Wednesday, September 14, 2005

Let’s Get Down to Work

Major Mike

I am sure that the Katrina Blame Game will continue well into the future, perhaps eclipsing the World Poker Tour as the number one game show on TV, but I think it is time to get down to providing solutions to all of the problems that were encountered during Katrina. Many of my ideas could be applied across the board for flood causing rains, earthquakes, and other natural disasters that are likely to occur locally or regionally.

Preemptive Evacuation Reimbursement Funding

When, in cooperation with State and Federal governments, local officials' call for evacuations, emergency funds should be guaranteed. This guarantee should be in place even in the event the evacuation turns out to be unnecessary...i.e. the hurricane shifts direction...the intensity diminishes...the damage is less than imagined. It is this guarantee that then precludes the finger pointing and the post disaster carping. Local officials, in a zero revenue environment, will be incentivized to make the right call, rather than the fiscally prudent call.

Good Samaritan Protection for Service Providers, Transporters, and Public Officials for Evacuation Casualties During Evacuations

Evacuating elderly, frail, and infirmed patients in an extremis situation is an inherently risky business. Remaining in place and ignoring evacuation orders can be, as we now know in spades, equally as risky. Descriptions of the harrowing transfers of many critical patients highlight the peril that critically ill patients are in when they are moved from their safer, stable environments. It is entirely conceivable that during a mandatory evacuation, that some of these critical patients could be lost. Without Good Samaritan protection, the movement of these patients may, in turn, become problematic due to potential legal liabilities. Facilities managers may be reluctant to become involved in evacuations without protections from litigation should evacuation caused injuries or death occur. Good Samaritan protection keeps hospital and nursing home owners from facing the impossible conundrum of a continuous stream of Hobson's choices facing them.

Define the Evacuation Requirements/Preparations of Owner/Operators of Hospitals and Nursing homes

In light of yesterday's indictments of the St Rita's owners for negligent homicide, a discussion of the issue is imperative. I suggest that these indictments are greatly misplaced. What are the existing statutory requirements for owner/operators? What are the moral obligations in light of the nearly impossible task of an owner/operator in evacuating nursing home patients when a mandatory evacuation is ordered well inside the time that it would take to do a safe and orderly evacuation? Would indictments be handed out to New Orleans' hospitals if conditions and lack of support had eventually caused deaths within those facilities? Especially when there was no indication that specific assistance was included anywhere in State and Local plans? Be careful here...arduous statutory requirements may well eliminate the existence of nursing homes and intensive care facilities inside the impact zone of hurricanes. From the Atlantic coast to Houston, nursing homes may evaporate because evacuation requirements of the elderly and feeble are, accordingly intense and arduous.

Appropriate regulatory requirements, coupled with more detailed and refined local evacuation plans, AND combined with more timely evacuation notices, would certainly result in reduced risk for patients and it would continue to incentivize the existence of nursing homes and hospitals.

Improved Modeling and Simulation Tools

The key elements of success in a fluid (no pun intended) environment are anticipation and appropriate reaction. By far, the best way to prepare detailed plans and reaction schemes is through modeling. Advanced modeling tools should be applied across, at a minimum, the 100-year impact zone for hurricanes. Modern modeling programs are more than capable of accepting the variety of variables that were encountered during Hurricane Katrina. Time of day of impact, tidal surge, rain volumes, wind patterns and speeds, and even looting patterns, can be modeled to give planners a decided edge in mobilizing given certain conditions. This would provide State and local officials with enough information to react...let's a Cat 3 hurricane, with a 15 foot tidal surge, 115 knot winds, that hits 20 miles south of their city. Results of the modeling should be able to predict flooded roads, intact bridges, target areas for looting, and the areas of greatest need.

This is no small investment, but it is the key to timely and cost effective reaction. Additionally, this is the type of "project" must be protected from the usual chicanery and pilfering that occurs in many "soft" product projects. It must be closely managed by a knowledgeable and forceful manager, that keeps his eye on the is not pork for Louisiana, nor any other hurricane impacted state.

Regional Pre-existing Contracts for Evacuation Resources

Regional contracting for evacuation resources should be contracted through standing, and maintained (paid for) contracts to bus and other transportation resources that are safely out of the modeled, affected areas. This may result, somewhat predictably, that contracts should be in place for Houston, TX; Shreveport, LA; Monroe, LA; Jackson, MS; Meridian, MS, Birmingham, AL; Montgomery, AL; Tallahassee, FL; Orlando, FL; Atlanta, GA; Augusta, GA; Columbia, SC; Fayetteville, NC; Raleigh Durham, NC; etc. that can ensure that required transportation can arrive to the area to be evacuated in a timely manner... less than four hour seems appropriate. These contracts could be awarded to private or regional transportation entities that have the necessary resources available, to support an evacuation scenario as modeled. It would remain the responsibility of State and local officials to exercise the responsiveness of those assets, and ensure value in those contracts. While these contracts may be seldom used, their value lies in the security of the assets and simple implementation triggers it would take to mobilize them under conditions that compress decision making windows for State and local leaders.

Regional Consolidation of Emergency Response Supplies

While it is impossible to eliminate all risk in pre-positioning supplies, pre-positioning hurricane relief supplies can be achieved, in parallel with contracting for evacuation services. So some, or all, of the cities listed above, may also serve as pre-positioning sites for non-perishable response materials, both private and public. This would reduce response times, and improve service to evacuees and survivors.

Plug and Play Command and Control

Migration must occur towards a wireless, continually connected emergency response system that does not require serious infrastructure construction in an emergency. The system should include response asset tracking, emergency responder training and accounting tracking, evacuee accounting, needs request and response control system, and pre-event communication capability. Conceptually, Federal, State, and local governments would be continually connected to each other, the Red Cross, the Salvation Army, and other integrated relief agencies, so that communication infrastructure connectivity is not an issue during crisis... a seemless transition could then occur from daily operations to emergency operations, speeding resources to affected areas.

Emergency Response Training for State and Local Officials

Governors, State agencies heads, city mayors and managers, must participate in a minimal, recurring training event that ensures they have a basic understanding of Federal capabilities and response times, private entity capabilities and response times, and jurisdictional responsibilities. Complete failure by local entities in New Orleans, and multiple failures at the State level...nuff said.

These are just the building blocks to more refined plans and better response results. But these steps are collectively needed to remove the results that are expected after these events from "chancy" to assured. If we are looking for guaranteed results in these situations, it will take money, foresight, difficult decision making, and planning. Without the will to see these changes through, the results after the next disaster could well be the same.

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