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Medical Sheltering

Medical Sheltering. Jeffrey Hoogheem – DSHS. Agenda. Medical Sheltering Basics Texas Statewide Medical Shelter Plan Medical Sheltering by Evacuation Area Selecting the Appropriate Shelter Medical Shelter Resources Summary. Medical shelter basics. Medical Shelter Plan Basics.

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Medical Sheltering

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  1. Medical Sheltering Jeffrey Hoogheem – DSHS

  2. Agenda • Medical Sheltering Basics • Texas Statewide Medical Shelter Plan • Medical Sheltering by Evacuation Area • Selecting the Appropriate Shelter • Medical Shelter Resources • Summary

  3. Medical shelter basics

  4. 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

  5. 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

  6. 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

  7. Texas statewide Medical shelter Plan

  8. State Support • State supported medical sheltering is primarily focused on evacuees who are transported on state transportation resourcesthrough coastal evacuation hubs

  9. 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.

  10. 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.

  11. Medical sheltering by evacuation area

  12. Medical ShelteringProposed Plan SE Texas Evacuation Area • San Antonio 5000 primary • Tyler 200 primary • Tyler/Marshall 400-600 additional

  13. Medical ShelteringProposed Plan Houston/Galveston Evacuation Area • San Antonio 5000 primary • Austin 250 additional • Bryan/College Station 450 additional

  14. Medical ShelteringProposed Plan Matagorda and Corpus Evacuation Areas • San Antonio 5000 primary • Austin 250 additional • Bryan/College Station 450 additional

  15. Medical ShelteringProposed Plan 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

  16. Selecting the Appropriate shelter

  17. 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.

  18. The Shelter Options

  19. General Population Shelters • Access to medical services • Access to prescription medications • Access to medical equipment • May or may not be provided on site

  20. Medical Shelters • Medical staff on site • Medical equipment and services on site • Access to prescription medications, may or may not be provided on site

  21. 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

  22. 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

  23. 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

  24. Medical Population Shelter Placement Individuals who require active monitoring, management, or intervention by a medical professional to manage their medical condition

  25. 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 buthave no access to a skilled nursing home/facility

  26. 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

  27. 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 regardinghis or her own placement

  28. Medical Shelter Staff & REsources

  29. 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

  30. Shelter Infection Control Kit • N95 Respirators • Surgical Masks • Non-latex Gloves • Hand Sanitizer • Disinfectant Wipes • Tissues • Alcohol Wipes • Exam Gowns

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

  32. Summary

  33. 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

  34. 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

  35. Questions?

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