 |
|
 |
Information About Hurricane Response Responding to Homelessness in Katrina’s Wake discusses the implications of the hurricane and proposes systemic solutions to the conditions that magnified its impact. The HCH Mobilizer for September 23 calls for organizational endorsements of the statement, and for President Bush to fulfill his promise to empty the shelters by October 15.The National Council will update this page as we learn of information of particular relevance to HCH providers. Please send new information or corrections to jlozier@nhchc.org.Topics discussed below are: • Housing Funds made available to previously homeless, Katrina-affected persons — added 9/29 • Health Status of Displaced Persons • Health Status and Coverage Issues • HHS Critical Infrastructure Data Request • Donations of Medical Supplies • Volunteerism • Professional Liability • Record-Keeping • Infectious Disease and Immunizations • Responding to the Consequences of Trauma • Shelter Health Care • US Department of Health and Human Services • Center for Medicare & Medicaid Services • HRSA information • CDC Information • Department of Housing and Urban Development • Department of Veterans' Affairs • Interagency Council on Homelessness • SSI • The HIPAA Privacy Rule • Education of Homeless Children • Community Voice Mail • Funds for Affected Programs Serving Cancer Patients • HCH Mobilizers on Katrina Issues • Essay by Kevin Kindamood • Katrina Websites of Our Colleagues • Cash Donations Housing Funds made available to previously homeless, Katrina-affected persons The federal Interagency Council on Homelessness has announced that people who were homeless prior to the hurricane and directly affected by it, are entitled to 18 months of housing, as well as temporary shelter, transportation, security deposits, utility payments, and housing counseling. See http://www.ich.gov/Health Status of Displaced Persons To give voice to people whose lives have been devastated by Hurricane
Katrina and the ensuing floods, The Washington Post, the Kaiser Family
Foundation, and the Harvard School of Public Health conducted a unique
survey of evacuees in shelters in the Houston area. More than 1 in 10 (14%)
Hurricane Katrina evacuees report a family member, neighbor or friend was
killed by the storm or subsequent flooding and more than half report that
their home was destroyed (55%) and that they are separated from or missing
members of their immediate family (53%). The survey also found that evacuees
in Houston shelters face serious health challenges that will complicate
relief and recovery efforts.Key health-related findings include:
* 52% report having no health insurance coverage at the time of the
hurricane. Of those with coverage, 34% say it is through Medicaid and 16%
through Medicare. Before the hurricane 66% of the people evacuated to
Houston shelters used hospitals or clinics as their main source of care and
of those, a majority (54%) used Charity Hospital of New Orleans,
substantially more than the second most common care site (University
Hospital of New Orleans, at 8%).
* 33% report experiencing health problems or injuries as a result of the
hurricane and 78% of them are currently receiving care for their ailments.
* 41% report chronic health conditions such as heart disease,
hypertension, diabetes and asthma.* 43% say they are supposed to be taking prescription medications, and
of those, 29% percent report having problems getting the prescription drugs
they need.
* Of the 61% who did not evacuate before the storm, 38% said they were
either physically unable to leave or had to care for someone who was
physically unable to leave.Among those surveyed, 98% are from the New Orleans area and about
three-quarters of those (73%) have lived there their whole lives. In
surviving this tragedy, an overwhelming majority of the evacuees in Houston
shelters (92%) say that religion played an important role in helping them
get through the past two weeks.
The full report is available at http://www.kff.org/newsmedia/7401.cfm Health Status and Coverage Issues As part of the Kaiser Family Foundation's commitment to help respond to the
devastation from Hurricane Katrina, the Kaiser Commission on Medicaid and
the Uninsured sponsored two briefings and released a new policy brief and
fact sheets in the past week focusing on the health status and coverage
issues facing the Gulf region's population and Louisiana, Mississippi,
Alabama and neighboring states in the wake of Hurricane Katrina.
http://www.kff.org/katrinaThe affected states in the Gulf region are among the nation's poorest with 1
in 5 residents relying on Medicaid and SCHIP for their health care coverage
and equally high rates of uninsured. The combination of poverty and poor
health among the citizenry makes the affected areas particularly vulnerable
in the wake of Hurricane Katrina. With the disaster, comes the increased
risk of disease and significant job loss leading to even more uninsured
individuals. Since the response to this crisis is evolving rapidly, we will
update our materials to reflect new developments. You will find the initial
resources available on our website, including:* Addressing the Health Care Impact of Hurricane Katrina: A Policy Brief summarizing the implications for both the health of the population and their access to needed care, the health impact on the affected states, and reviewing ways in which the federal government could assist in the health response; * Health Coverage in the Wake of Hurricane Katrina audio briefing with Ruth Kennedy, Medicaid deputy director of Louisiana; Barbara Edwards, deputy director, Ohio Department of Health & Human Services; and Jeanne Lambrew, associate professor, George Washington University focusing on health coverage issues; * Safeguarding the Health of Katrina Victims webcast of a briefing co-sponsored with the Alliance for Health Reform with US Surgeon General Richard Carmona, Ray Scheppach of the National Governors Association, Jim Tallon of the United Hospital Fund, and Senator Bill Frist on the health needs of Katrina victims and the federal response; and * Key state fact sheets and a side-by-side on the demographics and health coverage of Louisiana, Mississippi, Alabama, and Texas. We hope you find these materials useful as you work on this pressing national concern. If you have questions or would like to discuss related issues, please contact us at 202-347-5270 or by email at webmaster@kff.org . back to top HHS Critical Infrastructure Data Request The U.S. Department of Health and Human Services (HHS) has an urgent need to generate a status report for the victims of Hurricane Katrina. To facilitate the process for all states involved in relief efforts, we are immediately making available to you [Consolidated Health Centers] the HHS Critical Infrastructure Data System. Your current operational status is a priority as we make efforts to care for the victims and to meet your on-going needs.The HHS Critical Infrastructure Data System has been created to capture information on the following:· The current status of facility resources (what you have) · Critical resource requirements (what you need) · Daily patient diagnosis and symptom information (what you are treating) Consolidated Health Center grantees should have received more detail on this request directly from HRSA. To our knowledge it is not available on HRSA’s website.The National Health Care for the Homeless Council encourages providers to participate in this system but strongly cautions providers that this system is not a substitute for normal reporting of infectious diseases. It is critical that state and local public health authorities learn promptly of the presence of reportable diseases among displaced persons, and in the general population.
back to top Donations of Medical Supplies Medical supplies of all descriptions are needed by HCH projects that were hit by the hurricane or are assisting refugees. Tetanus and other vaccines, other pharmaceuticals, and diabetic supplies have been particularly requested. Please ship directly to one or more of the following HCH projects. We will add other HCH projects to this list as we learn of their needs.
Coastal Family Health Center, Biloxi MS and The Coastal Health Center in Biloxi Mississippi and the St. Charles Parish Community Health Center in Louisiana need mobile health units to reach their clients. Contact the respective Primary Care Associations: Louisiana PCA 225/927-7662, Mississippi PCA 601-981-1817.
Donations of Federal Surplus Property are available to homeless-serving organizations through the Title V program. See http://www.psc.gov/aos/federalprop/titleV.htmlback to top Volunteerism While numerous efforts to mobilize volunteer clinical providers for service in the Gulf region are underway, and while many HCH providers feel moved to contribute in this way, the National HCH Council sounds two notes of caution.
First, the need in the Gulf region will be long-lasting, and volunteers’ services may be more effectively used later, once facilities and systems of care are more firmly in place.
Second, the homelessness and related health care needs resulting from Katrina are not significantly different –except in scale- from the homelessness and health needs that HCH providers deal with every day. Service provided in response to the on-going crisis of mass homelessness in America is astoundingly important, and providers should carefully consider the impact of their departure on homeless service systems that are already overtaxed and unable to meet the need. The demand on HCH projects will only increase as evacuees from the Gulf Coast spread throughout the country. Already in many communities, HCH projects are taking the lead in organizing health services for people in the new shelters, and are seeing refugees among their usual clients.Persons interested in volunteering to assist with hurricane relief are encouraged to contact a nearby Health Care for the Homeless project. For clinicians, volunteering with projects in their home States avoids numerous licensure and liability problems. The Health Care for the Homeless Directory is accessible at http://www.bphc.hrsa.gov/hchirc/directory/default.htmThe Department of Health and Human Services has established a website https://volunteer.hhs.gov and toll-free number (1-866-KAT MEDI) to help identify health care professionals and relief personnel to assist in Hurricane Katrina relief efforts. HHS’ “Health Care Professionals and Relief Worker Personnel Page” is at https://volunteer.ccrf.hhs.gov/.The PATH Program in Texas seeks 60 experienced outreach staff to volunteer their services in several large cities in Texas . The cost of travel, food and lodging will be covered by the State of Texas . Individuals interested in applying to volunteer may request an application at: homelessoutreach@ahpnet.com or may apply online at www.pathprogram.samhsa.gov. For further information please call Richard Becker at 518-475-9146 Ext. 260 ( New York ) or Lynn Aronson at 805-452-9584 ( California ). Harmony House in Houston, a Respite Program and Organizational Member of the National HCH Council, anticipates a heavy demand to care for tuberculosis patients and seeks to employ a physician or nurse clinician. Contact Bill Bender at 713/236-0119.The Center for Law and the Public's Health at Georgetown and Johns Hopkins Universities has compiled resources addressing numerous legal and regulatory issues associated with the use of volunteer health personnel in response to Hurricane Katrina. The materials can be found at: http://www.publichealthlaw.net/Research/Katrina.htm.back to top Professional Liability A new Program Information Notice from the Health Resources and Services Administration clarifies HRSA policy regarding Federal Torts Claims Act (FTCA) coverage for FQHC personnel responding to the disaster outside of the FQHC’s usual Scope of Practice. In pertinent part it reads:Emergency response activities, including services to non-health center patients and services at temporary locations, will be considered part of a health center’s scope of project under the following circumstances:
• Services provided at non-health center sites are on a temporary basis and will cease with the end of the emergency.Note that volunteers are NOT covered by FTCA. The PIN may be reviewed at http://www.bphc.hrsa.gov/pinspals/pins.htm HRSA has provided the following information regarding FTCA coverage for Consolidated Health Center employees who cross state lines to practice at another health center in this emergency:Employees of health centers who wish to cross state borders and volunteer to provide care at a heath center that has been affected by Hurricane Katrina can apply for coverage under the Federal Tort Claims Act (FTCA) as Intermittent Federal Employees using the process described below . Volunteers should meet the licensure requirements in the affected state. The health center sending volunteers should identify a health center in need of assistance, and the sending and receiving health centers should agree on the volunteers to be sent before a request is initiated. The health center needing assistance should email a request to the Department of Health and Human Services (HHS) Secretary’s Operation Center at HHS.SOC@HHS.gov. The email request should:
§ Identify the requesting health center and give the full address; The health center sending volunteers should email a letter with the following information to Dan Beck dan.beck@hhs.gov:· Organization’s human resources point of contact and phone number; · A statement that the organization maintains documentation for credentialing verification; · List of volunteering employees’ name (first, middle, and last), home address, phone, email (if available), social security number, and profession credentialed in and specialty; · Indicate if accommodations at the destination location have been previously arranged (If arrangements have not been made, HHS will provide travel, housing, per diem, and transportation. In order to expedite travel, please forward the volunteers’ destination to Gene Carter at gene.carter@hhs.gov. The email should be copied to Sandy Bogucki, HHS Sandy.Bogucki@hhs.gov, Ann Knebel, HHS, ann.knebel@hhs.gov, Don Weaver, HRSA/BPHC (dweaver@hrsa.gov, Marilyn Biviano, HRSA/BPHC mbiviano@hrsa.gov, Amy Taylor, HRSA/BPHC ataylor@hrsa.gov, and John Cafazza, HRSA/BPHC jcafazza@hrsa.gov.In addition, a notarized letter with the same information should be mailed next day delivery to:
Logistics Personnel Section Department of Health and Human Services 200 Independence Ave, SW Room 638G Washington, DC 20201 Once all of this information is received, the HHS Secretary’s Operation Center will hire the volunteers as Intermittent Federal Employees. Volunteers will be sworn in as non-paid Federal employees for this service and will need verification of identification. Volunteers should bring with them a:· Passport, or · Driver’s license and social security card, or · Driver’s license and birth certificate back to top Record-Keeping HCH projects that provide services in response to this disaster are advised to keep the most complete records possible in the circumstances. Good documentation contributes to good patient care and protects providers from liability, and in this circumstance it is important for preserving the prospect of reimbursement of costs from FEMA. Agencies should record their costs, and should capture data on where their patients come from and where they were served. One promising way to establish records is the completion of Medicaid Presumptive Eligibility Forms for patients seen.Infectious Disease and Immunizations The Centers for Disease Control and Prevention has issued (09/05/05) important “Interim immunization recommendations for individuals displaced by Hurricane Katrina,” which are available at http://www.bt.cdc.gov/disasters/hurricanes/katrina/vaccrecdisplaced.asp. The site of the Society for Healthcare Epidemiology of America has a helpful collection of materials and links on Healthcare-Related Infection Control in Hurricane-Affected Areas athttp://www.shea-online.org/news/hurricane_katrina.cfm. The National Coalition for the Elimination of Tuberculosis reports that “no known TB exposures have occurred, so the immediate focus of TB screening in those evacuation centers should be to detect persons with TB disease, not LTBI, so broad-based tuberculin skin test screening is not being recommended in the temporary shelters.” Other reports from providers in Houston suggest an emerging tuberculosis problem among displaced persons. Responding to the Consequences of Trauma Our colleagues at the National Center on Family Homelessness provide excellent resources on the sequelae of traumatic events, with particular attention to the mental health needs of children and families. See their materials including an interactive training curriculum at http://www.familyhomelessness.org/online_trauma.html Shelter Health Care "Best Practices" document for emergency shelter health and safety, developed by Public Health Seattle and King County, provides useful, concise guidance for operators of shelters, It is available at http://www.metrokc.gov/health/hchn/recommended-shelter.pdf.The Health Care of Homeless Persons: A Manual of Communicable Diseases & Common Problems in Shelters & on the Streets, published by the Boston Health Care for the Homeless Program with the National Health Care for the Homeless Council, is available on-line or in hard copy at http://www.nhchc.org/manual.html.back to top US Department of Health and Human Services A useful portal to information from various federal agencies has been created at http://www.hhs.gov/katrina/. Center for Medicare & Medicaid Services The CMS site includes information on the waivers already adopted to facilitate use of Medicaid, Medicare and SCHIP by victims of the hurricane. The CMS press office has reported that additional waivers are in development, so this site bears monitoring for new developments: http://www.cms.hhs.gov/katrina/ HRSA Information The Health Resources and Services Administration is posting information about the Katrina response on its homepage at http://www.hrsa.gov. This site is being frequently updated and now includes a useful Question and Answer feature.back to top CDC Information The Centers for Disease Control and Prevention has collected its most relevant its recommendations for infection control, immunizations, and other health issues in the aftermath of Katrina at http://www.bt.cdc.gov/disasters/hurricanes/.Department of Housing and Urban Development Information on programs of the Department of Housing and Urban Development as they relate to hurricane recovery is available at http://www.hud.gov/katrina/index.cfm.back to top Department of Veterans' Affairs The Department of Veterans Affairs has a toll-free telephone number for veterans who normally receive health care at VA facilities in the area affected by the Hurricane. By calling 1-800-507-4571 veterans and family members can find out about health care, prescription drugs, and related questions for veterans displaced by the hurricane, and locate veterans who were hospitalized at VA facilities in the affected area.
The VA’s Katrina web page is at http://www1.va.gov/opa/katrina
Interagency Council on Homelessness The federal Interagency Council on Homelessness provides news of activities of various federal agencies on its website at http://www.ich.gov back to top SSI The National Law Center on Homelessness and Poverty reports that: Current SSI recipients who have been displaced by Katrina and have been unable to get their checks in the mail may go to the nearest SSA office or temporary SSA facility and the offices should be able to write checks to them directly. SSA will be setting up tables with representatives wherever FEMA sets up relief centers (at least the centers where FEMA has officials available to take FEMA assistance applications). SSA representatives at the FEMA centers should be able to write SSI checks directly to clients who are already enrolled but who have been unable to receive their checks. If people have questions about where they can find SSA offices (whether regular or the temporary offices), they can call 1-800-772-1213.
HIPAA Privacy Rule The HIPAA Privacy Rule allows covered entities to share patient information to assist in disaster relief efforts, and to assist patients in receiving the care they need. See “A Hurricane Katrina Bulletin: Disclosing PHI in Emergency Situations" at http://www.hhs.gov/ocr/hipaa/KATRINAnHIPAA.pdf.The HHS Office of Civil Rights has also issued “Hurricane Katrina Bulletin #2: Compliance Guidance and Enforcement Statement - 9/9/05”, available at http://www.hhs.gov/ocr/hipaa/EnforcementStatement.pdf back to top Education of Homeless Children The National Association for the Education of Homeless Children and Youth has issued an Action Alert regarding Katrina-related legislation that would undermine the requirement that homeless children have access to refgular public schools. Please see the alert at http://www.naehcy.org/legislative_update.html Community Voice Mail A free voicemail number can help evacuees access needed government benefits/services and receive messages from friends & family. For more information, please call 206-441-7872 or email sholmes@cvm.org jbrandon@cvm.org or salbertson@cvm.org. Funds for Affected Programs Serving Cancer Patients The Lance Armstrong Foundation (LAF) will distribute approximately $500,000 to assist cancer survivors, including those in active treatment, who have been affected by Hurricane Katrina. Funds will be disbursed to qualified non-profit organizations and cancer centers that are currently providing assistance to cancer survivors. Requests of up to $50,000 will be considered for internal review. (We are unable to provide funding directly to individuals; funding is limited to organizations.)Examples of funding requests might include, but are not limited to:
Click here for more information.
HCH Mobilizers on Katrina Issues The HCH Mobilizer is a periodic action alert issued by the National HCH Council. The September 12 issue “Rebuild No Shelters” discusses relief and reformation in the wake of Hurricane Katrina. The September 21 Mobilizer “Urgent Health Care Measure Under Consideration” urges action in support of legislation to liberalize Medicaid for hurricane victims.The September 23 Mobilizer is a major statement on Responding to Homelessness in Katrina’s Wake.Visit our home page to learn more about the work of our organization. Essay by Kevin Lindamood To read “Katrina’s Winds,” a powerful essay by Kevin Lindamood, Vice President for External Affairs at HCH of Baltimore, please click here.
back to top Katrina Websites of Our Colleagues Many of our colleagues working to end homelessness and to assure health care for all have developed web pages like this one, with information and analysis reflecting their own particular approaches to the disaster. You may wish to pursue particular interests at Katrina websites of the following organizations:• Association of Clinicians for the Underserved • Coalition for Human Needs • Corporation for Supportive Housing • Migrant Clinicians’ Network • National Alliance for the Mentally Ill • National Association for the Education of Homeless Children and Youth • National Law Center on Homelessness and Poverty • National Low Income Housing Coalition • National Policy and Advocacy Council on Homelessness • United States Human Rights Network Cash Donations Click here to learn about the HCH Disaster Fund. Click here to donate now. |