Response to Hurricanes for Hospitals

US Disaster Preparation and Lack of with Regards to the Hurricanes and US Administration
Introduction
The health policy relating to U.S. disaster preparation or lack thereof with respect to hurricanes is one that must include a better system of communication between the U.S. disaster response teams and the hospitals in the affected regions. As Hurricane Katrina showed, the U.S. was not prepared to handle the level of response needed in the wake of the catastrophe the hurricane produced. The problems with the response to Hurricane Katrina were numerous: there was no National Response Plan (NPR) in place and there was no National Incident Management System (NIMS) in existence. Additionally, the Federal Emergency Management Agency (FEMA) was virtually ineffective: it had been in decline for years, was suffering from significant turnover among top leaders, and the individuals who were in charge lacked the appropriate leadership experience and knowledge to oversee an effective response to a natural disaster like Hurricane Katrina (Lewis, 2009; Select Bipartisan Committee to Investigate the Preparation for and Response to Hurricane Katrina, 2006). Many lessons have been learned since Katrina that have enabled the U.S. to be better prepared to handle hurricanes and ensure that health care facilities are ready to treat those in need. This policy brief will describe the health policy issue, its impact on access/cost/quality, what the policy would do to ensure better access, what some of the potential unintended outcomes of the policy might be, and what stakeholders are likely to support and oppose and why.
The Policy
The policy under discussion is the problem of preparedness and a lack of coordination between the response agencies and local area hospitals. To provide care for people during an emergency situation in a time like a hurricane, proper precautions need to be followed and a protocol has to be developed that all stakeholders can appreciate and abide by. What this policy calls for is interagency collaboration to ensure that the effective quality care is being delivered to those in need during a hurricane disaster. This is an important policy because, as Katrina showed, only agencies that are motivated by a cohesive spirit will perform well. First, FEMA had inadequately trained staff and New Orleans’ Incident Command System (ICS) was not ready or prepared to respond to a disaster like Katrina, and this was the fault of leadership under both Director Michael Brown, who resigned shortly after Katrina, and New Orleans’ local government. Second, FEMA had been unable to provide adequate shelter for all those affected by the hurricane and the following flooding, and this was a result of leadership’s failure to organize. Third, leadership failed to provide adequate logistics in handling the response and had to rely on the leadership of the U.S. Coast Guard to accomplish anything of substance in the aftermath of Katrina (Samaan & Verneuil, 2009). The U.S. Coast Guard excelled and surpassed expectations in the wake of Katrina because it acted as an independent, autonomous organization with a single purpose and spirit of mission (Samaan & Verneuil, 2009). This type of spirit, vision, organization and independence was what FEMA needed to demonstrate to show it was ready. Today, there is a need for more coordination among hospitals in the regions affected by hurricanes and federal, state and local planners and responders so that facilities can be ready to accept patients and provide care when an emergency situation has been declared. There is also a need to determine whether the federal government is shouldering the cost of care in an emergency situation, whether access to care can be improved through interagency collaboration, and whether quality of care can be improved.
What It Would Do to Address the Issue (Intended Outcomes)
This policy would allow hospitals to accept patients under an emergency situation when a hurricane strikes with federal permission to provide treatment using emergency declaration funds. However, it requires that adequate correspondence and collaboration be conducted between health care facilities and responding agencies so that adequate care is available for patients impacted by a hurricane. This is essential to the policy’s success. As an example of why it is important there was with Katrina the interagency collaboration shown under Admiral Allen of the U.S. Coast Guard, who managed an effective collaboration with all three levels of agency response. As The Brooking Institution (2007) noted, “the Coast Guard rescue teams had pulled roughly 33,000 stranded Katrina victims off rooftops and overpasses. [Admiral Allen] was personally responsible for injecting some capacity for interoperability among the various civilian agencies at different levels—local, state and federal—integrating with that an effective military response” (p. 3). This collaboration was pivotal to the response because it brought civilian agencies in line with the Coast Guard to allow all of them to pursue one objective: to rescue thousands of stranded persons and get them to shelter. Hospitals were not involved in the treatment of many people because of bureaucratic delays and problems establishing effective lines of communication.
In order to avoid a lack of collaboration between response and health care, which can negatively impact the overall response to the disaster, this policy would effect a regulation protocol by which health care facilities play a more active role in collaboration. In the past the DOD and FEMA have been waiting for information to be processed before they could start responding. FEMA and the DOD should have pre-planning exercises in place with health care facilities allowing the paperwork of bureaucratic red tape to be sped up as quickly as possible. FEMA should have gotten military services to the local area by getting pre-written authorizations approved ahead of time so that when the hurricane landed with the expected force authorities anticipated, the military could respond with a simple phone call to allow for a joint effort of military response of health care provision to be made available on a large scale as quickly as possible (Philips, 2017). This would increase the likelihood of quality care being delivered during and after a hurricane. Access to care would be greatly improved, the cost of obtaining care would funded by the emergency declaration funds, and quality of care would be improved.
Unintended Outcomes
There are possible unintended outcomes that could arise as a result of this policy going into effect. Local and regional hospitals that could be impacted by hurricanes would have to develop new strategies and implementation plans through coordinated efforts with agency response teams. There would also be a need to monitor to conformity to federal and state regulations to ensure that health care facilities comply with the demands of this new approach to responding to and preparing for hurricanes in their regions. Thus there would need to be funds ensured ahead of time to allow for preparations to be made and costs of allocating these sums would have to be addressed by stakeholders.
Stakeholders
Information sharing, coordination of effort, and managing personnel directed by various leaders are the three significant issues that all stakeholders are likely to be impacted by. A disaster recovery plan is important for all stakeholders as well because it shows how they will coordinate, collaborate and achieve a unified effort towards a common goal. Health care facility operators are likely to support this policy because it will clarify their role in hurricane response and preparedness though there will also be significant hurdles to overcome in terms of planning and coordinating with relevant agencies. At the same time they are likely to benefit from the additional funding secured that they are provided to develop these plans. The federal and state and local response agencies are also likely support this policy as it means their effectiveness will be improved and a much more rapid response effort can be developed ahead of time with pre-planned steps for communicating quickly put into place. The public is likely to support this policy because it means that they will receive better care, improved access to care, and that the same problems seen during Katrina and other hurricanes will not be revisited. Cost of care will be covered by the federal government under emergency declarations funding and so the public will not have to worry about their own health care bills at the time.
Conclusion: How to Vote
Voting to support this policy should be the top priority over everyone in Congress as it will be a positive step in bridging the gap between current health care facilities and the agency response teams tasked with developing appropriate plans for hurricane disasters. By supporting this policy and voting for it Congress will be able to show constituents that they have put their best interests at heart. A policy such as this would create more cohesion and better communication among the most important players in delivering health care effectively to hurricane victims.

References
The Brookings Institution. (2007). 9/11, Katrina and the future of interagency disaster
response. Retrieved from https://www.brookings.edu/wp-content/uploads/2012/10/20070529.pdf
Lewis, D. E. (2009). Revisiting the administrative presidency: Policy, patronage, and
agency competence. Presidential Studies Quarterly, 39(1), 60-73.
Philipps, D. (2017). Seven hard lessons responders to Harvey learned from Katrina.
Retrieved from https://www.nytimes.com/2017/09/07/us/hurricane-harvey-katrina-federal-responders.html
Samaan, J. L., & Verneuil, L. (2009). Civil–Military Relations in Hurricane Katrina: a
case study on crisis management in natural disaster response. Humanitarian Assistance: Improving US-European Cooperation, Center for Transatlantic Relations/Johns Hopkins University, Baltimore, MD/Global Public Policy Institute, Berlin, 413-432.
Select Bipartisan Committee to Investigate the Preparation for and Response to Hurricane
Katrina. (2006). A failure of initiative. Retrieved from http://govinfo.library.unt.edu/a257.g.akamaitech.net/7/257/2422/15feb20061230/www.gpoaccess.gov/katrinareport/mainreport.pdf