According to the U.S. Bureau of Census, almost 1 in 5 adults - more than 50 million people - in the United States have a disability. In the 25 years since the American with Disabilities Act became law, emergency response has come a long way in assisting people who have disabilities, yet experience shows that individuals with access and functional needs are still the least able to take advantage of community resources and activities to prepare and respond to disasters.
Not every person with a disability will need assistance in a disaster and some individuals who live independently may have short-term or situation-based access and functional needs. Identifying these individuals can be challenging because people with disabilities may not self-identify and people who may live and function independently day-to-day could need additional assistance in disaster if their assistive technology or equipment is lost or damaged. Anticipating and planning for these needs is vital to protecting health and could prevent the need for legal action by individuals or community organizations.
ASPR recommends a planning approach called the CMIST Framework. The five integrated CMIST categories (Communication; Maintaining health; Independence; Services and support; and Transportation) provide a flexible, cross-cutting approach for addressing access and functional needs. Using the framework can help public health officials and emergency managers address a broad set of access and functional needs irrespective of specific diagnosis, status, or label.
Whether or not you use the CMIST Framework, consider this: the most reliable way to plan for access and functional needs is to ask. Even if you think you know, asking people with disabilities what type of assistance they may need can be eye-opening and reveal crucial gaps in community preparedness. Form an advisory panel of residents who have access and functional needs that are representative of your community, and ask them how your agency can assist them in a disaster. In emergency drills, involve people who actually have access and functional needs, not actors, to truly test your plan.
Consider these points as you engage people with access or functional needs on advisory groups and in drills:
Emergency planners know that shelters need to be accessible and shelter assessments must take access and functional needs into account. However, from the perspective of people with disabilities, how accessible are your emergency shelters, really, and can people with disabilities even reach these shelters?
What kind of accessible transportation should you reserve so that people with mobility limitations can evacuate if they need to? How much accessible transportation may be needed and exactly where in your community is it needed?
People with electrically powered durable medical equipment including oxygen concentrators and portable ventilators may need to evacuate quickly in prolonged power outages no matter what caused the outage. In a power outage how many people may need help getting out of their homes, especially from multi-story buildings? Do you know where these individual live in your community? Can you muster the staffing needed to canvass neighborhoods, knocking on doors to find people who may need evacuation assistance? How ready is your staff members and volunteers to guide or carry residents down multiple flights of stairs (think high-rise apartment building) if elevators aren’t running?
The new HHS emPOWER Map can help you determine how many people in your area rely on electrically powered durable medical equipment. This information also can help public health agencies work with emergency managers and local utility companies to anticipate specific power needs in shelters and in prioritizing power restoration.
Assistive equipment, like wheelchairs, walkers, canes, and hearing aids, can be lost or destroyed in disasters, leaving people in need of assistance who usually function independently. What kind of assistive equipment is prevalent in your community? Is your staff trained to evacuate residents with their assistive devices or equipment? If assistive devices do become damaged or separated from individuals with access and functional needs, are your staff and volunteers trained to identify and address these needs, especially in shelters? Are there community organizations that could partner with your agency to provide this training?
People with access and functional needs may use support services to assist with activities of daily living at home and, after a disaster, these service providers may be unavailable. People who use these services may be the most difficult population to uncover in your community. Reach out to these service providers to ask about the types of services their clients will need in a disaster and what the organizations would need from your agency to keep services in place. Ask, too, about their emergency plans and how to involve these organizations in your community emergency plans.
Communicating clearly during emergencies is vital to protecting health and saving lives; this includes communicating often about the status of transportation and the locations of shelters. Use multiple modes of communication and provide multiple types of messaging to ensure that everyone receives the information. What do residents say about how accessible your community’s emergency information is? What can you do to make it more accessible?
At first, it may seem too personal to ask about an individual’s access or functional needs, especially when engaging the disability community for the first time. Being successful requires practice, openness and a willingness to find and fix gaps. Remember, people with disabilities are the most knowledgeable about their own needs.
Has your organization engaged people with access and functional needs in community planning and drills? If so, share what your learned by commenting on this blog. Have a role model plan to share? Submit it to TRACIE, ASPR’s Technical Resources Assistance Center and Information Exchange.
