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Heat Emergency Registry and Surveillance System

Solution Overview

The St. Louis Department of Health utilizes a specialized database of residents who may require assistance during emergencies, combined with surveillance systems to monitor public safety during heat events.[1][2][8] This registry-based approach was created following a hot summer power outage in 2006 in which some areas lost electricity for two weeks, causing major problems in dealing with the city's most vulnerable populations.[7] The system was recognized by Harvard University's Ash Center for Democratic Governance and Innovation as one of 111 Bright Ideas in government in 2012.[6]

Technical Components

The Functional Needs Registry is a protected database containing information about individuals of any age residing in St. Louis who may require assistance in the event of an emergency.[3][4][5] The InDEP (Innovative Disaster Evacuation Planning) system serves as the core of the registry and is copyrighted by Innovative Data Systems.[4][5] The database is GPS-linked and can map people's locations by political ward or ZIP code, showing who has a mobility issue in each area.[7] The database is maintained on a server outside the city and can be accessed anywhere, though it is encrypted and has three different security hurdles.[7] Once a resident's information is approved by a review team, the database is updated with the person's name, address, phone number, emergency contact information, medications, and insurance information.[6] All records are protected by security software and maintained by the City of St. Louis Department of Human Services.[5]

Implementation Details

The registry was developed under the St. Louis City Health Commissioner's Investigation Authority and is administered from 1520 Market Street, 4th Floor, St. Louis, MO 63103.[4][6] Since the registry was implemented, more than 4,000 people have registered, with the total reaching approximately 8,000 registrants.[6][7] Information is added and updated internally through the city's elderly services database from senior centers and meal providers.[7] Due to staffing constraints, St. Louis uses volunteer organizations like AmeriCorps to keep the registry updated.[7] The St. Louis Area Agency on Aging is involved in administering the registry, with Dave Sykora serving as executive director.[6][7] The Department of Human Services manages the registry with office hours Monday through Friday 8:00 AM to 5:00 PM, and there is no cost associated with registering for the service.[3] Individuals can register by calling the local number (314) 657-1676 or toll-free at (877) 612-5918, or by completing an online application.[3][4] Eligible registrants are required to sign Confidentiality Authorization Forms prior to being placed on the registry.[3] Registrants receive semi-annual renewal notices asking them to update their application via paper or through the online registration process, and the city reviews the state's death registry.[3][5][7]

Benefits and Impacts

During the 1999 Midwest heat wave, St. Louis heat response remained effective because of conservative deactivation criteria, while Chicago's early declaration that the emergency was over may have led to additional deaths.[1] The registry helps officials with emergency planning by providing numbers and locations of where people are, according to the executive director of the St. Louis Area Agency on Aging.[7] In the event of an emergency, every effort is made to contact those persons on the registry to provide information about how to prepare for or respond to the emergency, information regarding facilities or shelters, and to check on their well-being.[3][5] A voice message from the Mayor is sent to residents on the registry, reminding them of resources such as cooling centers and utility assistance.[2] The Department of Health, along with staff from other city departments and groups, go door-to-door to check on vulnerable neighbors during heat events to ensure they are in a safe and cool environment that will protect their health and well-being.[2] The Department of Health conducts outreach all year but is particularly vigilant in times of extreme heat events and heat waves.[2]

Climate Adaptation Relevance

This system addresses extreme heat events and heat waves by enabling targeted outreach to vulnerable populations during climate-related emergencies.[1][2] The registry's GPS-linked mapping capabilities allow authorities to identify and reach residents with mobility issues during heat emergencies, providing critical support when extreme temperatures threaten public health.[7]

Business Analysis

The information collected through the registry is used for disaster planning and public health purposes by the City of St. Louis and is not available to the public.[3][4] Data gathered from enrollees can only be accessed and shared with emergency response, human service, and public health agencies to improve their ability to serve those in need, and none of the information is public record.[6] Authorities who have access to the information are required to follow confidentiality restrictions implemented by the St. Louis Department of Health and the Health Insurance Portability and Accountability Act.[6] The registry was developed under the St. Louis City Health Commissioner's Investigation Authority and is not public information.[5] St. Louis recently obtained legislative protection for everyone on its registry after initially only people protected by a government program were shielded from public disclosure under state sunshine law.[7] St. Louis makes it clear that there is no guarantee for services through the registry, with the hope that people understand by being on the registry, there will be people who know where they are and that they will be taken care of as best as possible.[7]

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