volunteer health practitioners to respond to an emergency. 10

(11) “License” means authorization by a state to engage in health or veterinary 11

services that are unlawful without the authorization. The term includes authorization under 12

the laws of the Virgin Islands to an individual to provide health or veterinary services based 13

upon a national certification issued by a public or private entity. 14

(12) “Other law” means law other than the provisions in this subchapter. 15

(13) “Person” means an individual, corporation, business trust, trust, partnership, 16

limited liability company, association, joint venture, public corporation, government or 17

governmental subdivision, agency, or instrumentality, or any other legal or commercial 18

entity. 19

(14) “Scope of practice” means the extent of the authorization to provide health or 20

veterinary services granted to a health practitioner by a license issued to the practitioner in 21

the state in which the principal part of the practitioner’s services are rendered, including any 22

conditions imposed by the licensing authority. 23

24

25

4

(15) “State” means a state of the United States, the District of Columbia, Puerto 1

Rico, the Virgin Islands, or any territory or insular possession subject to the jurisdiction of 2

the United States. 3

(16) “Territory” means the Virgin Islands. 4

(17) “Veterinary services” means the provision of treatment, care, advice or 5

guidance, or other services, or supplies, related to the health or death of an animal or to 6

animal populations, to the extent necessary to respond to an emergency, including: 7

(A) diagnosis, treatment, or prevention of an animal disease, injury, or 8

other physical or mental condition by the prescription, administration, or dispensing 9

of vaccine, medicine, surgery, or therapy; 10

(B) use of a procedure for reproductive management; and 11

(C) monitoring and treatment of animal populations for diseases that have 12

spread or demonstrate the potential to spread to humans. 13

(18) “VITEMA” means the Virgin Islands Emergency Management Agency 14

established under title 3 section 23 of this Code, 15

(19) “Volunteer health practitioner” means a health practitioner who provides 16

health or veterinary services, whether or not the practitioner receives compensation for those 17

services. The term does not include a practitioner who receives compensation pursuant to a 18

preexisting employment relationship with a host entity or affiliate which requires the 19

practitioner to provide health services in the Virgin Islands, unless the practitioner is not a 20

resident of the Virgin Islands and is employed by a disaster relief organization providing 21

services in the Virgin Islands while an emergency declaration is in effect. 22

§171b. APPLICABILITY TO VOLUNTEER HEALTH PRACTITIONERS. 23

This subchapter applies to volunteer health practitioners registered with a registration system 24

25

5

that complies with section 171d and who provide health or veterinary services in the Virgin 1

Islands for a host entity while an emergency declaration is in effect. 2

§171c. REGULATION OF SERVICES DURING EMERGENCY. 3

(a) While an emergency declaration is in effect, VITEMA may limit, restrict, or 4

otherwise regulate: 5

(1) the duration of practice by volunteer health practitioners; 6

(2) the geographical areas in which volunteer health practitioners may 7

practice; 8

(3) the types of volunteer health practitioners who may practice; and 9

(4) any other matters necessary to coordinate effectively the provision of 10

health or veterinary services during the emergency. 11

(b) An order issued pursuant to subsection (a) may take effect immediately, 12

without prior notice or comment. 13

(c) A host entity that uses volunteer health practitioners to provide health or 14

veterinary services in the Virgin Islands shall: 15

(1) consult and coordinate its activities with the Director and the 16

Commissioner of Health to the extent practicable to provide for the efficient and 17

effective use of volunteer health practitioners; and 18

(2) comply with any other laws relating to the management of emergency 19

health or veterinary services. 20

§171d. VOLUNTEER HEALTH PRACTITIONER REGISTRATION 21

SYSTEMS. 22

(a) To qualify as a volunteer health practitioner registration system, a system 23

must: 24

25

6

(1) accept applications for the registration of volunteer health practitioners 1

before or during an emergency; 2

(2) include information about the licensure and good standing of health 3

practitioners which is accessible by authorized persons; 4

(3) be capable of confirming the accuracy of information concerning 5

whether a health practitioner is licensed and in good standing before health services 6

or veterinary services are provided under this subchapter; and 7

(4) meet one of the following conditions: 8

(A) be an emergency system for advance registration of volunteer 9

health-care practitioners established by a state and funded through the 10

Department of Health and Human Services under Section 319I of the Public 11

Health Services Act, 42 USC Section 247d-7b ;; 12

(B) be a local unit consisting of trained and equipped emergency 13

response, public health, and medical personnel formed pursuant to Section 14

2801 of the Public Health Services Act, 42 U.S.C.§300hh; 15

(C) be operated by a: 16

(i) disaster relief organization; 17

(ii) licensing board; 18

(iii) national or regional association of licensing boards or 19

health practitioners; 20

(iv) health facility that provides comprehensive inpatient 21

and outpatient health-care services, including a tertiary care and 22

teaching hospital; or 23

24

25

7

(v) governmental entity; or 1

(D) be designated by the Commissioner of Health as a registration 2

system for purposes of this subsection. 3

(b) While an emergency declaration is in effect, the Commissioner of Health, the 4

Director or a person authorized to act on behalf of the Commissioner of Health or the 5

Director, or a host entity, may confirm whether volunteer health practitioners utilized in this 6

Territory are registered with a registration system that complies with subsection (a). 7

Confirmation is limited to obtaining identities of the practitioners from the system and 8

determining whether the system indicates that the practitioners are licensed and in good 9

standing. 10

(c) Upon request of a person in this Territory authorized under subsection (b), or 11

a similarly authorized person in another state, a registration system located in this Territory 12

shall notify the person of the identities of volunteer health practitioners and whether the 13

practitioners are licensed and in good standing. 14

(d) A host entity is not required to use the services of a volunteer health 15

practitioner even if the practitioner is registered with a registration system that indicates that 16

the practitioner is licensed and in good standing. 17

§171e. RECOGNITION OF VOLUNTEER HEALTH PRACTITIONERS 18

LICENSED IN OTHER STATES. 19

(a) While an emergency declaration is in effect, a volunteer health practitioner, 20

registered with a registration system that complies with section 171d and licensed and in 21

good standing in the state upon which the practitioner’s registration is based, may practice in 22

the Virgin Islands to the extent authorized by this subchapter as if the practitioner were 23

licensed in the Territory. 24

25

8

(b) A volunteer health practitioner qualified under subsection (a) is not entitled to 1

the protections of this subchapter if the practitioner is licensed in more than one state and any 2

license of the practitioner is suspended, revoked, or subject to an agency order limiting or 3

restricting practice privileges, or has been voluntarily terminated under threat of sanction. 4

§171f. NO EFFECT ON CREDENTIALING AND PRIVILEGING. 5

(a) In this section: 6

(1) “Credentialing” means obtaining, verifying, and assessing the 7

qualifications of a health practitioner to provide treatment, care, or services in or for a 8

health facility. 9

(2) “Privileging” means the authorizing by an appropriate authority, such 10

as a governing body, of a health practitioner to provide specific treatment, care, or 11

services at a health facility subject to limits based on factors that include license, 12

education, training, experience, competence, health status, and specialized skill. 13

(b) This subchapter does not affect credentialing or privileging standards of a 14

health facility and does not preclude a health facility from waiving or modifying those 15

standards while an emergency declaration is in effect. 16

§171g. PROVISION OF VOLUNTEER HEALTH OR VETERINARY 17

SERVICES; ADMINISTRATIVE SANCTIONS. 18

(a) Subject to subsections (b) and (c), a volunteer health practitioner shall adhere 19

to the scope of practice for a similarly licensed practitioner established by the licensing 20

provisions, practice acts, or other laws of the Virgin Islands. 21

(b) Except as otherwise provided in subsection (c), this subchapter does not 22

authorize a volunteer health practitioner to provide services that are outside the practitioner’s 23

scope of practice, even if a similarly licensed practitioner in this Territory would be 24

25

9

permitted to provide the services. 1

(c) The Director may modify or restrict the health or veterinary services that 2

volunteer health practitioners may provide pursuant to this subchapter. 3

(d) A host entity may restrict the health or veterinary services that a volunteer 4

health practitioner may provide pursuant to this subchapter. 5

(e) A volunteer health practitioner does not engage in unauthorized practice 6

unless the practitioner has reason to know of any limitation, modification, or restriction under 7

this section or that a similarly licensed practitioner in this Territory would not be permitted to 8

provide the services. A volunteer health practitioner has reason to know of a limitation, 9

modification, or restriction or that a similarly licensed practitioner in this state would not be 10

permitted to provide a service if: 11

(1) the practitioner knows the limitation, modification, or restriction exists 12

or that a similarly licensed practitioner in this state would not be permitted to provide 13

the service; or 14

(2) from all the facts and circumstances known to the practitioner at the 15

relevant time, a reasonable person would conclude that the limitation, modification, 16

or restriction exists or that a similarly licensed practitioner in this state would not be 17

permitted to provide the service. 18

(f) In addition to the authority granted by other Virgin Islands law to regulate the 19

conduct of health practitioners, the appropriate licensing board in this Territory: 20

(1) may impose administrative sanctions upon a health practitioner 21

licensed in the Virgin Islands for conduct outside of the Territory in response to an 22

out-of-state emergency; 23

24

25

10

(2) may impose administrative sanctions upon a practitioner not licensed 1

in the Virgin Islands for conduct in the Territory in response to an in-state emergency; 2

and 3

(3) shall report any administrative sanctions imposed upon a practitioner 4

licensed in another state to the appropriate licensing board or other disciplinary 5

authority in any other state in which the practitioner is known to be licensed. 6

(g) In determining whether to impose administrative sanctions under subsection 7

(f), the appropriate licensing board or other disciplinary authority shall consider the 8

circumstances in which the conduct took place, including any exigent circumstances, and the 9

practitioner’s scope of practice, education, training, experience, and specialized skill. 10

§171h. RELATION TO OTHER LAWS. 11

(a) This subsection does not limit rights, privileges, or immunities provided to 12

volunteer health practitioners by other laws. Except as otherwise provided in subsection (b), 13

this subchapter does not affect requirements for the use of health practitioners pursuant to the 14

Emergency Management Assistance Compact under subchapter II of this chapter. 15

(b) The Director pursuant to the Emergency Management Assistance Compact 16

may incorporate into the emergency forces of the Territory volunteer health practitioners who 17

are not officers or employees of the Government of the Virgin Islands, an instrumentality of 18

the Government or other political subdivision of the Government of the Virgin Islands. 19

§171i. REGULATORY AUTHORITY. The Director may promulgate rules to 20

implement this subchapter. In doing so the Director shall consult with and consider the 21

recommendations of the Adjunct General and any entity delegated to coordinate the 22

implementation of the Emergency Management Assistance Compact and shall also consult 23

24

25

11

with and consider rules promulgated by similarly empowered agencies in other states to 1

promote uniformity of application of this subchapter and make the emergency response 2

systems in the various states reasonably compatible. 3

§171 j. LIMITATIONS ON CIVIL LIABILITY FOR VOLUNTEER HEALTH 4

PRACTITIONERS; VICARIOUS LIABILITY 5

(a) Subject to subsection (c), a volunteer health practitioner who provides health 6

or veterinary services pursuant to this subchapter is not liable for damages for an act or 7

omission of the practitioner in providing those services. 8

(b) No person is vicariously liable for damages for an act or omission of a 9

volunteer health practitioner if the practitioner is not liable for the damages under subsection 10

(a). 11

(c) This section does not limit the liability of a volunteer health practitioner for: 12

(1) willful misconduct or wanton, grossly negligent, reckless, or criminal 13

conduct; 14

(2) an intentional tort; 15

(3) breach of contract; 16

(4) a claim asserted by a host entity or by an entity located in this or 17

another state which employs or uses the services of the practitioner; or 18

(5) an act or omission relating to the operation of a motor vehicle, vessel, 19

aircraft, or other vehicle. 20

(d) A person that, pursuant to this subchapter, operates, uses, or relies upon 21

information provided by a volunteer health practitioner registration system is not liable for 22

damages for an act or omission relating to that operation, use, or reliance unless the act or 23

24

25

12

omission is an intentional tort or is willful misconduct or wanton, grossly negligent, 1

reckless, or criminal conduct. 2

(e) In addition to the protections provided in subsection (a), a volunteer health 3

practitioner who provides health or veterinary services pursuant to this subchapter is entitled 4

to all the rights, privileges, or immunities provided by 19 V.I.C. § 217, 23 V.I.C. §1107, 24 5

V.I.C. §282 and any other law granting such rights, privileges and immunities. 6

§171k. WORKERS’ COMPENSATION COVERAGE. 7

(a) In this section, “injury” means a physical or mental injury or disease for which 8

an employee of this Territory who is injured or contracts the disease in the course of the 9

employee’s employment would be entitled to benefits under the workers’ compensation law 10

of this Territory. 11

(b) A volunteer health practitioner who dies or is injured as the result of providing 12

health or veterinary services pursuant to this subchapter is deemed to be an employee of the 13

Government of the Virgin Islands for the purpose of receiving benefits for the death or injury 14

under the workers’ compensation law of the Virgin Islands if: 15

(1) the practitioner is not otherwise eligible for such benefits for the injury 16

or death under the law of the Virgin Islands or another state; and 17

(2) the practitioner, or in the case of death the practitioner’s personal 18

representative, elects coverage under the workers’ compensation law of the Virgin 19

Islands by making a claim under that law. 20

(c) The Commissioner of the Virgin Islands Department of Labor shall adopt 21

rules, enter into agreements with other states, or take other measures to facilitate the receipt 22

of benefits for injury or death under the workers’ compensation law of the Virgin Islands by 23

volunteer health practitioners who reside in other states, and may waive or modify 24

25

13

requirements for filing, processing, and paying claims that unreasonably burden the 1

practitioners. To promote uniformity of application of this subchapter with other states that 2

enact similar legislation, the Commissioner of Labor shall consult with and consider the 3

practices for filing, processing, and paying claims by agencies with similar authority in other 4

states. 5

§171l. UNIFORMITY OF APPLICATION AND CONSTRUCTION. In 6

applying and construing this subchapter, as a “uniform act”, consideration must be given to 7

the need to promote uniformity of the law with respect to its subject matter among states that 8

enact it. 9

§171m. SEVERABILITY 10

If any provision of this subchapter,, or the application of any such provision to any 11

person, thing, or circumstance, is determined by any court of competent jurisdiction to be 12

invalid, the determination of invalidity does not affect, impair, or invalidate the other 13

provisions, or the application of the other provisions of this subchapter which can be given 14

effect without the invalid provision or application, and to effect this purpose the provisions of 15

this subchapter are severable.” 16

SECTION 2. Title 24 Virgin Islands Code, chapter 11, section 282 (a) is amended 17

after the phrase, “at the request of the Governor” by inserting “a host entity as defined in 23 18

V.I.C. (9)”, 19

BILL SUMMARY 20

The Uniform Emergency Volunteer Health Practitioner’s Act was adopted in 2006 21

and amended in 2007 by the National Conference of Commissioners of Uniform State Laws. 22

The Act’s adoption was in direct response to the severe problems experienced by states 23

24

25

14

during Hurricane Katrina caused by the lack of uniformity in state laws. 1

During the Hurricane volunteer health care providers, including doctors, nurses, 2

psychologists, EMTs, coroners, veterinarians and other health professionals were delayed, or 3

in some cases, prevented from providing critically needed health services due to an inability 4

to secure authorization expeditiously for these private-sector volunteers to practice within the 5

affected states. There were such problems as licensure requirements being different from 6

state to state and the issue of liability. 7

A primary purpose of this bill is to make the Virgin Islands a part of a uniform system 8

that quickly and efficiently facilitates the deployment and use of licensed practitioners to 9

provide health and veterinary services in response to declared emergencies. This bill (1) 10

establishes a system for the use of volunteer health practitioners capable of functioning 11

autonomously even when routine methods of communication are disrupted; (2) provides 12

reasonable safeguards to assure that volunteer health practitioners are appropriately licensed 13

and regulated to protect the public’s health and safety; (3) authorizes the Virgin Islands to 14

regulate, direct, and restrict the scope and extent of services provided by volunteer health 15

practitioners to promote disaster recovery operations; (4) imposes limitations on the exposure 16

of volunteer health practitioners to civil liability to create a legal environment conducive to 17

volunteerism; and (5) allows volunteer health practitioners who suffer injury or death while 18

providing services pursuant to this act the option to elect workers’ compensation benefits 19

from the host state if such coverage is not otherwise available. 20

The bill amends title 23 chapter 12 of the Virgin Islands Code. Chapter 12 also 21

contains the Emergency Management Assistance Compact, which was also adopted by all 50 22

states. The Emergency Management Assistance Compact provides for the interstate 23

recognition of licenses held by professionals responding to disasters and emergencies, 24

25

15

However the Compact cannot be efficiently used to supply the "surge capacity" required to 1

deliver health services during emergencies. This is because, aside from its application to 2

state government employees. A shortcoming of the Compact is that it extends its benefits 3

only to other emergency responders who go through a complicated process of entering into 4

agreements with their home jurisdictions to be deployed to other states pursuant to mutual aid 5

agreements. As a result, very few private sector volunteers were able to be deployed during 6

Katrina through the Compact and the capacity of state and federal government agencies to 7

immediately provide needed assistance was overwhelmed. 8

The objective of the National Conference of Uniform State Laws in adopting the 9

Uniform Emergency Volunteer Health Practitioner’s Act is to ensure that during 10

disasters and other emergencies health practitioners will be able to be quickly deployed 11

to health facilities and disaster relief organizations in accordance with clear and well-12

understood rules that will both meet the needs of volunteers and relief agencies and 13

provide an effective framework to ensure the delivery of high quality care to disaster 14

victims. 15

Internal section 171 sets forth the short title of the subchapter as “The Virgin 16

Islands Uniform Emergency Volunteer Health Practitioners Act. Section 171a sets forth 17

the definitions of the terms used in the body of the bill. 18

Prominent among the definitions is the definition of “disaster relief organization” The 19

comments of the National conference of Uniform State Laws Drafting Committee explain 20

that a disaster relief organization is an entity that provides disaster relief services or 21

assistance in response to an emergency declaration. The comments give as an example, the 22

American Red Cross, which has been chartered by Congress to provide emergency relief 23

services, as constituting a disaster relief organization as the term is used in the bill. Other 24

25

16

members of the National Voluntary Organizations Active in Disaster, Inc. (NVOAD) that 1

provide similar services may also be considered disaster relief organizations. The definition 2

limits such organizations, however, only to those expressly designated in federal or state 3

disaster relief plans, or which regularly plan and conduct their activities in coordination with 4

state or federal agencies. As used in this context, the reference to “its activities” means 5

emergency or disaster relief services that include the provision of health or veterinary 6

services. 7

As the Comments also explain, the definition defines the term “disaster relief 8

organization” narrowly to reflect the special rights and privileges given to disaster relief 9

organizations by this bill. The Comments further explain that disaster relief organizations are 10

one of only three types of private entities, including national or regional associations of 11

healthcare licensing boards or health practitioners and health facilities providing 12

comprehensive inpatient and outpatient care, that are authorized by internal section 171d (a) 13

(4) (C) of this bill to establish and operate registration systems for volunteer health 14

practitioners, without prior governmental approval. In addition, although generally the term 15

“volunteer health practitioners” does not include individuals with a pre-existing employment 16

relationship with a “host entity,” employees of disaster relief organizations acting as host 17

entities may be classified as volunteer health practitioners when their regular place of 18

employment is located in another state. 19

Under internal section 171a. (6) a “health facility” is an entity engaged in the 20

provision of health or veterinary services in its ordinary course of business or activities. The 21

term does not include individual health practitioners. The definition does not enumerate 22

specific types of facilities to avoid a restrictive interpretation of the term to mean only 23

facilities similar to the ones listed pursuant to certain canons of statutory construction. 24

25

17

Instead, all types of entities authorized by Virgin Islands law to provide health or veterinary 1

services are defined as health facilities. 2

Under section 171a (7) “health practitioner” is defined as an individual, not an entity, 3

who is licensed in any state, including the host state, to provide health or veterinary services 4

or who holds a national certificate that is recognized by the host state as equivalent to 5

licensure for purposes of providing health services to individuals or human populations or 6

veterinary services to animals or animal populations. As the Comments of the National 7

Conference of Uniform State Laws” Drafting Committee explains, the term makes reference 8

to the laws of other states for the purpose of allowing practitioners licensed in other states to 9

practice as volunteer health practitioners subject to the requirements and limitations provided 10

by this act, including the limitations on their scope of practice as provided. 11

Under section 171a (8) the term, “health services” broadly defined. As the 12

Comments provided by the Uniform Law Drafting Committee, the definition is patterned on 13

the definition under the HIPAA Privacy Rule, 45 C.F.R. 160.103. 14

The definition of health services includes those services provided by volunteer health 15

practitioners which relate to the health or death of individuals or populations and that are 16

necessary to respond to an emergency. As the Comments explain, health services under the 17

Uniform Emergency Volunteer Health Providers Act include direct patient health services, 18

public health services, provision of pharmaceutical products, and mortuary services for the 19

deceased. On an individual level, health services include transportation, diagnosis, treatment, 20

and care for injuries, illness, diseases, or pain related to physical or mental impairments. On 21

the population level, health services may include the identification of injuries and diseases, 22

and an understanding of the etiology, prevalence, and incidence of diseases, for groups or 23

members within the population. As the comments further explain, “health services” do not 24

25

18

include services that do not provide direct health benefits to individuals or populations. For 1

example, ancillary services administrative tasks, medical record keeping; transportation of 2

medical supplies would not be health services under this definition. 3

Under internal section 171a (9) a “host entity” is defined as the Virgin Islands agency 4

that uses the volunteer health practitioners. The term encompasses disaster relief 5

organizations, hospitals, clinics, emergency shelters, doctors’ offices, outpatient centers, or 6

any other places where volunteer health practitioners may provide health or veterinary 7

services, including the Red Cross and VITEMA. 8

Under internal section 171a (18) “volunteer health practitioner” is defined as a health 9

practitioner who provides health or veterinary services, whether or not the practitioner 10

receives compensation for those services. This definition is not like many federal and state 11

definitions that mandate that volunteers be without compensation. However there is a 12

limitation in that the term does not include a practitioner who receives compensation under a 13

preexisting employment relationship with a host entity which requires the practitioner to 14

provide health services in the Virgin Islands, unless the practitioner is not a resident of the 15

Virgin Islands and is employed by a disaster relief organization providing services in while 16

an emergency declaration is in effect. 17

Internal section 171b makes the measure applicable only in the case of an emergency. 18

Upon the declaration of an emergency, the benefits of the statute will become available to 19

volunteer practitioners who provide health services to a host entity in the Virgin Islands. 20

Internal section 171c provides for the regulation of health services and volunteer 21

health practitioners during a disaster or other emergency and authorizes the imposition of 22

limits and restrictions on the services to be provided. Under section 171c, restrictions, may 23

relate to (1) the duration of practice by volunteer health practitioners, (2) the geographical 24

25

19

areas in which volunteer health practitioners may practice, (3) the class or classes of 1

volunteer health practitioners who may practice, and (4) any other matters necessary to 2

coordinate effectively the provision of health or veterinary services. Additional restrictions 3

concerning the type and scope of services provided by volunteer health practitioners may 4

also be imposed. 5

Internal section 171d authorizes the use of each of the various types of registration 6

systems found to be effective in responding to the Gulf Coast Hurricanes of 2005. These 7

systems include not only federally sponsored local Medical Reserve Corps, ESAR-VHP 8

systems, and other systems expressly established under federal or state laws, but also 9

registration systems established by disaster relief organizations, such as Disaster Human 10

Resources System of the American Red Cross; systems established by associations of the 11

state licensing boards, such as the Federation of State Medical Licensing Boards, the 12

National Council of State Boards of Nursing and the Association of State and Provincial 13

Psychology Licensing Boards; systems established by national associations of health 14

professions, including the American Medical Association, the American Nurses Association, 15

the American Psychology Association, the National Association of Social Workers, the 16

American Counseling Association, the National Association of Chain Drug Stores, and the 17

American Veterinary Medicine Association; and systems established by major tertiary care 18

hospital systems. As the National Conference of Commissioners of Uniform State Laws 19

Drafting Committee’s Comments further explain, the Uniform Emergency Volunteer Health 20

Practitioners Act allows each of the various types of organizations to establish and operate 21

registration systems without explicit governmental approval because they have demonstrated 22

the resources, competence and reliability to review and communicate information regarding 23

the professional qualifications of health practitioners. 24

25

20

There is no requirement under section 171d for the Virgin Islands to approve 1

registration systems. As the Comments note, the Act empowers and legitimizes the 2

operations of numerous types of public and nongovernmental organizations that have 3

consistently demonstrated their ability to properly recruit, train, deploy and verify the 4

credentials of volunteer health practitioners. 5

Section 171d prescribes three primary mandates for registration systems. Each 6

system must (1) facilitate the registration of volunteer health practitioners prior to, or during, 7

the time their services may be needed; (2) maintain organized information about the 8

volunteers that is accessible by authorized personnel; and (3) be capable of being used to 9

verify the accuracy of information concerning whether the volunteers are licensed and in 10

good standing. 11

Internal section 171e addresses the need to recognize the licenses of practitioners; 12

licensed in other jurisdictions. The section in effect gives reciprocity to off-island health 13

practitioners who come into the Territory to provide emergency health services. The 14

protections of the statute are not conferred on practitioners who are not in good standing in 15

the jurisdictions of their licensure. 16

Internal section 171f makes it clear that the Act is not intended to impact 17

credentialing and privileging standards of a health care facility or to preclude them form 18

waiving any of these standards during an emergency. 19

Internal section 171g further regulates emergency volunteer health practitioners and 20

the services they will provide. The section prohibits practitioner for working beyond the 21

scope of the practitioner’s of practice. The section provides for the restriction of health 22

services that may be provided and may impose administrative sanctions for the conduct of 23

volunteer practitioners licensed within and without the Virgin Islands. 24

25

21

Internal section 171h clarifies that the measure is not intended to supplant the rights, 1

privileges and immunities conferred on volunteers under other statutes. It will not for 2

example limit protections volunteers now enjoy under the federal Volunteer Protection Act. 3

Internal section 171i authorizes the Director of VITEMA to promulgate rules to 4

implement the subchapter after consultation with the Adjunct General, any entity that 5

implements the Emergency Management Assistance Compact and with other states for 6

purposes of establishing uniformity of application and compatible response systems. 7

Internal section 171j governs liability. That section insulates emergency volunteer 8

health practitioners who provide health services under the subchapter from liability, and it 9

insulates persons, including host entities and the government who use entities from vicarious 10

liability for the acts or omissions of the volunteers. However this protection does not insulate 11

(1) willful misconduct or wanton, grossly negligent, reckless, or criminal conduct; (2) an 12

intentional tort;(3) breach of contract;(4) a claim asserted by a host entity or by an entity; or 13

(5) an act or omission relating to the operation of a motor vehicle, vessel, aircraft, or other 14

vehicle. 15

Internal section 171k extends Workers Compensation benefits to volunteers who are 16

not otherwise covered. The section requires the Commissioner of Labor to consult with other 17

jurisdictions in promulgating rules in order to achieve uniformity of application. 18

Internal section 171l is a standard provision found in all uniform acts. The intent of 19

section is to promote uniformity of application among all the jurisdictions that enact the 20

Uniform Emergency Volunteer Health Practitioners Act. 21

Internal section 171m is a severability clause to emphasize the Legislature’s intent to 22

have the subchapter enforced even though a portion of it may be held invalid. 23

24

25

22

Section 2 of the bill amends the Workers Compensation law to include the benefits 1

granted volunteers from outside the Territory under 24 V.I.C. (a) (6) who are requested by a 2

host entity under section, the Uniform Emergency Volunteer Health Practitioners Act, to 3

render to render service in the Virgin Islands in connection with a disaster or emergency. 4

Under existing law, the benefits under the Workers Compensation law are extended to those 5

volunteers who are requested by the either the Governor of the Adjunct General. 6

7

8

BR09-0371(a)/June 1, 2009/YLT 9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25