Transcript Document

Uses of HMIS to Support Disaster
Operations and Recovery:
Lessons Learned from Katrina/Rita
Brian Sokol, National HMIS TA Initiative, Abt Associates
David Talbot, DSI Inc.
Fran Ledger, Canavan Associates
David Canavan, Canavan Associates (Facilitator)
September 18-19, 2006 – Denver, Colorado
Sponsored by the U.S. Department of Housing and Urban Development
Overview
•
•
•
•
Learning Objectives
Dynamics of Disaster Response
Role of Information Management in Disasters
HMIS Usage in 2-1-1 Disaster/Recovery Efforts in
Louisiana
• City Of San Antonio uses of HMIS in Disaster
Response
September 18-19, 2006 - Denver, Colorado
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Learning Objectives
• Increased understanding of the possible functions of
HMIS during and after a major disaster.
• Provide a broad cross section of obstacles
encountered and successful interim and long-term
solutions developed.
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The Dynamics of Disaster Response
Brian Sokol, Abt Associates
September 18-19, 2006 – Denver, Colorado
Sponsored by the U.S. Department of Housing and Urban Development
The Dynamics of Disaster Response
• Katrina and Rita
• The Context: Homeless Services within the Total Disaster
Response
– Stages of Disaster
– Proximity to Disaster
– Emergency Support Functions
• Respondents/Organizations in a Disaster
– Types of Respondents
– Components of Organization
• Mission Conflict
• Information Management and Data Coordination
• Disasters Disrupt the Response
– Planner vs. “Academic” Perspectives
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Hurricanes Katrina and Rita
Katrina
Date
Rita
8/29/2006
9/24/2006
1330
100
2.5 Million
460,000
Individuals Homeless
770,000
76,500
Jobless
400,000
45,000
$100 Billion
$4.7 Billion
Deaths
Households in Need
Property Damage
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Eight Stages of Disaster Response
• Preparedness
– Planning
– Warning
• Response – “Day Of Impact”
– Pre-Impact
– Post-Impact
Cycles
• Recovery
– Restoration (six months)
– Reconstruction
Homeless Services
• Mitigation
– Hazard Perceptions
– Adjustments
Where we are now
Based on Drabek, 1986
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Spatial Dimensions
Organized Aid
Life goes on as normal, except for volunteerism
Filter
Staging Ground for Relief Activities
Fringe Impact
Some Damage
Homeless Services
Total Impact
Dynes, 1970
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Mapping the Storms in Space and Time
Rita
Katrina
September 18-19, 2006 - Denver, Colorado
by Hurricane
the U.S. Department
Housing and Urban Development
Source:Sponsored
Louisiana
ImpactofAtlas
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Aspects of Disaster Response – Emergency
Support Functions
1. Transportation
2. Communications
3. Public works and
engineering
4. Firefighting
Homeless
5. Emergency
Services
management
6. Mass care, housing
and human services
7. Resource support
8. Public health and
medical services
9. Urban search and rescue
10. Oil and hazardous materials
11. Agriculture and natural
resources
12. Energy
13. Public safety and security
14. Long-term community
recovery and mitigation
15. External affairs
Dept of Homeland Security, National Response Plan, 2004
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ESF-6: Mass care, housing and human services
• Lead Agencies: Red Cross and FEMA
• Tasks:
– Sheltering
– Feeding
– Emergency first aid
– Providing information about victims
– Unifying families
– Bulk distribution
– Short-term and long-term housing assistance
– Crisis counseling
– Providing for special needs victims
– Processing benefit claims
– Delivering ice, water, and emergency commodities
– Mail service to affected areas
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Respondents to a Disaster
Structure/Staffing
Consistent
Consistent
(with predisaster)
Tasks/
Mission New
New
Established Expanding
e.g., Fire
e.g., Red
Department Cross
mobilized
Extending
Emergent
e.g., Church, e.g., Ad hoc
business
coordinating
body, rescue
team
Dynes, 1970
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Walk-in
Volunteers
(Skilled/
Unskilled)
Homeless Services
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Components of Organization
Which comes first?
Social Order
More Coordinated
• Domain
– Formal recognition of
authority
• Task
– Formal division of labor
• Resources
– Mobilized people and
technologies
• Activities
– Specific behavior of
people or groups
Collective
Behavior
More Flexible
Kreps et al. 1986, 1989, 1993
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Mission Conflicts within Shelters
• Crisis Management
– Return community to “normalcy”
– Focus on basic needs and operations
– Loose privacy and eligibility rules
– FEMA/Local Respondents/Red Cross (?)
– Residents are “Evacuees”
– Sample goal: Close evacuation shelters quickly
• Human Services
– Restore individual lives to “normalcy”
– Overall Case Management
– Tight privacy and eligibility controls
– Victims/Human Service Organizations
– Residents are “Homeless”
– Sample goal: Keep shelters open as needed
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Information Management Processes
• Registration and Headcounts
–
–
–
–
Who is in the shelter?
Public Safety
Ordering Supplies/Meals
Tracking Vacancies/Reserving Beds
• Reunite Families
• Linking to Benefits and Services
• Coordinate Case Management
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Axes of Data Coordination
• Intra-Organizational
• Same db for shelter registration, missing persons, case
management, benefits receipt, health?
• Inter-Organizational
– Geographic: “Breadth”
• One db for all evacuees across the country?
– Disaster/Non-Disaster: “Depth”
• Use the same db (HMIS) for evacuation and homeless
shelters?
Coordination attempts can conflict with each other.
E.g., coordinating between disaster shelters and the homeless
system within a region may mean using a different disaster
system than the rest of the country.
Impossible to coordinate across all axes at once.
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Model of Information Management in Disasters
Self-Sufficient
Those most self-sufficient exit faster,
creating a shift in mission, activities, and
appropriate systems
Registration
Family
Search
Needs Social
Networks
Dominant Activities/
Information Systems
Social Services/
Information and Referral
Conflict
Needs Referrals
Needs Intervention
Coordinated Case
Management
Phase 1 Phase 2
Phase 3
Phase 4
Mission of Shelter
Crisis /Evacuation
Human Svcs/Homeless
Time
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Disasters Disrupt the Response
Emergency Management Perspective:
The goal should be for the victim to … encounter one
person who gathers all the necessary data and inputs it
into a database that is shared and transparent among all
human service providers at the Federal, State and local
level as required. This will likely increase efficiency,
reduce frustration of evacuees and expedite the delivery
of services for eligible recipients.
(The Federal Response To Hurricane Katrina: Lessons
Learned. White House Report, 2006)
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Can this ever work in a Disaster?
Need
Katrina Shelter Reality
Ample Lead-Time for Software
Configuration
One-day start up
Fully Wired
No Computers/Internet
Trained Staff, Expert Support
Walk-in volunteers
Integrated Organization
Disparate Activities
Hypothesis: If all these elements were addressed in advance,
then a comprehensive data system could work.
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Response to Rita at the Hirsch Shelter in
Shreveport
Rita can be seen as a test case for the hypothesis. By the time
Rita hit everything was up and running. What happened?
• Computers moved out to make room for cots
• 500 new people showed up, overwhelming intake processes:
handed paper forms
• Software experts left town, having lost their hotel rooms to
evacuees
• Volunteers reverted to their comfort zone
• Rita hit Shreveport
– Water seeped through roof and floors (electrocution risk)
– Case mgmt volunteers re-tasked to “sandbagging” and “trench
digging”
– Intermittent blackouts
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Response to Rita at the Hirsch Shelter in
Shreveport
9/22 4PM
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Same Room, 9/22 8PM
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Disasters Disrupt the Response
• Unlike other emergencies, no clear distinction
between incident and response, victim and
helper:
– “Organizations have to respond to being directly
impacted themselves (e.g., there can be direct and
indirect loss of personnel, resources, equipment,
and facilities)” (Quarantelli, 1989)
• Disasters almost always create the “wrong
conditions” and cut off planned resources
– Example: NYC’s Office of Emergency Management
was destroyed on 9/11
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Academic Perspective
“Much traditional disaster planning takes the disorganizing
aspects of emergency…and attempts to achieve greater
rationality and control of the anticipated situation...
“…[but] the disorganizing aspects are necessary in
order to develop the mobilization required to cope
with the tasks at hand…
“…the end result is more rational and, in time, more efficient
since a community has restructured itself to meet a set of
problems which its previous structure could not.
“Disaster planning should be made in the context of these
natural processes set off by a disaster event
“It should facilitate these processes, not impose a
model of human and technological efficiency which
has little relationship to reality.“ (Dynes, 1970)
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Summary Thoughts
Information management planners for disaster shelters
should account for the following:
1. Shelters have evolving missions and diverse populations:
– “Evacuation Shelter:” Manage the crisis; return to normalcy
– “Homeless Shelter:” Provide long-term human services
2. Order and coordination are often at odds with flexibility
and adaptation; disordered sometimes better
3. Disasters disrupt the environment of disaster response.
– Avoid systems requiring expertise and infrastructure that are
likely to fail under disaster conditions.
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HMIS Usage in 2-1-1
Disaster/Recovery Efforts
Fran Ledger,
Canavan Associates
September 18-19, 2006 – Denver, Colorado
Sponsored by the U.S. Department of Housing and Urban Development
“It is not the strongest of the
species that survives, nor the
most intelligent, but the one
most responsive to change.”
—Charles Darwin
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Louisiana’s HMIS and 2-1-1 History
• Nine HMIS Regions and Six 2-1-1 Regions
• All HMIS & 2-1-1 Regions use same vendor product
• HMIS & 2-1-1 has overlapping management &
software system
– 1 Software System – 1 Agency
• New Orleans
• Shreveport
• Lake Charles
– 1 Software System – 2 Agencies
• Baton Rouge
• Lafayette
• Monroe
– 2 Software Systems – 2 Agencies
• Hammond
• Houma
• Alexandria
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Key Components
• HMIS effectiveness will decrease with unclear
leadership and limited controls
• Keys to disaster HMIS usage
– Clear chain of command
– Rapid quality assurance
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Louisiana HMIS Response Timeline
• Friday, August 26th
– MOUs Activated
• UWNELA & VIA LINK
• Office of Emergency Preparedness & UWNELA
• Sunday, August 28th
– Mandatory Evacuation of New Orleans
• 1300 calls in first 12 hours
• VIA LINK staff relocating to UWNELA
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Louisiana HMIS Response Timeline
• Monday, August 29th
– Katrina makes landfall
– Levee failures flood 80% of New Orleans,
– 1/3 of Louisiana housing damaged or destroyed
• Wednesday, August 31st
– New Orleans telephone landlines fail
– United Way of America with CenturyTel expands
UWNELA call center
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Louisiana HMIS Response Timeline
• Wednesday, August 31st
– 4 Hours: 4 lines  56 lines
– All cell phone 2-1-1 calls route to UWNELA
– Call types: roof top rescues  clothing donation
• Thursday, September 1st
– 2500 calls/day
– UWNELA staff on 20 hr shifts
– United Way of America requests 2-1-1 volunteers from
around the country on its 2-1-1 listserve
– HUD, first federal agency to offer National Technical
Consultants and resources
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Louisiana HMIS Response Timeline
• Saturday, September 3rd
– Arrival of National Call Center and Resource Manager
Specialist
– Multi-state disaster HMIS launched
• Monday, September 5th
– 8,000 calls/day
– Mass need swamps FEMA & Red Cross
– UNWELA houses and feeds 70 volunteers
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Louisiana HMIS Response Timeline
• Saturday, September 17th
– 48 desktops arrive from HUD
– Call Center transitions from paper/pencil  HMIS
• Saturday, September 24th
– HUD consultants on site
– 12,000+ federal, state, and local resources made
available
– Rita hits & 310-Info evacuates to UWNELA
– 4,000 - 6,000 calls/day
– CNN, Red Cross & FEMA publicize 2-1-1
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Louisiana HMIS Response Timeline
• Tuesday, November 8th- 10th
– VIA LINK transitions back to New Orleans
– National Volunteers Depart
– ~50,000 call sheets to be entered
• Today
– Regional 2-1-1s have revised MOUs
– Regional 2-1-1s developing single phone system
– Regional HMISs developing statewide HMIS
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Special Thanks to:
• All the call center volunteers, local and national, for answering
the call in our countries greatest tragedy!
• Janet Durden, Executive Director, United Way of Northeast
Louisiana
• Marguerite Redwine, CEO, VIA LINK
• Karen Puckett, President, CenturyTel
• Peter Bishop, United Way of America
• Mike Roanhouse, Department of Housing and Urban Development
• Robert Bowman, President, Bowman Internet Systems, LLC
• Melissa Flourney, President, Louisiana Association of Non-Profit
Organizations, LANO
• My Landlord on Elm St. for chairs to sit on and a rental to put
them in!
September 18-19, 2006 - Denver, Colorado
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Mass Shelters-City Of San
Antonio
Successes and Lessons Learned in managing 17,000
refugees in the city of San Antonio
David Talbot
VP of Development
Data Systems International
September 18-19, 2006 – Denver, Colorado
Sponsored by the U.S. Department of Housing and Urban Development
Facilities
• Multiple facilities, not all connected
• Kelly USA
– Former US Air Force Base
– Maze like-difficult to navigate
– Multiple massive buildings
• Freeman Coliseum
– Huge single area
• LEVI
– Huge single area
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Prior To Arrival
• Around a 12 hour notice that the city would receive a fairly
sizable number of evacuees.
• No one could quantify or give a vague range of numbers to
expect.
• Guesstimates ranged between 2,000 and 40,000.
• The city immediately recognized this wasn’t a short term
disaster but a long term homeless problem and elected to
use their HMIS system from day one.
• City began tapping resources, favors, beg/borrow/steal
facilities, food, connectivity, medicine, volunteers.
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Prior To Arrival-Continued
• Facilities were set up
– Designated medical areas, bathing, etc
– Shelter bed areas were divided into a grid.
– Red Cross intake forms underwent minor
modification to add:
• Wrist Band ID
• Assigned Section
– HMIS System was customized by the city to
contain only the fields on the customized red
cross intake.
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A (fuzzy) look at the shelter
Grid Location
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Evolution of HMIS usage-Phase 1
• Phase 1-Missing Persons
– Data Entry done by 200 concurrent untrained volunteers, constant
rotation of new blood made training impossible.
• Some at local colleges working in two computer labs
• Keller-Williams Reality provided a good source of computer literate
volunteers.
• System was customized to give the user two functions with a single path
through the system-Find Clients/Add Client
– Rapid integration and collapsing of disparate systems.
• Excel spreadsheets/Access Databases/Other Systems
• Systems have a tendency to multiply like rabbits.
• Imported data from all systems in the greater San Antonio area, got all
Katrina sites using the same system, then uploaded batch to Katrina safe.
– Wristbands and Grid Location in HMIS made it relatively easy to locate
clients.
– Some normal system security measures were disabled (not all).
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Evolution of HMIS usage-Phase 2
• Phase 2-Transition out as many people as possible
– New workgroup was created with expanded functionality
specifically around the data points enabling a quick transition
out of the shelter.
• Section 8 Enrollments in LA=Section 8 in Texas
– The Phase 1 “super simple” workgroup continued to operate
for missing persons.
– Wristbands and Grid Location in HMIS made it relatively easy
to locate clients.
– Normal system security measures re-enabled.
• Rita hit about this time, yielding a batch of short term
evacuees.
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Evolution of HMIS usage-Phase 3
• Phase 3-Case Management
– Virtually every evacuee was “special needs” of some sort- .
Very old, disabled, children without parents…
– System was expanded to full regular case management mode
for case managers who began working with everyone in the
shelter.
– During Phase 3, FEMA started bussing/flying in evacuees from
other locations to consolidate efforts.
• Phase 3 transitioned into the Shaw Group, a subsidiary of
Halliburton, that was contracted by FEMA to transition the
remaining people out of shelters.
– They were given a workgroup and a group of user ids, the city
was removed from management of the shelter.
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In Retrospect
• What worked well
–
–
–
–
• What was a challenge
Wrist Bands
Grid Locations
Remote Data Entry Sites
Private business
assistance (HEB, Keller
Williams, Rackspace)
September 18-19, 2006 - Denver, Colorado
– Red Cross Intake Form
– Dozens of “centralized”
Katrina databases on the
internet.
– No clear chain of
command. City? Red
Cross? FEMA?
– Information Release
problems
– Infrastructure
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Next time around…
• Recommended changes to intake forms
– Drop pre-disaster address
– Add birth date in addition to age
– Better family structure and a clearer definition as to if the
family is together at shelter or not.
– A question: Were you enrolled in any government assistance
programs?
– Opt Out: I do not want my information posted publicly.
• Chain of command is clearer and defined from day 1?
• Localities handling evacuees use local HMIS system
uploading to a single publicly searchable database via a
defined standard such as HUD XML.
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Questions
• For more information on these presentations please
contact our presenters at:
– Brian Sokol at [email protected]
– Fran Ledger at [email protected]
– David Talbot at [email protected]
• For more information on HUD’s Disaster Technical
Assistance Project, contact
– David Canavan at [email protected]
– Ann Oliva at [email protected].
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