Responsibility For Coverage

The producer or promoter of any mass gathering has an obligation to provide for the safety and security of its participants, spectators, and workers. Few venues have enough regularly scheduled events to be able to provide medical care without assistance. This assistance is typically provided through an affiliation or contractual arrangement with an EMS system and/or a health care provider, such as a hospital. The goal of any venue should be to provide the same quality of health care and security one could reasonably expect as a normal citizen outside the venue.

The medical director plays a key role in the planning of the medical facility and the care it is to provide during a mass gathering. The medical director should be involved in the plan, setup, and maintenance of the medical facility and the selection, training, and function of each medical team member. This requires involvement not only in the event planning but, if possible, in the design and construction of the facility. The medical director's goal is to provide the best possible care within the constraints of the available resources. Early involvement of the medical director can only improve the amount and quality of the resources available at the event.

The licensing of all medical personnel is extremely important. Large events may be able to benefit from a "Good Samaritan law" permitting health care workers to practice outside their licensed state or jurisdiction. Such laws are typically useful only when the worker is practicing in a voluntary capacity. Any such legal ramifications should be investigated prior to the event. Unless a Good Samaritan law is in effect, all health care providers must be licensed to function as such during the event. Liability insurance is also extremely important to the medical director as well as the health care providers. The producer or promoter of an event may be able to obtain coverage for the medical care, or coverage may have to provided by the health care providers or their employers.

Several legal issues should be addressed in a contract with the producer of the event. A contract should allow the medical director to have the authority to obtain whatever supplies or resources are needed prior to and during the event. The contract should spell out who pays for the equipment, resources, and personnel. At a minimum, the contract should include start and end dates, fee structures, health department and medical license structures, equipment and personnel requirements, minimum medical care requirements, medical direction authority level, and emergency provisions for disasters or MCIs. As much detail as possible should be listed with respect to the size, location, and physical construction of the medical treatment facility; the transportation of patients and personnel; the lodging, parking, food, and hygiene provisions for personnel; and the communications system and devices.

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