209599 Management of Medical Surge During a Disaster: The Project MESH Medical-Legal Collaboration

Tuesday, November 10, 2009: 11:10 AM

Charles Miramonti, MD , School of Medicine, Indiana University, Indianapolis, IN
Chad S. Priest, RN, JD , Baker & Daniels LLP, Indianapolis, IN
Priscilla Keith, MS, JD , Hall Center, Indiana University School of Law - Indianapolis, Indianapolis, IN
In this presentation we describe MESH, the Managed Emergency Surge for Healthcare Project, an innovative collaboration among the Marion County Health Department, Indianapolis-area hospitals and a cadre of lawyers representing all sectors of the hospital and public health community, funded with a grant from the Department of Health and Human Services. Disasters threaten the ability of hospitals to remain operational, even after disaster conditions have abated. For hospitals that remain undamaged and able to operate, legal challenges, especially related to reimbursement, have the single largest impact on a hospital's ability to survive. These challenges are rarely addressed in conventional all-hazards disaster preparedness initiatives. As a result, hospitals are frequently forced to choose between regulatory compliance (and reimbursement) and doing the “right thing” during a disaster event. As part of an overall strategy to manage a surge of patients during a disaster, MESH has established a legal working group composed of (1) the Director and General Counsel of the Marion County Health Department, (2) in-house counsel and medical directors from hospitals in the Indianapolis-metro area and, (3) MESH staff and outside counsel retained for the purpose of providing legal support services to the group. Early in the process MESH conducted an innovative legal table-top exercise, exploring in detail the myriad legal barriers impacting hospitals during and after a disaster. The MESH collaboration is an active project. We hope that through our presentation we can promote discussion and thinking among a variety of public health and legal professionals around this important topic.

Learning Objectives:
1. At the completion of the presentation participants will be able to describe the benefits of medical-legal collaboration in the context of disaster management planning. 2. At the end of the presentation, participants will be able to identify the legal barriers to effectively managing medical surge during disaster events.

Keywords: Disasters, Law

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator on the multi-million dollar grant from the US Department of Health and Human Services that established Project MESH. I have significant experience in disaster planning and all-hazards preparedness. Relevant Professional Experience: Assistant Clinical Professor of Emergency Medicine, Indiana University School of Medicine at Indianapolis (IUSM), and IUSM Emergency Medicine Residency, 2004 to Present Fellowship Director of IUSM Out of Hospital Care Fellowship, 2005 to Present Deputy Medical Director of the IUSM Dept. of Emergency Medicine, Division of Out of Hospital Care, 2005 to Present Principal Investigator, 2007 Emergency Care Grant from Health and Human Services, 2007 to Present Director of Managed Emergency Surge for Healthcare, 2007 to Present Program Manager, Metropolitan Medical Response Grant, 2006 to Present Marion County Emergency Management Division ESF-8 Liaison, 2007 to Present Awards and Honors: EMS Medical Director of the Year 2006, Indiana Department of Homeland Security Emergency Medical Service Commission Clarian Service Excellence Gold Award 2002 Clarian Service Excellence Silver Award 2002
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.