Health Care Coalition Planning and Coordination Saved Lives During Severe Flooding Event in Eastern Kentucky

Eastern Kentucky Region 
February 15, 2025

On February 15, 2025, relentless rain swept across eastern Kentucky. As the rain fell onto already saturated and snow-covered ground, rivers and waterways began to overflow. The deluge quickly escalated into a catastrophic flooding event, impacting 13 counties in the eastern region and 11 others across the Commonwealth. As the waters rose, so did the urgency for a coordinated response to the lives of people in harm’s way—one that would test the region’s preparedness and the strength of its health care emergency networks.

In anticipation of unfavorable weather conditions, the Kentucky Department for Public Health and Kentucky Hospital Preparedness Program field staff activated their Regional Response Coordination Center, and Commonwealth officials activated the Emergency Operations Center. The Eastern Kentucky Healthcare Preparedness Coalition proactively began planning for possible evacuations and ways to support the health care sector. This early activation was not just a procedural step; it was a testament to the lessons learned from previous disaster responses and the effective communication mechanisms in place between health care and response partners.

The Eastern Kentucky Healthcare Preparedness Coalition is a health care coalition that receives funding and guidance from ASPR’s Hospital Preparedness Program. Kentucky contains eight Emergency Preparedness Coalition regions, each with designated Readiness and Response Coordinators. With Hospital Preparedness Program funding and guidance, Kentucky’s health care coalitions can establish partner networks, coordinate health care and emergency response, and host community-wide trainings and exercises, thereby promoting preparedness and strengthening regional readiness ahead of emergency events.

Prior to the flooding, the Eastern Kentucky Healthcare Preparedness Coalition strategically placed generators, ambulance buses, and evacuation and sheltering trailers in locations that had been previously impacted by extreme weather events. This foresight meant that when flooding escalated, these resources were already on the ground and ready to be deployed at a moment’s notice. As the floodwaters inundated communities, these prepositioned assets proved invaluable. Three ambulance buses, equipped to transport and triage multiple patients, were used immediately to evacuate a combined 241 patients from four nursing homes and one critical access hospital. The ability to move these at-risk patients quickly and safely was a direct result of the efforts made possible by the Kentucky Healthcare Preparedness Program and health care coalition’s networking, planning, and training. Field staff knew how to effectively respond to save lives prior to and during the flood thanks to similarly-focused training exercises, such as the Hospital Preparedness Program-required annual Medical Response and Surge Exercise. The team was also able to quickly deploy mission-ready response packages, such as evacuation equipment and ambulance buses specifically designed to safely evacuate facilities and transport patients while maintaining care.

The response to the flooding was a model for coordination and collaboration. Local Kentucky Department for Public Health and health care coalition teams worked together to coordinate the possible evacuation of a 113-bed acute care hospital, which included six intensive care unit patients. The hospital, surrounded by floodwaters held back by a flood wall, came within one or two feet of a catastrophic breach. Thanks to the robust medical operations coordination process, involving coordination between HCCs and regional partners, the hospital was able to shelter in place safely. Monitoring the situation, multiple hospitals and agencies across the Commonwealth engaged in real-time in case the facility needed to evacuate.

The Kentucky Healthcare Preparedness Program, Emergency Operations Center, Eastern Kentucky field staff, and Eastern Kentucky Healthcare Preparedness Coalition coordinated and shared resources, maintaining situational awareness internally and across coalition members. 
 

The 2025 flooding marked the third major flood event in eastern Kentucky in just four years. Each time, the Eastern Kentucky Healthcare Preparedness Coalition has activated its Regional Coordination Center and response plans based on National Weather Service briefings, allowing for a proactive rather than reactive approach. This event reinforced the need to establish a medical operations coordination center, which would further enhance the region’s ability to coordinate complex medical responses. The response also highlighted the need for an additional ambulance bus in the Eastern Kentucky Healthcare Preparedness Coalition to expand capabilities. Plans are already underway to acquire and retrofit another bus using Hospital Preparedness Program funding, ensuring that the region will be even better prepared for future events.

The February 2025 flooding in eastern Kentucky tested the region’s emergency preparedness and health care response systems. Thanks to the effective partnerships, planning, and investments made possible by the Hospital Preparedness Program, the response was swift, coordinated, and effective. Patients and geographically at-risk populations were kept safe, hospitals continued to operate under extreme conditions, and lives were protected. The event stands as a powerful example of how effective planning, response, and coordination efforts prepare communities for disasters and save lives when every second counts.