PLANNING FOR SPECIAL NEEDS

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PLANNING FOR SPECIAL NEEDS

• SEMA Conference
• April 5, 2007

YOUR PRESENTERS JENNY WILEY DEPT OF MENTAL
HEALTH DANTE GLINIECKI SEMA VICKY DAVIDSON
MISSOURI PLANNING COUNCIL FOR DEVELOPMENTAL
DISABILITIES
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DHSS GRANTS

• PUBLIC HEALTH PREPAREDNESS AND RESPONSE FOR
  BIOTERRORISM
• NATIONAL BIOTERRORISM HOSPITAL PREPAREDNESS

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The History

• 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

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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.

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ACCOMPLISHMENTS

• Networking
• State Emergency Plan Annex for Special Needs
  Population
• Co-Leads for the Annex
• Local Planning Template
• Standard Operating Guides

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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

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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)

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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.h
  tml
• Seniors and People with Disabilities
• Regional Meetings
• Special Needs Training (SEMA)

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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)

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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/uncomfortabl
  e caring for individuals
• Define different levels of care
• Shelter
• Shelter in place
• Registry
• Public Information - hotlines

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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

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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

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PLANNING FOR SPECIAL NEEDS Concepts of Operations

• Functional Based Need
• Special Needs Shelters
• Rescues
• Transportation
• Evacuation

• Facilities
• Registries
• Communications
• COAD SNP Committee
• Individual Preparedness

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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

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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

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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.)

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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

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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

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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/LTCDisasterP
  reparednessPlan.doc

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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

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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

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CONCEPTS OF OPERATIONSCOAD / SNP Committee / LTRC

• COAD Community Organizations Active in Disaster

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CONCEPTS OF OPERATIONSCOAD / SNP Committee / LTRC

• COAD Community Organizations Active in Disaster

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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

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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

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EMERGENCY PREPAREDNESS FOR PEOPLE WITH
DISABILITIES
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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)

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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.
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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

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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

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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

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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

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• Emphasize personal responsibility!

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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

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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 Americans with Disabilities Act
  (ADA)
• Section 504 of the Rehabilitation Act
• Avoid institutionalizing people with disabilities
• Understand such decisions can have devastating,
  life-altering consequences

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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.

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RESOURCES

• Missouri People First 1-800-558-8652
• Missouri Developmental Disability Resource
  Center http//www.moddrc.org/support_advocacy.ph
  p
• Missouri Network of Care http//missouri.network
  ofcare.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

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RESOURCES

• Great Plains ADA Project http//www.adaproject.or
  g/
• 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/
  

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QUESTIONS