1. PLANNING FOR INDIVIDUALS WITH DISABILITIES AND OTHER ACCESS AND FUNCTIONAL NEEDS: SPECIAL TOPICS FOR FIRST RESPONDERS

2.  This presentation was created by Nusura, Inc. for the Orange County Sheriff’s Division of Emergency Management

3. Facilitator Introductions  June Kailes  Andrew Neiman

4. Participant Introductions  Name  Title  Agency/organization  Role during an emergency

5. Logistics  Safety  Electronics  Breaks  Contact Info  Survey feedback

6. Agenda  Etiquette & Behavior  3 A’s of Response  Discussion

7. Etiquette & Behavior

8. General Etiquette  Always introduce yourself and anyone with you.  Offer assistance to anyone who may need assistance but always ASK FIRST.  Speak with adults like adults, no matter what disability or other AFN they may appear to have or not have.  Communicate directly with the person.

9. General Etiquette, continued  Introduce yourself at the individual’s height level so that height and stature are less intimidating.  Don’t “talk down,” yell, or shout.  Have a forward leaning body position. This shows interest and concern.

10. General Etiquette, continued  Keep questions/instructions short and simple.  Use facial expressions and gestures. Point to any objects as you speak about them.  Use pictures or objects to illustrate your words.  Demonstrate what you mean. Showing can be more effective than telling.

11. General Etiquette, continued  Let the individual know you are there to help.  Rephrase or restate if the individual does not understand. Sometimes it is only one word that is causing the confusion.  Accompany the individual to the safe location instead of giving only verbal directions.

12. Interpreters  Friends and family should only be used for urgent, short-term situations.  Just because someone knows the language doesn’t mean they have the skills to be an interpreter.  An interpreter should be positioned next to you so that the individual can see the interpreter and you at the same time.  Speak directly to the individual, not the interpreter.

13. Etiquette, Deaf & Hard of Hearing AFN  Avoid shining flashlights into the face or eyes.  Establish eye contact, if possible.  Do not look away or hide your mouth while speaking.  Do not chew gum while speaking.  Speak in normal tones and at a normal speed first.

14. Etiquette, Deaf & Hard of Hearing AFN  Remember that American Sign Language is not the only sign language, it is not English, and not all deaf/hard of hearing people use ASL.  Not everyone can read in English.

15. Behavior Tips, Deaf & Hard of Hearing AFN  Use facial expressions, gestures, and body language.  Point to objects as you speak about them.  Use pointer finger for directions.  Use written communication  Write down urgent details  Let them read as you write and allow interruption once point is made  Check for understanding  Allow person to write information for you

16. Etiquette, Blind/Low-vision AFN  Announce your presence and those with you.  Do not shout.  Never touch their cane or service animal, unless asked.  Do not separate them from their cane or service animal.  Announce your departure.

17. Behavior Tips, Blind/Low-vision AFN  Walk on the side opposite a guide dog or cane.  Offer your elbow.  Avoid holding on to the individual.  Let the individual hold on to you.  Provide a description of the route and surroundings as you approach them.

18. Etiquette, Cognitive/Mental Health AFN  Cognitive & mental health AFN can be difficult to identify. Take care, treat everyone with respect, speak to adults like adults.  If speech is slow, allow person to finish their sentence or reply.  Be empathetic.

19. Behavior Tips, Cognitive/Mental Health AFN  Rephrase or restate if the person does not understand. Sometimes it is only one word that is causing the confusion.  If the person is delusional, just let him or her know you are there to help.  Accompany the person to the safe location instead of giving verbal directions.  Try to reduce distractions and/or try to find a calmer, quieter place

20. Etiquette, Mobility/Dexterity AFN  Respect personal space.  The wheelchair or scooter is to be treated like the person. Don’t lean on or “handle” it.  Never move a person in a wheelchair or scooter unless you have permission from the person.

21. Etiquette, Mobility/Dexterity AFN  Approach a person in a wheelchair to shake his or her hand just the same as you would anyone else.  Sit down to speak at eye level with a person in a wheelchair.  Offer to place paperwork or other items where the person can access them as needed

22. Children  Sit or kneel to be at eye level  Avoid figurative language and keep phrases simple  Check for favorite things, use as a way to interact and bring them with the child  Use First/Then & Fill-in-the-blank  First we are going to put this jacket on you, then you can have a cookie

23. Questions/Discussion/Activities  Questions  Did we leave anything out?  Does anyone have personal experience that would be helpful?

24. 3 A’s of Response

25. 3-A’s of Response  Announcement  Assessment  Assistance

26. Announcement  Announce your arrival to the person/people  Be sure your presence is known.  Establish and maintain eye contact.  Clearly establish identification and purpose.  Present your official ID.

27. Announcement, continued  My name is __________. I'm here to help you.  I am a __________ (name your job).  I am here because __________ (explain the situation).

28. Announcement  Explain the incident and what is expected of the individual  Use communication strategies that work for the person -- speaking, notes, gestures, picture cues, or interpreter.  Avoid long explanation. Time is of the essence.  Keep it simple.

29. Assessment  Assess person for access and functional needs.  Do they need assistance with communication, transportation, or medical care?  Would some additional support or care help them remain healthy, safe, and independent?  Determine if shelter-in-place is possible.

30. Assessment- Questions to Ask  Do you have a friend or family member who can help you?  If so, keep them together!  Include family members and/or care givers in planning and evacuation.

31. Assessment- Questions to Ask  How can I help you?  Remember, some people may have need that are not visible  Focusing on support you can provide is more productive than trying to identify what disability they have  Listen to the person’s needs

32. Assessment- Questions to Ask  Do you have a survival kit or “go bag” that includes your necessary equipment, assistive devices, medicines, or supplies?

33. Assessment- Look or ask for:  Identification bracelet with specific personal information (allergies, diabetes, heart problems, sensory conditions, cognitive or mental health concerns, etc.)  Essential equipment and supplies (portable oxygen, batteries, hearing aids, glasses, cane for person who is blind or has low-vision, etc.)  Medications

34. Assessment- Look or ask for:  Mobility aids (wheelchair, walker, cane, service animal, etc.)  Communication strategies (language, sign language, head pointers, alphabet boards, speech synthesizers, etc.)  Emergency contact information

35. Assessment- Service animals and pets  If a service animal is with the individual, keep the service animal and the individual together.  Ask, “Do you have a survival kit for your service animal?”  If pets are involved, develop plans to transport pets as well

36. Assistance  Determine appropriate course of action together with the person if possible  Evacuation, shelter-in-place, give first aid, transport, etc.  Explain the benefits of evacuation and consequences of non-evacuation.  Communicate the plan and associated steps  Check for understanding  Execute the plan

37. Assistance: Communicate the Plan  Use communication strategies that work for the person.  Keep it simple.  Include transportation, destination, medications, medical equipment and supplies, refrigeration or power requirements, caregivers, service animals, and assistive devices.  Check that the plan meets the access and functional needs of the individual, caregiver and/or family members.

38. Assistance: Check for Understanding  Ask the person or the caregiver to repeat the plan (or critical elements of the plan).  Head nods do not necessarily mean the person understands.  Repeat the plan again, if necessary.  Use a different communication strategy if the individual does not seem to understand.  Try different words or phrases, picture cues, phrase board, accompany the person, etc.).  Keep it simple.

39. Assistance: Execute the Plan  Provide assistance to remove the person from danger.  Whenever possible do not separate the person from family members, caregivers, service animals, wheelchairs, walkers, “go bags”, medical equipment and supplies, medication, etc.

40. Assistance: Execute the Plan  Ask the person if he or she is “ok” or experiencing issues with any part of the plan while underway.  If issues come up, be flexible, clarify the issue, and consider the needs of the person in order to reduce the stress.  Orient the person to the safe location (shelter or otherwise) that is out of harm’s way with qualified personnel, physical access, access to information and consideration for his or her medical needs.

41. Evacuation Considerations  People have the right to refuse to evacuate.  Be familiar with your agencies policies and procedures around refusal.  Explain the consequences of not evacuating.  Try to remove barriers to evacuation  Use a evacuation refusal form or other similar documentation.

42. Questions?

43. Discussion  How do you interact with someone you don’t understand?

44. Discussion  What do you do if you’re trying to help someone evacuate from the 12 th floor and they won’t leave without their motorized wheelchair?

45. Discussion  What do you do if you’re trying to help someone evacuate and they appear really angry?

46. Discussion  Is your agency prepared to transport individuals with disabilities and others with access and functional needs who may need to be arrested?  How does your agency handle these situations?

47. Discussion  What resources does your agency have at their disposal to support individuals with disabilities and others with access and functional needs  Communication?  Maintaining Health?  Independence?  Support and Safety?  Transportation?

48. Discussion  Are the same resources that are available during business hours available during off-hours?  If not, how does that impact operations?  How do you handle these situations?

49. Discussion  What resources would be helpful for you to have access to?  Communication?  Maintaining Health?  Independence?  Support and Safety?  Transportation?

50. Discussion  Non-first responders, do your organizations have any resources that could be helpful to first responders?

51. Share your thoughts!

52. Thank You!  Please complete the course feedback form before you leave