It appears that Hurricane Irma evacuation shelter managers may make people wait outside for hours? If so, just welcome them in and then do the registration process inside.

Making evacuees wait outside adds the anxiety of worrying about whether they made the right decision to seek shelter, to the already existing fear of temporary “homelessness” becoming permanent.

“The storm is here,” Gov. Rick Scott said Saturday morning, noting that the storm surge could reach 15 feet in some places.
“Fifteen feet is devastating and will cover your house,” he said. “Do not think the storm is over when the wind slows down. The storm surge will rush in and it could kill you.” (A)

“The key things include the basic fundamentals of making sure you have adequate power sources, backup power generation and that you can run enough power for all of your facilities to really operate in a seamless fashion. Also, make sure you have appropriate water sources…..
Then certainly supplies, staff — making sure you have a team A that stays through the storm and a team B that can come back and essentially relieve team A — are critical components to a plan like this. Preparation ahead of time makes the difference. (B)

“With many South Florida residents fleeing their homes before Hurricane Irma, hospitals in Florida’s southernmost county have put their own evacuation plans into motion.
The three hospitals in Monroe County, which includes the Keys, are in the process of shutting their doors ahead of Irma’s expected Sunday arrival. The county has also ordered a mandatory evacuation for residents.
The Lower Keys Medical Center evacuated its remaining 11 patients Wednesday night in the North Carolina National Guard’s C-130 aircraft, according to hospital spokeswoman Lynn Corbett-Winn. The patients were transported to Gadsden Regional Medical Center in Alabama. The hospital will close its emergency department at 7 a.m. Friday.
Eleven patients from the Lower Keys Medical Center were evacuated to Gadsden, Alabama, in a North Carolina National Guard aircraft.
(C)

“Jackson Health System, the county’s public hospital system, said in a statement Friday that it would start operating in a state of emergency starting Saturday at 7 a.m. It said it had already canceled its appointments at its ambulatory care and primary care centers, and that its pharmacy and urgent care centers would close at 3 p.m. Friday. Emergency rooms at all of its facilities — including the flagship Jackson Memorial Hospital, Jackson North Medical Center in North Miami Beach and Jackson South Community Hospital in South Miami-Dade — will remain open.
Mount Sinai Medical Center, whose main campus is located on Miami Beach, said as of Thursday morning that it would not evacuate patients or essential staff. The center’s emergency centers in Miami Beach and Aventura also plan to remain open, said center president and CEO Steven D. Sonenreich.
“It is important to note that Mount Sinai is not a public shelter and once we are under a Hurricane/Tropical Storm Watch, only persons with medical emergencies, third-trimester maternity patients and individuals with special needs previously assigned to Mount Sinai will be accepted,” he said. (D)

“Emptying even a modest-sized hospital during a disaster often requires a vast logistical effort and the cooperation of ambulance teams and other hospitals. Sometimes a health system has enough resources to transfer patients within its own network of hospitals. But when that is not possible, Texas has procedures in place to move patients en masse.
A catastrophic medical operations center — set up in Houston during emergencies and run by the Southeast Texas Regional Advisory Council, a regional organization that coordinates medical disaster responses — matches patients to specific hospitals that can take them. Then the center passes a request for medical transport to an emergency medical task force that coordinates ambulances and emergency service crews contributed by fire departments around the state and, in the case of Harvey, the nation.” (E)

“While many Miami hospitals are shutting down as Hurricane Irma bears down on Florida, some are offering shelter to their pregnant patients, bracing for the increase in births that often accompanies these large storms.
At least three of the city’s hospitals have plans in place to care for women with advanced or high-risk pregnancies.
They could be busy.
(F)

“The first step is to make the decision early on whether the provider should remain open or evacuate. Turner said the media can often generate a lot of hype when major storm systems hit, so it’s critical for providers to rely on solid data sources, such as the National Oceanic and Atmospheric Administration.
NOAA provides weather forecast tools and satellite views that follow the storm and its path.
Once the organization determines whether to keep operations running, providers need to review their disaster preparedness plan and test staff by running drills, explained Turner.
No matter the size of the organization, much of the preparedness checklist is the same: food and water supplies, reliability of power sources and test phone and internet connections. (G)

“Prior to Hurricane Harvey striking the Houston area, Texas was already one of the most difficult states in the nation to have an abortion, with restrictions on insurance coverage and laws that have shut down abortion clinics by the dozen. But abortion clinics in the region affected by the flooding were not immune to damages, which is why Whole Women’s Health, the organization that sued and won in a 2016 Supreme Court case that ruled TRAP laws unconstitutional, has stepped up to the occasion.
Whole Women’s Health announced in a blog post this week that with the help of the Lilith Fund, a Texas-based abortion fund, will provide cost-free abortions to Hurricane Harvey survivors — some of whom missed appointments for the procedures due to the storm, and were unable to rebook appointments also due to the storm. The costs associated with traveling to have an abortion make the procedure unaffordable to many, and fewer clinics as a result of Harvey will only exacerbate this issue.
(H)

“In the wake of the devastating impact of Hurricane Harvey, Surescripts and Allscripts (NASDAQ:MDRX) are collaborating to provide free access to patient-specific medication history data for pharmacists in Texas and Louisiana for a limited time. Pharmacists interested in utilizing the service should visit www.surescripts.com/harvey for instructions on how to become authorized to access the Allscripts application through which they can then obtain patient consent to see a 12-month view of a patient’s medication history. Prescribers who do not already utilize medication history data through their electronic health record (EHR) software can also download the free, cloud-based application to gain access.” (I)

“More than a dozen Texas chemical and refining plants reported damaged storage tanks, ruptured containment systems and malfunctioning pressure relief valves as a result of Hurricane Harvey, portending safety problems that might not become apparent for months or years, according to a Houston Chronicle review of regulatory filings….
When Harvey swept through the Gulf Coast and Houston area, it forced the shutdown of hundreds of industrial facilities across the region. Now, with waters receding, these operations will be coming back on line in the coming weeks, raising the prospect of cancer-causing gas emissions, toxic spills, fires and explosions, said Sam Mannan, director of a center that studies chemical process safety at Texas A&M University.” (J)

“Houston’s sprawling network of petrochemical plants and refineries released millions of pounds of pollutants in the days after Hurricane Harvey began barreling toward Texas.
Even under normal operations, the hundreds of industrial facilities in the area can emit harmful chemicals. But from Aug. 23 to Aug. 30, 46 facilities in 13 counties reported an estimated 4.6 million pounds of airborne emissions that exceeded state limits, an analysis by the Environmental Defense Fund, Air Alliance Houston and Public Citizen shows.
Federal and state regulators say their air monitoring shows no cause for alarm. But the extra air pollution is just the latest concern for residents and environmental groups in the days after the storm. At least 14 toxic waste sites were flooded or damaged, raising fears of waterborne contamination. And nearly 100 spills of hazardous substances have been reported.” (K)

(A) Hurricane Irma Live Updates: ‘The Storm Is Here,’ Florida Governor Says, https://www.nytimes.com/2017/09/09/us/hurricane-irma-florida.html?mcubz=0
(B) Ochsner CEO Warner Thomas on Katrina, Harvey & Irma: ‘In any sort of disaster there’s also opportunity’, by Kelly Gooch, http://www.beckershospitalreview.com/hospital-management-administration/ochsner-ceo-warner-thomas-on-katrina-harvey-irma-in-any-sort-of-disaster-there-s-also-opportunity.html
(C) South Florida hospitals closing ahead of Hurricane Irma, by Michael Nedelman, http://www.cnn.com/2017/09/06/health/hurricane-irma-florida-hospitals-closing/index.html
(D) Will hospitals close during Hurricane Irma? Some already are evacuating, by Elizabeth Koh, http://www.miamiherald.com/news/weather/hurricane/article171710102.html
(E) After Harvey Hit, a Texas Hospital Decided to Evacuate. Here’s How Patients Got Out, by SHERI FINK and ANDREW BURTON, https://www.nytimes.com/2017/09/06/us/texas-hospital-evacuation.html?smprod=nytcore-ipad&smid=nytcore-ipad-share&_r=0
(F) Miami hospitals prepare for surge in births during Hurricane Irma, by Julie Steenhuysen and Jilian Mincer, https://www.yahoo.com/news/miami-hospitals-prepare-surge-births-during-hurricane-irma-204516684.html
(G) How hospitals can prepare for Hurricane Irma, by Jessica Davis, http://www.healthcareitnews.com/news/how-hospitals-can-prepare-hurricane-irma
(H) Texas Abortion Provider Offers Cost-Free Abortion Services to Hurricane Harvey Survivors, by Kylie Cheung, https://www.themarysue.com/reproductive-justice-6/
(I) Sure scripts and Allscripts Join Forces to Make Patient Medication History Data Available to Pharmacists in the Wake of Hurricane Harvey, http://www.businesswire.com/news/home/20170906006529/en/Surescripts-Allscripts-Join-Forces-Patient-Medication-History
(J) Government ill-equipped to monitor industrial plants damaged by Hurricane Harvey, by Mark Collette and Matt Dempsey, http://www.houstonchronicle.com/news/houston-texas/houston/article/Government-ill-equipped-to-monitor-industrial-12178805.php
(K) More Than 40 Sites Released Hazardous, by TROY GRIGGS, ANDREW W. LEHREN, NADJA POPOVICH, ANJALI SINGHVI and HIROKO TABUCHI, https://www.nytimes.com/interactive/2017/09/08/us/houston-hurricane-harvey-harzardous-chemicals.html

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