Ready Seniors Symposium and Workshop

1. Ready Seniors Symposium and Workshop Planning Ahead – Assisting Isolated Elders in an Emergency Rhonda Schwartz, ACL Aging Services Program Specialist Kathleen Otte, ACL Regional Administrator

2. Many Community-Living Older Adults are Isolated • People living longer, with complex health issues • Rebalancing LTSS System • Cultural Changes – older adults less likely to live with or near relatives • “Elder Orphans”

3. Older Adults Disproportionately Affected by Disasters • 2017 California wildfires: majority of victims were over age 70 • Katrina: per the CDC, more than 70% of people who died were elderly, while people 60 and older only accounted for 15% of the population

4. Puerto Rico 2017(Chart from June 8, 2018 New York Times article by Sheri Fink, entitled “New Data Sheds Light on Death Toll of Hurricane Maria in Puerto Rico”)

5. Puerto Rico 2017Chart From The George Washington University Milken Institute of Public Health, ASCERTAINMENT OF THE ESTIMATED EXCESS MORTALITY FROM HURRICANE MARÍA IN PUERTO RICO, p. 10.

6. Puerto Rico 2017* • During October 2017 and November 2017, there were 5,545 reports of elder abuse. • This is almost half the number of reports that were made for the entire 2016 calendar year (12,682). *preliminary data; subject to change

7. Puerto Rico – 2017(preliminary data; subject to change)

8. Puerto Rico – 2017(preliminary data; subject to change)

9. Disasters: What We Know • Disasters can happen at anytime, anywhere and vary in magnitude • Presidential disaster declarations have happened in nearly every state and many states several times (e.g. hurricanes, floods, tornadoes, forest fires, etc.) • Resilient individuals, facilities and communities result when a “whole community” and “all hazards” preparedness and response approach is adopted

10. Planning at the Community Level • Determine Geographic area to be covered • Identify Resources/Vulnerabilities/Partners: • e.g., senior centers, home-delivered meal providers, case management agencies, HCBS providers, transportation providers, hospitals, community health centers, volunteers, etc. Source: NYC Emergency Management. Community Emergency Planning in NYC, A Toolkit for Community Leaders, pp. 17-18, https://www1.nyc.gov/assets/em/downloads/pdf/Toolkit.pdf

11. Establish and Foster Partnerships • “A disaster isn’t the time to be handing out business cards--Take a whole community and all hazards approach to planning” • Engage partners and foster development of partnerships and healthcare coalitions to ensure emergency plan and response alignment and integration at all levels (e.g., facility, community, State/local agency)

12. Establish and Foster Partnerships • “Build an emergency network”: “Building relationships in your community is one of the most powerful things you can do to prepare for an emergency. Communities with strong social ties are able to communicate, identify needs, and coordinate resources more effectively. Developing an emergency network during non-emergency times will help your community be much more prepared to respond to and recover from emergencies of all shapes and sizes.” NYC Emergency Management. Community Emergency Planning in NYC, A Toolkit for Community Leaders, p. 19, https://www1.nyc.gov/assets/em/downloads/pdf/Toolkit.pdf

13. Get Organized “Take time to develop your mission and strategies for how your lead team will organize and communicate. • What is the mission of your emergency network? What roles to do you need to be able to fulfill your mission? • What is the structure? Who will have what responsibilities? • When and how frequently will you meet? Who will set up meetings? • How will you communicate with each other and your larger community? • How will you keep your network engaged throughout the year?” Source: NYC Emergency Management. Community Emergency Planning in NYC, A Toolkit for Community Leaders, p. 16, https://www1.nyc.gov/assets/em/downloads/pdf/Toolkit.pdf

14. “Plan Inclusively” • “Objectives: • Be familiar with the services required for people with disabilities, access, or functional needs. • Identify partners in your community who can help your plan address various needs. • Things to consider: • People who have disabilities, access or functional needs may require communication, transportation, health or other kinds of assistance during emergencies. • For example, how can you connect with community partners who support seniors, people with limited English proficiency, people who are homebound and/or live in high-rise buildings? Are these community organizations part of your network?” Source: NYC Emergency Management. Community Emergency Planning in NYC, A Toolkit for Community Leaders, p.21, https://www1.nyc.gov/assets/em/downloads/pdf/Toolkit.pdf

15. Local Network Examples

16. Red Hook Check-In https://www.redhookcheckin.org/ • Aims to connect residents who may need assistance to their neighbors and needed resources in times of crisis. • Focuses on building relationships throughout the year that can be leveraged in times of emergency. • Grew out of a medical relief effort during Hurricane Sandy. From: NYC Emergency Management, Disability, Access & Functional Needs Fifth Symposium Report, p. 19

17. Ready Red Hook Webpage

18. Map

19. Ready Red Hook Emergency Plan • Timeline: what to do 72 hours before and after an emergency • Tips on preparing disaster plan, “go-bag,” emergency supplies kit • Evacuation and non-evacuation tips • What to do re: pets

20. Redhook Hub Webpage

21. VOAD (Voluntary Organizations Active in Disaster)https://www.nvoad.org/ • Coalition of 56 national organizations (faith-based, community-based and other non-profit organizations) and 56 State/Territory VOADs, which represent Local/Regional VOADs and hundreds of other member organizations throughout the country. • Facilitates partnerships with federal, state and local emergency management and other governmental agencies, as well as for-profit corporations, foundations, and educational and research institutions. • Primary point of contact for voluntary organizations in the National Response Coordination Center (at FEMA headquarters), a signatory to the National Response Plan, and an Emergency Support Function partner of many other federal agencies.

22. NJVOAD (www.njvoad.org)

23. NJVOAD Resources

24. NYC Emergency Management Community Preparednesshttps://nycem.samaritan.com/custom/504/#/volunteer_home

25. NYC Emergency Management Community Preparednesshttps://nycem.samaritan.com/custom/504/#/volunteer_home

26. ACL Federal Partner Agency - HHS Office of the Assistant Secretary for Preparedness and Response (ASPR)

27. HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) • Created in the wake of Hurricane Katrina to lead the nation in preventing, preparing for, and responding to the adverse health effects of public health emergencies and disasters • Focuses on preparedness planning and response; building federal emergency medical operational capabilities; countermeasures research, advance development, and procurement; and grants to strengthen the capabilities of hospitals and health care systems in public health emergencies and medical disasters • Provides federal support, including medical professionals through ASPR’s National Disaster Medical System, to augment state and local capabilities during an emergency or disaster

28. ASPR Office of Emergency Managementhttps://www.phe.gov/about/oem/Pages/default.aspx • Medical Reserve Corps (MRC): a national network of volunteers, organized locally to improve the health and safety of their communities. (https://mrc.hhs.gov/HomePage) • The MRC network comprises nearly 1,000 community-based units and almost 200,000 volunteers located throughout the United States and its territories. • MRC volunteers include medical and public health professionals, as well as other community members without healthcare backgrounds.

29. Medical Reserve Corps (https://mrc.hhs.gov/HomePage)

30. Health Care Coalitions • Groups of individual healthcare and response organizations – such as hospitals, EMS providers, emergency management organizations, public health agencies, and more – working in a defined geographic location to prepare for and respond to disasters and emergencies. • Office of HHS Assistant Secretary for Preparedness and Response (ASPR): Hospital Preparedness Program provides funding for HCCs. • To find HCCs in your area, go to: https://www.phe.gov/Preparedness/planning/hpp/Pages/find-hc-coalition.aspx

31. Toolkit • Link to toolkit: https://acl.gov/news-and-events/announcements/new-resource-available-emergency-planning-toolkit-aging-and-0

32. Topics Covered • Assessments and Preparedness Planning • Identifying Older Adults and People with Disabilities • Effective Messaging • Supporting Evacuation and Transportation Needs • Addressing Sheltering and Housing Needs • Legal Advocacy for Older Adults and People with Disabilities • Recovery

33. Reaching Isolated Older Adults

34. HHS emPOWER Map 3.0 https://empowermap.hhs.gov/ • Use the map to find the monthly total of Medicare beneficiaries as well as Medicare beneficiaries with electricity-dependent equipment claims at the U.S. state, territory, county, and zip code level. • Turn on “real-time” natural hazard and NOAA severe weather tracking services to identify areas and populations that may be impacted and are at risk for prolonged power outages. • Local organizations can use the data to identify ways to provide support to the community in an emergency, such as providing access to power to help individuals recharge their batteries.

35. ESRI software

36. ESRI Software features

37. Reaching Isolated Older Adults: Outreach “Some examples include: • Work with elected officials. • Present at community meetings and events. • Distribute flyers and outreach materials. • Work with other organizations that serve residents. • Promote or host [an] emergency preparedness event.” Source: NYC Emergency Management. Community Emergency Planning in NYC, A Toolkit for Community Leaders, p.22, https://www1.nyc.gov/assets/em/downloads/pdf/Toolkit.pdf

38. Locating Isolated Older Adults • HCBS providers • HDM programs • Area Agencies on Aging • Adult Protective Services/Guardianship programs • Senior centers • Congregate meal sites • Houses of Worship • Health care coalitions • Census data • GIS Mapping • Utility registries • Special Needs registries • Caregivers/relatives • Volunteers/Neighbors • Senior housing • Private apartment complex mgmt.

39. Caregiver/Individual Preparedness

40. Individual Preparedness* • Events may happen without warning • Caregiver may be separated from older adult when event occurs and cannot reach him/her • Utilities may be interrupted • Official assistance may be delayed *From Preparing for Disaster for People with Disabilities and other Special Needs, FEMA and American Red Cross, August 2004, p.2., www.fema.gov/media-library/assets/documents/897

41. Elements of Preparedness* • Be Informed • Have an emergency supplies kit • Make a Plan From Preparing Makes Sense for Older Americans. Get Ready Now. www.ready.gov/sites/default/files/documents/files/older_americans.pdf

42. Before Making a Plan*… • Assess the older adult’s needs -what assistance might the older adult need? -what can she do for herself? What resources does she have? -can the older adult evacuate in an emergency? *From FEMA and American Red Cross, Preparing for Disaster for People with Disabilities and other Special Needs, August 2004, www.fema.gov/media-library/assets/documents/897

43. Preparedness Tips for Older Adults/Caregivers • Understand the risks that the community is likely to face • Enroll in the local special needs emergency registry; may require annual registration • Notify the utility company of any needs for power for medical equipment • Get to know your loved one’s neighbors • Keep portable cell phone chargers on hand • Arrange for back-up in case primary caregiver not available • Sign up to receive official communications in an emergency • Keep at least a half a tank of gas in the car and some cash on hand

44. NADRC Disaster Planning Toolkit for People Living with Dementia (September 2018) https://nadrc.acl.gov/ • Helps people living with dementia, their family members, and their caregivers understand what to expect in the event of a disaster and how to prepare for it.

45. NADRC Disaster Planning Toolkit for People Living with Dementia (September 2018) https://nadrc.acl.gov/ • Made up of seven tip sheets and checklists for persons living with dementia, their families, and others, including friends and neighbors. • Covers the following: Planning for a Disaster, Important Contacts, Emergency Supplies Checklist, My Medical Conditions and Care Needs, Disaster Planning Tips for People Living Alone with Dementia, Planning for After a Disaster, and Tips for Communication and Responding to Dementia Symptoms.

46. RESOURCES FOR OLDER ADULTS AND CAREGIVERS • FEMA and American Red Cross, Preparing for Disaster for People with Disabilities and other Special Needs, August 2004, www.fema.gov/media-library/assets/documents/897 • Preparing Makes Sense for Older Americans. Get Ready Now. www.ready.gov/sites/default/files/documents/files/older_americans.pdf • Personal Preparedness for Older Adults & Their Caregivers. https://www.cdc.gov/aging/emergency/preparedness.htm • Ready.gov preparedness information for older adults. https://www.ready.gov/seniors • NADRC Disaster Planning Toolkit for People Living with Dementia (September 2018). https://nadrc.acl.gov/sites/default/files/uploads/docs/12125NADRCdisasterplanToolkit_0.pdf

47. Contact InformationKathleen OtteRegional Administrator - Regions I and IIAdministration for Community LivingUS Dept. of Health & Human Services(212) 264-2976 kathleen.otte@acl.hhs.govRhonda SchwartzAging Services Program Specialist – Region IAdministration for Community LivingUS Dept. of Health & Human Services(617) 565-1165rhonda.schwartz@acl.hhs.gov