County Level Disaster County Level Disaster Preparedness and Response for Preparedness and Response for

Persons with Mobility Impairments: Persons with Mobility Impairments: Results from the University of Kansas Results from the University of Kansas

Nobody Left BehindNobody Left Behind Study Study Michael H. Fox, Sc.D., Glen W. White, Ph.D., Michael H. Fox, Sc.D., Glen W. White, Ph.D.,

Catherine Rooney, M.A., Jennifer Rowland, Ph.D., P.T. Catherine Rooney, M.A., Jennifer Rowland, Ph.D., P.T.

Research and Training Center on Independent Living at the Research and Training Center on Independent Living at the University of KansasUniversity of Kansas

2nd Planning Meeting On Disaster Preparation And Emergency 2nd Planning Meeting On Disaster Preparation And Emergency Response For People With Disabilities,Response For People With Disabilities,

Kansas City, July 24 –26, 2005Kansas City, July 24 –26, 2005

Nobody Left BehindNobody Left Behind

Three year grant, TS#-08040, awarded the KU RTC/IL Three year grant, TS#-08040, awarded the KU RTC/IL by the Association for Teachers of Preventive by the Association for Teachers of Preventive Medicine and the Centers for Disease Control and Medicine and the Centers for Disease Control and Prevention Prevention

http://www.nobodyleftbehind2.orghttp://www.nobodyleftbehind2.org

Glen White, University of Kansas, P.I.Glen White, University of Kansas, P.I.

Michael Fox, Kansas University Med Center, Co-P.I. Michael Fox, Kansas University Med Center, Co-P.I.

October, 2002 – September, 2005October, 2002 – September, 2005

AIM: Understand county level disaster preparedness AIM: Understand county level disaster preparedness and response around needs of persons with and response around needs of persons with mobility impairmentsmobility impairments

Nobody Left BehindNobody Left BehindThe Nature of the ProblemThe Nature of the Problem

Typically, disaster preparedness and Typically, disaster preparedness and emergency response systems are emergency response systems are designed for non-disabled persons, for designed for non-disabled persons, for whom escape or rescue involves walking whom escape or rescue involves walking or running. or running.

In addition, many plans do not appear to In addition, many plans do not appear to specifically address the transition needs specifically address the transition needs back to pre-disaster conditions that are back to pre-disaster conditions that are required for persons with mobility required for persons with mobility impairments.impairments.

Objective: Objective:

To determine whether counties that To determine whether counties that have experienced a disaster during have experienced a disaster during 1998 - 2003 have systems of 1998 - 2003 have systems of workplace, home, and community workplace, home, and community disaster preparedness and emergency disaster preparedness and emergency response in place for residents with response in place for residents with mobility impairments.mobility impairments.

Focus Area #1

COUNTY PROGRAMS, POLICY, AND PRACTICE

Research Questions:Research Questions: Have disasters facilitated changes in Have disasters facilitated changes in

disaster preparedness and emergency disaster preparedness and emergency response policies and practices for persons response policies and practices for persons with mobility impairments? If so, how?with mobility impairments? If so, how?

Has the disaster preparedness and Has the disaster preparedness and emergency response planning process emergency response planning process included community stakeholders included community stakeholders representing people with disabilities? If so, representing people with disabilities? If so, what has been their involvement? With what what has been their involvement? With what outcomes?outcomes?

Focus Area #1

COUNTY PROGRAMS, POLICY, AND PRACTICE

Objective: Objective:

To evaluate surveillance systems in To evaluate surveillance systems in place at the county level that can place at the county level that can identify morbidity and mortality identify morbidity and mortality frequency and prevalence for frequency and prevalence for persons with mobility impairments persons with mobility impairments exposed to a disasterexposed to a disaster

Focus Area #2

ASSESSING RISK

Research Questions:Research Questions: Are counties able to assess Are counties able to assess

prevalence of persons with mobility prevalence of persons with mobility impairments who reside or work in impairments who reside or work in their jurisdictions and are at risk of their jurisdictions and are at risk of disaster exposure (calculating the disaster exposure (calculating the denominator)?denominator)?

Focus Area #2

ASSESSING RISK

Research QuestionsResearch Questions (continued)(continued)::

Are counties able to determine how many Are counties able to determine how many persons with mobility impairments are persons with mobility impairments are affected by disasters?affected by disasters?

Among counties that have surveillance Among counties that have surveillance systems in place, what are prevalence rates systems in place, what are prevalence rates of disaster exposure for persons with of disaster exposure for persons with mobility impairments, and what factors mobility impairments, and what factors appear to influence these rates? appear to influence these rates?

Focus Area #2

ASSESSING RISK

Objective: Objective:

To recommend modifications to To recommend modifications to county disaster coordinating county disaster coordinating agencies to address the health, agencies to address the health, safety, and survival needs of safety, and survival needs of people with mobility impairmentspeople with mobility impairments

Focus Area #3

ASSURANCE AND POLICY DEVELOPMENT

Research Questions:Research Questions:

What surveillance systems appear What surveillance systems appear most effective in assessing risk for most effective in assessing risk for people with mobility impairments people with mobility impairments exposed to disasters?exposed to disasters?

How can counties use surveillance How can counties use surveillance systems to better manage their risk for systems to better manage their risk for persons with mobility impairments? persons with mobility impairments?

Focus Area #3

ASSURANCE AND POLICY DEVELOPMENT

Research Questions Research Questions (continued)(continued)::

What county policies, practices, or What county policies, practices, or programs are exemplars of best practices programs are exemplars of best practices that can be emulated by counties around that can be emulated by counties around the U.S.? How can these policies, the U.S.? How can these policies, practices, and programs be incorporated in practices, and programs be incorporated in county disaster plans?county disaster plans?

Focus Area #3

ASSURANCE AND POLICY DEVELOPMENT

Nobody Left Behind- MethodsNobody Left Behind- Methods Identify Federal Emergency Management Agency Identify Federal Emergency Management Agency

(FEMA) declared disasters between 1998 - 2003(FEMA) declared disasters between 1998 - 2003

Select a random sample of 30 counties or Select a random sample of 30 counties or equivalent units (i.e., boroughs, reservations, equivalent units (i.e., boroughs, reservations, etc.) across each of the ten federal regionsetc.) across each of the ten federal regions

Interview these county emergency managersInterview these county emergency managers

Evaluate their disaster plans in place at time of Evaluate their disaster plans in place at time of occurrence and more recently for actions occurrence and more recently for actions targeting persons with mobility disabilitiestargeting persons with mobility disabilities

With assistance of national advisory panel, With assistance of national advisory panel, identify best practicesidentify best practices

Administer on-line consumer surveyAdminister on-line consumer survey

Representative County SelectionRepresentative County SelectionSelection of state level disaster occurrences so that each Selection of state level disaster occurrences so that each

of the ten federal regions is represented:of the ten federal regions is represented:

REGION I:REGION I: Connecticut, Maine, Massachusetts, New Hampshire,Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont. Rhode Island, Vermont.

REGION II:REGION II: New York, New Jersey, Puerto Rico, Virgin Islands. New York, New Jersey, Puerto Rico, Virgin Islands. REGION III:REGION III: Delaware, Maryland, Pennsylvania, Virginia, West Delaware, Maryland, Pennsylvania, Virginia, West Virginia, District of Columbia. Virginia, District of Columbia. REGION IV:REGION IV: Alabama, Florida, Georgia, Kentucky, Mississippi, Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee.North Carolina, South Carolina, Tennessee. REGION V:REGION V: Illinois, Indiana, Michigan, Minnesota, Ohio, Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin. Wisconsin. REGION VI:REGION VI: Arkansas, Louisiana, New Mexico, Oklahoma, Texas. Arkansas, Louisiana, New Mexico, Oklahoma, Texas. REGION VII:REGION VII: Iowa, Kansas, Missouri, Nebraska. Iowa, Kansas, Missouri, Nebraska. REGION VIIIREGION VIII: : Colorado, Montana, North Dakota, South Dakota,Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming. Utah, Wyoming. REGION IX:REGION IX: Arizona, California, Hawaii, Nevada. Arizona, California, Hawaii, Nevada. REGION X:REGION X: Alaska, Oregon, Washington, Idaho.Alaska, Oregon, Washington, Idaho.

Consumer Survey Consumer Survey Do you have a personal disaster experience to share?Do you have a personal disaster experience to share?We want to hear from persons with mobility limitations who We want to hear from persons with mobility limitations who have experienced a disaster. have experienced a disaster.

Please complete our on-line surveyPlease complete our on-line survey at:at:  

http://www.nobodyleftbehind2.orghttp://www.nobodyleftbehind2.org&&

Click on “Click on “Consumer Survey”Consumer Survey”

Nobody Left BehindNobody Left BehindWhat did we ask?What did we ask?

Examples of survey questions:Examples of survey questions:– ““Does your current emergency management Does your current emergency management

plan have a protocol to assist people with plan have a protocol to assist people with mobility impairments during an emergency?” mobility impairments during an emergency?”

– ““To your knowledge, were people with mobility To your knowledge, were people with mobility impairments included in the process of impairments included in the process of developing these protocols?”developing these protocols?”

– ““If no written formal protocols exist to assist If no written formal protocols exist to assist people with mobility impairments, to your people with mobility impairments, to your knowledge what do emergency services knowledge what do emergency services personnel do to assist people with mobility personnel do to assist people with mobility impairments during an emergency?impairments during an emergency? “ “

Summary Research Tables Summary Research Tables Corresponding to Corresponding to

Research Questions for Research Questions for Nobody Left BehindNobody Left Behind

Research Questions 1: Have disasters Research Questions 1: Have disasters facilitated change for people with mobility facilitated change for people with mobility

impairments?impairments?Table 1. Reasons for Modifying County Disaster PlansTable 1. Reasons for Modifying County Disaster Plans Using Chi-squared tests, none of these 2x2 relationships are statistically significantUsing Chi-squared tests, none of these 2x2 relationships are statistically significant

N=30 Revisions prompted by disaster?

Revisions prompted by people with disabilities?

Revisions prompted by federal mandates?

Revisions prompted by other concerns?

County disaster plan revised since disaster?

Yes

%

No

%

Yes

%

No

%

Yes

%

No

%

Yes

%

No

%

Yes (n=29) 27.6 72.4 6.9 0.0 58.6 41.4 6.9 93.1

No (n=1) 0.0 100 0.0 100 0.0 100 0.0 100

Research Questions 2: Were people with Research Questions 2: Were people with disabilities included in the planning disabilities included in the planning

process?process?

Four of the six best practice sites had Four of the six best practice sites had people included in the process. This people included in the process. This question was only answered for six question was only answered for six counties engaged in the planning counties engaged in the planning process (Question #14)process (Question #14)

Research Question 3: Are sites able to Research Question 3: Are sites able to assess prevalence based upon adequate assess prevalence based upon adequate

surveillance?surveillance?

Table 2. Reported Surveillance of Counties Experiencing Table 2. Reported Surveillance of Counties Experiencing DisastersDisasters

# Counties Frequencies Data Validity

Measure Category Count

# people with mobility impairments in county

13 < 75 4(13%) Census -3Database-5Estimate -5

FairGoodPoor

300-400 2 (7%)

3,000-10,000 6(20%)

>10,000 1(3%)

# persons injured in disaster

30 None 27(90%)

<100 1(3%)

100-300 1(3%)

10,000 1(3%)

# persons killed in disaster

30 None 26(87%)

1-5 3(10%)

2,749 1(3%)

# persons with mobility impairments killed

30 None 28(93%)

1 1(3%)

Unknown 1(3%)

# persons with mobility impairments rescued

30 None 17(57%)

2-15 4(13%)

25-100 4(13%)

>100 5(16%)

Unknown 1(3%)

Research Questions 4&5: Surveillance Research Questions 4&5: Surveillance that allows estimates of prevalence of that allows estimates of prevalence of

people with mobility impairments at risk people with mobility impairments at risk

in a disaster?in a disaster? No way to determine prevalence rates No way to determine prevalence rates

based upon surveillance systems in based upon surveillance systems in place.place.

However, we may want to test this further However, we may want to test this further with our site in Coffey County. Where with our site in Coffey County. Where there are accurate data registries, this there are accurate data registries, this measure could be possible.measure could be possible.

Research Question 6: Surveillance Research Question 6: Surveillance systems that appear most effective – systems that appear most effective –

possible “best practices.”possible “best practices.”

Six counties identified as possible “best practices” (out of 30) based Six counties identified as possible “best practices” (out of 30) based upon two criteria: upon two criteria:

1. Having in place guidelines for persons with disabilities; and1. Having in place guidelines for persons with disabilities; and

2. Identifying operating procedures in place that follow the guidelines2. Identifying operating procedures in place that follow the guidelines

Table 3. Differences Between Disaster County Sites Table 3. Differences Between Disaster County Sites Identified as Best Practices and All Other SitesIdentified as Best Practices and All Other Sites

All mean differences were tested using ANOVA for between group All mean differences were tested using ANOVA for between group differences.differences.

Disaster County Characteristic

Best Practice Site (6) Other Disaster Site (24) Significance, p-value

Mean Total Population 571,266 217,711 .285

Area in square miles 2,248 2,436 .932

Persons per square miles 205 1,783 .575

% urban area 67 58 .721

% White 91 76 .097

Median household income $36,577 $38,914 .568

% above median income 33 29 .849

% below poverty 13 14 .610

% with Center for Independent Living

50 63 .429

% persons with physical disability > 5

8.4 9.7 .392

% people with disabilities 5-64 years old

5.1 7.2 .141

% people with disabilities >64 years old

29.1 30.7 .551

%t with employee who took FEMA course

17 42 .271

% knowing how many people with disabilities live within district

100 29 .001

Research Question 6: Surveillance Research Question 6: Surveillance systems that appear most effective – systems that appear most effective –

possible “best practices.”possible “best practices.”

Six counties identified as possible “best practices” (out of 30) based Six counties identified as possible “best practices” (out of 30) based upon two criteria: upon two criteria:

1. Having in place guidelines for persons with disabilities; and1. Having in place guidelines for persons with disabilities; and

2. Identifying operating procedures in place that follow the guidelines2. Identifying operating procedures in place that follow the guidelines

Table 4. Adjusted Odds Ratio of a Model to Predict the Table 4. Adjusted Odds Ratio of a Model to Predict the Probability of Being a Best PracticeProbability of Being a Best Practice

Using logistic regression, none of these factors in this model were Using logistic regression, none of these factors in this model were

significantly associated with predicting best practice.significantly associated with predicting best practice.

Disaster County Characteristic

B S.E. Wald Statistic

95% Confidence Interval for Exp(B)

Signf Odds Ratio (Exp(B))

Urban -.141 1.554 .008 .041, 18.281 .928 .869

Had CIL in district

-1.630 1.616 1.018 .008, 4.648 .313 .196

Were above median income

.141 1.554 .008 .055, 24.227 .928 1.151

Had taken FEMA or similar disaster course

-1.912 1.549 1.523 .007, 3.078 .217 .148

Knew about how many persons with disabilities lived within district

21.724 9210.681 .000 .000, *** .998 2.72E+09

Constant -20.024 9210.681 .998 .000

Nobody Left BehindNobody Left BehindWhat did we find out?What did we find out?

Findings - Emergency ManagersFindings - Emergency Managers::

People with disabilities either were not represented People with disabilities either were not represented or had minimal representation in the emergency or had minimal representation in the emergency planning processplanning process

The (G197) FEMA Emergency Planning and Special The (G197) FEMA Emergency Planning and Special Needs course pertaining to people with disabilities Needs course pertaining to people with disabilities appears useful in increasing county awareness, appears useful in increasing county awareness, though only 27% of county emergency managers though only 27% of county emergency managers reported completing itreported completing it

Only 20% of the emergency managers reported Only 20% of the emergency managers reported having specific guidelines in place to assist having specific guidelines in place to assist people with mobility impairments during people with mobility impairments during emergenciesemergencies

Nobody Left BehindNobody Left BehindWhat did we find out?What did we find out?

Findings - Emergency Managers:Findings - Emergency Managers:

Surveillance efforts to identify persons with Surveillance efforts to identify persons with mobility impairments are weak mobility impairments are weak

• 57% of county managers did not know how many 57% of county managers did not know how many persons with mobility limitations lived within their persons with mobility limitations lived within their jurisdictionjurisdiction• Of those who claimed to know, most gave broad Of those who claimed to know, most gave broad estimates estimates based on unreliable sourcesbased on unreliable sources• 27% of counties used Census or self-reported registries 27% of counties used Census or self-reported registries

to identify this figure more accuratelyto identify this figure more accurately

Among counties having this figure, the data Among counties having this figure, the data are primarily used for planning are primarily used for planning

purposes- purposes- shelter, education, evacuation, shelter, education, evacuation, etc.etc.

Nobody Left BehindNobody Left BehindWhat did we find out?What did we find out?

Findings- Emergency Managers:Findings- Emergency Managers:

• 20% of emergency managers reported having 20% of emergency managers reported having specific guidelines in place to assist people with specific guidelines in place to assist people with mobility impairments during emergenciesmobility impairments during emergencies

• Among jurisdictions that did not (24 or 80%):Among jurisdictions that did not (24 or 80%):

• 38% (9) identified transportation accommodations 38% (9) identified transportation accommodations that they have in placethat they have in place

• 17% (4) identified accessible shelters and other 17% (4) identified accessible shelters and other educational programs that sought to reach out to educational programs that sought to reach out to persons with disabilitiespersons with disabilities

Nobody Left BehindNobody Left BehindWhere are we now?Where are we now?

Findings of Emergency Managers:Findings of Emergency Managers:

Among jurisdictions not having specific details Among jurisdictions not having specific details or guidelines in place, or guidelines in place, allall (24) told us that they (24) told us that they were important to havewere important to have

– ““Every person’s life is important….”Every person’s life is important….”

– ““I have never seen a publication that would address I have never seen a publication that would address many of these impairments….”many of these impairments….”

– ““We have it, just not in our particular plan…covered We have it, just not in our particular plan…covered in council on aging and human resource protocols.”in council on aging and human resource protocols.”

– ““It’s a fact of life. They are out there, they need It’s a fact of life. They are out there, they need assistance, and you’ve got to address it.”assistance, and you’ve got to address it.”

Nobody Left BehindNobody Left BehindWhat did we find out?What did we find out?

Findings - Emergency Managers:Findings - Emergency Managers:

97% (29) of disaster management plans had 97% (29) of disaster management plans had been revised since the time of the county been revised since the time of the county disaster we asked aboutdisaster we asked about

But among these, only 2 (7%) revised their plans owing But among these, only 2 (7%) revised their plans owing to disability related concernsto disability related concerns

Other reasons driving revisions of plans:Other reasons driving revisions of plans:– Annual review (72%)Annual review (72%)– Federal mandates (59%)Federal mandates (59%)– State mandates (24%)State mandates (24%)– Disaster (28%) Disaster (28%) – Other factors (34%)Other factors (34%)

Nobody Left Behind - FindingsNobody Left Behind - Findings

Among jurisdictions Among jurisdictions notnot having specific guidelines in place having specific guidelines in place (24), 5 (21%) told us they (24), 5 (21%) told us they were were planning to develop them. planning to develop them. 19 (79%) told us they 19 (79%) told us they were notwere not. Reasons why not:. Reasons why not:

– ““If need is brought to our attention, we will If need is brought to our attention, we will accommodate…”accommodate…”

– ““We are trying to focus on special needs as a whole…”We are trying to focus on special needs as a whole…”

– ““It is covered in other plans…”It is covered in other plans…”

– ““We don’t need to be any more specific than we already We don’t need to be any more specific than we already are..”are..”

– ““Confidentiality issues…”; “limited local authority…”Confidentiality issues…”; “limited local authority…”

– ““We are overwhelmed with the demands of Homeland We are overwhelmed with the demands of Homeland Security…”Security…”

– ““My office is only staffed by one volunteer….”My office is only staffed by one volunteer….”

Nobody Left Behind ~ Findings Sites reporting no specific guidelines stated the Sites reporting no specific guidelines stated the

following resources were needed to develop them:following resources were needed to develop them:

– 67% financial resources67% financial resources

– 33% knowledgeable and trained personnel33% knowledgeable and trained personnel

– 17% greater education for the public17% greater education for the public

– 25% a FEMA/State/or County mandate25% a FEMA/State/or County mandate

Among reporting sites, who told us they were Among reporting sites, who told us they were planning to develop the guidelinesplanning to develop the guidelines

– One told us the idea originated with our interview, One told us the idea originated with our interview, another started with discussions of the needs of non-another started with discussions of the needs of non-English speaking residents, one mentioned particular English speaking residents, one mentioned particular advocate associated with universityadvocate associated with university

Nobody Left BehindNobody Left BehindConsumer Survey FindingsConsumer Survey Findings

There are inaccessible escape routesThere are inaccessible escape routes

Few people know how to use the adaptive Few people know how to use the adaptive escape chairs for wheelchair usersescape chairs for wheelchair users

There was no accessible transportation after There was no accessible transportation after the disaster event to get around in the the disaster event to get around in the communitycommunity

Very slow response in helping citizens with Very slow response in helping citizens with disabilities return to their homes (e.g., disabilities return to their homes (e.g., rebuilding ramps, moving debris, etc.)rebuilding ramps, moving debris, etc.)

Nobody Left BehindNobody Left BehindConsumer Survey FindingsConsumer Survey Findings

• Shelters, including bathrooms, were not Shelters, including bathrooms, were not accessible for wheelchair usersaccessible for wheelchair users

• During extended power outages, persons During extended power outages, persons were unable to use assistive equipment and were unable to use assistive equipment and medical devicesmedical devices

• Power outages disabled elevators, forcing Power outages disabled elevators, forcing persons with mobility limitations to be persons with mobility limitations to be dependent upon neighbors or emergency dependent upon neighbors or emergency workersworkers

Nobody Left BehindNobody Left BehindConsumer Survey FindingsConsumer Survey Findings

““It is really difficult to get the utility company to It is really difficult to get the utility company to understand power is a need, if disabled.”understand power is a need, if disabled.”

““I ambulate with forearm crutches and my leg I ambulate with forearm crutches and my leg stamina is limited. As a social service provider stamina is limited. As a social service provider in NYC, I am in tall buildings often and one in in NYC, I am in tall buildings often and one in particular had an evacuation drill. There were particular had an evacuation drill. There were no plans or equipment to assist me. They told no plans or equipment to assist me. They told me to ignore the drill. me to ignore the drill. I felt very vulnerable I felt very vulnerable because I attend regular work meetings because I attend regular work meetings in this building.”in this building.”

Nobody Left BehindNobody Left BehindConsumer Survey FindingsConsumer Survey Findings

““I have juvenile rheumatoid arthritis and use a I have juvenile rheumatoid arthritis and use a wheel chair. We had a bomb threat at work, wheel chair. We had a bomb threat at work, which was very scary. Everyone evacuated, which was very scary. Everyone evacuated, but I was still left on the 3but I was still left on the 3rdrd floor by the floor by the stairwell for the firefighters to come get me. stairwell for the firefighters to come get me. But, no one came. But, no one came. Finally, I just struggled Finally, I just struggled and I used pure fear to get myself down and I used pure fear to get myself down the stairs and outside.the stairs and outside. It was scary just to It was scary just to realize that there are not really any procedures realize that there are not really any procedures in place to help someone like me in an in place to help someone like me in an emergency.”emergency.”

Nobody Left BehindNobody Left BehindWhere do we think this will lead?Where do we think this will lead?

Improved SurveillanceImproved Surveillance

The need to know how many people are at The need to know how many people are at risk in disasters who may have mobility risk in disasters who may have mobility impairmentsimpairments

Nobody Left BehindNobody Left BehindWhere do we think this will lead?Where do we think this will lead?

Technology AdaptationTechnology Adaptation

Use of new devices that will improve escape, Use of new devices that will improve escape, rescue and survival for persons with rescue and survival for persons with mobility impairmentsmobility impairments

Nobody Left BehindNobody Left BehindWhere do we think this will lead?Where do we think this will lead?

Environmental changesEnvironmental changes

Housing: safe rooms, slide escapes, common Housing: safe rooms, slide escapes, common shelters, implementing ADA accessibility shelters, implementing ADA accessibility guidelines, special needs awareness programs guidelines, special needs awareness programs (SNAP)(SNAP)

Workplace: space, lighting, energy backup, Workplace: space, lighting, energy backup, employee inputemployee input

Community: participation in planning process by Community: participation in planning process by persons with disabilities persons with disabilities

Environment Factors: AccessEnvironment Factors: Access

Americans with Disabilities Act Accessibility Americans with Disabilities Act Accessibility Guidelines (ADAAG) require accessible Guidelines (ADAAG) require accessible means of egress, areas of rescue means of egress, areas of rescue assistance, alarms, and signage in public assistance, alarms, and signage in public buildings covered under Title II and Title III buildings covered under Title II and Title III of the ADA.of the ADA.

Is it time to enforce the ADA?Is it time to enforce the ADA?

Environment Factors: Environment Factors: Assistive TechnologyAssistive Technology

Devices such as those that use a tread chair that Devices such as those that use a tread chair that uses caterpillar-like action to move people with uses caterpillar-like action to move people with mobility limitations down the stairs and other mobility limitations down the stairs and other similar equipment needs to be made available.similar equipment needs to be made available.

Nobody Left BehindNobody Left BehindWhere do we think this will lead?Where do we think this will lead?

Enhanced Training and Education for:Enhanced Training and Education for:

First responders, disaster managers, other First responders, disaster managers, other county officialscounty officials

Employers, employeesEmployers, employees

Persons with disabilitiesPersons with disabilities

Future DirectionsFuture Directions

Our Charge?Our Charge?

Develop an action agenda for Develop an action agenda for developing new programs, developing new programs, practices, and policies concerning practices, and policies concerning disaster preparedness and disaster preparedness and emergency response for people emergency response for people with disabilitieswith disabilities..

Additional Sources of InformationAdditional Sources of Information

http://www.nobodyleftbehind2.orghttp://www.nobodyleftbehind2.org

&&

Click on “Click on “Resources”Resources”