Responding to Harvey: new twists on persistent challenges

Responding to Harvey: new twists on persistent challenges

September 6, 2017

As we wrap up the thirteenth day of being activated to support the response and recovery to Hurricane Harvey, we’ve had a few minutes between calls and emails to think about the different types of challenges this event has presented. While some have been expected, (if there are constants in disaster responses, communications obstacles are certainly one), others have been new and more difficult to predict.


In an earlier post, Nicolette ruminated on two of the major challenges we’ve seen so far – facilitating deliveries of critical healthcare supplies in record-breaking floods and successfully advocating for an activation of the Federally-funded Emergency Prescription Assistance Program (EPAP). In a way, these represent new twists on persistent challenges. Access and re-entry has plagued disasters responses for a variety of reasons. We’ve been passionate about advancing access and re-entry solutions and were encouraged to see this issue prioritized from the beginning for this response, with partners jointly developing guidance and sharing it widely. However, while access and re-entry procedures for ground transportation were essentially squared away early on for this response, somewhat ironically, ground transportation proved to be a second-tier issue for responders simply because floodwaters prevented ground transportation from even being an option in the beginning.


As a result, we found ourselves making new relationships with aircraft providers as delivery by helicopter was the only viable option for several days. I can’t emphasize enough how impressed I was at the willing attitude these companies and organizations had, readily responding to cold calls and emails from response organizations like ours, asking how they could assist, what do we need from them. It was another instance of disasters bringing out the best in people, both on the front lines and behind the scenes.


Another persistent challenge that saw a new angle during Harvey was protecting uninterrupted access to medicines. More specifically, we saw this challenge for uninsured patients. Like many partners, we’ve advocated for an activation of EPAP for over a week now, as the program provides essential funds for uninsured patients to refill medicines and replace medical equipment. However, in the state with the highest population of uninsured patients, we and other partners continue to struggle with understanding why the state has not requested an activation of the program.


Finally, we continue to grapple with a persistent challenge that is not endowed with a new twist or added dimension. And that is the ramification(s) of potentially inadequate patient education and availability of information on refilling. Our emergency operations center (EOC) has received a surge in recent days from patients asking for help with getting refills of their medications. Many are not insured, or they can’t afford to pay out of pocket (and they’ve lost their credit cards or wallets), or they just don’t know where to start.  Many need equipment such as oxygen tanks and nebulizers, which pharmacies don’t always carry, so even getting to a pharmacy isn’t a complete answer for their health needs.


As part of our preparation for Hurricane Irma, we’re pushing out prescription preparedness information and guidance as much as we can, partly as a lesson learned from Harvey partly as our general practice. We’re encouraging patients to take all medicine with them, take advantage of the emergency 30-day refills Florida’s disaster declaration allows, and to take pictures of their insurance cards and pill bottles.


But our experiences with the response to Harvey has indicated that a major action item for the industry is patient education and resources. Disasters are a frightening time, and the last thing patients should be worrying about is where to get their medicines. I know we’ll be working with partners across the space to determine not just how we can just empower patients, but create and centralize the information they need. 

Sarah Baker, MPP

Sarah Baker is the Programs Manager at Healthcare Ready. In this capacity, she provides a wide range of policy research, writing, and analytical support to the organization's preparedness initiatives. Prior to joining Healthcare Ready, Sarah served as a consultant to the Department of Homeland Security and a variety of private sector organizations, during which time she supported the design, conduct, and evaluation of scores of preparedness exercises. Sarah recently received her Masters in Public Policy from Georgetown University's McCourt School of Public Policy and holds a B.A. degree from the University of Notre Dame.