1. Sheltering for Disabilities and Special Needs enABLED in Emergencies Conference 2009

2. The Region 18 Counties 177 cities 6.3 Million* (27%) 877,000 with disabilities* (24%) 120+ hospitals 500+ nursing homes

3. Tropical Storm Allison Houston, Texas June 2001

4. Hurricane Katrina Houston, Texas August 2005 Largest Patient Reception in US History

5. Hurricane Rita Texas Gulf Coast September, 2005 Largest mass evacuation in US history

6. 2008 Hurricane Season Ike: Largest EMS deployment in US history

7. So how do we improve next time???

8. Evacuation Surge Zones Planned evacuation times Phased-in return times Pre-identified shelter Hubs 19 acute care hospitals 121 nursing homes 1.2 million citizens

9. Disparity between assumption and reality

10. So what IS right for healthcare?

11. Catastrophic Medical Operations Center (CMOC) Local and Regional asset Co-located in the HEC Recognized by the MACG for health and medical coordination NIMS Compliant Command authority Logistical and Operational Components Stand up when requested by EOC, EMC, State, or other jurisdictions of authority

12. Mission Identify and meet the healthcare needs of the region Protect and maintain medical infrastructure of all regional healthcare facilities Provide appropriate transfer to healthcare facilities based on capacity and capability Coordinate unique requirements of “special needs” population Maintain patient tracking records

13. “One Stop Shop” Coordination and organization of movement of medical special needs persons during a disaster Organization of transportation assets for patient movement

14. “One Stop Shop” Facility Assistance Patient Tracking Organization of Regional Public Health Issues Presentation Trending Coordination of Mass Fatality Issues

15. Evacuation Hubs

16. Special Needs Elderly/infirmed Pediatric Neurological/mental disorders Multi-organ disease Dialysis Immunocompromised Handicapped Technologically dependant

17. Identifying our Special Needs Population… 211 Registry –It is estimated that less than 10% of our special needs population have registered Distrust –Privacy –Mistrust of government Personal reasons –Don’t want to leave their home –Don’t want to leave their pets –Fear from last time….

18. Identifying our Special Needs population… Health homes Home health care Hospital discharge Church and faith- based organizations HOA’s Community leaders Healthcare for the Homeless

19. Secondary Facility (MSN RLR) Location, Location, Location……. Patient population Staffing Supplies Medical gases Emergency power Nutritional support Access/Security

20. Field Hospitals Collaborative effort –Houston Fire Department –Regional Hospital Preparedness Council Regional Asset Deployment time: 4 hrs Shelter, equipment, pharmaceuticals Personnel…..

21. Electricity Outages

22. Loss of Water and Sewer

23. Access Challenges Healthcare Employees Fuel Access to work

24. Transportation Ambulances Limited distribution Tracking Fuel Conflicting priorities Travel time Staging Timeout

25. Alternate Care Sites and Sheltering

26. 56 of 109 hospitals in affected zone Hospital Evacuations/Closures

27. EM Resource

28. EMTrack ASP and Mobile

29. Repatriation Community Infrastructure Loss Medical Infrastructure Loss Transportation Assets Individuals’ desire to return Financial Implications Tracking EMTALA

30. Questions