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Disaster Preparedness for Vulnerable Persons Receiving In-Home, Long-Term Care in South Carolina

Published online by Cambridge University Press:  28 June 2012

Sarah B. Laditka*
Affiliation:
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
James N. Laditka
Affiliation:
Office for the Study of Aging, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
Carol B. Cornman
Affiliation:
Office for the Study of Aging, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
Courtney B. Davis
Affiliation:
Office for the Study of Aging, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
Maggi J. Chandlee
Affiliation:
Office for the Study of Aging, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
*
Master of Health Administration Program DirectorDepartment of Health Services Policy and ManagementArnold School of Public Health, Health Sciences Building800 Sumter St.University of South Carolina Columbia, South Carolina 29208 USA E-Mail: sladitka@gwm.sc.edu

Abstract

Purpose:

The purpose of this study was to examine how agencies in South Carolina that provide in-home health care and personal care services help older and/or disabled clients to prepare for disasters.The study also examines how agencies safeguard clients' records, train staff, and how they could improve their preparedness.

Methods:

The relevant research and practice literature was reviewed. Nine public officials responsible for preparedness for in-home health care and personal care services in South Carolina were interviewed. A telephone survey instrument was developed that was based on these interviews and the literature review. Administrators from 16 agencies that provide in-home personal care to 2,147 clients, and five agencies that provide in-home health care to 2,180 clients, were interviewed. Grounded theory analysis identified major themes in the resulting qualitative data; thematic analysis organized the content.

Results:

Federal regulations require preparedness for agencies providing inhome health care (“home health”). No analogous regulations were found for in-home personal care. The degree of preparedness varied substantially among personal care agencies. Most personal care agencies were categorized as “less” prepared or “moderately” prepared. The findings for agencies in both categories generally suggest lack of preparedness in: (1) identifying clients at high risk and assisting them in planning; (2) providing written materials and/or recommendations; (3) protecting records; (4) educating staff and clients; and (5) coordinating disaster planning and response across agencies. Home health agencies were better prepared than were personal care agencies.

However, some home health administrators commented that they were unsure how well their plans would work during a disaster, given a lack of training. The majority of home health agency administrators spoke of a need for better coordination and/or more preparedness training.

Conclusions:

Agencies providing personal care and home health services would benefit from developing stronger linkages with their local preparedness systems. The findings support incorporating disaster planning in the certification requirements for home health agencies, and developing additional educational resources for administrators and staff of personal care agencies and their clients.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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References

1. Simerman, J, Ott, D, Mellnik, T: Early data challenge assumptions about Katrina victims. Austin American Statesman 30 December 2005.Google Scholar
2. King, R: Flood-ravaged hospitals are diagnosing their needs for this hurricane season. New Orleans Times-Picayune 21 May 2006.Google Scholar
3. Hyer, K, Brown, L, Berman, A, Polivka-West, L: Establishing and refining hurricane response systems for long-term care facilities Health Aff (web exclusive) 2006:w407–w411.CrossRefGoogle Scholar
4. Laditka, S, Laditka, J, Xirasagar, S, et al. : Protecting nursing home residents during disasters: An exploratory study from South Carolina. Prehospital Disast Med 2007;22:4652.CrossRefGoogle ScholarPubMed
5. Laditka, S, Laditka, J, Xirasagar, S, et al. : Providing shelter to nursing home evacuees in disasters: Lessons from Hurricane Katrina. Am J Public Health epub ahead of print 02 January 2008, doi: 10.2105/AJPH.2006.107748.Google Scholar
6. Government Accounting Office: Evacuation of hospitals and nursing homes. Disaster preparedness: Preliminary observations on the evacuation of hospitals and nursing homes due to hurricanes. Briefing for congressional committees, 16 February 2006. Available at http://www.gao.gov/new.items/d06443r.pdf.Accessed 18 August 2006.Google Scholar
7. US Office of Inspector General. Nursing home emergency preparedness and response during recent hurricanes. August 2006 Available at http://oig.hhs.gov. Accessed 19 February 2006Google Scholar
8. Rosenbaum, S. Olmstead, v. L.C.: Implications for older persons with mental and physical disabilities. Washington, DC: AARP Public Policy Institute; 2000. INB#30 and #2000-21.Google Scholar
9. United States Supreme Court: Olmstead v. L.C. Vol 527 U.S. 581 1999.Google Scholar
10. Johnson, A, Howe, JL, McBride, MR, et al. : Bioterrorism and emergency preparedness in aging (BTEPA): HRSA-funded GEC collaboration for curricula and training. Gerontol Geriatr Educ 2006;26(4):6386.CrossRefGoogle ScholarPubMed
11. Saliba, D, Buchanan, J, Kington, RS: Function and response of nursing facilities during community disaster. Am J Public Health 2004;94(8):14361441.CrossRefGoogle ScholarPubMed
12. Silverman, MA, Weston, M, Llorente, M, et al. : Lessons learned from Hurricane Andrew: Recommendations for care of the elderly in long-term care facilities. South Med J 1995;88(6):603608.CrossRefGoogle ScholarPubMed
13. Fernandez, L, Byard, D, Lin, C, et al. : Frail elderly as disaster victims: Emergency management strategies. Prehospital Disast Med 2002;17(2):6774.CrossRefGoogle ScholarPubMed
14. Friedman, E: Coping with calamity. How well does health care disaster planning work? JAMA 1994;272(23):18751879.CrossRefGoogle ScholarPubMed
15. Colmers, JM: Ready or not? Am J Public Health 2007;97Suppl 1:s7s8.CrossRefGoogle Scholar
16. Arnold, J: Disaster medicine in the 21st Century: Future hazards, vulnerabilities, and risk. Prehospital Disast Med 2002;17(1):311.CrossRefGoogle ScholarPubMed
17. Mangum, WP, Kosberg, JI, McDonald, P: Hurricane Elena and Pinellas County, Florida: Some lessons learned from the largest evacuation of nursing home patients in history. Gerontologist 1989;29(3):388392.CrossRefGoogle ScholarPubMed
18. Gulitz, E, Kurtz, A, Carrington, L: Planning for disasters: Sheltering persons with special health needs. Am J Public Health 1990;80(7):879880.Google ScholarPubMed
19. Hughes, SL, Renehan, M. Home Health: In: CJ, Evashwick, ed. The Continuum of Long-Term Care. 3rd ed. Clifton Park, NY: Delmar Learning, 2005, pp. 87111.Google Scholar
20. Centers for Medicare and Medicaid Services (CMS) Health Care Information Service (HCIS).Medicare Part A & Part B from the Health Care Information System (HCIS) HHA National State Summary for Completed Year 2004. Available at http://www.nahc.org/HHHCIS2004.pdf.Accessed 23 June 2007.Google Scholar
21. Poisal, JA, Truffer, C, Smith, S, et al. : Health spending projections through 2016: Modest changes obscure Part D's impact. Health Aff;w242–w253. Available at: http://content.healthaffairs.org/cgi/reprint/hlthaff.26.2.w242.pdf. Accessed 23 July 2007.CrossRefGoogle Scholar
22. Fox-Grage, W, Coleman, B, Freiman, M: Rebalancing: Ensuring greater access to home and community-based services. Available at http://www.aarp.org/ research/housing-mobility/homecare/fs132_hcbs.html. Accessed 23 June 2007.Google Scholar
23. Kitchener, M, Ng, T, Harrington, C: Medicaid state plan personal care services: Trends in programs and policies. J Aging Soc Policy 2007;19(3):926.CrossRefGoogle Scholar
24. Pande, A, Laditka, S, Laditka, J, Davis, D: Aging in place? Evidence that a state Medicaid waiver program helps frail older persons. Home Health Care Services Quarterly 2007;26:3960.CrossRefGoogle ScholarPubMed
25. Riddix, L, Dellar, U: The ice storm in eastern Canada 1998 KAMEDO Report No. 74. Prehospital Disast Med 2001;16(1):5052.CrossRefGoogle Scholar
26. Kientz, C: A model of preparedness: State associations partner for disaster response. Caring 2004;23(9):1013.Google Scholar
27. Wiehardt, S: Ten minutes! Caring 2002;21(1):2429.Google ScholarPubMed
28. Citarella, B, Mueller, C, Tosh, M: Disaster preparedness and home care: Is there a connection? Caring 2004;23(9):1721.Google Scholar
29. Rodriguez, D, Long, CO: Preparedness for the home healthcare nurse. Caring 2006;24(1):2027.Google ScholarPubMed
30. Ross, KL, Bing, CM: Emergency management: Expanding the disaster plan. Home Healthc Nurse 2007;25(6):370377.CrossRefGoogle ScholarPubMed
31. Sienkiewicz, J, Wilkinson, G, Cubbage, B: A patient classification system for emergency events in home care. Home Healthc Nurse 2007;25(6):378385.CrossRefGoogle ScholarPubMed
32. Balinsky, W, Sturman, M: Emergency preparedness in the home care environment, a follow up study, Part 1. Caring 2006;25(1):4047.Google Scholar
33. Balinsky, W, Sturman, M: Emergency preparedness in the home care environment, a follow up study, Part 2. Caring 2006;25(2):7881.Google Scholar
34. Phreaner, D, Jacoby, I, Dreier, S, McCoy, N: Disaster preparedness of home health care agencies in San Diego County. J Emerg Med 1994;12(6):811818.CrossRefGoogle ScholarPubMed
35. Kirkpatrick, DV, Bryan M: Hurricane emergency planning by home health providers serving the poor. Journal of Health Care for the Poor and Underserved 2007;18:299314.CrossRefGoogle ScholarPubMed
36. Joint Commission on Accreditation of Healthcare Organizations: Tips for addressing emergency management. The Source 2005;3(8):37.Google Scholar
37. Joint Commission on Accreditation of Healthcare Organizations: Proposed revisions to the emergency management standards, Hospital (HAP), Critical Access Hospital (CAH), and Long Term Care (LTC) Accreditation Programs.Available at http://www.jointcommission.org/library/tm_physicians/tmp_05_07.htm. Accessed 11 July 2007.Google Scholar
38. Joint Commission on Accreditation of Healthcare Organizations: Revised emergency management standards. Available at http://www.jointcommis sion.org/Library/TM_Physicians/tmp_05_07.htm Accessed 11 July 2007.Google Scholar
39. Joint Commission on Accreditation of Healthcare Organizations: 2006–2007 standards for home health, personal care, support services, and hospice. Available at http://www.jcrinc.com/3235/ . Accessed 23 July 2007.Google Scholar
40. Doherty, M: An emergency management model for home health care organizations. Home Health Care Management and Practice 2004;16(5):374382.CrossRefGoogle Scholar
41. South Carolina Department of Health and Environmental Control: Health Licensing, Home Health Agencies, DHEC Regulation 61–77. Available at http://www.scdhec.gov/health/licen/hrtypfac.htm.Accessed 01 March 2007.Google Scholar
42. South Carolina Department of Health and Environmental Control: Home Health Patient Information Booklet, accredited by Community Health Accreditation Programs n.d. 43. South Carolina Department of Health and Environmental Control: Division of Community Long Term Care, Elderly/Disabled Policy and Procedure Manual; 2005.Google Scholar
44. Glaser, B, Strauss, A: The Discovery of Grounded Theory. Chicago: Aldine, 1967.Google Scholar
45. Luborsky, M: The identification and analysis of themes and patterns. In: J, Gubrium, Sankar, A, (eds.) Qualitative Methods in Aging Research. Thousand Oaks, CA: Sage Publications, 1994, pp 189210.Google Scholar
46. Miles, M, Huberman, A: Qualitative Data Analysis: An Expanded Sourcebook. 2nd. ed. Thousand Oaks, CA: Sage Publications, 1994, pp 8141.Google Scholar
47. National Association of Home Care and Hospice. 2007 Regulatory Blueprint for Action. Available at http://www.nahc.org/regulatory/2007Blueprint.pdf. Accessed 28 June 2007.Google Scholar
48. Laditka, SB, Laditka, JN, Houck, MM, et al. : Ethical Issues in Training for Disaster Preparedness to Serve Frail Older People: An Innovative Approach to Graduate Health Management Education. In: LA, Parrish, ed. Business Ethics in Focus. New York: Nova Science Publishers, In Press.Google Scholar
49. Holahan, J, Ghosh, A: Understanding the recent growth in Medicaid spending, 2000–2003. Health Aff (Millwood) [W5-52-W55-62]. Available at http://con tent.healthaffairs.org/cgi/content/abstract/hlthaff.w5.52.Accessed 23 July 2007.CrossRefGoogle Scholar
50. Smith, V, Gifford, K, Ellis, E, Wiles, A, Rudowitz, R, O'Malley, M: Medicaid Budgets, Spending and Policy Initiatives in State Fiscal Years 2005 and 2006. Available at http://www.kff.org/medicaid/7392.cfm. Accessed 21 July 2007.Google Scholar