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Health Care Coalitions in Texas Restore Essential Functions


Winter storms in February 2021 impacted all 254 counties in the state of Texas resulting in power outages, impassable roadways, and dwindling resources. Texans flooded into emergency departments – in many cases using them as warming centers, quickly overwhelming hospital facilities and their staff. Other health care facilities, including long-term care facilities, nursing homes, and dialysis facilities struggled to run essential electric equipment and provide heating at the same time.

Response Activities:

Health care coalitions (HCCs) in Texas leveraged response-related procedures and infrastructure established with Hospital Preparedness Program (HPP) cooperative agreement funding to meet the urgent needs of health care facilities throughout the state.

In some instances, HCCs partnered with their local fire departments to set up filtered water stations and replenish potable water in hospitals, nursing homes, long-term care facilities, dialysis centers, and other affected health care facilities. In addition, several Texas HCCs coordinated transportation from hospitals to other warming centers using Texas Emergency Medical Task Force (EMTF) Ambulance Buses (AMBUS), to alleviate crowding in emergency departments.

One major hospital system* comprised of 50 acute care hospitals across Texas, noted almost all facilities reported electricity and health care service dependent patients were arriving in their emergency departments. With help from ASPR’s Regional Emergency Coordinator (REC), the facilities utilized de-identified HHS emPOWER Program (emPOWER) data on the total number of Medicare beneficiaries who rely on electricity-dependent durable medical equipment and assistive devices and/or essential health care services in a geographic area, down to the ZIP Code. The emPOWER data allowed the facilities to better predict, plan, and prepare for the volume and needs of incoming patients at-risk of negative health outcomes. emPOWER provides federal data, mapping, and artificial intelligence tools, as well as training and resources, to help communities nationwide protect the health of at-risk Medicare beneficiaries.


In total, the widespread loss of electricity lasted over a week and necessitated collaboration among a variety of partners across the state, including the Texas Department of State Health Services (DSHS), the Texas Division of Emergency Management (TDEM), the Texas Department of Transportation (TxDOT), the Texas Department of Public Safety (TXDPS), the Texas Animal Health Commission and Texas A&M AgriLife Extension Service (AgriLife), and amateur radio operators. When looking forward to future incidences of severe winter weather, lessons learned from the storm inspired more collaboration and planning. As an example, Texas’ End Stage Renal Disease (ESRD) Network is identifying alternate power resources for dialysis facilities to mitigate any incident with widespread power loss. With the loss of power, many utilities were unable to provide much needed clean water to health care facilities. Subsequent planning has included finding alternate sources of clean water and the means to transport and store it, as necessary.

*This hospital system is located in the following HCCs in Texas: HCC E (DFW), HCC I (El Paso), HCC O (Austin/Central Texas), HCC P (San Antonio), HCC HQR (Houston/Southeast Texas), HCC U (Corpus Christi) HCC V (Rio Grande Valley).