​The rains have finally ended, but the challenges facing Houston-area hospitals in the wake of Hurricane Harvey are just beginning. More than 20 healthcare facilities, nursing homes, and assisted living facilities in the Houston area were evacuated, according to an August 30, 2017, article on CNBC. Dozens more announced that they were on “internal disaster status," but still caring for patients, Darrell Pile, chief executive officer of the advisory council that has been coordinating disaster response, said in the article. Some facilities might not be fully functional for a month, according to an August 30, 2017, STAT article. Lessons learned from past hurricanes and implementation of emergency management plans were credited with helping to mitigate the damage (see HRC Alerts, August 30, 2017: How Did Houston Hospitals Handle Hurricane Harvey?). One hospital remained open and dry thanks to a $50 million network of floodgates built around the facility after tropical storm Allison hit in 2001, according to an August 29, 2017, article on PBS.org. Damage from Allison cost that particular facility $2 billion, the article said. But even the best laid plans were occasionally foiled by the storm. Harvey “challenged every plan we've written, every resource, every piece of inventory," Pile said in an August 30, 2017, article in the Washington Post. Another hospital described in the Post article consulted their disaster plan when a nearby levee was an inch away from its capacity and then called for evacuation. A large cancer center in Houston was forced to cancel its outpatient procedures, but remained open for more than 500 inpatients and their families, according to an August 31, 2017, article on NPR.org. The article includes an interview with a doctor who walked eight blocks through flooded streets to meet a box truck that drove her to the hospital for work the Sunday after the storm. “The unsung heroes in this disaster are our nurses, our lab techs, our pharmacy techs, our food services, our security" who kept everyone safe, she said. As the waters finally begin to recede, healthcare providers are facing new challenges. People are showing up at shelters with health issues caused by the flood, such as stomach and respiratory problems, as well as preexisting conditions that need immediate treatment, according to an August 29, 2017, article on NPR.org. Additionally, the article notes, people will face a host of flood-related mental health challenges, including posttraumatic stress disorder. One of the most pressing needs, the article says, will be treating the sizable number of people who need dialysis. About a third of the city's dialysis centers are still open, according to the NPR article, and providers are attempting to proactively call patients who need treatment and arrange transportation, even if that means sending in boats. Hospitals in nearby areas, including Tennessee and others in Alabama, were preparing to take on patients who had been evacuated from Texas. The U.S. Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response created a page with Hurricane Harvey materials, including updated information as well as disaster-specific resources for professionals.

HRC recommends: Regardless of the area of the country where a healthcare facility is located, facilities must have robust plans in place for weather-related and other natural disasters. Planning, training, and providing resources for disaster management are critical to a healthcare facility's preparedness, response, and recovery efforts. Risk managers should remain aware of what resources and assets are available to them, including resources from federal, state, and local governments.