The first and the best answers are prevention and preparation. The consensus of most scientists is that global warming is responsible for much of what the world is experiencing. The release of fluorocarbons into the atmosphere, a byproduct of the combustion of gasoline, is a major culprit. There is proof positive that we have burned a hole in our ozone layer. The systematic cutting of forests reduces their capacity to “scrub” the air and turn noxious carbon dioxide into the oxygen we need to breathe. Obviously, we need to reverse these trends. We need to reduce our use of gasoline and produce renewable energy sources such as wind and solar power. The good news is that increasing numbers of people the world over are committed to “going green.”
What became evident during Hurricane Katrina is that nurses and other personnel employed by home care organizations will play a crucial role in future disaster preparedness. Katrina claimed many lives. It left people in their homes that needed to be rescued, many of whom were disabled and unable to leave home on their own. They often had no access to medication or food, or the money to buy it if it were available. Health problems became exacerbated. Hospitals were filled to capacity. Temporary shelters had to be established in school gymnasiums, National Guard armories, and football stadiums. The need to bring health care and supportive services to those in these make-shift shelters expanded exponentially. Since hospitals and physicians were overwhelmed, it fell on the shoulders of the two million members of the home care community to respond. And respond they did. Home care nurses are trained to provide high-quality care in response to whatever environment the patient calls home. They share the common value of service. They put the needs of the sick, hurting, and infirm even before their own safety. They run in the direction of trouble, not away from it.
While Katrina brought to light the heroic intervention of home care nurses and caregivers, it also revealed a number of impediments which prevented caregivers from responding. For example, home care personnel were not designated as first responders, meaning that they did not have access to the disaster scene. They did not have priority access to needed gasoline, which would allow them to reach the disaster site. They were not included in state emergency communication networks.
Questions also arose related to the reciprocity between states to permit the practice of nursing in a different state (other than the original licensing state) during emergencies. It was unclear whether Medicare would continue to pay a nurse who works for an agency in a state other than where the crisis occurred, or provide health care at a shelter outside of the licensing state. Obviously, federal and state rules need to be waived to allow home care personnel to respond during such crises. Senator Susan Collins (R-ME), the ranking member of the Senate Homeland Security Committee, has introduced legislation which would remove such obstacles and empower home care agencies and their personnel to respond when and where they are needed most. Given her amazing track record for success, the odds are excellent that she will succeed, and that all Americans will be the better for it.
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Val Halamandaris, President of the National Association for Home Care & Hospice (NAHC), has been the driving force behind the association and other home care-focused organizations for more than 40 years. He is also founder and director of The Caring Institute, a non-profit organization that nationally recognizes stellar caring, integrity and public service.
Prior to NAHC Halamandaris was on the House of Representatives Select Committee on Aging, where he was senior counsel and director of oversight. The Honorable Claude Pepper was chairman of the committee. Prior to joining the House Committee staff in 1978, Halamandaris was associate counsel to the US Senate Committee on Aging between 1969 and 1978. From 1962 to1969 he worked with US Senator Frank E. Moss, who was instrumental in the founding of the Senate Aging Committee in 1961.
