HJNO Nov/Dec 2020

42 NOV / DEC 2020 I  HEALTHCARE JOURNAL OF NEW ORLEANS COLUMN INSURANCE Nearly 15 years to the day after Hurri- cane Katrina devastated the New Orleans region, Hurricane Laura made landfall in the southwestern corner of Louisiana and blazed a 21-parish path of destruc- tion up the state’s western border. More than 1.3 million Louisiana residents felt the Category 4 storm’s impact—an impact compounded by the challenges already facing the state due to the COVID-19 pan- demic. From extensive property damages and widespread power outages to pri- mary care practice closures and critical healthcare needs, our state’s recovery from Laura will be a complex one that re- quires support from all sectors, including healthcare. The Vulnerability Factor Natural disasters are always devastat- ing regardless of where they strike, but in the case of Laura, the devastation tar- geted an already vulnerable region. When socioeconomic challenges exist, the im- pact of a natural disaster becomes even more far-reaching. And when a pandemic is in progress in an affected region, the recovery process is even more complex and challenging. The American Community Survey re- ports that the poverty rate across the 21 parishes impacted by Laura is 21 percent, compared to a national poverty rate of 14 percent. Within these parishes, according to the survey, nearly 200,000 residents are over age 65, and more than 200,000 have disabilities and special healthcare needs. Nearly 43,000 of these residents lack access to a vehicle, and 73 percent of very low-income renters in these par- ishes spend more than half their annual income on housing, leaving them with limited funds for critical needs like food and healthcare. Compounding these issues for Louisi- ana families is the COVID-19 pandemic, which significantly increased rates of un- employment, food insecurity and shelter insecurity according to research by the nonprofit Center on Budget and Policy Priorities (CBPP). As the pandemic pro- gressed, the high demand for support with these social determinants of health (SDOH) brought added stressors to com- munity-level social service organizations that were already strained before Laura’s arrival. In addition, the majority of Louisiana residents—94 percent, in fact—already live in a designated Healthcare Provid- er Shortage Area (HSPA) for primary care physicians, according to the Prima- ry Care and Prevention Services HRSA (Health Resources and Services Admin- istration) Data Warehouse. Of the 21 parishes affected by Laura, only a small segment of Calcasieu Parish—the part of the parish that is home to Lake Charles— is not a designated primary care HPSA. And in the wake of Laura, the availability of primary care services was even more limited thanks to the COVID-19 pandem- ic, evacuations, property damage and power outages. The Recovery Process Louisiana’s recovery from Laura will be a long one, but it is one in which all sec- tors in our state must engage. The health- care sector has been at the forefront of those critically needed response efforts. From large health systems to small pri- vate practices, from DME companies to THE HURRICANE LAURA RESPONSE: How Louisiana’s Healthcare Sector Has Risen to the Fore