Transcript Document

Emergency Planning & Preparedness
for Special Needs/Vulnerable
Populations
Amelia Muccio
Director of Disaster Planning
NEW JERSEY PRIMARY CARE
ASSOCIATION
Learning Objectives
• Discuss the definition of special
needs/vulnerable populations
• Explain what is currently being done to
assist this population
• Discuss emergency planning techniques for
people with diabetes and asthma
• Identify next steps for Community Health
Centers
Disaster Exercise: ‘Be the Disaster’
Anticipate Crises
• According to Webster's Dictionary, knowledge is
“the fact or condition of knowing something with
familiarity gained through experience or
association.”
• Therefore, one woman’s hindsight (experience)
can be someone else’s knowledge.
• We must incorporate emergency planning into our
everyday routine without eliciting
fear/panic/anxiety.
Your Mission: Create a Dog Tag
“Aurora’s Tag”
• ID tag on collar reads:
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Aurora
954.975.7550
(home/land line)
Is That Sufficient?
ID Needs More Information & Redundancy
• Aurora FerrignoMuccio
• Full Address
• Mobile Number
• Vet’s Number
• While initial tag was
adequate, it would not
be helpful during a
disaster.
Definition of Special Needs/Vulnerable
• In disaster preparedness and response, the terms
"vulnerable" or "special needs" populations are often used
to characterize groups whose needs are not fully addressed
by traditional service providers.
• People who feel they cannot comfortably or safely access
and use the standard resources offered in disaster
preparedness, relief and recovery.
• They include but are not limited to those who are
physically or mentally disabled (blind, Deaf, hard-ofhearing, cognitive disorders, mobility limitations), limited
or non-English speaking, geographically or culturally
isolated, medically or chemically dependent, homeless,
frail/elderly and children.
Who Are We Protecting?
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Elderly
Disabled
High Dx Prevalence
Pregnant Women
Homeless
Children
Low SES
Minorities
Low Education Level
Non-English Speaking
First Problem:
The Definition
• No ‘one size fits all’ definition
• Diversity within Special Needs/Vulnerable
• Too narrow of a definition includes a
chance of exclusion
• Too broad of a definition will include
everyone
• Need definition that is balanced but will
NOT leave anyone behind
Do We Know What ‘They’ Need?
Second Problem:
The Diversity
Third Problem:
Self-Classification
• What if I do not
consider myself
“disabled,”
“vulnerable” or
“special needs?”
Rule of Thumb on Definition
• During a disaster, who
enters American Red
Cross shelter population?
• Hint: it is not you and I...
• Common threads:
– lack of social and fiscal
safety net
– Lack of freedom/mobility
• Dependency!!!
The Special Needs/Vulnerable Community
Example: Langa Settlement, South Africa
• Similar populations
• Patient demographic:
• Underinsured &
Uninsured
• Stigmatized Poor
• Socially Stressed
• Migrant
• High Disease
Prevalence
• Low Education
Levels
Rebuilding Part of Langa Settlement after
Massive Fire (1000+)
Langa Rebuilt in 1 Day But
Our Communities Need Much Longer
• Lack of fiscal
resources (savings)
• Lack of safety nets
(Renter’s Insurance)
• Voiceless
• The population
FQHC’s serve will
have difficulties
recovering from a
disaster.
• Therefore, we must
focus on prevention
and preparedness.
What is Needed?
Special Needs Registry
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Advanced registration
State or County driven
Register online or by phone
Central database linked to Police, OEM,
EMS, Etc.
2. ‘Just in Time’ registration
• Assist those who did not pre-register
Transportation Needed!!!!
Broward County, Florida
Registration or Roundup
• Elderly population
• Advanced Special Needs
Registry
• EMS transports registered
disabled to Hurricane Shelters
• Police transport homeless and
high-risk areas (mobile homes)
• Some accuse County of
dumping them (homeless
cannot bring personal
belongings and disabled
transported with records)
New Jersey Special Needs Advisory Panel
(NJSNAP)
• NJSNAP identifies issues affecting members of
New Jersey’s special needs population in their
emergency preparedness, and issues affecting
emergency management personnel as they prepare
to assist individuals with special needs.
• NJSNAP is also tasked with making
recommendations, developing solutions, drafting
proposed legislation, formulating memos of
understanding, and devising programs to address
identified issues as directed by NJOEM.
The Value of Partnerships
• Diverse population
requires diverse
solutions
• Must be a joint effort
to take care of special
needs/vulnerable
populations
• Multiple stakeholders
across disaster
continuum
Emergency Planning for Diabetes & Asthma
Real Life Implications: Hurricane Katrina
• Of the more than 1,300+ people who died because
of Hurricane Katrina, more than 70% were over
age 60.
• New Orleans has one of the largest diabetic
populations in South
– People fled without shoes
– Medicare allows only one pair per year
– Many patients with diabetes developed wounds
(skin ulcers to limb amputations)
Special Needs/Vulnerable Populations
• High risk of
mortality/morbidity
during disaster due to
mobility,
transportation, social
network, and illness
(O2 dependent)
issues.
Hurricane Wilma, October 2005
Example #1
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No electricity
No working phone
No automobile
No generator
You are geographically
isolated
• Your family member
enters into diabetic stupor
• What do you do?
Hurricane Wilma, October 2005
Example #2
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No electricity
No working phone
No generator
No automobile
Pharmacies have been
closed for 3 days
• Family member runs out
of asthma medication and
is experiencing breathing
distress
• What do you do?
Diabetics & Asthmatics
• Diabetics:
– Disaster is major
stressor and affects
insulin levels
– Mobility issues
– Difficulty evacuating
– Lack of medication
– No storage for insulin
– Wound care issues
arise
• Asthmatics:
– Disaster affects
respiratory system
– Sensitive population,
canaries in a coal mine
– Lack of medication
– Difficulty evacuating
– Environmental
pollutants post-disaster
Diabetics: Evacuation & Wound Care
Asthmatics: Environmental Exposure PostDisaster
Know What Your CHC Can Offer
• Assist hospitals with patient surge
• Dispatch mobile vans into community
• Function as Alternate Care Site for treatment of nonacute patients (walking wounded)
• Serve as POD (Point of Distribution) for prophylaxis
• Function as screening Center and provide disease
surveillance
• Serve existing patient population (vulnerable
population) during event (stay open later)
Basic Emergency Planning:
Disaster Needs Mimic Everyday Needs
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Organizational agility
Plans, drills, and evaluations
Training and education
Staff protection and support
Communications and reporting
Supplies and equipment
Security
JCAHO and HRSA PIN*
M+P>R+R
Successful Disaster Planning Equation
• CHC’s are planning for events (pandemic,
hurricane, power outage, outbreak,
terrorism) that require high levels of predisaster preparedness (prevention, and
mitigation activities).
• Disaster is reasonably expected and
preparedness initiatives have been
undertaken.
• Examples of low levels of pre-disaster
preparedness, economic depression and
long-term civil war
Recommendation #1. Diabetics/Asthmatics Obtain
Emergency Health Information Card/MedicTag
• An emergency health information card &
MedicTag communicates to rescuers what they
need to know about patient if they find him/her
unconscious or incoherent, or if they need to
quickly help evacuate them.
• An emergency health information card should
contain information about medications,
equipment, allergies and sensitivities,
communication difficulties , preferred treatment,
treatment-medical providers, and important
contact people.
Recommendation #2: Diabetics/Asthmatics Obtain
Additional Medication
• Medication: It is best if your patients are
able to maintain at least a 7 to 14 day
supply of essential medications
(insulin/inhalers) and keep this supply with
them at all times.
• If this is not possible, even maintaining a
three day supply would be extremely
helpful.
Recommendation #3: Diabetics/Asthmatics Establish a Personal
Support Network—“Be a Good Neighbor”
• Check on your elderly/disabled neighbors
especially if they lack local family members
• Know their family contact info
• Keep in mind their limitations
• Power failures in high rises have killed many
elderly/disabled
• They die of dehydration in their own homes b/c
they could not walk down the stairs (phones were
out)
Recommendation #4: FEMA Independent Study: IS-197.SP
Special Needs Planning Considerations for Service/Support Providers
• Course Objectives
– Describe the impact of different types of hazards on
special needs populations.
– Describe challenges during the different phases of an
emergency.
– Explain how to develop emergency plans and work
with emergency management and other local officials
during the planning process for your local community.
• CEUs: 0.4
• Course Length: 4.5 hours
Recommendation #5: Utilize CHC’s Waiting Room as Disaster
Education Tool
• Next to Cosmo and GQ, add disaster
preparedness resources
• Plenty of free/nominally priced brochures
on emergency disaster planning, family
disaster plans, go bags, emergency supplies
kits, communication plans, special needs
planning, shelter-in-place, and disaster
coloring books for children
In Summary
• Diversity prevents one single definition from being all
inclusive
• Advanced Special Needs Registries are needed
• CHC’s populations need additional emergency planning
considerations
• Assist patients in incorporating emergency preparedness
into their daily routine
• Diabetics and Asthmatics need to have emergency
supplies kits with medical documentation, extra
medication, and medical supplies
Successful Emergency Preparedness:
Plan. Drill. Revise.