disaster preparedness and response for persons with mobility impairments: results of the nobody left...

Disaster Preparedness Disaster Preparedness andand Response for Response for

Persons with Mobility Persons with Mobility Impairments:Impairments:

Results of theResults of the Nobody Left Nobody Left BehindBehind ProjectProject

Michael H. Fox, Sc.D., Glen W. White, Ph.D., Michael H. Fox, Sc.D., Glen W. White, Ph.D., Catherine Rooney, M.A., Jennifer Rowland, Ph.D., P.T. Catherine Rooney, M.A., Jennifer Rowland, Ph.D., P.T.

Research and Training Center on Independent Research and Training Center on Independent Living at the University of KansasLiving at the University of Kansas

Governor’s Public Health ConferenceGovernor’s Public Health ConferenceWichita, KansasWichita, Kansas

April 11, 2006April 11, 2006

Nobody Left BehindNobody Left Behindhttp://www.nobodyleftbehind2.orghttp://www.nobodyleftbehind2.org

Three year grant, TS#-08040, awarded the KU RTC/IL by the Association Three year grant, TS#-08040, awarded the KU RTC/IL by the Association for Teachers of Preventive Medicine and the Centers for Disease for Teachers of Preventive Medicine and the Centers for Disease

Control and PreventionControl and Prevention

Glen White, Ph.D., KUGlen White, Ph.D., KU, P.I., P.I.

Michael Fox, Sc.D., Michael Fox, Sc.D., KUMC, Co-P.I.KUMC, Co-P.I. October, 2002 – September, 2005October, 2002 – September, 2005

AIM:AIM: To understand county level disaster To understand county level disaster preparedness and response around needs preparedness and response around needs of persons with mobility impairmentsof persons with mobility impairments

http://www.nobodyleftbehind2.org/

Persons with Disabilities in the U.S.Persons with Disabilities in the U.S.

50 million people with a self reported disability 50 million people with a self reported disability represent 19% of the 257 million people represent 19% of the 257 million people >> age 5 age 5 in the civilian non-institutionalized U.S. in the civilian non-institutionalized U.S. population population

Within this population, Census 2000 found: Within this population, Census 2000 found: 9.3 million Americans with a sensory disability 9.3 million Americans with a sensory disability

involving sight or hearing. involving sight or hearing. 21.2 million with a condition limiting basic 21.2 million with a condition limiting basic

physical activities, such as walking, climbing physical activities, such as walking, climbing stairs, reaching, lifting, or carrying.stairs, reaching, lifting, or carrying.

18.2 million of those 16 and older with a 18.2 million of those 16 and older with a condition that made it difficult to go outside condition that made it difficult to go outside the home. the home.

Nobody Left BehindNobody Left BehindThe Nature of the ProblemThe Nature of the Problem

Typically, disaster preparedness and Typically, disaster preparedness and emergency response systems are emergency response systems are designed for non-disabled persons, for designed for non-disabled persons, for whom escape or rescue involves walking whom escape or rescue involves walking or running. or running.

In addition, many plans do not appear to In addition, many plans do not appear to specifically address the transition needs specifically address the transition needs back to pre-disaster conditions that are back to pre-disaster conditions that are required for persons with mobility required for persons with mobility impairments.impairments.

The True Scope of the IssueThe True Scope of the Issue 90% of presidential declared disasters result 90% of presidential declared disasters result

from natural phenomena in which from natural phenomena in which floodingflooding was was a major componenta major component

Annually, the U.S. averages 100,000 Annually, the U.S. averages 100,000 thunderstorms thunderstorms

Galveston Texas Galveston Texas hurricane hurricane in 1900 killed more in 1900 killed more than 6,000. Death toll from Katrina still than 6,000. Death toll from Katrina still unknown, but exceeds 2,000.unknown, but exceeds 2,000.

Average of 22 “killerAverage of 22 “killer tornados tornados” each year. ” each year.

About 13,000 About 13,000 earthquakesearthquakes of various of various magnitudes in the U.S. each yearmagnitudes in the U.S. each year

Katrina Federal Disaster Funds - Katrina Federal Disaster Funds - $62.5 Billion $62.5 Billion Washington Post, 9/9,2005Washington Post, 9/9,2005

Cost to People with DisabilitiesCost to People with Disabilities

Cost to People with DisabilitiesCost to People with DisabilitiesSpecial Needs Assessment 4 Katrina (SNAKE Special Needs Assessment 4 Katrina (SNAKE

Teams) – National Organization on Disability Teams) – National Organization on Disability (NOD)(NOD)

RecommendationsRecommendations– Disability and aging organizations involved in the Disability and aging organizations involved in the

Katrina response effort report their budgets are Katrina response effort report their budgets are depleted. depleted.

– No use or under-use of disability and aging No use or under-use of disability and aging organizations organizations

– Need for participation of disability groups in planning Need for participation of disability groups in planning processprocess

– Emergency information needs to be in accessible formatEmergency information needs to be in accessible format

Nobody Left BehindNobody Left BehindResearch Activities OverviewResearch Activities Overview

Focus Area #1 County Programs, Policy, and

Practice

Focus Area #2 Assessing Risk

Focus Area #3 Assurance and Policy Development

Objective:Objective: To determine whether counties that have To determine whether counties that have

experienced a disaster during 1998 - 2003 experienced a disaster during 1998 - 2003 have systems of workplace, home, and have systems of workplace, home, and community disaster preparedness and community disaster preparedness and emergency response in place for residents emergency response in place for residents with mobility impairments.with mobility impairments.

Focus Area #1Focus Area #1

COUNTY PROGRAMS, POLICY, AND PRACTICECOUNTY PROGRAMS, POLICY, AND PRACTICE

Research QuestionsResearch Questions:: Have disasters facilitated changes in disaster Have disasters facilitated changes in disaster

preparedness and emergency response policies preparedness and emergency response policies and practices for persons with mobility and practices for persons with mobility impairments? If so, how?impairments? If so, how?

Has the disaster preparedness and emergency Has the disaster preparedness and emergency response planning process included community response planning process included community stakeholders representing people with stakeholders representing people with disabilities? If so, what has been their disabilities? If so, what has been their involvement? With what outcomes?involvement? With what outcomes?


COUNTY PROGRAMS, POLICY, AND PRACTICECOUNTY PROGRAMS, POLICY, AND PRACTICE

Objective:Objective:

To evaluate surveillance systems in To evaluate surveillance systems in place at the county level that can place at the county level that can identify morbidity and mortality identify morbidity and mortality frequency and prevalence for frequency and prevalence for persons with mobility impairments persons with mobility impairments exposed to a disasterexposed to a disaster


ASSESSING RISKASSESSING RISK

Research Questions:Research Questions: Are counties able to assess prevalence Are counties able to assess prevalence

of persons with mobility impairments of persons with mobility impairments who reside or work in their who reside or work in their jurisdictions and are at risk of disaster jurisdictions and are at risk of disaster exposure (calculating the exposure (calculating the denominator)?denominator)?



Research Questions (continued):Research Questions (continued):

Are counties able to determine how many Are counties able to determine how many persons with mobility impairments are persons with mobility impairments are affected by disasters?affected by disasters?

Among counties that have surveillance Among counties that have surveillance systems in place, what are prevalence rates of systems in place, what are prevalence rates of disaster exposure for persons with mobility disaster exposure for persons with mobility impairments, and what factors appear to impairments, and what factors appear to influence these rates? influence these rates?



Objective: Objective:

To recommend modifications to county To recommend modifications to county disaster coordinating agencies to address disaster coordinating agencies to address the health, safety, and survival needs of the health, safety, and survival needs of people with mobility impairmentspeople with mobility impairments


ASSURANCE AND POLICY DEVELOPMENTASSURANCE AND POLICY DEVELOPMENT

Research Questions:Research Questions:

What surveillance systems appear most What surveillance systems appear most effective in assessing risk for people with effective in assessing risk for people with mobility impairments exposed to disasters?mobility impairments exposed to disasters?

How can counties use surveillance systems How can counties use surveillance systems to better manage their risk for persons with to better manage their risk for persons with mobility impairments? mobility impairments?


ASSURANCE AND POLICY DEVELOPMENTASSURANCE AND POLICY DEVELOPMENT

Research Questions (continued):Research Questions (continued):

What county policies, practices, or What county policies, practices, or programs are exemplars of best programs are exemplars of best practices that can be emulated by practices that can be emulated by counties around the U.S.? counties around the U.S.?

How can these policies, practices, and How can these policies, practices, and programs be incorporated in county programs be incorporated in county disaster plans?disaster plans?


ASSURANCE AND POLICY DEVELOPMENT ASSURANCE AND POLICY DEVELOPMENT

Nobody Left Behind-Nobody Left Behind- Methods Methods

Identify Federal Emergency Management Agency Identify Federal Emergency Management Agency (FEMA) declared disasters between 1998 - 2003(FEMA) declared disasters between 1998 - 2003

Select a random sample of 30 counties or Select a random sample of 30 counties or equivalent units (i.e., boroughs, reservations, equivalent units (i.e., boroughs, reservations, etc.) across each of the ten federal regionsetc.) across each of the ten federal regions

Interview these county emergency managersInterview these county emergency managers

Evaluate their disaster plans in place at time of Evaluate their disaster plans in place at time of occurrence and more recently for actions occurrence and more recently for actions targeting persons with mobility disabilitiestargeting persons with mobility disabilities

With assistance of national advisory panel, With assistance of national advisory panel, identify best practicesidentify best practices

Administer on-line consumer surveyAdminister on-line consumer survey

Nobody Left BehindNobody Left BehindMethodsMethods

What did we ask?What did we ask?Examples of survey questions:Examples of survey questions:

– ““Does your current emergency management Does your current emergency management plan have a protocol to assist people with plan have a protocol to assist people with mobility impairments during an emergency?” mobility impairments during an emergency?”

– ““To your knowledge, were people with mobility To your knowledge, were people with mobility impairments included in the process of impairments included in the process of developing these protocols?”developing these protocols?”

– ““If no written formal protocols exist to assist If no written formal protocols exist to assist people with mobility impairments, to your people with mobility impairments, to your knowledge what do emergency services knowledge what do emergency services personnel do to assist people with mobility personnel do to assist people with mobility impairments during an emergency?impairments during an emergency? “ “

Representative County SelectionRepresentative County SelectionSelection of state level disaster occurrences so that each Selection of state level disaster occurrences so that each

of the ten federal regions is represented:of the ten federal regions is represented:

REGION I: Connecticut, Maine, Massachusetts, New Hampshire,Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont. Rhode Island, Vermont.

REGION II:REGION II: New York, New Jersey, Puerto Rico, Virgin Islands. New York, New Jersey, Puerto Rico, Virgin Islands. REGION III:REGION III: Delaware, Maryland, Pennsylvania, Virginia, West Delaware, Maryland, Pennsylvania, Virginia, West Virginia, District of Columbia. Virginia, District of Columbia. REGION IV:REGION IV: Alabama, Florida, Georgia, Kentucky, Mississippi, Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee.North Carolina, South Carolina, Tennessee. REGION V:REGION V: Illinois, Indiana, Michigan, Minnesota, Ohio, Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin. Wisconsin. REGION VI:REGION VI: Arkansas, Louisiana, New Mexico, Oklahoma, Texas. Arkansas, Louisiana, New Mexico, Oklahoma, Texas. REGION VII:REGION VII: Iowa, Kansas, Missouri, Nebraska. Iowa, Kansas, Missouri, Nebraska. REGION VIIIREGION VIII: : Colorado, Montana, North Dakota, South Dakota,Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming. Utah, Wyoming. REGION IX:REGION IX: Arizona, California, Hawaii, Nevada. Arizona, California, Hawaii, Nevada. REGION X:REGION X: Alaska, Oregon, Washington, Idaho.Alaska, Oregon, Washington, Idaho.

Summary Research Tables Summary Research Tables Corresponding to Corresponding to

Research Questions for Research Questions for Nobody Left BehindNobody Left Behind

Research Questions 1: Have disasters facilitated Research Questions 1: Have disasters facilitated change for people with mobility impairments?change for people with mobility impairments?

Table 1. Reasons for Modifying County Disaster PlansTable 1. Reasons for Modifying County Disaster Plans Using Chi-squared tests, none of these 2x2 relationships are statistically significantUsing Chi-squared tests, none of these 2x2 relationships are statistically significant

N=30

Revisions prompted by disaster?

Revisions prompted by people with disabilities?

Revisions prompted by federal mandates?

Revisions prompted by other concerns?

County disaster plan revised since disaster?

Yes

%

No

%

Yes

%

No

%

Yes

%

No

%

Yes

%

No

%

Yes (n=29) 27.6 72.4 6.9 93.1 58.6 41.4 6.9 93.1

No (n=1) 0.0 100 0.0 100 0.0 100 0.0 100

Research Questions 2: Were people with Research Questions 2: Were people with disabilities included in the planning process?disabilities included in the planning process?

Four of the six best practice sites had people with Four of the six best practice sites had people with disabilities included in the process. This question disabilities included in the process. This question was only answered for six counties engaged in the was only answered for six counties engaged in the planning process (Question #14)planning process (Question #14)

Of the total survey only 4 out of 30 sites (13%) had Of the total survey only 4 out of 30 sites (13%) had people with disabilities included in the disaster people with disabilities included in the disaster planning processplanning process

Research Question 3Research Question 3

Are sites able to assess prevalence based upon Are sites able to assess prevalence based upon

adequate surveillance?adequate surveillance?

Table 2. Reported Surveillance of Counties Experiencing Disasters

# Counties Frequencies Data Validity

Measure Category Count

# people with mobility impairments in county

13 < 75 4(13%) Database-5 Census-3Estimate-5

GoodFairPoor

300-400 2 (7%)

3,000-10,000 6(20%)

>10,000 1(3%)

# persons injured in disaster 30 None 27(90%)

<100 1(3%)

100-300 1(3%)

10,000 1(3%)

# persons killed in disaster 30 None 26(87%)

1-5 3(10%)

2,749 1(3%)

# persons with mobility impairments killed

30 None 28(93%)

1 1(3%)

Unknown 1(3%)

# persons with mobility impairments rescued

30 None 17(57%)

2-15 4(13%)

25-100 4(13%)

>100 5(16%)

Unknown 1(3%)

Research Questions 4 & 5: Were surveillance Research Questions 4 & 5: Were surveillance systems in place that allowed estimates of systems in place that allowed estimates of

prevalence of people with mobility impairments prevalence of people with mobility impairments at risk in a disaster?at risk in a disaster?

No way to determine prevalence rates No way to determine prevalence rates based upon surveillance systems in place.based upon surveillance systems in place.

However, we may want to test this further However, we may want to test this further with our site in Coffey County. Where with our site in Coffey County. Where there are accurate voluntary data there are accurate voluntary data registries, this measure could be possible.registries, this measure could be possible.

Research Question 6: Surveillance systems Research Question 6: Surveillance systems that appear most effective – that appear most effective –

possible “best practices.”possible “best practices.”

Six counties* identified as possible “best practices” Six counties* identified as possible “best practices” (out of 30) based upon two criteria: (out of 30) based upon two criteria:

1.1. Having in place guidelines for persons with Having in place guidelines for persons with disabilities; anddisabilities; and

2.2. Identifying operating procedures in place that Identifying operating procedures in place that follow the guidelinesfollow the guidelines

* Best practice sites included the following counties/jurisdictions: * Best practice sites included the following counties/jurisdictions: Dubuque County, Iowa; Brooklyn-New York City, New York; Coffey Dubuque County, Iowa; Brooklyn-New York City, New York; Coffey County, Iowa: Maricopa County, Arizona; Norton City, Virginia; County, Iowa: Maricopa County, Arizona; Norton City, Virginia; Lincoln County, Nebraska.Lincoln County, Nebraska.

Disaster County Characteristic Best Practice Site (6)

Other Disaster Site (24)

Significance, p-value

Mean Total Population 571,266 217,711 .285

Area in square miles 2,248 2,436 .932

Persons per square miles 205 1,783 .575

% urban area 67 58 .721

% White 91 76 .097

Median household income $36,577 $38,914 .568

% above median income 33 29 .849

% below poverty 13 14 .610

% with Center for Independent Living 50 63 .429

% persons with physical disability > 5 8.4 9.7 .392

% people with disabilities 5-64 years old 5.1 7.2 .141

% people with disabilities >64 years old 29.1 30.7 .551

%t with employee who took FEMA course 17 42 .271

% knowing how many people with disabilities live within district

100 29 .001

Table 3. Differences Between Disaster County Sites Identified as Best Table 3. Differences Between Disaster County Sites Identified as Best Practices and All Other SitesPractices and All Other Sites

All mean differences were tested using ANOVA and Mann-Whitney for between group differences.

Nobody Left BehindNobody Left BehindWhat did we find out?What did we find out?

Findings - Emergency ManagersFindings - Emergency Managers::

People with disabilities either were not represented People with disabilities either were not represented or had minimal representation in the emergency or had minimal representation in the emergency planning processplanning process

The G197 FEMA Emergency Planning and Special The G197 FEMA Emergency Planning and Special Needs course pertaining to people with disabilities Needs course pertaining to people with disabilities appears useful in increasing county awareness, appears useful in increasing county awareness, though only 27% of county emergency managers though only 27% of county emergency managers reported completing itreported completing it

Only 20% of the emergency managers reported Only 20% of the emergency managers reported having specific guidelines in place to assist people having specific guidelines in place to assist people with mobility impairments during emergencieswith mobility impairments during emergencies


Findings - Emergency Managers:Findings - Emergency Managers:

Surveillance efforts to identify persons with Surveillance efforts to identify persons with mobility impairments are weakmobility impairments are weak

• 57% of county managers did not know how 57% of county managers did not know how many many persons with mobility limitations lived persons with mobility limitations lived within within their their jurisdictionjurisdiction• Of those who claimed to know, most gave broad Of those who claimed to know, most gave broad

estimates based on unreliable sourcesestimates based on unreliable sources• 27% of counties used Census or self-reported 27% of counties used Census or self-reported registries to identify this figure more registries to identify this figure more accuratelyaccurately


Findings- Emergency Managers:Findings- Emergency Managers:

• 20% of emergency managers reported having 20% of emergency managers reported having specific guidelines in place to assist people specific guidelines in place to assist people with mobility impairments during emergencieswith mobility impairments during emergencies

• Among 24 (80%) of jurisdictions that did not:Among 24 (80%) of jurisdictions that did not:

• 38% (9) identified transportation accommodations 38% (9) identified transportation accommodations that they have in placethat they have in place

• 17% (4) identified accessible shelters and other 17% (4) identified accessible shelters and other educational programs that sought to reach out in educational programs that sought to reach out in some way to persons with disabilitiessome way to persons with disabilities

Nobody Left BehindNobody Left BehindWhere are we now?Where are we now?

Findings of Emergency Managers:Findings of Emergency Managers:

Among jurisdictions not having specific details Among jurisdictions not having specific details or guidelines in place, or guidelines in place, allall (24) told us that they (24) told us that they were important to havewere important to have

– ““Every person’s life is important….”Every person’s life is important….”

– ““I have never seen a publication that would address I have never seen a publication that would address many of these impairments….”many of these impairments….”

– ““We have it, just not in our particular plan…covered We have it, just not in our particular plan…covered in council on aging and human resource protocols.”in council on aging and human resource protocols.”

– ““It’s a fact of life. They are out there, they need It’s a fact of life. They are out there, they need assistance, and you’ve got to address it.”assistance, and you’ve got to address it.”


Findings - Emergency Managers:Findings - Emergency Managers:

97% (29) of disaster management plans had 97% (29) of disaster management plans had been revised since the time of the county been revised since the time of the county disaster disaster we asked aboutwe asked about

But among these, only 2 (7%) revised their plans owing But among these, only 2 (7%) revised their plans owing to disability related concernsto disability related concerns

Other reasons driving revisions of plans:Other reasons driving revisions of plans:Annual review (72%)Annual review (72%)Federal mandates (59%)Federal mandates (59%)State mandates (24%)State mandates (24%)Disaster (28%) Disaster (28%) Other factors (34%)Other factors (34%)

Nobody Left BehindNobody Left Behind - Findings - Findings Among jurisdictions Among jurisdictions notnot having specific guidelines in having specific guidelines in

place (24), 5 (21%) told us they place (24), 5 (21%) told us they were were planning to develop planning to develop them. 19 (79%) told us they them. 19 (79%) told us they were notwere not. Reasons why not:. Reasons why not:

• ““If need is brought to our attention, we will If need is brought to our attention, we will accommodate…”accommodate…”

• ““We are trying to focus on special needs as a We are trying to focus on special needs as a whole…”whole…”

• ““It is covered in other plans…”It is covered in other plans…”

• ““We don’t need to be any more specific than we We don’t need to be any more specific than we already are..”already are..”

• ““Confidentiality issues…”; “limited local authority…”Confidentiality issues…”; “limited local authority…”

• ““We are overwhelmed with the demands of Homeland We are overwhelmed with the demands of Homeland Security…”Security…”

• ““My office is only staffed by one volunteer….”My office is only staffed by one volunteer….”

Nobody Left Behind Nobody Left Behind FindingsFindings

Sites reporting no specific guidelines stated the Sites reporting no specific guidelines stated the following resources were needed to develop them:following resources were needed to develop them:

• 67% financial resources67% financial resources

• 33% knowledgeable and trained personnel33% knowledgeable and trained personnel

• 17% greater education for the public17% greater education for the public

• 25% a FEMA/State/or County mandate25% a FEMA/State/or County mandate

Among reporting sites, who told us they were Among reporting sites, who told us they were planning to develop the guidelinesplanning to develop the guidelines

• One told us the idea originated with our interview, One told us the idea originated with our interview, another started with discussions of the needs of non-another started with discussions of the needs of non-English speaking residents, one mentioned particular English speaking residents, one mentioned particular advocate associated with universityadvocate associated with university

Consumer SurveyConsumer Survey Do you have a personal disaster experience to share?Do you have a personal disaster experience to share?We want to hear from persons with mobility limitations We want to hear from persons with mobility limitations

who have experienced a disaster. who have experienced a disaster.

Please complete our on-line surveyPlease complete our on-line survey at:at:

http://www.nobodyleftbehind2.orghttp://www.nobodyleftbehind2.org&&

Click on “Click on “Consumer Survey”Consumer Survey”


Nobody Left BehindNobody Left BehindConsumer Survey FindingsConsumer Survey Findings

There are inaccessible escape routesThere are inaccessible escape routes

Few people know how to use the adaptive Few people know how to use the adaptive escape chairs for wheelchair usersescape chairs for wheelchair users

There was no accessible transportation after There was no accessible transportation after the disaster event to get around in the the disaster event to get around in the communitycommunity

Very slow response in helping citizens with Very slow response in helping citizens with disabilities return to their homes (e.g., disabilities return to their homes (e.g., rebuilding ramps, moving debris, etc.)rebuilding ramps, moving debris, etc.)


• Shelters, including bathrooms, were not Shelters, including bathrooms, were not accessible for wheelchair usersaccessible for wheelchair users

• During extended power outages, persons During extended power outages, persons were unable to use assistive equipment and were unable to use assistive equipment and medical devicesmedical devices

• Power outages disabled elevators, forcing Power outages disabled elevators, forcing persons with mobility limitations to be persons with mobility limitations to be dependent upon neighbors or emergency dependent upon neighbors or emergency workersworkers


““It is really difficult to get the utility company to It is really difficult to get the utility company to understand power is a need, if disabled.”understand power is a need, if disabled.”

““I ambulate with forearm crutches and my leg I ambulate with forearm crutches and my leg stamina is limited. As a social service provider stamina is limited. As a social service provider in NYC, I am in tall buildings often and one in in NYC, I am in tall buildings often and one in particular had an evacuation drill. There were particular had an evacuation drill. There were no plans or equipment to assist me. They told no plans or equipment to assist me. They told me to ignore the drill. me to ignore the drill. I felt very vulnerable I felt very vulnerable because I attend regular work meetings because I attend regular work meetings in this building.”in this building.”


““I have juvenile rheumatoid arthritis and use a I have juvenile rheumatoid arthritis and use a wheel chair. We had a bomb threat at work, wheel chair. We had a bomb threat at work, which was very scary. Everyone evacuated, which was very scary. Everyone evacuated, but I was still left on the 3but I was still left on the 3rdrd floor by the floor by the stairwell for the firefighters to come get me. stairwell for the firefighters to come get me. But, no one came. But, no one came. Finally, I just struggled Finally, I just struggled and I used pure fear to get myself down and I used pure fear to get myself down the stairs and outside.the stairs and outside. It was scary just to It was scary just to realize that there are not really any procedures realize that there are not really any procedures in place to help someone like me in an in place to help someone like me in an emergency.”emergency.”

Nobody Left BehindNobody Left BehindNew DirectionsNew Directions

Received $162,000 funding from the Received $162,000 funding from the National Institute on Disability and National Institute on Disability and Rehabilitation Research to conduct Rehabilitation Research to conduct research on two tasks: research on two tasks: • Identify barriers and gaps that Centers for Identify barriers and gaps that Centers for

Independent Living personnel have experienced Independent Living personnel have experienced concerning people with disabilities in the recently concerning people with disabilities in the recently affected hurricane areas and relocation centersaffected hurricane areas and relocation centers

• Identify barriers and gaps that emergency Identify barriers and gaps that emergency personnel have experienced concerning people personnel have experienced concerning people with disabilities in the recently affected hurricane with disabilities in the recently affected hurricane areas and relocation centersareas and relocation centers

Current ResearchCurrent Research

Early February, 2006Early February, 2006– Visited with CIL staff and consumers from Southern Visited with CIL staff and consumers from Southern

Mississippi and visited Katrina affected areas in Mississippi and visited Katrina affected areas in Gulfport and BiloxiGulfport and Biloxi

Late February, 2006Late February, 2006– Visited with CIL staff and consumers from Southern Visited with CIL staff and consumers from Southern

Louisiana conducting interviews in Baton Rouge and Louisiana conducting interviews in Baton Rouge and visiting Katrina affected areas around New Orleans visiting Katrina affected areas around New Orleans (e.g., 9(e.g., 9thth Ward, Arabi, St. Bernard Parrish) Ward, Arabi, St. Bernard Parrish)

March, 2006March, 2006– Visited with CIL staff in AlabamaVisited with CIL staff in Alabama

Consumer ReportsConsumer Reports

FearFear– Dense darkness Dense darkness – Safety (looters)Safety (looters)– Unknown (where Unknown (where

to go? What to do? to go? What to do? When can I go When can I go back, if ever?)back, if ever?)

– What will my life What will my life be like now?be like now?

Consumer ReportsConsumer Reports

ResignationResignation – The system is The system is

broken and will broken and will not help me. not help me.

– There is nothing I There is nothing I can control or do.can control or do.

– I have invested I have invested my whole life in my whole life in my home and now my home and now it is gone.it is gone.

Consumer ReportsConsumer Reports Anger Anger

– ““FEMA stands for F*** FEMA stands for F*** Every Mississippian Every Mississippian Again.” Again.”

– The response of The response of authorities at all levels authorities at all levels was too little too late.was too little too late.

– When we stayed with When we stayed with family after the disaster; family after the disaster; there was lots of tension there was lots of tension (When you going to leave?)(When you going to leave?)

Centers for Independent Living Centers for Independent Living ReportsReports

QuestionQuestion MS MS CILsCILs

S. LA S. LA CILsCILs

Anyone with DP training at your Anyone with DP training at your CILs?CILs?

NoNo Yes, Yes, limited limited

Before Katrina, did your CIL have a Before Katrina, did your CIL have a plan to provide services in the event plan to provide services in the event of a disaster?of a disaster?

NoNo Yes, Yes, limitedlimited

Did your Center have an informal or Did your Center have an informal or formal relationship with first-formal relationship with first-responders before Katrina?responders before Katrina?

NoNo NoNo

How many PEOPLE WITH How many PEOPLE WITH DISABILITIES from your county had DISABILITIES from your county had to relocate following Katrina? to relocate following Katrina?

Thou-Thou-sandssands

35+ K35+ K

Centers for Independent Living Centers for Independent Living ReportsReports

QuestionQuestion MS CILsMS CILs S. LA S. LA CILsCILs

What were your CIL’s What were your CIL’s most significant most significant accomplishments during the accomplishments during the shelter and recovery phase?shelter and recovery phase?

Finding Finding consumers; consumers; getting well getting well over $100,000 over $100,000 of equipment of equipment to consumersto consumers

Continuing Continuing to provide to provide services services post-post-KatrinaKatrina

Based on your Katrina Based on your Katrina experience how can CILs be experience how can CILs be more effective in helping more effective in helping pwd in future disasters?pwd in future disasters?

Train, train, Train, train, train for DP; train for DP; both staff and both staff and consumers; consumers; work more work more closely with DP closely with DP specialistsspecialists

Locate, Locate, evacuate, evacuate, pre-assess, pre-assess, move to move to CIL-contr. CIL-contr. sheltershelter

Much remains to be done…Much remains to be done… People with disabilities must be treated as a separate group with separate People with disabilities must be treated as a separate group with separate

needs and not combined with “special needs.” Such designations only needs and not combined with “special needs.” Such designations only widen disparities.widen disparities.

The overwhelming response of people with disabilities affected by Katrina is The overwhelming response of people with disabilities affected by Katrina is that they don’t want to be forgottenthat they don’t want to be forgotten

Exemplary disaster preparedness and emergency response procedures and Exemplary disaster preparedness and emergency response procedures and annexes need to be developed and used to help get people with disabilities annexes need to be developed and used to help get people with disabilities out of harm’s wayout of harm’s way

Mission: to promote Mission: to promote emergency preparedness emergency preparedness inclusion, research, inclusion, research, education, awareness andeducation, awareness andplanning for people with planning for people with disabilities at the local, state, disabilities at the local, state, and national level through a and national level through a variety of means.variety of means.

The Consortium consistsThe Consortium consistsof the American Association of the American Association on Health and Disability on Health and Disability (AAHD), the University of (AAHD), the University of Kansas Research and Training Kansas Research and Training Center on Independent Living, Center on Independent Living, and the University of New and the University of New Mexico Center for Mexico Center for Development and Disability.Development and Disability.

Additional Sources of InformationAdditional Sources of Information

www.nobodyleftbehind2.orgwww.nobodyleftbehind2.org

Findings submitted to: Journal of Disability Policy Studies

in response to Call for Papers Disaster Preparation and Emergency Response for People

with Disabilities: Research, Policy and Practice


disaster preparedness and response for persons with mobility impairments: results of the nobody left...

Documents

needs of persons

emergency response systems

emergency response policies

katrina response effort

predisaster conditions

sensory disability

persons wi

underuse of disability