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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). Overview . Learning Objectives

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uses of hmis to support disaster operations and recovery lessons learned from katrina rita

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)

overview
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 Sponsored by the U.S. Department of Housing and Urban Development

learning objectives
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.

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

the dynamics of disaster response

The Dynamics of Disaster Response

Brian Sokol, Abt Associates

the dynamics of disaster response1
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

hurricanes katrina and rita
Hurricanes Katrina and Rita

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

eight stages of disaster response
Eight Stages of Disaster Response
  • Preparedness
    • Planning
    • Warning
  • Response – “Day Of Impact”
    • Pre-Impact
    • Post-Impact
  • Recovery
    • Restoration (six months)
    • Reconstruction
  • Mitigation
    • Hazard Perceptions
    • Adjustments

Cycles

Homeless Services

Where we are now

Based on Drabek, 1986

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

spatial dimensions
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

mapping the storms in space and time
Mapping the Storms in Space and Time

Rita

Katrina

Source: Louisiana Hurricane Impact Atlas

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

aspects of disaster response emergency support functions
Aspects of Disaster Response – Emergency Support Functions
  • Urban search and rescue
  • Oil and hazardous materials
  • Agriculture and natural resources
  • Energy
  • Public safety and security
  • Long-term community recovery and mitigation
  • External affairs
  • Transportation
  • Communications
  • Public works and engineering
  • Firefighting
  • Emergency management
  • Mass care, housing and human services
  • Resource support
  • Public health and medical services

Homeless

Services

Dept of Homeland Security, National ResponsePlan, 2004

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

esf 6 mass care housing and human services
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

respondents to a disaster
Respondents to a Disaster

Structure/Staffing

Walk-in

Volunteers

(Skilled/

Unskilled)

Tasks/

Mission

Homeless Services

Dynes, 1970

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

components of organization
Components of Organization

Social Order

More Coordinated

Collective

Behavior

More Flexible

Which comes first?

  • Domain
    • Formal recognition of authority
  • Task
    • Formal division of labor
  • Resources
    • Mobilized people and technologies
  • Activities
    • Specific behavior of people or groups

Kreps et al. 1986, 1989, 1993

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

mission conflicts within shelters
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

information management processes
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

axes of data coordination
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.

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

model of information management in disasters

Self-Sufficient

Registration

Dominant Activities/

Information Systems

Family Search

Needs Social Networks

Social Services/ Information and Referral

Needs Referrals

Coordinated Case Management

Needs Intervention

Phase 1 Phase 2 Phase 3 Phase 4

Mission of Shelter

Crisis /Evacuation Human Svcs/Homeless

Model of Information Management in Disasters

Those most self-sufficient exit faster, creating a shift in mission, activities, and appropriate systems

Population Type

Conflict

Time

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

disasters disrupt the response
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)

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

can this ever work in a disaster
Can this ever work in a Disaster?

Hypothesis:If all these elements were addressed in advance, then a comprehensive data system could work.

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

response to rita at the hirsch shelter in shreveport
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

response to rita at the hirsch shelter in shreveport1
Response to Rita at the Hirsch Shelter in Shreveport

9/22 4PM

Same Room, 9/22 8PM

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

disasters disrupt the response1
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

academic perspective
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)

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

summary thoughts
Summary Thoughts

Information management planners for disaster shelters should account for the following:

  • Shelters have evolving missions and diverse populations:
    • “Evacuation Shelter:” Manage the crisis; return to normalcy
    • “Homeless Shelter:” Provide long-term human services
  • Order and coordination are often at odds with flexibility and adaptation; disordered sometimes better
  • Disasters disrupt the environment of disaster response.
    • Avoid systems requiring expertise and infrastructure that are likely to fail under disaster conditions.

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

hmis usage in 2 1 1 disaster recovery efforts

HMIS Usage in 2-1-1 Disaster/Recovery Efforts

Fran Ledger,

Canavan Associates

slide26
“It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”

—Charles Darwin

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

louisiana s hmis and 2 1 1 history
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

key components
Key Components
  • HMIS effectiveness will decrease with unclear leadership and limited controls
  • Keys to disaster HMIS usage
    • Clear chain of command
    • Rapid quality assurance

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

louisiana hmis response timeline
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

louisiana hmis response timeline1
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

louisiana hmis response timeline2
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

louisiana hmis response timeline3
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

louisiana hmis response timeline4
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

louisiana hmis response timeline5
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

slide35
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 Sponsored by the U.S. Department of Housing and Urban Development

slide36

Mass Shelters-City Of San AntonioSuccesses and Lessons Learned in managing 17,000 refugees in the city of San Antonio

David Talbot

VP of DevelopmentData Systems International

facilities
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

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

prior to arrival
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.

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

prior to arrival continued
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.

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

a fuzzy look at the shelter
A (fuzzy) look at the shelter

Grid Location

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

evolution of hmis usage phase 1
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).

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

evolution of hmis usage phase 2
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.

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

evolution of hmis usage phase 3
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.

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

in retrospect
What worked well

Wrist Bands

Grid Locations

Remote Data Entry Sites

Private business assistance (HEB, Keller Williams, Rackspace)

What was a challenge

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

In Retrospect

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

next time around
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.

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

questions
Questions

September 18-19, 2006 - Denver, Colorado Sponsored by the U.S. Department of Housing and Urban Development

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