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How public health and law enforcement agencies work together

Dr Joseph Costa, D. H. Sc., PA-C

Health Policy and Management

MPH 525

Dr Adeniyi Mofoluwake Adijolola

June 2013

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Table of contents

Chapter Page

1. Introduction………………………………………………………………………… 4

2. Collaboration between Public Health and Law Enforcement Agencies……………. 5

Agencies formed by the collaboration of public health and law enforcement agencies... 5

The National Disaster Medical System…………………………………………. 5

The Disaster Medical Assistance Teams………………………………………... 5

Urban Search and Rescue Task Forces………………………………………….. 5

Mobile Emergency Response Support ….………………………………………. 6

Specific collaboration that occurred between different public health and law enforcement agencies in response to …………………………………………………... 6

How volunteer agencies helped and hindered the collaboration…………………………… 7

How to make improvements in the event of a recurrence in the future…………….………. 8

What went wrong with the Disaster Management of Hurricane Katrina…………….…….. 9

What went well with the Disaster Management of Hurricane Katrina……………….…… 10

How public health agencies function and the manner in which they functioned…….…… 10

The role of local, state and federal government in response to Hurricane Katrina…….….. 10

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3. Federal policy regarding disaster management and public health ………………….. 12

Summary……………………………………………………….……………………………. 14

Recommendation……………………………………………………….…………………… 14

References ………………………………………………………………..…………………. 15

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Chapter 1

Introduction

During a vacationed in the United States in October 2005 shortly after Hurricane Katrina before then; I had been in touch with my friend and classmate who left Nigeria after our compulsory one year internship to seek greener pastures in the US. I informed her of my intention to spend part of my annual leave in the US and she promised to host me. On my arrival, she was not available to attend to me. I couldn’t even reach her but her sister informed me that she had travelled to volunteer help to the victims of hurricane Katrina. While in Nigeria, I was aware of the disaster that occurred in the US but did not have an idea how bad it was. I did think it was noble of her to offer her medical skills, knowledge and experience to help to the victims of

Hurricane Katrina. While vacationing I watched the television more and I had an idea how bad it was. I watched the aftermath of the hurricane and its devastation daily, those scenes are still this deeply seated in my memory. Then I understood my friend’s desire to help, no one who could help these victims would have held back.

I have chosen to write up on how public health and law enforcement agencies worked together during Hurricane Katrina because; I want to learn more about emergency preparedness and response to natural disasters as it is certain that natural disasters of this form can still occur all over the world (Teitelbaum & Wilensky, 2013). For instance, natural disasters that have resulted in flooding have occurred after Hurricane Katrina in some parts of the world and some may still occur in the future. In the United States, Hurricane Sandy occurred in year 2012 and in Nigeria flooding occurred in 2011 and 2012. Hurricanes are natural disasters that threaten the health of the public by affecting large populations and leading to morbidity and mortality (Teitelbaum & Wilensky, 2013). A hurricane can also be defined as a tropical storm with winds reaching a constant speed of 74mph or more. It might bring high winds, torrential rains and storm surges as it lands. These storm surges and torrential rains lead to flooding (Hurricane.com, 1994 - 2013). Hurricane Katrina occurred on the 29th of august 2005. It was previously a category five storm when it moved close to ; it became a category three storm (Hurricane.com, 1994 - 2013). It landed on the United 5

States gulf coast and it reached , Florida, Alabama and (Teitelbaum & Wilensky, 2013).

Hurricane Katrina was the worst and one of the deadliest, costliest and most destructive natural disasters in US history. It caused death amongst humans and animals, flooding, damaged properties, disrupted communications, resulted in shortage of essential services (electricity, portable water, food, fuel), damaged healthcare and public health system (CDC, 2005). An estimated 1,833 persons were killed and property destroyed was estimated at $81 billion in Louisiana, Florida, Texas, New Orleans, and Mississippi (Knabb, Rhome & Brown, 2005; Swenson & Marshall, 2005).

Chapter 2

Collaboration between Public Health and Law Enforcement Agencies It is essential for public health and law enforcement agencies to collaborate in the management of natural disasters. This collaboration is essential to planning and response because a lot of public health preparedness plans include law enforcement (Bowen W., 2013). Several public health and law enforcement agencies collaborated to support the public health and medical-care functions and execute emergency management in response to the devastation of Hurricane Katrina (CDC, 2005). According to the Centers for Diseases Control and Prevention (2005); “the CDC/ATSDR (Agency for Toxic Substance and Disease Registry) collaborated and deployed 182 members of the United States Public Health Service Commissioned Corps, CDC Epidemic Intelligence Service officers and federal civilian personnel to provide technical support and additional personnel for critical public health functions (e.g., public health needs assessment; disease surveillance; laboratory support; prevention and control of infectious diseases, including food borne, waterborne, and vector borne diseases; mental health services; sanitation and water quality; chemical-exposure management; and injury prevention and control)”. The United States Department of Health and Human Services aims at ensuring that all the four phases of emergency management – preparedness, response, recovery, and mitigation are managed (DHS, 2006). As a result, the US Department of Homeland Security on the 1st of March 2003, created the Federal Emergency Management Agency (FEMA) to support US citizens and first responders in working together to build, sustain and improve United States’ our capability to prepare for, protect against, respond to, recover from and mitigate hazards (FEMA, 2013).

Agencies formed by the collaboration of public health and law enforcement agencies The National Disaster Medical System (NDMS); it was transferred from the Department of Homeland Security to the Department of Health and Human Services. The NDMS team consists of doctors, nurses, pharmacists, etc. that provide medical and allied care to victims of disaster. The NDMS team is sponsored by hospitals, public safety agencies or private 6 organizations. It is assisted by the Rapid Deployment Force (RDF) team which composes of officers of the Commissioned Corps of the United States Public Health Service (US DHHS, 2013).

The Disaster Medical Assistance Teams (DMAT); it is made up of doctors and paramedics that provide medical care at disasters. They also include National Nursing Response Teams (NNRT), National Pharmacy Response Teams (NPRT), Veterinary Medical Assistance Teams (VMAT), Disaster Mortuary Operational Response Teams (DMORT) (which provide mortuary and forensic services) and National Medical Response Teams (NMRT) (which decontaminates victims of chemical and biological agents) (USDHHS, 2013).

Urban Search and Rescue Task Forces (US&RTF); it specializes in urban search and rescue, disaster recovery and emergency triage by searching to find trapped victims after disasters, rescuing (at times by safely digging victims out of tons of collapsed concrete and metal), making rescues safe for rescuers and caring for victims before and after a rescue (FEMA, 2012).

Mobile Emergency Response Support (MERS); it provides communications support to local public safety teams by operating trucks with satellite uplink, computers, telephone and power generation at staging areas near disasters so that responders can communicate with the outside world; erecting portable cell phone towers to allow responders access telephone systems and airlifting of assets of Mobile Air Transportable Telecommunications System (MATTS) (US DHHS, 2013).

Specific collaboration that occurred between different public health and law enforcement agencies in response to Hurricane Katrina The Department of Veterans affairs evacuated its local hospitals. The Department of Defense set up field hospitals at the New Orleans International Airport and abroad naval vessels (Teitelbaum & Wilensky, 2013). FEMA responded to the emergency with the use of the small, decentralized teams formed by the collaboration of public health and law enforcement agencies. They include; Disaster Medical Assistance Team, Urban Search and Rescue Task Force, National Disaster Medical System, Disaster Mortuary Operations Response Team, Disaster Medical Assistance Team and Mobile Emergency Resource Support (DHS, 2006). Eleven Disaster Mortuary Operational Response Teams with two Disaster Portable Mortuary Units were deployed to assist in identification and body recovery operations (DHS, 2006). FEMA activated the National Response Coordination Center (NRCC) in Washington, DC and the Regional Response Coordination Centers (RRCC) in Atlanta, Georgia, and Denton, Texas before the storm shifted. They tracked the storm and prepared to coordinate the response (DHS, 2006). In Alabama, Mississippi and Louisiana Emergency Operations Centers (EOC) were activated to prepare for a second landfall. All the 15 Emergency Support Functions (ESF) were activated by the NRCC, RRCCs, and the state’s EOCs as well as the Defense Coordinating Officer (a military liaison) as specified in the National Response Plan (NRP) (DHS, 2006).

Both FEMA’s National and Advanced Emergency Response Teams (ERT), Multiple Response Teams, Mobile Emergency Operations Vehicles (MEOV), Mobile Emergency 7

Response Support (MERS) and National Disaster Medical System (NDMS) teams personnel were deployed and pre-positioned to the affected and forecasted affected areas to help states position commodities and personnel in safe response areas as soon as storm conditions subsided and it was considered safe for responders to go into the affected area, provide communications equipment and other support in response to the emergency (DHS, 2006). FEMA activated federal operational stage areas and mobilization centers to accept commodity delivery and dispense these commodities (ice, water, meals ready-to-eat (MREs), to local points of distribution within affected areas, staging areas in all affected states and the Meridian Naval Air Station in Mississippi; Maxwell Air Force Base and Craig Field in Alabama; Camp Beauregard, Barksdale Air Force Base and the New Orleans Superdome in Louisiana and additional commodities were ordered for daily delivery (DHS, 2006). As the conditions permitted, life sustaining and life saving efforts continued, Rapid Needs Assessment teams assessed damages in affected areas, conducted initial assessment of damages and got emergency management response personnel into these areas despite the destruction to roads and bridges in these areas that made air and water the only available means of accessing stranded victims (DHS, 2006). The destruction of the communications infrastructure made it difficult for emergency responders to get on top of the situation and communicate to state or federal Personnel outside affected areas but; FEMA’s national US&R task forces, the U.S. Coast Guard, National Guard troops, active duty federal troops and state and local first responders performed search and rescue missions actively rescuing over 50,000 victims.

The U.S. Coast Guard personnel conducted over thirty thousand rescues. Over eighty teams were activated and deployed by the National Disaster Medical System (NDMS) to support response efforts. Medical Needs Assessment Teams which comprised of more than fifty Disaster Medical Assistance Teams were deployed by FEMA regions IV and VI to assess medical needs in affected areas (DHS, 2006). 3 National Medical Response Teams, 5 Veterinary Medical Assistance Teams and 3 International Medical Surgical Response Teams were activated to work with 4 Management Support Teams to provide logistical, managerial and operational support for NDMS teams in affected area. The NDMS also supported search and rescue operations by evacuating over two thousand five hundred people with special needs (DHS, 2006). Joint integrated operations were established by FEMA’s Federal Coordinating Officer (FCO) and Mississippi’s State Coordinating Officer. FEMA, state and local emergency management responders worked together addressing matters that arose (DHS, 2006). All of these agencies developed and coordinated emergency routes from the hurricane sites to the nearest hospitals.

How volunteer agencies helped and hindered the collaboration During this devastating incident, volunteer agencies provided the greatly needed manpower which was able to save lives, augment emergency staff and allow emergency responders concentrate on advanced and or specialized skills while the volunteers addressed basic task (Fernandez, Barbera, & Van Dorp, 2006). Several volunteer agencies like the American Red Cross, Feeding America previously known as America's Second Harvest, , Southern Baptist Convention, Salvation Army, Oxfam, Common Ground Collective, Burners Without Borders, , , Catholic Charities and others all 8 helped the nation provide for victims during the Hurricane Katrina disaster (Jones, 2006; Newsroom, 2005). A large percentage of these volunteers were unpaid (ARC, c 2013). These volunteer agencies raised US$4.25 billion from the public to manage this disaster over half of which was raised by Red Cross (ARC, c 2013). Volunteer agencies provided privately chartered planes to evacuate patients from Charity Hospital in New Orleans, communication in areas with damaged or destroyed communications infrastructure and used their network of amateur ham- radio operators to help locate survivors (Palm R., 2005). They manned several feeding units, shower and laundry facilities; assessed teams; mucked out homes; removed debris from affected areas and sent volunteer laborers to clean and rebuild affected homes; provided medical treatment, shelters, kitchens, water, snacks and food, comfort kits (toothpaste, soap, washcloths and toys for children), cleanup kits (brooms, mops and bleach) for victims; vaccinated rescue workers at risk of tetanus due to the unsanitary conditions with tetanus toxoid and registered acted as a hub for medical and health providers, aid workers, community organizers, legal representatives and people with a variety of skills (ARC, c 2013; Newsroom, 2005). Volunteer endowment agencies raised funds to rebuild schools in affected area and help schools suffering from an onslaught of refugees. The American Red Cross provided emergency financial assistance to 1.4 million families (ARC, c 2013) and the Salvation Army provided more than $365 million to serve more than 1.7 million people in nearly every state (The Salvation Army, 2006). Volunteer teams provided Emergency Response Vehicles which was used to provide food, clothing and water to victims, (ARC, c 2013). Pastoral and care counselors of volunteer agencies helped comfort the emotional and spiritual needs of Hurricane Katrina victims (Volunteer ministers, 2013). They published a donors' guide for individuals and organizations looking for philanthropic options for Gulf Coast recovery (PNY, c 2008- 2012). Though these volunteer agencies were essential resources during the management of Hurricane Katrina disaster because of the vacuum in authority, they focused on addressing the largest demands during the incidents and this ineffective use hindered emergency activities by creating health, safety and security problems as well as distracting responders from their duties (Fernandez, Barbera & Van Dorp, 2006). This resulted in morbidity and mortality of victims, volunteers and emergency responders; damage to properties; reduction in volunteer’s ability to cope; poor perception of emergency responders by the public and disruption in actions of untrained and uncoordinated volunteers leading to a decrease in response effectiveness and resources available to victims (Fernandez, Barbera & Van Dorp, 2006).

How to make improvements in the event of a recurrence in the future To ensure improvements in management of natural disasters in form of hurricanes and storms in the future, it is essential to create an effective and efficient disaster volunteer management system whose scope is above that of individual organizations keeping in mind the benefits, risks and challenges associated with previous volunteer response and volunteers should be encouraged to participate in this model in order to ensure a safe, effective and efficient response (Fernandez, Barbera & Van Dorp, 2006). DHS headquarters and FEMA need to establish a defined use for multiagency coordination entities that expedites the resolution of issues, facilitate incident management, coordinate policy, is more amenable to collaborative activities and provides strategic guidance and direction to support incident management activities at the most appropriate operation level (Morris J. C., 2005). These measures will help to avoid the unnecessary and time consuming coordination that was present in the response to the disaster 9 caused by Hurricane Katrina (DHS, 2006). There is also a need for Public Health to use its core functions to assist other health care organizations address workforce issues which includes; educating the public in order to improve the public’s awareness of issues with sheltering in disasters, developing systems that will match the volunteer personnel resources with identified needs better. Educating the public on the individual’s roles and responsibilities in emergency response is also essential. Strengthening partnerships, improving planning among the partners will lead to the more effective use of volunteers (Ringel, Chandra, Leuschner, Lim, Lurie, Ricci, Schaefer, Shea, Shugarman & Wasserman, 2007)

What went wrong with the Disaster Management of Hurricane Katrina and why? There was a major deficiency in planning, response and recovery in the emergency management of Hurricane Katrina’s disaster. This resulted in an ineffective response, an inability to anticipate and address potential shortcomings through adequate contingency planning, reasonableness of field request, lack of supplier inventories and transportation resources (DHS, 2006). The delay in response to New Orleans’ flooding and failure to implement New Orleans’ evacuation plan resulted in ordering victims to last resort shelters without any provisions for food, water, security, or sanitary conditions. Shelters were in a state of chaos. The New Orleans Superdome “the shelter of last resort” handled 30,000 persons though it was designed to handle 800 persons and the New Orleans Civic Center sheltered 25,000 persons though it was not designed as an evacuation center. There were reports of rape, murder, gang violence, suicide and beating among the evacuees (Thevenot & Russell, 2005). The emergency response and recovery plan also failed to plan to assist people with functional needs. Of the 1800 people who died as a result of this disaster, majority were elderly and people with disabilities (Dawalt R.P., 2011). The Joint Field Office staff and other deployed Federal personnel lacked a working knowledge of the National Incident Management System and a basic understanding of Incident Command System principles (Tuohy, R., Donahue, A., c 2006). According to the congress; FEMA and the Red Cross "did not have a logistics capacity sophisticated enough to fully support the massive number of Gulf coast victims" (DHS, 2006), it lacked an asset visibility program which made it difficult for FEMA personnel, state and local responders to know the type and quantity of commodities that were expecting not to talk of when the resources would arrive. It took time to establish an operational delivery system to supply adequate quantities of commodities to support victims in the beginning. Efforts were duplicated because of the lack of proper coordination between the multiple agencies (NRCC, RRCC & ERT) during the Hurricane Katrina response. These agencies had to hold multiple conference calls to resolve these issues (DHS, 2006). Though political leaders appeared to be anxious and frustrated on national television as residents continued to be stranded by the flood; remained without food, water or shelter and died from exhaustion and violence; there were allegations that the delay in government’s response was due to class, race and other factors (De Moraes, L., 2005).

Though, mandatory evacuation orders were issued for the Mississippi Gulf Coast, coastal Louisiana and the city of New Orleans. The mayor of New Orleans, Ray Nagin, hesitated for several hours before issuing the evacuation order and after being issued, it was haphazardly implemented (Morris J. C., 2005). When FEMA officials in Washington were informed of the aftermath of the flooding caused by the storm in New Orleans by a subordinate at the New 10

Orleans Superdome, they did not act. Instead, they tried to confirm the report of the flooding with the Army Corps of Engineers, who were not in contact with their team in New Orleans and as a result, responded they were not aware of any report of flooding. This resulted in a delay for several hours allowing large portions of the city to be flooded (Morris J. C., 2005). Problems arose with the management, supply and distribution of pharmaceuticals and medical equipments needed by health care providers in provision of medical care to hurricane victims and evacuees. Despite delivering supplies to affected areas, effective manner of inventory and efficient and equitable allocation methods were absent. Medications and medical equipments specific for persons with special needs and chronic conditions were not supplied (Ringel et al, 2007). Public and Private Organizations’ efforts were not coordinated. The available Strategic National Stockplie (SNS) did not match the necessary needs because it was configured for responses to bioterrorist attack and Public health agencies to reimburse private-sector companies on time (Ringel S. et al, 2007).

What went well with the Disaster Management of Hurricane Katrina A pre-existing relationship existed between the federal, state and local agencies during the preparedness in response to Hurricane Dennis. This played out as an advantage during the response to Hurricane Katrina by facilitating the integration of Hurricane Katrina’s response personnel (DHS, 2006). It also enhanced the establishment of joint integrated operations between FEMA’s Federal Coordinating Officer (FCO) and Mississippi’s State Coordinating Officer as well as local and state counterparts in FEMA (DHS, 2006). Despite the destruction of the communications infrastructure, FEMA was able to deploy a MERS detachment containing satellite equipment and link to the Gulfport area to establish communications and provide Support (DHS, 2006). Some government agencies were actively surveying the damage from the storm as soon as the weather permitted flights using the Coast Guard’s launch of several helicopters from its air station at Mobile, Ala to commence search and rescue operations in the city. This enabled an availability of reports of detailed devastation along the Mississippi coast and New Orleans. After a while, military helicopters, private boats and Louisiana Fish and Wildlife Service boats joined in the rescue efforts (Morris J. C., 2005).

How public health agencies functioned and the manner in which they functioned Public health agencies responded to Hurricane Katrina using the three core functions of public health. It assessed the situation by addressing the health issues in the population following Hurricane Katrina’s devastation. Using the function of assurance, it put in place necessary actions to meet the community’s health needs by provision of medical services to disaster victims through volunteers and public health agencies. Through policy development, it advocated for the use of evidence based research in the implementation of public policy that promotes the public’s health (Ringel et al, 2007). They coordinated the medical workforce, medical supplies and equipment, ensured communication amongst each other, cared for special needs populations, monitored for infectious diseases and provided healthcare personnel who volunteered their time and efforts attending to victims of Hurricane Katrina (Ringel et al, 2007). Though the public health agencies responded to the disaster on time; they did not coordinate volunteers properly, did not match their skills with the identified needs, assign them to where these skills will meet the victim’s needs and it could not link persons with special needs to 11 needed services. There was no method agreed upon for the verification of credentials and skills of the health care professionals that volunteered (Ringel et al, 2007).

The role of local, state and federal government in response to Hurricane Katrina. The local government was the primary provider of emergency response to the disaster; it activated the Emergency Operations Center and notified the state emergency management agency government because it was not financially empowered to control the devastating effects of the hurricane. The state government monitored the situation, evaluated local response efforts, determined the situation was beyond the state’s capability, alerted the federal government and requested for its’ assistance (Senate committee on homeland security and governmental affairs, 2006). Both the federal and state government declared a state of emergency which authorized FEMA to organize and mobilize resources to help the victims of Hurricane Katrina. The federal government assisted the state and local government as designated by the National Response Plan (NRP) coordinated by federal agencies like; the Department of Homeland Security which is responsible for Emergency Support Function (ESF) and the Department of Health and Human Services which is responsible for coordinating public health and medical services (Lister A. S., 2005). The DHHS requested support from designated support agencies and the American Red Cross to coordinate its functions. During this disaster, the DHHS assessed public health and medical needs, provided medical care personnel, supplied health and medical equipments, cared for patients, ensured health, safety and security of humans, drugs, medical devices, veterinary drugs and agricultural products. It also took the responsibility for public health and medical information, vector control, potable water, wastewater and solid waste disposal, victim identification and mortuary services (Lister A. S., 2005).

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Chapter 3

Federal Policy Regarding Disaster Management and Public Health A federal policy regarding disaster management and public health titled, the “Post-Katrina Emergency Management Reform Act of 2006” and later renamed the Post-Katrina Act was passed on the 31st of March, 2007 to consolidate emergency management and ensure proper disaster management (Bea K., 2006). The Post-Katrina Act set out a new law, amended the Homeland Security Act (HSA) and modified the Robert T. Stafford Disaster Relief and Emergency Assistance Act (the Stafford Act) (Bea K., 2006). It also created new leadership positions and position requirements within the Federal Emergency Management Agency (FEMA), brought with it new missions, restored some previous missions and strengthened the authority of FEMA (Bea K., 2006). It adds the functions of the existing FEMA (alerting emergency systems, continuing operations and government activities) with those of the Preparedness Directorate. It created a National Integration Center (NIC) to maintain the National Incident Management System (NIMS) with the assistance of Corporation for National and Community Service, coordinate volunteer activities and deploy first responders to disaster sites (Bea K., 2006). It also created a National Infrastructure Simulation and Analysis Center (NISAC) to support disaster activities and establish a relationship with federal entities with critical infrastructure responsibilities under Homeland Security Presidential Directive 7; a National Operations Center (NOC); an office for a Chief Medical Officer (CMO) who will plan for medical issues related to any kind of disaster; a National Response Plan (NRP) to manage incidents; a Disability Coordinator to assesses coordination of “emergency management policies and practices with the needs of individuals with disabilities like training, accessibility of entry, transportation, media outreach, and general coordination and dissemination of model best practices” (Bea K., 2006). It also establishes a Remedial Action Management Program (RAMP) through the collaboration of the National Council on Disability and the National Advisory Council to analyzes programs and develop guidelines to accommodate individuals with disabilities in emergency response facilities and designated a Small State and Rural Advocate and a National Advisory Council (Bea K., 2006).

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It established an administrator for FEMA and enabled him to provide recommendations related to emergency-management directly to Congress after informing the Secretary; develop a logistics system that enables officials to track goods and services from FEMA to the affected state; establish equipment program pre-positioned in at least eleven locations to support state, local, and tribal government disaster assistance operations and disclose information to law enforcement agencies in a manner consistent with Privacy Act requirements on individuals sheltered or evacuated (Bea K., 2006). FEMA’s Administrator will formally agree with non- federal officials on standards of appointing personnel with regards to their credentials and the type of resources needed during disaster response and collaborate with federal and non- government players to develop a “recovery strategy” which will summarize existing programs, assess their use in the environment after disasters, discuss funding and determine the best strategies that will meet disaster requirements (Bea K., 2006). He/ she will also develop a “housing Strategy” which will compile housing resources available for victims of disaster from government and non government entities, advocate for the disabled and their housing needs, allocate them as the need arises and establish Hurricane Katrina and Rita recovery offices in Mississippi, Louisiana, Alabama, and Texas (Bea K., 2006). The Post Katrina Act, afforded FEMA the responsibility of leading and integrating the United States’ efforts and responsibilities (including protection) for all hazards and catastrophic incidents, partnering with non-federal entities to create a national emergency management system and developing response capabilities for the federal government (Bea K., 2006). It created ten regional offices and appointed regional administrators to attend to regional priorities like developing regional capabilities for a “national catastrophic response system,” (e.g. Regional Advisory Councils, Regional Office Strike Teams and Regional Emergency Communications Coordination Working Groups) and developed a regional Response Coordination Center (Bea K., 2006). It re-authorized the ERT, US&R teams, Metropolitan Medical Response Grant Program and authorized them to be funded. It is able to reunite families after a disaster. FEMA will collaborate with the Department of Justice, the National Center for Missing and Exploited Children, the Department of Health and Human Services and the American Red Cross to establish the National Emergency Family Registry, the locator system and the child locator center (Bea K., 2006).

The opinion of this writer is that, the Post Katrina Act is concise. It addresses all the flaws of the evacuees, victims, government and volunteers in the response to Hurricane Katrina even to an extent that it makes provision for privacy in information disclosure to law enforcement agencies on individuals sheltered or evacuated. It provides funding for all the activities stipulated in the act. But then, the economic burden of natural disasters are huge therefore, these policies should put in place preventive modalities in areas that are threatened and modalities to decrease the economic burden of disasters that cannot be prevented. There is also a need for policies to enforce existing flood insurance requirements that are applicable to individuals who live in high risk areas or create it if it does not exist and develop cost-effective proposals to enforce requirements for mandatory flood insurance so as to decrease the need for disaster assistance (FEMA, 2003). The congress should collaborate with the agency responsible for execution of the policy to ensure that mandatory purchase of flood insurance is not waived for any purpose and explore incentives to expand coverage. The policy should include a competitive prioritized grant award based on performance measures to be given to reward and encourage states that prepare 14

for these disasters best (FEMA, 2003). This will enhance preparedness in the event of a disaster, policy adherence and reduce the need for government funding in the event of a disaster and non- governmental organizations raising funds.

Individuals and communities had challenges with legal authority, control of resources and jurisdiction over populations. This was because legal authorities in some states did not have a hurricane disaster management plan (they had neither practiced nor trained in managing disasters and had to improvise to respond to the public’s safety and health problems) and states that had were affected by communications outages and fuel shortages. Communities made control and command difficult for law enforcement agencies they had to put aside their egos and worked with non- law enforcement agency to coordinate their efforts (Smith & Rojek 2006). They controlled looting, arrested some looters and chased some away. To prevent people from running over themselves out of desperation, they had to provide security at distribution points. As their tasks increased, they ran out of personnel. As the individuals in the community’ returned to their homes the need for legal authority increased because some of them dealt with their loss drinking alcohol and abusing substances. The police arrested more people for drug possession and driving under the influence. The individuals called the police more to offer services on domestic violence and neighborhood conflicts as well as agencies to provide transport for people leaving the hospital and to counsel kids whose parents found it difficult to control them (Smith & Rojek, 2006). Current disaster management policies are not sufficient to meet the needs of communities in the event of another disaster. These policies will not be sufficient until a mandatory flood insurance coverage is enacted.

Summary This paper describes how the United States’ public health and law enforcement agencies collaborated and responded to the disaster caused by Hurricane Katrina. It tells of how volunteer agencies helped and hindered the collaborative efforts and how improvements can be made in the event of a recurrence in the future. Things that went well during these times and things that went wrong. Why things went wrong? How public health agencies functioned during these times and the manner in which they responded. It also tells of the role played by the local, state and federal government. A federal policy regarding disaster management, The Post Katrina Act was discussed in detail as well as the writer’s opinion of needs to be changed in regard to the policy. The challenges individuals and communities had with legal authority, control of resources and jurisdiction over population was highlighted. The writer concluded that current disaster management policies are insufficient in meeting the community’s needs in the event of another disaster.

Recommendation This writer recommends that The Post Katrina Act and all it represents should be enforced. In areas prone to natural disasters that will result in flood in the United States, a mandatory flood insurance policy should be passed. The congress should also ensure that it is not waived for any sort of reason. At all levels of government there should be an emergency preparedness team that 15 is trained always ready to respond if there is a need to manage disasters. Everyone should have a basic knowledge of disaster response. This knowledge can be used for themselves and not other members of the public in certain situations. In schools, churches and other religious institutions basic life saving skills should be taught. The law enforcement workforce and those in training to commence working as law enforcers, public health workforce and public health students should be trained in emergency response and preparedness. This should be mandatorily included in their courses to ensure background knowledge of response to emergencies.

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