1. 2-1-1 Texas -- Unmet Disaster Needs: Katrina-Rita, 2005

2. Collaboration of Research, Service, & Policy Funded by Department of Homeland Security Science & Technology Directorate Funded by Department of Homeland Security Science & Technology Directorate Health & Human Services Commission, Austin, TX Texas 2-1-1 I&R Network Health & Human Services Commission, Austin, TX Texas 2-1-1 I&R Network Urban Planning Program & Hazards Reduction & Recovery Center Texas A&M University Urban Planning Program & Hazards Reduction & Recovery Center Texas A&M University Texas 2-1-1 Area Information Centers, Directors & Data Base Managers Texas 2-1-1 Area Information Centers, Directors & Data Base Managers Bame-Wick: Emg Mgmt2

3. Research Team & Collaborators Hee Ju Kim Tiffany Kleb Jee Young Lee Pratik Mhatre Allie Norman Courtney Payne Ashley Shaw Frank Shaw Meng Xue Hee Ju Kim Tiffany Kleb Jee Young Lee Pratik Mhatre Allie Norman Courtney Payne Ashley Shaw Frank Shaw Meng Xue Marcia Bastian Robyn Bell Tasha Davis Aatmaja Desai Rhonda Dunn Dayna Finley Andrew Garza Abha Grover Erin Harrison Marcia Bastian Robyn Bell Tasha Davis Aatmaja Desai Rhonda Dunn Dayna Finley Andrew Garza Abha Grover Erin Harrison Roger Adams Sudha Arlikatti Deborah Ballard Lisa Dicke Sue Geller Anne Hotze Allen Irby Michael Longnecker Kay Parker Teresa Tai Beth Wick Doug Wunneburger Roger Adams Sudha Arlikatti Deborah Ballard Lisa Dicke Sue Geller Anne Hotze Allen Irby Michael Longnecker Kay Parker Teresa Tai Beth Wick Doug Wunneburger Collaborators Research Team 3Bame-Wick: Emg Mgmt

4. OBJECTIVES: A) To present overview of 2-1-1 and role in disasters: 1) Background 2) Disaster roles 3) Experiences B) To present study findings of 2-1-1 total calls for help to meet disaster & community unmet needs in Texas for Katrina-Rita, Fall 2005: 1)Over TIME (8/1/05 to 12/31/05) 2)By LOCATION (aggregated to Texas county) 3)By LOCATION x DISASTER PHASES 4)By NEEDS 5) E.G.: HEALTH NEEDS OBJECTIVES: A) To present overview of 2-1-1 and role in disasters: 1) Background 2) Disaster roles 3) Experiences B) To present study findings of 2-1-1 total calls for help to meet disaster & community unmet needs in Texas for Katrina-Rita, Fall 2005: 1)Over TIME (8/1/05 to 12/31/05) 2)By LOCATION (aggregated to Texas county) 3)By LOCATION x DISASTER PHASES 4)By NEEDS 5) E.G.: HEALTH NEEDS 4

5. 2-1-1 IN DISASTER MANAGEMENT 2-1-1 is the communications link for unmet needs in disaster response and homeland security preparedness 2-1-1 is the communications link for unmet needs in disaster response and homeland security preparedness 2-1-12-1-1 Needs Victims / Evacuees / Family-Friends Community Resources Volunteers/ Donations Health & Social Services Basic Needs/ Social & Financial Support Access Barriers Unmet Needs Bame-Wick: Emg Mgmt5

6. 6 6 What is 2-1-1?

7. Bame-Wick: Emg Mgmt7 7 7 The Federal Communications Commission Ruling “We find that the Information & Referral Petitioners have demonstrated sufficient public benefits to justify use of a scarce public resource and we therefore assign 211 to be used for access to community information and referral services.” July 21, 2000

8. Hood Howard Presidio Brewster Val Verde Culberson Hudspeth Jeff Davis El Paso Crane Pecos Reeves Crockett Terrell UptonReagan Andrews Ward Loving WinklerMidland Ector Glasscock Martin Bandera Jim Hogg La Salle Webb Starr Zapata Dimmit Zavala Maverick Kinney Uvalde Frio Medina Nueces Brooks Hidalgo Duval Kenedy Willacy Cameron Jim Wells Kleberg Wilson McMullen Bexar Atascosa Bee Live Oak San Patricio Karnes Guadalupe Gonzales Mason McCulloch Edwards Sutton Schleicher Kerr Real Kimble Menard Nolan Tom Green Irion Mitchell Sterling Coke Runnels Concho Coleman TaylorCallahan Bell Blanco Kendall Comal Gillespie Llano Travis Hays Caldwell Burnet Williamson Comanche Mills San Saba Brown Eastland Hamilton Lampasas Coryell Erath Bosque Somervell Swisher Randall Hockley Gaines Yoakum Cochran Dawson Terry Lynn Lubbock Deaf Smith Bailey Parmer Lamb Hale Castro Hartley OldhamPotter Moore Dallam Sherman Knox Kent ScurryBorden Garza CrosbyDickens FisherJones King Stonewall Haskell Hall Motley Floyd Briscoe Hardeman Cottle Foard Childress Jack Young Stephens Shackelford Throckmorton Parker Palo Pinto Wise Baylor Archer Wilbarger Wichita Clay Montague GrayCarson ArmstrongDonley Hutchinson Roberts Wheeler Collingsworth Hemphill Ochiltree HansfordLipscomb Jefferson Trinity Brazos Lavaca Victoria Goliad Refugio De Witt Calhoun Aransas Jackson Wharton Milam Bastrop Fayette Lee Austin Colorado Burleson Washington Robertson Waller Brazoria Matagorda Fort Bend Harris Galveston Chambers Montgomery Walker Grimes Madison Jasper Liberty Hardin Polk San Jacinto Tyler Anderson Ellis Falls McLennan Hill Freestone Limestone Leon Navarro Henderson Dallas Tarrant Johnson Denton Kaufman Van Zandt Collin Rockwall Hunt Smith Cherokee Houston Nacogdoches Angelina Rusk Shelby Panola Franklin Rains Wood Hopkins Marion Gregg Upshur Harrison Titus Camp Morris Cass Newton Orange San Augustine Sabine Fannin Cooke Grayson Delta Lamar Red River Bowie Gulf Coast Region* South Central TX Region* North Central Texas Dallas Region* North Central Texas Fort Worth Region* Rio Grande Region* Panhandle Region* South Plains Region* Alamo Region* Tip of Texas Region* Heart of Texas Region North Texas Region Brazos Valley Region * Coastal Bend Region Permian Basin Region* Central Texas Region* Texoma Region* Concho Valley Region West Central Texas Region Southeast TX Region* South Texas Region Golden Crescent Region East Texas Region North East Texas Region Middle Rio Grande Region Deep East TX Region Texas 2-1-1 I&R Network (TIRN): 25 Regional Call Centers for Statewide Coverage 8 Statewide coverage, July 2004 Network for 24/7 coverage in Texas Roll-over call technology & arrangements

9. 9 2-1-1’s Response to Disasters DISASTER EXAMPLES: 9/11 Floods Blizzards Ice Storms “Miracle on the Hudson” Power outages Tornadoes Wildfires, Firestorms Mudslides, Sinkholes Earthquakes Haz Mat, Chemical fires & spills H1N1 Tsunami  AND MORE! HURRICANE EXAMPLES: Charley Ivan Fay Katrina Rita Wilma Dolly Edouard Gustav Ike Humberto Dean Emily  AND MORE!

10. Bame-Wick: Emg Mgmt10 2-1-1 Disaster Response: Typical Types of Calls 1) Pre-event  evacuation information  location and availability of shelters  inquiries from people with special needs  preparation for the storm  rumor control 2) During the event  reassurance  crisis intervention  interagency inquiries  changes in community resources 3) Immediate Aftermath  location of essential services (water, ice, food, shelter, health)  rescue needs  debris removal needs  power outages  case management 4) Recovery  disaster relief financial assistance  disaster-caused health issues  disaster-related transportation  housing recovery and repair

11. 11 2-1-1 Designated by Texas Emergency Management as a communication network for evacuation, disaster & recovery social support I&R in Texas, 2005+ Katrina: 8/29/05 Rita: 9/24/05 11Bame-Wick: Emg Mgmt

12. 12 2-1-1  UNIQUE RESEARCH OPPORTUNITY: 2-1-1 data is “real time” record of unmet disaster & community needs before, during, & after Katrina & Rita. Texas Network of 2-1-1 data represents State-wide coverage for unprecedented scope of data over location and time. Avoid survey biases vs. tertiary “universe” of data re: caller unmet needs. Texas I&R Network coordinated data collection & recording for all AICs beginning of 2005 – uniform unit of analysis & coding date & location. 2-1-1  UNIQUE RESEARCH OPPORTUNITY: 2-1-1 data is “real time” record of unmet disaster & community needs before, during, & after Katrina & Rita. Texas Network of 2-1-1 data represents State-wide coverage for unprecedented scope of data over location and time. Avoid survey biases vs. tertiary “universe” of data re: caller unmet needs. Texas I&R Network coordinated data collection & recording for all AICs beginning of 2005 – uniform unit of analysis & coding date & location. LIMITATIONS : Missing DATE data: Summary reports by 4 call centers missing DATE data = 33% missing, biased by location of these call centers. Missing LOCATION data: 7% missing location, biased distribution. Missing NEED data: 5% missing NEED data, randomly distributed. Data entry for NEED data not coded consistently per 2-1-1 taxonomy of needs vs. narrative in database or on paper. Merged 25 different databases, cleaned, recoded, validated. LIMITATIONS : Missing DATE data: Summary reports by 4 call centers missing DATE data = 33% missing, biased by location of these call centers. Missing LOCATION data: 7% missing location, biased distribution. Missing NEED data: 5% missing NEED data, randomly distributed. Data entry for NEED data not coded consistently per 2-1-1 taxonomy of needs vs. narrative in database or on paper. Merged 25 different databases, cleaned, recoded, validated.

13. Analysis: 2-1-1 Texas Hurricane Data, Fall 2005 13 635,983 Fall 2005 : Recorded 2-1-1 Calls = 635,983 8/1/05 to 12/31/05  DATE : Daily 8/1/05 to 12/31/05  DISASTER PHASE : Baseline (8/1 – 8/25/05) Immediate needs (H+4 to 7 days) Evacuation (H -3 to -1 days) Short-term needs (H+ 2 nd -4 th week) Landfall Recovery (2 nd month +) Urgent (H +1 to +3days)  LOCATION : (254 Texas counties) Disaster sites vs. evacuation destinations Adjusted for population size to control for urban/rural bias (per 2005 Texas Census Data: # Households/Co. 635,983 Fall 2005 : Recorded 2-1-1 Calls = 635,983 8/1/05 to 12/31/05  DATE : Daily 8/1/05 to 12/31/05  DISASTER PHASE : Baseline (8/1 – 8/25/05) Immediate needs (H+4 to 7 days) Evacuation (H -3 to -1 days) Short-term needs (H+ 2 nd -4 th week) Landfall Recovery (2 nd month +) Urgent (H +1 to +3days)  LOCATION : (254 Texas counties) Disaster sites vs. evacuation destinations Adjusted for population size to control for urban/rural bias (per 2005 Texas Census Data: # Households/Co. Bame-Wick: Emg Mgmt13

14. 1.a) 2-1-1 Total Calls by Day in Texas, Fall 2005 (N=635,983 calls reported) Katrina Landfall 8/29/05 Rita Landfall 9/24/05  Thus, extend disaster management beyond immediate phase for extended evacuation. 8/1/05 9/1/05 10/1/05 11/1/05 12/1/05 Characteristic weekly call patterns (Pent-up demand on Mondays, decreasing volume during week, low volume on weekends & holidays). Significant spike in calls during hurricane post-landfall periods. New, higher threshold of calls during recovery (vs. baseline). 14

15. 15 1.b) 2008: Total 2-1-1 Calls Handled by Day in Texas: Dolly, Edouard, Gustav, Ike (7/1-12/31/08; N=1,251,416)  Thus, need new model for disaster management for extended evacuation & compounded disasters events. Characteristic weekly call patterns. High 2-1-1 demand for unmet needs 2-3 weeks after immediate disaster phase. Higher threshold of calls after each hurricane disaster – possible cumulative unmet recovery needs &/or greater reliance on 2-1-1.

16.  Texas 2-1-1 Calls ▪ Texas= 586,747 (92%) ▪ Out of State= 6,627 (1%) ▪ Missing location= 42,609 (7%)  Calls by Population Size  Major Metro 5 Counties (64.5%)  Other Urban 39 Counties (22.8%)  Small Towns & Rural 210 Counties (12.7%) 16  Thus, mobilize human & financial disaster resources to urban evacuation destinations to address largest volume of unmet needs.

17. Population Adjustment: Based on 2005 Census # of house- holds per County. Adjustment for urban/rural bias. Greater than expected risk for unmet needs in disaster counties and urban evacuation destinations, adjusted for population size. Demand for services fairly low in rural counties except disaster sites. West Texas cities unexpected high risk for unmet needs of Katrina evacuees flown out for evacuation from Rita. 17 2.b) Total 2-1-1 Calls Adjusted Ratio per 100 Households, Fall 2005  Thus, disaster counties & evacuation destinations needed resources beyond local community resources for hurricane victims, regardless of urban/rural size.

18. 2.c) Total 2-1-1 Calls Adjusted by Population Size, with HURRICANE EVACUATION ROUTES, Fall 2005  High-risk counties in the path of Hurricane Rita & evacuation routes northward.  Identified trend among major highway evacuation routes.  Hot-Spots ▪ D/FW, Midland, and Taylor Co. ▪ I-20 ▪ Waller County is key area for evacuation ▪ Hwy 6  B/CS ▪ Hwy 290  Austin 18  Thus, mobilize resources along evacuation routes through smaller urban areas for support on route to metropolitan evacuation destination or alternative shelter destination.

19. Bame: FEMA-VI19 Baseline 8/1/05 to 8/25/05 Katrina Evacuation H -3 to -1 days Katrina Landfall 8/29/05 3) Tracking 2-1-1 Total Needs over Time & Location by Katrina- Rita Disaster Phases, 8/1/05 - 12/31/05 3) Tracking 2-1-1 Total Needs over Time & Location by Katrina- Rita Disaster Phases, 8/1/05 - 12/31/05 Increase in Houston & Austin areas & hwys to I-45 to Tyler & D/FW Katrina H + 1-3 days Increase Houston; B/CS Hwy 6 & I-35 San Antonio to D/FW + north to OK 19

20. Katrina H + 3rd Week Katrina H + 4-7 days 5 metro areas + smaller urban (Bryan, Corpus, Beaumont, Tyler) Concentrating in 5 metro areas + smaller urban; I-45 corridor; I-10 & 1-20 to/from LA Katrina H + 2nd Week Houston & B/PA & other metro; up I-45, Hwy 6, & north up rural E. Tx Rita Landfall 9/24/05 Rita Evacuation H -3 to -1 days Rita H + 1-3 days Hwy 6 inland & I-35 SA- D/FW corridors; Gulf Coast & E. Tx into rural counties inland 20

21. Bame: FEMA-VI21 Rita H + 3rd Week Rita H + 4-7 days Houston & B/PA & other metro; I-35 &, Hwy 6; west on I-20; decrease in rural counties. Houston & B/PA areas & other metro starting to decrease; Hwy 60 in rural counties from Tyler-B/PA; increase W. Tx cities high for Katrina evacuee needs. Rita H + 2nd Week Concentration in metro & smaller urban locations, reduction in rural. Rita H + 5-8 Weeks Rita H + 9-12 Weeks Rita H + 4th Week 3+ mos. similar to baseline distribution of 2-1-1 calls but higher volume. 21

22. 22 4) UNMET NEEDS 4.a) Disaster Needs: Emergency / Crisis First Responder Organizations: FEMA, Red Cross, Salvation Army Locate / Missing Volunteer / Donations 4.a) Disaster Needs: Emergency / Crisis First Responder Organizations: FEMA, Red Cross, Salvation Army Locate / Missing Volunteer / Donations 4.b) Primary Needs in Disasters: Housing / Shelter Food / Water Health / Safety Transportation / Directions 4.b) Primary Needs in Disasters: Housing / Shelter Food / Water Health / Safety Transportation / Directions 4.c) Other Community Needs: Animal-related Education / Training Employment Financial Information & Referral Legal Other Misc. & Non-Disaster: Housing / Shelter Food / Nutrition Health / Safety Transportation Clothing / Supplies Crisis / Emergency Volunteer / Donations 4.c) Other Community Needs: Animal-related Education / Training Employment Financial Information & Referral Legal Other Misc. & Non-Disaster: Housing / Shelter Food / Nutrition Health / Safety Transportation Clothing / Supplies Crisis / Emergency Volunteer / Donations Bame-Wick: Emg Mgmt

23. FOOD Therapeutic Diets Life Cycle (by age) Subsidized Food Programs Water Disaster& Emergency Food Food Preparation Supplies Appliances Weight Related Problems HEALTH Types of Health Services Dental Emergency / Crisis Home health Medical OB/GYN Public Health /Immunization/Vaccine Mental Health Abuse – persons; substance Community support services Counseling/ Support Group Mental disability / Mental illness Ancillary Health-Related Services Financial / Insurance Food / Nutrition Health Education / Information Health Facility / Organizations Legal – Health related Pharmaceutical / Equipment Professionals Respite / Caregiver Transportation – Health related Volunteer / Donations – Health Vulnerable Groups Children / Elderly Disability / Eye care / Hearing Women’s Health Death / Funeral HOUSING Types Shelter Rental Ownership Mobile Home Group Home Public Housing Vulnerable Groups Low income Disabled Homeless Elderly Children Housing Services Location/Relocation Rehab/Repair Financial Assistance Information/ Counseling Utility Household Goods TRANSPORTATION Equipment Gas and fuel Vehicle problems U-Haul / Moving Trailers Operational Directions Road closures Road conditions Traffic information Emergency management Other Transportation Financial assistance Evacuation information Legal restrictions Local information 23 4.b) Unmet Primary Needs in Disasters: Katrina-Rita, Fall 2005

24. 5) HEALTH Unmet Needs, Katrina-Rita, Fall 2005

25. 25 5a) Types of Unmet Health Needs: Katrina-Rita, Fall 2005 Health Needs- % of Demographic Types (N=28,910) % of Mental Health Needs (N=27,490) % of Facility / Provider Needs (N=20,123) % of Public Health Needs (N=31,589)

26. 26 Medical Care & Treatment Needs Health Facility Needs 8/1/05 9/1/05 10/1/05 11/1/05 12/1/05 101* Health Financial & Insurance Needs 8/1/05 9/1/05 10/1/05 11/1/05 12/1/05 Pharmacy & Equipment Needs 8/1/05 9/1/05 10/1/05 11/1/05 12/1/05

27. Bame-Wick: Emg Mgmt27 Health Facility Needs Health Financial & Insurance Needs Pharmacy & Equipment Needs Medical Care & Treatment Needs

28. 28Bame-Wick: Emg Mgmt Health Facility Needs Health Financial & Insurance Needs Pharmacy & Equipment Needs Medical Care & Treatment Needs

29. Bame-Wick: Emg Mgmt29 RECOMMENDATIONS & CONCLUSIONS: Mapping of 2-1-1 call patterns assists in identifying where to mobilize resources for the preparation, evacuation, and recovery phases of disaster management. This project helping to develop national standards for 2-1-1 disaster data collection and reporting. Disseminate information to officials at the federal, state, and local levels for appropriate resource allocation and policy development in their disaster mitigation & management efforts based on real-time data. To analyze type & volume of 2-1-1 callers’ unmet needs by location and over time for portrait of community resiliency and outcome measures for program evaluation. RECOMMENDATIONS & CONCLUSIONS: Mapping of 2-1-1 call patterns assists in identifying where to mobilize resources for the preparation, evacuation, and recovery phases of disaster management. This project helping to develop national standards for 2-1-1 disaster data collection and reporting. Disseminate information to officials at the federal, state, and local levels for appropriate resource allocation and policy development in their disaster mitigation & management efforts based on real-time data. To analyze type & volume of 2-1-1 callers’ unmet needs by location and over time for portrait of community resiliency and outcome measures for program evaluation.

30. Thank You Questions? Bame-Wick: Emg Mgmt30