1. 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

2. 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

3. Disaster Preparedness for Persons with Mobility Impairments
October, September 2005
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:

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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 --

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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, )

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

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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?

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

29. Nobody Left Behind Findings
For more Information:
Nobody Left Behind Findings