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by Molly Reid, AARP Bulletin, August 20, 2010
In Louisiana, state and city officials have made some key changes in their emergency evacuation plans for older residents since the nightmare of Katrina.
When hurricane storms whipped up river waters that breached the levees and flooded New Orleans five years ago, older and disabled men and women suffered and even died in disproportionate numbers.
In one nursing home alone, St. Rita’s in St. Bernard Parish, 35 elderly patients were found dead after huge storm waves came crashing into the one story building.
Of the 1,471 documented deaths from Katrina and the levee failures, nearly half were people age 74 and older, according to the nonprofit Greater New Orleans Community Data Center.
Most of these victims died in their homes and communities; at least 68 were found in nursing homes.
Out of chaos
In 2006, a year after the storms in Louisiana, Act 540 was born of that chaos and suffering.
Passed by state legislators, the law requires stricter, more detailed evacuation plans for the 110 nursing homes in Louisiana’s 22 coastal parishes—which have a total of 14,674 beds. Now these homes must submit detailed evacuation plans annually.
The law also mandates a better system of communication to connect nursing home administrators and the state’s health and hospitals officials before and during an emergency evacuation, says Lisa Faust, communications director for the Louisiana Department of Health and Hospitals (DHH).
Moreover, City Hall has improved its evacuation measures, with plans to pick up seniors with specific medical needs at their homes during an emergency evacuation. Older men and women who do not meet the requirements for medical pickup but have no transportation of their own can still be evacuated by a city-sponsored bus service, but must find their own way to the nearest bus stop, according to the New Orleans Office of Emergency Preparedness. Individuals who know they will need city transportation during an evacuation are encouraged to register with the city’s Citizen Assisted Evacuation Plan database.
To craft Act 540, which covers the state’s nursing homes that are most vulnerable to hurricanes and floods (but does not cover assisted living centers), a committee of health care professionals examined all strategic parts of an evacuation—including transportation, shelter, food and medicine, generators, and communication, says Malcolm Tietje, the state program manager charged with implementing the law.
“All the issues that arose during the hurricane [were] brought to the surface, and we tried to find a workable solution for those problems,” Tietje says.
Mistakes cost lives
Before Katrina, nursing homes were required to develop evacuation plans, but they were not updated regularly or cross-checked by state officials to ensure, for example, that a nursing home’s transportation plans were valid.
“If a nursing home turned in a plan and it said they had a transportation contract—check,” Faust says.
Indeed, state officials too often simply filed the plans away without even reading them. After Katrina, the state found that a number of nursing homes had contracts with the same transportation company, which couldn’t have begun to handle all the patients in those homes.
The new law requires facilities to submit a detailed evacuation plan that must be updated each year and include actual signed contracts for essential needs.
Finding lost relatives
“Rather than just saying, ‘Yeah, we have somebody we can call,’ they now have fully executable plans,” Faust says.
Many families lost touch with their relatives who were in nursing homes and that was a critical issue in the aftermath of Hurricane Katrina. Now, the state has set up an online system for tracking patients and nursing home facilities during an emergency. State officials, hospital and nursing home administrators, and families of patients can access the system, and nursing homes are required to provide twice-daily status reports during an evacuation or other emergency, says Rosanne Pratts, executive director for emergency preparedness for DHH.
With the new system, state officials can troubleshoot, provide assistance and communicate with facilities more easily, she says.
Both Act 540 and the online tracking system affect the licensing requirements for nursing homes. If they fail to meet the regulations, “they could lose money from Medicare reimbursements,” Tietje explains.
Now, he says, “ It’s gotten much better—their response and their efforts to get the plans in on time.”
Molly Reid is a reporter based in New Orleans. Her work appears regularly in the Times-Picayune.
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