medical sheltering in texas 2012 texas emergency management conference
TRANSCRIPT
Medical Sheltering in Texas2012 Texas Emergency Management Conference
Agenda
1. Medical Sheltering Basics2. Texas Statewide Medical Shelter
Plan3. Medical Sheltering by Evacuation
Area4. Selecting the Appropriate Shelter5. State Medical Shelter Support6. Local & Regional Planning7. Summary
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MEDICAL SHELTER BASICS
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Medical Shelter Plan Basics
Medical Shelters are primarily for high acuity evacuees (and caregivers) requiring skilled nursing care and constant medical oversight
Identification of medical evacuee is critical at embarkation hub◦Reduce time on road◦Medical evacuees arrive at the correct
destination◦Reduces evacuee being moved twice
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Medical Shelter Plan
Establish medical shelters in San Antonio and other selected cities, as required
◦Evacuate medical evacuees to San Antonio first
◦Evacuate medical evacuees to other selected cities, as necessary
◦Establish/support medical shelters in other locations as necessary
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Medical Support Considerations
Local medical professionalsAccess to physician office or clinicMedical emergency- call 911On-site clinical careRequest DSHS Mobile Medical
Team ◦8 teams currently rostered
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TEXAS STATEWIDE MEDICAL SHELTER PLAN
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State Support
State supported medical sheltering is primarily focused on evacuees who are transported on state transportation resources through coastal evacuation hubs
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Medical Evacuation
• In the past (prior to 2010) medical evacuees were evacuated to multiple locations across the state of Texas.
• We now plan to consolidate Medical Sheltering in San Antonio.
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Medical Shelter PlanAdvantages of consolidating medical
sheltering in San Antonio
◦Consistent levels of care◦Consolidation of resources◦Access to significant medical system in a
major city◦Ability to allocate resources properly to best
support the population including: transportation assets, hospital beds,
pharmaceutical caches, medical equipment caches etc.
MEDICAL SHELTERING BY EVACUATION AREA
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Texas Medical Sheltering
SE Texas Evacuation Area
◦San Antonio 5000 primary
◦Tyler 200 primary◦Tyler/Marshall 400-600
additional
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Texas Medical Sheltering
Houston/Galveston Evacuation Area
◦San Antonio 5000 primary
◦Austin 250 additional
◦Bryan/College Station 450 additional
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Medical Sheltering
Matagorda & Corpus Evac Areas
◦San Antonio 5000 primary
◦Austin 250 additional
◦Bryan/College Station 450 additional
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Medical Sheltering
Lower Rio Grande Valley Evac Area
◦Laredo 450 primary
◦San Antonio 5000 primary
◦Austin 250 additional
◦Bryan/College Station 450 additional
LRGV Shelter Plan (Cat 1 or 2)◦2 medical shelters
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SELECTING THE APPROPRIATE SHELTER
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Population Definitions
• General evacuees:Ability to function independently each day. Evacuee may or may not have disabilities, functional or access needs including minor medical care
• Medical evacuees:Require skilled medical care and are people that may or may not have disabilities, functional or access needs.
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The Shelter Options
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General Population Shelters
• Access to medical services
• Access to prescription medications
• Access to medical equipment
• May or may not be provided on site
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Medical Shelters
• Medical staff on site• Medical equipment
and services on site• Access to
prescription medications, may or may not be provided on site
Medical Support to Shelters
Jurisdictions that provide sheltering (pt to pt, hub cities, drive-ups) should have capacity to provide medical services
◦Medical services to general population shelters
◦Establishment of a medical shelter
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General Population Shelter Placement
Individuals who are able to meet their daily needs either by themselves or with a caregiver and may require some assistance with activities of daily living
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General Population Shelter Placement
Some examples include people that are: ◦ Dependent on medical oxygen◦ Mobility disability /self ambulating with or
without DME, including wheelchair◦ Deaf or hard of hearing, blind or low vision
with or without a service animal◦ Diabetic, insulin dependent/diet controlled◦ People with no disabilities, functional or
access needs
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Medical Population Shelter Placement
Individuals who require active monitoring, management, or intervention by a medical professional to manage their medical condition
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Medical Population Shelter Placement
Some examples include people who are:◦ Hospice patients◦ Ventilator patients◦ Tracheotomy which requires suctioning◦ Extensive wound management requiring a sterile
environment or suctioning◦ Requiring isolation due to infectious disease◦ Dysrhythmia management◦ Receive skilled nursing care at home◦ Previously from a skilled nursing facility but have
no access to a skilled nursing home/facility
Shelter Selection ProcessTriage personnel should do a rapid
assessment to determine the most appropriate shelter placement option for evacuees◦ Individuals requiring skilled medical care
will go to medical shelters◦ Some evacuees with lower acuity medical
needs can go to general population shelters but may have a choice of a medical shelter
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Shelter Selection ProcessTriage personnel should provide information
to the individual about the type of shelters and services available in each
If the individual does not require skilled medical care but still meets medical shelter placement criteria then the individual will make an informed decision regarding his or her own placement
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STATE MEDICAL SHELTER SUPPORT
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Medical Shelter Push PackSupport 100 Patients3 PalletsIncludes items such as:
◦General Medical Supplies◦Sharps Containers◦O2 Masks & Regulators◦Pillows/Blankets/Towels◦Diapers◦Flashlights◦OTC Medications
Shelter Infection Control Kit
N95 RespiratorsSurgical MasksNon-latex GlovesHand SanitizerDisinfectant WipesTissuesAlcohol WipesExam Gowns
Contracts
BCFSPharmacy Medical Staffing
◦Medical Doctors◦Physicians Extenders (NP, PA, etc)◦Nurses◦EMTs/Paramedics◦Other Medical Specialties
LOCAL & REGIONAL PLANNING
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Planning ConsiderationsState Plan
◦Major events Hurricane evacuation Large scale disasters
Local Plan◦Smaller local events
Ice storms Power outages
Planning ConsiderationsLocal plans are still necessaryPlanning is essential
◦Know your jurisdictional demographics
◦Know your resources◦Know your partners
Jurisdictional DemographicsWhat percentage of your population
may need a medical shelter during an event?
What percentage of your population may not need a medical shelter, but may have functional or access needs?
What are the age demographics of your population?
The more knowledgeable you are about your population, the better your planning will be.
ResourcesSitesTransportationMedical assetsFoodWrap around servicesAssistive servicesStaffing
PartnersNo you can’t do it alone
◦ Medical Reserve Corp◦ Citizen Emergency Response Teams◦ Hospitals◦ Home Health◦ Public Health◦ Emergency Management◦ Regional Advisory Councils◦ Department of Public Safety◦ Volunteer and Advocacy groups◦ Local businesses◦ Elected officials◦ Others…
SUMMARY
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Summary
No longer using categories 0-5◦Two types of evacuees
Medical evacuee General evacuee
◦For Transition Planning: 0-3 probable gen pop shelter 4 medical shelter 5 institutional facility
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SummaryChronic and minor medical
conditions in general sheltersFNSS support in gen pop sheltersAccess to medical services in gen
pop sheltersKnow your population –
demographicsIdentify resources nowIdentify and plan with local
partners now 41
QUESTIONS?
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Debbie EvansTexas Department of State Health [email protected]
Jeff HoogheemTexas Department of State Health [email protected]