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?

1
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
Policy University of New Mexico School of Medicine
2
? 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

3
? Our Agenda

• Setting the Stage Translational Research
• Lessons Learned What Works, What Doesnt and
  What Difference Does It Make?
• Issues and Possible Mitigation Strategies
• Wrapping Up An Alternative Approach to Disaster
  Planning

4
Setting the Stage Translational Research
5
K n o w l e d g e T r a n s l a t i o n
Knowledge Creation
Knowledge Mining

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 Community Policies and
Practices
Individual
Policy and Practice
Organization
Community
Dissemination
Pre-Investigation
Investigation
6
LESSONS LEARNED WHAT DO WE KNOW AND HOW WELL
DO WE KNOW IT?
7
Federal Assessments 2006 Nationwide Plan Review
https//www.dhs.gov/xlibrary/assets/Prep_Nationwid
ePlanReview.pdf
8
Federal Assessments, Continued Senate Committee
on Homeland Security Report
http//hsgac.senate.gov/_files/Katrina/FullReport.
pdf
9
? Federal Assessments, Continued

• 2005 Failure of Initiative. Report
  http//katrina.house.gov/full_katrina_repor
  t.htm
• Inspector Generals Report on Nursing Homes
  http//oig.hhs.gov/oei/reports/o
  ei-06-06-00020.pdf
• Lessons Learned Information Sharing
• www.llis.gov

10
University Assessments Impact of Hurricane
Katrina
http//www.rtcil.org/products/NIDRR_FinalKatrinaRe
port.pdf
11
http//www.nobodyleftbehind2.org/
12
? University Assessments, Continued
Vulnerable Populations  Emergency Preparedness
Conference http//www.umaryland.edu/healthsecuri
ty/mtf_conference/index.htmlinfo
13
The Impact of Southern California
Wildfires On People With Disabilities April 2004
Disability Organization Assessments
http//www.calsilc.org/impactCAWildfires.pdf
14
Disability Organization Assessments, Continued
THE IMPACT OF  HURRICANES KATRINA AND RITA ON
PEOPLE WITH DISABILITIES A LOOK BACK AND
REMAINING CHALLENGES
http//www.ncd.gov/newsroom/publications/2006/hurr
icanes_impact.htm
15
? 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/kat
  rina.pdf
• 2005 National Council on Disability Saving Lives
  Report
  http//www.ncd.gov/newsroom/publications/2006/hurr
  icanes_impact.htm

16
? Whats 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.

17
ISSUES AND POSSIBLE MITIGATION STRATEGIES
18

• Issues

• Scenarios and Disaster Plans
• Personal and Organizational Planning
• Identifying and Locating People with Disabilities
  
• Identification of Target Groups

19

• Issues

• Scenarios and Disaster Plans
• Personal and Organizational Planning
• Identifying and Locating People with Disabilities
• Defining Target Populations

20
? Issues Scenarios Disaster Plans

• The majority ofplans cannotmanage catastrophic
  events
• Both plans and exercises are scaled to familiar
  events
• Think the unthinkable

21
? 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

22
? 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

23
Emergency Management Under Title II of the ADA
U.S. Department of JusticeCivil Rights
DivisionDisability Rights Section     Americans
with Disabilities Act ADA Checklist for
Emergency Shelters
http//www.ada.gov/pcatoolkit/chap7shelterchk.htm
Module Two Federal Changes
24
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 persons 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.

25
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.

26

• Issues

• Scenarios and Disaster Plans
• Personal and Organizational Planning
• Identifying and Locating People with Disabilities
• Defining Target Populations

27

• 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

28
? Resources for Personal Planning
72hours.org http//www.72hours.org/index.html Pre
pareNow.org http//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/ Nationa
l Organization on Disability Prepare Yourself!
Campaign http//www.nod.org/index.cfm?fuseactionp
age.viewPagepageID1430nodeID1FeatureID1625r
edirected1CFID12437936CFTOKEN96203152
?
Module Four Tools
29
? 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-Disa
bilities-Guide-2006.pdf American Red Cross Be
Prepared Campaign http//www.redcross.org/service
s/prepare/0,1082,0_239_,00.html Emergency
Preparedness at Home for People With
Disabilities http//www.disabilitypreparedness.org
/Emer20Prep20at20home20rev206-07-06.pdf Disa
ster Preparedness for Persons with Mobility
Impairments  www.nobodyleftbehind2.org/
Module Four Tools
30
? 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, batteries

Module Four Tools
31
? 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

32

? 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
33

• Issues

• Scenarios and Disaster Plans
• Personal and Organizational Planning
• Identifying and Locating People with Disabilities
• Defining Target Populations

34
? 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

35
? 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.
36
? 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
37

• Issues

• Scenarios and Disaster Plans
• Personal and Organizational Planning
• Identifying and Locating People with Disabilities
• Defining Target Populations

38
? 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

39
? 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?

40
? 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

41
? 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

42
WRAPPING UP AN ALTERNATIVE APPROACH TO DISASTER
PLANNING
43
(No Transcript)
44
For More Information
Dr. Anthony Cahill Center for Development and
Disability 2300 Menaul Boulevard NE Albuquerque,
NM 87107 [phone] phone [phone]
fax Acahill_at_salud.unm.edu