1. Being Prepared in the Eye of the Storm: Disaster Response 101
Mary T. Henderson
Associate Commissioner
Texas Long-Term Care Regulatory Services

2. Learning Objectives: Ensuring your state is ready when disaster hits
Successful partner engagement
Triaging the Unexpected
Lessons learned in the aftermath
12/5/2019

3. Are you ready when disaster hits? Harvey Impact Timeline

4. Forecast Advisory – 1000 08/23/17 (Wednesday)

5. Forecast Advisory – 0700 08/24/17 (Thursday)

6. Forecast Advisory – 2200 08/25/17 (Friday)

7. Rainfall by 0800 Saturday 08/26/17

8. Rainfall by 0700 Monday 08/28/17

9. Rainfall by 0700 Wednesday 08/30/17

11. La Vita Bella (Assisted Living Facility), Dickinson, Texas (31 miles southeast of Houston)

13. Is your state ready? (A hurricane doesn’t care if your agency is transforming)
Advance Communication
Internal
Call down lists are current and tested; staff shelter in place/evacuation plans are communicated
Know your state agency emergency contacts, and state emergency management contacts
See:
Participate in training and exercises throughout the year; Review state situation report and FEMA briefing
Determine who will be staffing your state operations center (SOC) and stay in contact
External
By June 1, alert is sent to providers to remind of hurricane season and emergency preparedness responsibilities
Notify every licensed residential facility (SNF/NF, ALF, ICF, PPECC, and In-Patient hospice) and ask their plans (if hurricane is forecast to hit their area)
Remind providers if they evacuate, they must advise us when and where they are going
If mandatory evacuation order in place, provider refuses to evacuate, I've notified local law enforcement and they enforce the order or monitor
12/5/2019

14. Successful Partner Engagement
Have designated liaison with state operations center (SOC) (In Texas, Director of Survey Operations)
On call 24/7 to match hours the SOC is operational until they stand down
Daily calls with internal/external stakeholders to relay latest weather news, where there are issues, challenges providers are experiencing, etc.
Set up a webpage visible/accessible to providers and remind them that is where they can find specific information
State media services available 24/7 to post latest information (EX: contact person for the 1135 waiver requests)
Partner with trade organizations, quality monitoring program, and ombudsman to ensure communication on policies, issues, etc.
12/5/2019

15. Successful Partner Engagement (continued)
Monitor locations where LTC residents have moved; sometimes daily onsite monitoring is involved
If sheltered in place, daily calls to ensure sufficient staff and supplies (food, medication, generator fuel)
Call each HHA and hospice agency to ensure operations and consumer continuity of care
Respond to inquiries from public media, legislators, Governor’s office, CMS, etc.
Coordinate calls from family members trying to locate loved ones; encourage registration with American Red Cross’ Safe and Well program
Assist shelters that call with high medical needs individuals who may need NF placement; we assess the individual and coordinate with local NFs
12/5/2019

16. Triaging the unexpected
New leadership in your agency
Mandatory evacuation order vs. Non- mandatory
The need for Governor’s approval to waive licensing rules/statutes; obtaining CMS waivers
Facilities can never do too many recounts (resident left bus and hid in closet)
214 providers evacuated (NF, ALF, ICF, HHA)
Total # of residents/individuals evacuated: 5447
Total # of facilities still closed: 22
Facilities refusing mandatory evacuation, but ultimately requiring evacuation/rescue
12/5/2019

17. Lessons Learned in the Aftermath
Have a list of current staff and contact information of all stakeholders to ensure consistent, prompt communication
Know what the expectation is for communication between area/agencies; develop a communication plan agency-wide
Have standardized rule waivers in place pre-approved by the Governor’s office
Complaint investigations must be thoroughly reviewed and evaluated
Need for more specific emergency management plans and requirements in rule for assisted living facilities
Implement more specific regulations for assisted living facilities related to content of emergency plans and require mandatory compliance with emergency evacuation orders
Expect the unexpected…Always
“Facts” are not always true (social media)
12/5/2019

18. Lessons Learned in the Aftermath (continued)
Houston wasn’t flooded because of its land use planning.
Harvey unloaded 33 trillion gallons of water in the U.S.
La Vita Bella
Left Adrift Report
Commentary: reaching the wrong conclusions after Hurricane Harvey
HHSC Regulatory Request for Suspension of Rules Under Disaster Declaration
12/5/2019

19. THANK YOU!
Questions?
Contact information:
Mary T. Henderson
Associate Commissioner
Long Term Care Regulatory Services
O: (512)
C: (512)
12/5/2019