Geriatric Mental Health Disaster and Emergency Preparedness

70 Geriatric Mental Health Disaster and Emergency Preparedness
the state level for administrative and oversight expenses but are not spent
for direct service. During disaster recovery, the U.S. Administration on
Aging is charged with coordinating with FEMA and individual state emergency
management agencies to work with recovery response agencies such
as the American Red Cross.
In the event of a mass displacement of individuals during a public
emergency, even with prior planning efforts, experience has shown that
many older individuals evacuate without appropriate medications, medication
records, and/or health records. Because agencies knew that lack of
health information would be a problem during the 2005 hurricane recovery
efforts, the federal government suspended certain provisions of the
federal privacy rule, the Health Insurance Portability and Accountability
Act (HIPAA). Among other benefits, this suspension permitted the exchange
of information between shelters and health care providers, which
would not have been possible in other circumstances. This was particularly
critical during the recovery from Katrina and Rita as entire medical
offices and their medical records simply no longer existed. The American
Medical Association (AMA) estimated that 5,500 physicians were displaced
along with all of their patient records. Many of these physicians did
not return to the area. Even physicians with electronic medical records had
backed up their systems within the damaged region and therefore lost
their backups as well as original records (Hurricane Katrina Community
Advisory Group & Kessler, 2007).
Funding at the state level does succeed in providing funds closer to
the disaster impact area because states are theoretically in a better position
to understand their own local and often unique needs. A seemingly
coherent federal response can quickly become fragmented in its implementation.
At the state level, there are wide variations in individual laws
that govern response to emergency situations. Some states utilize broad
definitions of what constitutes an emergency; 41 states specifically describe
what constitutes a disaster, and 38 states identify what constitutes
an emergency (Hodge & Anderson, 2008). Further complicating the situation
is that 27 states and the District of Columbia have definitions for
what are called disasters/emergencies, as well as for public health emergencies
(Hodge & Anderson).
There has been an effort among states to reformulate and redefine
their definition of emergency and related emergency powers to match
the language provided in the Model State Emergency Health Powers Act
(MSEHPA) developed in 2001 by the Centers for Law and the Public’s
Health (Ridenour, Cummings, Sinclair, & Bixler, 2007; Rosenkoetter, Co-