Challenges of service coordination for evacuees of Hurricane Maria through the National Disaster Medical System

Authors

  • Neil M. Vora, MD
  • Aaron Grober, MPH
  • Bradley P. Goodwin, PhD
  • Michelle S. Davis, PhD
  • Chris McGee, LCSW-BCD
  • Sara E. Luckhaupt, MD, MPH
  • Jennifer A. Cockrill, MS, MPH
  • Selena Ready, PharmD
  • Laura Nichole Bluemle, DPT
  • Lauren Brewer, BSN, MPH
  • Angela Brown, EdD
  • Cassidy Brown, RN, MSHS
  • Julie Clement, DBH, PA-C
  • Diane L. Downie, MPH
  • Michael R. Garner, MPA
  • Ruby Lerner, RN, MS
  • Margaret Mahool, RN, BSN
  • Shirley A. Mojica, MEd
  • Leisha D. Nolen, MD, PhD
  • Melanie R. Pedersen, LCSW-BCD
  • Mary Jane Chappell-Reed, MS, RD
  • Edecia Richards, MSN, APRN, FNP-C
  • Jonathan Smith, RN
  • Kitichia C. Weekes, MA
  • Jeanette Dickinson, MPH
  • Charles Weir, PhD
  • Thomas I. Bowman, MS
  • Jeanne Eckes, RN MBA

DOI:

https://doi.org/10.5055/jem.2018.0369

Keywords:

hurricane, dialysis, disaster, evacuation

Abstract

Objective: To describe the challenges of service coordination through the National Disaster Medical System (NDMS) for Hurricane Maria evacuees, particularly those on dialysis.

Design: Public health report.

Setting: Georgia.

Report: On November 25, 2017, there were 208 patients evacuated to Georgia in response to Hurricane Maria receiving NDMS support. Most were evacuated from the US Virgin Islands (97 percent) and the remaining from Puerto Rico (3 percent); 73 percent of these patients were on dialysis, all from the US Virgin Islands. From the beginning of the evacuation response through November 25, 2017, there were 282 patients evacuated to Georgia via NDMS, with a median length of coverage through NDMS for those on and not on dialysis of 60 and 16 days, respectively.

Conclusion: The limited capacity and capability of dialysis centers currently in the US Virgin Islands are delaying the return to home of many Hurricane Maria evacuees who are on dialysis.

Author Biographies

Neil M. Vora, MD

Centers for Disease Control and Prevention; New York City Department of Health and Mental Hygiene

Aaron Grober, MPH

Agency for Toxic Substances and Disease Registry

Bradley P. Goodwin, PhD

Agency for Toxic Substances and Disease Registry

Michelle S. Davis, PhD

US Virgin Islands Department of Health

Chris McGee, LCSW-BCD

Federal Bureau of Prisons

Sara E. Luckhaupt, MD, MPH

Centers for Disease Control and Prevention

Jennifer A. Cockrill, MS, MPH

Office of the Assistant Secretary for Preparedness and Response

Selena Ready, PharmD

Food and Drug Administration

Laura Nichole Bluemle, DPT

Indian Health Service

Lauren Brewer, BSN, MPH

Centers for Disease Control and Prevention

Angela Brown, EdD

Centers for Disease Control and Prevention

Cassidy Brown, RN, MSHS

Federal Bureau of Prisons

Julie Clement, DBH, PA-C

Centers for Medicare and Medicaid Services

Diane L. Downie, MPH

Centers for Disease Control and Prevention

Michael R. Garner, MPA

Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response

Ruby Lerner, RN, MS

Food and Drug Administration

Margaret Mahool, RN, BSN

Immigration and Customs Enforcement

Shirley A. Mojica, MEd

Department of Health and Human Services, Administration for Children and Families

Leisha D. Nolen, MD, PhD

Centers for Disease Control and Prevention

Melanie R. Pedersen, LCSW-BCD

Federal Bureau of Prisons

Mary Jane Chappell-Reed, MS, RD

Federal Bureau of Prisons

Edecia Richards, MSN, APRN, FNP-C

Department of Health and Human Services

Jonathan Smith, RN

Indian Health Service

Kitichia C. Weekes, MA

Centers for Medicare and Medicaid Services

Jeanette Dickinson, MPH

Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response

Charles Weir, PhD

Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response

Thomas I. Bowman, MS

Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response

Jeanne Eckes, RN MBA

Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response

References

Zoraster R, Vanholder R, Sever MS: Disaster management of chronic dialysis patients. Am J Disaster Med. 2007; 2: 96-106.

Dossabhoy NR, Qadri M, Beal LM: Nephrologic impact of Hurricanes Katrina and Rita in areas not directly affected. J La State Med Soc. 2015; 167: 254-256.

Calling on NDMS: Available at https://www.phe.gov/Preparedness/responders/ndms/Pages/calling-ndms.aspx. Accessed 2017.

Coverage Guidelines: Available at https://www.phe.gov/Preparedness/responders/ndms/definitive-care/Pages/coverageguidelines.aspx. Accessed 2017.

National Disaster Medical System Federal Coordinating Center Guide: Available at https://www.hsdl.org/?view&did=27648. Accessed 2017.

US Public Health Service Access Teams: Available at https://www.phe.gov/Preparedness/planning/abc/Pages/sat.aspx. Accessed 2017.

Published

05/01/2018

How to Cite

Vora, MD, N. M., A. Grober, MPH, B. P. Goodwin, PhD, M. S. Davis, PhD, C. McGee, LCSW-BCD, S. E. Luckhaupt, MD, MPH, J. A. Cockrill, MS, MPH, S. Ready, PharmD, L. N. Bluemle, DPT, L. Brewer, BSN, MPH, A. Brown, EdD, C. Brown, RN, MSHS, J. Clement, DBH, PA-C, D. L. Downie, MPH, M. R. Garner, MPA, R. Lerner, RN, MS, M. Mahool, RN, BSN, S. A. Mojica, MEd, L. D. Nolen, MD, PhD, M. R. Pedersen, LCSW-BCD, M. J. Chappell-Reed, MS, RD, E. Richards, MSN, APRN, FNP-C, J. Smith, RN, K. C. Weekes, MA, J. Dickinson, MPH, C. Weir, PhD, T. I. Bowman, MS, and J. Eckes, RN MBA. “Challenges of Service Coordination for Evacuees of Hurricane Maria through the National Disaster Medical System”. Journal of Emergency Management, vol. 16, no. 3, May 2018, pp. 203-6, doi:10.5055/jem.2018.0369.

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Articles