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The out of the ordinary can lead to the extraordinary: a Louisiana human services agency finds ways to improve its operations after Hurricane Katrina.

Jefferson Parish Human Services Authority (JPHSA) is an 18-year-old, locally governed, publicly funded provider of behavioral healthcare and developmental disability services on the east bank and west bank of the Mississippi River next to New Orleans. On August 29, 2005, Hurricane Katrina forever changed Louisiana's most populous parish and the lives of its residents, as well as our agency and employees.

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My appointment as JPHSA's executive director was 18 months prior to the event that altered us on a personal and organizational level. Although I knew we would experience transformational change with the new strategic plan and change timeline already in place, I never anticipated the "sucker punch" that knocked us off course in a whirlwind of uncontrolled chaos.

As hurricane season is again upon us, anxiety from still too fresh memories results in what we refer to as the "crisis du jour." These are not really crises, but with our diminished coping skills, it is often necessary to deal with the distractions of daily problems rather than remain focused on larger goals.

This May, my Executive Team followed the same steps as in the past: updating disaster plans and telephone trees and ensuring that the people we serve and staff have personal evacuation plans in place. We conducted refresher training on the official Jefferson Parish Hurricane Preparedness and Citizen Evacuation Transportation Plans, and on the Web-based Employee Bulletin Board we use to communicate during emergencies. We continue to use our electronic newsletter and staff meetings to reinforce information and plans. Several of us even participated in a drill to test the Citizen Evacuation Transportation Plans, as our clinicians and other staff will provide emergency mental healthcare backup to EMTs and assistance to those with special needs during a real evacuation. Still, I know that even the most comprehensive, well-thought-out plan is subject to shredding in an instant. I wonder if we have the inner strength to survive another event, even a minimal storm. A summer afternoon thunderstorm is often enough to stir memories of water, too much water.

Sitting at my desk, I can look out my window and see the several storefronts of a strip shopping center across the street. They all sit empty. Outside, debris is gone but the damage on the inside is still apparent through the windows, and gaping holes remain in the roof. The recovery process is incomplete. We are still in recovery as well, and our recovery is on a personal level as well as an organizational level.

It is easier to accept that we can never be completely prepared or in control. We cannot provide lighting and air-conditioning when there is no power; we cannot restore flood-soaked and mildewed client records; we cannot ask staff to return to work when they do not have homes, vehicles, or even clothing; we cannot provide services in a facility with roof leaks, no working plumbing, and active mold. We must plan and prepare for the expected, but we also must always remain poised to effectively deal with the unexpected. Most importantly, we must always be aware and sensitive to the impact a disaster has on the staff.

Although our employees were scattered after Katrina, our emergency plans worked. I was communicating with the Executive Team less than 24 hours after the storm. We used telephone trees to locate staff, ensure their safety, and determine their status. Two weeks later, we gathered in the basement of the Capital Building in Baton Rouge to plan for implementing an organizational recovery plan. At that time, we did not know the real extent of the damage to our three facilities, homes and, most importantly, community.

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During the second week after Katrina, with an "official pass" allowing entry into Jefferson Parish, which was still under martial law, my husband and I, along with my CFO and her husband, entered the parish for a firsthand look. The parish had sustained severe flooding from levee breaches after Katrina passed through. We found our 40,000-square-foot east bank facility standing but with heavy wind damage, massive roof leaks, and evidence of looters likely trying to gain access to the pharmacy. Our vans had been vandalized and two were missing. File cabinets were overturned; computers were missing; records were soaked; and there was the stench of mold, urine, and unknown odors, which became all too familiar during the following months. The building housing our smaller east bank facility flooded as well.

The west bank facility faired much better: one broken window, a downed sign, and some uprooted ornamental trees. Most of the building was without electricity and, as a result, there were no lights or air-conditioning, and areas reeked of rotting food in agency refrigerators.

We had to destroy all the medicine in both of our pharmacies due to going more than two weeks without air-conditioning. All of our closed records in off-site storage were lost to the flood, and all of the open and closed records in the main east bank building were lost to water damage and mold. The good news: The computer network rebooted.

On September 21, 2005, enough staff had returned to open services on the west bank. Other than a few administrative staff members, everyone reported to this facility. Without electricity in most of the building, we set up shop in the main lobby, where we could depend on natural light through the front windows. Employees dressed in T-shirts and shorts to deal with the oppressive heat. We took turns going to the National Guard station for ice, water, and MREs (meals ready to eat) for lunch. Most of us survived on MREs for days, as there were only a few scantly stocked grocery stores open and no open restaurants. With the 6 a.m. to 6 p.m. curfew, there was little time to go to the few places that were open.

As our doors unlocked, the stream of individuals and families in crisis quickly turned into a flood of needy humanity. We saw people from Orleans, Plaquemines, and St. Bernard Parishes, which were devastated and had no services to offer. Many faces were also familiar. Once phone service was reconnected, we started calling our clients to locate the hundreds who had not reappeared, and eventually sent teams of employees into neighborhoods to look for them. The teams even had psychiatrists as members, bringing a new meaning to "house call."

We remained in crisis mode and depended on adrenaline. We were hot, often thirsty and hungry, under extreme stress--did I mention hot? Many employees lost homes, cars, and all their possessions. Some still had missing family members and pets. Yet we managed to work as a team in the real sense of the word. Job boundaries disappeared. Psychiatrists were mopping floors and taking out garbage; support staff were making MRE, ice, and water runs and keeping bathrooms clean; everyone was focusing on the needs of old clients, new clients, and their family members.

Communication was the critical success factor. We held "back porch" meetings every few days to gather all returned staff and to update one another, as phone and e-mail services were inconsistent. We encouraged storytelling. Sharing experiences, ranging from the tragic and sad to the totally absurd and hilarious, helped us get through the days. Talking to one another was a key to survival for both JPHSA and its employees.

I understood the importance of having the Executive Team be highly visible and accessible at all times. We shared our experiences and worries and focused on being the best listeners possible. We talked about the next day and rehashed previous days. Redundancy may be boring when times are good, but redundancy is comforting in times of crisis. We all experienced sleeplessness, diminished short-term memory, and fatigue, but this became a common bond.

I frequently stated that we needed to make lemonade from our lemons, or that we had windows of opportunity that we could use. One afternoon, someone suggested that we really should "make some lemonade out of all the lemons that came our way." So we did. Each of us had a refreshing glass of ice-cold lemonade during our back porch meeting. The lemonade provided a break from the sweat and heat of the building, and everyone grabbed onto the positive spin.

JPHSA became a refuge for many of our employees: a place to concentrate on the needs of clients, their families, and one another, while taking their minds off personal needs if only for a few hours; a place to share feelings and fears; and, finally, a place to continue transformational and meaningful change.

Through up-close and personal interaction without the restrictions of job description or rank, and a realistic yet hopeful attitude, we have managed to hack our way through barriers and to set a course to ensure JPHSA will remain a healthy, vibrant organization for years to come. We have learned to make our own lemonade out of the lemons that come our way. In doing so we have left behind many of the fears that come with change: leaving behind the old and embracing the new--first in crisis and now because we recognize the necessity.

Two years have passed since Hurricane Katrina, and I believe we have finally finished making decisions influenced by crisis and dealing with issues in survival mode. We have moved on to a recovery focus for the staff, the agency, the community, and most importantly for the people we serve. We have returned to data-driven decisions along with continual assessment of need. Our "lemonade" includes:

* Creating a new Administrative Services division as an agency-wide resource for support services

* Moving to centralized scheduling to ensure maximized capacity and productivity

* Implementing open access for screening and intake of new clients

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* Moving to a new management information system with an electronic health record

* Developing and adopting supervision guidelines to improve staff development and performance

* Expanding and monitoring internal staff training

* Establishing a utilization management/level of care system

* Accepting a 20-minute medication management standard

* Managing and consolidating all forms

* Developing rules to control procedures

* Launching an agency-wide staff recognition program

The list will continue to grow. Yes, we can give ourselves a confident toast to the future, yet we will always be mindful of lessons learned through our experiences, knowing we can handle any lemons that come our way.

Jennifer R. Kopke, MA, LAC, is Executive Director of Jefferson Parish Human Services Authority in Metairie, Louisiana. To contact the author, e-mail jennkopk@jphsa.org.

BY JENNIFER R. KOPKE, MA, LAC
"The pessimist complains about the wind; the optimist expects it to
change; the realist adjusts the sails."
--William Arthur Ward

"Each of us makes his own weather, determines the color of the skies in
the emotional universe which he inhabits."
--Archbishop Fulton Sheen

"When fate hands you a lemon, make lemonade."
--Dale Carnegie

"We are not interested in the possibility of defeat."
--Queen Elizabeth
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Article Details
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Title Annotation:DISASTER RESPONSE
Author:Kopke, Jennifer R.
Publication:Behavioral Healthcare
Article Type:Cover story
Geographic Code:1U7LA
Date:Sep 1, 2007
Words:1820
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