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Dr. Jennifer E. Weiss, co-director of HUMC’s Pediatric Covid-19 Center
Dr. Jennifer E. Weiss, co-director of the Children’s Covid-19 Recovery Center at HUMC, spoke about research on children with chronic Covid-19.
NorthJersey.com
In the early days of the Covid-19 pandemic, as overcrowded New Jersey hospitals struggled to find staff to care for critically ill patients, Gov. Phil Murphy called on medical professionals across the country to help out at one of the country’s first COVID-19 centers. .
More than 31,000 responded to the call.
They come from all over the country. They provide care – in person and through telehealth – to 1.4 million New Jersey residents. And these medical professionals were as diverse as their needs, able to communicate with patients in 36 languages.
Out-of-state doctors, nurses, respiratory therapists, and mental health professionals can help become a temporary licensing program that waives the criminal background checks and licensing fees common in other states.
A new study by researchers at Rutgers and the New Jersey Department of Consumer Affairs examines how professional licensing works.
The “random experiment” offers lessons for future public health emergencies, said Humayun J. Chaudhry, president and chief executive officer of state medical boards, in comments on the study, published this month in the journal Health Affairs.
As the pandemic has spread, 45 states have tried similar strategies to expand their health care providers, but this is the first to be analyzed.
“The numbers were staggering,” said Anne M. Nguyen, lead author of the study and assistant research professor at Rutgers University’s Center for Public Health Policy. It was heartwarming to see someone from every state come from all over the country because they heard our call for help.
The out-of-state health professionals provided critical assistance at New Jersey hospitals during the crisis and helped meet the growing demand for counseling and behavioral health care during the first year of the outbreak, the authors found. The United States does not have a national licensing system for health professions, so each state issues licenses. The New Jersey experiment demonstrated the importance of states’ “regulatory flexibility” during a public health emergency.
Two main groups used the temporary permits — nurses and respiratory therapists who came to help with hospital care, and physicians and mental health providers who provided remote care — by phone or FaceTime or Zoom — for both those with and without Covid. – Covid patients.
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Many who answered the call had, in fact, never left their homeland. They were temporarily licensed in New Jersey but worked elsewhere to care for New Jersey patients. This was especially true for mental health care providers. Although the program was intended to address the need for Covid care, it also expanded access to non-Covid care.
Here’s who got temporary permits:
- Thirty-five percent were nurses and nurse practitioners, 27% were physicians, 26% were mental health providers, and 2% were respiratory therapists.
- They came from all states, but the largest numbers came from New York, Pennsylvania and Delaware, along with Florida and California.
- Communicate with patients in 36 languages.
- They were mostly non-Hispanic white women between the ages of 40 and 59.
- They cared for Medicare and Medicaid patients as well as those covered by private insurance.
- About 30% of those who took the license did not use it.
Telehealth services were essential for the program to operate, especially as the demand for mental health services increased. Before the pandemic, doctors and other providers had to see a patient at least once in the office before paying for a telehealth visit.
Changes in federal law prompted by the pandemic, however, allowed practitioners to take on new patients via telehealth. As a result, the use of telehealth has increased. According to a national survey from June to October 2020, 46% of behavioral health visits compared to 0.4% last year; During the same period, 22% of medical visits were virtual, compared to 0.3%.
The temporary licensing of out-of-state professionals was the largest of several emergency measures taken to boost New Jersey’s workforce. Retirees who left their professional health care careers in the last five years have been brought back to work, and nursing students and others have been placed in non-frontline jobs within months of graduation. Doctors from other countries also had an easier time practicing in New Jersey.
In addition, the U.S. military and National Guard sent personnel to the state’s nursing homes and a few hospitals, while other hospitals and health systems paid nursing agencies millions of dollars to fill the gaps.
Two caveats
New Jersey’s program for out-of-state medical providers provides lessons on what to do in future outbreaks, the authors said. But there are two caveats.
First, when cases of Covid-19 clustered in New York, New Jersey and Washington state, Murphy asked for help. In a more widespread emergency, medical personnel are needed at home and may not be able to help elsewhere.
Second, the study did not examine the quality of care provided by temporary licensees. There is currently no information on whether any of them have been disciplined by the regulatory board for their work in New Jersey. The Department of Consumer Affairs did not respond to inquiries about whether any such measures had been taken.
Out-of-state doctors, nurses and counselors who traveled to the rescue were a short-term solution. The program aims to “help address workforce needs during this critical time,” Nguyen said. “And yes, it helped.”
Now New Jersey and most states face an even more intractable shortage of long-term health care professionals as retirements and pensions are depleted after the stress of the pandemic.
And starting August 1, only respiratory therapists from other states can get a temporary license. Everyone should apply through the normal process.
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