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In the early days of the COVID-19 pandemic, as overburdened hospitals in New Jersey struggled to find staff to care for desperately ill patients, Governor Phil Murphy made a call to doctors nationwide to help one of the country’s first COVID hotspots.

Over 31,000 people responded to the call.

They came from every state. They provided care – in person and through telehealth – to 1.4 million New Jersey residents. And these doctors were as diverse as the state that needed them, they could talk to patients in 36 different languages.

The help of doctors, nurses, respiratory therapists, and mental health professionals from other states was made possible by a temporary licensing program that abolished the usual criminal background checks and licensing fees for reputable licensees in other states.

A new study by researchers at Rutgers and New Jersey’s Consumer Affairs Division that licenses professionals has assessed how it works.

“Unplanned Experiment” offers lessons for imminent public health threats, said Humayun J. Chaudhry, president and CEO of the Federation of State Medical Chambers, in a commentary on the study, which was published this month in the journal Health Affairs.

As the pandemic spread, 45 states eventually tried similar strategies to expand the pool of healthcare providers, but this is the first analysis.

“The numbers were amazing,” said Ann M. Nguyen, lead author of the study and assistant professor at the Rutgers University Center for State Health Policy. “When we saw a person coming from every state across the country because they heard our call for help … it was warm.”

The authors found out-of-state health workers provided key relief during the New Jersey hospital crisis and helped meet the growing need for counseling and behavioral care in the first year of the pandemic. There is no national licensing system for the medical professions in the United States, so each state issues licenses. The New Jersey experiment demonstrated the importance of states’ “regulatory flexibility” during public health emergencies.

Two main groups used temporary licenses – practicing nurses and respiratory therapists who came to help with inpatient care, and doctors and mental health providers who provided care remotely – by phone, FaceTime, or Zoom – for both COVID and others people. – COVID patients.

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Many who responded never actually left their home states. They were temporarily licensed in New Jersey but worked elsewhere to care for New Jersey patients. This was especially true of psychiatric care providers. And while the program was designed to meet the need for COVID care, it also expanded access to COVID-free care.

Here’s who got the temporary licenses:

The use of telehealth was essential for the program to work, especially as the demand for mental health services escalated. Prior to the pandemic, doctors and other providers had to see the patient at the office at least once before they could bill for telehealth visits.

However, pandemic-inspired changes to federal law have enabled practitioners to admit new patients through telehealth. As a result, the use of telehealth has increased rapidly. From June to October 2020, a national survey found that 46% of behavioral health visits were virtual, compared with 0.4% the previous year; In the same period, 22% of medical visits were virtual, compared to 0.3% a year earlier.

The temporary license for out-of-state specialists was the largest of several emergency measures adopted in New Jersey to increase the workforce. Retirees who quit their healthcare career in the past five years were allowed to return to work, and nursing and other students were recruited into off-the-line positions within months of graduation. Doctors from other countries also had an easier time applying for an internship in New Jersey.

In addition, the U.S. military and the National Guard sent personnel to state nursing homes and several hospitals, while other hospitals and health systems were paying millions of dollars to travel nursing agencies to fill the gaps.

Two caveats

The authors say the New Jersey Out-of-State Healthcare Provider Program offers lessons on what to do in future pandemics. Read also : Five Citizen Volunteers Receive Appointments to Douglas County Health Board as Alternates – Douglas County. But there are two caveats.

First, Murphy asked for help when COVID-19 cases were concentrated in New York State, New Jersey and Washington. In a more common case, medical workers would be needed at home and might not be able to help elsewhere.

Second, the study did not look at the quality of care provided by temporary licensees. There is currently no information available on whether any of them have been fined by regulators for their work in New Jersey. The Department of Consumer Affairs did not answer the question as to whether such actions had been taken.

The out-of-state doctors, nurses, and counselors who rode to the rescue were a short-term solution. The program was designed to “help meet the needs of workers at a terrible time,” said Nguyen. – And yes, it helped.

Now New Jersey and most states face a more difficult-to-solve long-term health worker shortage as their ranks have been depleted by resignation and early retirement from the stress of the pandemic.

And as of August 1, only breathing therapists from other states can get a temporary license. All others must apply in the normal process.

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