Health Center News

Planning for the Next Disaster – Lessons for Primary Care Associations

A new project by NACHC highlights the challenges, lessons learned, and response by Community Health Centers, PCAs, and other non-profit organizations following the natural disasters in 2017. Listen to the following podcast to learn more. 

With hurricane season upon us, Community Health Centers along the coast are likely braced for the worst.  More important, they likely have a response plan in place to deal with the aftermath. Ever since Hurricane Katrina struck the Gulf Coast in 2005, health centers have become seasoned practitioners of formulating disaster response strategies. Beyond hurricanes, health centers have confronted wildfires, floods, tornadoes, and the Zika virus, to name a few. One could also argue that since there are more health center sites now than 10 years ago, the odds are they are more likely to encounter a disaster and be part of a response.  Certainly health centers are more aware of the value of emergency preparedness and investing time in planning and forging collaborative partnerships. Primary Care Associations (PCAs) are also key stakeholders, providing leadership, guidance and technical assistance to health centers in their states.

“PCAs and FQHCs have a lot more capability in emergency management,” explains Tom Knox, Director of Emergency Preparedness and Education Programs for the Florida Association of Community Health Centers (FACHC).  “As a PCA, we not only offer technical assistance, we can help solve issues during EM events across a broad spectrum of problems on behalf of members.  During Hurricane Irma, we marshaled state and private relief resources, located temporary staff housing, diesel fuel, evacuation routes, pharmaceutical storage to name but a few.  We want to be in a position to guide our members towards solutions at critical times.”

Another important role the PCA plays is as a liaison between the Health Resources and Services Administration (HRSA) and various national and international relief organizations that respond to the disaster area. HRSA needs situational awareness of the impacted community and, obviously, the aid organizations need to know where to assist.  The PCA can provide that information to help the recovery progress run more efficiently.

At the Texas Association of Community Health Centers (TACHC), staff was in contact with area health centers before, during and after Hurricane Harvey hit Texas in August 2017. Shortly after the storm the PCA was sending daily emails to impacted health centers and holding daily phone calls. TACHC was also in regular communication with HRSA to relay information so that health center staff could focus on other pressing issues on the ground.

“Within about 24 hours, we had spoken to almost every CEO or someone from the health center to do a very raw, real assessment of what was going on because many of them were not able to be at the health centers yet – they were still flooded or they had been evacuated, so there wasn’t really a clear understanding of what the needs were,” says Christina Brito-Tigerina, Clinical Care Coordinator/Emergency Preparedness at TACHC. “Within a couple of days, though, we did conduct a needs assessment with those directors to really understand the baseline of their damage and what their initial needs were.”

TACHC’s efforts to communicate and coordinate during Hurricane Harvey were not lost on health center supporters outside of Texas. Their work helped get supplies from donors like Direct Relief into the impacted area, mobilized other health center staff to help with items like repackaging medications to enable their distribution, and brought in mobile health care units from California and Florida.

The association was also able to help health center employees who were impacted by the storm. Recognizing that health center staff were also experiencing trauma, they brought in a volunteer who met with and trained staff on how to spot trauma in themselves, other staff and patients.

Harvey left much of Houston under water, displacing thousands of people and causing damage to a lot of homes. Health center staff were not excluded from this experience, so to relieve some of the stress associated with being displaced and more TACHC created a fund to help employees.

“We – unsolicited – started getting money from people to help, and so we developed an application process,” says José E. Camacho, Executive Director of TACHC. “I think we had $15,000 and we sent the applications to health centers to distribute to their employees. We thought we might get 5 or 10 applications – turns out we got 200 applications in, and so we had to go raise money for that.”

The overwhelming amount of applications that were received meant TACHC had to fundraise to provide support to those employees. The association was able to distribute $1,000 grants to health center employees and is now in the process of going back to those employees to see if they need additional support.

Though this particular effort came together on the fly, TACHC emphasizes the importance of having their overall emergency preparedness plan in place and implementing it early once the storm became a reality.

FACHC’s Knox says the PCA Emergency Management Advisory Coalition (EMAC), a group of PCA emergency preparedness staffers who meet on a regular basis to network and exchange information on disaster preparedness, has helped the health center community stay plugged in on the latest best practices, communications, resources and strategies for disaster response.

“Emergency management is very important for health centers – not only for financial reasons, but if you want to do a good job by your patients who need you during events you have to be open, running and resilient and that’s hard to do…” Knox adds. “Seventy-five percent of it is having stuff in place and ready before the flood hits, or the tanker breaks, or the wildfire comes, or a hurricane or tornado.”

José Camacho notes that even sending reminders of things that might seem like common sense, like taking servers off of the floor before an impending storm, can prove helpful during a crisis.

Knox and FACHC have also offered guidance to health centers on important emergency preparedness factors such as automatic notification tools so that important information can reach the right people at the push of the “send” button. Also, since cell phones and the internet are often damaged or affected by disasters, FACHC has distributed satellite phones to members so they can effectively communicate their status to stakeholders, including HRSA. There has also been a focus on ensuring that health center staff have family emergency plans, an important planning element given that health center staff often find themselves in the unique role of both victim and responder during disasters.

Knox notes that health center disaster response plans are becoming more coordinated and robust than four or five years ago, and that’s a good thing. Not only are health centers counted on to meet local public health needs during disasters, it’s compulsory.