1. Planning Tools You Can Use To Meet The Needs Of People With Disabilities In An Emergency: What To Do, What Not To Do, And What Difference Does It Make? Dr. Anthony Cahill Senior Research Scientist and Director, Division of Disability and Health Policy University of New Mexico School of Medicine

2. Disclaimer! The opinions expressed in this presentation are solely those of the author, and do not represent the official opinions of: The University of New Mexico Any Local, State, Intergovernmental Compact or Federal Agency Any National Government, Anywhere The United Nations The United Federation of Planets

3. Our Agenda Setting the Stage: Translational Research Lessons Learned: What Works, What Doesn’t and What Difference Does It Make? Issues and Possible Mitigation Strategies Wrapping Up: An Alternative Approach to Disaster Planning

4. Setting the Stage: Translational Research

5. Individual Knowledge Creation Knowledge Mining Organization Community K n o w l e d g e T r a n s l a t i o n State of the Science Conference Peer-Reviewed Publications Internet Resources Training and Dissemination Clearinghouse Social Marketing & Risk Assessment Literature Review Preparedness Search for Best Practices Review Emergency Management Policies and Practices Review Community Policies and Practices Pre-InvestigationInvestigation Dissemination RESEARCH Policy and Practice

6. LESSONS LEARNED: WHAT DO WE KNOW AND HOW WELL DO WE KNOW IT?

7. Federal Assessments 2006 Nationwide Plan Review https://www.dhs.gov/xlibrary/assets/Prep_NationwidePlanReview.pdf

8. Federal Assessments, Continued Senate Committee on Homeland Security Report http://hsgac.senate.gov/_files/Katrina/FullReport.pdf

9. Federal Assessments, Continued 2005 “Failure of Initiative….” Report http://katrina.house.gov/full_katrina_repor t.htm Inspector General’s Report on Nursing Homes http://oig.hhs.gov/oei/reports/oei-06-06- 00020.pdf “Lessons Learned” Information Sharing www.llis.gov

10. University Assessments Impact of Hurricane Katrina http://www.rtcil.org/products/NIDRR_FinalKatrinaReport.pdf

11. http://www.nobodyleftbehind2.org/

12. University Assessments, Continued Vulnerable Populations: Emergency Preparedness Conference http://www.umaryland.edu/healthsecurity/mtf_conference/index.html#info

13. The Impact of Southern California Wildfires On People With Disabilities April 2004 Disability Organization Assessments http://www.calsilc.org/impactCAWildfires.pdf

14. THE IMPACT OF HURRICANES KATRINA AND RITA ON PEOPLE WITH DISABILITIES: A LOOK BACK AND REMAINING CHALLENGES Disability Organization Assessments, Continued http://www.ncd.gov/newsroom/publications/2006/hurricanes_impact.htm

15. Disability Organization Assessments, Continued 2005 AARP Report: We Can Do Better http://www.aarp.org/research/assistance/lowincome/better.html 2006 Transport Policy Institute Lessons Learned From Katrina and Rita http://www.vtpi.org/katrina.pdf 2005 National Council on Disability Saving Lives Report http://www.ncd.gov/newsroom/publications/2006/hurricanes_im pact.htm

16. What’s The Bottom Line For You? Studies are of varying quality We know a lot about what went right, what went wrong, and what we can do to improve “Translational Research”: converting what we know into what to do about what matters.

17. ISSUES AND POSSIBLE MITIGATION STRATEGIES

18. Issues Scenarios and Disaster Plans Personal and Organizational Planning Identifying and Locating People with Disabilities Identification of Target Groups

19. Issues Scenarios and Disaster Plans Personal and Organizational Planning Identifying and Locating People with Disabilities Defining Target Populations

20. Issues: Scenarios & Disaster Plans “The majority of…plans cannot…manage catastrophic events” “Both plans and exercises are scaled to familiar events” “Think the unthinkable”

21. Scenarios & Plans, Continued Most initial search and rescue is carried out by citizens/survivors Individuals first turn to other members of “communities of interest” of which they are members Survivors arrive at shelters/ evacuation points/hospitals by private means, bypassing official systems

22. Scenarios & Plans, Continued…. Too few health care facility plans at all levels include assessing the medical and functional support needs of people with disabilities Durable medical equipment, service animals, personal care attendants, medications, transportation, evacuations Now defined as “essential services”

23. Emergency Management Under Title II of the ADA U.S. Department of Justice Civil Rights Division Disability Rights Section Americans with Disabilities Act ADA Checklist for Emergency Shelters http://www.ada.gov/pcatoolkit/chap7shelterchk.htm Module Two: Federal Changes

24. Emergency Management Under Title II of the ADA, Continued Emergency managers and shelter operators need to ensure that sheltering programs are accessible to people with disabilities, including individuals who use wheelchairs. Local governments and shelter operators may not make eligibility for mass care shelters dependent on a person’s ability to bring his or her own personal care attendant. The ADA generally requires emergency managers and shelter operators to make reasonable modifications to policies, practices, and procedures when necessary to avoid discrimination.

25. Emergency Management Under Title II of the ADA, Continued A reasonable modification must be made unless it would impose an undue financial and administrative burden. This includes modifying “no pets” policies to incorporate service animals, use of kitchen facilities for people with medical conditions, and modifying sleeping arrangements to meet disability-related needs.

26. Issues Scenarios and Disaster Plans Personal and Organizational Planning Identifying and Locating People with Disabilities Defining Target Populations

27. Issues: Personal and Organizational Planning Too little personal preparedness planning by individuals with disabilities Too little organizational disaster planning by agencies providing services to people with disabilities Too little planning for the needs of this population by health emergency management agencies and employers

28. Resources for Personal Planning 72hours.org http://www.72hours.org/index.html PrepareNow.org http://www.preparenow.org/links.html American Red Cross “Be Prepared Campaign” http://www.redcross.org/services/prepare/0,1082,0_239_,00.html Federal Emergency Management Agency “Are You Ready” Campaign http://www.fema.gov/areyouready/ National Organization on Disability “Prepare Yourself!” Campaign http://www.nod.org/index.cfm?fuseaction=page.viewPage&pageID=1430& nodeID=1&FeatureID=1625&redirected=1&CFID=12437936&CFTOKEN=9 6203152 Module Four: Tools

29. Resources, Continued Emergency Planning For People Who Use Assistive Technology Devices Powered By Electricity or Batteries http://www.jik.com/techartV4.doc Tips for People With Mobility Limitations from Los Angeles County http://www.cert-la.com/ESP/ESP-Disabilities-Guide-2006.pdf American Red Cross “Be Prepared Campaign” http://www.redcross.org/services/prepare/0,1082,0_239_,00.html Emergency Preparedness at Home for People With Disabilities http://www.disabilitypreparedness.org/Emer%20Prep%20at%20home%20r ev%206-07-06.pdf Disaster Preparedness for Persons with Mobility Impairments www.nobodyleftbehind2.org/ Module Four: Tools

30. Common Elements of Personal Planning Individuals should be prepared to maintain themselves for a minimum of 72 hours (three days) without services (food stores, electricity, water, etc.) Supplies of food and water Change of clothes Medications Flashlight, portable radio, batteries Module Four: Tools

31. Common Elements, Continued Copies of prescriptions Service information ( Medicare or Medicaid cards, health insurance plan cards, social security card) First Aid Kit Food for service animals and DME, if applicable Contact information for family, caregivers, close friends who could help

32. Common Elements, Continued For disasters in which an evacuation might happen, these items should be placed in a “To-Go Kit” – a durable, lightweight container such as a duffle bag. These items can be used at home in the event of a disaster that requires people to stay in their homes. Module Four: Tools

33. Issues Scenarios and Disaster Plans Personal and Organizational Planning Identifying and Locating People with Disabilities Defining Target Populations

34. Issues: Identifying and Locating People with Disabilities …Or, How To Create A Really BAD Registry! Bad: Collect as much information as you possible can about every aspect of the person's needs and life. Good: Focus on information that the first responder will need to get the person from their home or other location to a hospital, shelter, etc. Name Location Type(s) of disability Medication – what and where is it? Caregivers? If yes, contact information Durable Medical Equipment? If yes, what and where is it? Service animals? If yes, what kind, leash or harness, food Other needs

35. Issues: Identifying & Locating, Continued Bad: the bigger the registry, the better! Good: maintain registries that will be used on a local level. Bad: create a registry that relies on technology. Good: technology is great, but make sure there are always hard copies available of the latest version. Bad: Wait until a disaster happens to let local emergency managers know that the registry exists. Good: always coordinate your activities with the local emergency management community, particularly the county emergency manager.

36. Issues: Identifying & Locating, Continued Federal disability discrimination laws do not prevent employers from obtaining and appropriately using medical or health information necessary for a comprehensive emergency evacuation plan. http://www.eeoc.gov/facts/evacuation.html

37. Issues Scenarios and Disaster Plans Personal and Organizational Planning Identifying and Locating People with Disabilities Defining Target Populations

38. Issues: Defining Target Populations Prior federal policy contained categories of “Special Needs” populations Problems include lack of focus and inability to identify specific needs of targeted populations Gradual replacement of the term with a functional approach

39. “Special Needs” – the Draft Target Capability on Functional & Medical Support Sheltering “…the population requiring support accommodated in general shelters is maximized by meeting individual functional and medical support needs…. “What were they doing yesterday?”

40. Functional And Medical Support Sheltering: How? Population requiring medication / consumable supplies / DME support Population requiring functional support (when existing caregiver is not available) Population requiring medical support

41. 2006 Reauthorization of the Homeland Security Appropriations Bill (HR 5441) Redefines “Special Populations”: “Before, during and after an incident, members of the population may have additional needs in one or more of the following functional areas: maintaining independence, communication, transportation, supervision or medical care”

42. WRAPPING UP: AN ALTERNATIVE APPROACH TO DISASTER PLANNING

44. For More Information: Dr. Anthony Cahill Center for Development and Disability 2300 Menaul Boulevard NE Albuquerque, NM 87107 (505) 272-2990 phone (505) 272-9594 fax Acahill@salud.unm.edu