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opinion | Kathleen Sebelius

How post-Katrina New Orleans transformed its health care system

Ambulances transferred patients from the Interim LSU Hospital to the new University Medical Center in New Orleans earlier this month.Brett Duke/NOLA.com via AP

Ten years ago this week, Hurricane Katrina and the levee failures devastated New Orleans. Compounding the personal devastation experienced by residents and making the immediate response even more unmanageable was the fact that the city’s few major health care providers were severely incapacitated. After the storm, only three of the city’s nine hospitals remained open, making recovery more complicated and access to health care much more difficult for a population that already had limited access. New Orleans had one of the highest uninsured rates in the country and had long struggled with health outcomes.

But what has happened to the city’s health care system since Katrina has been nothing short of transformational. Its new, reimagined, resilient health care system is a model for cities across the country for creating healthier communities and stable care delivery systems.

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When Katrina hit, the ensuing floodwaters devastated the city’s health care system. With major city hospitals closed and flooded, ambulances underwater, and medical professionals evacuated or flooded out themselves, there were virtually no options for critical care.

It’s hard to imagine a more bleak situation, and yet a spirit of ingenuity and resilience prevailed. Doctors and nurses set up neighborhood-based “pop-up” clinics — out of ice chests, in grocery stores, and wherever solid ground still existed. Hundreds of New Orleanians desperate for care flocked to the makeshift pop-up clinics to receive health services.

The resilience of New Orleans in the face of such catastrophe was inspiring. In particular, Dr. Karen DeSalvo, former health commissioner of New Orleans, saw a way to build a health care system following the floods based on the delivery needs of patients.

Today, with the help of significant federal investment, the region boasts more than 50 neighborhood health clinics that provide high quality, accessible health care in neighborhoods that historically did not have access to primary care. These clinics also provide mental health services, which were vital in the aftermath of such a catastrophic event.

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To say New Orleanians were suffering from trauma following the storm doesn’t do justice to the real psychological impact a disaster like this has on people who lost their homes, children, parents, and livelihoods. So the city took a simple but profound step: It began to integrate mental health care into primary care, allowing clinics to assess patients’ mental health when they came in, and adjust treatments accordingly.

As the city rebuilt its health care delivery system and local leaders sought to redevelop the city’s economy, health care also became an economic engine for the city’s recovery.

By making significant investments in the development of the New Orleans Biomedical Corridor, the city helped to establish itself as a research hub and as an innovator in promoting healthy lifestyles. For example, the award-winning Fit NOLA initiative has taken innovative approaches to childhood obesity, while the city has also added almost 100 miles of bike paths and trails since the storm to encourage alternative means of transportation and healthy lifestyles. The $1.1 billion University Medical Center, which opened its doors to patients just this month in the heart of downtown New Orleans, will promote these proactive initiatives – while also serving as the region’s new Level 1 trauma center. And soon the biomedical corridor will see a new major medical center, with the Southeast Louisiana Veterans Healthcare System expected to open its doors next year.

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As we examine the recovery of one of American’s greatest cities over the last decade, there is a rightful focus on how infrastructure and water management has changed to make this city resilient for the challenges a coastal city will always face. Often the greatest innovations emerge when there are no other options; one of the greatest stories of this city’s recovery can be found in changes to the health care delivery system. And those innovations have helped provide New Orleanians with a better, more accessible health care delivery system, better prepared to weather the next storm.

Kathleen Sebelius is former secretary of the Department of Health and Human Services.

Related:

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Bill Golden: Invest in coastal infrastructure — or we all lose

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