Editor’s Note: As Hurricane Sandy hits the east coast, we are reminded of the phenomenal role civil society organizations play in disaster. This particular story, about the vivid experiences of the leaders of the Coastal Family Health Center in the wake of Hurricane Katrina, is a powerful epic read and a reminder about what really matters.
In mid-2005, with patients numbering more than 30,000, Coastal Family Health Center (CFHC) had developed into a complex operation. Its nine sites were spread throughout the Mississippi Gulf Coast in a mix of buildings and trailers. Providing medical and dental services, and with a mission to serve all seeking treatment without regard for ability to pay, Coastal Health was funded, as most community health centers are, by a mix of sources, including patient payments, private health insurers, and government grants. Their patients had their own complex issues—CFHC provided specialized services to those living with AIDS and to those without a home. Most of the center’s patients were uninsured.
Under the leadership of CEO Joe Dawsey, Coastal was in pretty good shape. It was operating on a $10 million annual budget, and although it had only $500,000 in reserves, it owned all of its buildings. In 2004, 175 staff members completed 104,000 patient visits, according to records. Dawsey, who previously led a community health center in Alabama, was hired into the position five years earlier after the organization had started running a serious deficit. Most of the management team was at odds with the board and had left within a short period. Since then the organization has stabilized and expanded. One of the members of the board which hired Dawsey said that she had known for years that executive leadership was wanting at the organization. “We had had a number of lawsuits filed by staff,” she said. “He brought fairness and order, and we have not had one since [then] that I can recall.”
On August 27, 2005, Dawsey and other staff, left the administrative offices in Biloxi for the weekend. They were preparing to batten down the hatches for the coming storm,. making sure that they picked everything up off the floor and covered the desks and computers in case the roof leaked=Dawsey also took some extra precautions like making sure he had contact information for key staff. He also backed up the practice management system (which included digitized patient files , such as billing information and payroll) off-site in two different locations. By early Saturday, however, he realized that if the storm were as strong as predicted, a loss in power could delay payroll. So he and other staff returned to the office to write checks. Then he went home to Mobile to wait out the storm.
“The door itself was open,” Dawsey says about his return on the August 30, and he was unprepared for the damage he would find. “A desk was jammed against it so I had to break through. When I did get inside, the mud was probably six or eight inches deep on the floor, and the furniture was just scattered everywhere. Everything had been ruined. All that was left were the top two shelves of the pharmacy in that building. A couple of other staff people were there just standing outside. I don’t know how to describe it except that they were in shock. Not just because of this, but because their own homes had been flooded. One of those people and I drove over to the Biloxi clinic and it was even worse. Water and mud and stuff was up over the top of it, and everything in that building was ruined. Then we went over to the Gulfport clinic, and the roof had been blown off. So we kept going to visit Vancleave, where there was some damage, but not as bad.”
And it was not just the physical infrastructure of CFHC that was gone, the patient files and billing information had been destroyed in both the original and backup locations.
|Background on Community Health Centers|
|Number of Community Health Centers in 2005||952|
|Number of CHC patients in 2005||14,133,103|
|Number of uninsured patients in 2005||5,623,377|
|Two-thirds of CHC patients are racial/ethnic minorities.|
|Nearly 40% of patients are uninsured, only 14.8% have private health insurance, the remainder receive some sort of public insurance (Medicare, Medicaid, SCHIP, etc.)|
|CHC Revenue Sources3|
|Section 330 grants (HHS)||22%|
|State government, local government, foundation grants||12%|
|Other federal grants||4%|
|Percent of Health Centers Providing Select Services Onsite4|
|General Primary Medical Care||100%|
|Preventive Dental Care||73%|
|Mental Health Treatment/Counseling||74%|
|Substance Abuse Treatment/Counseling||50%|
|Smoking Cessation Program||58%|
|HIV Testing And Counseling||91%|
|Glycosylated Hemoglobin Measurement,Diabetes||85%|
|Blood Pressure Monitoring||99%|
|Blood Cholesterol Screening||89%|
|Weight Reduction Program||76%|
|Community Health Center Katrina Factoids6|