Indian Health Services Emergency Director Engineers Vigilance with Harmony

LaRoche1.jpgWASHINGTON — Most people probably prefer not to think about floods, tornadoes and other natural and unnatural disasters, but Capt. Darrell LaRoche, USPHS, always is thinking about ways to plan for catastrophes.

As the director of Emergency Services for the Indian Health Service (IHS) since 2009, LaRoche oversees trauma services, emergency medical services, emergency management and continuity of operations for his agency. that the job takes organizational and interpersonal skills.

“There are a lot of different disciplines that come together to respond. It is finding the harmony with those groups and getting them moving ahead in the right direction,” he said about his job.

IHS services are administered through a system of 12 area offices and 163 IHS and tribally-managed service units. A large part of LaRoche’s responsibilities are to maintain vigilant for situations that will require emergency planning or preparation and then helping the area offices and IHS facilities respond effectively.

LaRoche said one of his most rewarding professional experiences was working as the incident coordinator for the H1N1 pandemic for IHS in 2009. He maintained medical surveillance of the flu situation within the American Indian/Alaska Native communities and facilitated interactions between IHS sites and states to receive necessary supplies to take care of flu patients. In addition, daily calls, which eventually became weekly calls, were conducted with IHS staff, and representatives from the Bureau of Indian Affairs and Bureau of Indian Education to brief them on the situation and to make sure the medical facilities had the necessary personal protective equipment, antivirals and vaccine to protect workers. 

The experience was especially meaningful, he said, because of his connection to the population he serves; LaRoche is a member of the Lower Brule Sioux Tribe in South Dakota.

“I was pretty proud of the IHS response to that and the coordination of how we all worked together as an agency and also as a federal government,” he recounted.

One of most challenging aspects of LaRoche’s job is the large number of tribal communities that IHS serves, each with its own needs and concerns.

“Tribes have a unique status with their sovereignty,” he said. “One thing you may hear from people who work with the tribal communities is that there are 565 tribes, and there are 565 solutions as to what we are trying to do.”

Not only is LaRoche a member of the Native American community, he also is a second-generation IHS employee.

His father, the late William LaRoche, joined the U.S. Public Health Service in 1971 and worked for IHS as an engineer before retiring as a captain in the Commissioned Corps in February of 1997. The younger LaRoche was commissioned in 1992, and the two worked together for the IHS before the father retired.

LaRoche said that, growing up, he had actually wanted to be a physician, but his father urged him to get an engineering degree. He followed his dad’s advice and received a bachelor’s degree in civil engineering from the University of New Mexico.

“It ended up that I had a scholarship with IHS, and so when I graduated as an engineer, I ended up going into the [agency’s] health facilities’ engineering program,” he said.

While many in his field limit their work to engineering, LaRoche also got involved in emergency management when he was working as the hospital facilities engineer at the Santa Fe Indian Hospital back in the mid 1990’s. While there he participated in the hospital’s emergency-management committee and led the revision of the hospital’s emergency-management plan.

Those were but a few of LaRoche’s many career experiences that prepared him for his current position. He also deployed with the HHS to help with the response to Hurricane Ivan in 2004, as well as the California Wildfires in 2007. In addition, LaRoche participated in the Harvard University National Preparedness Leadership Initiative in 2008.

Before becoming the IHS Deputy Director of Emergency Services in 2008, he served as the director of Health Facilities and Emergency Management Point of Contact for the IHS Albuquerque Area. He became director of IHS Emergency Services in February of 2009. From February of 2011 to July of 2011 he also served as the acting deputy director in the IHS Office of Clinical and Preventive Services.

“What I found out about myself was that I was able to take on some of these new roles and get outside of my comfort zone and actually learn these new programs fairly quickly,” he said.

His training as an engineer has given him a great background for what he does today, he said.

“Engineers are taught to define the problem, look at the current state and what is known, identify the resources, define the desired end state, then formulate the plan to get from here to the end state,” he said. “You see this in emergency planning,”

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