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Moreland Commission

April 18, 2013
 
People who are dependent on mechanical ventilators (breathing machines) for survival are most severely impacted by the prolonged power outages and uncoordinated emergency response. These individuals rely on power for their survival – for their every breath. Despite the unique and pressing needs, this group is among the most underserved and unrecognized.
 
As the Moreland Commission prepares its set of recommendations to Gov. Cuomo's office, we at the Stony Brook University VENTure Think Tank would like to take this opportunity to present recommendations relevant to vent-dependent people. Our recommendations are-as follows:
 
  1. Keep ventilator-users in their homes as a first course of action.
  2. If community evacuation is mandated, assist ventilator-users to stay with friends and family in safe areas.
  3. If community evacuation is mandated, create a system of accessible community-based “safe havens” in local hotels and Red Cross facilities.
 
Recommendation One: Keep ventilator-users in their homes as a first course of action.
 
According to physicians, respiratory therapists, and ventilator users, themselves, the home the safest location for ventilator-dependent people. Everything needed, including medical supplies, durable medical equipment, a bed, and the user's own ventilator are present. In the event of any prolonged power outage, the safety of the home environment can be maintained through access to secondary power supplies (generators, batteries and recharge of batteries).  This can be inexpensively implemented through coordinated efforts of power provider, the American Red Cross, local municipal employees (fire department, police department, EMS), and health care professionals. The goal must be to maintain a power supply needed to run medical equipment, despite the power outage.
 
Strategies to meet this goal depend on the geographic location and demands of the ventilator-user. They include:
  • gas or propane-powered generators to power medical equipment;
  • a coordinated protocol, possibly manned by local emergency responders, to charge and deliver batteries;
  • the development of longer-lasting or solar voltaic batteries;
  • a proactively stocked warehouse of usable batteries and inverters for delivery to ventilator-dependent people;
  • car or taxi service and access fuel to allow transport of nurses and caregivers to the ventilator-user's home when public transportation and gasoline are not available.

 
Recommendation Two: 2.      If community evacuation is mandated, assist ventilator-users to stay with friends and family in safe areas.
While remaining in their own homes is the most desirable option, if there is a community evacuation, ventilator-users can be transported to the homes of family or friends, needed equipment provided, and transportation of nursing staff ensured.
 
Strategies to meet this goal include:
  • accessible transportation from the ventilator-user's home to a safe home of a friend or family member;
  • delivery of a usable hospital bed, lift, and medical equipment; a Medicaid billing code or Red Cross volunteer activity that can fund this protocol.
 
Recommendation Three: 3.    If community evacuation is mandated, create a system of accessible community-based “safe havens” in local hotels and Red Cross facilities.
 
In the event of an impending natural disaster, it is often recommended that people, regardless of their health care needs, seek the safety of shelters. People on ventilators, however, cannot do this, as they are often inaccessible, not equipped for ventilator users' needs, or transport is not possible.  They are told to go to hospitals, an extremely expensive and dangerous alternative.
The cost of a hospital stay in an intensive care unit is more than $15,000 per day. Hotel rooms in a place with a secure secondary power source would be far less expensive and far safer. To implement ventilator-user-equipped safe havens, the following must also be put into place:
  • accessible transportation to the safe havens that allow for a wheelchair to also be transported;
  • local, county-based hotels with secure primary and secondary power sources certified as Red Cross facilities to serve as safe havens;
  • a notification service, possibly via text message, to nursing staff and/or caretakers, who can be kept apprised of the ventilator user's location;
  • a Medicaid billing code to reimburse hotels for the used rooms;
  • provision of medical equipment, batteries, and supplies;
  • a notification system to inform ventilator-users, of locations and how to access them.
 
Implementation of these recommendations will keep people on ventilators safe before, during, and following a natural disaster like Hurricane Sandy. Ventilator-users were not merely experiencing an inconvenience during the power outage; their very survival was at risk. In fact, some lost their lives for this reason. This is preventable.
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