Our friends at the Kentucky Primary Care Association (KPCA) recently met with NACHC staff about what they are experiencing after deadly floodwaters ravaged the communities in eastern Kentucky, claiming 38 lives.
Interim KPCA Chief Executive Officer Molly Lewis described how exhausted and traumatized health center staff are still responding to the immediate needs of the community, even as their own homes were damaged and their cars washed away in the flooding. This is not the first time health centers have been both victims and responders to a natural disaster and kept their doors open to help.
Several Community Health Centers and their dedicated staff have been impacted: Juniper Health, Inc., UK North Fork Valley Community Health Center, Mountain Comprehensive Health Corporation, Mountain Comprehensive Care Center, Inc., and Mountain Health Alliance dba Little Flower Clinic.
A federal disaster declaration has been issued for the eastern Kentucky counties of Breathitt, Clay, Floyd, Johnson, Knott, Leslie, Letcher, Magoffin, Martin, Owsley, Perry, Pike, and Wolfe following the flooding, and 12 emergency shelters are currently operating with a total population of 300. NACHC’s partner, Direct Relief, has committed an initial $250,000 to facilitate the rapid deployment of emergency medical supplies and operating funds. Direct Relief is also coordinating with KPCA, Kentucky VOAD, the Governor’s office, and several local health centers and free clinics around urgent health needs.
Access to clean water or electricity remains intermittent or nonexistent in some areas, and many roads in the area have been washed-out, with more than 40 bridges reportedly washed out in Jackson County alone. It is difficult to get supplies in and out of affected areas — medicines, food, hygiene supplies and even a hot shower for families living in shelters.
“Our members and their employees have experienced devastating loss- physical buildings underwater, servers and administrative services washed away, school sites destroyed,” said Lewis. “Some of our members are operating out airplane hangars, retired high schools, elementary school parking lots, and spontaneous campgrounds. But they are operational, and they continue to meet their members’ needs just like they always do. It is important to note, that our health providers have experienced personal loss—loss of loved ones, homes, vehicles and possessions, and loss of hope. It is important that we support the resilience of these special communities. At KPCA, we work to improve access to healthcare. We do this through our members. I am impressed everyday by their compassion and innovation. We are all better off because we are in communities that care.”
Other health centers have offered to help eastern Kentucky, but red tape around the Federal Tort Claims Act coverage for providers who volunteer their services is posing some hurdles. The only health centers who can receive FTCA coverage for services provided in or near disaster areas, or for persons displaced by a disaster are those either directly affected or whose service area was located in or near an area that was affected. The requirements for each arrangement is slightly different and a deeming application for individual providers has to be submitted to the Bureau of Primary Health Care for approval before the coverage goes into effect. This can take time. KPCA is steadily working through those challenges.
“Health care employees from across the state and beyond want to help,” said Lewis. “Unfortunately, such generosity is prohibited. Alone, community health center workers must dig their clinics out of the mud, respond to traumatized, sick and injured patients, and then go home to dig out their own homes. They are tired, and they need some help. Others want to help. Doctors, nurses, aides, community health workers, pharmacists, therapists and the like want to help their fellow healthcare workers. Western Kentucky providers still recovering from the tornadoes in December were the first to offer assistance to their friends in Eastern Kentucky. But it is an empty promise because the laws make it too risky, too troublesome, too human. Bureaucratic limitations undermine the nature of a public health service program. Healthcare workers are kind and resilient, dedicated and selfless. The law is in the way. When my UHAUL drives its fifth trip past the caravan of FEMA, National Guard, and public relief, I recognize that our hearts are all in the right place, but some are more nimble than others. No one can mobilize and respond faster than a network of providers with the common mission to serve Kentuckians with person centered, community based, cost effective, consumer informed care than community health care workers. Let us help. Federal Tort Claim Act liability coverage should be applied to all FTCA covered center employees and it should be portable.”
It’s important note that this is not the first time health centers have encountered challenges with FTCA. Over the course of the past few years, since Hurricane Katrina, health center advocates and NACHC fought for an easier path to allow health center employees to care for neighbors in nearby communities, and to expand FTCA coverage to licensed medical practitioners who wish to volunteer at health centers, especially during disasters.
Meanwhile, KPCA remains focused on helping where they can. The association has started a relief fund to help safety net providers. “KPCA is committed to helping our members in the region, and their patients, recover. This relief fund is one of the many ways KPCA is taking immediate action to help,” said Lewis. “Our team is working with the clinics to meet their needs. Several truckloads of relief supplies have already been delivered to them, more are on the way, and we’re just getting started! Donations to our Kentucky Rural Health Collaborative will help ensure residents have access to the essential health services provided by our CHC and RHC members. Please make a donation to help our safety net providers today.”
Mountain Comprehensive Health Corporation has also posted a video on their website, describing how donated resources are helping the centers case managers assist families who lost everything in the flooding. You can view that video here.