How Hurricane Responders Track People Whose Lives Depend on Power: Registries of Medically Fragile Residents

By Christine Vestal, Stateline, Pew Charitable Trusts, Oct. 2, 2017

Photo: While conducting search and rescue in the mountains of Puerto Rico a CBP Air and Marine Operations Black Hawk located this home a half mile from a peak with HELP painted its roof; US Customs and Border Protection

In the aftermath of Hurricane Irma, large swaths of Florida went without power for days. Sweaty and frustrating for millions, the lack of electricity could have been deadly for tens of thousands of mostly elderly Floridians who rely on home health equipment such as oxygen concentrators, ventilators, motorized wheelchairs and dialysis machines.

But in much of the state, first responders and public health officials knew exactly where the most vulnerable residents lived and what their medical needs were.

That’s because Florida, like a handful of other hurricane-prone states, requires counties to create registries of residents who are most vulnerable to severe storms and the prolonged power outages that follow them. Some states also maintain their own databases of medically fragile residents.

As the US population ages and more people opt for home health care services instead of lengthy hospital and nursing home stays, the number of Americans who rely on the electrical grid to power life-sustaining home devices is soaring.

That fact, combined with climatologists' predictions that the number of major storms is likely to increase, puts an increasing number of Americans at risk when the power goes out.

Hurricane Sandy, which hit the East Coast in 2012, caused prolonged power losses for millions of residents in 17 states and sent hundreds of medically fragile people to hospital emergency departments to plug in their devices. At the same time, people with life-threatening injuries were crowding the same hospitals, creating chaos and death.

That's when the US Department of Health and Human Services (HHS) decided to help states locate and care for electricity-dependent residents during natural disasters. Using Medicare claims data, the agency created a database of people who use home medical equipment paid for by the federal insurance program for the elderly and disabled.

Since its launch in 2015, emPOWER [Editor's Note: Please know that there are many entities with the name — or variation of this name — for other businesses but this is a government service.] has been used by health officials in 43 states, five territories and three cities to plan for the emergency needs of 3.8 million people with medical devices, according to HHS. Most recently it was used in the US Virgin Islands and Puerto Rico to locate and evacuate dialysis patients following Hurricanes Irma and Maria.

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When Hurricane Irma hit, in September, it caused one of the nation's largest power outages ever measured. More than 16 million people lost power in the Southeast, about 7 million of them in Florida.

Eight people died in a sweltering nursing home after the storm knocked out its air conditioning system, and Gov. Rick Scott, a Republican, later issued an emergency ruling requiring all Florida nursing homes to have backup power systems.

In Hillsborough County, where Tampa is located, public health preparedness director Ryan Pedigo said specialized medical shelters with generators ran smoothly despite widespread power outages.

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How Hurricane Responders Track People Whose Lives Depend on Power: Registries of Medically Fragile Residents

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