Prospects for AT Reuse in Disasters

1. Prospects for AT Reuse in Disasters NATTAP Southeastern Regional Conference November 20, 2008 Elliot Harkavy EGH & Associates

2. Introduction to Emergency Management

3. Emergency Management System Begins Locally City/County Resources: • Fire/ emergency medical services (EMS) • Police • Local departments of health & human services • Hospitals and other health care providers • Office of Emergency Management (OEM) • American Red Cross • VOAD (Voluntary Organizations Active in Disaster)

4. Emergency Management • State • State Police • National Guard • Department of Health • Department of Human Services • Emergency Management Agency (EMA) • Federal • Dept. of Homeland Security • Dept. of Health & Human Services • Dept. of Justice (FBI) • EPA, Dept. of Treasury (ATF), USDA

5. The Silos of Federal, State & Local “Preparedness” Fire/ Emergency Medical Services Homeland Security/ Emergency Mgmt. Public Health Food/ Agriculture Law Enforcement Human Services

6. Local Incident Management Incident Command System (ICS) • Model for first responders (EMS, fire, police) for command, control, and response coordination • Coordinates agencies working toward shared goal: stabilize the incident, and protect life, property & environment

7. Local Incidents – Scale and Complexity • All emergencies start locally • As scale/complexity increase, state and federal support may be needed • Larger incidents require increased coordination and information flow across agencies • Managing complex incidents requires… • Data to assess the evolving situation • Tools to analyze and interpret the data • Interoperability to share information/decisions across diverse agencies and IT systems • Resources: what, where, and how to supply

8. Managing Large Scale Emergencies • Homeland Security Presidential Directive-5 (HSPD-5) directs Homeland Security Secretary to develop and administer: • National Incident Management System (NIMS) • National Response Framework (NRF) To ensure effective management of large-scale emergencies

9. NIMS Overview • A consistent, nationwide approach for incident management • Requires Federal, State, tribal, and local governments to work together before, during, and after incidents • Involves preparing for, preventing, responding to, and recovering from domestic incidents • All causes, sizes, and complexities of incidents

10. NIMS Compliance • All Federal departments and agencies were required to adopt NIMS by Sep 30, 2005 • State and local organizations must have adopted NIMS to receive Federal preparedness grants and contracts by 2005 • DHS publishes standards, guidelines, and compliance protocols as needed • NIMS Integration Center (DHS/FEMA) • All responders to a Federally declared disaster must be trained in NIMS/ICS and be operating within ICS

11. National Response Framework (NRF) • Provides framework for: • Federal interaction with State, local, and tribal governments; the private sector; and NGOs • For domestic incident prevention, preparedness, mitigation, response, and recovery activities. • Describes capabilities and resources and establishes responsibilities, operational processes, and protocols. • Signed by all cabinet agency secretaries

12. Structure of NRF • Base Plan • General structures and overviews • Emergency Support Function (ESF) Annexes • Guidance to the 15 ESFs defined by the plan • Incident Annexes • Guidance for specific incident types • Support Annexes • Additional information to guide emergency management • Appendices: Key definitions and guidelines

13. NRF Elements Most Relevant to AT Reuse • ESF #6 – Mass Care, Housing and Human Services • ESF #8 – Public Health and Medical Services • ESF #14 – Long Term Community Recovery • Key Annexes: • Volunteer and Donations Management • Catastrophic Incident

14. Emergency / Disaster Cycle

15. Basic Definitions: Declarations What are Declarations? • Public announcements • Legal determinations • Made by an authorized government official • Triggering special emergency powers • Allowing expenditure of emergency funds

16. Emergency and Disaster Declarations Many types of declarations: • Level of government: local, state, federal • Geographic area: part of a city, entire city, county, region, or a state • Type of event: • Any threat to life, health, safety, property • Specific threat: public health, drought, fire, insurrection

17. Governor’s Declaration of State of Emergency • Activates emergency plans and authorize deployment and use of personnel • Allows suspending certain regulatory statutes • Trigger special powers • To control persons and property • To mobilize state assets • To seek mutual aid from other states • A requirement for a Federal Declaration of Emergency or Major Disaster

18. Federal Declarations • Stafford Act is the principal discretionary federal authority to assist state and local governments in responding to catastrophic events of any type • Stafford Act activated by declaration of either • A “major disaster” or • An “emergency” • The Stafford Act provides for federal authorities and funds

19. Both “Major Disaster” and “Emergency” declarations authorize the same emergency measures Emergency Powers – President may: direct any Federal agency, with or without reimbursement, to utilize its authorities and the resources granted to it under Federal law . . . in support of state and local emergency assistance efforts to save lives, protect property and public health and safety, and lessen or avert the threat of a catastrophe. “Emergency” Powers

20. Federal Funding for Emergencies are Limited to • “Provide assistance to affected state and local governments for”: • Issuance of warnings of risks or hazards • Public health and safety information, including dissemination of such information • Provision of health and safety measures, and • Management, control, and reduction of immediate threats to public health and safety • Individual Assistance • Payments to individuals for temporary housing, necessary expenses, immediate needs caused by emergency

21. “Major Disaster” Provides The following functions are provided only with a “Major disaster” declaration, and not under “Emergencies”: • Public assistance • Funding of at least 75% of cost of repair, reconstruction, replacement of public facilities damaged by a declared event • Crisis Counseling • Disaster Unemployment • Legal Services • Relocation Assistance • Food Stamps • Human Services Case Management • Replacement of DME

22. Emergency Management & PWD

23. Disasters in the United States • We all hear about the 100 or so major disasters each year • In these events thousands of people are displaced and damage is over $1 Million, often much, much more • Perhaps you may hear about the 1000 or so Emergencies • In these events dozens, perhaps even hundreds of people are displaced and damage may be significant to those people • Every year, American Red Cross responds to over 65,000 disasters • Vast majority are single family home fires • To the impacted families, this event may be catastrophic

24. Disasters’ Impact on People with Disabilities (PWD) • 2000 Census reports that nearly 30% of US Households have a member with a disability • No evidence that PWD more/less likely to be involved in a disaster • But when PWD are impacted, their needs may be greater • May need to replace DME or AT • Can be separated from caregivers • Schedules and treatments/therapies interrupted

25. Emergency Managers & PWD • Prior to Hurricane Katrina: • Many responders and emergency managers couldn’t spell disability • Since 2005, much has changed: • Federal • DHS has an Office of Special Needs & Interagency Collaboration Council • FEMA has a specific Disabilities Coordinator • FEMA’s Deputy Administrator for Grants comes from the Disability Community • DOJ ruled that shelters must be accessible • State/Local • PWD now on RADAR • Unfortunately, much focus on Registries & Medical Needs Shelter • “Doesn’t the Registry take care of all the needs?”

26. Lessons Learned from Hurricane Katrina • Two of the primary reasons that people did not evacuate in the path of Katrina: • Was PWD – with no means to evacuate • Had a PWD in family or HH with no means to evacuate • Combined to account for over 1/3 of those who didn’t evacuate • Many who evacuated lost most/all DME & AT • Very difficult to replace when all commerce is out • Few responders knew about DME, even fewer AT • Most shelters not equipped to handle PWD • Many inaccessible • Little/no DME or AT • Help must be coordinated through NIMS • Unsolicited donations & unaffiliated responders cause problems

27. Since Hurricane Katrina • FEMA has: • Included accessible busses and ambulances in evacuation plans • Developed a go-kit of accessibility tools for shelters • Promoted the need for Medical Needs Sheltering • Red Cross has: • Trained volunteers to be better at serving PWD • Included accessibility in shelter surveys • My chapter in the DC area has partnered with NOD to: • Survey all shelters in the region, including accessibility • Purchase a cache of accessibility tools • Approximately 10% of a DHS UASI grant for preparedness

28. There is a Need for AT Reuse • FEMA has worked with HHS to replace DME lost/damaged in Disaster.. But… • May be limited to only the largest disasters • Presidentially declared “Major Disasters” with IA • It takes time after the disaster to set up • It requires a supply of new equipment to be available • May not cover all DME • Not clear if it covers any/all AT • Since DME and AT are not on most emergency management RADAR, it is unclear if/how DME/AT would be replaced if not covered under by FEMA/HHS

29. Proving the Concept • Not aware of any active program for AT Disaster Reuse • Kansas AT Project looking into this • First step to a widespread AT Disaster Reuse program is a limited pilot program to prove concept • Show emergency managers that this can work • Learn how to make it work with limited risk/scope • Plan for 6-12 months • Start by building relationships with key response groups: • Emergency Management • American Red Cross • Local Health/Human Services Agencies • VOAD (Voluntary Organizations Active in Disaster) • Work with them to gain interest, then develop, Pilot Plan • If successful in initial pilot, build rollout on success • If not as successful, learn lessons and try again until successful

30. Questions to Address with Pilot • Logistics – For Disaster - How to: • Collect the items for reuse • Sort, clean, refurbish and catalog re-use items • Web-based catalog for easy access during emergency across affected areas • How to distribute reuse items • Getting it to where it needs to go without interfering with other responders • Support items distributed • Regulatory issues – What to be concerned about? • Lessons Learned • Potential models for success • What is needed to meet AT needs of impacted PWD • Messaging – How do we reach the partners and clients to let them know we’re here and can help • What training is required for response/recovery partners • to raise awareness • to facilitate optimal utilization

31. Sources for Pilot Funding • Homeland Security Funding- UASI/SHSGP • Need to build support with Government Partners • Start with training/education what is AT • HHS Funding – Need to explore if appropriate • NIDRR: • This is perhaps one of the best sources of $.  • NIDRR has a current focus on accessibility and emergency issues   • They have a discretionary funding pot - formal application on web site.  • Posted notice for RERC last year on emergency issues that wasn’t funded, • Have had several DRRP grants, so they are open to the issues.  • RSA • EPA – Position this as a pilot e-waste reuse program • Private foundations focused on PWD and/or Green

32. Questions? Elliot HarkavyEGH & Associateseharkavy@eghassociates.comwww.eghassociates.comw - 301-652-4511f - 202-318-0514