Hurricane Helene and Hurricane Milton forced home-based care providers in the impacted areas to up their games, to go even further to care for their clients and patients.

Helene and Milton had devastating impacts on the Southeast. The former resulted in loss of more than 200 lives, and the latter is considered one of the worst storms to reach Florida in recent years.

As a response to Hurricane Helene, the Centers for Medicare & Medicaid Services (CMS) rolled out a number of flexibilities to help relieve home health care providers operating in areas impacted by the storm. These flexibilities included extended deadlines for quality reporting and patient assessment requirements, and temporarily forgoing some of the geographical requirements for telehealth services.

For home care providers in Florida, the Home Care Association of Florida (HCAF) emerged as a resource during this time.

Denise Bellville, executive director of HCAF, said many of its provider members reached out about clients who would not evacuate.

“I talked to a provider who was serving a paraplegic [client], and they were doing wound care,” she told Home Health Care News. “He lived alone and refused to leave, and he was in the direct path of Hurricane Helene. The provider just felt the urgency of, ‘What am I going to do?’ The same kind of situation happened again when Milton came through, we had some providers say, ‘Those in Zone A refused to leave.’ In all of these instances, I asked the providers to contact their patients’ physicians and/or family.”

Founded in 1989, HCAF is a nonprofit home-based care trade organization.

In addition to directing providers on who to contact, the HCAF staff also reached out to the local law enforcement for aid in helping remove these individuals from impact zones.

After both storms, providers still need help to be able to get up and running again, according to Bellville.

“When the storms were over, providers asked where their caregiver could find gas,” she said. “How far away is that? Is there gas in every county that was hit? We got a curfew letter from the Department of Health … so we did have to work with the department so that [agencies] could send their caregivers out to provide services.”

In the aftermath of the disasters, HCAF staff were also connecting providers whose offices had been flooded with other local providers that were willing to temporarily share their offices.

Plus, HCAF helped providers look for clothing, toiletries, food resources and local organizations that could be of service.

Impact on providers

For Andy Malivuk, the owner of Seniors Helping Seniors Pinellas County, Hurricane Milton alone had a 10% to 15% impact on revenue.

“There’s still a lot of people that are displaced, both caregivers and receivers of care,” he told HHCN. “Some of them went to Jacksonville, some of them went to Orlando, and they couldn’t come back because there was no electricity. In some places, even when electricity was back up and running, there were sewage and water issues. There continues to be quite a mess to coordinate.”

Pennsylvania-based Seniors Helping Seniors is a personal care franchise company that has over 200 locations in 36 states. The company’s Pinellas County location serves roughly 130 clients.

Malivuk believes that the state of Florida was really integral when it came to his agency’s emergency preparedness.

“I’ll give the state of Florida some kudos here, because they do a really good job of making sure that, if you’re a licensed agency, they have some guidelines for you to follow to make sure that you have a comprehensive emergency management plan, and they also check in on it every year,” he said. “It’s a major part of the audit process or the survey process.”

As a result, most of the information needed for emergency planning is incorporated as part of the agency’s intake process.

“When you do the intake for the client, you take down a lot of the information,” Malivuk said. “What is their evacuation zone? What is their evacuation plan? Are there local family and friends that are going to be involved? If so, to what degree? Do they need to be registered with the county for Special Needs shelters, depending on their situation? Not only do you have to take that information, it’s also about putting that into practice. At least once a year you have to go through it and call everybody.”

The company also asks its caregivers to detail this information, in order to ensure their safety.

Leading up to a storm, Seniors Helping Seniors Pinellas County prioritizes based on the level of care and risk involved with each client.

“There’s a risk indicator on each client, and we call all of them and confirm their evacuation plan,” Malivuk said. “As soon as there’s a storm, we kick off that process. We understand, based on what evacuations are going to be called, what the initial impact is going to be.”

Similarly, Right at Home Charlotte County was able to implement its emergency response almost immediately.

Based in Omaha, Nebraska, Right at Home has more than 700 home care franchise locations across the U.S. and six other countries. The company’s Charlotte County location serves roughly 120 seniors.

Owner Heidi Nyvoll believes that during these times, communication is key.

“We have a conversation with both the clients and the caregivers,” she said. “With clients, it’s letting them know what to expect and what they’ll experience with us. We also had a conversation with the caregivers and others, saying ‘Hey, we have this hurricane team. Are you willing to help out when something happens?’ Then we go through what to expect.”

Some Right at Home Charlotte County caregivers chose to shelter with clients to ensure that their care wasn’t disrupted.

“We make sure that they go out there before the storm actually hits,” Nyvoll said. “This is usually about seven hours before we expect it, but this also depends on the rain and the wind. We monitor it very closely. We also ensure that the areas they’re staying are not in an evacuation zone, that’s important for us.”

Ultimately, Nyvoll said providers must balance keeping caregivers and clients safe in equal measure. She also believes that emergency plans cannot just collect dust.

“Every year we go through the same process for preparing, because you never know the day you’ll actually need it,” she said.