Hurricane Response & Recovery: Florida’s Assisted Living Facilities

1. Hurricane Response & Recovery:Florida’s Assisted Living Facilities George M. Tokesky Health Service & Facilities Consultant State Special Needs Shelter Coordinator Office of Public Health Nursing Florida Department of Health (561) 306-1253 George_Tokesky@doh.state.fl.us

2. Florida’s Demographics • 67 Counties • Total Population: 17.9 Million • 60+ Population: 22.1% • 435,263 Probable Alzheimer’s Cases* • 900,000+ “Vulnerable” Floridians *Evans et al. (JAMA, 1989)

3. Florida’s ALF Industry • 2,333 Licensed Assisted Living Facilities • 74,536 Total Assisted Living Beds • Specialty Licenses • Limited Mental Health • Limited Nursing Services • Extended Congregate Care As of March 1, 2006

4. Florida’s ALF Industry • Department of Elder Affairs • Rule Authority • Training & Technical Assistance • ALE Medicaid Waiver & Diversion Programs • Agency for Health Care Administration • Licensing • Monitoring • LTCOC, DCF & Other • ESF 8*

5. Emergency Management Plans • Chapter 400.441, F.S. • Chapter 58A-5.026, F.A.C. • Comprehensive Emergency Management Plan • October 1995 • Components • Emergency Plan Approval • Plan Implementation • Facility Evacuations • Host Facilities

6. Factoid: Florida is the most vulnerable state in the nation to hurricanes and has the highest predicted storm surges in the world, only to be exceeded by the nation of Bangladesh, which borders the Indian Ocean. National Hurricane Center

7. 2004 Hurricane Activity

8. 2005 Hurricane Activity

9. Unprecedented Hurricane Activity: 2004 - 2005 • Hurricane Charley Category 4 • Hurricane Frances Category 2 • Hurricane Ivan Category 3 • Hurricane Jeanne Category 3 • Hurricane Dennis Category 3 • Hurricane Katrina Category 1 • Hurricane Wilma Category 2

10. 2004 Hurricane Season • 67 Declared Counties • 1.25+ Million FEMA Applications • 8.5 Million w/o Power • 9 Million Evacuated • 360,000+ in RC Shelters • $42 Billion+ Damages

11. 2004 Hurricane Season • 114 Hospitals • 65 Nursing Homes • 85 Assisted Living Facilities • 29 Home Health Agencies

12. 2005 Hurricane Season • $10.5+ Billion Damages (Insured) • 63 deaths • 39,000 Applications for Temporary Housing • $2 Billion in Agricultural Damage

13. ALFs

14. 2004 Hurricane Activity

15. 2004 Hurricane Activity

16. 2004 Hurricane Activity

17. 2004 Hurricane Activity

18. 2004 Hurricane Activity

19. 2004 Hurricane Activity

20. 2004 Hurricane Activity

21. Hurricane Impact: Facility Evacuations • Facility Evacuations • Storm Track & Movement • Transportation • Vendor Agreements • Traffic • Host Facility • Staff • Stress

22. Hurricane Impact: Power Outages • Extended Power Outages • Food & Water • O2 Dependent Residents • Air Conditioning • Laundry Services • Generators • Fuel • Capacity

23. Hurricane Impact: Essential Services • Home Health Services • Medication Supplies • Durable Medical Supplies • Communications • Other

24. Hurricane Impact: Sheltering Resource • Special Needs Shelters • Displaced Elders/Persons with Disabilities • Assisted Living Facilities • Adult Family Care Homes • Group Homes • Community

25. Florida’s Response • Emergency Mutual Aide Compact • Deployments • ESF 8 • Agency for Health Care Administration • Florida Assisted Living Affiliation • Florida Health Care Association • Other • State SpNS Interagency Committee

26. Florida’s Response • FloridaAffordableAssistedLiving.org • Emergency Status System (ESS) • Online Self-Reporting • Evacuation Information • Emergency Contact • Power Status • Structural Damage • Census/Bed Availability

27. Lessons Learned • Disasters are unique to each community/facility • Proper planning prevents delays and confusion regarding roles & responsibilities, and ultimately, recovery • Self-sufficiency is the key to an effective emergency management plan

28. Lessons Applied • Review EM plans for ALL hazards • Establish backup vendor agreements • Establish secondary evacuation plans • Verify host facility agreements • Increase food and water supplies • Develop extended power outage plan • Communicate with local EM officials

29. 2006 HurricanePredictions • Professor William Gray, Colorado State • Revised – December 6, 2005: • 17 Named Tropical Storms • 9 Hurricanes • 5 Major Hurricanes (Cat 3-5) • Probability of a Major Hurricane Hitting a Gulf Coast State: 47% http://hurricane.atmos.colostate.edu/Forecasts/