And the Storms Came

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And the Storms Came

• Sarah S. Strawn, MS, RD
• Nutrition Services Administrator
• Alabama Department of Senior Services

4th State Units on Aging Nutritionists/Administrat
ors ConferenceAugust 2006
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ADSS Nutrition Services

• Title IIIElderly Nutrition Program
• 18,000 meals daily
• 13 AAAs and 350 senior centers
• 6 production units 1 frozen distribution unit
• Title XIXE/D Medicaid Waiver
• 6,000 frozen and breakfast 7-meal packs weekly
• 2 state operating agencies
• Vendor delivers D2D to clients throughout state

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And the storms came

• Hurricane IvanSeptember 16, 2004
• Category 3 landfall at Gulf Shores, AL
• Hurricane DennisJuly 10, 2005
• Category 3 landfall at Navarre Beach, FL
• Hurricane KatrinaAugust 29, 2005
• Category 3 landfall in southeast Louisiana and
  at Mississippi/Louisiana state line

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State of Alabama
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Each storm is different

• Hurricane Ivan
• Flood damage along the coast
• Wind damage in the interior major power outages
  damage to homes and centers no fuel
• Satsuma and Camden without power two days
• Hurricane Dennis
• Heavy rain

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Each storm is different

• Hurricane Katrina
• Heavy coastal flooding due to storm surge
• Satsuma without power for a week
• Vendor home office operations paralyzed
• Computer system inoperable
• Traditions frozen meal plant without power
• Shelf-stable meal supply shortages
• Influx of evacuees into Alabama
• Donated meals to state

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Lessons learned

• Each disaster brings unique challenges
• Some plan is better than no plan
• Centralize decision making and communications
• Maintain critical agency operations
• Recognize cannot anticipate every contingency
• Do the right thing
• Guard against complacency
• Incorporate relief efforts into existing
  structure
• Document!! Document!! Document!!!
• Evaluate actions and revise plans as needed

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ENP Operations

• Client intake forms modified
• Vulnerability information
• Document services to evacuees
• Disaster kits/emergency flyers
• AAA trainings of center managers
• Safe Shelters

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Vendor disaster planning

• Hazard analysis by company committee
• Disaster plan for food service units
• Developed new training manual
• State training seminar for managers
• Follow-up training of local staff
• Operational changes
• Improved computer security and back-up
• Better employee records
• Alternative menu options for disasters
• Invested in alternative power sources

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D2D delivery challenges

• Clients without power cannot utilize frozen meals
  and fresh milk often lack water
• Clients are the neediest of the needy
• Vendor has weekly client contact
• Cannot make up more than 2 days
• Deliveries documented electronically by
  individual client
• Clients may use up emergency meals prematurely

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D2D disaster plan

• Redefined service units to include
• 7 pack shelf stable meals 1 gallon water
• 7 pack breakfast meals NFDM Breakfast bar
• Maintain 2 day supply in state
• Meals coordinator authorizes delivery
• Centralized documentation approved
• Rotate stock during holiday periods
• Vendor distributes disaster planning tips

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Limitations

• Lack of menu variety
• Meals are not optimal nutritionally
• High in sodium
• Low in fiber
• Quality loss in storage
• Bread items stale and crumble Juice and NFDM
  change flavor and color
• High summer heat accelerates
• Product shortages in disasters

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Challenge Pool buying power

• Improve shelf-stable menu options
• Lower sodium entrees
• Bread items more nutrient dense less sodium
• Alternatives to non-fat dry milk
• Canned fruits in lieu of cookies
• Common nutrient standard
• Improve packaging
• Formal storage testing
• Evaluate options for self-heating meals

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Resources

• FSIS/FDA Guidelines for Retail and Foodservice
  Establishments Affected by Natural or Other
  Disaster Sept 2005
• http//www.foodsafety.gov/dms/retdisa2.html
• Emergency Handbook for Food Managers
• Twin Cities Metro Advanced Practice Center
• www.naccho.org/EQUIPh/

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Resources

• Are You Ready? A Guide to Citizens Preparedness
  FEMA H-34 http//www.fema.gov/library
• Administration on Aging Emergency Assistance
  Guide 2006
• http//www.aoa.gov/PRESS/preparedness/preparedness
  .asp