Prospects for AT Prospects for AT Reuse in DisastersReuse in Disasters

NATTAP NATTAP Southeastern Regional Southeastern Regional

ConferenceConferenceNovember 20, 2008November 20, 2008

Elliot HarkavyElliot HarkavyEGH & AssociatesEGH & Associates

Introduction to Introduction to Emergency Emergency

ManagementManagement

EGH & AssociatesEmergency Management Emergency Management

System Begins LocallySystem Begins LocallyCity/County Resources:City/County Resources: Fire/ emergency medical services (EMS)Fire/ emergency medical services (EMS)

PolicePolice

Local departments of health & human servicesLocal departments of health & human services

Hospitals and other health care providersHospitals and other health care providers

Office of Emergency Management (OEM)Office of Emergency Management (OEM)

American Red CrossAmerican Red Cross

VOAD (Voluntary Organizations Active in VOAD (Voluntary Organizations Active in Disaster)Disaster)

EGH & Associates

Emergency ManagementEmergency Management StateState

State PoliceState Police National GuardNational Guard Department of Health Department of Health Department of Human ServicesDepartment of Human Services Emergency Management Agency (EMA)Emergency Management Agency (EMA)

FederalFederal Dept. of Homeland SecurityDept. of Homeland Security Dept. of Health & Human ServicesDept. of Health & Human Services Dept. of Justice (FBI)Dept. of Justice (FBI) EPA, Dept. of Treasury (ATF), USDAEPA, Dept. of Treasury (ATF), USDA

EGH & Associates

PublicHealth

LawEnforcement

Homeland Security/

Emergency Mgmt.

Food/Agriculture

The Silos of Federal, The Silos of Federal, State State

& Local “Preparedness” & Local “Preparedness”

Fire/ Emergency

Medical Services

HumanServices

EGH & Associates Local Incident Local Incident

Management Management Incident Command System (ICS)Incident Command System (ICS)

Model for first responders (EMS, Model for first responders (EMS, fire, police) for command, control, fire, police) for command, control, and response coordinationand response coordination

Coordinates agencies working Coordinates agencies working toward shared goal: stabilize the toward shared goal: stabilize the incident, and protect life, incident, and protect life, property & environmentproperty & environment

EGH & Associates Local Incidents – Local Incidents –

Scale and ComplexityScale and Complexity All emergencies start locallyAll emergencies start locally

As scale/complexity increase, state and As scale/complexity increase, state and federal support may be neededfederal support may be needed

Larger incidents require increased Larger incidents require increased coordination and information flow across coordination and information flow across agenciesagencies

Managing complex incidents requires…Managing complex incidents requires… Data to assess the evolving situationData to assess the evolving situation Tools to analyze and interpret the dataTools to analyze and interpret the data Interoperability to share Interoperability to share

information/decisions across diverse information/decisions across diverse agencies and IT systemsagencies and IT systems

Resources: what, where, and how to Resources: what, where, and how to supplysupply

EGH & AssociatesManaging Large Scale Managing Large Scale

EmergenciesEmergencies Homeland Security Presidential Homeland Security Presidential

Directive-5 (HSPD-5) directs Directive-5 (HSPD-5) directs Homeland Security Secretary to Homeland Security Secretary to develop and administer:develop and administer:

National Incident Management System National Incident Management System (NIMS)(NIMS)National Response Framework (NRF)National Response Framework (NRF)

To ensure effective management of To ensure effective management of large-scale emergencieslarge-scale emergencies

EGH & Associates

NIMS OverviewNIMS Overview A consistent, nationwide approach for A consistent, nationwide approach for

incident managementincident management

Requires Federal, State, tribal, and local Requires Federal, State, tribal, and local governments to work together before, governments to work together before, during, and after incidentsduring, and after incidents

Involves preparing for, preventing, Involves preparing for, preventing, responding to, and recovering from domestic responding to, and recovering from domestic incidentsincidents

All causes, sizes, and complexities of All causes, sizes, and complexities of incidentsincidents

EGH & Associates

NIMS ComplianceNIMS Compliance

All Federal departments and agencies were All Federal departments and agencies were required to adopt NIMS by Sep 30, 2005required to adopt NIMS by Sep 30, 2005

State and local organizations must have State and local organizations must have adopted NIMS to receive Federal adopted NIMS to receive Federal preparedness grants and contracts by 2005preparedness grants and contracts by 2005

DHS publishes standards, guidelines, and DHS publishes standards, guidelines, and compliance protocols as neededcompliance protocols as needed NIMS Integration Center (DHS/FEMA)NIMS Integration Center (DHS/FEMA)

All responders to a Federally declared All responders to a Federally declared disaster must be trained in NIMS/ICS and disaster must be trained in NIMS/ICS and be operating within ICSbe operating within ICS

EGH & AssociatesNational Response Framework National Response Framework

(NRF)(NRF) Provides framework for:Provides framework for:

Federal interaction with State, local, and Federal interaction with State, local, and tribal governments; the private sector; and tribal governments; the private sector; and NGOsNGOs

For domestic incident prevention, For domestic incident prevention, preparedness, mitigation, response, and preparedness, mitigation, response, and recovery activities.recovery activities.

Describes capabilities and resources and Describes capabilities and resources and establishes responsibilities, operational establishes responsibilities, operational processes, and protocols.processes, and protocols.

Signed by all cabinet agency secretariesSigned by all cabinet agency secretaries

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Structure of NRF Structure of NRF Base PlanBase Plan

General structures and overviews General structures and overviews Emergency Support Function (ESF) Emergency Support Function (ESF)

AnnexesAnnexes Guidance to the 15 ESFs defined by the planGuidance to the 15 ESFs defined by the plan

Incident AnnexesIncident Annexes Guidance for specific incident types Guidance for specific incident types

Support Annexes Support Annexes Additional information to guide emergency Additional information to guide emergency

managementmanagement Appendices: Key definitions and Appendices: Key definitions and

guidelinesguidelines

EGH & Associates NRF Elements NRF Elements

Most Relevant to AT ReuseMost Relevant to AT Reuse

ESF #6 – Mass Care, Housing and Human ESF #6 – Mass Care, Housing and Human ServicesServices

ESF #8 – Public Health and Medical ServicesESF #8 – Public Health and Medical Services

ESF #14 – Long Term Community RecoveryESF #14 – Long Term Community Recovery

Key Annexes:Key Annexes: Volunteer and Donations ManagementVolunteer and Donations Management Catastrophic IncidentCatastrophic Incident

EGH & AssociatesEmergency / Disaster Emergency / Disaster

CycleCycle

Response

Recovery Prevention/Mitigation

Preparedness

EGH & Associates Basic Definitions: Basic Definitions:

DeclarationsDeclarations

What are Declarations? What are Declarations? Public announcementsPublic announcements

Legal determinations Legal determinations Made by an authorized government officialMade by an authorized government official

Triggering special emergency powersTriggering special emergency powers

Allowing expenditure of emergency fundsAllowing expenditure of emergency funds

EGH & AssociatesEmergency and Disaster Emergency and Disaster

DeclarationsDeclarationsMany types of declarations:Many types of declarations: Level of government: local, state, Level of government: local, state,

federalfederal Geographic area: part of a city, entire Geographic area: part of a city, entire

city, county, region, or a statecity, county, region, or a state Type of event: Type of event:

Any threat to life, health, safety, propertyAny threat to life, health, safety, property Specific threat: public health, drought, fire, Specific threat: public health, drought, fire,

insurrectioninsurrection

EGH & AssociatesGovernor’s Declaration of Governor’s Declaration of

State of Emergency State of Emergency Activates emergency plans and authorize Activates emergency plans and authorize

deployment and use of personneldeployment and use of personnel Allows suspending certain regulatory Allows suspending certain regulatory

statutesstatutes Trigger special powersTrigger special powers

To control persons and propertyTo control persons and property To mobilize state assetsTo mobilize state assets To seek mutual aid from other statesTo seek mutual aid from other states

A requirement for a Federal Declaration of A requirement for a Federal Declaration of Emergency or Major DisasterEmergency or Major Disaster

EGH & Associates

Federal DeclarationsFederal Declarations Stafford Act is the principal discretionary Stafford Act is the principal discretionary

federal authority to assist state and local federal authority to assist state and local governments in responding to catastrophic governments in responding to catastrophic events of any typeevents of any type

Stafford Act activated by declaration of eitherStafford Act activated by declaration of either A “major disaster” or A “major disaster” or

An “emergency” An “emergency”

The Stafford Act provides for federal The Stafford Act provides for federal authorities and fundsauthorities and funds

EGH & Associates

““Emergency” PowersEmergency” Powers Both “Major Disaster” and “Emergency” Both “Major Disaster” and “Emergency”

declarations authorize the same declarations authorize the same emergency measuresemergency measures

Emergency Powers – President may:Emergency Powers – President may: direct direct anyany Federal agency, Federal agency, with or without with or without

reimbursementreimbursement, to , to utilize its authorities and utilize its authorities and the resources granted to it under Federal lawthe resources granted to it under Federal law . . . . in support of state and local emergency . . in support of state and local emergency assistance efforts to save lives, protect assistance efforts to save lives, protect property and public health and safety, and property and public health and safety, and lessen or avert the threat of a catastrophe.lessen or avert the threat of a catastrophe.

EGH & Associates Federal Funding for Federal Funding for

Emergencies are Limited to Emergencies are Limited to ““Provide assistance to affected state and Provide assistance to affected state and

local governments for”:local governments for”: Issuance of warnings of risks or hazardsIssuance of warnings of risks or hazards Public health and safety information, Public health and safety information,

including dissemination of such informationincluding dissemination of such information Provision of health and safety measures, andProvision of health and safety measures, and Management, control, and reduction of Management, control, and reduction of

immediate threats to public health and immediate threats to public health and safetysafety

Individual Assistance Individual Assistance Payments to individuals for temporary Payments to individuals for temporary

housing, necessary expenses, immediate housing, necessary expenses, immediate needs caused by emergencyneeds caused by emergency

EGH & Associates ““Major Disaster” Major Disaster”

ProvidesProvidesThe following functions are provided only with a The following functions are provided only with a

“Major disaster” declaration, and not under “Major disaster” declaration, and not under “Emergencies”:“Emergencies”:

Public assistancePublic assistance Funding of at least 75% of cost of repair, Funding of at least 75% of cost of repair,

reconstruction, replacement of public facilities reconstruction, replacement of public facilities damaged by a declared eventdamaged by a declared event

Crisis CounselingCrisis Counseling Disaster UnemploymentDisaster Unemployment Legal ServicesLegal Services Relocation AssistanceRelocation Assistance Food StampsFood Stamps Human Services Case ManagementHuman Services Case Management Replacement of DMEReplacement of DME

Emergency Emergency Management & Management &

PWDPWD

EGH & AssociatesDisasters in the United Disasters in the United

StatesStates We all hear about the 100 or so major disasters We all hear about the 100 or so major disasters

each year each year In these events thousands of people are displaced and In these events thousands of people are displaced and

damage is over $1 Million, often much, much moredamage is over $1 Million, often much, much more Perhaps you may hear about the 1000 or so Perhaps you may hear about the 1000 or so

EmergenciesEmergencies In these events dozens, perhaps even hundreds of In these events dozens, perhaps even hundreds of

people are displaced and damage may be significant to people are displaced and damage may be significant to those peoplethose people

Every year, American Red Cross responds to Every year, American Red Cross responds to over 65,000 disastersover 65,000 disasters Vast majority are single family home firesVast majority are single family home fires To the impacted families, this event may be To the impacted families, this event may be

catastrophiccatastrophic

EGH & Associates

2000 Census reports that nearly 30% of US 2000 Census reports that nearly 30% of US Households have a member with a Households have a member with a disabilitydisability

No evidence that PWD more/less likely to No evidence that PWD more/less likely to be involved in a disasterbe involved in a disaster

But when PWD are impacted, their needs But when PWD are impacted, their needs may be greatermay be greater May need to replace DME or ATMay need to replace DME or AT Can be separated from caregivers Can be separated from caregivers Schedules and treatments/therapies interruptedSchedules and treatments/therapies interrupted

Disasters’ Impact Disasters’ Impact on People with Disabilities on People with Disabilities

(PWD)(PWD)

EGH & Associates

Prior to Hurricane Katrina:Prior to Hurricane Katrina: Many responders and emergency managers Many responders and emergency managers

couldn’t spell disabilitycouldn’t spell disability Since 2005, much has changed:Since 2005, much has changed:

FederalFederal DHS has an Office of Special Needs & Interagency DHS has an Office of Special Needs & Interagency

Collaboration Council Collaboration Council FEMA has a specific Disabilities CoordinatorFEMA has a specific Disabilities Coordinator FEMA’s Deputy Administrator for Grants comes from FEMA’s Deputy Administrator for Grants comes from

the Disability Communitythe Disability Community DOJ ruled that shelters must be accessibleDOJ ruled that shelters must be accessible

State/LocalState/Local PWD now on RADARPWD now on RADAR Unfortunately, much focus on Registries & Medical Unfortunately, much focus on Registries & Medical

Needs ShelterNeeds Shelter ““Doesn’t the Registry take care of all the needs?”Doesn’t the Registry take care of all the needs?”

Emergency Managers Emergency Managers & PWD& PWD

EGH & AssociatesLessons Learned from Lessons Learned from

Hurricane KatrinaHurricane Katrina Two of the primary reasons that people did not Two of the primary reasons that people did not

evacuate in the path of Katrina:evacuate in the path of Katrina: Was PWD – with no means to evacuateWas PWD – with no means to evacuate Had a PWD in family or HH with no means to evacuateHad a PWD in family or HH with no means to evacuate Combined to account for over 1/3 of those who didn’t Combined to account for over 1/3 of those who didn’t

evacuateevacuate Many who evacuated lost most/all DME & ATMany who evacuated lost most/all DME & AT

Very difficult to replace when all commerce is outVery difficult to replace when all commerce is out Few responders knew about DME, even fewer ATFew responders knew about DME, even fewer AT

Most shelters not equipped to handle PWDMost shelters not equipped to handle PWD Many inaccessibleMany inaccessible Little/no DME or ATLittle/no DME or AT

Help must be coordinated through NIMSHelp must be coordinated through NIMS Unsolicited donations & unaffiliated responders cause Unsolicited donations & unaffiliated responders cause

problemsproblems

EGH & Associates Since Hurricane Since Hurricane

KatrinaKatrina FEMA has:FEMA has:

Included accessible busses and ambulances in Included accessible busses and ambulances in evacuation plans evacuation plans

Developed a go-kit of accessibility tools for Developed a go-kit of accessibility tools for sheltersshelters

Promoted the need for Medical Needs ShelteringPromoted the need for Medical Needs Sheltering Red Cross has:Red Cross has:

Trained volunteers to be better at serving PWDTrained volunteers to be better at serving PWD Included accessibility in shelter surveysIncluded accessibility in shelter surveys My chapter in the DC area has partnered with My chapter in the DC area has partnered with

NOD to:NOD to: Survey all shelters in the region, including accessibility Survey all shelters in the region, including accessibility Purchase a cache of accessibility toolsPurchase a cache of accessibility tools Approximately 10% of a DHS UASI grant for Approximately 10% of a DHS UASI grant for

preparednesspreparedness

EGH & AssociatesThere is a Need for AT There is a Need for AT

ReuseReuse FEMA has worked with HHS to replace DME FEMA has worked with HHS to replace DME

lost/damaged in Disaster.. But…lost/damaged in Disaster.. But… May be limited to only the largest disasters May be limited to only the largest disasters

Presidentially declared “Major Disasters” with IAPresidentially declared “Major Disasters” with IA It takes time after the disaster to set upIt takes time after the disaster to set up It requires a supply of new equipment to be It requires a supply of new equipment to be

availableavailable May not cover all DMEMay not cover all DME Not clear if it covers any/all ATNot clear if it covers any/all AT

Since DME and AT are not on most Since DME and AT are not on most emergency management RADAR, it is emergency management RADAR, it is unclear if/how DME/AT would be replaced if unclear if/how DME/AT would be replaced if not covered under by FEMA/HHS not covered under by FEMA/HHS

EGH & AssociatesProving the Concept Proving the Concept

Not aware of any active program for AT Disaster ReuseNot aware of any active program for AT Disaster Reuse Kansas AT Project looking into this Kansas AT Project looking into this

First step to a widespread AT Disaster Reuse program is a First step to a widespread AT Disaster Reuse program is a limited pilot program to prove conceptlimited pilot program to prove concept Show emergency managers that this can workShow emergency managers that this can work Learn how to make it work with limited risk/scopeLearn how to make it work with limited risk/scope Plan for 6-12 monthsPlan for 6-12 months

Start by building relationships with key response groups:Start by building relationships with key response groups: Emergency ManagementEmergency Management American Red CrossAmerican Red Cross Local Health/Human Services AgenciesLocal Health/Human Services Agencies VOAD (Voluntary Organizations Active in Disaster)VOAD (Voluntary Organizations Active in Disaster)

Work with them to gain interest, then develop, Pilot PlanWork with them to gain interest, then develop, Pilot Plan If successful in initial pilot, build rollout on successIf successful in initial pilot, build rollout on success

If not as successful, learn lessons and try again until successful If not as successful, learn lessons and try again until successful

EGH & Associates Questions to Address Questions to Address

with Pilotwith Pilot Logistics – For Disaster - How to:Logistics – For Disaster - How to:

Collect the items for reuseCollect the items for reuse Sort, clean, refurbish and catalog re-use itemsSort, clean, refurbish and catalog re-use items

Web-based catalog for easy access during emergency across affected areasWeb-based catalog for easy access during emergency across affected areas How to distribute reuse itemsHow to distribute reuse items

Getting it to where it needs to go without interfering with other respondersGetting it to where it needs to go without interfering with other responders Support items distributedSupport items distributed

Regulatory issues – What to be concerned about?Regulatory issues – What to be concerned about? Lessons Learned Lessons Learned

Potential models for success Potential models for success What is needed to meet AT needs of impacted PWDWhat is needed to meet AT needs of impacted PWD

Messaging – How do we reach the partners and clients to let Messaging – How do we reach the partners and clients to let them know we’re here and can helpthem know we’re here and can help What training is required for response/recovery partners What training is required for response/recovery partners

to raise awarenessto raise awareness to facilitate optimal utilizationto facilitate optimal utilization

EGH & Associates Sources for Pilot Sources for Pilot

FundingFunding Homeland Security Funding- UASI/SHSGPHomeland Security Funding- UASI/SHSGP Need to build support with Government PartnersNeed to build support with Government Partners Start with training/education what is ATStart with training/education what is AT

HHS Funding – Need to explore if appropriate HHS Funding – Need to explore if appropriate NIDRR:NIDRR:

This is perhaps one of the best sources of $.  This is perhaps one of the best sources of $.  NIDRR has a current focus on accessibility and emergency NIDRR has a current focus on accessibility and emergency

issues  issues   They have a discretionary funding pot - formal application on They have a discretionary funding pot - formal application on

web site.  web site.  Posted notice for RERC last year on emergency issues Posted notice for RERC last year on emergency issues

that wasn’t funded, that wasn’t funded, Have had several DRRP grants, so they are open to the Have had several DRRP grants, so they are open to the

issues.  issues.  RSARSA EPA – Position this as a pilot e-waste reuse EPA – Position this as a pilot e-waste reuse

programprogram Private foundations focused on PWD and/or GreenPrivate foundations focused on PWD and/or Green

Questions?Questions?Elliot HarkavyElliot Harkavy

EGH & AssociatesEGH & Associateseharkavy@eghassociateeharkavy@eghassociate

s.coms.comwww.eghassociates.cowww.eghassociates.comm

w - 301-652-4511w - 301-652-4511f - 202-318-0514f - 202-318-0514