Testimony of President David L. Callender, MD, MBA, FACS The ...

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Testimony of President David L. Callender, MD, MBA, FACS The ...

Publié le : jeudi 21 juillet 2011
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TestimonyofPresidentDavidL.Callender,MD,MBA,FACSTheUniversityofTexasMedicalBranchbeforetheJointHearingoftheHouseofRepresentativesSelectCommitteeonHurricaneIkeDevastationandSenateIntergovernmentalRelationsSubcommitteeonFloodingandEvacuationsDecember3,2008
Testimony of David Callender, MD, MBA, FACS President, The University of Texas Medical Branch Wednesday, December 3, 2008
Mr.Chairman,andmembersoftheLegislatureandcommunity,IappreciatetheopportunitytoprovidethisstudycommitteewithinformationrelatedtothelessonsUTMBhaslearnedfromitsexperiencewithHurricaneIkeandtoalsoaskyouforyourcontinuedassistanceinourrecoveryefforts.IamDr.DavidCallenderandIserveaspresidentoftheUniversityofTexasMedicalBranchinGalveston.PriortocomingtoUTMBinSeptember2007,IservedasCEOoftheUCLAHealthSystem;beforethatIservedasExecutiveVicePresidentandChiefOperatingOfficerattheUTMDAndersonCancerCenter.Inbothpositions,Iplayedasignificantleadershiproleinhelpingthoseinstitutionsmanageeventsbroughtaboutbynaturaldisasters.Clearly,HurricaneIkehadaprofoundeffectonTheUniversityofTexasMedicalBranch.WhileIkewasonlyaCategory2stormaccordingtotheSaffirSimpsonhurricanescale,theassociatedstormsurgeandfloodingweremuchmorecharacteristicofaCategory4(orhigher)storm.Morethan750,000squarefeetoffirstfloorspace(outofatotalof7millionplussquarefeetofcampusspace)sustaineddamagefromsaltwaterfloodingduringthehurricane.ThefollowingcommentsdescribeourgeneralapproachtoprotectingandpreservingUTMB’scampusassetsbefore,duringandafterHurricaneIke.PreparingforweatherrelatedeventsCampuswidepreparationandtrainingforhurricanesisroutinelyconductedatUTMB,consistentwithourinstitutionaldisasterpreparednesspolicyAhurricanesimulationdisasterdrillwasconductedtwoweekspriortothestormExtensivecommunicationchannelswiththeTexasStateEmergencyOperationsCenterandlocal/regionalemergencyresponseteamswereinplacewellbeforethestorm’sarrivalAcomprehensiveIncidentCommandStructurewasinplaceandreadyforactivationpriortotheeventAmaximumof$100millionindisasterinsurancecoveragewassecuredbyTheUniversityofTexasSystemBoardofRegentsfortheHoustonregion’scampuses.ContractsfordisasterresponseserviceswereinplacethroughUTSystem’sOfficeofRiskManagementStocksoffuel,water,foodandmedicalsupplies,aswellasalternativepowersources,wereavailableontheUTMBcampusorstagedatnearbylocationsinadvanceofthestormEmployeesessentialtotheprovisionofsecurity,facilityoperations,emergencyhealthcareandemergencymanagementfunctionsweredesignatedaheadoftheevent
Testimony of David Callender, MD, MBA, FACS President, The University of Texas Medical Branch Wednesday, December 3, 2008
AstagedapproachtoHurricaneIkePhasedcessationofresearchactivities,cancellationofclinicvisitsandelectivesurgeries,dischargeofhospitalpatientsabletosafelyreturnhome,andtherelocationofacademicandvitalsupportfunctions(e.g.,finance),commenced120hoursbeforethestormCampusfacilitiesweresecuredaccordingtoprestormstandardsClosureoftheGalvestonNationalLaboratoryandallotherUTMBbiosafetylevellabswascompleted“bythebook”andwithoutincidentEssentialpersonnelwerenotifiedtomakeplanstobeinassignedlocationsatassignedtimesinadvanceofthestorm’sarrivalRegularcommunicationswithlocal,stateandfederalofficialswasmaintainedwiththeStateEmergencyOperationsCenterunderthedirectionofChiefJackColleyandtheOfficeoftheGovernorEffectiveevacuationofnonessentialpersonnel,studentsandhospitalizedpatients(includingprisoners)wasconductedaccordingtoprotocols,withnosignificantadverseevent,thanksinlargemeasuretoCaptainColley,thestaffoftheEOC,andonsiterepresentativesCharles“Boo”WalkerandDavidPopoff,whoworkedtosecureessentialtransportationassetsandtransferlocationsDuringandimmediatelyafterHurricaneIke750,000squarefeetofUTMB’sfirstfloorspacewasfloodedasaresultofsaltwaterstormsurgefromtheGalvestonBay;floodlevelsrangedfromafewinchesinUTMBsMoodyMedicalLibraryandtheSchoolofNursingandHealthProfessionsBuilding,tothreefeetinJohnSealyHospital,toeightfeetin“OldRed,”thestate’sfirstmedicalschoolUTMB’sincidentcommandteamandonsitestafffocusedonprovidingemergencymedicalservicesandonprotectingandpreservingcampusassetswhilesecuringessentialemergencyservicesforthecampus—food,power,water,naturalgas,communicationsUTMBprovidedemergencymedicalservicesforcommunitymembersandfirstresponderswhowereontheislandduringandimmediatelyafterthestormDuetotheintensedemandsonpersonnelfulfillingessentialdutiesduringandafterthehurricane,arotating“buddysystem”wasimplementedtoensurepersonalsafetyandcontinuedfitnessfordutyCleaningandrestorationofcampusfacilitiesbeganimmediately,supplementedwithcontracteddisastermanagementworkerswhoarrivedwithinadayofthestorm
Testimony of David Callender, MD, MBA, FACS President, The University of Texas Medical Branch Wednesday, December 3, 2008
UTMB’shighlytrainedsecurityofficersprovidedasafeenvironmentforstaffandkeptthecampusfreeofintrudersUTMB’stopprioritiesweretoattendtothemedicalneedsofasteadystreamofpatientsseekingemergencycareorshelter,toprovideasafeenvironmentforonsiteUTMBandcontractpersonnel,andtopreserveandprotectcampusfacilitiesandequipmentPostIkeprioritiesAddressingtheneedsofpatients,studentsandemployeesRelocated540medicalresidentstoalternativeclinicaltrainingsiteso Establi oyeesupportservicesoshedoffcampusstudentandempl rdthand4 yearmedicalstudentsinclinicalrotationsoffcampusoPlaced3 orcontinuityofpatientcarebyquicklyrestoringaccesstotheoProvidedf university’sCallCenter,patientACCESSline,InternetservicesandElectronicMedicalRecordsystemsImplementedplansimmediatelyafterinitialdamageassessmentstoo relocatecriticalpatientservicestomainlandlocationsEstablishedcollaborationswithlocalhospitalstoprovideforUTMBo physicianprivilegesandpracticeopportunitiesProvidedsupportservicesforemployeesandstudentsduringtheo transition;supportincludedhousingassistance,FEMAregistration,studentfinancialaid,counselingservices,anduninterruptedpayrolloperationsProtectingandpreservingUTMB’sresearchcapabilitiesoPreservedcriticalfrozenresearchspecimensandmajorequipmentRestoredresearchlabstofunctionalityasquicklyaspossibleo Locatedalternativeareastoconductvitalresearchprojectsthatneededo toproceedwithoutinterruptionRestoringcampusfunctionsInitiatedacompleteassessmentofdamages,inconcertwithUTSystemo RiskManagementBegancleanupanddehumidificationofdamagedbuildingswithin36o hoursofthearrivaloftropicalstormforcewindsoDevelopedaprioritizedschedulebasedonthedamageassessmenttoreturnbuildingstotheirdesignateduseasquicklyaspossibleNote:Basicservicessuchaswater,sewer,naturalgasandelectricitywereo dependentupontheCityofGalveston’sagedutilityinfrastructureandtookadditionaltime(morethanaweek)torestore;thissignificantlylimitedUTMB’srestorationefforts
Testimony of David Callender, MD, MBA, FACS President, The University of Texas Medical Branch Wednesday, December 3, 2008
InitialandcontinuedcriticalcollaborationsFederalgovernmente.g.,FEMA,DMAT,USNNassauStateofTexase.g.,Governor’sOffice,DSHS,NationalGuardCity/CountygovernmentandcommunityleadersTheUniversityofTexasSystem,manyUTinstitutions,otherTexasacademicinstitutions,manyhealthcareprovidersacrossthestateProfessionalorganizationse.g.,AAMC,ACGME,SocietyforMicrobiologyAlumni,localcommunities,friendsHurricanerelatedcostsfortheUniversityofTexasMedicalBranchBuildingCostsRelatedtoDamages$225.0MillionExternalCampusCleanup$67.0MillionClinicalEquipment$51.5MillionInfrastructure$43.2MillionResearchEquipment$17.6MillionITEquipment$11.7MillionKitchenReplacement$8.0MillionEducationReplacement$5.1MillionBusinessInterruption$276.4Million___________TotalProjectedCostIncurred$709.7MillionPotentialInsuranceCoverageforTheUniversityofTexasSystemis$100MillionRestoringservicesOverthepast11weeks,UTMBhasbeenabletorestoremostofitsresearchservices:TheGalvestonNationalLabwasunharmedandisoperationalo TheRobertE.Shopebiosafetylevel4labwasunharmedandiso operationalTheTrumanBlockerMedicalResearchBuildingsustainedverylittleo damageandisoperationalUTMB’sSchoolofMedicinereturnedtooperationswithnosignificantinterruptioninthestudents’academicexperience:stndAcademicservicesareoperational;oncampusclassesfor1and2o yearmedicalstudentsresumedOctober20rdthClinicalprogramsfor3and4 yearstudentshavecontinuedthrougho collaborativeagreementswithotherhealthcarefacilitiesinTexas
Testimony of David Callender, MD, MBA, FACS President, The University of Texas Medical Branch Wednesday, December 3, 2008
UTMB’sschoolsofNursing,HealthProfessionsandGraduateBiomedicalSciencesareoperationalClinicalserviceshavebeenrestoredand/orarenowavailableat:’snetworkofRegionalMaternalandChildHealthClinicsoUTMB ObstetricalunitsintheJohnSealyHospitalo Emergencyroom(fortreatmentofminoremergencies)intheJohnSealyo HospitalCommunitybasedclinicsonthemainlando ƒPrimaryandspecialtycareInpatientunitsatcollaboratinghospitalso ƒChristusStJohn(NassauBay)ƒClearLakeRegionalMedicalCenter(HCAClearLake)ƒMainlandMedicalCenter(HCATexasCity)ƒSt.JosephMedicalCenter(Houston)SelectedprimaryandspecialtyservicesonGalvestonIslando ChallengestoUTMB’srecovery59%ofUTMB’sannualbudgetedrevenuewasderivedfrompatientcareoperations;thatrevenuestreamhasbeensignificantlyreducedduetohurricanerelateddamagetheJohnSealyHospitalandcampusoutpatientclinicssustainedUTMBoutpatientclinicalservicesareoperationalinprimarycareandspecialtyservicesonthemainlandbutproductivityislimitedbyspaceavailabilityUTMB’soperatingexpensesrelatedtothecostofcampuscleanupeffortsandongoingpayrollforpersonnelhasresultedinrapiddepletionofcashreserves(exhaustedbyspring2009)LimitedaccesstoadditionaloperatingfundslimitsUTMB’spotentialtomeetexistingpayrollobligationsLackofworkingcapitallimitsUTMB’sabilitytorestorefacilitiesandequipmentnecessarytoreturntooperationsWhythereductioninthenumberofbedsatJohnSealySmithHospitalEssentialsupportservicesmustberelocatedandrestored:Inpatientpharmacyo Sterileprocessingfortheoperatingroomso Bloodbankserviceso oFoodservicesoRadiationoncologyservicesReopenedspacemustbecodecompliant(morespaceperbed)Bedspacemustaccommodatenecessaryequipment
Testimony of David Callender, MD, MBA, FACS President, The University of Texas Medical Branch Wednesday, December 3, 2008
Reducedpopulation(demand)onGalvestonIslandWhyUTMBcannotreopenitsLevelOneTraumaCenterFacilityrequiressignificantrestorationLossofessential,expensivemedicalequipmentLackofaccesstokeyservices(e.g.,operatingrooms,bloodbank)Difficultyinmeetingstaffingrequirements(physicianavailability)ThedriversforUTMB’srecentreductioninforceReducedrevenuestreamsfrominpatientandoutpatientcareAmajorportionofoperatingexpensesarerelatedtosalaryandbenefitsLackofadequatecashreservestofundsalariesandrestorationsUTMB’scashreserveswere$160millionbeforeHurricaneIkeo Withoutareductioninforce,cashreserveswouldbeexhaustedmoreo quicklyLackofavailableclinicalworkforhealthcareemployeesduetotheinabilitytoadmitpatientstotheJohnSealyHospitalforanextendedperiodoftimePossiblemitigationstrategiesImprovingCityofGalvestonutilitiesinfrastructure(water,sewer,power,naturalgas,communications)toensurerapidreturntooperationsforUTMBRaisingessentialservicestothesecondfloororhigherinallbuildings“Hardening”existingbuildingswherefeasible(e.g.,installingfloodgatesystemssimilartothoseusedintheTexasMedicalCentertoprotectthecoreareaoftheUTMBcampus)Developinga“hardened”facilitytobettersupportanimalresearchbyeliminatingtheneedtotransportanimalsduringweatherrelatedemergenciesDevelopinga“hardened”facilitywithreliablepowerandfuelsourcestomaintaintheresearchenterprise’sfrozenspecimens(“FreezerFarm”)RelocatingvulnerableservicestothemainlandonpropertyalreadybeingdevelopedbyUTMBasanAmbulatorySurgicalCenter,ImagingCenter,andOutpatientSpecialtyCareCenterTheUniversityofTexasMedicalBranchisworkingtoprotectandpreservevitalcapabilitiesandpreciousresourcesasweplanforthefuture.Allavenuesofpotentialfundingandsupportarebeingpursued.WeareworkingcloselywithstateleadershipandwiththeTexasHealthandHumanServicesCommissiontoanalyzetheimpactofour
Testimony of David Callender, MD, MBA, FACS President, The University of Texas Medical Branch Wednesday, December 3, 2008
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