Hurricane nursing home deaths cause a bipartisan gut-check in Congress

FILE- This Sept. 13, 2017, file photo, a patient is transported from The Rehabilitation Center at Hollywood Hills after a loss of air conditioning due to Hurricane Irma in Hollywood, Fla. Nine elderly patients died after being kept inside a nursing home that turned into a sweatbox when Hurricane Irma knocked out its air conditioning for three days, even though just across the street was a fully functioning and cooled hospital. (Amy Beth Bennett/South Florida Sun-Sentinel via AP, File)

WASHINGTON (Sinclair Broadcast Group) – Senators in the nation's capitol held a hearing Wednesday to evaluate the disaster preparedness and response for older Americans following natural disasters.

Hurricanes Harvey and Irma caused devastation along the gulf coast of Texas and the Florida peninsula, resulting in record flooding, fuel shortages, power outages and residential communities completely submerged in water. Authorities during both storms asked those living in the path of impact from the storms to evacuate.

But for many older and disabled residents of these areas, evacuations can be difficult logistically, mentally and physically. Nursing homes and assisted living facilities often face the difficult decision of when -- if at all -- to evacuate, and how to move less ambulatory patients or those suffering from dementia.

In Houston, a picture showing as many as 25 nursing home residents sitting waist-deep in rising water waiting to be rescued went viral.

In Beaumont, Texas, an anchor at FOX 4, Jasmine Styles, helped a reluctant elderly resident make the difficult decision to evacuate her home live on air. Port Arthur resident Dorothy Henley had called the station explaining she didn’t want to leave her home despite the rising floodwaters.

"But those belongings can be replaced. Miss Dorothy, we can't replace you. So, I want you to get out of that house, because now is better than if you've got a foot of water raging into your house, because then you're going to be in more of a panic," the anchor pleaded with Henley. Styles asking Henley to “keep dialing 911 no matter what happens.”

Just a few short weeks later, a nursing home in Hollywood Florida, lost power after Hurricane Irma. Eight residents died from heat exposure. More than 100 residents were evacuated from the home. Florida Governor Rick Scott said he had received many calls from nursing homes and assisted living facilities having problems with generators.

“We're doing everything we can to help them get either generators, fuel, power back on. It's one of the things we're doing aggressively," Scott said.

On Capitol Hill, the Senate Special Committee on Aging held a hearing to discuss common-sense solutions to the nation’s recent onslaught of natural disasters. Kicking off the hearing, Chairwoman Sen. Susan Collins displayed the graphic images of nursing home residents sitting partially submerged in water in Texas.

“We have learned many of the lessons from Katrina but we still have a long way to go,” Collins, a Republican from Maine, said.

Ranking member of the committee, Sen. Bob Casey, D - Penn, announced that he in conjunction with Collins and Sen. Bill Nelson, D- Fla, will introduce bipartisan legislation to require the Secretary of Health and Human Service to establish a 15-person national advisory committee to fix problems surrounding disaster relief for senior citizens and Americans with disabilities. The committee would consist of federal and local agency officials, as well as non-federal healthcare professionals with expertise in disaster response.

Collins said she recently spoke with the head of Centers for Medicare and Medicaid Services, the government agency that regulates nursing homes, who relayed struggles during national disasters with patients currently on dialysis.

“One of the problems was that the demand was so great that people were not able to have complete dialysis; they were hooked up to the machines for two hours -- when needed, a far longer period of time -- but the demand was such they were just trying to maintain people,” Collins said.

In a rare display of solidarity on Capitol Hill, Casey echoed Collin’s sentiments on elderly care.

Older citizens should not suffer for a day and then die. Die, in the unbearable heat. No person with a disability should have trouble following evacuation orders because of inaccessible transportation to shelters.

He said the government and Congress has an obligation to care for the greatest generation.

“These are folk who fought our wars, they worked in our factories, they built the middle class, they gave us the kind of life that we take for granted sometimes,” Casey said. “They sacrificed so much and they’ve lived lives of quiet dignity. We have a sacred obligation to them. To make sure those scenes that were depicted in that photograph and what happened in Florida never happens again.”

Committee member Sen. Thom Tillis proposed that older evacuees should be tracked better throughout the lifecycle of the evacuation process. Tillis added that most older Americans do not evacuate their homes due to fear of the unknown. He encouraged the committee to consider methods for improving communication to negate fears and fully explain in detail the evacuations to seniors.

“If we did a better job of communicating what this will look like earlier, where they are likely to go and how we are going to be stewards of them over the course of the process, then I think many who feel the safest thing to do is shelter in place, will be replaced with sense of comfort they will be taken care of through the process up to and including getting them back into their home,” Tillis said.

Hearing witness Karen DeSalvo, M.D., M.P.H., former health commissioner of the city of New Orleans, proposed expanding on a program implemented and scaled in Louisiana called “emPOWER.” The program used Medicare Claims data that “identified individuals with electricity dependent durable medical equipment and securely disclosed it to a local health department.” First responders and the health commissioner then went from door to door to verify the claims data was accurate.

According to Desalvo, 93 percent of the claims were accurate.

“Of the 611 people that the claims data had identified in the New Orleans community, only 15 were on our medical special needs registry,” Desalvo said in a statement.

Now the data collected can be paired with geo-mapping technology to “find the total of Medicare beneficiaries with electricity-dependent equipment claims at the U.S. state, territory, county, and ZIP code level.”

Witness Kathryn Hyer Ph.D., M.P.P., professor and director at the Florida Policy Exchange Center on Aging at the University of South Florida, conducted a study on nursing home residents during natural disasters.

Evaluating the effects of Hurricanes Katrina (2005), Rita (2005), Gustav (2008), and Ike (2008) on nursing home residents. Hyer’s group found “that among 36,389 Nursing Home residents exposed to the Gulf hurricanes, the 30- and 90-day mortality/hospitalization rates increased considerably compared to non-hurricane control years regardless of whether they evacuated or sheltered in place.”

“In total, there were 277 extra deaths and 872 extra hospitalizations within 30 days after exposure to any one of the storms,” Hyer said in a statement. “The very act of evacuation prior to the storm increased the probability of death at 90 days by 2.7 to 5.3 percent and increased the risk of hospitalization by 1.8 to 2 8.3 percent, independent of all other factors.”

She added that despite the tragic deaths, evacuations were cumulatively more dangerous then sheltering in place.

Hyer later told Collins that many evacuations often take place because power was not restored. In many cases, generators are not built in a way that can sustain or fuel was not readily available. Hyer proposed improving regulations to build nursing homes and assisted living facilities in areas that are not subject to flooding.

Witness Paul Timmons Jr, acts as president of Portlight Inclusive Disaster Strategies, Inc., a non-governmental organization specializing in disaster preparation and response for the aging community and Americans with disabilities.

Timmons described a situation where his organization helped a quadriplegic man. The individual was separated from his fiancé and placed in a special needs shelter, only to be released with nowhere to go except his destroyed home. He slept outside for several days and suffered a heatstroke. It was only when FEMA stepped in were they able to help him acquire a wheelchair accessible hotel room. He argued that measures should be in place preventing situations from getting to that point.

“People with disabilities have a right to equal access and non-discrimination,” Timmons said.

The final witness, Jay Delaney, fire chief and emergency management coordinator for the City of Wilkes-Barre, Pennsylvania, said his organization depends heavily on the hydrological data from the National Weather Service. Information on what the rainfall will be and the river cresting from risk-based analysis help them decide whether they need to evacuate residents.

“I think from an emergency management standpoint, we can prepare for a lot of these disasters because we have some of the best scientists in the world that predict what is going to happen,” Delaney said

Collins concluded the hearing by reminding the committee that September is “National Preparedness" month. This year’s theme is “Disasters don’t plan ahead you can.”

We should take that motto to heart. We are learning from every disaster and we are learning how being prepared today, can make the difference between safety and danger and in many cases, literally the difference between life and death.”
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