Medical Reserve Corps

The Medical Reserve Corps (MRC) is a nationwide network of community-based units initiated and established by local organizations to meet the public health needs of their communities. It is sponsored by the Office of the Surgeon General. The MRC consists of medical and non-medical volunteers who contribute to local health initiatives, such as activities meeting the Surgeon General’s priorities for public health, and supplement existing response capabilities in time of emergency. The MRC provides the structure necessary to pre-identify and credential, train, and activate medical and public health volunteers.

As of April 2005, there were over 250 local MRC units containing tens of thousands of volunteers. As of August 2006, MRC was present in all 50 states, Washington, D.C., Guam, Palau, Puerto Rico, and the U.S. Virgin Islands.

Why the MRC was established
The events of September 11, 2001, underscored a need for a mechanism to better utilize volunteer medical and public health professionals. Medical providers arrived at the emergency on their own and at personal risk. These providers wanted to help alleviate the strain on local medical systems where the terror incidents occurred. Despite their intentions, their presence became problematic for emergency managers.

The difficulties of using spontaneous, unaffiliated volunteers became apparent. Some of the issues that arose included volunteer credentialing, liability, and management.


 * Credentialing—Credentialing is a process by which volunteers’ degrees, certificates, licenses, and training are verified. September 11, 2001 demonstrated that it was difficult or impossible to verify volunteers’ licenses and professional qualifications when the emergency management system was overloaded or shut down, in a scenario that had only been considered and not planned for.
 * Liability—Another challenge faced on September 11, 2001, was the issue of liability. Some questions that arose included:
 * Who would provide the legal protections for volunteers, many of whom had come from other areas of the country?
 * What should occur if the volunteers were injured?
 * How would they be treated or compensated?
 * Who would manage and supervise the volunteers?
 * Management—Emergency and local medical managers could not deal with the spontaneous volunteers, as their resources were limited and focused on emergency response and on accounting for their own personnel. Ultimately, most were turned away.

The anthrax mailings of October 2001 and the subsequent mass medication dispensing responses further highlighted the need for a system already organized and in place. Federal, state, and local response assets were fully engaged and provided prophylactic doses of antibiotics to thousands of individuals who may have been exposed to the anthrax spores. The leaders quickly realized, however, that they would have been overwhelmed if the number of individuals at risk was much larger. They would need more workers for their point of distribution sites, including many more health professionals.

Lessons-learned sessions and after-action reports from the response to September 11, 2001 and the anthrax mailings discussed the need for a more organized approach to catastrophic disasters. They also identified many of the issues that needed to be addressed, including volunteer pre-identification, registration, credentialing, training, liability, and activation.

Affiliations
The MRC was founded after President Bush’s 2002 State of the Union Address, in which he asked all Americans to volunteer in support of their country. The MRC is a partner program of Citizen Corps, a national network of volunteers dedicated to ensuring hometown security. Citizen Corps, along with the Corporation for National and Community Service and the Peace Corps, are part of the President’s USA Freedom Corps, which promotes volunteerism and service nationwide.

How communities understand the MRC
Differences among communities may require alternative approaches to responding to natural disasters and emergencies. The terms medical and reserve indicate that trained personnel are available to respond to emergencies requiring support to the community’s health and medical resources. Corps refers to an organized body of individuals with a similar function, consistent with the example of Citizen Corps and the USA Freedom Corps.

Despite differences among communities, all communities can benefit from the MRC and can understand the MRC similarly. Many MRC units have found that the medical in Medical Reserve Corps should not limit them to recruiting only medical professionals. MRC units nationwide have determined a need for volunteers with various professional backgrounds to meet the health needs of their local communities. These include chaplains, to assist with mental health activities; attorneys, to assist with addressing issues of liability; and IT personnel, to assist with database management.

Local and national organization
Locally, each MRC unit is led by an MRC Unit Director and/or Coordinator, who matches community needs with volunteer capabilities. Local coordinators also are responsible for building partnerships, ensuring the sustainability of the local unit, and managing resources. The partnerships that the MRC Director must pursue include community businesses, and also neighboring MRC's. Local MRC units are typically organized under Health Departments or Community Faith Groups.

Nationally, the MRC is guided by the MRC Program Office, which is housed in the Office of the U.S. Surgeon General. The MRC Program Office serves as a clearinghouse for information and best practices to help communities establish, implement, and maintain MRC units nationwide. It sponsors an annual leadership conference, hosts a Web site, and coordinates with local, state, regional, and national organizations and agencies to help communities' preparedness. There are also Regional Coordinators (RCs) in all ten of the Department of Health and Human Services regions.

The MRC Program Office appoints personnel at the state level. The MRC Program Office staff and the RCs collaborate with the MRC State Coordinators to better integrate with local and state planning and response activities. All local MRC units are encouraged to collaborate with State Coordinators.

Local benefits
There are several benefits to establishing an MRC unit, as it:
 * bolsters public health and emergency response infrastructures by providing supplemental personnel
 * enables the community to meet specific health needs
 * allows the local community more autonomy so it is not as dependent on state and national resources
 * provides community members with the opportunity to participate in developing strategies
 * provides mechanisms for information sharing and coordination among all partner organizations
 * provides dialogue between emergency management and public health agencies
 * allows for national recognition of local public health and emergency response efforts

Starting a local unit
To start an MRC unit, first determine if there is a unit in your local area. A list of the MRC units, their locations, and contact information is available on the Find MRC Units page of the MRC Web site. If you are unable to find an MRC unit in your area, contact your region’s MRC RC or your state’s MRC State Coordinator for information on other MRC units in your area. If there is no MRC unit in your area, you can start one. Each community is different, so its approach to establishing an MRC unit will be different. Establishing an MRC unit consists of:
 * 1) reading and understanding the general guidelines — Guidelines that address many key issues in establishing an MRC unit. Two tools are the Getting Started: A Guide for Local Leaders (PDF 864 KB) and the Technical Assistance Series.
 * 2) registering the new MRC unit with the MRC Program Office — Registering allows MRC units to request technical assistance from the MRC National Program Office, apply for use of the official MRC logo, and be included in national MRC conferences. Registered units also are officially recognized as part of the White House’s USA Freedom Corps initiative and the Department of Homeland Security’s Citizen Corps. Volunteers are expected to be active members of the MRC community by participating and sharing information on the MRC Message Board or at MRC meetings. Regular updates of your unit profile, volunteer numbers, and recent activities also are requested.

To register, complete and submit the registration form. MRC Program Office staff review the application, and State Coordinators and RCs provide consultation as necessary. Upon approval, the MRC unit will be added to the online directory.

For more information, see How to Start an MRC.

Types of Volunteers
Possible front-line medical and public health volunteers include:
 * physicians (e.g., including surgeons, medical specialists, osteopaths)
 * physician assistants
 * nurses (e.g., nurse practitioners, registered nurses, licensed practical nurses, nursing assistants)
 * pharmacists
 * dentists
 * dental assistants
 * optometrists
 * veterinarians
 * emergency medical technicians
 * public health workers
 * epidemiologists
 * infectious disease specialists
 * toxicologists
 * mental health practitioners (e.g., psychologists, substance abuse counselors, social workers)
 * health educators/communicators
 * other medical and public health professionals

Possible administrative and other support volunteers include:
 * administrators and business managers
 * administrative assistants and office support staff
 * drivers
 * chaplains
 * training directors
 * trainers
 * volunteer coordinators
 * fundraising professionals
 * supply and logistics managers
 * interpreters/translators
 * amateur radio operators
 * other support personnel

Volunteer activities
Activities include, but are not limited to:


 * supporting local public health, while advancing the priorities of the U.S. Surgeon General, which are to promote disease prevention, improve health literacy, eliminating health disparities, and enhance public health preparedness
 * assisting local hospitals and health departments with surge personnel needs
 * participating in mass prophylaxis and vaccination exercises and community disaster drills
 * training with local emergency response partners

How to volunteer
The first step in becoming an MRC volunteer is to locate the MRC unit closest to you. Access the list of registered MRC units to find contact information and consult with your local unit about how you can get involved.

Partnering with an MRC
MRC units must partner with the community response agencies. To learn more about partnering with your local MRC unit, read Coordinating With Your Local Response Partners and access the list of registered MRC units for contact information. To access a list of national partner organizations recently spotlighted on the MRC Web site, see the MRC Spotlights.

Quotations
''“We truly believe that all response is local. The MRC program is vital to that local response, preparing communities nationwide to deal with a variety of emergencies including public health events.”''


 * Michael Fraser, Ph.D.
 * Deputy Executive Director
 * National Association of City and County Health Officials

''“Not only is the MRC emergency preparedness and response, but it is surge capacity, which is very much needed at the local level and the department of health for any community. There is a lot an MRC member can do to help, because of their desire to make a difference. I feel that local boards of health should champion the MRC, and even help to start units within their community.”''


 * Ronald C. Burger
 * Immediate Past President
 * National Association of Local Boards of Health

''“The Medical Reserve Corps program has the potential to make significant contributions to the health security of our people and our nation. The MRC stands out as a venue for volunteers from all professions and disciplines to assist in the preparation for and response to all Public Health Emergencies and can serve as a vehicle to better integrate response activities across geographical boundaries and all sectors of the health and public health communities.”''


 * Dr. James J. James
 * Director, Center for Disaster Preparedness and Emergency Response
 * American Medical Association

Federal- and national-level reports and documents

 * Federal Response to Hurricane Katrina: Lessons Learned (February 2006). p 105. Adobe PDF (2.86 MB)
 * Joint Commission on Accreditation of Healthcare Organizations Hospital – 2007 Medical Staff Standards.

Links to local MRC websites
State of California State of Florida State of Iowa State of Tennessee State of Kansas State of Massachusetts State of Minnesota State of Missouri State of New York State of North Carolina State of Ohio State of Oklahoma State of Texas State of Virginia
 * Medical Reserve Corps of Los Angeles
 * Orange County Medical Reserve Corps
 * Broward County Medical Reserve Corps
 * Iowa Medical Reserve Corps
 * Tama County Medical Reserve Corps
 * Middle Tennessee Medical Reserve Corps
 * Sedgwick County Medical Reserve Corps
 * Upper Merrimack Valley Medical Reserve Corps
 * University of Minnesota Medical Reserve Corps
 * Northeast Missouri Medical Reserve Corps
 * Mid-America Medical Reserve Corps
 * CNY Regional Medical Reserve Corps
 * Suffolk County Medical Reserve Corps
 * Specialized Medical Assistance Response Team
 * Chatham Medical Reserve Corps
 * Northeast Ohio Medical Reserve Corps
 * Oklahoma Medical Reserve Corps
 * Texas State Guard - Texas Medical Rangers
 * University of Virginia Medical Reserve Corps
 * Arlington County Medical Reserve Corps
 * Loudoun Medical Reserve Corps
 * Chesapeake Medical Reserve Corps
 * Southwest Virginia Medical Reserve Corps