TOOLS FOR ESTABLISHING SPECIAL NEEDS REGISTRIES IN NORTH CAROLINA

SA R A H J . WAT E R M A N

Safe from the Storm

Miles’ Law and Emergency Management

“Where you stand depends on where you sit”

Disasters do not affect all people equally. Addressing this vulnerability is a key goal of emergency management.

Timeline

Hurricane Andrew (1992) Revealed elderly population grossly underprepared for disaster

Hurricanes Floyd and Fran (1996) Substantial inland flooding

Subsidence in Western NC

Hurricane Katrina, August 2005

Waveland, MS

Project Background

*House Bill 2432

General Assembly tasked the Division of Emergency Management with a major preparedness project

Included a directive to develop “a model registry for use by the counties in identifying functionally and medically fragile persons in need of assistance during a disaster”

North Carolina Perspective

Methodology

Literature Review

Interviews with county representatives

Initial Findings

History of tracking vulnerable populations

Coastal Counties

Nuclear Bases

26 counties currently maintain registries

3,374 people enrolled in counties interviewed

Model in Practice

Determine Eligibility

Disseminate Information

Encourage Participation

Update Information

Activate during Disaster

Determine Eligibility

FEMA Definition

Definition in use varies county to county Too broad versus too restrictive

Long Term Care Facilities

RENCI Priority Tiers

Level 1 Patients requiring uninterrupted healthcare

Level 2 Patients requiring medical services within 48 hours

Level 3 Patients requiring medical services within 7 days

Disseminate Information

Home Health AgenciesMeals on WheelsHospitalsNursing HomesDoctor's OfficesFire DepartmentPolice DepartmentEMS/ ParamedicsVeteran's AdministrationDurable Medical Goods Companies

Utility Companies (Do NotDisconnect list)

Department of Social ServicesCouncil on AgingPlaces of WorshipRotary InternationalHealth DepartmentLocal NewspapersCounty and Local Television

StationsRadio Stations

Encourage Participation

Significant Challenge “Nunya business”

Government Intrusion

HIPAA/ Privacy Concerns

Successful Techniques Public Education Fairs

Provide help with forms

Community and volunteer groups

Update Information

Significant challenge Fluid population

Lack of resources

Most counties update annually

Successful Techniques Monitor Obituaries

Volunteers/Interns to call through list

Send birthday cards

Communicate with Fire, Police and EMS

Areas of Concern

Unintended consequences Discouraging Individual Preparedness

Scope of Problem

Understanding of HIPAA

State/Local Dissonance Definition

Turf

Conclusion

Outreach remains limited but is an incomplete measure of success

Special needs registries are one tool for emergency managers and county officials to use in improving preparedness