Maintaining independence - Individuals requiring support to be independent in daily activities may lose this support during an emergency or a disaster. This support may include supplies, durable medical equipment, and attendants or caregivers. • Communication - Individuals who have limitations that interfere with the receipt of and response to information will need that information provided in methods they can understand and use. They may not be able to hear verbal announcements, see directional signs, or understand how to get assistance all because of hearing, vision, speech, cognitive, or intellectual limitations, and/or limited English proficiency. • Transportation - Individuals who cannot drive or who do not have a vehicle may require transportation support for successful evacuation. This support may include accessible vehicles (e.g., lift-equipped or vehicles suitable for transporting individuals who use oxygen) or information about how and where to access mass transportation during an evacuation. • Supervision - Before, during, and after an emergency individuals may lose the support of caregivers, family, or friends or may be unable to cope in a new environment (particularly if they have dementia, Alzheimer’s or psychiatric conditions such as schizophrenia or intense anxiety). If separated from their caregivers, young children may be unable to identify themselves; and when in danger, they may lack the cognitive ability to assess the situation and react appropriately. • Medical care - Individuals who are not self-sufficient or who do not have adequate support from caregivers, family, or friends may need assistance with: managing unstable, terminal or contagious conditions that require observation and ongoing treatment; managing intravenous therapy, tube feeding, and vital signs; receiving dialysis, oxygen, and suction administration; managing wounds; and operating power dependent equipment to sustain life. These individuals require support of trained medical professionals. Individuals in need of additional response assistance may include those who have disabilities; who live in institutionalized settings; who are elderly; who are unaccompanied children; who are from diverse cultures; who have limited English proficiency; or who are non-English speaking; or who are transportation disadvantaged. They have typically exhausted all other resources (family, neighbors, public transportation, etc.) and still need assistance for evacuation and/or sheltering before, during, and possibly after a disaster or emergency. These individuals typically reside in single homes or multiple family dwellings in the State and are not residents of hospitals, residential health care facilities, or any community-based residences or services that are already subject to emergency planning requirements.
Ask to list specific access and functional needs such as (not all inclusive): People who live in institutions People with mental illnesses People with developmental disabilities People with hearing limitations or deafness Individuals with Alzheimer’s People with cultural differences
The law mandates integration and equal opportunity for people with disabilities: Stafford Act - Post-Katrina Emergency Management Reform Act (PKEMRA) - Federal civil rights laws Legal Authority and References for FNSS Law, regulations and agency guidance defines the scope of FNSS - Americans with Disabilities Act of 1990 - Rehabilitation Act of 1973 - Fair Housing Act
Some areas may refer to Personal Care Attendant Services (PCA) instead of Personal Assistance Services Discuss
Self-Determination – People with disabilities are the most knowledgeable about their own needs.2. No “One-Size-Fits-All” – People with disabilities do not all require the same assistance and do not all have the same needs. ␣␣ Different types of disabilities affect people in different ways. Preparations should be made for individuals with a variety of functional needs, including individuals who use mobility aids, require medication or portable medical equipment, use service animals, need information in alternate formats, or rely on a personal attendants.3. ␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣ emergency programs, services, and activities as people without disabilities.␣␣ Emergency recovery services and programs should be designed to provide equivalent choices for people with disabilities as they do for individuals without disabilities. This includes choices relating to short-term housing or other short-term and long-term disaster support services.4. ␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣ emergency programs, services, and activities provided by governments, private businesses, ␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣ Inclusion of people with various types of disabilities in planning, training, and evaluation of programs and services will ensure that all people are given appropriate consideration during emergencies.5. Integration – Emergency programs, services, and activities typically must be provided in an integrated setting. ␣␣ The provision of services such as sheltering, information intake for disaster services, and short-term housing in integrated settings keeps individuals connected to their support system and personal attendants and avoids the need for disparate service facilities.6. Physical Access – Emergency programs, services, and activities must be provided at locations that all people can access, including people with disabilities.␣␣ People with disabilities should be able to enter and use emergency facilities, and access the provided programs, services, and activities. Facilities typically required to be accessible include: parking, drop-off areas, entrances and exits, security screening areas, toilet rooms, bathing facilities, sleeping areas, dining facilities, areas where medical care or human services are provided, and paths of travel to and from and between these areas.1371387. ␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣ programs, services, and activities equal to the general population.␣␣ ␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣ ␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣ ␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣8. Effective Communication – People with disabilities must be given information that is comparable in content and detail to that given to the general public, as well as accessible, understandable, and timely.␣␣ Auxiliary aids and services may be needed to ensure effective communication. These may include pen and paper or sign language interpreters through on-site or video and interpreting for individuals who are deaf, deaf-blind, hard of hearing, or have speech disabilities. Individuals who are blind, deaf-blind, have low vision, or have learning ␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣ forms.9. ␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣ ␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣ procedures.␣␣ Service staff may need to change the way questions are asked, provide reader assistance to complete forms, or provide assistance in a more accessible location.10. No Charge – People with disabilities may not be charged to cover the costs of measures necessary to ensure equal access and nondiscriminatory treatment.␣␣ Examples of accommodations provided without charge to the individual may include: ␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣␣ additional storage space for mobility aids and other equipment;; lowered counters or shelves;; Braille and raised letter signage;; a sign language interpreter;; a message board;; assistance in completing forms and providing documents in Braille;; large print or audio recording.
Excited that Missouri will hold a Train-the-trainer – July 2011 (Missouri). Bring in experts from California. Course approved by DHS. Trained government employees and personnel from community- based organizations and non-governmental organizations ready to respond and deploy to disaster areas to work in shelters. The FAST members should have extensive knowledge of the populations they serve, their needs and available services and resources including housing, benefit programs and disaster aid programs. They assist in meeting essential FNSS so people can maintain their usual level of independence during disasters and emergencies.
Volunteers may become a train-the-trainer cadre.
Critical to include populations who experience functional access needs in planning at all levels. Missouri has provided accommodations, but they have been provided on the fly. Important to plan ahead of time.
Self-advocacy organizations. Mental Health organizations to include NAMI, Independent Living Councils. Area Agencies on Aging Assistive Technology Project, Providers of Transportation, CMS, DME, PCA’s, Communication (interpreter organizations) MRCs Home healthcare agencies Local organizations on disabilities, children and elderly
Other: Ask audience to identify other considerations Communication assistance (interpreters, signage, language, forms available in Braille) - DME, CMS, and/or PCA that assist with activities of daily living Access to medications to maintain health mental health and function Cognitive and intellectual disabilities Transportation resources - Access to orientation and way-finding Access to an air-conditioned and/or heated environment Individuals with dietary restrictions Providing food and supplies for service animals Post disaster alternative housing
Develop back-up plans for personal assistance services, hospice or other forms of in-home assistance!
2011 MO Flood: Tornado: Caruthersville and Seneca Good Friday 2011 Tornado Group Home Fire: SW, MO Ice Storms: Springfield, MO
Functional Needs Support Services Preparedness Missouri
FUNCTIONAL NEEDS SUPPORT SERVICES:PREPAREDNESS FORALL MISSOURIANS
Introductions Karen Benson Convoy of Hope - Global Disaster Response Director Missouri United Methodist Conference - Disaster Coordinator Debra HendricksDepartment of Social Services – Children’s Division Dante Gliniecki State Emergency Management Agency Statewide Area Coordinator
Access and Functional Needs:• Can be defined as someone needing supports to maintain independence in daily activities, communication, transportation/evacuation, supervision or medical care.
People with Access and Functional Needs:• People with disabilities: • Persons requiring – Physical bariatric equipment – Sensory – Mental health • People who are non- – Cognitive English speaking or who• Older individuals have limited language• Children abilities.• Women in late stages of • People with limited pregnancy transportation
Americans with Disabilities Act• Children and adults with disabilities are entitled to equal opportunity to participate in programs, services and activities in the most integrated setting.
Functional Needs Support Services (FNSS):• Are the services that enable children and adults to maintain their usual level of independence in general population shelters.• Intended to ensure equal access to all services provided by a shelter.• Supports needed to function independently can occur before, during and possibly after a disaster.
Functional Needs Support Services Include:• Reasonable modifications to policies, practices and procedures.• Durable Medical Equipment. (DME)• Consumable Medical Supplies. (CMS)• Personal Assistance Services. (PAS)• Other goods and services as needed.
Functional Assessment Support Teams (FAST): • Conduct Assessments • Evaluates Functional Needs • Determines Resources Needed
FAST:• Government Employees – SEMA, DSS, DMH, DHSS• Community based personnel – Centers for Independent Living, Councils• Non-governmental organizations – American Red Cross, Salvation Army
FAST Members:• Have extensive knowledge of the populations they serve.• Understand the needs of the shelter to which they were assigned.• Have access to available services and resources.• Include people who have access and functional needs.
Benefits of FAST:• Community resource.• Gives you, the local government, eyes and ears in the shelter.• Assists in identifying and providing FNSS.• Assists in meeting requirements of the American’s with Disabilities Act and other laws.
Advanced Planning is Critical• Don’t wait for a disaster to begin planning for persons who have access & functional needs.• Planning should occur at all levels of emergency preparedness.• Include stakeholders in the planning.
Integrated Community Planning Steps:• Review current plans.• Identify stakeholders.• Complete gap analysis.• Identify resources.• Establish relationships.
Identify Stakeholders• People requiring FNSS.• Agencies/ organizations that provide FNSS.• Advocacy organizations.• Providers of services.• Faith based organizations.• VOAD, COAD
Community Gap Analysis• Identify the types of disabilities and/or functional needs that exist within the community.• Determine the types of resources that will be needed to serve the community.
Identify Resources & Establish Relationships• Work with partners to help determine which tasks and responsibilities will be met by all stakeholders.• Establish relationships with providers and identify how they can support the needs of individuals with access & functional needs.
Considerations for FNSS Planning:• Reasonable • Mental health modifications to issues (i.e. policies, provision of quiet procedures, rooms) practices • Transportation• Communication • Cooled/heated• Access to environment medications • Other
FNSS Makes Sense• Don’t have to plan for two types of shelters.• Maximizes resources.• Supports already exist in communities.• Addresses the needs of all members of the community.• It’s the right thing to do!
Develop back-up plansfor personal assistance services, Hospice or other forms of in-home assistance!
Disasters in MissouriCarter County Tornado Flooding in WayneMay 25, 2011 County 2011
Fires Power Outages Floods Earthquakes Tornados Chemical Spills Ice/Snow & Plane Crashes Other Severe Terrorism Storms Pandemic Flu Severe Heat/Cold
ACCESS AND FUNCTIONALNEEDS EVENTS IN RECENTAND CURRENT DISASTERS• Shelters• Children• People with Disabilities• Ongoing Recovery
Deb HendricksKaren Benson Children’s Division Director, Global Missouri Department ofDisaster Response Social Services P.O. Box 88Convoy of Hope 330 S. 615 Howerton CourtPatterson Jefferson City, MO 65102 Springfield, MO 65802 Office: (573) 751- Office: (417) 4920 Fax:823-8998 x368 (573) 526-3971 Cell: (417) 466.5406 Debra.L.Hendricks@firstname.lastname@example.org Dante Gliniecki Statewide Volunteer Coordinator SEMA PO Box 116 Jefferson City MO 65102 573-526-9132 Dante.email@example.com