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Emergency Management 6


Recommendations

A. In coordination with private non-profit blood donation centers and other stakeholders, Texas should expand the state’s capacity to accept and manage blood donations during a crisis, including as a last resort the use of state facilities and staff.

B. Texas Department of Health should build a ready and coordinated “just-in-time” blood donation supply through a coordinated educational campaign.


Summary

The Texas Emergency Management Plan requires the Texas Department of Health (TDH) to provide and coordinate services, equipment, supplies and personnel to meet the health and medical needs that exceed the capability of any affected area during a crisis. TDH can address such needs using a variety of resources including staff and material resources currently existing in the state health system, other state assets from various support agencies, private enterprises and voluntary agencies and individuals.[1] Under this plan, TDH is also responsible for managing the blood supply during an emergency or crisis. In past emergencies, TDH has coordinated with private blood banks to perform this function.

The September 11, 2001 crisis brought many volunteers to blood banks across the country, including Texas. Calls for emergency blood donations came from local blood donation centers, as well as nationally from the American Red Cross. In other parts of the nation, emergency blood donation centers were established for local emergency needs.[2] Response from blood volunteers during this crisis was overwhelming. Blood donations soon exceeded the need, and local Texas blood donation centers were advising donors to sign a pledge card to return later. This experience points to the need to broaden and enhance the TDH plan for managing the blood supply during a crisis.

Several strategies could improve the preparedness of the state’s blood supply during an emergency. The current TDH Emergency Preparedness plans have focused primarily on bioterrorism and not a comprehensive coordination of emergency plans to secure the blood supply. In light of terrorism events that may include bodily harm from non-infectious agents, an enhanced plan could be developed in coordination with all stakeholders that would address increasing capacity through private Texas blood centers and their affiliated network across the nation, as well as creating safe auxiliary blood donation sites and staffing through public and private facilities and organizations. This could provide Texas with a last resort back-up blood donation system in certain crises.

Since blood products have relatively short shelf lives (about 42 days for whole blood donations), timing of blood donations is essential to maintaining adequate supplies, especially during a crisis. In addition, donors are limited to donating every 56 days so once they have given, that donor is not available for a repeat donation for some time. Therefore, spacing of donations is important to maintaining an appropriate blood supply.

Media coverage has a dramatic impact on the timing of donations, and thus the adequacy of the blood supply. During the September 11, 2001 incident, national organizations were still calling for donations when local blood centers already had their immediate needd met and were turning donors away or asking them to come back at a later date. Media releases were not effectively coordinated so the public received mixed messages. TDH could monitor the blood supply levels across the state and coordinate the media message with all stakeholders. In certain cases, TDH, in coordination with other stakeholders, may need to clarify Texas’ situation relative to what national media messages contain.

The second way TDH could assist with securing an appropriate timing of blood donations is to coordinate the development and implementation of a unified strategy to increase the number of regular blood donors and educate them about their role in emergencies. Regular blood supply donors now consist of only about 5 percent of the population. A more extensive list of regular donors would allow more easily for the management of donations. Emergency preparedness could be increased by higher numbers of regular donors who could be trained to donate in a systematic manner during a crisis. TDH, in coordination with other stakeholders, could promote higher numbers of donors through public service announcements that emphasize all Texans’ responsibility during emergencies. TDH could work with all stakeholders to develop a plan to organize and educate blood donors to donate regularly and to prepare during emergencies to donate on a call-up basis. This effort could be an expansion of some initiatives started by blood donation centers and the American Red Cross.

The state has many active blood donors in its state employee workforce. No effort has been made to actively promote a commitment of a certain number of blood donations per year. The number of committed state employee blood donors could be increased through a statewide drive. TDH could coordinate with existing state employee blood donation programs or with the Employee Retirement System’s communications to employees to include strategies that educate and mobilize this base of donors during a crisis.


Fiscal Impact

The Health and Human Services Commission will need to shift resources to enhance the Texas Department of Health’s ability to handle its emergency management responsibilities related to blood supply. The Texas Department of Health will need two additional staff positions to recruit, manage and coordinate a group of all appropriate stakeholders in blood supply operations and appropriate media campaign funding. For staff positions at $50,000 each in salary, this would require a shift of $100,000 for salaries and benefits of approximately $28,000. These staff would assist with the establishment of protocols for emergencies for increasing blood supplies through private blood centers and, as a last resort, through state and local facilities and staff. They would work with the Division of Emergency Preparedness to incorporate these protocols into the state plan. They also would assist with the coordination of media releases during an emergency and with the development and implementation of a campaign to increase donors. The campaign to increase donors should be coordinated with private blood centers and the American Red Cross, the State’s Employees Retirement System, the University of Texas System, Texas A&M University System, the governor’s office and legislative leadership.


[1] Texas Department of Health, Division of Emergency Preparedness, State Emergency Preparedness Plan, Annex H (Austin, Texas, October 9, 2001): http://www.tdh.state.tx.us/hcqs/ems/epplan.htm.

[2] U. S. Department of Health and Human Services, “NIH Blood Bank to Accept Blood Donations For New York City, Pentagon Emergencies.” Washington, D.C., September 11, 2001 (press release); and America’s Blood Centers, “Americans Respond to Terrorist Attacks by Donating record Amounts of Blood,” ABC Newsletter, September 14, 2001: www.americasblood.org.