LOUISIANA -- Louisiana's coastal-area nursing homes are better prepared to evacuate their residents than they were before hurricanes Katrina and Rita, officials said Tuesday.
But if those plans fall through, the state is preparing to back them up with transportation.
Also new to the mix is a triage center to be established in Baton Rouge to treat those evacuees physically unable to withstand lengthy trips to shelters in other parishes.
Many of the changes are the result of new laws and regulations enacted after the deaths of nursing home residents during Hurricane Katrina, including the highly publicized case of St. Rita's Nursing Home in St. Bernard Parish, where 35 of the home's residents died.
The owners of the home were found innocent of negligent homicide in a 2007 trial after they were criminally charged by the state Attorney General's office.
The state Department of Health and Hospitals did not track how many other nursing home evacuees died in the aftermath of the storms, DHH Public Information Officer Jolie Adams said.
State Health Officer Dr. Jimmy Guidry said if a nursing home's transportation plans fall through right before the approach of a hurricane, the state can provide buses to evacuate nursing home residents to some point north.
Guidry also said that if a mandatory evacuation is issued for an area with a nursing home, the nursing home must evacuate the residents.
"Before Katrina, it was up to the nursing home. If they don't evacuate now, they are on their own," Guidry said.
Joe Donchess, executive director of the Louisiana Nursing Home Association, said he has talked to a lot of nursing home owners and not one has said they won't evacuate if a mandatory evacuation is ordered for their area.
Guidry spoke about the nursing home backup plan Tuesday at an emergency evacuation bus triage drill behind the John M. Parker Agricultural Center at LSU.
Guidry said the state's triage plan is a lesson learned in the wake of Hurricane Katrina.
"If people get here at the triage point and they are sick, we can make sure they can continue on the trip without getting sicker," Guidry said.
Under the triage plan, the state Department of Transportation and Development has a contract for 700 out-of-state coach buses. The buses will be sent to parish pickup points to transport people of any age who don't have transportation to evacuate north.
Parish officials will use school buses to transport residents to the local pickup point.
Paramedics and doctors check the status of passengers at each parish pickup point and then notify the bus driver about passengers with medical issues, Guidry said.
When buses hit Baton Rouge on the way north to shelters, medical personnel, including 30 to 50 paramedics, 50 volunteers and two to three doctors, will be on hand to determine if the passengers are healthy enough to continue or need to be transferred to a hospital or a medical special-needs shelter, Guidry said.
Ken Pastorick, public information officer for DHH's Office of Public Health and Center For Community Preparedness, said the bus triage setup was not around during Hurricane Katrina.
"This allows us to be proactive and do something before the storm hits so folks don't get sick on us," Pastorick said.
Dr. Chris Trevino, who runs the emergency room at St. Elizabeth Hospital in Gonzales, created the bus triage center plan and is the incident commander of the site.
"Before, during Katrina, we did it all on the fly. Now we know what we are in for," Trevino said.
Donchess, speaking in a telephone interview Tuesday about the new requirements for nursing homes, said, "So many things we have in place now have us much more prepared."
Under a 2006 state law, nursing homes in 22 coastal parishes have to create emergency preparedness plans and submit them for review to DHH by March 1 of each year - three months before hurricane season begins.
The plans must include proof of transportation or a contract with a transportation company verified by a written agreement.
Before Hurricane Katrina, Adams said, coastal parish nursing homes were required to submit their evacuation plans only to their parish offices of emergency preparedness.
Under the new DHH regulations, the evacuation plans must include how many nursing home residents can ride a bus, how many need wheelchair-accessible vehicles, how many need transportation other than cars, buses or wheelchair vehicles but don't need ambulances, and how many need ambulances.
The evacuation plans must also include a written contract or agreement with a site to shelter the residents outside the area of risk.
Color photo of David Armand, of Acadian Ambulance, readying Troy Hidalgo for transport Tuesday morning during a bus triage drill at LSU. The state Department of Health and Hospitals ran the drill to test a new plan to care for south Louisiana residents with medical problems going north before a hurricane strikes. Hidalgo played the part of a resident with her heart problems. Meanwhile, new state requirements should improve evacuations from coastal-area nursing homes. (By Arthur D. Lauck)