by Barbara B. Citarella, RN, MS, CHCE, NHCP-BC, President & CEO, RBC Limited Healthcare & Management Consultants
With Hurricane Florence looming in the Atlantic Ocean, the timeliness of National Preparedness Month (NPM), which is recognized each September, is more important this year than ever before for so many people along the East Coast. This national month-long observance provides an opportunity to remind us that we all must prepare ourselves and our families now and throughout the year. This September will focus on planning, with an overarching theme: Disasters Happen. Prepare Now. Learn How. Health care providers, however, fall into a unique category, much like our emergency responders. They must take care of the community as well as their own families in a disaster. But each community is defined differently and is unique.
The distinctiveness of a community is based on many factors. These factors, many of which are social determinants, affect community resilience. Health care providers, especially home care and hospice, encounter the reality of social determinants on a daily basis. But the correlation between disaster preparedness, social determinants and resilience is relatively new.
Community health care providers (home care and hospice) see and understand the real world patients live in. While responsibility, and in some cases regulations, dictates our role in developing a patient care plan that includes disaster preparedness, it is clear that when a patient is struggling with basic everyday life needs, preparedness activities are not high on the to-do list. Activities such as stockpiling food and water may be impossible for some families who are barely getting by.
What are the social determinants that impact a community’s ability to respond survive and recover from an event?
Social determinants for resiliency are social variables such as health, education, wealth, transportation, and connectivity of a community. These differences make each community unique. As all disasters are handled at the local level, the strength of each community is what impacts the response. Hurricane Katrina helped to paint a clear picture of what happens to those most vulnerable during a disaster. For many people in New Orleans prior to Hurricane Katrina, life was a challenge. It was only when the disaster occurred that those issues presented themselves in a very stark reality.
Action reports from Katrina identified problems with communicating to people who had literacy and language barriers. Many had difficulty understanding information concerning the hurricane, including what to do and where to go. The areas of the city with the weakest economy were hit the hardest. Vulnerable populations struggled to find shelters and appropriate medical care.
Last year was a particularly difficult year for people around the country, and world, with large scale events such as three major hurricanes in the United States, wildfires, earthquakes, Ebola outbreak, the Las Vegas shooting, terrorist attacks with vehicles, floods, and monsoons.
Health care providers and emergency management personnel must have knowledge of the variables in the community, such as unemployment rates, income, population demographics, various cultures, religions, church activities, community activities, crime indicators, opioid addiction statistics, housing capabilities, and yes, even awareness and location of sex offenders. This information is necessary to prepare, respond and recover. This data also helps providers to work effectively as a team with the community emergency responders and health care coalitions. Collaboration like this is imperative to help move people in, up, down and through the impacted area as physical, mental, and social needs change.
Often in the past home care and hospice providers were not a part of the community preparedness activities. During the last few years there has been a significant change. The basis for the change comes in the form of health care coalitions. Health Care Coalitions (HCC) are groups of individual health care and response organizations in a defined geographic location that serve as multi-agency coordinating groups and support and integrate with public health and medical services activities. HCCs play a critical role in developing health care delivery system preparedness and response capabilities. Coalitions have recognized the value of community health workers especially in their ability to provide short term surge capacity as well as location and identification of vulnerable populations. Community health care providers know the geographic area well and can easily move around when roads are blocked. Additionally, their personnel are readily accepted by the community and recognized as providing needed and supportive services to those most fragile and at risk.
As an entity, health care coalitions are involved in strategic planning, operational planning and response, information sharing, resource coordination, and management. Coalitions have the capability to identify the social determinants for their specific geographic location. This is done by engaging all community providers and support groups in a collaborative effort to work together without bias for the betterment of the community. It is only through collaborative leadership that communities will be successful in preparedness, mitigation, response and recovery. All health care providers should reach out to the coalition in their location. You can access a list of all the health care coalitions in the country here.
Health care providers play an essential role in preparedness and response. Remember: Disasters Happen. Prepare Now. Learn How.
Additional Emergency Preparedness Resources:
- Emergency Preparedness Rule website (CMS) includes guidance, examples, FAQs…
- Hurricane Information Sheet (FEMA)
- Wildfire Information Sheet (FEMA)
- Flood Information Sheet (FEMA)
- Extreme Heat Information Sheet (FEMA)
- Emergency Preparedness Basic Surveyor Training Course (CMS)
- Preparing for Winter Weather: What to Have in Case of Emergency (MyHHQI Blog)