Louisiana HIV/AIDS office shows how to improve disaster planning
Educating HIV clients is one strategy
HIV/AIDS providers from across the United States felt some of the repercussions of Hurricane Katrina's devastation of New Orleans three years ago.
As Louisiana HIV clients landed in different cities around the nation, they often arrived to new towns without their payer information and not even knowing which antiretroviral drugs they had been taking.
Officials with the Louisiana Office of Public Health in New Orleans, LA, say the HIV/AIDS office has learned a lot from Katrina failures, and the same long-term problems should not happen again.
And if the way the state handled Hurricane Gustav this past August is any indication, then it likely won't happen again.
Lessons learned from the Hurricane Katrina disaster have helped the state's HIV/AIDS office improve preparation and response to hurricanes. These procedural changes were tested during the state's largest evacuation of about 1.8 million people when Hurricane Gustav headed for New Orleans.
Officials found that changes in disaster preparedness procedures worked well, and made it easier for the state to continue HIV/AIDS services a week after Gustav struck the coastline. The hurricane caused minor damage and power outages in the region.
"We have spent a lot of time on hurricane preparation protocols, and we spent a lot of time educating our staff on it," says Beth Scalco, MPA, MSW, director of the HIV/AIDS program in the Louisiana Office of Public Health.
The HIV/AIDS office's surveillance work was disrupted when Katrina struck, and the numbers of people living with HIV/AIDS (PLWHA) in the New Orleans area still are far lower than they were in the weeks before Hurricane Katrina.
But the information and communication problems Katrina wrought have been addressed with solutions that served the HIV/AIDS office well when Gustav struck.
Here's what they did and how they did it:
• Educating HIV/AIDS clients: "Since Hurricane Katrina, in May or June of each year, we give clients an informational brochure when they pick up their medications that month," Scalco says.
"Some of the problems after Katrina were that people didn't know what their medications were, and they didn't have them on them when they were evacuated," Scalco explains. "Often, HIV clients would go to the doctor or pharmacy to get their medication filled, and they didn't know that they were on the AIDS Drug Assistance Program (ADAP)."
So state HIV/AIDS officials spent time educating HIV clients about what they need to do if there was a hurricane approaching or if another type of disaster occurred.
"We said, 'You're on the ADAP program, and if you go to any other state then this is how you ask for the ADAP program,'" Scalco says. "And we gave them a nice, wallet-sized card to write their medications on, so they'd know what they are."
• Secure the state's HIV/AIDS hotline: "Also, one of the things we lost last time after Katrina was our information hotline," Scalco says.
"As the entire phone services went down, we didn't have a mechanism to keep the hotline going," Scalco explains. "Now we have arrangement with the Montrose [HIV/AIDS] Clinic in Houston, TX, to be our back-up."
At the end of August, 2008, when New Orleans prepared for being pounded by Hurricane Gustav, the state HIV/AIDS office called Montrose Clinic to say that when all AIDS hotline phone calls would be transferred to Houston once the New Orleans phone lines went down, Scalco says.
"We also have access to that hotline and didn't need to be in our office to answer calls," she adds. "So shortly after Gustav hit, we had staff on the info line, answering calls."
• Store data off-site: "Prior to Katrina, we had no off-site data storage," says Billy Robinson, PhD, an assistant professor at the Louisiana State University Health Sciences Center in New Orleans, and a biostatistician for the state's office of public health's HIV program.
"Now all data are mirrored at an off-site facility that is secure in terms of hurricanes, safe from disasters," Robinson says. "So on a regular basis, all that data are backed up."
Hurricane Katrina quickly taught the office that having its sole data back-up located on disks and on back-up tapes across the street was useless when the entire city flooded.
"If our building had a fire, then we'd know we had another way to get data," Gruber says. "But of course with Katrina, all those buildings were inaccessible, so it took us a while to get into our offices and retrieve computers and servers."
The HIV/AIDS offices had been located on a fifth floor of its building, but have been moved to the 11th floor since Katrina.
While no data were lost during Katrina, it couldn't be accessed for weeks. Now with off-site storage, it is instantly available, she adds.
Also, the HIV/AIDS staff prepared for Gustav by disconnecting computers and moving furniture and electronic items away from windows.
• Move supplies to safe location: "We lost a lot of supplies in Katrina because a lot of items had to be temperature controlled, and these buildings were without power for four-to-six weeks in August and September," Scalco says.
When New Orleans learned of Hurricane Gustav heading toward the city, the HIV/AIDS office followed a new protocol and shipped its two-month inventory to Monroe, the back-up site, Scalco explains.
"We took $75,000 in supplies and shipped them to Monroe for only $680 in shipping fees," she says. "The Monroe site had plans for keeping the supplies in temperature-controlled storage."
Even though Gustav did not cause flooding, it had knocked out power for long enough that the supplies would have been destroyed, Scalco notes.
The HIV/AIDS office decided to not ship the supplies back to New Orleans after Gustav, but to have them shipped to community-based organizations directly from Monroe. This strategy would save on the shipping expense, but also provide a couple of months of protection in the event of another hurricane in the region, she adds.
The new supplies storage site is a contracting organization, and the HIV/AIDS office can reimburse them for the staff time they spend in handling the supplies, she notes.
• Expedite payments: "There were no disruptions in pay after Gustav," Scalco says. "We grabbed every invoice we had in the week before this storm occurred, and we got it as fast as we could into the fiscal office."
With Hurricane Katrina, there had been so many invoices in different stages of the fiscal process that it was difficult to locate them after the city flooded, Scalco notes.
"But this time we gathered them all up and made sure they were moved to the next spot," Scalco adds.
HIV/AIDS providers from across the United States felt some of the repercussions of Hurricane Katrina's devastation of New Orleans three years ago.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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