In 2010, Tennessee experienced the worst flooding emergency since 1937. Floods had dramatic effects on Tennessean communities, considering that 52 counties were declared disaster areas. Homes and businesses were damaged or destroyed, and 24 citizens lost their lives.
The Tennessee Department of Health (TDH) responded in three main ways to the statewide devastation: 1) TDH activated its State Health Operations Center (SHOC) and Regional Health Operations Center (RHOC) to support Tennessee Emergency Management Agency (TEMA) activities; 2) Public Health Nurses assisted in American Red Cross (ARC) shelter operations; and 3) TDH reached out to pharmacies to ensure that flood victims could access needed medications.
The SHOC works as a designated facility to support ESF8 functions during a public health emergency. RHOCs are managed by regional health departments and linked to the statewide SHOC via redundant and bidirectional communications, so during an emergency, information flows from RHOC to SHOC to the State Emergency Operations Center (SEOC). TDH had conducted extensive training and exercising of the SHOC and RHOC activation and communications procedures prior to the flooding, and this training allowed facilities to respond rapidly and effectively to statewide requests for resources.
At the peak of the response efforts, more than 40 ARC shelters provided assistance for more than 4,000 displaced individuals. Due to a large number of flood victims seeking services, ARC requested that Public Health Nurses provide support for ARC shelter operations. TDH dispatched nurses to several shelters after conducting a quick needs assessment, which greatly enhanced ARC's ability to provide care and medical treatment to displaced people.
Much of TDH's outreach to pharmacies built on collaborative healthcare efforts established during the 2009 H1N1 response. TDH used its existing relationships with the Tennessee Pharmacist Association, the Tennessee Board of Pharmacy, and insurance providers to communicate the need for prescription overrides and to develop ways to assist evacuated individuals who did not have means to pay for medications.
Other cooperative efforts with healthcare organizations proved beneficial to response efforts as well. UnitedHealth Group provided early prescription refills to people whose medications may have been lost in the floods, opened a free counseling help line, and donated $50,000 to ARC relief efforts. The state TennCare call center also activated its Natural Disaster Procedures, a set of criteria by which the state can approve one-time prescription overrides for individuals whose medications suffered flood damage.
TDH's flood response efforts were effective and fast due to the support of many partners, including the ARC, TEMA, the Tennessee Academy of Family Practice, TennCare State Benefits Administration, state and local emergency management services, the State Coroner, the Salvation Army, Volunteer Organizations Active in Disaster, the United States Army Corps of Engineers, retail pharmacies, UnitedHealth Group, and local disaster animal response teams. Funds from CDC and the Office of the Assistant Secretary for Preparedness and Response (ASPR) supported TDH staffing costs and renovation of the SHOC.