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Uses of HMIS to Support Disaster Operations and Recovery: Lessons Learned from Katrina/Rita

Uses of HMIS to Support Disaster Operations and Recovery: Lessons Learned from Katrina/Rita. Brian Sokol, National HMIS TA Initiative, Abt Associates David Talbot, DSI Inc. Fran Ledger, Canavan Associates David Canavan, Canavan Associates (Facilitator). Overview. Learning Objectives

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Uses of HMIS to Support Disaster Operations and Recovery: Lessons Learned from Katrina/Rita

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  1. Uses of HMIS to Support Disaster Operations and Recovery: Lessons Learned from Katrina/Rita Brian Sokol, National HMIS TA Initiative, Abt Associates David Talbot, DSI Inc. Fran Ledger, Canavan Associates David Canavan, Canavan Associates (Facilitator)

  2. Overview • Learning Objectives • Dynamics of Disaster Response • Role of Information Management in Disasters • HMIS Usage in 2-1-1 Disaster/Recovery Efforts in Louisiana • City Of San Antonio uses of HMIS in Disaster Response September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  3. Learning Objectives • Increased understanding of the possible functions of HMIS during and after a major disaster. • Provide a broad cross section of obstacles encountered and successful interim and long-term solutions developed. September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  4. The Dynamics of Disaster Response Brian Sokol, Abt Associates

  5. The Dynamics of Disaster Response • Katrina and Rita • The Context: Homeless Services within the Total Disaster Response • Stages of Disaster • Proximity to Disaster • Emergency Support Functions • Respondents/Organizations in a Disaster • Types of Respondents • Components of Organization • Mission Conflict • Information Management and Data Coordination • Disasters Disrupt the Response • Planner vs. “Academic” Perspectives September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  6. Hurricanes Katrina and Rita September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  7. Eight Stages of Disaster Response • Preparedness • Planning • Warning • Response – “Day Of Impact” • Pre-Impact • Post-Impact • Recovery • Restoration (six months) • Reconstruction • Mitigation • Hazard Perceptions • Adjustments Cycles Homeless Services Where we are now Based on Drabek, 1986 September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  8. Spatial Dimensions Organized Aid Life goes on as normal, except for volunteerism Filter Staging Ground for Relief Activities Fringe Impact Some Damage Homeless Services Total Impact Dynes, 1970 September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  9. Mapping the Storms in Space and Time Rita Katrina Source: Louisiana Hurricane Impact Atlas September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  10. Aspects of Disaster Response – Emergency Support Functions • Urban search and rescue • Oil and hazardous materials • Agriculture and natural resources • Energy • Public safety and security • Long-term community recovery and mitigation • External affairs • Transportation • Communications • Public works and engineering • Firefighting • Emergency management • Mass care, housing and human services • Resource support • Public health and medical services Homeless Services Dept of Homeland Security, National ResponsePlan, 2004 September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  11. ESF-6: Mass care, housing and human services • Lead Agencies: Red Cross and FEMA • Tasks: • Sheltering • Feeding • Emergency first aid • Providing information about victims • Unifying families • Bulk distribution • Short-term and long-term housing assistance • Crisis counseling • Providing for special needs victims • Processing benefit claims • Delivering ice, water, and emergency commodities • Mail service to affected areas September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  12. Respondents to a Disaster Structure/Staffing Walk-in Volunteers (Skilled/ Unskilled) Tasks/ Mission Homeless Services Dynes, 1970 September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  13. Components of Organization Social Order More Coordinated Collective Behavior More Flexible Which comes first? • Domain • Formal recognition of authority • Task • Formal division of labor • Resources • Mobilized people and technologies • Activities • Specific behavior of people or groups Kreps et al. 1986, 1989, 1993 September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  14. Mission Conflicts within Shelters • Crisis Management • Return community to “normalcy” • Focus on basic needs and operations • Loose privacy and eligibility rules • FEMA/Local Respondents/Red Cross (?) • Residents are “Evacuees” • Sample goal: Close evacuation shelters quickly • Human Services • Restore individual lives to “normalcy” • Overall Case Management • Tight privacy and eligibility controls • Victims/Human Service Organizations • Residents are “Homeless” • Sample goal: Keep shelters open as needed September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  15. Information Management Processes • Registration and Headcounts • Who is in the shelter? • Public Safety • Ordering Supplies/Meals • Tracking Vacancies/Reserving Beds • Reunite Families • Linking to Benefits and Services • Coordinate Case Management September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  16. Axes of Data Coordination • Intra-Organizational • Same db for shelter registration, missing persons, case management, benefits receipt, health? • Inter-Organizational • Geographic: “Breadth” • One db for all evacuees across the country? • Disaster/Non-Disaster: “Depth” • Use the same db (HMIS) for evacuation and homeless shelters? Coordination attempts can conflict with each other. E.g., coordinating between disaster shelters and the homeless system within a region may mean using a different disaster system than the rest of the country. Impossible to coordinate across all axes at once. September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  17. Self-Sufficient Registration Dominant Activities/ Information Systems Family Search Needs Social Networks Social Services/ Information and Referral Needs Referrals Coordinated Case Management Needs Intervention Phase 1 Phase 2 Phase 3 Phase 4 Mission of Shelter Crisis /Evacuation Human Svcs/Homeless Model of Information Management in Disasters Those most self-sufficient exit faster, creating a shift in mission, activities, and appropriate systems Population Type Conflict Time September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  18. Disasters Disrupt the Response Emergency Management Perspective: The goal should be for the victim to … encounter one person who gathers all the necessary data and inputs it into a database that is shared and transparent among all human service providers at the Federal, State and local level as required. This will likely increase efficiency, reduce frustration of evacuees and expedite the delivery of services for eligible recipients. (The Federal Response To Hurricane Katrina: Lessons Learned.White House Report, 2006) September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  19. Can this ever work in a Disaster? Hypothesis:If all these elements were addressed in advance, then a comprehensive data system could work. September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  20. Response to Rita at the Hirsch Shelter in Shreveport Rita can be seen as a test case for the hypothesis. By the time Rita hit everything was up and running. What happened? • Computers moved out to make room for cots • 500 new people showed up, overwhelming intake processes: handed paper forms • Software experts left town, having lost their hotel rooms to evacuees • Volunteers reverted to their comfort zone • Rita hit Shreveport • Water seeped through roof and floors (electrocution risk) • Case mgmt volunteers re-tasked to “sandbagging” and “trench digging” • Intermittent blackouts September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  21. Response to Rita at the Hirsch Shelter in Shreveport 9/22 4PM Same Room, 9/22 8PM September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  22. Disasters Disrupt the Response • Unlike other emergencies, no clear distinction between incident and response, victim and helper: • “Organizations have to respond to being directly impacted themselves (e.g., there can be direct and indirect loss of personnel, resources, equipment, and facilities)” (Quarantelli, 1989) • Disasters almost always create the “wrong conditions” and cut off planned resources • Example: NYC’s Office of Emergency Management was destroyed on 9/11 September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  23. Academic Perspective “Much traditional disaster planning takes the disorganizing aspects of emergency…and attempts to achieve greater rationality and control of the anticipated situation... “…[but] the disorganizing aspects are necessary in order to develop the mobilization required to cope with the tasks at hand… “…the end result is more rational and, in time, more efficient since a community has restructured itself to meet a set of problems which its previous structure could not. “Disaster planning should be made in the context of these natural processes set off by a disaster event “It should facilitate these processes, not impose a model of human and technological efficiency which has little relationship to reality.“ (Dynes, 1970) September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  24. Summary Thoughts Information management planners for disaster shelters should account for the following: • Shelters have evolving missions and diverse populations: • “Evacuation Shelter:” Manage the crisis; return to normalcy • “Homeless Shelter:” Provide long-term human services • Order and coordination are often at odds with flexibility and adaptation; disordered sometimes better • Disasters disrupt the environment of disaster response. • Avoid systems requiring expertise and infrastructure that are likely to fail under disaster conditions. September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  25. HMIS Usage in 2-1-1 Disaster/Recovery Efforts Fran Ledger, Canavan Associates

  26. “It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.” —Charles Darwin September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  27. Louisiana’s HMIS and 2-1-1 History • Nine HMIS Regions and Six 2-1-1 Regions • All HMIS & 2-1-1 Regions use same vendor product • HMIS & 2-1-1 has overlapping management & software system • 1 Software System – 1 Agency • New Orleans • Shreveport • Lake Charles • 1 Software System – 2 Agencies • Baton Rouge • Lafayette • Monroe • 2 Software Systems – 2 Agencies • Hammond • Houma • Alexandria September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  28. Key Components • HMIS effectiveness will decrease with unclear leadership and limited controls • Keys to disaster HMIS usage • Clear chain of command • Rapid quality assurance September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  29. Louisiana HMIS Response Timeline • Friday, August 26th • MOUs Activated • UWNELA & VIA LINK • Office of Emergency Preparedness & UWNELA • Sunday, August 28th • Mandatory Evacuation of New Orleans • 1300 calls in first 12 hours • VIA LINK staff relocating to UWNELA September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  30. Louisiana HMIS Response Timeline • Monday, August 29th • Katrina makes landfall • Levee failures flood 80% of New Orleans, • 1/3 of Louisiana housing damaged or destroyed • Wednesday, August 31st • New Orleans telephone landlines fail • United Way of America with CenturyTel expands UWNELA call center September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  31. Louisiana HMIS Response Timeline • Wednesday, August 31st • 4 Hours: 4 lines  56 lines • All cell phone 2-1-1 calls route to UWNELA • Call types: roof top rescues  clothing donation • Thursday, September 1st • 2500 calls/day • UWNELA staff on 20 hr shifts • United Way of America requests 2-1-1 volunteers from around the country on its 2-1-1 listserve • HUD, first federal agency to offer National Technical Consultants and resources September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  32. Louisiana HMIS Response Timeline • Saturday, September 3rd • Arrival of National Call Center and Resource Manager Specialist • Multi-state disaster HMIS launched • Monday, September 5th • 8,000 calls/day • Mass need swamps FEMA & Red Cross • UNWELA houses and feeds 70 volunteers September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  33. Louisiana HMIS Response Timeline • Saturday, September 17th • 48 desktops arrive from HUD • Call Center transitions from paper/pencil  HMIS • Saturday, September 24th • HUD consultants on site • 12,000+ federal, state, and local resources made available • Rita hits & 310-Info evacuates to UWNELA • 4,000 - 6,000 calls/day • CNN, Red Cross & FEMA publicize 2-1-1 September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  34. Louisiana HMIS Response Timeline • Tuesday, November 8th- 10th • VIA LINK transitions back to New Orleans • National Volunteers Depart • ~50,000 call sheets to be entered • Today • Regional 2-1-1s have revised MOUs • Regional 2-1-1s developing single phone system • Regional HMISs developing statewide HMIS September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  35. Special Thanks to: • All the call center volunteers, local and national, for answering the call in our countries greatest tragedy! • Janet Durden, Executive Director, United Way of Northeast Louisiana • Marguerite Redwine, CEO, VIA LINK • Karen Puckett, President, CenturyTel • Peter Bishop, United Way of America • Mike Roanhouse, Department of Housing and Urban Development • Robert Bowman, President, Bowman Internet Systems, LLC • Melissa Flourney, President, Louisiana Association of Non-Profit Organizations, LANO • My Landlord on Elm St. for chairs to sit on and a rental to put them in! September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  36. Mass Shelters-City Of San AntonioSuccesses and Lessons Learned in managing 17,000 refugees in the city of San Antonio David Talbot VP of DevelopmentData Systems International

  37. Facilities • Multiple facilities, not all connected • Kelly USA • Former US Air Force Base • Maze like-difficult to navigate • Multiple massive buildings • Freeman Coliseum • Huge single area • LEVI • Huge single area September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  38. Prior To Arrival • Around a 12 hour notice that the city would receive a fairly sizable number of evacuees. • No one could quantify or give a vague range of numbers to expect. • Guesstimates ranged between 2,000 and 40,000. • The city immediately recognized this wasn’t a short term disaster but a long term homeless problem and elected to use their HMIS system from day one. • City began tapping resources, favors, beg/borrow/steal facilities, food, connectivity, medicine, volunteers. September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  39. Prior To Arrival-Continued • Facilities were set up • Designated medical areas, bathing, etc • Shelter bed areas were divided into a grid. • Red Cross intake forms underwent minor modification to add: • Wrist Band ID • Assigned Section • HMIS System was customized by the city to contain only the fields on the customized red cross intake. September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  40. A (fuzzy) look at the shelter Grid Location September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  41. Evolution of HMIS usage-Phase 1 • Phase 1-Missing Persons • Data Entry done by 200 concurrent untrained volunteers, constant rotation of new blood made training impossible. • Some at local colleges working in two computer labs • Keller-Williams Reality provided a good source of computer literate volunteers. • System was customized to give the user two functions with a single path through the system-Find Clients/Add Client • Rapid integration and collapsing of disparate systems. • Excel spreadsheets/Access Databases/Other Systems • Systems have a tendency to multiply like rabbits. • Imported data from all systems in the greater San Antonio area, got all Katrina sites using the same system, then uploaded batch to Katrina safe. • Wristbands and Grid Location in HMIS made it relatively easy to locate clients. • Some normal system security measures were disabled (not all). September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  42. Evolution of HMIS usage-Phase 2 • Phase 2-Transition out as many people as possible • New workgroup was created with expanded functionality specifically around the data points enabling a quick transition out of the shelter. • Section 8 Enrollments in LA=Section 8 in Texas • The Phase 1 “super simple” workgroup continued to operate for missing persons. • Wristbands and Grid Location in HMIS made it relatively easy to locate clients. • Normal system security measures re-enabled. • Rita hit about this time, yielding a batch of short term evacuees. September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  43. Evolution of HMIS usage-Phase 3 • Phase 3-Case Management • Virtually every evacuee was “special needs” of some sort- . Very old, disabled, children without parents… • System was expanded to full regular case management mode for case managers who began working with everyone in the shelter. • During Phase 3, FEMA started bussing/flying in evacuees from other locations to consolidate efforts. • Phase 3 transitioned into the Shaw Group, a subsidiary of Halliburton, that was contracted by FEMA to transition the remaining people out of shelters. • They were given a workgroup and a group of user ids, the city was removed from management of the shelter. September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  44. What worked well Wrist Bands Grid Locations Remote Data Entry Sites Private business assistance (HEB, Keller Williams, Rackspace) What was a challenge Red Cross Intake Form Dozens of “centralized” Katrina databases on the internet. No clear chain of command. City? Red Cross? FEMA? Information Release problems Infrastructure In Retrospect September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  45. Next time around… • Recommended changes to intake forms • Drop pre-disaster address • Add birth date in addition to age • Better family structure and a clearer definition as to if the family is together at shelter or not. • A question: Were you enrolled in any government assistance programs? • Opt Out: I do not want my information posted publicly. • Chain of command is clearer and defined from day 1? • Localities handling evacuees use local HMIS system uploading to a single publicly searchable database via a defined standard such as HUD XML. September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

  46. Questions • For more information on these presentations please contact our presenters at: • Brian Sokol at brian_sokol@abtassoc.com • Fran Ledger at fran@davidcanavan.com • David Talbot at david@data-systems.com • For more information on HUD’s Disaster Technical Assistance Project, contact • David Canavan at david@davidcanavan.com • Ann Oliva at ann.oliva@gmail.com. September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

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