In the fall of 2010, the gulf coast of the United States is again struck by a category four hurricane. Five years of planning and preparation swing into action. Hospitals, structurally reinforced to survive such storms, remain open and operational, serving their communities during and after the storm. State and Federal recovery plans assist displaced people return to home and even find jobs. The criticisms of Katrina resulted in palpable change!
As life returns to normal, people begin to shift their healthcare needs from the hospitals back to the community. To the horror of those who have moved back home, they find that many of their doctors have not returned. Not only are the medical professionals missing, but the all important ancillary providers are absent. In many communities, only one dentist or chiropractor is able to return and restart their practices. Healthcare services become the next disaster to spread across the region.
Where Did All the Doctors Go?
While most hospitals in the United States are corporately owned and supported, most healthcare providers are owners or employees of small, local businesses. Even the biggest medical practices in a community are regionally limited in presence, thus when a community is temporarily displaced by disaster, the most secure healthcare providers find themselves displaced as well.
Few small businesses have the financial reserves to meet fixed costs of business during a forced shutdown. The problem for healthcare practices is complicated by the costs associated with malpractice insurance, general liability insurance, employee benefits, healthcare student loans, equipment leases, licensure and more. In most cases, healthcare practices maintain less than two weeks funds for fixed expenses in reserve. Although the delay in payment inherent to insurance billing and other third party payment systems can help bridge the period of shutdown, the shutdown will eventually manifest as a gap in cash flow.
Faced with the probability of financial ruin, many healthcare providers seek new practice opportunities after only a short period of displacement. Once established in a new community, the likelihood of uprooting the family again and moving back to their old home is very small. This was the experience following hurricanes Andrew, Opal, Charlie and Katrina.
What Should Be Done?
The key need for the community is the return of their most trusted and valued professionals. These professionals have a key need as well; they need to reestablish their practice as soon as possible. The most obvious solution is to include these healthcare professionals in the disaster response and recovery plan. One significant lesson observed during hurricane Katrina is that if a healthcare provider is not part of the response plan before the disaster, there will be no role for them during the response and recovery.
How do healthcare providers become part of their local disaster plan?
The opportunities to participate in a disaster response exist in a matrix based on the intersections of four options:
- Paid vs. Volunteer
- Hospital vs. Office/Clinic
The matrix is:
| Paid at Hospital | Volunteer at Hospital |
| Paid at Office/Clinic | Volunteer at Office/Clinic |
The healthcare provider seeking to survive as a business may initially serve a volunteer role, but they must eventually transition to a paid, fee for service role and reestablish their profitable business operations.
From Free to Fee
How does a healthcare provider make the transition from a volunteer to a paid provider?
Here are some suggestions:
- The healthcare professional must state how long they can offer their services for free. Healthcare providers in various jurisdictions are constrained as to the type of services that can be offered for free and circumstances in which services can be offered for free, thus it is essential that healthcare providers be explicit regarding the commitments they can make. For example,
“I can afford to volunteer for one week. I can afford to bring X amount of supplies. If we run out of materials before two weeks, you supply the material and I’ll stay the remainder of the time I stated.”
After the two weeks are up, before the healthcare provider pulls out and leaves, the provider should talk with the people they have been helping. At this point, the community can ask the provider to stay and begin providing services for a fee.
- When the community writes the disaster response and recovery plans (before a disaster hits), the healthcare providers should register with the ESF-8 (Emergency Support Function 8) office of their local and state Emergency Operations Center. This office is responsible for ensuring that critical services, including healthcare, are included in disaster planning. Further, during a disaster response and recovery, the ESF-8 office is responsible for ensuring that the critical service provider receives supplies and resources to remain operational.
- Become a community resource as a healthcare service provider and receive referrals for fee based services. This is completely ethical. In fact, it’s a win-win solution. The community keeps its healthcare professionals and the healthcare provider has work. What could be better?
The bottom line is that healthcare businesses need to understand the different ways to participate in a disaster response, and they need to get over the stigma of profiting from disaster. Realize that the people receiving healthcare services don’t mind paying for them. Similarly, communities and emergency management professionals must expand their plans to include all healthcare professionals in the community, not just the medical physicians, nurses and hospital staff. After all, the healthcare providers in a community were important to the community before the disaster, how much more important are these professionals after the disaster?
Griffin Works offers Pawsitive Interactions with Service Dogs During Response Operations©, an audience-customized training that breaks down barriers by offering hands-on handling training and demonstrations with working service dogs for fire departments, EMS agencies, and public safety organizations.
Part of the National Domestic Preparedness Consortium and home to the National Emergency Response and Recovery Training Center, TEEX has been leading homeland security training since 1998. The major TEEX programs include fire and rescue, infrastructure and safety, law enforcement, economic and workforce development, and homeland security. As a member of The Texas A&M University System, TEEX is unique in its ability to access a broad range of emerging research and technical expertise. Beginning with course design and development all the way through hands-on instruction and national certification testing, TEEX delivers comprehensive training through both classroom and hands-on instruction and as online courses.
The National Child Traumatic Stress Network (NCTSN) was created by Congress in 2000 as part of the Children’s Health Act to raise the standard of care and increase access to services for children and families who experience or witness traumatic events. This unique network of child-serving professionals, caregivers and young adults, researchers, and national partners is committed to changing the course of children’s lives by improving their care and moving scientific gains quickly into practice across the U.S. The NCTSN is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA) and coordinated by the UCLA-Duke University National Center for Child Traumatic Stress (NCCTS).
The Emergency Management Institute (EMI) is part of the Department of Homeland Security’s Federal Emergency Management Agency (FEMA). The EMI provides national leadership in developing and delivering training to ensure that individuals and groups having key emergency management responsibilities possess the requisite skills to effectively perform their jobs.
The High Alert Institute maintains a list of reviewed courses provided by governments, universities and professional organizations. This list is geared towards the non-emergency management person who participates in disaster planning, preparedness, response, recovery or mitigation as part of their job responsibilities.
The High Alert Institute has partnered with Shutterstock to distribute stock images from the nature images donated by our supporters. For eligible stock images, Shutterstock will donate a portion of the royalty to the High Alert Institute. There is no cost to charitable organizations or to Shutterstock customers.
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Koi need forever homes, too! For pond enthusiasts, freshwater exotic and ornamental fish may not be available through pet stores or rescues in their area. The High Alert Institute Aquatic Pet Shelter Rehoming Program will be happy to assist you in stocking your new pond or adding a new finned friend to your school. Coming soon – when you adopt a Koi from the High Alert Institute Aquatic Pet Shelter Rehoming Program, we can arrange for delivery to your door anywhere in the continental United States.
Have you always wanted a Koi pond but don’t have the space one? Sponsor a Koi in our community shelter pond and we send you photos of your sponsored animal. Coming soon are live Koi Cameras above and below the water to enjoy your sponsored Koi anytime.
Dumping of freshwater non-native species and exotic aquatic pets into wild habitats is a man-made disaster that is truly preventable. The Institute’s Aquatic Pet Welfare Partnership works to raise awareness and reduce the impact on healthy ecosystems through education, as well as rescue and rehoming. Joined by champions of animal welfare and environmental stewardship, this association of aquatic pet rescue operations and aquatic pet shelters across the United States aims to save our finned friends and preserve our waterways together.
Want to share our cause with family, friends, and colleagues? Looking for a non-traditional way to celebrate a birthday or honor someone special? Support the Institute by starting your own Peer-to-Peer fundraising challenge! Let your contacts know why our mission is important to you and what they can do to support your cause. START YOUR OWN FUNDRAISER for the High Alert Institute.
From the staffing pool to the shelter ponds, from the boardroom to the classroom, and from reading the science to writing the analyses, High Alert Institute programs and services benefit from the experience, expertise, and generosity of our volunteers. Put your talents to use for good and to good use – VOLUNTEER TODAY.
Make your donation twice as nice by rehoming aquatic pets and providing a rehabilitation companion pet to a deserving person, family, or facility. Sponsor part or all of a Joy of Koi Program pond installation – complete with rehomed koi – and give the gifts of love and recovery.
Professional photographers, amateurs, and legal copywrite holders are all welcome to participate in the High Alert Institute Nature Photo Donation Program. Sales of the images benefit the Institute and donors are eligible for tax deductions equivalent to the fair market value of their photos. Landscapes, seascapes, animals, flowers – all may be accepted – whether new or vintage images. People may be included in the photo but only if unidentifiable (i.e., blurred figures at a distance).
Did you know that unused patents and copyrights can be donated to charity? Intellectual Property (IP) just sitting on a shelf will lose value as it becomes obsolete. The High Alert Institute IP Donation Program seeks to rescue stranded, technology-related IP with the potential for development into marketable products. Once accepted by the program, the owner/inventor is eligible for a tax deduction equivalent to the fair market value of the IP. The Institute receives the patent licensing fees or revenue from the sale of the IP to businesses, helping us to fund our mission. In turn, businesses are able to advance their markets and create jobs for less money than starting a project from scratch.
Disasters are defined as situations in which needs exceed or overwhelm available resources. Some disasters affect an entire community, while other disasters impact individuals and families. Crises of physical or psychological health can be very personal disasters.
The therapeutic value of pets during illness, trauma, and recovery is well established. And Koi fish may be well suited for people who are not able to provide verbal pet commands or physically care for pets like dogs and cats. Koi ponds are also a source of beauty and peace, providing an ideal setting for quiet reflection or meditation.
We are working to partner with pond installers and aquatic pet rescues/shelters to offer free or reduced-cost ponds with rehomed Koi fish to people seeking this type of pet therapy.
Disasters disrupt life and impact our sense of personal, family, and community safety. Survivors and responders alike often are not aware of the emotional, psychological or spiritual challenges that they may face from disaster onset through recovery. With two decades of experience training responders and communities to prepare for the behavioral health aspects of disasters, we will continue to provide education and a curated list of resources to groups or individuals.
Non-medical factors that impact overall health are termed Social Determinants of Health or SDoH. Noise pollution, poor air quality, and poor water quality are three environmental factors known to have a strong link to overall health. And the same environmental factors that impact humans impact their pets and other animals in their care. We continue to assist in advocacy, education, and technology development to mitigate the impact of SDoH on humans and animals alike.
Our efforts in shelter and rescue are the main focus of our environmental stewardship, reducing the environmental impact of non-native aquatic animals being dumped into public waterways. The High Alert Institute also assists innovators with the design, development, and evaluation of green and renewable energy technologies. Reducing the carbon footprint associated with disaster preparedness, response, and recovery furthers our continued mission to mitigate risk and improve resilience.
We partner with public and private organizations, sharing resources and fostering partnerships to improve disaster preparedness, response, and recovery, and mitigation.
The High Alert Institute team has over a century of combined research experience in medical, nursing, behavioral health, and disaster sciences. Our team provides support to researchers and technology developers through comprehensive literature searches and reviews, as well as failure mode database searches and adjudicated reviews.
When disaster strikes, most aquatic pet owners have limited options to secure the safety of their pets. Sheltering in place may not be possible if there is no power to provide aeration and “pet-friendly” shelters do not include ponds or aquariums. Our goal is to provide an option for aquatic pet owners in need of rescue and shelter for their finned friends.
Our goal is to share our two decades of disaster readiness experience with animal welfare organizations, shelters, caretakers, and pet owners, as they implement contingency plans for natural and manmade disasters.
