Hell on Wheels

By Joseph Straw


Partners. Given the limitations of reaching special-needs individuals through voluntary registration, it is critical to work with organizational stakeholders to maximize outreach to the special-needs population in a jurisdiction. Emergency response managers can do this by reaching out to their partner government agencies that serve those populations, from social services to health and mental health agencies. Emergency managers must also reach out to leaders in various private organizations and industries that serve and represent special-needs communities, explains Georgianna Armstrong, emergency management coordinator for Kern County, California, whose efforts Devylder points to as a national model. Included in the latter category are groups such as hospitals, nursing homes, home healthcare providers, charitable organizations, and advocacy groups.
What. After identifying who in a jurisdiction qualifies as a special-needs person or organization, the next step is to work with those stakeholders to determine their needs.
Crisis management authorities can use planning to forge relationships across agencies and among public and private sector participants. Similarly, security professionals and other first responders involved in evacuation planning at a facility or for a locality should use the planning process to forge relationships with special needs populations and assess needs.
Kern County has used this approach. For example, during development of a dam-failure evacuation plan, officials established a primary committee to oversee the process. Leadership established three subcommittees representing different segments of the special needs population: the medically fragile or mobility challenged, the cognitive or sensory challenged, and the “resource challenged,” generally referring to residents without access to cars. Each subcommittee includes not just advocates but also members of the populations they target. Representatives with special needs were sought out and invited to participate by relevant social service agencies and organizations.
The result was eye opening, says Armstrong, who like her peers had feared friction and poor communication. Those fears proved unfounded. Government planners were thrilled to have the special needs community’s input, while the community didn’t know that emergency managers wanted it. “They were glad someone asked,” she says.
The subcommittees and their members served primarily to voice concerns and highlight needs to members of the primary committee, which drafted the plan that was recently approved by the county’s board of supervisors. Throughout 2011 and 2012, the county will exercise and test this plan, and the subcommittees will be called on to recruit members of the accessibility and functional needs communities to participate in the drills.
The exercises, Armstrong says, are critical to highlight any lingering gaps in plans and services. “We can’t guess what their needs are,” she says.
The collaboration must carry on throughout the emergency management process, up to and including event response, Devylder says. He recommends that every emergency operations center (EOC) include an advocate for special needs populations. That person should either have a background in advocacy or be a member of the special needs community “with the expertise and responsibility to ask hard questions,” he says.
Where and how. It’s all well and good to get a list of the special needs population and to know what their requirements are, but exactly how will those needs be accommodated? With regard to the evacuation itself, many jurisdictions have a two-pronged approach: they make fairly concrete plans to assist in evacuations of institutions like hospitals and assisted-living facilities but must rely on partner organizations in the community to target special needs populations living independently in the community.
Then there are the additional needs that will arise once those persons have been evacuated to shelters or temporary accommodations. What it takes to meet that goal has shifted over time. In the late 1990s, for example, authorities who selected sheltering accommodations typically planned to have an appropriate fraction of shelter space designated and specially equipped to handle the needs of the elderly and disabled. And whenever possible, they favored use of shelter spaces that were built after 1992—the first year the requirements of the Americans with Disabilities Act (ADA) were imposed on newly constructed public spaces. Individual shelters were designated and prepared to serve populations with specific needs, like hospital patients, the physically disabled, and the elderly.
But requirements for meeting the needs of various populations have greatly expanded. As one emergency manager notes, there has been a “pretty significant shift in what ADA compliance is over the past eight years.”
The trend began with the launch of the U.S. Department of Justice’s (DOJ’s) Project Civic Access about a decade ago, explains attorney David Bohannon of the University of Maryland’s Center for Health and Human Security. Under that initiative, the DOJ selects specific cases among formal complaints of ADA violations submitted by county and municipal governments. It investigates those and seeks resolution through a public settlement that yields corrective measures without litigation.
Since 2000, the DOJ has arrived at more than 180 program settlements around the country. The DOJ also brings lawsuits where that is the only way to resolve a case. Among the localities with cases pending are Broward County, Florida, and Montgomery County, Maryland. Bohannon says that emergency managers may not realize that the DOJ will prosecute for noncompliance.
And the legal pressures are increasing. With the national focus on emergency management that followed 9-11 and Katrina, the disability advocacy community has pressed hard for accessible programs. Responding to those demands, FEMA has raised the bar for accessibility by issuing the Guidance on Planning for Integration of Functional Support Services in General Population Shelters (FNSS guidance) late in 2010. In that document, the agency recommends that all emergency shelters go well beyond basic ADA compliance. They should be capable of catering not only to evacuees’ medical and special needs but also to their religious needs and other preferences.
Among the guidance’s recommendations: development of agreements for vendors to supply equipment like oxygen generators, hearing aids, telecommunications devices for the deaf, such as TTY/TDD phones, software for computer-aided real-time translation, and synthesizers for computer-based text-to-speech services. FEMA further recommends accommodations in shelters such as communications materials printed in Braille, a “quiet area” for the elderly and persons with autism, mental health services, and food to accommodate personal dietary restrictions, such as vegetarian and kosher meals.
Kiefer notes that the regulations do not forbid “niche” shelters, such as those focused on caring for the elderly or new mothers, but they imply that all shelters should be able to accommodate any special needs population.
The document has raised serious concerns among emergency managers who are committed to accessibility but who worry how they can address those requirements and still protect as many people as possible, given their limited resources.
“It’s pretty concerning,” comments Mike Womack, director of the Mississippi Emergency Management Agency. “I think it could force a change, really impacting the number of local governments and the number of nonprofit organizations that are willing to do sheltering,” Womack states.
Womack says he hopes the DOJ will provide states with a better sense of what constitutes a “good faith effort to comply with the FNSS guidance.”
Bohannon, who attended a briefing on the document hosted by FEMA and the DOJ, says that both agencies portrayed the guidance “as being an aspirational document, meaning that this is what you should aim for.”
The problem, he said, echoing Womack’s concerns, is that budgets are tight, so emergency managers need to know “where is the safe harbor or [what are] the minimum requirements.” They do not need to know “what the top of the mountain is,” Bohannon says.
The critical legal standard in ADA cases is “reasonable accommodation,” Bohannon says. “A DOJ prosecutor would see the role of FNSS as helping establish what is a reasonable standard within the profession of emergency management.” Different emergency managers may define that standard differently, but from a legal standpoint, Bohannon explains, “a DOJ prosecutor may say, ‘we think it’s reasonable because FEMA says so.’”
How emergency managers will handle those demands remains to be seen.




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