1 medical sheltering jeffrey hoogheem – dshs. agenda 1.medical sheltering basics 2.texas statewide...

TEXAS DEPARTMENT OF STATE HEALTH SERVICESTEXAS DIVISION OF EMERGENCY MANAGEMENT 1

Medical Sheltering

Jeffrey Hoogheem – DSHS

TEXAS DEPARTMENT OF STATE HEALTH SERVICESTEXAS DIVISION OF EMERGENCY MANAGEMENT

Agenda

1. Medical Sheltering Basics2. Texas Statewide Medical Shelter Plan3. Medical Sheltering by Evacuation Area4. Selecting the Appropriate Shelter5. Medical Shelter Resources6. Summary

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MEDICAL SHELTER BASICS

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Medical Shelter Plan Basics

• Medical Shelters are primarily for high acuity evacuees (and caregivers) requiring skilled nursing care and constant medical oversight

• Identification of medical evacuee is critical at embarkation hub– Reduce time on road– Medical evacuees arrive at the correct destination– Reduces evacuee being moved twice


Medical Shelter Plan

• Establish medical shelters in San Antonio and other selected cities, as required– Evacuate medical evacuees to San Antonio

first– Evacuate medical evacuees to other selected

cities, as necessary– Establish/support medical shelters in other

locations as necessary


Medical Support Considerations

• Local medical professionals• Access to physician office or clinic• Medical emergency- call 911• On-site clinical care• Request DSHS Mobile Medical Team – 8 teams currently rostered


TEXAS STATEWIDE MEDICAL SHELTER PLAN

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State Support

• State supported medical sheltering is primarily focused on evacuees who are transported on state transportation resources through coastal evacuation hubs


Medical Evacuation• In the past (prior to

2010) medical evacuees were evacuated to multiple locations across the state of Texas.

• We now plan to consolidate Medical Sheltering in San Antonio.


Medical Shelter Plan• Advantages of consolidating medical sheltering in

San Antonio– Consistent levels of care– Consolidation of resources– Access to significant medical system in a major city– Ability to allocate resources properly to best

support the population including:• transportation assets, hospital beds,

pharmaceutical caches, medical equipment caches etc.


MEDICAL SHELTERING BY EVACUATION AREA

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Medical ShelteringProposed Plan

SE Texas Evacuation Area– San Antonio 5000 primary– Tyler 200 primary– Tyler/Marshall 400-600 additional



Houston/Galveston Evacuation Area– San Antonio 5000 primary– Austin 250 additional– Bryan/College Station 450 additional



Matagorda and Corpus Evacuation Areas– San Antonio 5000 primary– Austin 250 additional– Bryan/College Station 450 additional



Lower Rio Grande Valley Evacuation Area– Laredo 450 primary– San Antonio 5000 primary– Austin 250 additional– Bryan/College Station 450 additional

LRGV Shelter Plan (Cat 1 or 2)– 2 medical shelters


SELECTING THE APPROPRIATE SHELTER

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Population Definitions• General evacuees:

Ability to function independently each day. Evacuee may or may not have disabilities, functional or access needs including minor medical care

• Medical evacuees:Require skilled medical care and are people that may or may not have disabilities, functional or access needs.


The Shelter Options


General Population Shelters

• Access to medical services

• Access to prescription medications

• Access to medical equipment

• May or may not be provided on site


Medical Shelters

• Medical staff on site• Medical equipment and

services on site• Access to prescription

medications, may or may not be provided on site


Medical Support to Shelters

Jurisdictions that provide sheltering (pt to pt, hub cities, drive-ups) should have capacity to provide medical services– Medical services to general population

shelters– Establishment of a medical shelter


General Population Shelter Placement

• Individuals who are able to meet their daily needs either by themselves or with a caregiver and may require some assistance with activities of daily living


General Population Shelter Placement

• Some examples include people that are: – Dependent on medical oxygen– Mobility disability /self ambulating with or without

DME, including wheelchair– Deaf or hard of hearing, blind or low vision with or

without a service animal– Diabetic, insulin dependent/diet controlled– People with no disabilities, functional or access needs


Medical Population Shelter Placement

• Individuals who require active monitoring, management, or intervention by a medical professional to manage their medical condition


Medical Population Shelter Placement

• Some examples include people who are:– Hospice patients– Ventilator patients– Tracheotomy which requires suctioning– Extensive wound management requiring a sterile environment

or suctioning– Requiring isolation due to infectious disease– Dysrhythmia management– Receive skilled nursing care at home– Previously from a skilled nursing facility but have no access to a

skilled nursing home/facility


Shelter Selection Process

• Triage personnel should do a rapid assessment to determine the most appropriate shelter placement option for evacuees– Individuals requiring skilled medical care will go to

medical shelters– Some evacuees with lower acuity medical needs can

go to general population shelters but may have a choice of a medical shelter


Shelter Selection Process

• Triage personnel should provide information to the individual about the type of shelters and services available in each

• If the individual does not require skilled medical care but still meets medical shelter placement criteria then the individual will make an informed decision regarding his or her own placement


MEDICAL SHELTER STAFF & RESOURCES

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Medical Shelter Push Pack• Support 100 Patients• 3 Pallets• Includes items such as:– General Medical Supplies– Sharps Containers– O2 Masks & Regulators– Pillows/Blankets/Towels– Diapers– Flashlights– OTC Medications


Shelter Infection Control Kit

• N95 Respirators• Surgical Masks• Non-latex Gloves• Hand Sanitizer• Disinfectant Wipes• Tissues• Alcohol Wipes• Exam Gowns


Contracts

• BCFS• Pharmacy • Medical Staffing– Medical Doctors– Physicians Extenders (NP, PA, etc)– Nurses– EMTs/Paramedics– Other Medical Specialties


SUMMARY

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Transitional Planning

• No longer using categories 0-5• Two types of evacuees– Medical evacuee– General evacuee

• For Transition Planning:– 0-3 probable gen pop shelter– 4 medical shelter– 5 institutional facility


2012 Transitional Planning

• Jurisdictions with pt to pt and Hub areas– Primarily focused on general evacuees– Chronic and minor medical conditions in

general shelters– FNSS support in gen pop shelters– Access to medical services in gen pop shelters


QUESTIONS?

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1 medical sheltering jeffrey hoogheem – dshs. agenda 1.medical sheltering basics 2.texas statewide...

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