1. Partners in Data Recovery and Reporting Jeanne Spears, RN Disaster Health Services 0

2. Background Red Cross Disaster Surveillance System  Partnership with CDC since 1987  Goal is to provide accurate, timely description of the health-related needs of disaster-affected population  Data used for planning, preparedness, response and recovery efforts for Red Cross, local, state, and federal agencies 1

3. CDC/ARC Surveillance Committee Members  Red Cross - Disaster Health Services  CDC - National Center for Environmental Health Tasked to  Update forms and processes to capture disaster-related illness, injury, and death  Increase capacity of Red Cross’ volunteers to capture and report these data  Develop and pilot processes to ensure data sharing with DRO and partners during the disaster 2

4. Morbidity and Mortality Surveillance

5. Why Collect Morbidity and Mortality Data?  To identify potential threats to client(s) requiring immediate public health action(s)  To provide data for situational awareness  To assist in plan and prepare for future responses  To promote awareness of nursing practice in disasters 4

6. Why Collect Morbidity and Mortality Data? (cont’d)  To support states compliance with the National Mass Care strategy  To disseminate findings to the preparedness community and advance disaster science 5

7. Hurricane Sandy, New York, 2012 6

8. Disaster Health and Mental Health Support shelters, outreach & condolence visits Assess, record and report surveillance data Nearly 113,000 contacts and visits during Sandy response 7

9. Surveillance in Shelters  Nov., 2012 – 2922 shelter client visits  90% treated by staff  2% referred to hospital  8% referred to other healthcare professionals 8

10. Health Services NY Shelter Visits  29% - mental health issues  22% - follow-up care  19% - exacerbation chronic conditions  13% - acute conditions

11. Reasons for Visits by Shelter

12. Neighborhood Outreach Surveillance  In Nov., Outreach, made 5320 contacts  Queens, Staten Island, Brooklyn, Coney Island, Nassau and NYC  Included…hotels, homes & high-rise apartments 11

13. When Does Red Cross Collect Surveillance Data? Depends on size of Disaster Levels: Level l – Chapter disaster response (e.g., single or small multi-family house fire or flood) Level ll – Chapter response larger multi-family or neighborhood event (e.g., multi-family or apt fire) Level lll – Multi-chapter, state, or regional disaster response Level lV and above – National HQ response 12

14. Red Cross Data published in CDC’s Morbidity and Mortality Weekly Report 13 Tornado-Related Fatalities Five States, Southeastern US, April 25–28, 2011. July 20, 2012 61(28);529-533

15. 14

16. Aggregate Morbidity Surveillance 15

18. Aggregate Morbidity Form PART I 17

19. Aggregate Morbidity Form PART II 18

20. 19 Contact Service Sites – Shelters and Non- Shelters Client Heath Record Health Service Visit Visual of What a Contact Is

21. Aggregate Morbidity Form PART III 20

22. PART IV: Reason for Visit 21

23. Aggregate Morbidity Form PART V 22

24. New to Aggregate Morbidity Form Functional and Access Needs 23

25. C-MIST Functional and Access Needs – Definitions Communication: Visual or hearing problems; require equipment or assistance Maintain Health: Disease, injury, pregnancy, mental health issues; require medication, medical supplies, oxygen, temp control, or daily care (ADLs) Independence:  Mobility issues; require medical equipment for safety, comfort, mobility, and ADL’s  Infant services and service animal accommodations Services/Support: Requires support (e.g., family, caregiver, qualified shelter volunteer, or local agency) provide non-medical ADL’s Transportation: Requires transportation to a medical care facility for treatment or non-medical appointment 24

26. Morbidity Flow Chart – Reporting Process 25

27. Disaster-Related Mortality Surveillance 26

28. Disaster-related Surveillance  All deaths associated with a disaster  All single and multi-family fires deaths  Information obtained about disaster- related deaths are identified by media outlets, fire and police departments, hospitals and emergency departments or other similar sources

29. Condolence Visits Once deaths are verified, Red Cross usually schedule condolence visits with the family  Condolence visits include health services, mental health and/or spiritual care and possibly client casework For larger scale fatalities, an integrated care team is established to contact families 28

30. Mortality Surveillance Form

31. Mortality Surveillance Form PART II 30

32. Mortality Surveillance Form PART III 31

33. Mortality Surveillance Form PART III 32

34. Mortality Flow Chart – Reporting Process 33

35. Publications to Date 2012  Evaluation of the American Red Cross Disaster-Related Mortality Surveillance System by Using Hurricane Ike Data - Texas, 2008. Disaster Med Public Health Preparedness. 2012  Deaths Associated with a Historic Tornado Disaster--Southeastern United States, April 25-28, 2011.MMWR Morb Mortal Wkly Rep. 2012; 61(28);529-533  Disaster-related injuries and illnesses treated by American Red Cross Disaster Health Services during Hurricanes Gustav and Ike. Southern Medical Journal 106, no. 1 (2013): 102-108 2013  Fatalities Associated with the April 2011 Tornadoes (accepted for publication in American Journal of Public Health)  Fatalities Associated with Hurricane Sandy (accepted by MMWR) 34

36. Thank You, Jeanne Spears, RN Jeanne.spears@redcross.org 202-367-5454 35