The Role and Contribution of Occupational Therapy Services in Emergencies and Disasters Florida Occupational Therapy Association Annual Conference Workshop November, 2015 Orlando, FL Michael J Steinhauer, OTR, MPH, FAOTA The Steinhauer Group, LLC Boynton Beach, FL

Today’s Purpose To explain the 4 phases of emergency management and best understand how occupational therapists can best contribute to an emergency or disaster at these phases. To identify what role you as health care professionals have in working with emergency management planners, first responders, your organizations and in the communities you live and work.

Defining “Access and Functional Needs” Populations Any individual, group, or community whose physical, mental, emotional, cognitive, cultural, ethnic, socio-economic status, language, or any other circumstance that creates barriers to understanding or the ability to act/react in the manner in which the general population has been requested to proceed. OTs think functional challenges, not diagnostic categories

WHY PREPARE? REALITY CHECKS: 46 percent of people with disabilities say they do not know whom to contact about emergency plans for their community in the event of a crisis.

REALITY CHECK 53 percent of people with disabilities say that they have not made plans to quickly and safely evacuate their home or know who to contact for assistance with preparing.

Only 20 percent of municipal emergency managers have specific guidelines to assist people with mobility impairments during emergencies

57 percent of emergency managers do not know how many people with mobility impairments live in their jurisdiction

REALITY CHECK Many people with disabilities in New Orleans were evacuated without their medicine, medical equipment, wheelchairs or guide animals.

2003 California Wildfires: many were unable to see approaching danger or hear announcements to evacuate. There was a lack of transportation for those unable to drive. Emergency telephones at evacuation sites were not equipped for people who were deaf, and were not within reach of people in wheelchairs. Reality Check

Emergency planning is now learning to serve people with disabilities. Whole community approach: the more we know about all people in our communities, the better we can meet our obligations for their reasonable accommodations as well as their medical and personal needs. OTs are accommodation experts “Medicine will save your life. OT will save your living!” Lessons Learned

Americans With Disabilities Act Requirements (and many other federally related acts and statutes) State/Local Legal Compliance: licensure acts, certification, accreditation, county contracts, insurance/HMO contracts, facility policies, etc. Liability Issues for lack of planning at every level Legal Basis for Emergency Planning Around Access and Functional Needs Populations

Emergency Phase 1 MITIGATION Meaning: The action of lessening in severity or intensity. Hazards are mitigated, not people. 4 Phases of Emergency Management! The OT role is substantial in Phases 2-3-4

MITIGATION Examples: Buying flood insurance Landscape around the home Cut overhanging trees Improve infrastructure Assure shelter accessibility in your community 4 Phases of Emergency Management!

Emergency Phase 2 PREPAREDNESS Individuals, Families, Neighborhoods (Role for OT in every treatment setting) Personal Level Sheltering at Home or Evacuation (Role for OT) County Level (Role for OT) Within Organizations (COOP) 4 Phases of Emergency Management!

Emergency Phase 2: COOP-A Role for OT Continuity of Operations Planning for Organizations: Identifying your Role and Contribution During an Emergency Preparedness for Caregiver and Clients Readying the Physical Office Space (Command Posts, Alternative Work Sites) Prioritizing Clients Communications Planning Providing Resources to the municipal EOC 4 Phases of Emergency Management!

PREPAREDNESS City and County Municipal Planning Activities (Radiologic, Chemical, Weather, Communications, Evacuations, Transportation, Warnings and Sirens, Resources like DME, Exercises, Drills) Registries in Some Counties OTs: JOIN ADVISORY COUNCILS 4 Phases of Emergency Management

PREPAREDNESS (Related to your representation of Self Determination Principles) Self Determination No One Size Fits All Inclusion in Planning Equal Access Physical Access Effective Communication Program Modification 4 Phases of Emergency Management!

Emergency Phase 3 RESPONSE Evacuation Planning at the Street Level (Planning for transfers i.e., with transportation resources, access to reception centers and shelters) Services of a Reception Center (Role for OTs): Mental health, personal care and DME needs, assistive communication technologies, etc. 4 Phases of Emergency Management!

RESPONSE Meeting Equipment and Staff Needs (Role for OTs) Sheltering Options-General, Medical, Functional Needs (Role for OTs): Personal care and DME needs, transfer training, assistance with ADLs, 4 Phases of Emergency Management

Emergency Phase 4 RECOVERY County Long Term Recovery Committees Case Management Assistance with FEMA Claims Housing, transportation, and service needs after the incident – community reintegration ALL ROLES FOR OTs 4 Phases of Emergency Management!

Take a Break! “ The mind can only absorb what the bottom can endure.” 10 Minutes

Inside the facility setting (hospital, SNF, ALF, DD group homes, etc): working with d-c planners, participating in COOP committees, assuring personal preparedness (see next slides). In the community setting (home health, day care, outpatient, neighborhood associations, etc): personal/family/community preparedness Integrating with municipal planners: advisory committees, reception centers, shelters OT as an Emergency/Disaster Resource

Inside an academic setting (schools, universities): working with COOP committees, enlightening your customers about personal/family preparedness. Doing these things: OTs assessing/treating evacuees (mental health, physical dysfunction, developmental disabilities, etc) OTs identifying adaptive equipment resources, then individual needs, and complete order for response setting OT representation during agency/facility exercises and drills OT representation at the EOC Evaluating need for personal care services in response setting OT member of the COOP team for the agency/facility OT as an Emergency/Disaster Resource

Refresher: patient/client/resident education around emergencies and disasters: key aspects of planning

1 ST : Prepare to Stay at Home Pet Safety Plan Healthy Snacks/Cooked Food First Aid Supplies

Prepare to Stay at Home Battery Operated Radio, or Weather radio Extra Batteries Flashlights Deck of cards, book or something to do for several hours

2 ND : Prepare your Evacuation Kit Get some supplies for your kit Keep kit near the front door or closet

Prepare Your Evacuation Kit ID Cell Phone Keys A Little Money Names, phone numbers of important contacts

Prepare Your Evacuation Kit Medical Information A Few Days Supply of Medicine Supplies for Your Medical Condition

3 RD : Plan for your Pets Crate or Cage and Leashes Special Diet Food or Pills Identifying Tags Favorite Toy

Here’s a Handy Device: Emergency Preparedness Cycle

ABOVE ALL Look out for your neighbor. It is the right thing to do!!!

Michael Steinhauer, OTR, MPH, FAOTA The Steinhauer Group, LLC aka Midwest Emergency Planning Services 9566 Sun Pointe Drive Boynton Beach, FL The contribution of OT is unique! Thank you folks