Access Denied - Release of our access and re-entry report

The issue of access and re-entry to disaster sites of critical personnel is a pretty specific issue that most people don’t think about on a daily basis. If there was a “top 10” list of disaster response priorities from citizens, I’m almost positive that this issue would not make the list. Policies that govern how critical private sector functions resume operations after an emergency are really important, but a bit dry. And even though this issue is not as scintillating as other disaster response-related topics, it is an important one that plays a major role in disaster response and community recovery. It is also the most common request for assistance Healthcare Ready receives during a disaster response.

The challenges posed by disjointed policies on access and re-entry can complicate disaster responses by delaying when critical private sector personnel and supplies can enter a disaster area. Though our focus is healthcare operations, this problem also impacts many sectors, such as telecommunications, energy, etc. When private sector personnel cannot enter a community to assess and repair the damage caused by a disaster, operations are not sustainable. As it relates to healthcare operations, both personnel AND health supplies (including medical products) are needed to support healthcare facilities such as hospitals and clinics. Often, the hospitalization rates and number of emergency department visits surge during a disaster – which is not the time to have a major delay in deliveries or shortage of staffing onsite.

In winter and spring 2016, Healthcare Ready decided to take a hard look at the current state of disaster access and re-entry across the United States. We realized that while there are a number of efforts that have been undertaken to address this issue across the country, there was no baseline assessment on the status of access and re-entry programs and policies. In addition, there has been no single resource which identified the states and cities that have an access program, which program they used, or the details of the program. This resource gap has major implications for both private sector companies and emergency management agencies. In the absence of a ‘one stop shopping’ list of access programs and requirements, the private sector must expend significant resources determining and adhering to differing programs and requirements throughout the country. On the public sector side, emergency management agencies may not know of a program in place in a city or state that could work in their jurisdiction, and help to enhance their preparedness and response operations.

In an effort to close this gap, we created a comprehensive review of the issue and the solutions that are being introduced.

We are proud to share the results of this research with the publication of our first report: Access Denied: Delivery of Critical Healthcare Products and Personnel to Disaster Sites. As the first report on this issue of its kind, this report includes a state-by-state guide of the access programs that are available across the United States and key points of contact for those programs, as well as recommendations for states and cities considering implementing a program,.

In our research and drafting of the report, we were able to reach out to many public and private sector experts who work on this issue through surveys, interviews and group meetings. We heard a few general themes, and built on pre-existing work, most of which have been captured in the report.

• It’s difficult to figure out the status of a program in each state.

For the private sector, determining the status of the program and the main POC was often a challenge. There are some states that truly excel at private sector outreach. It was generally recognized that outreach and communication on the status of programs was truly a full time job and not for the faint at heart. State emergency managers also expressed frustration that there was a lack of visibility about the programs that were in development in neighboring states.

• Running programs can be costly. Streamlined solutions (at the state-level) are preferred.

The operation of an access program requires dedicated staff and resources to make it work. Staff turnover and budgetary priorities often make it difficult for emergency management agencies to find the funds to sustain a program. Due to this and other reasons, outsourcing the program to a third party (like CEAS or ER-ITN) can be an attractive option for the public sector, but can be a turnoff for the private sector as there is a fee associated with registration in the program.

• Coordination with law enforcement is vital to the success of a program (at the roadblock).

All experts agreed that the key to making the program impactful was better coordination with law enforcement. If the officers who are managing roadblocks are not aware of the access programs in place, and do not recognize the badges or credentials that parties will use to gain access, the program will not be a success.

There are a number of recommendations in the report for jurisdictions looking to create or improve their access and re-entry programs. We hope that this report will serve as a great resource as we all work on this issue. While we recognize that this baseline assessment is just a start, it does provide a status check on the current programs (and a few programs that are in development). We look forward to working on this issue with our public and private sector partners in the future. There is still a lot of work left to do, and we are hopeful that this report will jump start the conversation on the issue.