Ready to Serve: Unleashing Volunteer Health Professionals Across State Lines

Introduction: A Legal Lifeline in Emergencies

In a crisis, access to qualified health professionals can mean the difference between order and chaos. Yet bureaucratic barriers too often prevent medical volunteers from crossing state lines just when they’re needed most. The Uniform Emergency Volunteer Health Practitioners Act (UEVHPA), model legislation drafted in 2006 by the Uniform Law Commission, enables licensed volunteer health practitioners (VHPs) to serve during declared emergencies without requiring redundant licensure.

While a legal pathway exists, the supporting infrastructure is under threat. The Medical Reserve Corps (MRC)—a key component of state and local surge staffing—is facing possible elimination due to proposed federal budget cuts. MRC units have long provided essential support to public health departments, hospitals, and emergency shelters. Their dissolution would significantly weaken the nation’s volunteer response capacity.

Simultaneously, chronic staffing shortages in public health and healthcare systems—especially in rural and underserved areas- have reached a critical point. Years of underfunding, workforce burnout, and attrition accelerated by the COVID-19 pandemic have eroded emergency readiness. Many communities now lack both the workforce and operational resilience needed to mount timely, scalable disaster responses.

Although UEVHPA has been enacted in several states, its limited adoption and uneven implementation hinder national effectiveness. As climate-driven disasters, infectious disease outbreaks, and mass casualty events increase in scale and frequency, the need for a consistent, cross-border licensure mechanism is more urgent than ever. We need a reliable, legally supported framework that can swiftly mobilize skilled professionals where and when they’re needed.

The Case for UEVHPA Expansion

1. Cross-Border Credentialing Needs a Uniform Standard
Health emergencies cross state lines. UEVHPA provides a consistent legal mechanism to recognize out-of-state practitioners who are pre-registered in approved systems, eliminating delays caused by emergency declarations or ad hoc executive orders. In times when every hour matters, reducing administrative bottlenecks can save lives.

2. State-by-State Patchwork = Delayed Response
States that have not enacted UEVHPA often rely on mutual aid agreements or executive waivers to authorize volunteer health professionals. These processes are frequently inconsistent, bureaucratically burdensome, and subject to delays in fast-moving emergencies. This patchwork approach reduces the effectiveness of surge support.

3. NGOs as Credentialing Authorities: A Missing Piece
Many non-governmental organizations already conduct primary-source credential verification, provide emergency-specific training, and offer liability and malpractice insurance. Despite this, most state implementations of UEVHPA do not formally recognize NGO-managed VHP registries, resulting in duplicative verification efforts and lost opportunities to augment the response with already-prepared personnel.

4. Updating UEVHPA to Recognize NGOs
Colorado’s statute explicitly recognizes “registration systems operated by disaster relief organizations” (see CO Rev Stat §25‑1.5‑605). Other states should adopt similar language, formally integrating NGO registries and removing ambiguity about their eligibility under UEVHPA. Doing so would leverage existing infrastructure without the need for new state-run platforms.

5. Trusted Systems Already in Place
UEVHPA integrates seamlessly with several well-established systems:

• ESAR-VHP, [note, this page has been removed from ASPR's website] a federally supported program that verifies volunteer credentials before deployment

• Medical Reserve Corps (MRC), [note, this page has been removed from ASPR's website] though its future remains uncertain due to potential funding cuts

• State-specific programs like WAserv (WA) and MA Responds (MA)

• NGO-operated rosters that meet or exceed national standards for credentialing, training, and liability protection

With the anticipated drawdown of federal support for MRC, it is more important than ever to recognize and invest in alternative systems of credentialed emergency volunteers.

Challenges to Adoption — and How to Overcome Them

Despite the clear value of UEVHPA, adoption and implementation remain inconsistent across the country. Barriers include:

• Lack of awareness among legislators and emergency management officials about UEVHPA’s legal framework and practical benefits

• Liability concerns, especially regarding volunteers affiliated with non-governmental organizations

• Variation in accepted registration systems, which complicates reciprocity across states

To overcome these barriers, key solutions include:

• Launching targeted outreach and education campaigns for lawmakers and state emergency preparedness leaders

• Publishing model implementation guides that explicitly include qualified NGO-managed systems

• Building public–private partnerships to create hybrid VHP registries that combine state, federal, and nonprofit verification data

These steps would expand the pool of qualified volunteers, reduce duplication of effort, and ensure rapid access to surge support when it’s needed most.

Why Now? Growing Threats Demand Faster Mobilization

The United States is facing a steady increase in large-scale emergencies—driven by climate change, infectious disease outbreaks, and infrastructure vulnerabilities. In 2023 alone, the Pacific Northwest endured severe wildfires that overwhelmed local EMS capacity. Along the Gulf Coast, repeated hurricanes stretched public health systems to their limits. These events revealed the systemic fragility of state-bound credentialing models.

Meanwhile, the national healthcare workforce continues to shrink due to retirements, burnout, and lack of funding. According to the Association of State and Territorial Health Officials, more than 20% of the public health workforce plans to retire or leave within five years. That trend, combined with the uncertainty surrounding MRC, leaves a widening gap in response capability that cannot be ignored.

What Comes Next: Aligning Policy with Reality

To fully unlock the potential of UEVHPA, action is needed at every level:

1. Federal Leadership: Agencies like HHS and ASPR should condition emergency preparedness funding on state-level adoption and implementation of UEVHPA.

2. State Legislation: States must pass or update laws to clearly authorize NGO-affiliated VHP registries, aligning legal definitions with operational realities.

3. NGO Accountability and Coordination: National and regional NGOs should standardize and publicly document their credentialing, training, and insurance policies to build trust with public-sector partners.

Together, these efforts would create a nationwide network of surge-ready, legally deployable health volunteers.

The Bottom Line

The infrastructure to verify, train, and insure volunteer health professionals already exists. What’s missing is a modern, legally sound mechanism to move them quickly across state lines during crises. UEVHPA is that mechanism. But to realize its full potential, we must expand its adoption, modernize its implementation, and formally recognize the role that non-governmental systems play in emergency preparedness.

With staffing shortages mounting and MRC’s future in question, now is the time to act. UEVHPA should no longer be viewed as a niche legal tool—it must be treated as a core pillar of national emergency readiness.