Preparedness for Persons with Mobility Impairments By Catherine Rooney, Michael H. Fox, Glen W. White, and Jennifer Rowland Considerations in Emergency Preparedness: A Two Track Conference Mailman School of Public Health Columbia University Washington, D.C. December 13-15, 2005

Nobody Left Behind Findings Intro: “I have Juvenile Rheumatoid Arthritis and use a wheelchair.  We had a bomb threat at work… Everyone evacuated, but I was still left on the 3rd floor by the stairwell for the firefighters to come get me. But no one came. Finally, I just struggled and I used pure fear to get myself down the stairs…” (From: Nobody Left Behind On-line Consumer Survey, 2004). Nobody Left Behind Findings

Disaster Preparedness for Persons with Mobility Impairments October, 2002 - September 2005 www.nobodyleftbehind2.org The aim of the research study I will be talking about goal is to assure Nobody is left behind. Thus, the research project is appropriately title NLB:

Nobody Left Behind Findings CDC grant awarded to KU, RTC/IL, TS# 08040, Principle Investigators: Dr. Glen White and Dr. Michael Fox. Objectives: To determine if emergency preparedness and response systems Meet the needs of persons with mobility impairments; Use surveillance systems to identify persons with mobility impairments; Have elements of emerging best practices. Nobody Left Behind Findings

Nobody Left Behind Findings Methods Identify Federal Emergency Management Agency (FEMA) declared disasters between 1998 – 2003. Select a random sample of 30 counties or equivalent units (boroughs, parishes, cities) across each of the 10 federal regions. Interview the county emergency managers. Nobody Left Behind Findings

Nobody Left Behind Findings Methods (Cont.) Evaluate disaster plans and any programs for persons with mobility impairments. Identify possible best practices. Administer on-line consumer survey. Consult with project advisors to recommend changes. Nobody Left Behind Findings

Nobody Left Behind Findings Nature of the Problem Lack of empirical data on the safe, efficient evacuation of people with disabilities, including mobility impairments. Not aware of any other research with the focus of persons with mobility limitations. Non-research related surveys include the California Wildfires by the California XXXXX, The (11, by XXX, Nobody Left Behind Consumer survey, and others Consumer information for persons with disabilities Nobody Left Behind Findings

Research on Disasters and Persons with Mobility Impairments Few empirical research studies were found. Two studies identified correlation between disabilities and risk of death from earthquakes (Chou, Y., Huang, N., & Lee, C., 2004; Osaki, Y. & Minowa, M., 2001). On popular search engines for PW mL or PWD

New Findings from Katrina Survey of evacuees in Houston shelters found: 61% did not evacuate before the storm. 38% were either physically unable to leave or caring for someone who was physically unable to leave (Kaiser, Harvard, Washington Post). Using a random sampling method Transportation was the primary cause of not leaving. The study confirms the pictures on the television on those left behind --

Nobody Left Behind Findings Nature of the Problem Current evacuation systems are designed for non-disabled persons where walking or running is required (survival of the fittest mindset). Overall mindset of the survival of the fittest Nobody Left Behind Findings

Nobody Left Behind Findings Nature of the Problem Restoration of accessible and other post-disaster living situations for persons with mobility impairments are often not addressed. Nobody Left Behind Findings

Focus Areas of the Research Emergency Managers Training Surveillance Systems Local Emergency Management Plan Guidelines Inclusion of Persons with Mobility Impairments Nobody Left Behind Findings

Findings on Emergency Managers Training 63% of the emergency managers had not taken the FEMA, G197, or similar course on “special needs populations.” Conclusion: Most emergency managers are not trained in disability- related disaster issues. Nobody Left Behind Findings

Elements of Best Practices in Emergency Managers’ Training Local emergency management plan specifies that training and exercises involve persons with disabilities. Drills include evacuating persons with mobility impairments from different situations. . Nobody Left Behind Findings

Findings on Surveillance Systems Among the emergency managers, 57% do not know how many people with mobility impairments live within their jurisdiction. Nobody Left Behind Findings

Surveillance Findings (Cont.) Among those who had numbers on persons with mobility impairments: 17% use database systems. 17% use an estimate. 10% use census data. . Nobody Left Behind Findings

Elements of Best Practices with Surveillance Planning for Special ‘Medical’ Needs Shelter (shelter for medical and electricity/equipment needs) Plan covers identifying persons/needs, creating database, shelter design and location, consumer education. (Lamar University, Department of Nursing, Pam Moss, RN., Beaumont Emergency Management, Sgt. Robert Smith). Nobody Left Behind Findings

Response to Katrina “Taking a lesson from New Orleans, Kansas Gov. Sebelius ordered state emergency planners to identify residents of Kansas’ major cities who would be unable to evacuate … whether due to a physical disability or lack of transportation.” (From: Lawernce Journal-World, 9-8-05)

Consumer Survey Collected on-line personal disaster experiences from persons with mobility limitations. From participants’ recommendations two disaster preparedness posters were created. www.nobodyleftbehind2.org click on “Findings”

Findings on Emergency Management Guidelines Only 20% of the emergency managers reported having specific guidelines to assist persons with mobility impairments during disasters. Nobody Left Behind Findings

Elements of Best Practices on Plan Guidelines Created Annex/Appendix on Persons with Disabilities. Made specific reference to the needs of persons with disabilities in the various sections of the local emergency plan. For persons with mobility limitation the training covered safe handling procedures for wheelchair users, rescues from para-transit vans, having persons with disabilities participate in the exercises, and so on. Nobody Left Behind Findings

Findings on Inclusion of Persons with Mobility Impairments Little to no representation of persons with mobility impairments in planning or revision stages. No Best Practices Found Conclusions: Lack of inclusion of persons with disabilities. Those sites with guidelines to address persons with mobility impairments were more likely to have consulted with an Aging Organization or Disability Organization or a persons with a disability. Nobody Left Behind Findings

Nobody Left Behind Findings Findings on Resources Needed To develop guidelines for persons with mobility impairments, emergency managers need: 67% Financial resources. 33% Knowledgeable and trained personnel. 25% A FEMA, State, or County mandate. 17% Greater public education efforts. Nobody Left Behind Findings

Nobody Left Behind Findings Consumer Feedback No evacuation plans in multi-story buildings, leaving people who are unable to walk abandoned at stairwells or at inoperable elevators without assistance. Nobody Left Behind Findings

Nobody Left Behind Findings Consumer Feedback The Americans with Disabilities Act (ADA) has been in existence for more than 15 years, yet disaster-related or local services still can be found to be inaccessible and disaster-related personnel uninformed of the needs and how to assist people with disabilities. Nobody Left Behind Findings

Nobody Left Behind Findings Consumer Feedback Other frightening and sometimes life-threatening situations occur when infrastructures fail, including electrical power outages and non-accessible transportation. Nobody Left Behind Findings

Questions After Katrina Are there differences in disaster preparedness for persons who are disabled, seniors, or the seriously ill, and within classes, races and among states? 4 years after 9/11, when will local emergency management infrastructures be strengthened?

The Next Disaster: Avian & Pandemic Influenza Are You Prepared? Have You Prepared Your community, including Persons with Disabilities?

Nobody Left Behind Findings For more Information: www.nobodyleftbehind2.org Nobody Left Behind Findings