Using FNSS Guidance and Establishing Accessible General Population Shelters Iowa Partners in Preparedness Conference Ju

1. Using FNSS Guidance and Establishing Accessible General Population Shelters Iowa Partners in Preparedness ConferenceJune 22-23, 2011 Karin Ford, MSPS Iowa Department of Public Health Photo courtesy of FEMA/Patsy Lynch Kam Kennedy American Red Cross FEMA Region VII

2. Overview • Provide an overview of Functional Needs Support Services (FNSS) in general population shelters • Discuss Red Cross FNSS Guidance to Chapters • Provide examples of integration from recent responses and a response model for consideration • Discuss Iowa’s work with FNSS in general population shelters • How to make temporary changes for accessibility

3. Defining FNSS • Services that enable children and adults to maintain their usual level of independence in general population shelters. These 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

4. Red Cross Vision for Accommodation • Safely accommodate individuals with disabilities and those with functional needs in our congregate shelters by working with partners and increasing and sustaining capacity within the Red Cross • Provide appropriate referrals to partners when reasonable accommodation is not possible

5. Red Cross – Vision for Accommodation • Exceptions: • Individuals who need: • Continuous medical supervision • Acute, life-sustaining medical care • Individuals who are a danger to themselves or others

6. Americans with Disabilities Act (ADA) Under the ADA, the Red Cross must: • Make reasonable modifications to its policies, practices and procedures when necessary to deliver shelter services to clients with disabilities • Provide auxiliary aids and services to ensure effective communication • Welcome people with service animals • Ensure that shelter facilities are physically accessible for people who use wheelchairs or other mobility devices

7. Recommendations • Shelter Inventory • Community Planning • Response

8. Shelter Inventory • 56,000 + shelter inventory • Agreements updated annually • Facilities physically surveyed every three years

9. Integrated Community Planning • Work with all stakeholders to: • Review current plans • Conduct community gap analysis • Identify resources • Establish relationships with resource providers

10. Response • Ensure Health Services (HS)/Disaster Mental Health (DMH) staff are present in shelters • Identify and address individual client needs • Use Initial Intake and Assessment Tool during registration • Consult with HS/DMH to address needs • HS and DMH will work directly with client to determine resources and next steps • New “scope of practice” model replacing nursing protocols

11. FNSS in Joplin

12. FAST Concept • Functional Assessment Support Teams • Model from California • Provides for deployment of local teams to conduct assessments within shelters and bring state resources to bear • Under consideration in Missouri

13. FNSS in Iowa • Karin Ford, MSPS IDPH • Working with Polk and Story counties to establish accessible shelters • Developing coalitions with faith based groups • Include providers in shelter management and case management

14. Emergency Management and Title II of the ADA • Requires that programs, services, and activities directly provided by state and local governments, and third parties must be accessible to people with disabilities • The ADA also requires making reasonable accommodations to policies, practices, and procedures when necessary to avoid discrimination against people with disabilities

15. Accessible General Population Shelter • Temporary features • Must meet ADA standards • Must be safe • Meet minimum accommodation

16. Four Main Areas Parking Entrance Common areas Bathroom/shower

17. Accessible Parking • ADA and Iowa Code • first spot must be van accessible • parking space 96 inches • van access 96 inches on right side • car access 60 inches • permanent upright signage • signage alerts to wider access aisle

18. Number of Accessible Spaces • 1 to 25 – 1 • 26 to 50 -2 • 51 to 75 -3 • 76 to 100 -4 • 101 to 150 -5 • 151 to 200 -6 • 201 to 300 -7 • 301 to 400 -8 • 401 to 500 -9 • 501 to 1000 • 2 percent of total • 1001 and over • 20 plus 1 for each 100 over 1000

19. Temporary Parking • Can use temporary signage • Three stalls = two accessible stalls with access aisle in middle • First space must be van accessible • Close to entrance • Flat surface • Remember 96 inches wide • Access aisles 60 or 96 inches

20. Temporary Parking

21. Orange Cone for the access aisle • place orange cone at the end • easily moved • blocks parking • temporary • curb cuts

22. Temporary Upright Signage • Print and laminate • Post on temporary stand • Post high enough

23. Ramps • Can be temporary • Must meet ADA specifications • Handrails • No ski slopes

24. Entrance • Exterior doors follow locality fire code • Automatic openers are not required

25. Entrance of the Shelter • Must be accessible • Sidewalk 36 inches wide • Can use temporary ramp • Signage to accessible entrance

26. Common Areas • Sleeping areas • Eating areas • All goods and services on one level unless working elevator • Alternate formats – signage, warning systems • Quiet room • Medicots • Transfer boards

27. Adequate space • 40 square feet • pwd need 80 square feet • medicots, higher wider • placed against a wall • stability • near exit

28. Bathroom/shower • Both accessible • Toilet 17-19 inches from finished floor • Raised toilet seat • 5 foot radius and grab bars for transfer • Temporary grab bars • Must hold up to 250 lbs • Roll in showers with transfer benches • Handheld or adjustable shower features

29. Bathroom

30. Bathroom/Sink • Paper towels and soap can be on the counter • Hang lower dispensers or mirror

31. Service Animals • Perform a task to mitigate the effects of a disability • Miniature horses but subject to certain limitations • Is not a pet • Do not touch or give the animal food or treats without the permission of the owner • Wearing its harness, it is on duty • If you are asked to take the dog, hold the leash not the harness • Service animals travel with their human partner • Do not need to be registered or show proof • Can only remove if the service animal posses a threat or is not housebroke

32. Importance of Pre-Planning • Care facilities, group homes • Are already identified • Have Continuity of Operations Plans • Can become an asset to the response

33. Medical Shelters • Must be staffed with doctors, nurses and trained staff • Best case scenario, pre-established transfer locations and locations of the same level of care are secured before a disaster • Need medical shelters to not overwhelm the hospitals

34. How am I going to remember all this? • ADA homepage has toolkits and checklists – http://www.ada.gov/shleterck.htm • FNSS Guidance • Department of Justice technical assistance - (800) 514-0301 (voice) • Call me 515-242-6336

35. Questions? Contact Information: Karin Ford, MSPS IDPH 321 E 12th Street Des Moines, Iowa 50319-0075 515-242-6336 Karin.Ford@idph.iowa.gov Kam Kennedy American Red Cross Special Representative to FEMA R-VII 9221 Ward Parkway Kansas City, Missouri (o) 816-283-7520 (bb) 816-808-3024 Kam.kennedy@fema.gov