1. CMIST DATA -LONG ISLAND
Using the CMIST model to develop evidence-based practice: A study from Disaster shelters at Hurricane Sandy
Mary Casey Lockyer MHS, RN, CCRN and Janice Springer DNP, RN, PHN American Red Cross
Background
Results
Conclusion
CMIST provides a comprehensive model that exceeds ADL screening.
A public-health functional needs model is appropriate for congregate care shelters.
Process increased awareness of support needs for chronic health conditions and maintaining independence for clients in community shelters.
CMIST provides language to assist community emergency planners and local public health to better prepare for disaster events.
This public health model allows for a comprehensive identification of needs for clients in shelters and allows for integration of those with access and functional needs into the general population congregate shelter maintaining their support system of family and friends.
The ability of a community to recover from disaster is linked to the post-disaster health of individuals impacted by the disaster.
Early identification and support of client needs in shelters can diminish morbidity, enhance resilience and contribute to community recovery.
Across different shelters with different demographic populations, a pattern emerged showing consistently that 70% of clients screened had needs related to Maintaining Health with the rest of the need scattered amongst the other four categories. Needs included managing chronic medical conditions in order to prevent diminishing health such as replacing medications, as well as support of function such as access to meals, support for special dietary needs, replacement of mobility equipment, cots properly sized for sleeping support and emotional health care. Once durable medical equipment, cots and consumable medical supplies were obtained, the most requested resource was for personal assistance services.
Over many years, disparities and inconsistencies have been reported in identifying and meeting client needs for support in disaster shelters. Systems of intake that rely on self-report of needs, or instruments based on medical need are insufficient to reach the range of the whole community.
In 2010 an “intake team” was formed with representatives from the American Red Cross, FEMA Office of Disability Integration and Coordination and the US Department of Health and Human Services including representatives from the Offices of Emergency Preparedness under the Assistant Secretary for Preparedness and Response, Administration for Children and Families, Agency on Aging and the At-Risk, Behavioral Health and Community Resilience section. This team developed an intake tool and contributed feedback on several studies of the tool's use during disasters in ,leading to recognition that a public health model was needed. A revised process of Cot-to Cot was then partnered with the CMIST model for testing during Hurricane Sandy, 2012.
Further Study is needed to demonstrate if:
CMIST DATA -LONG ISLAND
Methods
During Hurricane Sandy in shelters in New York and New Jersey, an access and functional needs model called CMIST was utilized to assess shelter populations.
Communication,
Maintaining health,
Independence,
Services, Support/Self-determination, and Transportation needs
were assessed by licensed health care providers (primarily registered nurses) using a job aid to assure that all areas of function were included clients/or family groups were assessed with this job aid in Long Island, New York shelters.
Select References
FEMA. (2011) Guidance on Planning for Integration of Functional Needs Support Services in General Populations Shelters. Retrieved from:
Kailes, June I. and Enders, Alexandra. (2007). Moving beyond "special needs": A framework for emergency management and planning. Journal of Disability Policy Studies, 17(4), 230.
Key Contributors
Marcie Roth, FEMA Office of Disability Integration and Coordination
Jonathan White Office of Human Services Emergency Preparedness & Response Administration for Children and Families
Kelly Johnson and Harvey Ball, Moira Shea (ret.),
Assistant Secretary for Preparedness and Response
Division for At-Risk Individuals, Behavioral Health, and Community Resilience (ABC); Office of Preparedness and Emergency Operations
Deborah Knickerbocker,
Office of Preparedness and
Emergency Operations
Katherine Galifianakis, American Red Cross
Dee Yeater, Volunteer, American Red Cross