Every year as the summer sun dries the fields and bakes the forests surrounding our residential treatment center, my fire awareness is triggered. So starts the months-long fire season in California.
In the past three years, we have been impacted by fire in a variety of ways. In 2017 we were on high alert as the nearby community of Santa Rosa burned in the Tubbs Fire. In 2018 our staff lost homes in the Camp Fire, and this year our residential treatment facility was evacuated under threat from the Kincaid Fire in Sonoma County. Our experiences have taught us to prepare for the unthinkable, because the unthinkable—in terms of disaster preparedness—is the new normal in California.
2020 will begin a decade that is facing mandatory power outages, weather conditions that are unpredictable and increasingly extreme, and all manner of natural and human-caused disasters. So it becomes increasingly important that we in behavioral health treatment are prepared for every eventuality.
In 2017 the need for a total and immediate evacuation of our campus became a distinct possibility. As a team we grabbed the disaster plan—you know, that binder—and reviewed our options. We had been using and training on a plan that identified one local community center as a shelter and simply suggested we go there in case of an emergency. While the plan met the goals of being complete and well thought out, what it lacked was an awareness that the emergency that threatens us the most is the one we cannot imagine. And in recent years, the unimaginable has become common: whole towns have been destroyed by fire, all access to facilities have been eliminated by floods, and the generators we have for emergency power failures were designed to meet needs during only a few hours of power failure. The days-long outages we experienced this year challenged our systems in ways that we simply could not have imagined when the disaster plan was created. In October, when we were in fact evacuated from our campus, we experienced challenges that simply could not have been anticipated as we designed the plan around the conference table.
And so begins the process of evaluating our response to the unknown. Our newly designed disaster plan needs to incorporate real-life responses to whatever comes our way, including adjustments to the following areas.
This year our county-wide evacuation included power outages that impacted cell reception on campus. An evacuation of twenty-eight clients plus staff is difficult enough without throwing in the lack of phone service. Having a satellite phone on hand is now necessary.
E-mail does not work in a disaster. Having the cell number of every team member is critical. Creating a dynamic staff text thread is something I wish I had every day of our evacuation. It was very difficult under pressure to remember who to include and how to find their cell numbers. Communicating with families and referents was a daily exercise, and that communication was a game changer for them in terms of awareness and comfort with our capability.
Our experiences have taught us to prepare for the unthinkable, because the unthinkable—in terms of disaster preparedness—is the new normal in California.
At every stage of our recent evacuation, we had a team comprised of those who could and were willing to step away from their families (many of whom were evacuated as well) to continue providing services for our clients. Our ability to communicate and problem solve in the immediate was critical. The team was comprised of different folks each day: nurses we borrowed from other facilities, overnight staff to provide respite for clinicians who labored sixteen hours per day, and case managers who provided stability and counseling as if we had never left our campus. We called in all staff who could help us, and they showed up in unbelievable ways by bringing food, providing weather and fire updates, doing rounds, conducting groups, and driving folks to meetings. The staff and volunteers who joined us that week are bonded in a way that is reminiscent of “trench buddies” (i.e., soldiers united by the extremes of active combat). We weathered the worst together and our clients thrived.
Recent disasters have reshaped our transportation awareness. While a few vans are all that are necessary for day-to-day programming, when thirty-five people and their overnight bags need to be moved quickly, multi-passenger vehicles are critical. This year we forethought to rent a fifteen-passenger van that was absolutely essential to our successful departure from the property.
The existing disaster plan called for our team to evacuate clients to a local community center that was recognized as a logical meeting area. Of course, in a county-wide evacuation, not only was the center itself evacuated, but so was our secondary gathering place, and our third choice, and even the first hotel we chose thirty-five miles away. With a mass exodus came the challenge of finding a place that could accommodate all our clients and staff. We were battling thousands of folks who were also fleeing their homes. We ended up at a hotel two hours from the facility.
Some facilities will have difficulty with the very realistic challenge of evacuating clients. It was expensive and labor-intensive, and probably impractical for a larger facility or one with clients who were less mobile. Thankfully, we had sister facilities who were offering beds, information, and moral support—these have been added to our newly devised disaster plan, as partners who can be counted on to support in a variety of ways are critical. I include DHCS in this list of partners. We checked in with them every morning of our evacuation and reported census and status. They were supportive and it was clear that we were in uncharted territory with this mass evacuation.
The evacuation of our facility in October of this year was shocking, disruptive, and expected in this era of environmental unpredictability. It is our duty as providers to be prepared. It is our responsibility not only to treat our clients, but to protect them. We need to think of disaster preparedness as a regular part of our leadership responsibility and training protocol.
For the past several years, we have practiced evacuating physically. We pull the fire alarm, we gather in the transportation area to prepare for leaving campus, and we practice sheltering in place. We routinely train for power outages and explosions. We know the disaster might come from any area—fire, flood, violence, earthquake, and others—and it is equally important for us to recognize that the disaster may be one we are not expecting. We have to be prepared for anything, and that requires foresight, creativity, and bravery; things we in this industry have in spades.
Jen Carvalho is the CEO of Casa Palmera in Del Mar, California. She is a program leader and has piloted programs during rolling power outages, and wildfire evacuations. Carvalho and her staff are focused on safe provision of services in an increasingly challenged environment.