Inside HRSA - January 2008
 
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From the Gulf Coast: Signs of Improvement In a Sea of Challenges

August 2007 marked the second anniversary of the landfall of Hurricane Katrina, the costliest natural disaster to have ever hit the United States. The scope of the damage was without parallel in modern U.S. history, and two years after the waters finally receded, huge challenges remain.

It has been estimated that almost 450,000 individuals in both Louisiana and Mississippi were displaced by the storm, including an estimated 160,000 children. In New Orleans, efforts continue to rebuild and fortify levees and flood walls against new storms, while Biloxi residents work to rebuild housing for the thousands who continue to live in trailers.

Health care in the region took a heavy blow, too. Before the storm, 1.8 million Louisianans lived in areas defined by HRSA as Health Professional Shortage Areas (HPSAs).

By June 2007, that number had swollen to 2.8 million as many doctors left the area. The number of people living in areas short of dental and mental health care providers climbed as well.

  

Joe M. Dawsey, executive director of Coastal Family Health, cuts the ribbon opening their new clinic in Biloxi with Board President Martha Milner.
Joe M. Dawsey, executive director of Coastal Family Health, cuts the ribbon opening their new clinic in Biloxi with Board President Martha Milner.

But against these grim statistics, there is reason for optimism. Two HRSA grantees among the hardest hit in the region have made strides toward restoring operations, and have made the difficult task of rebuilding better by finding positives along the way.

Coastal Family Health Center

In Mississippi, Coastal Family Health Center lost four out of nine clinic sites, with the remaining five sustaining severe damage.

According to Joe Dawsey, Coastal’s executive director, challenges since the storms have included finding contractors, dealing with the expense of rebuilding, and locating and maintaining staff, who themselves have trouble finding adequate housing.

“There are very few fish in a very large pond and I am fishing without bait,” Dawsey said of his efforts to hire experienced staff. “Nurses are almost impossible to hire and retain.”

HIV/AIDS care has also presented challenges due to migration of people out of, then back into, the area. Dawsey said that Coastal has accounted for about 70 percent of their pre-Katrina AIDS patients and is doing outreach to find the others.

But it hasn’t all been bad. Dawsey said the help Coastal received from across the country gave him the opportunity to work “with some of the most compassionate, caring people in the world. Without the help of the volunteers and other Community Health Centers, we would not be open.”

Dawsey and Coastal marked a milestone Dec. 13 with an Open House to celebrate the reconstruction and opening of new clinics in Biloxi, Bay St. Louis and Moss Point. Since Katrina, Coastal had managed to serve 30,000 people annually in repaired clinics and from temporary sites in tents and leased buildings.

“The rebuilt sites allow us to provide services in quality, modern facilities, but there’s still a tremendous need for mental health and medical services for the uninsured,” he said. Coastal also plans to build a new clinic in D’Iberville, just north of Biloxi.

CFHC Biloxi Clinic Grand Opening
CFHC Biloxi Clinic Grand Opening

 

EXCELth, Inc.

Prior to Katrina, EXCELth had a service area that encompassed the entire city of New Orleans. EXCELth was the largest HRSA-supported health center in Louisiana with nine sites; the patient population was over 12,000 and patient encounters exceeded 62,000 yearly.

As a result of the storm’s devastation, EXCELth now operates only two of its former sites that managed to escape major damage: Ida Hymel and Algiers. A third site that survived the storm, formerly operated by the Daughters of Charity, was later added to EXCELth’s service area, according to Brandon Wood, the HRSA project officer who oversees the grant.

The organization also began operation of a temporary Baton Rouge site and mobile unit to assist displaced city residents living in trailer communities.

EXCELth’s recovery has been slow but steady over the past two years as it reorganizes to determine its new role within the still developing New Orleans healthcare infrastructure. The organization’s user numbers and encounters are approximately half of its initial rates, and they are operating with around half of their pre-Katrina workforce.

That level of service tracks recent estimates that put the current population of New Orleans between 200,000 and 280,000 in a city that some 450,000 people once called home.

U.S. Postal Service delivery data, which is considered to be a reliable indicator of population change in the area, pegs the figure slightly higher, at 70 percent of reported totals before the storms.

HRSA presented EXCELth an Expanded Medical Capacity award of $600,000 and a New Access Point award of $650,000 in April 2007. Additional funding was also awarded later in the summer, including a NAP grant for $920,833 and an EMC grant for $354,013.

The EMC funds are expected to increase the patient capacity, while the NAP funds will be used to provide health services to the Gentilly neighborhood of New Orleans, an area severely impacted by Hurricane Katrina that currently has no health center.

To Learn More:

About HRSA’s Health Center program, go to bphc.hrsa.gov.

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