At Least 2.5 Million Home Health Patients Using Medical Equipment Vulnerable to Natural Disasters

With Hurricane Barry making landfall in Louisiana earlier this week, severe weather season is officially upon us.

While no deaths have yet been reported yet as a result of the storm as of Tuesday, natural disasters such as hurricanes, fires and tornadoes present life-threatening risks for home-based care recipients nationwide, especially those who depend on electronic in-home medical equipment.

For one, home-bound patients who rely on electronic medical equipment don’t always have access to back-up power sources in the event of an outage. But advocates say developing policies and expanding access to battery storage and solar technologies for these patients could change that. 

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“Hospitals have to have fairly high levels of resilient power,” Lewis Milford — head of Clean Energy Group, a nonprofit organization focused on addressing issues related to clean energy and climate change — told Home Health Care News. “That’s required by law. The sad irony is that we want to move people out of hospitals, but we have no similar protections for them while they’re at home. We’re basically saying … you should get your medical care at home, but we’re not going to make sure that the equipment that’s provided will actually run.” 

Currently, at least 2.5 million Medicare members rely on electricity to power home health equipment, according to a study by Clean Energy Group and Meridian Institute, another nonprofit focused on problem-solving to improve lives, the economy and the environment.

“Health care trends suggest that 2.5 million number is just going to continue to grow as more people opt to age in place,” Marriele Mango, lead author of the study and resilient power fellowship program associate for Clean Energy Group, told HHCN. “In the end, energy security just isn’t there for them in the way that it is in a nursing home, assisted living home or a hospital.”

In the event of a natural disaster, lack of energy security can be fatal.

Take Puerto Rico and other Caribbean islands for example. In the three months following Hurricane Maria, 4,645 people died.

Health care complications — including outage-related issues such as medical device failures — resulted for nearly one-third of those deaths.

But future fatalities can be prevented, the study authors argue.

“Battery storage is a new solution that could fundamentally change how medically vulnerable households prepare and prevail through an outage,” Mango said. “The public health and energy fields must start working together to ensure that this high-risk population is protected with these new emerging energy technologies in the event of an outage.”

Currently, the biggest roadblock to getting backup power to home health patients is affordability. But private and public payers have the power to change that.

“In order for this to be accessible and affordable, there need to be systems in place to make it that way,” Mango said. “Medicaid and Medicare have the opportunity to support that by subsidizing systems as part of a critical medical requirements.”

Additionally, they recommend supporting research and data development around the in-home, electricity-dependent population, as well as for utilities to develop residential battery storage programs.

“There’s no reason why local utilities — along with solar and storage providers — [and] home health care providers can’t begin to solve these problems,” Milford said. “These are problems that can be resolved. They just have to focus on it and realize it’s a problem now.”

While ensuring home health patients have backup power sources is not currently a requirement for home health agencies, they are required to meet certain emergency preparedness standards.

In 2016, the Centers for Medicare & Medicaid Services (CMS) released its final emergency preparedness rule. Among other requirements, it says home health agencies must have primary and back up communication options, participate in community disaster planning to coordinate care and communicate patients’ needs to appropriate parties in the event of a disaster. 

In light of those requirements, many home health providers have made disaster planning an annual priority. In fact, Iris Rancatore, assistant vice president of clinical risk for Amedisys Inc. (Nadaq: AMED), previously told HHCN that planning was instrumental in navigating care in the Carolinas amid Hurricane Florence in 2018.

“We attribute our success to the emergency preparedness and education of our patients and employees prior to a disaster, as well as the creative and innovative recovery solutions implemented by our corporate support staff on site and here in the corporate office,” Rancatore said.

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