Hurricanes Katrina

1
Hurricanes Katrina RitaandThe Ryan White CARE
Act Program

• July 2006 Update

2
Overview

• Tropical Storm August 24, 2005
• Became Hurricane Katrina August 25th - hitting
  Miami-Dade Broward Counties with winds at 70
  knots as Category 1
• Traveled over the Gulf of Mexico at Category 5
• Entered US again on August 29th at the northern
  Gulf Coast at Category 4, and traveled inland
  over Louisiana and southern/central Mississippi
  causing extreme coastal erosion and massive
  destruction of land and property
• Weakened to Category 1 and to a tropical storm
  northwest of Meridian, MS over last days of
  August

3
National Hurricane Center

• Katrina was the costliest and one of the five
  deadliest hurricanes to ever strike the US. the
  damage and loss of life inflicted by this massive
  hurricane in Louisiana Mississippi was
  staggering. one of the most devastating natural
  disasters in US history, as reported by the
  National Hurricane Center.

4
Hurricane Rita

• September 18th Tropical storm near the Bahamas
• September 20th sideswiped the Florida Keys -
  Category 2
• Gulf of Mexico as Category 5 and 175 mph winds
• Hit the US just weeks after Hurricane Katrina on
  September 24th at the Texas/Louisiana Border as a
  Category 3 hurricane with major flooding
• Prompted massive evacuations along the Gulf Coast
  
• Caused widespread damage in southwest Louisiana
• September 26th downgraded to tropical depression

5
CARE Act Grantees

• Louisiana 4 Title I sites (New Orleans EMA) 10
  Title II sites 9 Title III 2 Title IV 1 CBDP
• Mississippi 1 Title II 7 Title III 2 Title
  IV 1 CBDP
• Alabama 1 Title II 9 Title III 2 Title IV
• Numerous sub-grantees, contractors and satellite
  sites throughout the three States
• (many sites receive funding from more than one
  CARE Act Title and therefore may reflect
  duplicate counts)

6
Impact on Residents

• Loss of life
• Over 1,400 deaths (Hurricane Katrina)
• Over 100 (Hurricane Rita)
• Loss of pets
• Loss of homes
• Loss of jobs schools
• Loss of possessions
• Forced to relocate
• Delay in rescue/relocation operations
• HIV diagnosis
• Medications, stigma, sexual preference, stress,
  support services

7
Persons Living with HIV/AIDS

• More than 21,000 PLWHAs were living in
  disaster-affected counties before Hurricane
  Katrina
• 2,646 in Alabama
• 12,849 in Louisiana
• Nearly 7,400 lived in the New Orleans
  metropolitan area alone
• 5,567 in Mississippi
• The Henry J. Kaiser Family Foundation HIV/AIDS
  Policy Fact Sheet, Assessing the Number of
  People with HIV/AIDS in Areas Affected by
  Hurricane Katrina, 9/2005

8
HAB Assistance

• Working with grantees to
• Determine extent of damage needs
• Technical Assistance
• Advice and Clarification
• Local versus Federal restrictions on programs
• Site Visits
• Exploring new clinic openings
• Regular conference calls
• National AIDS Organizations
• Reimburse Title II providers with Title I funds

9
Status of CARE Act Clients

• Approximately 2,200 CARE Act clients were
  evacuated provided services
• Title I, Title II, ADAP, Title III and Title IV
  funded programs reported providing services
• 35 States, primarily Texas and Louisiana, and the
  District of Columbia enrolled HIV evacuees
• Texas reported over 800 evacuees receiving CARE
  Act services
• Louisiana reported over 700 evacuees receiving
  CARE Act services

10
Alabama

• Initial concerns power outages
• Clinics closed temporarily 1 week
• All sites are now operational
• Collaborating to ensure needs are met with
• State Department of Health
• Community Based Organizations
• AIDS Service Organizations
• Private Philanthropic Organizations

11
Louisiana

• Grantees still struggling
• Limited resources
• Staffing shortages and concerns
• Repair of facilities
• Equipment replacement
• Return of clients
• Need to enhance existing services

12
Louisiana (continued)

• Title I EMA operational - 2 of 4 sites open (1
  closed and 2 merged)
• Funded primary care sites mostly destroyed
• Baton Rouge Bogalusa continue to demonstrate
  increased demand clients
• Budgets are strained
• New Orleans Title I transferred 1.3 million to
  Title II programs for Title I eligible clients
• New Orleans area continues to have decreased
  capacity and closed/destroyed facilities

13
Mississippi

• Some providers report still operating out of
  trailers due to destruction of sites
• Seeing approximately 50 percent of pre-hurricane
  patient load
• All CARE Act funded grantees of record are open
  and providing services

14
Texas

• Texas ADAP Dallas Houston EMAs received large
  number of evacuees with multiple demands on
  programs
• Grantees joined forces with community based
  providers to
• Absorb evacuees into outpatient services
• Medical
• Medication Assistance
• Case Management

15
Texas (continued)

• ADAP
• Received in-kind donations from 7 major drug
  companies for September and October
• Louisiana Medicaid provided funding assistance to
  the Texas ADAP to purchase pharmaceuticals for
  Louisiana Medicaid eligible clients

16
Ongoing Challenges

• Current status of evacuees, returning clients,
  staff and facilities
• Scope and demographics of epidemic
• Tracking clients who have been displaced
• Housing for returning and relocating evacuees
• Primary care service provision in temporary and
  damaged facilities
• Need for increased funding to provide services
• Enrolling displaced evacuees in Medicare Part D

17
Ongoing Challenges (continued)

• Transportation for clients to/from services
• Food clothing
• Planning for
• Development of future sites
• Service provision
• Long term impact to clients
• Future manmade or natural disasters
• Determining residency
• Increased requests for information
• Re-establishing and maintaining communication

18
Ongoing Challenges (continued)

• Meeting CARE Act legislatively mandated
  requirements and restrictions, as well as
  conditions of award
• Unable to use CARE Act dollars to pay for
  medications for non-resident clients (ADAP)
• Unable to reimburse service providers for care to
  non-resident evacuees
• Unable to provide funds for non-CARE Act
  expenses, such as food, clothing and shelter
• Inability to provide care without documentation,
  i.e., medical records, HIV diagnosis, etc

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Hurricane CategoriesSaffir/Simpson Hurricane
Scale (For Reference Purpose)

• CAT Winds Surge
• 1 74-95 mph (64-82 knots (kt) 4-5 ft
• 2 96-110 mph (83-95 kt) 6-8 ft
• 3 111-130 mph (96-113 kt) 9-12 ft
• 4 131-155 mph (114-135 kt) 13-18 ft
• 5 155 mph (135 kt) 18 ft

20
Contact Information

• Ivana R. Williams, MPA, PT
• Senior Program Management Officer
• DHHS, HRSA, HAB
• Division of Science and Policy
• [phone]
• Iwilliams_at_hrsa.gov