By Marsha Shuler
The Advocate
Copyright 2007 Capital City Press
All Rights Reserved
WASHINGTON — Though more than two years has passed since Hurricane Katrina, arguments continue over the state’s policy governing the care of nursing home residents in hurricane and other disaster situations.
“This has not moved forward as fast as we wanted. There’s no easy answer to it,” Senate Health and Welfare Committee chairman Joe McPherson said Monday.
The state is still operating under emergency rules for nursing home requirements developed in the wake of the August 2005 hurricane.
Senate and House health committees met jointly Monday as the state Department of Health and Hospitals moved to extend “emergency” rules requiring nursing homes to submit plans to both evacuate and “shelter in place” their elderly and disabled residents.
DHH is finishing the permanent rules to cover disaster situations, said Jimmy Guidry, DHH’s medical director.
McPherson, a nursing home owner, said the state needs to spell out more clearly when nursing homes can let their residents stay in place when an emergency situation looms.
“There’s still a lot of confusion whether you shelter in place or evacuate,” McPherson said.
Proposed rules will set out building code and other standards that would allow “sheltering in place” during an otherwise mandatory evacuation, Guidry said.
Voluntary evacuations are just that - decisions left up to nursing home operators, Guidry said. Mandatory is mandatory unless nursing homes can meet certain standards required to win approval of emergency preparedness officials, he said.
Nursing homes “would be spending more money” to meet those building standards, but evacuations would still occur “because nobody is willing to take the hit of ‘Why didn’t you evacuate?’ ” McPherson said.
Some of the requirements of the emergency rules came under attack by the Louisiana Nursing Home Association.
Association lobbyist Joe Donchess said nursing homes don’t want to see some of the standards carried over into permanent rules as they are written today.
Donchess said the rule requiring nursing homes to have generator capacity to run air conditioning and sewage system is too costly and unnecessary. The time nursing home evacuees can stay in unlicensed sheltering sites is also too short, he said.
Meanwhile, DHH’s Guidry said transportation of the fragile nursing home residents remains a concern. “We are ahead of where we were before Katrina,” he said.
But Guidry said every new school bus in Louisiana should be air conditioned, then “we will have the assets at the local level that can be used to save patients.”
Many nursing homes have contracts with the same ambulance companies, Guidry said. He said the ambulances will in future major disasters have to shuttle patients to staging areas to get them out of harm’s way so more people can be moved.