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TENNESSEE

TENNESSEE. FEMA DR 1909 TN. RECOVERY PROJECT. Introduction Becky Stoll, LCSW. Centerstone - Vice President, Crisis & Disaster Management State of TN Disaster Mental Health Committee - Chair Nashville Fire Department - Clinical Director, CISM Team Middle Tennessee CISM Team

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TENNESSEE

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  1. TENNESSEE FEMA DR 1909 TN RECOVERY PROJECT

  2. IntroductionBecky Stoll, LCSW • Centerstone - Vice President, Crisis & Disaster Management • State of TN Disaster Mental Health Committee - Chair • Nashville Fire Department -Clinical Director, CISM Team • Middle Tennessee CISM Team - Clinical Director

  3. The 1,000 Year Tennessee Flood

  4. Some Background • May 2-3, 2010, areas in Tennessee received over 13 inches of rainfall in less than 48 hours • This became the worst Natural Disaster in TN history • It is second only to Hurricane Katrina as the worst disaster in Region IV (TN, KY, AL, MS, NC, SC, & FL) history • 46 out of the 95 Counties in Tennessee were declared Federal Disaster Areas • Over 67,000 FEMA applications for disaster assistance had been received as of August 9, 2010

  5. Rescue Efforts Depended Upon Everyone

  6. What is Tennessee Recovery Project? The Tennessee Recovery Project (TRP) is a program created through a FEMA grant to provide free emotional outreach services to persons affected by the recent Tennessee floods.  TRP’s purpose is to support the emotional well being of flood survivors by increasing resiliency while decreasing chronic mental health diseases related to the flooding event. Centerstone, along with 4 other mental health agencies, are working together at TRP in all of the counties that were declared Federal Disaster Areas under FEMA DR 1909 TN.

  7. Tennessee Recovery Project The Tennessee Recovery Project (TRP) is being administered via FEMA’s Immediate Services Program (ISP) (first 90 days post event) and Regular Services Program (RSP) (subsequent nine months to the anniversary date of the event).

  8. Phases of the Response • Search and Rescue • Recovery • Assessment of Need • Strategic Planning • Provision of post event services • After Action Planning

  9. DisastersAccess & Functional Needs Seriously Mentally Ill

  10. Name Change“Access & Functional Need” 2010 Term formerly know as “Special needs” was replaced with “Access and special needs” FEMA felt “access & functional needs” was more inclusive Term “special needs” did not work in emergency planning because it does not provide the guidance to operationalize the tasks needed

  11. “Access & Functional Need” 2010 Another problem with “special needs” was it lead to segregation and unequal service for people with disabilities No one wants to be “special” during an emergency, they want to receive the same services as everyone else. Term “Access & functional needs” is more useful as a description of everyone who may require accommodations throughout a disaster

  12. FEMA’s New Philosophy The “special needs” approach should be eliminated from emergency planning because accommodations for people with access and functional needs should always be incorporated throughout all plans.

  13. FEMA Definition“Access & Functional Need” “Those actions, services, accommodations, and programmatic, architectural, and communication modifications that a covered entity must undertake or provide to afford individuals with disabilities a full and equal opportunity to use and enjoy programs, services, activities, goods, facilities, privileges, advantages, and accommodations in the most integrated setting……”

  14. “Access & Functional Need” These include: Elders Physical Sensory Mental health Pregnant women Cognitive/intellectual Language/communication Others who must be identified locally

  15. Functional Needs Support Services Services that enable individuals to maintain their independence in a general population shelter • Reasonable modifications to P&Ps • Durable medical equipment • Consumable medical supplies • Personal assistance services • Other goods and services as needed

  16. During a Disaster Seriously Mentally Ill During a disaster those diagnosed with a serious mental illness often: functional very well rise to the occasion Assist others

  17. Post Disaster Seriously Mentally Ill This is a very vulnerable group who can be greatly impacted by the social disruption of a post-disaster world.

  18. Post DisasterSeriously Mentally Ill Less Prepared: • Less likely to have supplies or an emergency plan • Dependent on others to take precautions/evacuate New/Recurrent Symptoms • More likely to develop stress-related symptoms • Relapse of prior symptoms • Disruption of social situation • Prior Dx. of PTSD more vulnerable

  19. Disrupted Mental Health Care System Loss of caretaker • Family/friends may be dead, injured, displaced • Caretakers focusing energy on recovery Mental Health Services Disrupted • Providers are closed • Pharmacy/medication access • Transportation Increased Demand for Mental Health Services • Increase after a disaster • Diversion of resources

  20. Preparation Seriously Mentally ill Disaster Preparedness/Planning • Emergency contacts • Medication • Contact with EMA Special Care/Services • Psychological First Aid (PFA) • Do not isolate/Stigmatize • Psychiatric medication Responders Trained • Train on recognizing mental illness • Know where to access assistance

  21. State of Tennessee Disaster Mental Health Response Plan(DMHRP)

  22. DMHRP Development 2011 • American Red Cross • Centerstone • Mental Health Cooperative • Metro Nashville Public Health Department • Tennessee Department of Mental Health • Tennessee Emergency Management Agency • Tennessee Association of Mental Health Organizations • Tennessee Department of Health • Volunteer Behavioral Health Care System

  23. Initial Response

  24. FEMA Crisis Counseling Program

  25. Resource Allocation

  26. Highlights of the DMHRP Mission • Facilitate coordinated state, regional, and local mental health planning, intervention, and response efforts relative to disasters of any type • Maintain quality care, safety, and security for survivors, their families, disaster responders, and volunteers.

  27. Highlights of the DMHRP • State Committee • TEMA • Tennessee Department of Mental Health and Substance Abuse Services • Tennessee Department of Health • American Red Cross • Each of the Regional Disaster Mental Health Committees

  28. Highlights of the DMHRP • Regional Committees (7) • TN Department of Mental Health and Substance Abuse Services Regions • Representatives of: • EMA’s • Mental Health Centers • County Health Departments • Department of Mental Health • Red Cross • Others as appropriate

  29. Highlights of the DMHRP • The plan does not supersede any current Disaster Mental Health Plans that local communities may have established. • Needs Assessments • Red Cross • Community Mental Health Center or Health Department • Rosters of available disaster mental health response professionals maintained

  30. Highlights of the DMHRP • Response Phases • After Action Reviews • Agencies deploying their Disaster Mental Health Teams and ARC Disaster Mental Health volunteers are provided as pro bono services.

  31. DMHRP Status • June 2012 • Presented on FEMA’s Think Tank Conference Call on 06/28/12. • July 2012 • The DMHRP Annexed to the State of Tennessee’s All Hazards Response Plan, and • Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) to assume responsibility for the Disaster Mental Health Response Plan. • August 2012 • State Committee concurs with recommendations and TDMHSAS assumes leadership for DMHRP

  32. DMHRP Status • Educate stakeholders in key disaster response capacities such as hospitals, local EMA’s and local public health emergency preparedness programs in the concepts of disaster mental health and the strategies for response that are outlined in the DMHRP. • Exercise plan in a large scale exercise with other interdisciplinary agencies.

  33. Centerstone 1101 6th Avenue North Nashville, TN 37208 (615) 460-4481 Becky.Stoll@centerstone.org Becky Stoll, LCSW

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