Planning Tools You Can Use To Meet The Needs Of People With Disabilities In An

Emergency: What To Do, What Not To Do, And What Difference Does It Make?

Dr. Anthony Cahill Senior Research Scientist and

Director, Division of Disability and Health PolicyUniversity of New Mexico School of Medicine

Disclaimer!

The opinions expressed in this presentation are solely those of the author, and do not

represent the official opinions of:

The University of New Mexico

Any Local, State, Intergovernmental Compact or Federal Agency

Any National Government, Anywhere

The United Nations

The United Federation of Planets

Our Agenda

Setting the Stage: Translational Research

Lessons Learned: What Works, What Doesn’t and What Difference Does It Make?

Issues and Possible Mitigation Strategies

Wrapping Up: An Alternative Approach to Disaster Planning

Setting the Stage:

Translational Research

Individual

KnowledgeCreation

KnowledgeMining

Organization

Community

K n o w l e d g eT r a n s l a t i o n

State of the Science Conference

Peer-Reviewed Publications

Internet Resources

Training and Dissemination

Clearinghouse

Social Marketing &Risk Assessment

Literature Review

Preparedness

Search for Best Practices

Review Emergency Management

Policies and Practices

Review CommunityPolicies and Practices

Pre-Investigation Investigation Dissemination

RE

SE

AR

CH

Po

licy

and

Pra

ctic

e

LESSONS LEARNED:

WHAT DO WE KNOW

AND

HOW WELL DO WE KNOW IT?

Federal Assessments

2006 Nationwide Plan Review

https://www.dhs.gov/xlibrary/assets/Prep_NationwidePlanReview.pdf

Federal Assessments, Continued

Senate Committee on Homeland Security Report

http://hsgac.senate.gov/_files/Katrina/FullReport.pdf

Federal Assessments, Continued

2005 “Failure of Initiative….” Report http://katrina.house.gov/full_katrina_report.htm

Inspector General’s Report on Nursing Homes http://oig.hhs.gov/oei/reports/oei-06-06-00020.pdf

“Lessons Learned” Information Sharing www.llis.gov

University

Assessments

Impact of Hurricane Katrina

http://www.rtcil.org/products/NIDRR_FinalKatrinaReport.pdf

http://www.nobodyleftbehind2.org/

University Assessments, Continued

Vulnerable Populations:  Emergency Preparedness Conference

http://www.umaryland.edu/healthsecurity/mtf_conference/index.html#info

The Impact of Southern California Wildfires

OnPeople With Disabilities

April 2004Disability Organization Assessments

http://www.calsilc.org/impactCAWildfires.pdf

THE IMPACT OF  HURRICANES KATRINA AND RITA ON PEOPLE WITH DISABILITIES: A

LOOK BACK AND REMAINING CHALLENGES

Disability Organization Assessments, Continued

http://www.ncd.gov/newsroom/publications/2006/hurricanes_impact.htm

Disability Organization Assessments, Continued

2005 AARP Report: We Can Do Better http://www.aarp.org/research/assistance/lowincome/better.html

2006 Transport Policy Institute Lessons Learned From Katrina and Rita http://www.vtpi.org/katrina.pdf

2005 National Council on Disability Saving Lives Report http://www.ncd.gov/newsroom/publications/2006/hurricanes_impact.htm

What’s The Bottom Line For You?

Studies are of varying quality

We know a lot about what went right, what went wrong, and what we can do to improve

“Translational Research”: converting what we know into what to do about what matters.

ISSUES AND POSSIBLE MITIGATION STRATEGIES

Issues

Scenarios and Disaster Plans

Personal and Organizational Planning

Identifying and Locating People with Disabilities

Identification of Target Groups

Issues

Scenarios and Disaster Plans

Personal and Organizational Planning

Identifying and Locating People with Disabilities

Defining Target Populations

Issues: Scenarios & Disaster Plans

“The majority of…plans cannot…manage catastrophic events”

“Both plans and exercises are scaled to familiar events”

“Think the unthinkable”

Scenarios & Plans, Continued

Most initial search and rescue is carried out by citizens/survivors

Individuals first turn to other members of “communities of interest” of which they are members

Survivors arrive at shelters/ evacuation points/hospitals by private means, bypassing official systems

Scenarios & Plans, Continued….

Too few health care facility plans at all levels include assessing the medical and functional support needs of people with disabilities

Durable medical equipment, service animals, personal care attendants, medications, transportation, evacuations

Now defined as “essential services”

Emergency Management Under Title II of the ADA

U.S. Department of Justice

Civil Rights DivisionDisability Rights

Section    

Americans with Disabilities Act

ADA Checklist for Emergency Shelters

http://www.ada.gov/pcatoolkit/chap7shelterchk.htmModule Two: Federal Changes

Emergency Management Under Title II of the ADA, Continued

Emergency managers and shelter operators need to ensure that sheltering programs are accessible to people with disabilities, including individuals who use wheelchairs.

Local governments and shelter operators may not make eligibility for mass care shelters dependent on a person’s ability to bring his or her own personal care attendant.

The ADA generally requires emergency managers and shelter operators to make reasonable modifications to policies, practices, and procedures when necessary to avoid discrimination.

Emergency Management Under Title II of the ADA, Continued

A reasonable modification must be made unless it would impose an undue financial and administrative burden.

This includes modifying “no pets” policies to incorporate service animals, use of kitchen facilities for people with medical conditions, and modifying sleeping arrangements to meet disability-related needs.

Issues

Scenarios and Disaster Plans

Personal and Organizational Planning

Identifying and Locating People with Disabilities

Defining Target Populations

Issues: Personal and Organizational Planning

Too little personal preparedness planning by individuals with disabilities

Too little organizational disaster planning by agencies providing services to people with disabilities

Too little planning for the needs of this population by health emergency management agencies and employers

Resources for Personal Planning

72hours.orghttp://www.72hours.org/index.html

PrepareNow.orghttp://www.preparenow.org/links.html

American Red Cross “Be Prepared Campaign”http://www.redcross.org/services/prepare/0,1082,0_239_,00.html

Federal Emergency Management Agency “Are You Ready” Campaign

http://www.fema.gov/areyouready/

National Organization on Disability “Prepare Yourself!” Campaign

http://www.nod.org/index.cfm?fuseaction=page.viewPage&pageID=1430&nodeID=1&FeatureID=1625&re

directed=1&CFID=12437936&CFTOKEN=96203152

Module Four: Tools

Resources, Continued

Emergency Planning For People Who Use Assistive Technology Devices Powered By Electricity or Batteries

http://www.jik.com/techartV4.doc

Tips for People With Mobility Limitations from Los Angeles County

http://www.cert-la.com/ESP/ESP-Disabilities-Guide-2006.pdf

American Red Cross “Be Prepared Campaign”http://www.redcross.org/services/prepare/0,1082,0_239_,00.html

Emergency Preparedness at Home for People With Disabilities

http://www.disabilitypreparedness.org/Emer%20Prep%20at%20home%20rev%206-07-06.pdf

Disaster Preparedness for Persons with Mobility Impairments

 www.nobodyleftbehind2.org/ Module Four: Tools

Common Elements of Personal Planning Individuals should be prepared to maintain

themselves for a minimum of 72 hours (three days) without services (food stores, electricity, water, etc.)

Supplies of food and water

Change of clothes

Medications

Flashlight, portable radio, batteriesModule Four: Tools

Common Elements, Continued

Copies of prescriptions

Service information ( Medicare or Medicaid cards, health insurance plan cards, social security card)

First Aid Kit

Food for service animals and DME, if applicable

Contact information for family, caregivers, close friends who could help

Common Elements, Continued

For disasters in which an evacuation might happen, these items should be placed in a “To-Go Kit” – a durable, lightweight container such as a duffle bag.

These items can be used at home in the event of a disaster that requires people to stay in their homes.

Module Four: Tools

Issues

Scenarios and Disaster Plans

Personal and Organizational Planning

Identifying and Locating People with Disabilities

Defining Target Populations

Issues: Identifying and Locating People with Disabilities

…Or, How To Create A Really BAD Registry!

Bad: Collect as much information as you possible can about every aspect of the person's needs and life.

Good: Focus on information that the first responder will need to get the person from their home or other location to a hospital, shelter, etc.

Name

Location

Type(s) of disability

Medication – what and where is it?

Caregivers? If yes, contact information

Durable Medical Equipment? If yes, what and where is it?

Service animals? If yes, what kind, leash or harness, food

Other needs

Issues: Identifying & Locating, Continued

Bad: the bigger the registry, the better!

Good: maintain registries that will be used on a local level.

Bad: create a registry that relies on technology.

Good: technology is great, but make sure there are always hard copies available of the latest version.

Bad: Wait until a disaster happens to let local emergency managers know that the registry exists.

Good: always coordinate your activities with the local emergency management community, particularly the county emergency manager.

Issues: Identifying & Locating, Continued

Federal disability discrimination laws do not prevent employers from obtaining and appropriately using medical or health information necessary for a comprehensive emergency evacuation plan.

http://www.eeoc.gov/facts/evacuation.html

Issues

Scenarios and Disaster Plans

Personal and Organizational Planning

Identifying and Locating People with Disabilities

Defining Target Populations

Issues: Defining Target Populations

Prior federal policy contained categories of “Special Needs” populations

Problems include lack of focus and inability to identify specific needs of targeted populations

Gradual replacement of the term with a functional approach

“Special Needs” – the Draft Target Capability on Functional & Medical Support Sheltering

“…the population requiring support accommodated in general shelters is maximized by meeting individual functional and medical support needs….

“What were they doing yesterday?”

Functional And Medical Support Sheltering: How?

Population requiring medication / consumable supplies / DME support

Population requiring functional support (when existing caregiver is not available)

Population requiring medical support

2006 Reauthorization of the Homeland Security Appropriations Bill (HR 5441)

Redefines “Special Populations”:

“Before, during and after an incident, members of the population may have additional needs in one or more of the following functional areas: maintaining independence, communication, transportation, supervision or medical care”

WRAPPING UP:

AN ALTERNATIVE APPROACH TO DISASTER PLANNING

For More Information:

Dr. Anthony Cahill Center for Development and Disability

2300 Menaul Boulevard NEAlbuquerque, NM 87107(505) 272-2990 phone

(505) 272-9594 faxAcahill@salud.unm.edu