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Yet Another Catastrophe: Health, Human Services Hurting

Posted on: Wednesday, 17 May 2006, 09:05 CDT

By Geoff Pender, The Sun Herald, Biloxi, Miss.

May 17--GULFPORT -- Like everything else it touched, Katrina overwhelmed and devastated state health and human services operations, a part of Mississippi's social fabric that had many holes and seams even before the storm.

South Mississippi hospitals suffered more than $450 million in damage and losses. Almost every one of them has since lost physicians and nurses, worsening pre-Katrina nationwide personnel shortages. Society's most vulnerable -- children, the elderly, the poor -- suffered and continue to suffer the worst Katrina offered. The state's welfare system and South Mississippi nursing homes, child care services and other programs are reeling.

The Health and Human Services Committee of the Governor's Commission on Recovery, Rebuilding and Renewal made 42 recommendations, many in response to shortcomings Katrina pointed out.

Most of the committee's goals remain unmet, but that's not unexpected, said committee Chairman Chris Anderson, head of Singing River Hospital. Many of the recommendations do not offer a quick fix, and the community's attention has been more on the short term.

"I never envisioned this plan as something printed on Jan. 1 and put into play on Jan. 2," Anderson said, a view echoed by Gov. Haley Barbour about the entire commission report. "It was rather more a 20-year vision."

For instance, the recommendations include assessing and overhauling the state's trauma care system, an area where Anderson says "there are some pretty significant shortcomings." This is, in part, due to a lack of trauma doctors statewide. The state had already made some attempts to at least study the problem. Committee recommendations include a pay incentive program for doctors.

"Doctors are not compensated very much for being on call all weekend and nights," Anderson said. "When you look at the burden, stress and intensity of what they're doing, there's very little financial or other type recognition for them."

But some of the committee's recommendations are a direct response to Katrina and beg prompt action. Like most of Katrina's lessons, the key appears to be in communications and planning. And perhaps the key committee recommendation was for the creation of a state health and human services disaster director -- someone focused solely on planning for Katrina-like catastrophe and coordinating health care communications afterward.

"We had never anticipated anything with this breadth," Anderson said. "We had a plan for our campuses, but that plan contemplated that there were other hospitals within an hour that could help. And our plans called for us to be supplied for about four days. In this storm, that was not sufficient. In the future, it needs to be 10 days."

"We had volunteers from all over showing up every day for weeks -- nurses, doctors -- wanting to help," Anderson said. "Often someone would show up with the right skill set a hospital needed. But also people would show up and they would do something we already had five or six people doing. But we didn't know how to tell them to go to this hospital or clinic where they would be needed, because we didn't know what was going on. If all volunteers and relief supplies could go to some central location, they could be put to better use.

"We had 10 hospitals calling other hospitals on a one-on-one basis asking for help," Anderson said. "That's another instance where a coordinator could help, having protocols, where instead of making 50 calls, somebody would know where beds are available and what type patients they could take."

The committee also made recommendations that the state improve its computer records for the Department of Human Services, foster care, medical records and others, using satellite mapping and other new technology.

Don Taylor, DHS director, said the state is moving in this direction.

Already, Taylor said, his agency has piggybacked onto a system created by Louisiana and has been using it to track recipients and prevent food-stamp fraud.

"Wouldn't it be great if with a click on the computer we knew where every elderly person on oxygen or dialysis was, or where every foster home is?" Taylor said. "Absolutely, I think that will happen."

The series

The Sun Herald is taking a look at where we are five months after the Governor's Commission on Recovery, Rebuilding and Renewal presented its report to Gov. Haley Barbour.

May 7: An overview of the commission's work

May 8: Land Use

May 9: Transportation

May 10: Public services

May 11: Housing

Friday: Tourism

Saturday: Small business

Sunday: Agriculture, forestry and marine resources

Monday: Defense and government contracting

Tuesday: Education

Today: Health and human services

May 18: Non-governmental organizations

To read excerpts from the recommendations from the Health and Human Services Committee of the Governor's Commission, go to www.sunherald.com

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Health and human services

Some recommendations from the Health and Human Services Committee of the Governor's Katrina commission, and comments from committee chairman Chris Anderson and state Department of Human Services Director Don Taylor:

-- The position of health and human services director should be created.

Status: Not done; had been requested for June 1

Comments: "This person could facilitate some type of storage plan, to make sure that fuel is available for doctors and nurses," Anderson said. "Another problem was there were roughly 15 different state agencies showing up at hospitals on a daily basis to assess us -- did we have enough workers, enough tetanus vaccine, asking the same questions and handing us forms. It would help if one group or agency could coordinate that."

-- A committee of health care providers should be appointed to study a regional health information organization accessible to all participating providers.

Status: Not done; long-term goal

Comments: "I think this is relatively low-cost for a huge benefit," Anderson said. "There's a lot of effort around the country to integrate computers to transfer records between medical facilities. Eventually, it will be like going to a bank ATM."

-- Case management should focus on children under state custody and ensure that displaced parents meet their obligations.

Status: Progress being made; Legislature failed to act on request for more enforcement officers

Comments: "We're doing a lot better," Taylor said. "In fact, last year we received $3.3 million in federal high-performance child support bonuses last year. We have increased collections by about $12 million from the year before, and we are now $9 million over last year, for a total of about $212 million. But we could do better. We will try again next year for more positions."

-- When a disaster is imminent, have special needs shelters for people who need oxygen, dialysis and other care identified in every county.

Status: Expected to be in place by hurricane season.

Comments: "Jackson County has already made great progress, working with the Red Cross, hospitals and the county and with a corporate sponsor, Chevron, providing assistance," Anderson said.

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Copyright (c) 2006, The Sun Herald, Biloxi, Miss.

Distributed by Knight Ridder/Tribune Business News.

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Source: The Sun Herald (Biloxi, Miss.)

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