Preparedness

Health Quilt Emergency Preparedness 2008 Activities

The most recent hurricanes impacting the Gulf Coast of Texas requiring large scale evacuations has highlighted a concern for the care of persons with special needs.  This population of the Gulf Coast region must be placed in a position of continuing care, recovery, and return to the most appropriate living environment as soon as possible.  The processes that must be applied in any response plan, must include, coordination before any evacuation is identified; coordination of care during the evacuation, coordination and continuance of care at the alternate shelter locations; and coordination of the recovery protocols.

The University of Texas Health Science Center in partnership with local, state, and federal agencies and the private community has consistently supported emergency preparedness, response and recovery efforts in the Gulf Coast Region and throughout the state.    Prior to 2008, activities on the care of special needs populations during mass evacuation situations include:

Influenced by this involvement prior to 2008, the Health Quilt team committed to explore how to assure that information exchange would be available during disasters, particularly for the most vulnerable of a community.    In addition, it is felt that emergency preparedness funding dollars could be a key component to support the HIE infrastructure for a community.    Events of the past year have unfolded in ways that could not have been anticipated.

Preparedness

2-1-1 Project and Personal Preparedness Planning

On February 29^th, 2008 HealthQuilt hosted a Disaster Preparedness Conference, which was held with the City and County Preparedness Groups and the Catastrophic Medical Operations Center Leadership.   The medical home concept was presented and explored as a community resource for planning for vulnerable populations.   The medical leadership for children (Texas Childrens), frail elderly (UT Geriatrics), and medical special needs adults (TIRR/MHHS) discussed the issues that occurred during Katrina / Rita.   The preparedness leadership from the City and County suggested increasing the number of individuals to enroll into 2-1-1 from medical homes.    We then developed materials in English, Spanish, Vietnamese and began piloting them with volunteer students from University of Houston at Clear Lake at eight primary care clinics and in collaboration with United Way.   An additional feature was to give patients educational materials on personal preparedness.   Upon completion of the pilot, the City of Houston approached HealthQuilt to implement throughout Houston.   Recruiting 63 students from the Greater Houston area, HealthQuilt and the City Of Houston sent representatives to local clinics for enrollment of at-risk patients in need of evacuation at over fifty primary care sites.   The program was deemed a success as the number of enrollees exceeded previous year’s performances for the time period.   The project results are currently being prepared for submission to peer reviewed journal.  

Medical Special Needs Protocols and Training

The development of medical special needs protocols in sheltering emergency preparedness activities is essential for the health and well-being of the citizens in vulnerable populations.   Under contract with the Department of State Health Services (Port Arthur subcontract), HealthQuilt in collaboration with emergency room physicians and special needs physicians from Baylor College of Medicine, Texas Children’s Hospital, University of Texas at Houston, and MHHS/ TIRR developed the first draft of the State of Texas Medical Special Needs Shelter Policies and Procedures.  Included in these are pediatric and adult clinical care guidelines for care in shelters and how to implement telemedicine support services from emergency and remote specialists.   The training for our Region 5/6 was conducted during July 2008.   The importance to our local health information exchange effort was important for one main reason, it gained the buy-in for the HIE project using the Quality Health Record as a key tool for emergency setting/hospital follow up with the primary care medical home.   

Unanticipated Roles in Ike Acute / Recovery Management

A. During the first week of Ike:

• Tested and ready to implement a reverse call technology to support a survey of Metro and 2-1-1 registrants.
• Developed a phone survey to be used for intake via a 1-800 number.
• Survey database integrated for short-term needs identification using KISS Case Management for housing / other needs.
• Establishing medical homes for patients with a focus for getting patients into safety net clinics housed at City of Houston facilities to use HealthQuilt processes
• Establish Personal Health Record / QHR
• Telemedicine Access
• “Break the Glass” emergency access to personal health record
• Development of future individual emergency preparedness plans.

B. In the second week of Ike, we received a call from the Red Cross to support medical special needs operations at the Red Cross Shelters.   This was done to augment the efforts from the Harris County Hospital District.  In addition the following was done:

Preparedness Presentation and Documents

• "Proposal for Medical Special Needs Populations Emergency Planning, Managment, and Recovery"
  By Kim Dunn, MD, PhD     Connie Dias, RN     Rachel McDonald, RN
  An overview of HealthQuilt's past preparedness activies and future opportunities.
• HealthQuilt Preparedness 2009 Mapping Document
• HealthQuilt Preparedness 2009 Action Plan
• Medical Special Needs Shelter Protocols