As Hurricane Ian makes landfall, Florida health centers stand ready

By Noah Smith

Hurricane Ian approached Category 5 earlier in the day, with winds over 150 miles per hour off the west coast of Florida.

Several federally licensed health centers (FQHCs), which provide primary preventive care to everyone, regardless of ability to pay, are on Ian’s planned path. Over a million patients are currently on Ian’s path. For many people, FQHCs are their only source of healthcare other than emergency services – which is also the case during and after natural disasters.

“In many communities, after a hurricane, the local private sector will not be ready to open. FQHC’s mission is to respond immediately to the needs of their community. They need to be opened immediately if people need a place to go… for the uninsured and the elderly this is the only place to go except for the emergency room which is the worst place to go said Andrew Behrman, President and CEO. of the Florida Association of Community Health Centers, which has 54 FQHCs among its members.

Behrman, who has more than 20 years of experience in his role, said the combination of high costs, long wait times and the diversion of limited resources makes a post-hurricane emergency a suboptimal choice for non-emergency care.

Ahead of the storm, Behrman said Florida FQHCs are currently focused on staff and patient safety. He said most will be closed today and likely tomorrow, mainly due to patient evacuations.

“We encouraged those in the evacuation zone to get out of there,” Behrman said, adding that clinics used “every tool possible,” including email, text, Facebook and Facebook. personal phone calls to inform patients. clear out. “I’ve lived in Florida for over 60 years, and the last thing you want to do is be in the path of Category 4 or 5 storms,” ​​he said.

FQHCs in Florida have also been testing generators and are coordinating details to stay in touch with the local and state emergency operations center as well as Behrman’s organization — one of the most critical aspects of disaster response and recovery, Behrman said. To ensure continuity of communications, FHQCs located in the hurricane’s path were provided with satellite phones. Plans are also in place to deploy “MASH-style” tents so people can still be treated even though a building has been made operational, as well as generators and washing stations soon after the storm passes. These purchases were made possible through a Direct Relief Covid-19 Resilience Grant.

Although not set up for emergency care, FQHCs are also prepared to stabilize acute trauma patients before bringing them to an appropriate facility, Behrman said, noting again that communication, in this case with a local acute care center, was vital.

Providing continuity of care, especially for chronic conditions, has proven crucial in the aftermath of the hurricanes.

A decades-long study published in JAMA showed a 33.4% higher death rate after major hurricanes in the United States. The increase in mortality rates has been observed in causes of death such as injuries, infectious and parasitic diseases, respiratory diseases, cardiovascular diseases and neuropsychiatric diseases. No increase was observed in deaths attributable to cancer.

During disasters and in everyday life, certain groups are more vulnerable to adverse health effects. Age, income and having a disability, along with other social determinants of health, are correlated with poorer health outcomes, which can be amplified during natural disasters when disruptions in medical care is more likely to occur, making it more difficult to obtain drugs and electrical medical devices.

According to a Direct Relief analysis of data from the US Health Resources and Services Administration, of the 1.05 million qualified federal health center patients on the hurricane’s path, about 11% are under the age of six, 50% live at or below the federal poverty level, 18% have high blood pressure, 31.5% are classified as overweight, 4% have asthma, and 8% have diabetes. Over 20% of patients speak a language other than English.

In Pinellas County, 25% of the population is over the age of 65, 8.5% above the US national average of 16.5%. Hillsborough County’s population is younger than average, but 14% of the population lives below the poverty line, compared to a national average of 11%.

In the two counties, which are the two largest counties by population on the Gulf Coast in Hurricane Ian’s projected path, approximately 18,000 people have power-dependent medical devices. The national average per county is 895 people. A 2010 study showed that the average critical care ventilator battery backup lasted between about 20 and 170 minutes.

Earlier this summer, in line with a program established in 2007, which began in the aftermath of Hurricane Katrina to help sustain FQHCs, Direct Relief pre-positioned a dozen hurricane preparedness packs in Florida. The packs, which contain over 210 different products, and have been refined and updated based on feedback from FQHCs and other medical providers, currently contain a range of antibiotics, syringes, first aid supplies basic and medications to treat conditions such as diabetes, hypertension, and severe allergic reactions. One of the recipients this year was the Tampa Family Health Center, one of the largest federally qualified health centers in Florida.

Behrman said as the storm approaches and the mission shifts from evacuation to reopening, his organization and the FQHCs they support will remain focused on the issues involved.

“At the end of the day, we may be the only option for people,” he said.