Responses to follow-up questions from the hearing titled: "Looking out for the Very Young, the Elderly and Others with Special Needs: Lessons from Katrina and other Major Disasters,"
Subcommittee on Economic Development, Public Buildings,
and Emergency Management
Transportation and Infrastructure Committee
U.S. House of Representatives
Follow-Up Questions and Responses to the Hearing Entitled:
"Looking out for the Very Young, the Elderly and Others with Special Needs: Lessons from Katrina and other Major Disasters"
Tuesday, October 20, 2009
2167 Rayburn House Office Building
Please share some of the examples cited in your report Effective Emergency Management with respect to effective community preparedness.
- After the 1993 World Trade Center bombing, at the suggestion of the local emergency management office, the Associated Blind (a local service provider for low- and no-vision clients) worked with the New York City Fire Department to develop a building evacuation plan and drill for its staff, most of whom have limited or no vision. The Associated Blind wanted a plan for staff members that covered the range of problems that could occur during a disaster. On September 11, 2001, their efforts paid off. The entire staff calmly and safely evacuated the building's ninth floor, a success they attribute directly to customized advance planning and drills.
- Jim Davis, the emergency management coordinator in Pittsylvania County, Virginia, worked to increase the safety of people with hearing disabilities. Davis first worked with a local college to obtain a $5,000 grant to buy radios and then engineered them to vibrate pillows as a warning mechanism. As a result of his efforts, local citizens who were deaf requested additional training. To respond to their request, Davis provided community emergency response training (CERT) with sign language interpretation. For his efforts, Davis received the 2007 Clive Award at the National Hurricane Conference
- OK-WARN for the Deaf and Hard-of-Hearing – (http://www.ok.gov/OEM/Programs_&_Services/Preparedness/OK-Warn_for_the_Deaf_and_Hard-of-Hearing/index.html) This program offers a method for people with hearing disabilities to receive notification of weather-related hazards in Oklahoma. Warning notifications are sent via alphanumeric pagers and emailed to everyone listed in the database. Each person can choose the type of warnings he or she wishes to receive. People can also limit their notifications to selected counties within the state.
- To better serve people with vision impairment, the Massachusetts Emergency Management Agency (MEMA) partnered with community services for the blind to develop CDs that contain the same emergency information provided on its website. These CDs were distributed to public libraries and throughout the community. They "describe procedures for sheltering-in-place, evacuation, mass care shelters, the Emergency Alert System, pet safety, and special needs information".
- Emergency Planning and Special Needs Populations (G197) - The U.S. Fire Administration developed this course to increase the skill and knowledge of emergency planners with respect to the needs of people with disabilities. This course aims to educate any group that is responsible for the safety of people with disabilities. This includes first responders, nonprofit organizations, community service organizations, and health care providers. The information contained in this course could also benefit those who develop emergency plans as a profession.
- The WGBH National Center for Accessible Media (NCAM), a division of Boston's public broadcaster WGBH, "is uniting emergency alert providers, local information resources, telecommunications industry and public broadcasting representatives, and consumers in a collaborative effort to research and disseminate approaches to make emergency warnings accessible. This project, funded by the Department of Commerce's Technology Opportunities Program (TOP), is addressing a most urgent need—"the one to develop and encourage adoption of standardized methods, systems and services to identify, filter and present content in ways that are meaningful to people with disabilities leading up to, during, and after emergencies" (http://ncam.wgbh.org/news/pr_20050915.html)
To the best of your knowledge are persons with disabilities of all types being included to the level they should be to make emergency planning successful?
No. While a number of resources provide recommendations for including and working with people with disabilities in emergency planning, there is very little evidence that these recommendations have been implemented or evaluated. In recent years, Congress and the White House have demanded that people with disabilities be afforded the same consideration during emergency planning as all other individuals. Although some improvement in this area is evident, catastrophic events, such as Hurricane Katrina and the California wildfires, exposed the gaps that still exist in many emergency plans and preparedness efforts. These events reinforce the need for additional action to protect the lives of people with disabilities against disasters.
In your opinion why is a regional disability coordinator vital to successful planning and execution?
Effective emergency management requires leadership and collaboration within and across federal, state, local and tribal governments. For leadership and collaboration to be successful, there must be: (a) an emergency management infrastructure with requisite knowledge and capacity as it relates to people with disabilities, and (b) a cadre of personnel with training and expertise to complete a range of disaster management tasks. Based on its most recent research, NCD is not aware of the existence of such a knowledge base, infrastructure capacity and personnel at the federal or regional level. NCD is also not aware of any federal agency plan to timely build the necessary 'disability' capacity within and across the 10 FEMA Regions. In the absence of a plan to install capacity within FEMA, and its 10 Regions, a FEMA Regional Disability Coordinator is a critical and currently missing source of disaster management leadership and expertise that links federal, state, local and tribal levels of government.
Section 513 of H.R. 5441, the Post Katrina Emergency Management Reform Act (PKEMRA) lays out 11 broad duties and responsibilities for a National Disability Coordinator (NDC) at FEMA. FEMA has not provided the NDC with staffing at either the national or regional level. In effect, then, one person as NDC is responsible for creating and implementing the essential tasks included in Section 513. This requires that the NDC interact with a range of federal, state, local and tribal governmental offices and community-based groups, incorporate the needs of individuals with disabilities into national preparedness systems, and ensure accessible transportation for individuals in the event of an evacuation, among other critical tasks. This is an unrealistic expectation for any single individual.
A Regional Disability Coordinator (RDC) position within each of the ten FEMA Regions could effectively expand and support the work of the FEMA National Disability Coordinator, both in implementing disaster management activities with various levels of governments and with community-based groups and in coordinating planning, response and recovery activities. A FEMA RDC could provide a link between state and federal networks and could also expand his or her work to local and tribal governments, thus ensuring a level of coordination and collaboration with expertise that is currently not available. Additionally, given the number of open disasters at any particular time, response coordination responsibilities present a significant drain on the time and resources of the FEMA NDC. An RDC in every FEMA Regional Office also could multiply FEMA personnel available to be present in Joint Field Offices to coordinate and support outreach to victims with disabilities when disaster strikes.
In reporting to their specific regions, each RDC could partner with their Regional FEMA Administrator to infuse current operational plans with strategies specific to the needs of individuals with disabilities in times of emergencies. Through this partnership, they could also craft any additional plans necessary to address potential gaps in services for individuals with disabilities. Furthermore, the RDCs could engage regional FEMA divisions and state and local authorities to ensure a coordinated and comprehensive effort to support individuals with disabilities in times of emergencies.
To best incorporate the needs of individuals with disabilities in emergency management, the ten RDCs could work directly with direct care and advocacy agencies, both public and private. To do so, the Coordinator could partner with area organizations such as independent living centers, statewide independent living councils, developmental disability councils, affiliates of national disability organizations, and state disability coalitions to better understand the specific barriers and challenges individuals with disabilities face during an emergency. The Coordinators could then utilize this information to develop training materials in collaboration with such agencies, ensuring that the materials are developed in accessible formats.
Each of the ten FEMA regions employs several hundred Disaster Assistance Employees (DAEs) in addition to those maintained at the national level. A FEMA RDC could train all regional DAEs on general disability sensitivity and disability issues that arise within their specializations, which include communication, transportation, housing, and medical services. RDCs could also hire DAEs to be deployed as Disability Specialists during regional emergencies. Finally, RDCs could seek out and hire DAEs with disabilities and ensure that accommodations are readily provided to ensure these DAEs ability to fully perform their duties.
In your statement, you list places where disabled citizens eat, work, worship, recreate, and socialize and how to get information to them there. What about adding places where people shop – drugstores, supermarkets?
The list of suggested avenues of distribution for disaster-related education programs provided in NCD's written testimony and in its Effective Emergency Management report is certainly non-exhaustive. Drugstores and supermarkets also represent valuable venues for information distribution. However, as lifestyles and shopping habits vary across populations, ensuring that such information is available in a wide variety of locations is essential. Likewise, it is imperative that all materials be developed and distributed in a manner which ensures accessibility in format and content for all people, regardless of disability.
Did you or your organization participate in preparing the Comprehensive Preparedness Guide 301: Special Needs Planning?
NCD played a small role when CPG 301 was first worked on, for which NCD ensured it gave FEMA / DHS credit (which was noted in one of the Government Accountability Office's reports). However, since the interim guidance was issued last summer, NCD's involvement has been limited to routinely exchanging information with FEMA and Civil Rights and Civil Liberties (CRCL) staff to be kept apprised of where the CPG 301 is in process.
You emphasize that for extending warnings the importance of using people who are as similar to the target population as possible. What are your recommendations as to how to achieve this in small and remote communities?
The similarity and familiarity of messengers to message recipients play an important role in maximizing the effectiveness of disseminating warnings to individuals in any location, including small and remote communities. To facilitate this, it is imperative that emergency management professionals focus attention on relationship-building with nonprofits that service the needs of people with disabilities in a particular community. Although remote and small communities may present some unique challenges to readily identifying and accessing members of the disability community, there exist some existing built-in partners that may assist in these efforts.
Centers for Independent Living (CILs) represent an example of a ready-made network of disability organizations across the country, servicing many small and remote areas as well as large and densely populated ones. CILs are grassroots, advocacy organizations run by and for people with disabilities that provide individual and systems advocacy, information and referral, peer support, and independent living skills training. There is at least one CIL in every Congressional district across the country. CILs that service the needs of people with disabilities in rural America are members of the Association of Programs for Rural Independent Living (APRIL).
By partnering with disability organizations run by and familiar to people with disabilities to involve people with disabilities in all stages of disaster planning, emergency management professionals can build their credibility tremendously amongst a remote or small community's disability population. Partnering organizations, such as CILs, could not only assist in helping to identify individuals with disabilities to take part in all phases of disaster planning, they also represent potential credible messengers for the development and use of Public Service Announcements (PSAs) and warning messages.
You also mention that the individual assistance program within FEMA needs to address "assistive devices and durable medical equipment". What is the difference between these two terms? How are these devices and equipment treated now?
An assistive device is typically a device designed to assist people in performing activities of daily living, such as walking, eating, bathing, and dressing. Examples include items that provide support or help a person with a mobility disability to be mobile, like a walker, or to complete tasks, such as a dressing stick or shower chair. Durable medical equipment (DME) is equipment that serves a medical purpose that is reused on a regular basis, is generally not useful for a person in the absence of illness or disability, is suitable for use within the home, and is often prescribed by a physician. Examples of DME may include items that can also be classed as assistive devices, such as hearing aids, low vision aids, etc., and may also include items such as portable oxygen equipment, hospital beds, catheters, and wheelchairs (manual and electric). In addition to DME and assistive devices, some people with disabilities utilize service animals, which are animals specially trained to provide specific support to a person with a disability.
People with disabilities often face separation from important durable medical equipment (DME), assistive devices, and service animals through the course of a disaster. Emergency responders often evacuate people with disabilities without consideration of evacuating vital assistive technology or custom-fit assistive devices, and medical equipment vital to the individual's survival or independence. The individuals who do evacuate with these items are often later separated from them in order to access general population shelters. Such shelters may be inaccessible to some DME and/or are unaware of their legal responsibility to accept and accommodate persons using service animals. These separations often create heavy reliance on emergency assets, minimize or prevent an individual from being independent, and slow post-event recovery.
Individual financial assistance was established under Sec. 408 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (The Stafford Act) to provide grants and funds for rental housing, reconstruction, temporary repairs, and other needed assistance. Sec. 408 specifies that individuals can access financial assistance for disaster-related medical, dental, and funeral expenses (Sec. 408(e)(1)) and/or personal property, transportation, and other "necessary expenses or serious needs resulting from the disaster" (Sec. 408(e)(2)). On its website, FEMA explains these provisions this way: "Money is available for necessary expenses and serious needs caused by the disaster. This includes: disaster-related medical and dental costs;…Other necessary expenses or serious needs as determined by FEMA; Other expenses that are authorized by law" (emphasis added).
While individuals who acquired their disabilities and thus medical and "other serious needs" due to the disaster may easily find themselves covered within such language, the causal and ambiguous word choice without reference to examples may have the unintended consequence of discouraging applications for replacement DME, assistive devices, and service animals for those whose use of such items predated the disaster. The word choice may also translate into confusion or delay for those tasked with processing the applications against the eligibility criteria.
To remedy this ambiguity, lawmakers might consider the addition of the phrases "items related to the independence of persons with disabilities" and "replacement expenses" to Sec. 408(e)(2) - "…to address personal property, transportation, items related to the independence of persons with disabilities, and other necessary expenses, including replacement expenses, or other serious needs resulting from the major disaster." Following these changes, it would be imperative that an accurate explanation of that provision follow in FEMA's disaster assistance literature, including direct mention of DME, assistive devices, and service animals, with specific examples of items that qualify, so that there can be no question in the mind of the applicant or the application processer that these items are eligible for Individual Assistance.
NCD further recommends that the FEMA registration / intake process for Individual Assistance include questions about disability needs. Individual Assistance applications for people with disabilities should be flagged for immediate follow-up and contact by an employee with expertise with disability needs to ensure that the application for assistance has been completed and understood to ensure prompt and thorough assistance.
Please explain what you mean by non-structural mitigation and how this can help disabled persons.
Non-structural mitigation involves activities and decision making systems which provide the context within which disaster management and planning operates and is organized. Non-structural mitigation is most commonly used to refer to policies and practices, including land-use policies, zoning, crop diversification, building codes, and procedures for forecasting and warning. In a broader context, non-structural mitigation includes measures such as: training and education; public education; evacuation planning; institution building; and, warning systems.
NCD's recent research report "Effective Emergency Management" describes a host of activities and promising practices, some of which were introduced in the preparedness Chapter 2. Some researchers argue that information is often the most valuable resource for effective mitigation. As individuals implement the actions suggested in the preparedness literature, they are mitigating the impact of future disasters. The simple task of developing an emergency preparedness bag can mitigate the effects of loss of medications, assistive devices, communications, and related resources.
Insurance is another nonstructural mitigation measure that can be used (with limits, depending on provider coverage) to replace lost items, from assistive devices to critical medical equipment to accessible housing. In addition, public education programs reduce risk by informing and motivating individual as well as collective preparedness. For example, the Alabama Chemical Stockpile Emergency Preparedness Program (CSEPP) was developed to mitigate the potential impact of a hazardous chemical release on the people living near the facility, where well over 1,000 individuals participated in a special needs registry (including people with medical and transportation needs as well as those who required specialized equipment). Although evacuation of the area was the first line of defense against human exposure, a second option—sheltering in place—became the focus of this program. Residents in the immediate response zone (those closest to the facility) were given the following:
- Respiratory protection equipment that would provide limited protection while evacuating or sheltering in place.
- Portable room air cleaners that used charcoal filters to remove the chemical weapons agent from the safe room.
- Tone-alert radios designed to provide hazard notification and protective measures advice.
- Shelter-in-place kits to reduce the infiltration of potentially contaminated air into the safe room.
The unique thing about the CSEPP is that planners considered the needs of people with disabilities. They realized that some people might encounter difficulties setting up the portable room air cleaner or establishing their safe room. Consequently, adjustments were made that enhanced the effectiveness of these mitigation activities for people with disabilities. One of these adjustments was the substitution of painters tape instead of the duct tape normally included in the shelter-in-place kit, after Argonne National Laboratory concluded that "painters tape…[was] more user friendly and provided a level of in-leakage protection at least equal to conventional duct tape and plastic." Furthermore, trainers went to the homes of those at risk to set up protective devices and provide in-home training for both individuals and support persons. An extensive effort was put forth to establish a registry of persons who would require assistance in the event of an accident.
What do you recommend for inclusion in the FEMA mitigation program?
Two of the major policy and program gaps that NCD has identified through NCD's research that are directly on point are: (a) there is a lack of involvement of people with disabilities in local planning throughout all phases of the life cycle of an emergency, and (b) there is a lack of available resources to local communities to address the emergency concerns of the local community affecting all people and especially those with disabilities.
NCD's recommendation to address these gaps and related issues regarding the program is three-fold. First, we would suggest that Federal grant requirements and federal grant incentives be established and/or used to ensure the direct involvement of people with disabilities in state, local and tribal funding proposals to FEMA and DHS particularly for grant programs and priorities that emphasize mitigation and recovery disaster cycles. Under such an approach, judging of state and local funding proposals would necessitate establishing benchmark and evaluation criteria that demonstrate the inclusion of, and address the needs of, people with disabilities.
Second, establish a national clearinghouse for disabilities and disasters where information (e.g., promising practices, evidence-based practices) can be organized and archived into easily retrievable and accessible formats for individuals and organizations. Information should be organized into sections on preparedness, response, recovery, and mitigation. A federal agency should be tasked with routinely updating and disseminating content, including guidance materials, technical reports, and empirical research. Such a clearinghouse needs to provide information in multiple types of accessible formats. Include the International Association of Emergency Managers (IAEM) Special Needs Committee in an advisory capacity in this endeavor.
Third, FEMA should develop specific mitigation planning and risk assessment tools for use by governments that are designed to highlight a municipality's special needs population profile. Currently, few hazard mitigation analyses and risk assessments include a view of a community's vulnerability through a vital set of criteria such as: population size, demographics, and/or density. As a result, too often there is a predictable and perennial shortage between resources for emergency response by general population shelters and persons with functional supports and service needs needs, or there is a disconnect between accessible vehicles for transportation-disadvantaged populations and persons with special needs. Therefore, it is critically important that specific attention be given to comprehensively identifying those members of a community who have special needs prior to a disaster event. Failure to do so often leaves this group at a distinct disadvantage, perhaps even disenfranchises them from the broad community response effort within a general population shelter.
Planning seems to be the key to successful mitigation and recovery. How would you assess the planning process today? What recommendation would you make for that process?
To improve the planning process today, the mitigation planning regulation at 44 CFR Part 201 should include language that requires that local and state risk assessments and mitigation plans will include specific information about all special needs populations within the relevant jurisdiction.
Hazard mitigation is any action that reduces the destructive and disruptive effects of future disasters. Mitigation efforts generally offer the best and most cost-effective methods of addressing the impacts associated with disasters. To support better mitigation planning for future disasters, Congress enacted the Disaster Mitigation Act (DMA) of 2000, P.L. 106-390. The DMA demonstrated the desire and expectation of the U.S. Congress that states and communities become more proactive in reducing the long-term impacts of disasters. Prior to the passage of the DMA of 2000, only half of the states in the U.S. mentioned natural hazards and disaster loss reductions in local plans. In addition, only 11 states mandated pre-disaster or post-disaster assessments as a part of a comprehensive plan.
Section 322 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act), 42 U.S.C. 5165, as amended by the Disaster Mitigation Act of 2000 (DMA) (P.L. 106-390), provides for States, Tribes, and local governments to undertake a risk-based approach to reducing risks to natural hazards through mitigation planning.
FEMA is the lead agency supporting implementation of the DMA requirements and makes funds available to support efforts to meet these requirements. In 2002, FEMA issued regulations and guidelines to implement the DMA 2000 requirements for mitigation planning by states and communities. To be eligible for FEMA funds, state and local entities are required to prepare DMA 2000 Hazard Mitigation Plans for natural hazards. Both structural and non-structural measures may comprise such plans. The plans require vulnerability assessments and modeling tools are available to support this work.
FEMA has implemented the various hazard mitigation planning provisions through regulations at 44 CFR Part 201. These reflect the need for States, Tribal, and local governments to closely coordinate mitigation planning and implementation efforts, and describes the requirement for a State Mitigation Plan as a condition of pre- and post-disaster assistance, as well as the mitigation plan requirement for local and Tribal governments as a condition of receiving FEMA hazard mitigation assistance. The regulations governing the mitigation planning requirements for local mitigation plans are published under 44 CFR §201.6. Under 44 CFR §201.6, local governments must have a FEMA-approved Local Mitigation Plan in order to apply for and/or receive project grants under the following hazard mitigation assistance programs: Hazard Mitigation Grant Program (HMGP); Pre-Disaster Mitigation (PDM); Flood Mitigation Assistance (FMA); and, Severe Repetitive Loss (SRL).
More specifically, the 44 C.F.R. §201.6(c)(2)(ii) requirement for local mitigation plans indicates that:
"The risk assessment shall include a description of the jurisdiction's vulnerability to the hazards described in paragraph (c)(2)(i) of this section. This description shall include an overall summary of each hazard and its impact on the community. An overview of the community's vulnerability assessment is a summary of the hazard's impact to the community's vulnerable structures. This summary shall include, by type of hazard, a general description of the types of structures (e.g., buildings, infrastructure, and critical facilities) affected by the hazard. The overview shall also include a general description of the extent of the hazard's impact to the vulnerable structures. This information can be presented in terms of dollar value or percentages of damage. The Plan should note any data limitations and identify and include in the mitigation strategy actions for obtaining the data necessary to complete and improve future vulnerability assessments." [FEMA, July 2008; See, http://www.fema.gov/library/viewRecord.do?id=3336 ]
However, the mitigation planning regulation at 44 CFR Part 201 does not require a discussion about facilities that house special populations at risk, such as people who are elderly, people wih disabilities, children, or others with special needs. Additionally, a cursory review of some municipalities' mitigation plans and risk assessments reveals a general absence of demographic data and information regarding unique community and/or individual special needs circumstances. Furthermore, feedback from the field, indicates that those "who have been given the lead on ESF6 issues, County Emergency management and others are unable to identify populations (e.g., special needs) that would need very specific additional assistance."
To reiterate, NCD recommends that to improve the planning process today, the mitigation planning regulation at 44 CFR Part 201 should include language that requires that local and state risk assessments and mitigation plans will include specific information about all special needs populations within the relevant jurisdiction.
What change, if any, would you recommend for the Stafford Act to help the agency be more nimble and effective in its response to persons with special needs?
Mitigation efforts represent the single best strategy to reduce the impacts of disasters. However, research reveals that mitigation efforts appear to be minimal at best in communities across the nation, particularly with respect to persons with special needs. Efforts to redress this situation require the involvement of voluntary organizations to mitigate risk at the household level, as well as federal mandates to involve people with disabilities in mitigation planning, revision of guidance documents for use by the public and private sectors, and funding to provide disability-specific mitigation measures.
During a disaster, both human and material resources need to be mobilized quickly. The responses to hurricanes Katrina, Rita, Ike, and Gustav demonstrated that local organizations are well positioned to act quickly and often are the initial responders to a disaster. Staff and volunteers associated with local NGOs were involved immediately with response activities, such as evacuation and basic needs assistance, but they faced difficulties in meeting these constituent needs over the long term due to financing and poor coordination.
Currently, the Stafford Act allows a state to contract with companies for services such as debris removal prior to an event. Other than the American Red Cross for some shelter services, however, there is no provision to allow the government to contract with NGOs for services related to human recovery. Established contracts between the federal government and local NGOs are one possible mitigation mechanism for pre-positioning needed resources, services and supports. Having these contracts in place could encourage a more efficient, timely, and coordinated local response. Many of the NGOs belong to a national coalition of nonprofit organizations that respond to disasters as part of their overall mission (e.g., Baptist Family and Children's Services). In lieu of preparing individual organizational contracts, the federal government could consider contracting with the national or state NGO for nongovernmental support or with some of the umbrella nonprofit organizations.
Recovery from disasters is not simply the restoration of roads and buildings, but a long process of restoring individual and community functioning. Human recovery goes beyond infrastructure recovery to include restoring the social and daily routines and support networks that foster physical and mental health and promote well-being. NCD's recent research into the disaster recovery experiences of people with disabilities specifically reflects: problems with securing accessible temporary housing; failure of insurance to cover disability-specific needs and gaps in federal assistance; loss of access to health care; disruption to caregiver networks; and ineffective or nonexistent case management, all of which undermine the abilities of people with disabilities to recover in the short-term and long-term.
Furthermore, emergency managers and non-governmental organizations (NGOs) often work side by side in a disaster context to provide relief and recovery assistance. Yet these same key resources often remain distant from people with disabilities and disability organizations. Although we know that NGOs deliver services to support human recovery after disasters have ended there is no system of services or operating plan to support human recovery. Current federal and state guidance lacks a focus on human recovery, offers virtually no protocols on how to implement human recovery (particularly for those who have the fewest resources predisaster), and provides little support for long-term case management. Further, NGO roles have not been formalized or integrated into local and state planning and recovery efforts. In addition, there is limited guidance on how to implement human recovery plans. Despite ESF and NIMS provisions that articulate the need for health-related services to support human recovery (e.g., ESF-6 focuses on mass care and ESF-14 on long-term recovery), there is a lack of clarity in terms of how to operationalize this guidance, and there is no standard alignment of resources with these functions.
NCD's recommendation for change to the Stafford Act to help the agency (FEMA) be more nimble is to develop a mitigation-oriented and recovery-specific service system and operating plan to guide human recovery and integrate NGO roles and responsibilities into relevant federal policies and guidance such as the National Incident Management System (NIMS) and the Stafford Act as an important first step to formalizing NGO involvement. This would involve several steps. First, there is a need to establish clear federal guidance or templates outlining how NGOs should be involved in the plans for human recovery via ESF-6 and ESF-14 and supported by the Stafford Act. Second, there is a need to address the area of case management. One of the key roles and responsibilities NGOs provide is case management. Case management, as defined by the Stafford Act, is for "services, to victims of major disasters to identify and address unmet needs" (42 U.S.C. 5189d § 426, Case Management Services). Expanding the definition of case management to include direct services may help address short-term and long-term recovery needs by ensuring their consistent coverage. The Stafford Act could also include provisions for an NGO capacity assessment for human services, directions for state and local governments to integrate NGOs into planning and service delivery, and guidance for how to publicly fund the designated services.
How can mitigation be used to reduce risks to those persons with special needs?
Section 322 of the Disaster Mitigation Act of 2000 requires mitigation planning at the local level before receipt of Hazard Mitigation Grant Program (HMGP) funds. To assist locals with mitigation planning, FEMA has introduced a series of mitigation planning guides over the past few years (FEMA 2002). In FEMA 386-1 Getting Started: Building Support for Mitigation Planning, FEMA outlined three steps to launch the mitigation planning process. Step 1 recommends that local planners assess community support to see if the community is ready to initiate mitigation planning. Step 2 creates the planning team and obtains official support and recognition for the effort. In Step 3, the public is engaged and a public education campaign is created. Throughout the mitigation planning series, FEMA recommends that the team, outreach efforts, and educational campaigns be inclusive.
There are several possible points of intervention in the FEMA mitigation planning series that would heighten involvement of people with disabilities. Doing so would raise issues of concern, increase awareness, and build useful partnerships. Currently, the mitigation planning guides do not offer specific ideas for including or reaching out to people with disabilities. For example—
- Task B of Step 1 determines whether the community is ready to begin the planning process. That effort taps into how much citizens know about hazards in their community. Surveys and other tools could be used to assess the knowledge of specific groups, including people with disabilities, workplaces that employ people with disabilities, and organizations that provide support to this population. This task also identifies available resources that can be tapped, particularly employers and organizations.
- Task C of Step 1 addresses barriers to knowledge, support, and resources, including interest levels and funding. By surveying community members and those who link to people with disabilities, it is possible to identify barriers to mitigation planning within the disability community.
- The final part of Step 1 encourages the identification of a mitigation "champion." This person could be recruited from within the disability community, providing a conduit and an advocate for information, insights, and communication both to and from people with disabilities.
- In Step 2, a planning team is assembled. Stakeholders are generally identified (pages 2-4 to 2-5), but the disability community is not specifically mentioned here. A checklist (Worksheet #1) does not include any representatives from disability agencies or organizations.
- In Step 3, the public is engaged and a community education effort is launched. Step 3 is thus the next most important dimension of mitigation planning that must be influenced. Broad-based engagement that is open and accessible to all must be made possible. This section should require that locations for meetings be accessible and offer, for example, sign language interpretation and Braille materials. The guide recommends the use of instruments to gather information, such as questionnaires, but does not acknowledge a need for alternative formats. The public education campaign relies on news media, written materials, outreach activities, and the Internet. This section of the plan does not include suggestions about making outreach materials accessible. A simple checklist could be inserted to assist planners.
- In Step 2, mission and vision statements are developed. This effort provides an opportunity to introduce a broadly inclusive consideration of all affected, including low-income, senior, and disability sectors of the community.
Additional guides elaborate on other elements of the mitigation planning effort, such as loss estimation, historical preservation, implementation, and assessment. Two strategies might be considered in future revisions of these documents: (1) integration of the suggestions listed above, and (2) creation of a stand-alone guide that provides specific means for including and reaching out to vulnerable populations, for example, people with disabilities.