GAO: Hospitals, nursing homes not ready for evacuation?

May 30, 2006 3:37 PM

           

Hospital and nursing home administrators face challenges related to evacuations caused by hurricanes, including deciding whether to evacuate and obtaining transportation, according to a report by the Government Accountability Office (GAO).

Although state and local governments can order evacuations, health care facilities can be exempt from these orders. Facility administrators are generally responsible for deciding whether to evacuate, and if they decide not to evacuate, they face the challenge of ensuring that their facilities have sufficient resources to provide care until assistance arrives.

If hospital adminitrators choose to evacuate, contractors providing transportation for hospitals and nursing homes could be unlikely to provide facilities with enough vehicles during a major disaster such as a hurricane, because local demand for transportation would likely exceed supply.

Nursing home administrators tell the GAO that they face unique challenges during evacuations. For example, they must locate receiving facilities that can accommodate residents who may need a place to live for a long period of time. The National Disaster Medical System (NDMS), a partnership of four federal departments, is the primary federal program that supports the evacuation of patients in need of hospital care during disasters such as hurricanes, but the program was not designed nor is currently configured to move nursing home residents.

Although NDMS supported evacuation efforts during Hurricane Katrina that included nursing home residents, according to program officials, it is not designed to evacuate this population.

In preparing for and carrying out the evacuation of transportation-disadvantaged populations, such as the elderly or persons with disabilities, during a disaster, states and localities face challenges in identifying these populations, determining their needs, and providing for and coordinating their transportation. The elderly are likely to be represented among the transportation disadvantaged because they are more likely, compared with the general population, to have a disability, have low income, or choose not to drive.

GAO has observed mixed efforts at the state and local levels to address the evacuation needs of the transportation disadvantaged. Some emergency management officials tell GAO that they did not yet have a good understanding of the size, location, and composition of the transportation disadvantaged in their respective communities.

However, GAO also observed efforts in some locations to address the evacuation needs of the transportation disadvantaged by encouraging citizens to voluntarily register with their local emergency management agency, integrating social service providers into emergency planning, and other measures. GAO will continue to examine the extent to which the transportation disadvantaged are addressed in state and local evacuation efforts as part of its ongoing work.

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