Most behavioral health agency executives who witnessed one or more fierce storms during the past two hurricane seasons would agree with the adage, “If you fail to plan, you plan to fail.” But many of those who experienced some of Mother Nature's fury would quickly warn that even the best planners will see that their plans inevitably change.
In military terms, “No plan survives the first shot,” says James Clifford, CFO at Peace River Center in Bartow, Florida, where operations were affected several times during Florida's hurricane ordeal of 2004. “But if you have thought about it, and then things don't go the way you expected, you're far ahead of the people who haven't thought about it at all.”
Lessons in disaster planning and response that were learned across a wide area from Texas to Florida over the past two years hold great importance for behavioral health agencies nationally. The lessons are applicable whether the event confronting the agency is a weather emergency, a man-made threat, or even the untimely death of a beloved staff member. Large-scale events can affect every aspect of an agency's operations. But many agency leaders who have had recent practice in disaster response say an organization accomplishes a lot when it takes care of its people and thereby puts them in a position to do the same for clients.
Even in their inland surroundings east of Tampa, staff members at Peace River Center know to be prepared for what tropical weather might have in store. CEO Mary Lu Kiley explains that disaster-planning efforts have traditionally focused on making the center's network of 19 facilities in three counties self-reliant when trouble occurs.
As a result, all facilities that remain open 24/7 are equipped with water tanks to supply fresh water in emergencies. Each residential facility maintains a disaster kit, with the contents varying by location. All facilities with computer servers have installed lightning protection for their systems. And all of the organization's maintenance trucks carry wet-dry vacuuming equipment and power generators. “If they can get into a facility, they have power to do work,” Clifford says.
Still, unforeseen circumstances require constant communication among members of the center's executive team. “We make decisions as we go along,” Kiley says. For example, when Hurricane Charley in 2004 ripped through one of the center's outpatient clinics in the community of Wauchula, staff members traveled north to Bartow to obtain necessary medications for clients.
Some facility leaders found last year that decision making on the fly became the norm, and that it often took partnerships with other organizations to allow critical functions to resume. Hurricane Katrina caught operators in the south central Mississippi service area of Pine Belt Mental Healthcare Resources largely flat-footed. “We had a plan that worked for minor storms, but it all assumed that we would be able to communicate,” says Jerry Mayo, executive director of the Hattiesburg-based organization. Leaders had expected to communicate with staff through the media and with clients via telephone, but neither of those was operating in the days following Katrina's arrival.
If clients could get to their facility, they would leave notes at the door, and case managers would follow up as soon as they could, Mayo recalls. By 48 hours after Katrina hit, some staff were working at Pine Belt's main location, which stayed open for 4 hours in the middle of the day even though it still had no electricity.
“The number-one priority was to get back in business, to have some visibility in the office as soon as possible,” Mayo says. That is made all the more complicated when a storm of Katrina's magnitude causes severe disruption in staff members’ own lives, and Mayo acknowledges that the response effort got off to a slow start. “There is a day or two of shock, and then it starts happening,” he says.
One effort that allowed normal operations to resume more quickly involved an arrangement between Pine Belt and a local hospital. For group home clients who had to be relocated to a Pine Belt residential facility, the hospital agreed to help fill prescriptions and keep track of medication needs. “We'll figure out how to pay for it when all is said and done,” Mayo says. “In the future we would try to have everything in place in advance.”
Similarly, Spindletop MHMR Services in Beaumont, Texas, realized the benefits of partnerships last year when Hurricane Rita hit—at a time when it was already busy serving Hurricane Katrina evacuees from Louisiana. While some arrangements for clients had been made in advance, such as the transfer of clients from a 16-bed crisis stabilization unit in an evacuated area to a state facility, others had to be negotiated when the need arose. About a dozen key managers were able to negotiate the use of space at another mental health center to establish a central command.
“We took many of our servers, and we were able to set up a system that was active within 24 hours,” says N. Charles Harris, Spindletop's CEO. “This gave us access to important financial data.” In addition, Harris says, the center was able to establish dedicated phone lines through an arrangement with the Texas Council of Community Mental Health Mental Retardation Centers, Inc.