Messing with Texas: The Katrina and Rita Experience

1
Messing with Texas The Katrina and Rita
Experience

• Dave Wanser, Ph.D.
• Deputy Commissioner for Behavioral and Community
  Health
• Texas Department of State Health Services
• dave.wanser_at_dshs.state.tx.us

2
Ramping upand upand up

• Initial projection of 25,000 evacuees
• Eventually 450,000, give or take 25,000
• Evacuees were in 202 of 254 Texas Counties
• The number of shelters changed day by day. The
  number of official shelters nearly a month
  after Katrina and a few days after Rita was 400,
  housing an estimated population of 9,900, mostly
  special needs. There were likely twice that
  number.

3
Timelines

• 8-28 Texas SOC activated to 24/7 status
• 8-29 Katrina landfall
• 8-29 DSHS ESC activated to 24/7 status
• 9-1 Governors Emergency Declaration
• 9-2 Presidential Emergency Declaration
• 9-3 1115 waiver submitted
• 9-20 Rita evacuation begins
• 9-24 Rita landfall
• 10-21 ESC stands down

4
SOC, ESC, JFO, Leaning Forward and Standing Up

• Personnel assignment and deployment issues
• Impossible to focus the fuzzy picture
• Managing, or at least trying to manage
  communication and coordination. Issues of single
  point of contact within Texas and with SAMHSA
• Federal, State and Local bedfellows

5
Two terms sorely in need of a Makeover

• Temporary Shelter
• Special Needs

6
Gimme Shelter

• Mega-shelters
• Special Needs shelters
• Non-urban shelters
• Non-sanctioned shelters
• Constant flow in and out, opening and closing of
  shelters
• Constantly changing assessments of populations
  and needs

7
MH and SA Response

• Just-in-time training in mega and special needs
  shelters
• By 9-7 MHSA issues were among the main concerns
  in shelters
• Management of state hospital access opening
  sub-acute unit
• Well over 1000 staff from MH and SA contracted
  providers were in shelters 24/7
• Red Cross policy barrier
• MH versus SA response

8
Best Guess Data

• MH opened to service 7,509
• SA opened to service - 1,828
• State facility admissions 123
• 1115 waiver served 11,272
• (all services, as of October)
• Why all these numbers are vastly under- reported

9
Lessons

• Have a plan and work the plan
• Sustainability of training, organization and
  staffing
• Public health and other governmental agencies
  awareness and openness to MHSA issues is lacking
• Plan past the emergency phase
• Understand the gaps between what the feds can do,
  what the state can do, and what locals will do
• Appreciate the importance of policy coordination
• Take care of your people
• All disasters are local

10
5 things to do before the next disaster

• Address confidentiality and data sharing issues
• Develop a better menu of tactical tools, i.e.
  warm lines, public education
• Update what we say and do about trauma,
  particularly to secondary contacts
• Use technology to track evacuees
• Develop and use an after-action report if you
  were an impacted state, read those from impacted
  states if you were not.