And the Storms Came… Sarah S. Strawn, MS, RD Nutrition Services Administrator Alabama Department of Senior Services 4th State Units on Aging Nutritionists/Administrators Conference August 2006

ADSS Nutrition Services Title III—Elderly Nutrition Program –18,000 meals daily –13 AAAs and 350+ senior centers –6 production units + 1 frozen distribution unit Title XIX—E/D Medicaid Waiver – 6,000 frozen and breakfast 7-meal packs weekly – 2 state operating agencies –Vendor delivers D2D to clients throughout state

And the storms came… Hurricane Ivan—September 16, 2004 –Category 3; landfall at Gulf Shores, AL Hurricane Dennis—July 10, 2005 –Category 3; landfall at Navarre Beach, FL Hurricane Katrina—August 29, 2005 –Category 3; landfall in southeast Louisiana and at Mississippi/Louisiana state line

State of Alabama

Each storm is different Hurricane Ivan –Flood damage along the coast –Wind damage in the interior; major power outages; damage to homes and centers; no fuel –Satsuma and Camden without power two days Hurricane Dennis –Heavy rain

Each storm is different… Hurricane Katrina –Heavy coastal flooding due to storm surge –Satsuma without power for a week –Vendor home office operations paralyzed Computer system inoperable Traditions frozen meal plant without power Shelf-stable meal supply shortages –Influx of evacuees into Alabama –Donated meals to state

Lessons learned Each disaster brings unique challenges Some plan is better than no plan –Centralize decision making and communications –Maintain critical agency operations –Recognize cannot anticipate every contingency –Do the right thing –Guard against complacency –Incorporate relief efforts into existing structure Document!! Document!! Document!!! Evaluate actions and revise plans as needed

ENP Operations Client intake forms modified –Vulnerability information –Document services to evacuees Disaster kits/emergency flyers AAA trainings of center managers Safe Shelters

Vendor disaster planning Hazard analysis by company committee Disaster plan for food service units –Developed new training manual –State training seminar for managers –Follow-up training of local staff Operational changes –Improved computer security and back-up –Better employee records –Alternative menu options for disasters –Invested in alternative power sources

D2D delivery challenges Clients without power cannot utilize frozen meals and fresh milk; often lack water Clients are the “neediest of the needy” Vendor has weekly client contact Cannot “make up” more than 2 days Deliveries documented electronically by individual client Clients may use up emergency meals prematurely

D2D disaster plan Redefined service units to include –7 pack shelf stable meals + 1 gallon water –7 pack breakfast meals +NFDM + Breakfast bar Maintain 2 day supply in state Meals coordinator authorizes delivery Centralized documentation approved Rotate stock during holiday periods Vendor distributes disaster planning tips

Limitations Lack of menu variety Meals are not optimal nutritionally –High in sodium –Low in fiber Quality loss in storage –Bread items stale and crumble; Juice and NFDM change flavor and color –High summer heat accelerates Product shortages in disasters

Challenge: Pool buying power Improve shelf-stable menu options Lower sodium entrees Bread items more nutrient dense; less sodium Alternatives to non-fat dry milk Canned fruits in lieu of cookies Common nutrient standard Improve packaging Formal storage testing Evaluate options for self-heating meals

Resources FSIS/FDA Guidelines for Retail and Foodservice Establishments Affected by Natural or Other Disaster Sept Emergency Handbook for Food Managers Twin Cities Metro Advanced Practice Center Twin Cities Metro Advanced Practice Center

Resources Are You Ready? A Guide to Citizens Preparedness FEMA H Administration on Aging: Emergency Assistance Guide