Getting Ready: The Role of AT Providers in Emergency Management Amy S. Goldman Institute on Disabilities at Temple University Consultant, Pass It On Center Pass It On Center - AT Reuse Strand1

Learner Objectives Identify two challenges presented to AT users by emergencies and disasters List three opportunities for providers to “have the conversation” about getting ready Describe two key points of information that should be known by/provided to AT users regarding emergency preparedness

Background Thousands of people are affected by emergencies and disasters each year – fires, floods, tornados, hurricanes, natural as well as man-made People with disabilities are disproportionately affected. Katrina and Rita triggered a new focus on the need to make improvements in emergency management for people with disabilities. People affected by Katrina and Rita are still “recovering”

“If you don’t think you’ll be able to evacuate, find out ahead of time where you can go for shelter. Do try to evacuate; staying in a shelter should be a last alternative. The Red Cross and other service organizations continue to operate with an ill defined “special needs” approach to sheltering. Be specific about what needs you have and press for details about what shelters can and will meet them. Be aware that if you need personal assistance and are without your own PCA, you may be at risk of nursing home placement. Also, if you’re a ventilator user and know you’ll need emergency power, explain this carefully and make sure planners truly understand your needs. It’s also risky because local shelters may be poor alternatives; if you live in a coastal community and a level five hurricane strikes, local shelters, if available at all, are likely to be far less safe than evacuating.” -from Prepare for the Worst: How CILs Can Assist Individuals in Disaster Preparation (2005)

Priorities Survival Shelter Health Function

What You Should Know Shelters may or may not be accessible (entry, bathrooms, cots, etc.) People may get separated from their AT People may lose one or more components of their AT People may acquire disability for which AT can help People may lose their “human” assistance, and need AT to function People may be without power for many days AT provided in one location may not be allowed to transition with the individual to another location

“Social service agencies must understand that they have a significant role in emergency preparedness, response, and recovery. They provide a support network for people with disabilities that emergency management cannot replace. In planning, FEMA, other federal agencies, and state and local emergency planners must help to set the expectations for the performance of social services agencies, and the social services agencies themselves must educate their clients about agency roles in a disaster.” (National Emergency Training Center Emergency Management Institute 1993).

National Council on Disabilities Report (8/12/09) Convene a Disabilities and Disasters White House Summit Appoint permanent West Wing disability staff position, including disasters View the exclusion of disability issues in emergency management as a civil rights issue Ensure availability of accessible, affordable health care after a disaster including funds for health care support

National Council on Disabilities Report (8/12/09) Expand disaster recovery funding to cover disability issues, including … loss of durable medical equipment and assistive devices Accept personal responsibility for preparedness in a disaster context, involving caregivers as needed Create (personal) contingency plans - GET READY!

National Leadership Summit on Emergency Management and AT Reuse MITIGATION PREPARATION RESPONSE RECOVERY Washington, DC | Feb. 23 – 24, 2010 Bringing together leaders in emergency management, disability, assistive technology, and AT reuse Successful Strategies, Innovative Partnerships, Futures Planning

National Leadership Summit on Emergency Management and AT Reuse Recommendations Increase participation of people with disabilities who are AT users in development and implementation of emergency planning and preparation efforts. Increase efforts to educate people with disabilities regarding the need for, and steps to, individual preparedness, especially as it pertains to AT (back up chargers, labeling components, records). “Have the conversation” at the point of AT device assignment/delivery. (Train providers).

The Conversation: Why Acknowledges the importance of AT to an individual’s independence, security, health and well-being – all of which are at risk in an emergency/disaster AT service providers may be the only connection to a service system who can bring the preparedness message to the person and his/her family Devices and services

Are you ready?? Are you and your family ready? (understand and model preparedness) What if there’s an emergency or disaster at work? At home? Does your business have a plan for Continuity of Operations ( search for 1/18/2011 webinar)

The Conversation: Who Individuals with disabilities Their families Agencies providing service/supports coordination Direct support professionals Sample planning guide inclusivepreparedness.org

The Conversation: Who OT, PT, Speech-language pathologists Educators IL staff ATPs Vendors Sales reps Others?

The Conversation: When As part of assessment process As part of the Rx process Upon delivery of a new device Upon repair of a device As part of transition planning

What Have a comprehensive listing of all AT used at home, at school, or at work Maintain current records of the products and related peripherals: manufacturer /vendor contact information; make; model; serial number; payment source Keep current evaluation reports, prescriptions, and product information in a place with other key health-related information

What REGISTER the products LABEL items LABEL all peripherals

What Who can assist in an evacuation? Registry? Written emergency plan “Go” bag Medical and AT records Alternate power sources Low tech back up

Back Up Systems for AAC Users (and AAC for Responders) Emergency Communication 4All down- loadable communication boards EMERGENCY.shtml EMERGENCY.shtml Coming August 2011! $2.99 “app” from CreateAbility Concepts, Inc., based on Emergency Communication 4ALL

Part of our professional responsibilities: SLPs Audiologists and SLPs have emerging roles in emergency preparedness. They may be responsible for educating the first-response teams or emergency-care providers and for assisting with the development of emergency or disaster preparedness plans. Audiologists can educate first- responders and providers about communicating with individuals who are deaf or hard of hearing and about the likelihood of ear trauma, temporary or permanent hearing loss, and tinnitus among victims on the scene of blast-related incidents. SLPs can educate first-responders and health care providers about the communication needs of persons who rely on augmentative and alternative communication systems and individuals with intellectual disabilities, dementia, traumatic brain injury, and speech and language impairments. Nunez, Beamer, Deussing,Paul & Aulbach,

Part of our professional responsibilities: OTs OTs can assist individuals and communities in coping with disaster situations and in returning to optimal occupational performance (Rosenfeld, 1982; 1989) In disaster situations the focus of OT is to facilitate engagement in occupation in order to support participation in adaptive disaster recovery and resumption of valued life roles and activities (AOTA, 2002) Working together with the client, OTs can plan and implement interventions that enable people to reestablish balance in daily life in activities of daily living, work, leisure, and social participation OTs need to be knowledgeable about how national, state, and local governments and private agencies involved in disaster management are organized, and how to gain entry into these systems Knowledge of available resources and understanding of local plans for responding is critical if the therapist is to facilitate rapid humanitarian responses. AOTA, Disaster Preparedness Concept Paper (2005)

AT REUSE PROGRAMS MAY BE ABLE TO PROVIDE DEVICES Know how to find these programs and how to make your client’s needs known Advocate for the provision of reused equipment as a stop-gap measure, until the individual can get the new equipment they need. Return reused equipment to the inventories of the reuse program when no longer needed. Your services may be needed to make sure people get the “right” equipment (and can use it safely and appropriately!)

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Offering Services – Emergency Response What does your state say about out-of-state licensees? Is there a Good Samaritan law that will protect you if you volunteer your services? Is there a state registry of volunteers (e.g. that can facilitate credentialing?)

So: What will YOU do to get ready?? …….

DISCLAIMER This work is supported under five-year cooperative agreement #H235V awarded by the U.S. Department of Education, Office of Special Education and Rehabilitative Services, and is administered by the Pass It On Center of the Georgia Department of Labor – Tools for Life. However, the contents of this publication do not necessarily represent the policy or opinions of the Department of Education, or the Georgia Department of Labor, and the reader should not assume endorsements of this document by the Federal government or the Georgia Department of Labor Pass It On Center - AT Reuse Strand28