NTSPP Note:  Dr. Webster and a very small cadre of psychiatrist volunteers carried the load.  Hopefully after psychiatrist disaster training, we can more equitably share the load during future crises and avoid burning out our best and finest.  Thanks to Frank Webster,  Carol North,  and all of you who stoically and heroically served.

From Frank Webster MD:  Hello all, Well, the last evacuees departed for the Houston/Galveston area yesterday afternoon. The clinic was shut down yesterday as well. This was truly an amazing operation that stood up rapidly, provided over 1200 medical service contacts and 120 mental health contacts.

I just want to take a couple of moments and thank a few people. (in no particular order)

 Thanks to everybody who was involved, either in directly caring for people down at the Convention Center, or the good people who worked harder to make those of us able to go down there to provide services. In the mental health area especially, it is crucial to not load up the crisis system when you can provide field services.

Thanks to the folks at Parkland, UT, and Green Oaks who had to work extra hard to cover for me when I was out.

 Thanks to Ray Fowler, Warren, and all of the people at the DCC/MRC/DMOC who are amazingly organized and work so hard to make this type of thing run well despite the inherent chaos an unpredictability.

 Thanks to Dr. North for coming back to take on the leadership in this.

 Thanks to Drs’ Brenner, Jenkins, Bennett, Mohl, Balfour, Rekerdres, Shah, Schwarz, Ghose, Wolf, Lane who worked the majority of the shifts.

 Thanks to the folks at Adapt Crisis Services who were tirelessly (or tiredly) there 24/7. They are an amazing group of people, and did a great job in managing some very difficult people. (thanks especially Tonia and Demetra).

 Thanks to the folks at Transicare (Scott, Angie, Jana…) who were there when needed and would serve basically to cover any whole in the system.

 Thanks to the folks at Dallas Metrocare who took on the pharmacy role, and who provided on site staff for the special needs population, and did a great job.

 Thanks to the folks at ValueOptions (Jack Szczepanowski, Conway McDanald, Sandy Potter, Felicia Spaulding) who took the approach of “whatever it needs to work”.

 Also a special thanks to UNT medical student Kelly Grabbe, who I assumed must have been a senior level resident, given her organizational skills and her ability to fit right in and get to work.

 Thanks to anybody I missed in this. It is truly an amazing thing to be a part of and I am very proud of our community who was willing to step up twice in 2 weeks and serve a population of evacuees (a few of who came up and said hi and thanks from the Gustav evacuation).

 Frank Webster, MD

 Medical Director Psychiatric Emergency Services   Parkland Memorial Hospital/UT Southwestern

 Medical Director Integrated Crisis Services   Green Oaks Hospital

09.22.2008 Monday 1700 CDT  Hello all, Most of the evacuees left today on buses. There are about 50 people left in the convention center. They are Galveston evacuees, and they are due to depart on Wednesday.

Well over 1200 patients were served medically and approximately 120 received mental health services. There will be one more day of mental health coverage for Tuesday 9/23. The medical clinic will be closed tomorrow at 1200, as will the mental health clinic.SCHEDULE/SCHEDULE NEEDS:   Tuesday 9/23/08: Frank Webster 1000-1200. All mental health services will switch to prn after this.

Thanks yet again for all of your hard work and flexibility and cooperation.
 Frank Webster, MD   

Medical Director Psychiatric Emergency Services Parkland Memorial Hospital/UT Southwestern

 Medical Director Integrated Crisis Services Green Oaks Hospital

NTSPP Note:  Frank and a very small cadre of psychiatrist volunteers carried the load.  Hopefully after psychiatrist disaster training, we can more equitably share the load during future crises and avoid burning out our best and finest.  Thanks to Frank Webster,  Carol North,  and all of you who stoically and heroically served.

NEED:  PSYCHIATRIST ONSITE AND BACK-UP ON MONDAY 1000-1400 AND TUESDAY 1000-1400    Contact Frank.Webster@UTSouthwestern.edu. See Ike: Volunteer above for new volunteer info. Check with www.ntspp.org for updates.

Hello all,  As of 1500 today (09.21), there are 600-650 residents at the Dallas Convention Center. They are service about 950 meals at a time, meaning that there are many clients in hotels who are coming back to the Convention Center for meals and other services.

 There is currently no clear indication of how much longer shelter operations will continue. Many of the people who came up on their own have returned, and many of those left are in need of some types of service.

The Medical Coverage is being provided by the Parkland HOMES people. On site medical treatment will be available through this evening, and from 1000-1400 after today. Approximately 1250 people have received medical services, and about 120 have received mental health services.

We still have Adapt Crisis Services on site from 0800-2200. I am recommending that change from 0800-1800 as of Monday.

In terms of psychiatric coverage, we will provide coverage 1000-1600 Sat and Sunday. We will go from 1000-1400 as of Monday. Sunday is well covered, Monday and Tuesday are open.

 SCHEDULE/SCHEDULE NEEDS:

 Sunday 9/21 (1000-1600) (Dr. Webster is telephone backup)

 Tim Wolff 1000-1400

Celia Jenkins 1200-1600

 Monday 9/22 (1000-1400): NEED PSYCHIATRIST ON-SITE & TELEPHONE BACK-UP.

 (Frank Webster 1130-1400    Has other obligations, any assistance appreciated.)

  Tuesday 9/23 (1000-1400): NEED PSYCHIATRIST ON-SITE & TELEPHONE BACK-UP

Please contact me (frank.webster@utsouthwestern.edu) directly for psychiatric coverage availability.

Please contact Janie Metzinger at Jmetzinger@mhadallas.org for non-physician scheduling

Thanks yet again for all of your hard work and flexibility and cooperation.

Frank Webster, MD

Medical Director Psychiatric Emergency Services

Parkland Memorial Hospital/UT Southwestern

Medical Director Integrated Crisis Services

Green Oaks Hospital

1530 CDT Friday 09.19.2008 Update on Psychiatric Physician Schedule & Needs at DCC through Monday Sep 22:   Need:  Monday, 09.21.2008 1000 through 1400 Onsite & Back-Up.

 Hello All, We are cutting back the hours covered slightly. I am hopeful that we can reassess coverage needs as of Monday, but I would like to provide coverage for the same times that the medical crew is there.

 Thanks! Frank Webster frank.webster@utsouthwestern.edu

 Friday 9/19 (1000-1800) (Dr. North is telephone backup)

 John Bennett 1000-1200

Frank Lane 1300-1800

Frank Webster prn until 1600 (I have Epic ASAP training at 1600-the new Psych ER computer system

Carol North prn  

Saturday 9/20 (0900-1600) (Dr. Lane is Telephone backup)

Jane Miles 0900-1100

Frank Webster 1100-1600

Sunday 9/21 (1000-1600) (Dr. Webster is telephone backup)

Tim Wolff 1000-1200

Celia Jenkins 1200-1600

Monday 9/22 (1000-1400) NEED ONSITE & BACKUP

See www.ntspp.org for updates, FEMA info, and volunteer badge and process info

PSYCHIATRISTS  NEEDED FRIDAY, SATURDAY & SUNDAY.

Hello All,   Current Coverage is below.  Friday is covered.  Most of Sunday is covered.  We could really use help on Saturday.   Thanks!   Frank Webster  MD.  Sign up with me at Frank.Webster@utsouthwestern.edu.  New volunteers check box above for how to get badge. 

(NTSPP note:   DCMS general medicine clinic has transferred care.  We psychiatric physician volunteers are still needed.  Could folks give Frank Webster and Carol North a rest?)

Friday 9/19 (1000-1800) (need Telephone backup)
  
   John Bennett                1000-1200 

   Frank Lane                   1300-1800
   Frank Webster              prn until 1600 (I have Epic ASAP training at 1600-the new Psych ER computer system
   Carol North                   prn

 Saturday 9/20 (1000-1800) (schedule and telephone backup)

    John Bennett                  1000-1200

 Sunday 9/21 (1000-1800) (schedule and telephone backup)

     Tim Wolff                      1000-1200

    Celia Jenkins                  1200-1600

SHELTER: Thursday 4 pm

Laundry started pick up today & will be on Tues & Thurs 1800-1900 hrs

Laundry drop off will be Mon & Weds 0830-1000 hrs

Houston has asked us to hold off sending folks back for now – so we will have company into next week

FEMA requires registration before moving into hotels that FEMA selects, and

FEMA requires their number & picture ID for moving

Medical clinic will transfer from MRC to PMH HOMES medical staff with operation 1000-1400 hrs

Mental Health will move to a 12 hour shift daily

EMS will continue 24/7 daily

Meds pick up will be 1600-1800

OEM update:

The State call had a different emphasis today. It was on transitioning people back to their homes or to hotels and apartments if they don’t have anything to go home to. There will be a big meeting with FEMA after the call to work out funding details. Another call will be held this afternoon to explain the process. Also, the State has buses ready to fan out as soon as the damaged counties are ready for folks to return. We have heard that Harris County and Houston may be open, but we are waiting on official confirmation.

We had 930 folks in the shelter overnight. We were able to consolidate the other Dallas shelters into one; and appreciate the help from DISD and DART in moving people. FEMA has set up a table to register them so they should be ready to move to hotels as soon as that program is announced today. Other social services are welcome to set up in the Library; contact Kjerstine Nielsen at 214-670-7809.

The Dallas Fire-Rescue Team has been released and will return to the City this afternoon. They did a great job with search and rescue in the Orange County and Bolivar Peninsula areas. The Debris Team working in Houston continues their work. They are now asking for “load and haul” assistance more than tree cutting, so our Park Dept may be called on to help with that. Mary Nix is talking with the Houston contingent as we speak.

Hopefully more later on the transition to hotels or bus repatriation to the southern areas.

FEMA info Dr. Barnes sent:

 3 Areas Points:

#1. Hotel/Motel Program:

Good for 30 day period beginning first day of Implementation – until October 14th.

Can be extended after that time.

1-800-621-FEMA

 #2. State Critical Needs Incidental Program

Funding up to $500 for incidentals

60 day period and not be extended

1-888-766-3258

#3. Emergency Food Stamp program – HHS: 1-877-541-7905

Card may also be used on hot, ready to eat foods, not normally allowed under federal rules

TexasBenefits.com

www.HHSC.state.tx.us (emergency food stamps)

If they are already on stamps and in the affected area, then they will be automatically reloaded.

Apply by : October 17th.

* The attachment shows the Houston Estimated Time for Completion of Substantial Restoration.

Dave

Dave Hogan, LCSW, DAPA

Crisis Intervention Manager

Environmental & Health Services

City of Dallas

1500 Marilla, 2DN

Dallas, TX 75201

(214) 670-4225 phone

(214) 957-6902 cell

(214) 670-4669 fax

david.hogan@dallascityhall.com

Hello all, As of 1200 today, we have about 700+ people at the Dallas Convention Center.   The medical folks have seen over 800 and mental health has seen over 90, a mixture of onsite and offsite (other shelters) people.

 I am anticipating that we will be growing less busy, although yesterday was still fairly brisk, and a lot of the volume was in the evening.   With that in light, psychiatric coverage will continue from 0800-2200 today. For Thursday 9/18, we will change the coverage from 1000-1900, and 1000-1800 for Friday 9/19.   I will generate the weekend schedule tomorrow, but I am planning on approximately 6 hours of time on Sat/Sunday.    We will need telephone backup for these.

 We were just informed that the medical folks may be standing down their clinic tomorrow afternoon (not finalized) and turning over the medical care the Parkland HOMES group.

 What that would mean for mental health is a continued but decreased on site presence for Adapt, Transicare and psychiatry.

SCHEDULE/SCHEDULE NEEDS:

 Wednesday 9/17: (Dr. John Bennett is telephone backup)

 Subroto Ghose 0830-1330

Felicia Akingbala 1200-1400

John Bennett 1400-1600

Adam Brenner 1400-1800

Margaret Balfour 1800-2200 (Dr. Wolff available from 1800-2200 if needed)

Dr’s Webster and North are PRN

 Thursday 9/18 (1000-1900) (Frank Webster telephone backup)

 Frank Webster 1000-1500

Subroto Ghose 1500-1900

Erika Navarro 1700-1900 (as backup)

Paula Dobbs-Wiggins 1600-1800 (as backup)

 Friday 9/19 (1000-1800)

 Need coverage from 1000-1800 and telephone backup

 Sat 9/20  To be determined  ~ 6 hours

Sun 9/21  To be determined ~ 6 hours

 Please contact me (frank.webster@utsouthwestern.edu) directly for psychiatric coverage availability.

 Thanks yet again for all of your hard work and flexibility and cooperation.

 Frank Webster, MD

 Medical Director Psychiatric Emergency Services

Parkland Memorial Hospital/UT Southwestern

Medical Director Integrated Crisis Services

Green Oaks Hospital

2300 CDT  Monday 09.15.2008:  Hello all, We received word that there may be anywhere from 0 to 600 dialysis patients arriving starting tomorrow afternoon (Tuesday). The reason for the ambiguity is that about half of the Houston area dialysis centers are still without power. The ones that are not able to provide the services have been requested to call their patients and ask them to report for possible transport to the DFW area. The more centers that have power, the less patients that are likely to come here.

 Due to the significant psychiatric co-morbidity of dialysis patients, we have been asked to have extra psychiatric staff available after 1400 tomorrow. I don’t want to send people down there for nothing, but if you would please send me your contact information and availability for tomorrow after 1400. We will only ask people to go to the Convention Center if needed.

 Also, if Dr. Jenkins could send out a list of preferred psychotropics for those patients on dialysis, it would be greatly appreciated.

 Please contact me (frank.webster@utsouthwestern.edu) directly for psychiatric coverage availability.

Thanks yet again for all of your hard work and flexibility and cooperation.

 Frank Webster, MD

 Medical Director Psychiatric Emergency Services   Parkland Memorial Hospital/UT Southwestern

 Medical Director Integrated Crisis Services  Green Oaks Hospital

 PSYCHIATRISTS NEEDED at DCC:  Thursday added
See below for Gaps in Shifts. Sign up for Thursday all shifts please.  Unlicensed residents can work, but they will need to work with a licensed provider.    Many thanks to the people who are doing this.    My understanding is that the State will reimburse you or your employer for time here. Sandy Potter has the details on this (sandy.potter@valueoptions.com).    See www.ntspp.org for updates and official information.  SIGN UP WITH FRANK WEBSTER MD  Frank.Webster@utsouthwestern.edu.

CURRENT NEEDS:  Monday 2100 to 2200.  Wednesday 1400 – 1800.  Thursday 0800-2200.

CURRENT WISHES:  Back-ups or extra coverage all shifts.The current schedule is:

Monday 9/15: NEED:  2100 to 2200.   GLAD TO HAVE: Extras at any shift
John Bennett 0800-0900

Adam Brenner 0830-1100

Celia Jenkins 1300-1800

Frank Lane 1830-2100

I (Frank Webster can cover from ~1100 onwards, but we do need better coverage than just me)

Carol North will be intermittently available in the AM and the PM, but will be unavailable from 1100-1300 or so.

Tuesday 9/16: NEED:  None.   GLAD TO HAVE: Extras at any shift
Subroto Ghose 0830-1200

John Bennett 1200-1600

Arthur Westover 1600-1800

Margaret Balfour 1800-2200

Carol North prn

 I  (FW) am not available on this day at all on 9/16 due to providing coverage for the Parkland Psychiatric Emergency Room.

Wednesday 9/17: NEED 1400-1800. GLAD TO HAVE: Extras any shift.
Subroto Ghose 0830-1330

Felicia Akingbala 1200-1400

Margaret Balfour 1800-2200

Frank Webster after 1230

Carol North prn

Thursday 9/18: NEED 0800-2200.  NONE SCHEDULED YET.  PLEASE SIGN UP.

BADGE PROCEDURE
If you are not yet badged, the procedure is…

 1. Once you are on the schedule, bring with you your driver’s license, proof of your credentials (your UT badge will do)and a copy of the e-mail containing your specific time/date/location assignment.

 2. Go to the Dallas County Health and Human Services Department, 2377 Stemmons Expressway, 4th Floor to get your disaster volunteer badge.

Thanks, 

Frank Webster, MD   Frank.Webster@utsouthwestern.edu

 Medical Director Psychiatric Emergency Services Parkland Memorial Hospital/UT Southwestern  & Medical Director Integrated Crisis Services  Green Oaks Hospital

STATE OPERATIONS UPDATE: Just to keep you posted on Ike.

    The State of Texas has conducted extensive search and rescue operations, so far over 5200 people have been rescued pre and post landfall. The State is also now providing communities with pods of “food, water, and ice”. Wide spread power outages continue throughout the effected areas. The priorities for restoration are Hospital/medical care facilities, water and water treatment. Approximately 2.5 million people remain without power. Several hundred thousand have had power restored today.

    Some areas received such extensive damage that rebuilding will be required. Temporary housing will be obtained (no timeline mentioned).

 CONVENTION CENTER OPERATIONS:

    The Dallas Convention Center is now set up for operations, and is providing 24/7 medical and mental health services.

    As of 1600 the Convention Center has 886 people registered. People have been leaving and others coming in throughout the day. There are approximately 300 special needs people in route by bus from Houston. Many of these are dialysis patients who are being sent to the DFW area due to lack of power at dialysis facilities. ETA is after midnight.

    Mental Health has seen over 55 individuals, including some in the Richardson Shelter.

    Over 500 people have been served on the medical side.

 Frank Webster MD