MiSILC Roundtable – Emergency Preparedness – Executive Summary
As a society the United States has been significant strides in the supporting persons with disabilities to remain in their communities. Accessible housing, assistive technology, specialized para-transit services and personal assistants are a few of the examples of services that have promoted an individual’s basic civil rights. A disability is viewed as part of the human experience, not a sign of defect or shame.
As this success is celebrated, disasters have occurred with far-reaching impact. The attack on the World Trade Center and Hurricane Katrina are examples of overwhelming loss of life and community devastation. The vulnerability of life resonated across the country along with the need for emergency preparedness. Michigan communities joined these conversations with one example being in our State Capital – Lansing, Michigan. A team of professionals including emergency management officials and representatives from the disability community worked diligently to identify the unmet needs. A main area of vulnerability identified was the special needs of older adults and people with disabilities. Initial challenges identified include 1) Mobility issues which impact the ability to move to safe shelters 2) Impairments due to hearing or vision loss that impact ability to receive emergency warnings. 3) Interruption or delays in services including personal care, transportation and meal delivery due to travel restrictions or dangers 4) Increased risk to personal safety due to prolonged power outages are for those using durable medical equipment such as electric beds or oxygen equipment.
In 2014/2015 Lansing had the opportunity for a more in-depth perspective. Following the 2013 Lansing Ice Storm which knocked out 40% of the area’s electrical power for up to two weeks, a task force was formed to evaluate the situation. A doctoral evaluator was hired to facilitate separate focus groups with adults with various disabilities and their personal care assistants. Second, in January 2015, a fire occurred at a senior living apartment building which included individuals with disabilities. The Taskforce met with a resident of the building who was apartment including medical equipment was severely damaged and representatives of emergency responders. Two different disasters with common issues:
- Communication difficulties are a problem common to all types of emergencies at all levels. While those responding to a disaster have an incident command structure to facilitate communication; those directly impacted by a fire or other emergency are often out of the loop. This contributes to unease, discomfort, and even danger as people lack information to make timely decisions that impact their safety.
- Lack of planning for emergencies, and lack of important supplies in an Emergency Go Kit can become life-threatening. The majority of seniors and individuals with disabilities take medications that assist in the management of their medical conditions. Along with medications, an Emergency Go Kit could include list of medical devices or assistive technology, dietary restrictions, and plans for people who have challenges in unfamiliar or chaotic environments.
- Lack of connections to a support network, even temporarily, can also be life threatening. Individuals that are displaced may need special resources to build their supportive living environment in a new location even temporarily. It can put an unnecessary demand on first responders and other crisis personnel.
This paper will provide explore these issues and propose recommendations for change. It is recognized that disabilities are unique to the individual; however an emergency disaster is a great equalizer, with an increased the likelihood of being put in harms’ way. As a Statewide Independent Living Council, our responsibility is to support the efforts of emergency responders and promote emergency preparedness skills to all of Michigan’s citizens with disabilities.
Section 1 -Need Statement
Michigan currently has 2.1 million citizens with disabilities with a projected increase to 2.3 million by 2030 (1). This statistic would include medical conditions that impact walking, communication, and decision making. These are individuals that may be living independently in their own apartments, working, raising families and supporting their community resources.
A review of emergency management training materials reflect on the paradigm of Perception and Response to Risk by Paul Slovic. “Inaccurate perception of risk is something that affects all people and all cultures, regardless of education, background, or income, among other factors. People perceive risks as being either too great or too small…. The study of risk perception is so important because it helps us to better determine what emergency communicators must do to correct perceptions through communication, and in turn, influence behavior that more appropriately addresses individuals’, communities’, and entire countries’ hazard profiles.” (2) The challenge for a person with a disability is that their individual processing skills or access to resources may be impacted by the sole nature of their disability.(3)
At a baseline level, emergency planners attempt to educate the public on what plans and materials they need to have in place in case of emergency, regardless of their disability status. This report will highlight the most important components towards appropriate preparedness for the disability community, but will also include some of the best resources available listed in an appendix.
In all of these categories, the general advice for the public can and will apply to most in the disability community. However, the everyday considerations of persons with disabilities also have an impact on how to prepare for an emergency. We will highlight those considerations in our discussion. Planners are looking at the community being prepared in three specific ways:
- To create the individual, household, or family plans in case of emergency.There is a wealth of emergency preparedness material available, however the challenge is to make it meaningful to the individual. The important part is to take some action towards preparedness on a continuing basis, so that if an emergency occurs no one is placed in a position where they cannot do anything to help themselves. Perfection is not the goal of the preparedness planners, as people simply are not perfect. Instead, doing something can help to prevent issues from becoming bigger in the middle of a disaster. The first step in this planning is looking at how your household/family will communicate with each other when you are separated, especially if phone or internet connections are unavailable. This can include items such as an agreed upon meeting location, or an out-of-area contact that the household can coordinate with for messages. This communication portion should also take into account the emergency plans of anyone’s workplace, school, community center, or other location that they normally spend time at. For a person with a disability, this communications plan is especially important, as the support network may need to travel to support the individual and their ability to be self-sufficient in an emergency. The support network should have the information on where the emergency supplies are kept, how the members of the network should contact each other should the person with a disability not be in communication, and what supplies are necessary to maintain independence if power is unavailable. More resources for creating plans are available in the index.
- To prepare an emergency kit that will handle the needs of the household without outside support for 72 hours. This is a critical piece of emergency preparedness; first responders in most situations will reach you but depending on the severity of the event; it can take up to three days. There are a number of different elements that can be applied to the development of an emergency kit, but the basics include:
- 1 gallon of water per person per day (total 3 gallons per person)
- Non-perishable food sufficient for three days per person
- Battery powered or hand crank radio for receiving NOAA weather and emergency updates
- First aid kit
- Local maps
- Cell phones and solar or battery chargers
- Extra batteries for all battery-powered tools
- Materials for sheltering in place, including plastic sheeting and duct tape
- Materials for personal sanitation, including plastic bags, sanitation wipes, and ties
- Manual can opener
- Manual tools for shutting off utilities
- Local hard copy maps
Persons with disabilities should have an emergency go kit, items that are needed if an evacuation is necessary. This will help first responders accurately assist individuals; saving valuable time. Examples include:
- Medication and/or list of current medications.
- Adaptive communication alternatives.
- Items for service animals.
- Emergency contact phone numbers.
- Copies of identification.
- Comfort items, such as a small stuffed animal or blanket.
At its most basic level, everything each person needs to get through a day without electricity, natural gas/propane, refrigeration, or other household utility or convenience should be considered and included in the emergency kit. More specific resources on the planning of your emergency kit are included in the appendix to this paper.
- Being aware of the dangers that exist after a disaster occurs and what to expect from emergency services. The post-disaster period in preparedness is very specific to the type of disaster that occurred. A fire, tornado, earthquake, or other structure-damaging event may cause evacuation and the need for emergency shelters, where chemical leaks, a terrorist event, blizzard, or other environmental hazard may cause a need to shelter in place. For people with disabilities, having an emergency plan and go kit may allow for smoother transition.
Section 2 -Interface with State and Local Planning
For Michigan, “The Division of Emergency Preparedness & Response (DEPR) is the emergency preparedness and response arm of the Michigan Department of Health and Human Services. The division serves to protect the health of Michigan citizens before, during and after an emergency through the integration of public health and medical preparedness initiatives and by leveraging diverse partnerships. DEPR maintains a dual role in both preparedness planning and in emergency response. These activities encompass all hazards, including natural and man-made disasters, acts of bioterrorism, infectious disease outbreaks and other emergencies that impact the health of the public.” (4)
A strength of this plan is that it is designed to handle all contingencies and all of the varying needs of the population of the state. Persons with disabilities are recognized by their statistical predominance in the more urban areas of the state. However, the implementation of actual relief efforts are delegated with responsible parties at the state and local level. The state plan therefore relies on existing programs through state agencies to provide relief efforts in their specific areas of expertise.
This delegation makes some sense. In an emergency, there is no time to “reinvent the wheel” and design new programs to assist a potential special needs population such as persons with disabilities. Relying on local efforts to provide the appropriate level of services allows for the fastest implementation of relief programs and makes the best use of available personnel. At the statewide level, it also makes sense to include programs from agencies within their area of expertise. Part of the recovery portion of emergency planning is to restore needed services as quickly as possible. By bringing those agencies into the emergency plan, this allows for an orderly process of resource prioritization and response.
At the local level, planning efforts focus on two components, mitigating known hazards prior to an emergency and the coordination of a response during and after an emergency. In both of these efforts, the local emergency planning body maintains planning documents that outline the hazard lists, what sensitive locations those hazards may impact, and mitigation and other plans to be implemented in the event that the emergency occurs. The documents are designed and maintained in such as fashion as to allow the responders to implement what is in the plan, and not spend time researching or confirming the accuracy of the documentation. This leads to a couple of inherent flaws that are going to occur regardless of design. First, every document runs a risk of being out-of-date at the time the emergency occurs. All of these agencies do have staff that are updating both the resources and hazards on a regular basis. However, we all know that once something goes down on paper it is likely to be outdated. Second, the documents are only as good as the data that these agencies are able to collect. In the case of persons with disabilities, this is likely going to mean a multitude of bad data.
We know that data maintained by CILs in this state is only as good as the clients provide, and include a number of instances where relocation is a part of the client goals. We also know that site reviews for accessibility are only as good as of the date they are done, and can easily be out of date when building managers and owners update a site per the recommendations of the review. We would therefore reject any notion that data sharing between CILs is somehow going to solve an emergency preparedness issue of knowing where vulnerable people reside in order to prioritize services to those individuals. We would instead prefer looking at how the provision of services can be more accessible in their design in the first place, so that as persons with disabilities come forward for emergency services that they are able to be served promptly and efficiently.
The question then becomes where the subject matter experts on disability services are inside of emergency preparedness planning and management. The answer on a review of available information is that there is no internal expertise in these organizations, as their expertise is in emergency services. Instead, they are going to rely on local networks for information. CILs can be an important bridge in this process, by identifying themselves as a resource and by finding ways to ensure that staff receives training in emergency preparedness to assist consumers.
Section 3 – Recommendations for Action
After this admittedly brief review, the Roundtable submits the following recommendations to the Council for adoption:
- The Council and CILs should collaborate on finding appropriate grant resources to supplement staff training on emergency planning, including finding opportunities to have staff be certified preparedness trainers to assist consumers in their individual preparedness efforts;
- Intake for consumers at the CIL level should include assessments on individual emergency preparedness and whether services are needed;
- Centers for Independent Living across the state should create connections with the local emergency management agencies in their regions to offer services such as accessibility reviews of emergency shelters and other relocation and service locations to ensure access for all persons with disabilities;
- The Council should engage the Governor’s office on the inclusion of persons with disabilities on emergency management councils, including the Michigan Citizen-Community Emergency Response Coordinating Council;
- Emergency Planning Officials should look to develop resource opportunities to grow diversity within emergency management professionals to include persons with disabilities.
Section 4 – Conclusion
The Roundtable would like to acknowledge the efforts of the Community Disaster Resilience for Older Adults and People with Disabilities Taskforce, the Michigan Disability Rights Coalition and the Disability Network Capital Area for sharing their research on this topic.
(1) http://www.michigan.gov/mdhhs/0,5885,7-339-71550_2955_54051_54052-255399–,00.html Retrieved 1/3/2016
(2) https://training.fema.gov/…/session%20… Retrieved 1/3/2016
(3) American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC
(4) http://www.michigan.gov/mdhhs/0,5885,7-339-71548_54783_54826—,00.html Retrieved 1/3/2015