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Planning for individuals with special needs in emergency situations. Accomplishments, local planning, lessons learned, recommendations, and future steps discussed by experts. Includes practical tips and resources.
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PLANNING FOR SPECIAL NEEDS YOUR PRESENTERS: JENNY WILEY DEPT OF MENTAL HEALTH DANTE GLINIECKI SEMA VICKY DAVIDSON MISSOURI PLANNING COUNCIL FOR DEVELOPMENTAL DISABILITIES SEMA Conference April 5, 2007
DHSS GRANTS • PUBLIC HEALTH PREPAREDNESS AND RESPONSE FOR BIOTERRORISM • NATIONAL BIOTERRORISM HOSPITAL PREPAREDNESS
Special Needs Task Force Steering Committee • Committees: • Committee I • Age, physical, mental, emotional, cognitive • Committee II • Cultural, ethnic, socio-economic status, language, citizenship status, homeless • Pediatric Advisory Committee The History
Special Needs Definition Any individual, group, or community whose age, physical, mental, emotional, cognitive, cultural, ethnic, socio-economic status, language, citizenship status, or any other circumstance creates barriers to understanding or the ability to act/react in the manner in which the general population has been requested to proceed during all phases of emergency management.
ACCOMPLISHMENTS • Networking • State Emergency Plan Annex for Special Needs Population • Co-Leads for the Annex • Local Planning Template • Standard Operating Guides
Next Steps • Steering Committee continues to meet • Encourage planning at the local level • Provide consultation and educational trainings as requested • Include the Special Needs Population in State/Local Emergency Preparedness Exercises. • Train the Trainer • Functional Based
Functional Based • Medical • Communication • Supervision • Functional Independence • Transportation • Response to guidance from public officials • FEMA is considering a draft definition of special needs defined as: need or needs of an individual that impact their ability to independently carry out the functions of daily living (functional vs. medical model)
Local Planning • Local Planning Template • Resource Tool Kits • Children and Youth • http://www.dhss.mo.gov/PediatricToolkit/index.html • Culturally competent Disaster Planning Response • http://www.dhss.mo.gov/SpecialNeedsToolkit/index.html • Seniors and People with Disabilities • Regional Meetings • Special Needs Training (SEMA)
Ice Storm: BolivarLessons Learned • Institute a call-back system for special needs • Clearly define what is a special needs shelter • Triage • Special medical equipment: COPD, oxy cylinder • Identify mental health needs • Function based sheltering • Persons with special needs have pets too • “Special” special needs population • Domestic violence victims • Children in foster care – behavioral issues • Bariatrics (Springfield)
Ice Storm: BolivarLessons Learned • Educate Public to take care of special needs population in home • Individual planning/contingency plans • Family members dropped off at shelter/uncomfortable caring for individuals • Define different levels of care • Shelter • Shelter in place • Registry • Public Information - hotlines
Ice Storm: Region D • Shelters • Too many shelters – consider how to pre-plan and pre-position supplies • Lack of appropriate shelters due to power outages • Children – older adults – sexual offender (pre 95) • Due Diligence • Multi-agency Resource Centers – worked issues i.e. underprivileged children needing clothes/ clothes and vouchers for washing • Priority system for bulk distribution: from state ARC/EOC • National Guard: incredible resource • Define shelter vs. warming center • Emergency rooms – record numbers • Educate Faith Based Organizations about assisting • Neighborhood outreach teams • Build volunteerism in local communities • ARC is us
Ice Storm: Region D • Special Needs: • No lead agency: Local EOCs; LPHAs • Need working definition of special needs/Triage • Transportation • Special Needs shelter: inadequate electrical supply/MSU had to return to school – need medical shelter • Personal preparedness: medicines/ bring own supplies/caregiver if available • Oxygen: 1 hospital: 1000 bottles filled • State law requiring prescription for oxygen • Durable medical equipment: bottles and regulators • FEMA Reimbursement issues for for-profit hospitals who sheltered special needs/ MOU through local EOC • Special waivers – nursing home to exceed licensed capacity
Functional Based Need Special Needs Shelters Rescues Transportation Evacuation Facilities Registries Communications COAD – SNP Committee Individual Preparedness PLANNING FOR SPECIAL NEEDS Concepts of Operations
CONCEPTS OF OPERATIONSFunctional Based Needs • New Concept of Operations from National Experts • Use Existing Functions to Meet Special Needs • Adapt Current Functions (Read Annex) to SNP • Example: Combo Mass and SNP Shelter
CONCEPTS OF OPERATIONSSNP Shelter • Use the Functional Based Need Approach • Begin with Mass Care Shelters • Adapt Some Shelters for SNP Shelter • Create Combo Mass and SNP Shelter • See Example Table of Organization • Identify Lead Agency and Resources
CONCEPTS OF OPERATIONSRescues • Pre-planning and Mitigation is the Best Practice – Rescue Becomes Unnecessary • Access Training and Resources for Rescue (see Toolkits at www.dhss.mo.gov) • Consider: • Registries • Transport • Impact on EMS Services • Consider All Resources (CILs, AAA, Senate Bill 40 Boards, etc.)
CONCEPTS OF OPERATIONSTransport • Consider Accessible Transport (OATS, Senate Bill 40 Boards, etc) • Plan for Moving Adaptive Equipment • Assess Potential Needs and Size and Scope of SNP • Incorporate Partner Agencies • Arrange Contracts, Mutual Aid – MOUs in Advance • Watch for Double Committing Resources –Ex: Bus Company Obligated to 2 or More EMAs
CONCEPTS OF OPERATIONSEvacuation • Plan for Individuals and Facilities • Appoint Lead Agency and Supports • Plan SNP Shelter Locations, Reception Centers, Feeding Sites • MOUs for Out of Jurisdiction Sites • Plan Transport • Evacuation Routes and Resources
CONCEPTS OF OPERATIONSFacilities • Plan for Long Term Care Facilities • Nursing Homes • Congregate Care and Group Home Facilities • SPORCs or NORCs • Schools • MOUs for Out of Jurisdiction Sites • Plan Transport • Evacuation Routes and Resources • See DHSS web site • http://www.dhss.mo.gov/SeniorServices/LTCDisasterPreparednessPlan.doc
CONCEPTS OF OPERATIONSSNP Registries • Considerations • Privacy HIPPA • Managing Expectations • Maintenance • Size and Usefulness • Reluctance by SNP to Share Info • TMI • Effectiveness of a Registry • Local Registry vs State
CONCEPTS OF OPERATIONSCommunications • Identify EAS Messaging Systems in the Local Area • Electronic Warning Devices • Broadcast (Radio, TV, Internet) • NOAA Weather Radio (SAME) • Reverse 911 • Phone Tree • Section 255 of the Communications Act • Americans with Disabilities Act (ADA • Adaptive Technologies
COAD – Community Organizations Active in Disaster CONCEPTS OF OPERATIONSCOAD / SNP Committee / LTRC
COAD – Community Organizations Active in Disaster CONCEPTS OF OPERATIONSCOAD / SNP Committee / LTRC
CONCEPTS OF OPERATIONSCOAD / SNP Committee / Citizen LTRC / Council • COAD – Community Organizations Active in Disaster • Special Needs Populations Committee Includes • Public Health • Voluntary Agencies • Emergency Management • First Responder • Disability Community • Health Care Agencies • Hospitals and Clinics • Long-term Recovery Committees • Citizen Councils
CONCEPTS OF OPERATIONSIndividual Preparedness • An Important Mitigation Activity • Involve Partner Agencies • Centers for Independent Living • Home Health Care Agencies • Senate Bill 40 Boards • Faith Based Organizations • Red Cross • Senior and Disability Services • Local Public Health Agencies • Other Agencies • COADs • Citizen Corps Programs
“SPECIAL NEEDS” FACTS: National: • 54 million have disabilities • 14 million have mobility and other disabilities • 2 million have limitations in communication • 1/10th of the population have hearing limitations Missouri: • 906,570 age 5 and older have disabilities in Missouri (2005 American Community Survey) • Approximately 100,000 with DD in Missouri • 784,467 Seniors (Missouri Senior Report - 2005)
Inclusion of people with disabilities and other special needs must occur at ALL phases of emergency management.Remember, planning saves lives - it is too late to bring people to the table to start planning when you are in the midst of a disaster.
WHAT CAN YOU DO? • Get to Know your special needs community • Individuals living with supports or with family • Advocacy organizations • Congregate residential settings • Senior housing • Vocational supports • Disability specific groups • State schools • Government agencies • Transportation providers • Treatment programs
WHAT CAN YOU DO? • Assess resources and needs • Knowledge and expertise regarding specific populations • Trained staff • Accessible transportation/ experienced drivers • Resources/ medical supplies • Connections to clinicians and other community resources • Agency registries - access to individuals with special needs • Agency disaster plans
WHAT CAN YOU DO? • Make communications accessible • Cognitive disabilities • Deaf/ hard of hearing • Blind/ visual limitations • Implement a variety of communications strategies • Warnings/ watches • Announcements • Public/ awareness information • Signage
WHAT CAN YOU DO? • Educate special needs populations • Media campaigns • Presentations • Booths at health fairs/ conferences • Direct mailings • Partnering with local/ regional disability organizations • Door-to-door campaigns • Encourage volunteerism
WHAT CAN YOU DO? • Develop a safe/ effective evacuation plan • Consider all types of special needs • Accessible transportation/ trained drivers • Personal care assistants • Service animals • Supplies/ DME • Individuals with disabilities should be able to bring personal care assistants or family members • Personal care assistants should be able to bring family members
WHAT CAN YOU DO? • Educate special needs populations regarding “sheltering in place” • Develop a safe/ effective sheltering plan • Consider all types of functional needs • Title II of the American’s with Disabilities Act (ADA) • Section 504 of the Rehabilitation Act • Avoid institutionalizing people with disabilities • Understand such decisions can have devastating, life-altering consequences
SERVICE ANIMALS: • Service animals are not considered as pets, they are necessary supports for individuals with disabilities. • If evacuation and sheltering are necessary, service animals can stay with the individual.
RESOURCES: • Missouri People First: 1-800-558-8652 • Missouri Developmental Disability Resource Center: http://www.moddrc.org/support_advocacy.php • Missouri Network of Care: http://missouri.networkofcare.org/ • Missouri Association of County Developmental Disabilities Services (MACDDS): http://macdds.org/county_info.html • Missouri Centers for Independent Living: http://mosilc.org/CIL.htm
RESOURCES: • Great Plains ADA Project: http://www.adaproject.org/ • Disability Preparedness Resource Center: www.disabilitypreparedness.gov • National Organization on Disabilities: www.nod.org/emergency • Missouri State Emergency Management Agency: http://sema.dps.mo.gov/ • Preparedness Information: http://www.prepare.org/