Impact Feature Issue on Disaster Preparedness and People with Disabilities

Hurricanes Katrina and Rita left more than 1,300 dead in their wake, caused more than $80 billion in damage over 90,000 square miles, and forced mass evacuations from five states along the Gulf Coast. An estimated 600,000 households were displaced from affected areas and 50,000-100,000 remained in temporary housing six months later. As a result, 44 states and the District of Columbia received millions of evacuees, providing them with care and shelter over an extended period. These events tested the nation’s ability to respond to catastrophic events and demonstrated the importance of ensuring the effectiveness of federal, state, and local plans and the ability to quickly synchronize intergovernmental efforts.

Lauching a Nationwide Review

Following Hurricane Katrina, the National Organization on Disability (N.O.D.) Emergency Preparedness Initiative (EPI) deployed four Special Needs Assessment 4 Katrina Evacuees (SNAKE) teams into the Gulf region to evaluate conditions for people with disabilities in mass care settings (Review the Special Needs Assessment 4 Katrina Evacuee (SNAKE) Report and findings)​. Our teams witnessed first-hand the human crisis unfolding for all persons impacted by the storm, and reported real-time information specifically related to people with disabilities to Department of Homeland Security (DHS) and Federal Emergency Management Agency (FEMA) officials. The SNAKE teams returned to Washington, D.C. on September 14, 2005, and the following day President Bush asked the DHS to conduct a review, in cooperation with local counterparts, of emergency plans in every major city in America. In response to President Bush’s call for a nationwide plan review, Secretary Michael Chertoff further ordered that reviews include a rigorous examination of how communities plan to prepare, inform, evacuate and care for people with disabilities. As part of that effort, the DHS Office of Civil Rights and Civil Liberties (CRCL) led a team of subject-matter experts who used a detailed assessment tool specifically designed for the purpose of assessing the level to which states and urban areas are taking actions to address requirements associated with integrating people with disabilities into the emergency planning process.

In addition to these efforts, on September 29, 2005, Congress, in the Conference Report on H.R. 2360, DHS Appropriations Act of 2006, indicated the importance of having plans in place to deal with catastrophic events and the need to include people with disabilities in emergency management planning. Congress emphasized that it is imperative that states and urban areas ensure sufficient resources are devoted to developing plans for the complete evacuation of all residents, including people in hospitals and nursing homes, and residents without access to transportation, in advance of and after such an event.

Nationwide Plan Review Findings

In June 2006, DHS and the U.S. Department of Transportation released the Nationwide Plan Review Phase 2 Report detailing the results of the review of urban and state emergency preparedness nationwide, including findings on emergency planning in relation to people with disabilities. The DHS review revealed major fragmentation, inconsistencies, and critical gaps throughout the plans. Few plans demonstrated in-depth planning and proactive thinking in preparing to meet the needs of people with disabilities before, during, and after emergencies. Most plans delegated critical responsibilities to third parties or other governmental entities without adequate coordination, oversight, or assurance of resources, and contained no indication that a delegated function would be executed in a timely and effective manner. More specifically, most plans failed to do the following:

• Address evacuation for persons with disabilities;
• Meet the need to keep together people with disabilities, family members, caregivers, and durable medical equipment;
• Establish tracking procedures that will assure reunification;
• Acknowledge that traditional emergency notification and communication methods are not accessible for people with certain disabilities;
• Ensure that the local or regional Red Cross is equipped with adequate disability-related knowledge, experience, training, and resources to serve people with disabilities who seek sheltering at mass care facilities;
• Require that communication in mass care shelters be accessible to people who are deaf, deaf-blind or hard of hearing, those who are blind or who have low vision, and individuals with cognitive disabilities;
• Ensure that shelter personnel will not separate individuals with disabilities from their service animals (a practice generally prohibited under the Americans with Disabilities Act) or clarify that service animals are not pets;
• Include a way to re-integrate people with disabilities from these shelter facilities back into a more integrated setting at the earliest appropriate opportunity; and
• Illustrate better planning for the smaller percentage of persons who are medically fragile.

The review revealed that across state and urban emergency plans, “disability” was inconsistently defined and often treated as a sub-group of the umbrella of “special needs,” “at-risk,” or “vulnerable populations.” The term “special needs” often referred to an extremely broad segment of the population, including people with disabilities, minority groups, people who do not speak English, children, and the elderly. In practice, the term also included people who live in poverty or on public assistance; people without private transportation or who rely on public transportation; people who rely on care-givers for assistance in daily living and would need similar assistance in an emergency; and people who live independently or with caregiver(s) in homes, assisted living housing, nursing homes, supervised group homes, hospitals, and other health care facilities. These groups obviously represent a large and complex variety of concerns and challenges in relation to emergency planning and response. In addition, few plans incorporated state or urban area disability demographics documenting the prevalence of persons with disabilities in their communities. And few plans recognized that the state and local governments have legal obligations to those residents under the Americans with Disabilities Act and other authorities.

In response to these shortfalls in emergency plans nationwide, the report presented recommendations, including the following (U.S. Department of Homeland Security & U.S. Department of Transportation, 2006):

• States should designate a specific state agency that is responsible for providing oversight and ensuring accountability for including people with disabilities in the shelter operations process.
• The federal government should develop a consistent definition of the term “special needs.”
• The federal government should provide guidance to state and local governments on incorporation of disability-related demographic analysis into emergency planning.
• Federal, state, and local governments should increase the participation of people with disabilities and disability subject-matter experts in the development and execution of plans, training, and exercises.
• Federal, state, and local governments should work with the private sector to identify and coordinate effective means of transporting individuals with disabilities before, during, and after an emergency.
• The federal government should provide technical assistance to clarify the extent to which emergency communications, including public information associated with emergencies, must be in accessible formats for persons with disabilities. This assistance should address all aspects of communication, including, for example, televised and other types of emergency notification and instructions, shelter announcements, and applications and forms for government and private disaster benefits.

As the findings illustrate, until emergency planners understand and address the prevalence and needs of persons with disabilities in their states and communities, as well as their commensurate federal civil rights obligations, inadequate preparation and implementation will continue to be the norm.

Additional Findings

As DHS and others have found, while most Emergency Operation Plans (EOPs) make scattered references to people with disabilities, sorely lacking is any consistency of approach, depth of planning, or evidence of safeguards and effective implementation. Most jurisdictions significantly underestimate the amount of advance planning and coordination that is required to effectively address the integration and accommodation of individuals with disabilities. A 2004 survey of emergency managers conducted by EPI revealed that 76% do not have a paid expert on staff to advise on special needs issues and 73% said that no funding had been received to address and plan for special needs issues (N.O.D. & Harris Interactive, 2004). The 2004 survey also revealed that 42% of emergency managers had preparedness materials for people with disabilities; however, only 16% of those 42% had those same educational materials available in an accessible format. In addition, SNAKE team findings revealed that 85.7% of community-based organizations that provided services to people with disabilities and seniors in areas affected by Hurricane Katrina did not know how to access their emergency management system prior to the storm.

Although strides are being made toward fully integrating people with disabilities in community life, substantial improvement is necessary to integrate people with disabilities in emergency planning and readiness.

Principles for Improvement

To increase the effectiveness of emergency preparedness in relation to persons with disabilities, individuals who have disabilities, their families, service providers, and advocates, as well as their communities as a whole and government leaders at all levels, must recognize and act upon the following principles:

• Through personal and community planning, all people must have the same opportunity to survive natural and human-made disasters.
• Emergency workers can be provided the tools, equipment, and training to maintain the independence of persons with disabilities in an emergency event.
• Persons with disabilities can develop a realistic and successful emergency plan through educating themselves and emergency workers on how to best help them during an emergency.
• All transportation, reception centers, shelters, and medical services can be accessible for all people, and all people can maintain dignity and self-respect.

Some recommendations for implementing these principles include:

• Increase the rate of participation of people with disabilities in emergency planning.
• Increase the rate of participation of people with disabilities in emergency preparedness, response, and recovery drills and exercises.
• Direct DHS funding to promote the full integration of people with disabilities in all aspects of emergency preparedness, response and recovery.
• Ensure that during an emergency, Telecommunications Relay Services (TRS) personnel, Public Safety Answering Point (PSAP) personnel, and captioners can travel to and from their designated facilities to provide continuity of services for persons with hearing and speech disabilities.
• Integrate the needs of individuals with disabilities into the National Response Plan (NRP) and National Incident Management System (NIMS).2
• Coordinate evidence-based federal research into the effectiveness of audio, visual, and/or tactile protocols and technologies related to emergency preparedness, alerting, warning, and response for individuals with disabilities.3
• Ensure comprehensive medical approaches that address the health care and medical needs of individuals with disabilities across the life-span of an emergency event.

Conclusion

One of the most important roles of government is to protect its citizenry from harm, including helping people prepare for and respond to emergencies. Making local, state, and federal government emergency preparedness and response programs accessible to people with disabilities is a critical part of this responsibility. People with disabilities throughout the country will continue to risk suffering and death in disproportionate numbers unless we dramatically improve disability-related emergency planning processes and readiness.