Emergency management plans require recurrent and continued revision since former emergent events may have provided new insights about things to do different. Lessons learn enhance the time associated to emergency response and provides an objective guide to follow when crisis and multiple priorities press upon the aftermath response. The VA Caribbean Healthcare System will always prioritize on objectives that seek to prioritize on the safety of Veterans and their employees.
All our stakeholders can support the response in the aftermath of a disaster or emergency by being ready themselves and learning how they can support the VA mission in times of need. Below you will find links to critical sites or information you may want to save:
What happens in VACHS when an emergency is activated?
In response to a disaster or critical emergency, the VACHS will activate the Hospital Incident Command System (HICS). This is a group of leaders who will lead the assessment, planning, and response effort in the aftermath of an emergency. In all emergencies, VA will expect a rapid accountability of staff and of vulnerable patients. Accountability may be attained through phone calls, text, visits, or outreach efforts, among some.
Who are vulnerable patients?
Vulnerable patients are those defined within a specific clinical group who are at a disadvantage due to their health risk factors characteristics, including sociodemographic, and that because of these factors, may have a slower recovery time in the exacerbation of their disease. This vulnerability may be physical, psychological or social. Natural disasters may increase morbidity and mortality of vulnerable patients because continuity of care gets interrupted.
During the aftermath of a disaster, patients can keep in contact with their health care providers using some of the following tips:
- My Healthy Vet
- Phone calls
- Text messaging
- VEText 2-way communication
- Home Based Primary Care visits
Critical Links and Files
Puerto Rico and USVI Local Resources
- The Guide for Public Health in Emergency and Disaster "Guía de Salud Pública en Emergencias y Desastres” is the Puerto Rico Department of Health -Public Health Guidance for Emergency and Disasters that was published this morning at their webpage https://www.salud.gov.pr (Spanish version).
- Ready: For building your individual and family plans Plan Ahead for Disasters | Ready.gov
- Virgin Island Territorial Emergency Management Agency (VITEMA) : Home (vi.gov)
- Puerto Rico Emergency Management Bureau (PREMB) Manejo de Emergencias – Negociado para el Manejo de Emergencias y Administración de Desastres (pr.gov)
- Puerto Rico All-Hazard Plan, https://manejodeemergencias.pr.gov/wp-content/uploads/2021/05/PRhazardsplanoctober2020version1-1-min.pdf
- Puerto Rico Emergency Portal System (PREPS)PREPS - Puerto Rico Emergency Portal System
FEMA Caribbean Area Division: Puerto Rico | FEMA.gov
Health Information Card
An emergency health information card communicates to first responders what they need to know about you if they find you unconscious, incoherent or if they need to quickly help you evacuate. An emergency health information card should contain information about any disabilities, medications, any equipment you use, allergies, communication difficulties you may have, preferred treatment and medical providers, and emergency contacts.
Print the emergency health information card located below and complete it with a permanent ink pen. Make multiple copies of the card to keep in emergency supply kits, car, wallet or purse, wheelchair pack, etc.
Don’t run out of medications
Emergent disaster events can affect access to healthcare services, including, access to medications. Don’t run out of medications, when preparing for an emergency, make sure you have at least 15 days of medication supplies available at home. You can refill your medications by using the known procedures, like:
- Submitting your refill mail slip as soon as you receive your mailed supply
- Using My Healthy Vet for refills and/or communicating with your primary care provider
Veterans should be aware that there are emergencies that significantly disrupt the VA operation, affecting the ability to timely send medications to patients. In these scenarios, the Hospital Command Incident Commander can activate a program called Heritage for emergency refills.
When Heritage is activated, Veteran patients can go to any local retail pharmacy to obtain needed refills. Veteran patients must take an empty active VA prescription bottle (not older than 6 months and with refills available) or a new VA prescription on a VA form by an authorized VA provider to a retail pharmacy. This does not include controlled substances.
The Heritage Health Customer Care Line is available for both VA patients and Pharmacies for any billing questions or coverage at 1-866-265-0124, option 1.
Important phone numbers to collect before an emergency
Partners in the community
Save contact information of agencies who can assist you during or after an emergency in your community:
Pharmacy Network Listing for Puerto Rico and the Virgin Islands
Emergency Pharmacy Refill Program
Veteran patients can go to any local retail pharmacy to obtain needed refills. Veteran patients must take an empty active VA prescription bottle (not older than 6 months and with refills available) or a new VA prescription on a VA form by an authorized VA provider to a retail pharmacy. This does not include controlled substances.
The Heritage Health Customer Care Line is available for both VA patients and Pharmacies for any billing questions or coverage at 1-866-265-0124, option 1.
Heritage Hours of Operations for Hurricane Coverage:
- Monday through Friday, 7:00 am to 11:00 pm EST
Saturday and Sunday, 9:00 am to 5:30 pm EST
Collecting Data and Reporting References
The Atlantic hurricane season is June 1 – November 30. Never underestimate the value of being prepared!
Given the ongoing global supply chain issues, everyone should consider early storm preparation. You can get tips and hints on how to make sure you and your family are hurricane ready on this web page and also visit the Hurricane Tips for Veterans and Families page at Hurricane Tips for Veterans and Families - VA Sunshine Healthcare Network.
Check out the information below to learn more about hurricanes, hazards associated with hurricanes, and what you can do to prepare.
Make a Plan
Make a plan today. Your family may not be together if a disaster strikes, so it is important to know which types of disasters could affect your area. Know how you’ll contact one another and reconnect if separated. Establish a family meeting place that’s familiar and easy to find.
Step 1: Put a plan together by discussing the questions below with your family, friends or household to start your emergency plan.
Step 2: Consider specific needs in your household.
Step 3: Fill out a Family Emergency Plan
Step 4: Practice your plan with your family/household
See the Hurricane Preparedness Guide for Veterans and Families below (also available in Spanish)
Guidance, links and printable material is available at Ready.gov.
Know your Watches and Warnings
Part of preparing for a hurricane is understanding the National Weather Service (NWS) forecast products, especially the meaning of NWS watches and warnings.
- Hurricane Watch: Hurricane conditions (sustained winds of 74 mph or greater) are possible within your area. Because it may not be safe to prepare for a hurricane once winds reach tropical storm force, the NHC issues hurricane watches 48 hours before it anticipates tropical-storm-force-winds.
- Tropical Storm Watch: Tropical storm conditions (sustained winds of 39 to 73 mph) are possible within the specified area within 48 hours.
- Storm Surge Watch: The possibility of life-threatening inundation from rising water moving inland from the shoreline somewhere within the specified area, generally within 48 hours.
- Hurricane Warning: Hurricane conditions (sustained winds of 74 mph or greater) are expected somewhere within the specified area. NHC issues a warning 36 hours in advance of the tropical-storm-force winds to give you time to complete preparations.
- Tropical Storm Warning: Tropical storm conditions (39 to 73 mph) are expected within you area within 36 hours.
- Storm Surge Warning: The danger of life-threatening inundation from rising water moving inland from the shoreline somewhere within the specified area, generally within 30 hours.
- Extreme Wind Warning: Extreme sustained winds of a major hurricane (115 mph or greater), usually associated with the eyewall, are expected to begin within an hour. Take immediate shelter in the interior portion of a well-built structure.
Before, During and After a Hurricane
Before a Hurricane - Plan
The best time to prepare for a hurricane is before hurricane season begins on June 1. It is vital to understand your home's vulnerability to storm surge, flooding, and wind. Here is your checklist of things to do BEFORE hurricane seasons begins.
- Know your zone: Find out if you live in a hurricane evacuation area.
- Be prepared for hurricane season: The National Weather Service hurricane preparedness information can help you be prepared.
- Put together an emergency kit: Put together a hurricane disaster supply kit. Check emergency equipment, such as flashlights, generators, and storm shutters. Ensure you have enough medications on hand.
- Develop or review your family emergency plan: Before an emergency happens, sit down with your family or close friends and decide how you will get in contact with each other, where you will go, and what you will do in an emergency. Keep a copy of this plan in your emergency supplies kit or another safe place where you can access it in the event of a disaster. Start at the Ready.Gov emergency plan webpage.
- Review your insurance policies: Review your insurance policies to ensure that you have adequate coverage for your home and personal property.
During a Hurricane - Stay Safe
When a hurricane threatens your community, be prepared to evacuate if you live in a storm surge risk area. Allow enough time to pack and inform friends and family if you need to leave your home.
- Secure your home: Cover all of your home's windows. Permanent storm shutters offer the best protection for windows. A second option is to board up windows with 5/8 inch exterior grade or marine plywood, built to fit, and ready to install. Buy supplies before the hurricane season rather than waiting for the pre-storm rush.
- Stayed tuned in: Check the websites of your local National Weather Service office and local government/emergency management office. Find out what type of emergencies could occur and how you should respond. Listen to the weather radio at NOAA Weather Radio or other radio or TV stations for the latest storm news.
- Follow instructions issued by local officials. Leave immediately if ordered!
- If NOT ordered to evacuate:
- Take refuge in a small interior room, closet, or hallway on the lowest level during the storm. Put as many walls between you and the outside as you can.
- Stay away from windows, skylights, and glass doors.
- If the eye of the storm passes over your area, there will be a short period of calm, but at the other side of the eye, the wind speed rapidly increases to hurricane force winds coming from the opposite direction.
After a Hurricane
- Stay informed: Continue listening to a NOAA Weather Radio or the local news for the latest updates. If you evacuated, return home only when officials say it is safe.
- Stay alert: Once home, drive only if necessary and avoid flooded roads and washed-out bridges. If you must go out, watch for fallen objects in the road, downed electrical wires, and weakened walls, bridges, roads, and sidewalks that might collapse.
- Assess the damage: Walk carefully around the outside of your home to check for loose power lines, gas leaks, and structural damage. Stay out of any building if you smell gas, if floodwaters remain around the building, if the building or home was damaged by fire, or if the authorities have not declared it safe.
- Carbon monoxide poisoning is one of the leading causes of death after storms in areas dealing with power outages. Never use a portable generator inside your home or garage. When the power goes out, keep your generator outside. Generator tips available here.
- Use battery-powered flashlights. Do NOT use candles. Turn on your flashlight before entering a vacated building. The battery could produce a spark that could ignite leaking gas, if present. Power outage tips available here.
- Know where to get disaster assistance. Click here for FEMA disaster assistance information.
Resources (National, Federal, State, and more)
- How to Prepare for a Hurricane | Hurricane Preparedness 101 (togetherpuertorico.com)
- CDC natural disasters and severe weather
- CDC: emergency preparedness and response
- Disaster Assistance Improvement Program (DAIP)
- EPA Natural Disasters and Weather Emergencies
- Federal Emergency Management Agency (FEMA)
- FEMA Social Hub
- Food & Drug Administration Emergency Preparedness and Response
- Ready.Gov Disasters & Emergencies Resource
- U.S. Department of Health & Human Services
- U.S. Department of Homeland Security
- USA.gov Disasters and Emergencies
- San Juan, PR (weather.gov)
- National Hurricane Center
- Florida Disaster Emergency Information
- Ready.Gov – Hurricanes
- FEMA Mobile App and Text Messages
- National Weather Service
- National Hurricane Center
- Links to State/US Government Hurricane Resources
- National Oceanic and Atmospheric Administration
- Storm Prediction Center
Disaster Assistance, Evacuation and Road Maps
Tornado safety tips
To stay safe during a tornado, prepare a plan and an emergency kit, stay aware of weather conditions during thunderstorms, know the best places to shelter both indoors and outdoors, and always protect your head.
To protect yourself and your family from harm during a tornado, pay close attention to changing weather conditions in your area. If you know thunderstorms are expected, stay tuned to local radio and TV stations or an NOAA weather radio for further weather information. Some tornadoes strike rapidly without time for a tornado warning. The following weather signs may mean that a tornado is approaching:
- A dark or green-colored sky
- A large, dark, low-lying cloud
- Large hail
- A loud roar that sounds like a freight train
If you notice any of these conditions, take cover immediately, and keep tuned to local radio and TV stations or to a NOAA weather radio or check the internet.
Know when to shelter. Falling and flying debris causes most deaths and injuries during a tornado. Although there is no completely safe place during a tornado, some locations are much safer than others.
- Go to the basement or an inside room without windows on the lowest floor (bathroom, closet, center hallway).
- If possible, avoid sheltering in a room with windows.
- For added protection get under something sturdy (a heavy table or workbench). Cover your body with a blanket, sleeping bag or mattress. Protect your head with anything available.
- Do not stay in a mobile home.
Flood safety tips
During a Flood Watch or Warning
- Gather emergency supplies, including non-perishable food and water. Store at least 1 gallon of water per day for each person and each pet. Store at least a 3-day supply.
- Listen to your local radio or television station for updates.
- Have immunization records handy (or know the year of your last tetanus shot).
- Store immunization records in a waterproof container.
- Bring in outdoor items (lawn furniture, grills, trash cans) or tie them down securely.
- If evacuation appears necessary, turn off all utilities at the main power switch and close the main gas valve.
- Leave areas subject to flooding such as low spots, canyons, washes, etc. (Remember: avoid driving through flooded areas and standing water.)
After you return home, if you find that your home was flooded, practice safe cleaning.
After Flooding Occurs
- Avoid driving through flooded areas and standing water. As little as six inches of water can cause you to lose control of your vehicle.
- Do not drink flood water, or use it to wash dishes, brush teeth, or wash/prepare food. Drink clean, safe water.
- If you evacuated, return to your home only after local authorities have said it is safe to do so.
- Listen for boil water advisories. Local authorities will let you know if your water is safe for drinking and bathing.
- During a water advisory, use only bottled, boiled, or treated water for drinking, cooking, etc.
- When in doubt, throw it out! Throw away any food and bottled water that comes/may have come into contact with floodwater.
- Prevent carbon monoxide (CO) poisoning. Use generators at least 20 feet from any doors, windows, or vents. If you use a pressure washer, be sure to keep the engine outdoors and 20 feet from windows, doors, or vents as well. Never run your car or truck inside a garage that is attached to a house even with the garage door open.
The initial damage caused by a flood is not the only risk. Standing floodwater can also spread infectious diseases, bring chemical hazards, and cause injuries.
After you return home, if you find that your home was flooded, practice safe cleaning. Remove and throw out drywall and insulation that was contaminated with floodwater or sewage. Throw out items that cannot be washed and cleaned with a bleach solution: mattresses, pillows, carpeting, carpet padding, and stuffed toys. Homeowners may want to temporarily store items outside of the home until insurance claims can be filed. See recommendations by the Federal Emergency Management Agency (FEMA).
Clean walls, hard-surfaced floors, and other household surfaces with soap and water and disinfect with a solution of one cup of bleach to five gallons of water.
Wildfire safety tips
Wildfires affect everyone. They can spread fast and harm us. Wildfires are getting bigger and more dangerous. More people are living in areas at risk for wildfires, but we can take action to prepare. Learn how to prepare your household and community.
Protect yourself from smoke.
When wildfires create smoky conditions it’s important for everyone to reduce their exposure to smoke. Wildfire smoke irritates your eyes, nose, throat, and lungs. It can make it hard to breathe and make you cough or wheeze. Children, pregnant women, and people with asthma, chronic obstructive pulmonary disease (COPD), or heart disease, need to be especially careful about breathing wildfire smoke.
Keep smoke outside.
- Choose a room you can close off from outside air.
- Set up a portable air cleaner or indoor air filtration to keep the air in this room clean even when it’s smoky in the rest of the building and outdoors. If you use a do-it-yourself box fan filtration unit, never leave it unattended.
- A respirator is a mask that fits tightly to your face to filter out smoke before you breathe it in.
- You must wear the right respirator and wear it correctly. Respirators are not made to fit children.
- If you have heart or lung disease ask your doctor if it is safe for you to wear a respirator.
- Avoid using candles, gas, propane, wood-burning stoves, fireplaces, or aerosol sprays and don’t fry or broil meat, smoke tobacco products, or vacuum.
- If you have a central air conditioning system, use high efficiency filters to capture fine particles from smoke. If your system has a fresh air intake, set the system to recirculate mode or close the outdoor intake damper.
Pets and other animals can be affected by wildfire smoke too.
- Learn how to protect your pets and livestock.
- Some evacuation centers do not accept animals. Check Petfinders for shelters or RedRover for information on local animal shelters and rescue groups
Keep track of fires near you so you can be ready.
- AirNow’s “Fires: Current Conditions” page has a map of fires throughout North America.
- NOAA’s “Fire weather outlook” page maps fire watches and warnings.
- Listen to the Emergency Alert System (EAS) and National Oceanic and Atmospheric Administration (NOAA) Weather Radio for emergency alerts.
Learn more about protecting yourself from wildfire smoke.
- Finding out what could happen to you
- Making a disaster plan
- Completing the checklist
- Practicing your plan
Stay healthy during power outages.
Large fires can cause long-term power outages. Read about what to do if your power goes out, including:
- Preventing carbon monoxide poisoning
- Food safety
- Safe drinking water
- Power line hazards