tennessee

RECOVERY PROJECT

FEMA DR 1909 TN

IntroductionBecky Stoll, LCSW

Centerstone - Vice President, Crisis & Disaster Management

State of TN Disaster Mental Health Committee - Chair

Nashville Fire Department - Clinical Director, CISM Team Middle Tennessee CISM Team - Clinical Director

The 1,000 Year Tennessee Flood

Some Background

May 2-3, 2010, areas in Tennessee received over 13 inches of rainfall in less than 48 hours

This became the worst Natural Disaster in TN history

It is second only to Hurricane Katrina as the worst disaster in Region IV (TN, KY, AL, MS, NC, SC, & FL) history

46 out of the 95 Counties in Tennessee were declared Federal Disaster Areas

Over 67,000 FEMA applications for disaster assistance had been received as of August 9, 2010

Rescue Efforts Depended Upon Everyone

What is Tennessee Recovery Project?

The Tennessee Recovery Project (TRP) is a program created through a FEMA grant to provide free emotional outreach services to persons affected by the recent Tennessee floods.  TRP’s purpose is to support the emotional well being of flood survivors by increasing resiliency while decreasing chronic mental health diseases related to the flooding event.

Centerstone, along with 4 other mental health agencies, are working together at TRP in all of the counties that were declared Federal Disaster Areas under FEMA DR 1909 TN.

Tennessee Recovery Project

The Tennessee Recovery Project (TRP) is being administered via FEMA’s Immediate Services Program (ISP) (first 90 days post event) and Regular Services Program (RSP) (subsequent nine months to the anniversary date of the event).

Phases of the Response

Search and RescueRecoveryAssessment of Need Strategic PlanningProvision of post event services

After Action Planning

DISASTERSACCESS & FUNCTIONAL

NEEDS SERIOUSLY MENTALLY

ILL

Name Change“Access & Functional

Need”2010

TERM FORMERLY KNOW AS “SPECIAL NEEDS” WAS REPLACED WITH “ACCESS AND SPECIAL NEEDS”

FEMA FELT “ACCESS & FUNCTIONAL NEEDS” WAS MORE INCLUSIVE

TERM “SPECIAL NEEDS” DID NOT WORK IN EMERGENCY PLANNING BECAUSE IT DOES NOT PROVIDE THE GUIDANCE TO OPERATIONALIZE THE TASKS NEEDED

“Access & Functional Need”

2010

ANOTHER PROBLEM WITH “SPECIAL NEEDS” WAS IT LEAD TO SEGREGATION AND UNEQUAL SERVICE FOR PEOPLE WITH DISABILITIES

NO ONE WANTS TO BE “SPECIAL” DURING AN EMERGENCY, THEY WANT TO RECEIVE THE SAME SERVICES AS EVERYONE ELSE.

TERM “ACCESS & FUNCTIONAL NEEDS” IS MORE USEFUL AS A DESCRIPTION OF EVERYONE WHO MAY REQUIRE ACCOMMODATIONS THROUGHOUT A DISASTER

FEMA’s New Philosophy

The “special needs” approach should be eliminated from

emergency planning because accommodations for people with

access and functional needs should always be incorporated

throughout all plans.

FEMA Definition“Access & Functional

Need”“THOSE ACTIONS, SERVICES,

ACCOMMODATIONS, AND PROGRAMMATIC, ARCHITECTURAL, AND COMMUNICATION

MODIFICATIONS THAT A COVERED ENTITY MUST UNDERTAKE OR PROVIDE TO AFFORD

INDIVIDUALS WITH DISABILITIES A FULL AND EQUAL OPPORTUNITY TO USE AND ENJOY

PROGRAMS, SERVICES, ACTIVITIES, GOODS, FACILITIES, PRIVILEGES, ADVANTAGES, AND

ACCOMMODATIONS IN THE MOST INTEGRATED SETTING……”

“Access & Functional Need”

These include:EldersPhysical Sensory Mental health Pregnant womenCognitive/intellectual Language/communication Others who must be identified locally

Functional Needs Support Services

Services that enable individuals to maintain their independence in a general population shelter

Reasonable modifications to P&PsDurable medical equipmentConsumable medical suppliesPersonal assistance servicesOther goods and services as needed

During a Disaster Seriously Mentally Ill

DURING A DISASTER THOSE DIAGNOSED WITH A SERIOUS MENTAL ILLNESS OFTEN:

FUNCTIONAL VERY WELL

RISE TO THE OCCASION

ASSIST OTHERS

Post Disaster Seriously Mentally Ill

THIS IS A VERY VULNERABLE GROUP WHO CAN BE GREATLY IMPACTED BY THE SOCIAL DISRUPTION OF A POST-DISASTER WORLD.

Post DisasterSeriously Mentally Ill

LESS PREPARED:LESS LIKELY TO HAVE SUPPLIES OR AN EMERGENCY PLANDEPENDENT ON OTHERS TO TAKE PRECAUTIONS/EVACUATE

NEW/RECURRENT SYMPTOMSMORE LIKELY TO DEVELOP STRESS-RELATED SYMPTOMSRELAPSE OF PRIOR SYMPTOMSDISRUPTION OF SOCIAL SITUATIONPRIOR DX. OF PTSD MORE VULNERABLE

Disrupted Mental Health Care System

LOSS OF CARETAKERFAMILY/FRIENDS MAY BE DEAD, INJURED, DISPLACEDCARETAKERS FOCUSING ENERGY ON RECOVERY

MENTAL HEALTH SERVICES DISRUPTEDPROVIDERS ARE CLOSEDPHARMACY/MEDICATION ACCESSTRANSPORTATION

INCREASED DEMAND FOR MENTAL HEALTH SERVICESINCREASE AFTER A DISASTERDIVERSION OF RESOURCES

Preparation Seriously Mentally ill

DISASTER PREPAREDNESS/PLANNINGEMERGENCY CONTACTSMEDICATIONCONTACT WITH EMA

SPECIAL CARE/SERVICESPSYCHOLOGICAL FIRST AID (PFA)DO NOT ISOLATE/STIGMATIZEPSYCHIATRIC MEDICATION

RESPONDERS TRAINEDTRAIN ON RECOGNIZING MENTAL ILLNESSKNOW WHERE TO ACCESS ASSISTANCE

State of TENNESSEE DISASTER MENTAL HEALTH RESPONSE

PLAN

(DMHRP)

DMHRP Development2011

AMERICAN RED CROSSCENTERSTONE MENTAL HEALTH COOPERATIVE METRO NASHVILLE PUBLIC HEALTH

DEPARTMENT TENNESSEE DEPARTMENT OF MENTAL

HEALTH TENNESSEE EMERGENCY MANAGEMENT

AGENCY TENNESSEE ASSOCIATION OF MENTAL

HEALTH ORGANIZATIONS TENNESSEE DEPARTMENT OF HEALTH VOLUNTEER BEHAVIORAL HEALTH CARE

SYSTEM

INITIAL RESPONSE

FEMA CRISIS COUNSELING

PROGRAM

RESOURCE ALLOCATION

HIGHLIGHTS OF THE DMHRPMISSION

Facilitate coordinated state, regional, and local mental health planning, intervention, and response efforts relative to disasters of any type

Maintain quality care, safety, and security for survivors, their families, disaster responders, and volunteers.

HIGHLIGHTS OF THE DMHRP State Committee

TEMATennessee Department of Mental

Health and Substance Abuse Services

Tennessee Department of HealthAmerican Red CrossEach of the Regional Disaster Mental

Health Committees

HIGHLIGHTS OF THE DMHRP Regional Committees (7)

– TN Department of Mental Health and Substance Abuse Services Regions

– Representatives of:EMA’sMental Health Centers County Health DepartmentsDepartment of Mental HealthRed Cross Others as appropriate

Highlights of the DMHRP The plan does not supersede any current

Disaster Mental Health Plans that local communities may have established.

Needs Assessments– Red Cross– Community Mental Health Center or Health

Department

Rosters of available disaster mental health response professionals maintained

HIGHLIGHTS OF THE DMHRP

Response Phases After Action Reviews Agencies deploying their

Disaster Mental Health Teams and ARC Disaster Mental Health volunteers are provided as pro bono services.

DMHRP STATUS June 2012

Presented on FEMA’s Think Tank Conference Call on 06/28/12.

July 2012 The DMHRP Annexed to the State of Tennessee’s

All Hazards Response Plan, and Tennessee Department of Mental Health and

Substance Abuse Services (TDMHSAS) to assume responsibility for the Disaster Mental Health Response Plan.

 August 2012 State Committee concurs with recommendations

and TDMHSAS assumes leadership for DMHRP

DMHRP STATUS

Educate stakeholders in key disaster response capacities such as hospitals, local EMA’s and local public health emergency preparedness programs in the concepts of disaster mental health and the strategies for response that are outlined in the DMHRP.

Exercise plan in a large scale exercise with other interdisciplinary agencies.

Becky Stoll, LCSW

Centerstone

1101 6th Avenue North

Nashville, TN 37208

(615) 460-4481

Becky.Stoll@centerstone.org