Sheltering for Disabilities and Special Needs

enABLED in Emergencies Conference 2009

The Region18 Counties

177 cities

6.3 Million* (27%)

877,000 with disabilities*

(24%)

120+ hospitals

500+ nursing homes

Tropical Storm Allison Houston, Texas June 2001

Hurricane Katrina Houston, Texas August 2005

Largest Patient Reception in US History

Hurricane RitaTexas Gulf Coast September, 2005

Largest mass evacuation in US history

2008 Hurricane SeasonIke: Largest EMS deployment in US history

So how do we improve next time???

Evacuation Surge Zones

• Planned evacuation times

• Phased-in return times

• Pre-identified shelter Hubs

• 19 acute care hospitals

• 121 nursing homes• 1.2 million citizens

Disparity between assumption and reality

So what IS right for healthcare?

Catastrophic Medical Operations Center (CMOC)

• Local and Regional asset• Co-located in the HEC• Recognized by the MACG for health and

medical coordination• NIMS Compliant• Command authority• Logistical and Operational Components• Stand up when requested by EOC, EMC,

State, or other jurisdictions of authority

Mission• Identify and meet the healthcare needs of the region• Protect and maintain medical infrastructure of all regional

healthcare facilities• Provide appropriate transfer to healthcare

facilities based on capacity and capability• Coordinate unique requirements of “special

needs” population• Maintain patient tracking records

“One Stop Shop”

• Coordination and organization of movement of medical special needs persons during a disaster

• Organization of transportation assets for patient movement

“One Stop Shop”

• Facility Assistance

• Patient Tracking• Organization of

Regional Public Health Issues

• Presentation Trending

• Coordination of Mass Fatality Issues

Evacuation Hubs

Special Needs

• Elderly/infirmed• Pediatric• Neurological/mental

disorders• Multi-organ disease• Dialysis• Immunocompromised• Handicapped• Technologically

dependant

Identifying our Special Needs Population…

• 211 Registry– It is estimated that less than

10% of our special needs population have registered

• Distrust– Privacy– Mistrust of government

• Personal reasons– Don’t want to leave their home– Don’t want to leave their pets– Fear from last time….

Identifying our Special Needs population…

• Health homes• Home health care• Hospital discharge• Church and faith-

based organizations• HOA’s• Community leaders• Healthcare for the

Homeless

Secondary Facility(MSN RLR)

• Location, Location, Location…….

• Patient population• Staffing• Supplies• Medical gases• Emergency power• Nutritional support• Access/Security

Field Hospitals

• Collaborative effort– Houston Fire

Department– Regional Hospital

Preparedness Council• Regional Asset• Deployment time: 4 hrs• Shelter, equipment,

pharmaceuticals• Personnel…..

Electricity Outages

Loss of Water and Sewer

Access Challenges

Healthcare Employees Fuel Access to work

Transportation Ambulances

Limited distribution Tracking Fuel Conflicting priorities Travel time Staging Timeout

Alternate Care Sites and Sheltering

56 of 109 hospitals in affected zone

Hospital Evacuations/Closures

EM Resource

EMTrack ASP and Mobile

Repatriation Community Infrastructure Loss Medical Infrastructure Loss Transportation Assets Individuals’ desire to return Financial Implications Tracking EMTALA

Questions