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Access to Readiness Coalition

byJune Isaacson Kailes

Southern California WildfiresAfter Action Report

September 2008

Southern California Wildfires After Action Report 2

Required citation:

Kailes, J. 2008. Southern California Wildfires AfterAction Report, prepared in partnership with theAccess to Readiness Coalition, The CaliforniaFoundation for Independent Living Centers, and TheCenter for Disability Issues and the HealthProfessions at Western University of Health Sciences.

Permission is granted to copy and distribute thismaterial provided that:

1. Proper copyright notice and citation (above) isattached to each copy;

2. No alterations are made to the contents of thedocument;

3. The document is not sold for profit; and

4. The Center for Disability Issues and the HealthProfessions or the Access to Readiness Coalitonis notified of such use. Please [email protected] or go towww.access2readiness.org for contactinformation.

Southern California Wildfires After Action ReportBy June Isaacson Kailes, Associate DirectorCenter for Disability Issues and the HealthProfessions at Western University of HealthSciences, Pomona, CaliforniaPhone 310-821-7080 Fax [email protected] www.cdihp.org

This report is available at www.access2readiness.orgor www.jik.com/disaster.html


Acknowledgements

This report was made possible, in part throughgenerous support from:

• Administration on Developmental Disabilities

• California Consumer Protection Foundation’sCommunity Collaborative Fund

• California Department of Public Health, Office onDisability and Health

• Pacific Gas and Electric Company

The opinions expressed are those of the authorand the California Foundation of Independent LivingCenters (CFILC). They do not necessarily representthose of the funders.

Individuals chosen for their diverse perspectivesand technical expertise reviewed this report in draftform. The author thanks these individuals for theircandid and critical comments that assisted inmaking this report as accurate as possible.

• Stephanie A. Biedermann, Arthur LimanFellowship Attorney, Disability Rights Advocates,Berkeley

• Sarah W. Blackstone, President, AugmentativeCommunication Inc., Monterey

• Phyllis Dinse, Coalition Organizer, CaliforniaFoundation for Independent Living Centers,Sacramento

• Alexandra Enders, Senior Research Associate /Policy Analyst, Rural Institute on Disabilities,


University of Montana, Missoula, MT

• Judy Harkins, Gallaudet University, Washington,DC

• Teresa Favuzzi, Executive Director, CaliforniaFoundation for Independent Living Centers,Sacramento

• Debbie Fulmer, Department of HomelandSecurity, Office for Civil Rights and CivilLiberties, Washington, DC

• Brenda Premo, Center for Disability Issues andthe Health Professions at Western University ofHealth Sciences, Pomona

• Richard Ray, Department on Disability, DisabilityAccess and Services, Los Angeles

• Bill Vogel, Chief of the Management and StaffService Branch, California Department of SocialServices, Sacramento

Photographers: Leon Stevens, June Kailes, RobertKailes

Designed by: Kay Pegram, KaymarCommunications, [email protected]

Printed by: Sierra Office Supply & Printing,www.sierrabg.com


Dedication

This report is dedicated to the many peoplewith disabilities and activity limitations wholost their independence or their lives becauseinformation transfer and the lessons learnedand documented over the last 30 years, arenot yet uniformly applied.


Table of Contents

Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . .3

Dedication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

1. Executive Summary . . . . . . . . . . . . . . . . . . . . .9

2. Definition and Acronyms . . . . . . . . . . . . . . . .13

3. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . .24

3.1 Purpose . . . . . . . . . . . . . . . . . . . . . . . . .24

3.2 The Event . . . . . . . . . . . . . . . . . . . . . . . .25

3.3 Methods . . . . . . . . . . . . . . . . . . . . . . . . .26

4. Cross Cutting Issues . . . . . . . . . . . . . . . . . . .28

4.1. Narrow Definitions of Disability Do Not Work In Disaster Planning and Response . . . . . . . . . . . . . . . . . . . .28

4.2. Moving Emergency Planning from “Special Needs” to “Functional Needs” . . . . . . . . . . . . . . . .32

4.3. Grants and Funding . . . . . . . . . . . . . . . .40

4.4. Emergency Registries . . . . . . . . . . . . . .43

5. Communication Access . . . . . . . . . . . . . . . .47

5.1. People Who are Deaf, Deaf-Blind, and Hard of Hearing . . . . . . . . . . . . . . . .48

5.2. Mass Notification Systems for Evacuation . . . . . . . . . . . . . . . . . . . . .50

5.3. TV Broadcast . . . . . . . . . . . . . . . . . . . . .51

5.4. Emergency Warning Systems . . . . . . . .54


5.5. Public Safety Answering Points (PSAPs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59

5.6. Communication Access at Shelters and Assistance . . . . . . . . . . . . . . . . . . . .62

6. Mass Care and Shelter . . . . . . . . . . . . . . . . .68

6.1. ADA Requirements . . . . . . . . . . . . . . . .69

6.2. Medications, Durable Medical Equipment and Consumable Medical Supplies . . . .72

6.3. Health Advisories . . . . . . . . . . . . . . . . . .75

6.4. Compensate In-Home Supportive Services Homecare Workers for Services . . . . . . . . . . . . . . . . . . . . . .76

6.5. Functional Assessment and Service Teams Evacuation and Transportation . .77

7. Evacuation and Transportation . . . . . . . . . . .85

8. Nongovernmental Organizations Role of Provider and Advocacy Organizations in Disaster Response . . . . . . . . . . . . . . . . . . . .90

8.1. Disability Emergency Briefing Team . . . .92

8.2. Priority Emergency Client Contact List . .95

8.3. Timeliness of Hot Washes . . . . . . . . . . .96

8.4. Mitigation Assistance Programs . . . . . . .97

9. Long Term Care Facilities . . . . . . . . . . . . . . .99

10. Training and Exercise Programs . . . . . . . .101

10.1. Exercises . . . . . . . . . . . . . . . . . . . . . .105

10.2. Individual and Family Emergency Preparedness Training and Materials . . . . . . . . . . . . . . . . . . .107

"I got a phone callfrom a woman whowas using a powerchair who was givenliterally seconds to getevacuated out of herhome. The policemancame . . . telling herto get out. There wasno way for her to getout, no transportation.They grabbed aneighbor, picked herup, put her in theback of a car and tookher to the high school.When she got to thehigh school… she wasleft in the back seat(of the car), nobodywanted to beresponsible."


11. Summary of Recommendations . . . . . . . . .110

12. About the Sponsors and the Author . . . . . .135

12.1. The California Foundation for Independent Living Centers . . . . . . . .135

12.2 Center for Disability Issues andthe Health Professions . . . . . . . . . . . .135

12.3. The Author . . . . . . . . . . . . . . . . . . . . .136

13. References . . . . . . . . . . . . . . . . . . . . . . . . .138

14. Attachments . . . . . . . . . . . . . . . . . . . . . . . . .144

14.1. Key Informants . . . . . . . . . . . . . . . . .144

14.2. Sample: Emergency Notification: Register Your Cell Phone and E-Mail Address . . . . . . . . . . . . . . . . . .146

14.3. Review of Civil Rights Laws for People with Disabilities . . . . . . . . . . .147

Join Access to Readiness Coalition Form . . . . .152


This After Action Report (AAR) highlights manydisaster response and recovery areas of specificand significant concern to the diverse disabilitiescommunities in California. It documents theexperiences of people with disabilities andindividuals with access and functional needs. Theareas covered include:

• cross cutting issues,

• communication access,

• mass care and shelter,

• evacuation and transportation,

• role nongovernmental provider and advocacyorganizations in disaster response,

• long term care facilities,

• training and exercise programs.

Many of the local government AARs are silent onthese issues or only vaguely mention them.

This AAR offers 71 specific recommendations forstrengthening and improving preparedness,response actions and recovery efforts that areinclusive of people with disabilities and activitylimitations. Many of the recommendations reinforcea variety of continuing emergency concerns thatexisted before the 2007 fires and continues today.

1. Executive Summary


Information for this AAR was collected through: keyinformant interviews, stories collected via CaliforniaFoundation for Independent Living Centers’ Accessto Readiness Coalition review of hundreds of e-mails generated during and after the fires by NGOsstaff and government employees who worked asresponders, review of public hearing testimony,review of prior California disaster reports focusedon how people with disabilities fared, and review ofpresentations and discussions from forums focusedon the fires.

The intended audience includes the state,regional and local governments policy makers andemergency planners, non governmentorganizations), long term care facilities and olderadults and disability advocates.

Major cross cutting issues discussed include:

• Most disaster response systems are designedfor people who can: walk, run, see, drive, read,hear, speak and quickly understand and respondto instructions and alerts.

• Narrow definitions of disability do not work indisaster planning and response because thereare large segments of the population that havefunctional needs.

• The term “special needs” does not work becauseit does not provide guidance to operationalizeneeded planning tasks. A better way to thinkabout the needs of people with disabilities andactivity limitations is to use an orientation thatconsiders major functional needs:communication, medical, maintaining functionalindependence, supervision, and transportation.


• Preparing to accommodate people withfunctional needs often translates into emergencyresponse systems being better equipped toserve diverse and sometimes vulnerable groups.

• Good practice involves networking, building andstrengthening relationships that foster ongoingcommunication, coordination, cooperation andcollaboration between at risk communities andemergency managers.

• Involving qualified representatives from thesecommunities helps planners understand andthink through issues from disability, functionalneeds and aging perspectives and can helpprevent making mistakes.

• Separate “special needs population” planningand separate “special needs population”annexes are not effective. Segregating andisolating the needs of significant numbers of thepopulation does not make sense. It is inefficientwith regard to budgeting, procurement andresource allocation. Planning is not a two stageprocess comprised of “the critical plan” and then“the special plan.” Separate planning oftenmeans the planning is never is done.

• If the value that everyone should be included isnot infused into planning, then not everyone willbe included.

• Except for the Office of Emergency ServicesOffice of Access and Functional Needs, the statedevotes few fiscal resources to identifying andaddressing barriers to help ensure the safety ofall people, regardless of their functional needs.

• State and local government emergency policy


makers should allocate a percentage of annualfunding to strengthen and improvepreparedness, response actions and recoveryefforts that include people with functional needs.

For more information regarding the words andacronyms that are bolded in this report refer tosection 2. Definition and Acronyms.


AAR - After Action Report.

Accessible - having the legally required featuresand/or qualities that ensure entrance, participation,and usability of places, programs, services, andactivities by individuals with a wide variety ofdisabilities.

ADA - Americans with Disabilities Act - Signed intolaw July 26, 1990, a civil rights legislation intendedto make American society more accessible topeople with disabilities. It contains five titles:Employment, Public Service, PublicAccommodations, Telecommunications, andMiscellaneous, which includes prohibitions onthreats, coercion, retaliation, etc. against peoplewith disabilities.

ADAAG - Americans with Disabilities ActArchitectural Guidelines.

ARC - American Red Cross.

ASL - American Sign Language - A visual/gestural,non-written language with its own unique syntaxand grammar based on hand shapes, bodymovements and facial expressions.

A2R - Access to Readiness Coalition - organizedand supported by CFILC, is a network of disability-focused organizations and allies that are committedto strengthening California’s emergency planning,

2. Definitions and Acronyms


response and recovery to meet the needs of peoplewith disabilities and functional limitations. A2Rachieves this through public policy advocacy,community education and collaboration on thelocal, state, and national levels.

CATE - California Assistive Technology Exchange -An assistive technology device reutilizationprogram, similar to Craig’s List or eBay that is adatabase of items available for donation or salebetween two parties. This information assistspeople in locating usable durable medicalequipment (DME) until they can replace their morecustomized equipment.

CDC - Centers for Disease Control.

CDSS - California Department of Social Services.

CERT - Community Emergency Response TeamProgram - Educates people about disasterpreparedness for hazards that may affect their areaand trains them in basic disaster response skills,such as fire safety, light search and rescue, teamorganization, and disaster medical operations.Using the training learned in the classroom andduring training exercises, members can assistothers in their neighborhood or workplace followingan event when professional responders are notimmediately available to help. Members also areencouraged to support emergency responseagencies by taking a more active role in emergencypreparedness projects in their community.

CFILC - California Foundation for IndependentLiving Centers - A statewide disability advocacyorganization made up of Independent LivingCenters across California, whose mission is to


advocate for barrier-free access and equalopportunity for people with disabilities to participatein community life.

CMS - Consumable medical supplies - Includes, butis not limited to, catheters, ostomy supplies, gloves,bandages, and padding. These supplies are usuallydisposable and cannot withstand repeated use bymore than one individual.

DME - Durable medical equipment - Includes, but isnot limited to, wheelchairs (multiple types), canes,white canes, walkers, shower chairs, toilet chairs,raised toilet seats, oxygen equipment, nebulizertubing and machines, and speech generatingdevices.

ENS - Emergency Notification System - A systemthat sends alerts and warnings that affect lives andproperty. The system can make mass contacts viatechnology and non-technology audibly andvisually.

EOC - Emergency Operation Center.

FAST - Functional Assessment and Service Teams- Trained nongovernmental organizations (NGOs)and government workers ready to respond to anddeploy to disaster areas to work in shelters,temporary housing and other disaster recoverycenters. Team members have in depth knowledgeof the populations they serve, their cultures, andsupport service systems including housing,resources, benefit programs, and disaster aidprograms.

FCC - Federal Communications Commission.

FEMA - Federal Emergency Management


Administration.

Functional Needs Populations (formerly SpecialNeeds Population) - Populations whose membersmay have additional needs before, during, and afteran incident in functional areas, including but notlimited to: maintaining independence,communication, transportation, supervision, andmedical care. Individuals in need of additionalresponse assistance may include those who havedisabilities; who live in institutionalized settings;who are elderly; who are children; who are fromdiverse cultures; who have limited Englishproficiency or are non-English speaking; or who aretransportation disadvantaged.

Functionally equivalent - Equal to the sameinformation, goods and services received by peoplewithout disabilities.

Hot Wash - Performance discussions andevaluations after a training exercise or emergencythat identifies strengths and weaknesses of theresponse to a given event. It is should guide futureresponse direction in order to avoid repeating errorsmade in the past. The process usually includes allthe parties that participated in the exercise orresponse activities.

IHSS - In-Home Supportive Services.

Incident - An occurrence or event, natural orhuman caused, that requires a response to protectlife or property. Incidents, for example, can includemajor disasters, emergencies, terrorist attacks,terrorist threats, civil unrest, wild land and urbanfires, floods, hazardous materials spills, nuclearaccidents, aircraft accidents, earthquakes,


hurricanes, tornadoes, tropical storms, tsunamis,war-related disasters, public health and medicalemergencies, and other occurrences requiring anemergency response.

IM - Instant messaging - Unlike email instantmessaging software, this allows people to ‘talk’ inreal time by typing and receiving messages. It is atext-based computer conference over the Internetbetween two or more people who must be online atthe same time. When someone sends an IM, thereceivers are notified almost instantly that theyhave a message.

IP - Internet Protocol (IP) Relay - The caller uses acomputer to access a relay provider’s website.Communication Assistants (CA) relay conversationsback and forth between the computer user and thehearing individual(s). A deaf or hard of hearing usercan also request Voice Carry Over (VCO) with IPRelay. Callers provide the CA with their phonenumbers. The CA calls that number and thenconferences the hearing individual into the call.

IP Relay Service is a call center service similar toVoice Relay Services (VRS), which provides a thirdparty communication relay between Internet textingusers (mobile or stationary) and voice telephoneusers.

Local Government - A county, municipality, city,town, township, local public authority, schooldistrict, special district, intrastate district, council ofgovernments (regardless of whether the council ofgovernments is incorporated as a nonprofitcorporation under state law), regional or interstategovernment entity, or agency or instrumentality of a


local government; an Indian tribe or authorizedtribal entity, a rural community, unincorporated townor village, or other public entity.

Long term care facilities - A diverse group of:licensed care facilities, congregate facilities,residential facilities, nursing homes, assisted living,group homes, intermediate care facilities, seniorhousing, etc .

NGO - Nongovernmental Organization - An entitywith an association that is based on interests of itsmembers, individuals, or institutions. It is notcreated by a government, but it may workcooperatively with government and may receivegovernment funding. Such organizations serve apublic purpose, not a private benefit. Examples ofNGOs include faith-based charity organizationscommunity-based organizations such as theAmerican Red Cross. NGOs, including voluntaryand faith-based groups, provide relief services tosustain life, reduce physical and emotional distress,and promote the recovery of disaster victims. Oftenthese groups provide specialized services that helpindividuals with disabilities. NGOs and voluntaryorganizations play a major role in assistingemergency managers before, during, and after anemergency. They represent a vast array of humanand social service organizations.

Mutual Aid and Assistance Agreement - A writtenor oral agreement between and amongagencies/organizations and/or jurisdictions thatprovides a mechanism to quickly obtain emergencyassistance in the form of personnel, equipment,materials, and other associated services. Theprimary objective is to facilitate rapid, short-term


deployment of emergency support prior to, during,and/or after an incident.

OES - The Governor’s Office of EmergencyServices.

People with disabilities and activity limitations -Individuals who have one or more functionallimitations such as reduced or no ability to see,walk, speak, hear, breathe, learn, understandinformation, respond quickly, and manipulate and/orreach controls. This large population has a varietyof visual, hearing, mobility, cognitive, emotional andpsychiatric limitations and includes people of allages. Their sometimes overlapping functionalneeds include maintaining independence,communication, transportation, supervision, andmedical care.

PSAP - Public Safety Answering Point - A physicallocation where 911 emergency telephone calls arereceived and then routed to the proper emergencyservices.

Qualified Interpreter - An individual who interpretseffectively, accurately, and impartially, bothreceptively and expressively, between AmericanSign Language and spoken English. Preferably hascertification from the Registry of Interpreters for theDeaf.

Qualified people with disabilities - (Those who, interms of recruiting people for advising, planning,staffing and contracting work):

• Identify as people with disabilities and / oractivity limitations,

• Have a user’s perspective,


• Have personal experience with disability anddisability advocacy,

• Can speak broadly on disability issues asopposed to only addressing their own needs,

• Are knowledgeable about cross-disability accessissues (hearing, vision, mobility, speech, andcognitive limitations),

• Are knowledgeable about a variety of physical,communication, and program access issues.

Qualified people should:

• Be connected to and involved with segments ofnational, state or local constituencies of thedisability community, such as active involvementin broad-based disability organizations (of andfor blind, deaf, hard of hearing, learningdisability, developmental disability, independentliving, multiple chemical sensitivities, etc).

• Have in place and use communication arteries tofacilitate two-way communication with thesegments of the disability community they arerepresenting.

In addition, other types of experience may beneeded. For example, qualified advisors, trainers,contractors and consultants with disabilities mayneed to have:

• Disaster-related technical expertise.

• Advocacy experience, management experience,and training skills. [23]

REOC - Regional Emergency Operation Center.

SEMS - Standardized Emergency ManagementSystem.


SOC - State Operation Center.

SMS - Short Message Service - A communicationsprotocol allowing the interchange of short textmessages between mobile telephone devices. TheSMS technology has facilitated the developmentand growth of text messaging.

Speech-to-Speech Relay Service - A form ofRelay Services that provide CommunicationsAssistants (CAs) for people with speech disabilities,including those who use speech generatingdevices, who have difficulty being understood onthe phone. CAs are trained individuals familiar withmany different speech patterns and languagerecognition skills. The CA makes the call andrepeats the words exactly.

TRS - Telecommunications Relay Services - Atelephone service that uses operators, calledcommunications assistants (CAs), to facilitatetelephone calls between people with hearing andspeech disabilities and other individuals. TRSproviders-generally telephone companies-arecompensated for the costs of providing TRS fromeither a state or a federal fund. There is no cost tothe user.

VCO - Voice Carry Over - Allows people who aredeaf or hard-of-hearing users to use their voices tospeak directly to hearing people and to receiveresponses in text from the TelecommunicationsRelay Services (TRS) communications assistants(CAs).

VI - Video Interpreter is the third party in a relayedcall for Video Relay Services (VRS) using signlanguage interpreting and/or signed or oral


transliteration. A VI can also facilitate a VCO call.

VR - Video Relay - A form of TelecommunicationsRelay Service that enables people who are deaf,are hard of hearing, or have speech disabilities whouse American Sign Language (ASL) tocommunicate with voice telephone users throughvideo equipment, rather than through typed text.The caller uses a videophone or webcam with acomputer and a broadband connection to access avideo relay service call center staffed with signlanguage and/or oral interpreters andtransliterators. Since typing on a keyboard is notnecessary, video relay enables the hearing anddeaf parties to communicate naturally using signlanguage and/or speech reading. Video users whochoose to do so may also request Voice Carry Over(VCO), using a nearby landline or wireless phone tospeak directly to the other party. Such a requestmakes the telephone number available to the CAwho can then pass it on to the PSAP. With VCO inuse, the telecommunicator will hear the caller’svoice and not the voice of the Video Interpreter (VI).Depending on the VRS provider and the equipmentthe caller uses, the caller may be able to type tothe VI in order to clarify numbers, spelling or othersignificant information.

VRI - Videophone Remote Interpreting - Aninteractive video teleconferencing system thatutilizes a sign language interpreter at a call centerto interpret between sign language users and non-sign language users through video-conferencingequipment. This differs from VRS in that thehearing and deaf parties can be present in thesame room. Additionally, VRI is not regulated or


reimbursable by the FCC and costs are incurred bythe party hiring the VRI service.

VRS - Video Relay Service - A service provided bycommon carriers and other vendors that providesthird party communication relay between videotelephone users using Internet connections withvideophone or webcam and voice telephone users.Such services are located in call centers around thecountry.

Wireless IP Relay - The caller uses a handheldwireless device such as a text pager (i.e.BlackBerry, Sidekick, etc.) with web browser toconnect to a relay provider. (VCO is possible withwireless IP Relay if a landline phone withconference call capability is nearby, making locationinformation available to the CA who can pass italong verbally to the telecommunicator. WhenVCO is used, the telecommunicator will hear thecaller’s voice and not the voice of the CA.)


In California our next emergency never seems faraway. The threats are always present. Forexample, while completing this report (spring andsummer of 2008), California has over 1500 firesburning and the world seems to be experiencing anonslaught of extreme events and mega-catastrophes in the form of fires, floods andearthquakes.

3.1 Purpose

This After Action Report (AAR) highlights manydisaster response and recovery areas of specificand significant concern to the diverse disabilitiescommunities in California. Many of the localgovernment AAR reports are silent on these issuesor only vaguely mention them. This AAR offersspecific recommendations for strengthening andimproving preparedness, response actions andrecovery efforts that are inclusive of people withdisabilities and activity limitations. The intendedaudience includes the state, regional and localgovernments, policy makers and emergencyplanners, non government organizations (NGO),long term care facilities and older adults anddisability advocates.

3. Introduction


Some of the recommendations are new. Otherrecommendations reinforce a variety of continuingemergency concerns that existed before the 2007fires. These concerns are documented in previousreports written by California’s and other disabilitycommunities. [5, 6, 10, 11, 13, 15, 19, 20, 25, 26,27] The number of previous reports emphasizesthat lessons documented are not lessons learneduntil they are uniformly applied to disaster planningand response.

This report does not represent a comprehensivereview of all response systems. For example,beyond the scope of this report is the troubling, andunresolved question of what to do when thecommunication infrastructure is not intact. Many ofthe recommendations in this report require aworking communication network.

3.2 The Event

In October 2007, California experienced 15 wildfiresthat caused the largest evacuation in Californiahistory, with over 20,000 people taking refuge inmore than 50 emergency shelters, there wereapproximately half a million people evacuated.California’s fires seem to keep getting bigger andeach new report states that this was the biggestone!

"Planners cannotforesee everyoutcome, and incidentmanagers cannotanticipate everyscenario. Whiledisasters have alanguage of their own and no planguarantees success,inadequate plans areproven contributors tofailure."

U.S. Department ofHomeland Security[29]


3.3 Methods

This report documents the experiences of peoplewith disabilities and individuals with access andfunctional needs. Information was collectedthrough:

• Key informant interviews conducted in a semi-structured fashion, allowing interviewees torespond conversationally to open-endedquestions. Interviews were 10 to 45 minutes inlength and conducted by phone and in personfrom November 2007 through June 2008. (See14. Attachments - 14.1 Key Informants)

• Stories collected via California Foundation for

2007 Fires 2003 Fires

Dates of SOC Operations 10/21-11/4/07 10/21-11/5/05

Incident Period 10/21/07-3/31/08 10/21/03-3/31/04

Total Fire Incidents 24 in seven counties 14 in five counties

Counties Involved Los Angeles, Orange, Los Angeles, Riverside,Riverside, San Bernardino, San Bernardino, San San Diego, Santa Barbara Diego and Venturaand Ventura

Total Acres Burned 522,398 739,597

Human Fatalities 10 24

Human Injuries 139 246

Structures Destroyed 292 4,836

Residences Destroyed 2,233 3,631

Number of Persons Sheltered 22,195 unknown

Number of Shelters 54 unknown

Number of Persons Evacuated 324,500 Approx unknown

Table 1. Comparison of the 2007 Fires with the 2003 Fires

Independent Living Centers’ (CFILC) Accessto Readiness Coalition (A2R) 800 hotline andwebsite collection provided stories relayed bypeople working in the shelters (a number ofdisability organizations sent staff to shelters toassist with assessing and meeting essentialneeds of people with disabilities).

• Review of hundreds of emails generated duringand after the fires by NGOs staff andgovernment employees who worked asresponders in various settings.

• Review of documentation from public hearingtestimony.

• Review of prior California disaster reportsfocused on how people with disabilities fared. [6,7, 8, 9, 12, 13, 15, 19, 20]

• Review of American Red Cross (ARC)documents regarding services for individualswith disabilities.

• Discussions and presentations from:

- CFILC and Center for Disability Issues andthe Health Professions, Access to ReadinessCoalition Summit, January 11, 2008.

- Emergency Planning and PreparednessForum: Including People with DisabilitiesSponsored by City of San Diego DisabilityServices Program, Area Board XIII onDevelopmental Disabilities and Access toIndependence, January 23, 2008.

- California Department of DevelopmentalServices, Emergency Preparedness HotWash. 2008. Sacramento, April 29, 2007.



4.1 Narrow Definitions of Disability DoNot Work in Disaster Planning andResponse

It is common for emergency planners to be unclearregarding who is included in the “people withdisabilities and activity limitations.” Some planners,for example, when asked who makes up the specialneed populations, respond narrowly: “people withmobility disabilities,” “deaf people,” “blind people,”and “hospital patients.”

Many people need assistance, including thosewho do and those who do not identify as having adisability or activity limitation. Many needassistance, but have conditions that are not

apparent. Others haveobvious disabilities andlimitations but do not needassistance. Activity limitationcan be temporary resultingfrom, but not limited to,surgery, accidents andinjuries (sprains, brokenbones), pregnancy, etc. aswell as permanent conditions.Some activity limitationsresult from the disaster itself,and leave individuals more

4. Cross Cutting Issues

Most disaster responsesystems are designedfor people who can:walk, run, see, drive,read, hear, speak andquickly understand andrespond to instructionsand alerts.


vulnerable. [22]

The challenge is that mostdisaster response systemsare designed for people whocan: walk, run, see, drive,read, hear, speak and quicklyunderstand and respond toinstructions and alerts.Preparing to accommodatepeople with disabilities(diverse functional needs)often translates into beingbetter equipped to servediverse and sometimesvulnerable groups. Manypeople cannot safely orcomfortably use standard

response and recovery services, information orequipment. If the value that everyone should beincluded is not infused into planning, then noteveryone will be included.

There are many more people who havedisabilities and activity imitations than is commonlyrecognized. Traditional narrow definitions ofdisability do not work. Therefore, a function basedorientation should be integrated into disasterplanning and response.

When the Federal Emergency ManagementAdministration’s (FEMA) and the Centers forDisease Control’s (CDC) definitions of people withspecial needs are used, people with limited or noEnglish proficiency, older people, minority groups,children, people with serious mental illness, peoplewithout vehicles, people with specific dietary needs


and, pregnant women are also included.

This adds up to 50 percent of the populationwhen the most typical groups of “special needs”populations: people with disabilities, serious mentalillness, people who do not speak English or do notspeak English well, people 65 years old and overand children, age 15 and under, are counted. Byadding the entire institutionalized population, about4 million people (Census 2000, Summary File 1,Table PCT16) the percentage of individuals in thespecial needs category increases to 51.44%. SeeTable 2 below for detail. [22]

% of U.S. totalpopulation

Population Category Total (281,421,906)

Children, age 15 and under 64,272,779 22.84

Elderly, age 65 and over 34,991,753 12.43

Speak English “not well”, age 18-64 5,703,904 2.03

Speak English “not at all”, age 18-64 2,575,154 0.92

Noninstitutionalized population 33,153,211 11.78with a disability, age 16-64

Total special needs population 140,696,801 49.99

Data Source. U.S. Census Bureau, Census 2000 Summary File 1: table P2, totalpopulation; table PCT12, total population sex by age. Summary File 3: table P19, age bylanguage spoken at home by ability to speak English for the population 5 years and overand table P42, sex by age by disability status for the civilian noninstitutionalizedpopulation age 5 years and over.

Table 2. Percent of Americans with “Special Needs”


Some emergency managers question, “Whyfocus on such a small, insignificant group, whenthere are so many other priorities?” Given the sizeof the populations, people with disabilities andactivity limitations should not be thought of as theunfortunate special few. Functional limitations arecommon characteristics of the human experience.This is a very large group!

Many of these groups have little in commonbeyond the fact that their margin of resiliency maybe narrower and their vulnerability may be higherwhen compared to people without disabilities andactivity limitations and that they are often left out ofprograms, services and emergency planning. [19,26]

Accommodating this large group often translatesinto being better equipped to serve all people.Disasters and terrorism instantly escalate thenumber of people with new disabilities andfunctional limitations. [22]

While these population categories add up to50%, not everyone in these categories is likely tobe effected in every emergency. Depending on thetype of event, the time it occurs, its duration, andthe length of pre-event notice, different groups willbe affected. For example, an event with no noticethat occurs during the middle of a school day willleave many more children away from home andmore vulnerable than they would be if the eventhappened when they were home with their parents.People over 65 are not always at risk, some mayactually be leading and/or playing active roles in theresponse and management effort. The same is trueof people with disabilities.

Some emergencymanagers question,"Why focus on such asmall, insignificantgroup, when there are so many otherpriorities?" Peoplewith disabilities andactivity limitationsshould not be thoughtof as the unfortunateSPECIAL few.Functional limitationsare commoncharacteristics of thehuman experience.This is a very largegroup!


Depending on functional needs, and availabilityof regular support systems, many will need noassistance. Individuals who are immersed in acommunity where they do not need to speakEnglish, will rely on friends and neighbors who cantranslate emergency messages to address theircommunication needs. However, again dependingon the event, some subgroups, functionally defined,may need to be considered as a whole. Forexample, in the event of potential toxic exposures,all pregnant women will be vulnerable, whether ornot they speak English or have a disability. Amidday event that triggers a large-scale evacuationwill place individuals who rode public transit to theirjob that day in a “transportation disadvantaged”situation. Even though they may have a car athome or parked in a commuter parking lot,functionally, they are “carless” to respond to theevent.

Even if all people in all categories that make upthis 50% demographic are affected by an event, itdoes not necessarily mean that they all needassistance during any or all phases of responseand recovery. However, unless planners use afunction based approach to assess and addressunmet needs, there is no way to know whichindividuals will need additional consideration, andwhich will cope adequately on their own.

4.2 Moving Emergency Planning from “Special Needs” to “FunctionalNeeds”

Many lessons document, reinforce and underscore


that it is long past time to disaggregate the term“special need populations.” The term “specialneeds” does not work because it does not provideguidance to operationalize needed planning tasks.A better way to think about the needs of peoplewith disabilities and activity limitations is to use afunction based orientation that considers majorfunctional needs: communication, medical,maintaining functional independence, supervision,and transportation. Although everyone hasfunctional needs, the consequences of people withdisabilities and activity limitations not receivingneeded support, can be much more severe andmuch less forgiving. [19, 22]

Experience with disaster should raise the bar byincorporating learning, but this often has not beenthe case with functional needs issues. Peoplecontinue to lose their health, independence andsometimes their lives because information transferand lessons documented over the last 30 yearshave not been sufficiently learned and applied.

Disaster preparation and emergency responseprocesses, procedures, and systems can be mademore effective for people with disabilities, as well asfor the population as a whole. An essential elementof building appropriate levels of capacity, specificplanning, and response success is to move beyondfocus on special needs. A functional basedapproach is a more accurate and flexible planningand response framework. It is a framework basedon essential, sometimes overlapping, functionalneeds: communication, medical, maintainingfunctional independence, supervision, andtransportation. A function-based definition reflects

Many of thesegroups have little incommon beyond thefact that theirmargin of resiliencyis narrower and theirvulnerability ishigher whencompared to peoplewithout disabilitiesand activitylimitations and thatthey are often leftout of programs,services andemergency planning.


the capabilities of the individual, not the condition orlabel. [22]

Individuals in need of additional responseassistance may include those who have disabilities;who live in institutionalized settings; who areelderly; who are children; who are from diversecultures; who have limited English proficiency; orwho are non-English speaking; or who aretransportation disadvantaged.

This definition seeks to establish a flexibleframework that addresses a broad set of commonfunction-based needs irrespective of specificdiagnosis, statuses, or labels (e.g., children, theelderly, transportation disadvantaged). Thedefinition focuses on the following function-basedaspects:

Maintaining Independence – Individualsrequiring support to be independent in dailyactivities may lose this support during anemergency or a disaster. This support mayinclude consumable medical supplies (diapers,formula, bandages, ostomy supplies, etc.),durable medical equipment (wheelchairs,walkers, scooters, etc.), service animals, and/orattendants or caregivers. Supplying neededsupport to these individuals will enable them tomaintain their pre-disaster level ofindependence.

Communication – Individuals who havelimitations that interfere with the receipt of andresponse to information will need thatinformation provided in methods they canunderstand and use. They may not be able to


hear verbal announcements, see directionalsigns, or understand how to get assistance dueto hearing, vision, speech, cognitive, orintellectual limitations, and/or limited Englishproficiency.

Transportation – Individuals who cannot driveor who do not have a vehicle may requiretransportation support for successful evacuation.This support may include accessible vehicles(e.g., lift-equipped or vehicles suitable fortransporting individuals who use oxygen) orinformation about how and where to accessmass transportation during an evacuation.

Supervision – Before, during, and after anemergency individuals may lose the support ofcaregivers, family, or friends or may be unable tocope in a new environment (particularly if theyhave dementia, Alzheimer’s or psychiatricconditions such as schizophrenia or intenseanxiety). If separated from their caregivers,young children may be unable to identifythemselves; and when in danger, they may lackthe cognitive ability to assess the situation andreact appropriately.

Medical Care – Individuals who are not self-sufficient or who do not have adequate supportfrom caregivers, family, or friends may needassistance with: managing unstable, terminal orcontagious conditions that require observationand ongoing treatment; managing intravenoustherapy, tube feeding, and vital signs; receivingdialysis, oxygen, and suction administration;managing wounds; and operating power-dependent equipment to sustain life. These


individuals require support of trained medicalprofessionals. [22]

Separate “special needs population” planningand separate “special needs population” annexesare not effective. Segregating and isolating theneeds of significant numbers of the population doesnot make sense. It is inefficient with regard tobudgeting, procurement and resource allocation.Planning is not a two stage process comprised of“the critical plan” and then “the special plan.”Separate planning often means planning is never isdone.

People with disabilities and activity limitationsare diverse and should not be sidelined orcompartmentalized into a special needs box. Thecurrent general population is one that is diverse,aging, and focused on maintaining independenceas long as possible. The popularity of livingsituations that provide an “as needed” level of carein the least restrictive manner is becoming thenorm. Consideration must be given to people whomay be able to function independently undernormal situations, but who may need assistance inan emergency. [17]

Special implies difference and isolation and thatthe individuals needs are different from others.Among disability advocates, the special label isoften used for segregated programs. Programs andservices continue to miss the mark when peopleare seen and served as people having specialneeds instead of people who are a part of everysegment of the general population. As long asdisability and other special needs groups areviewed as unique or special, the system’s existing

Separate "specialneeds population"planning and separate"special needspopulation" annexesare not effective.Segregating andisolating the needs ofsignificant numbers ofthe population doesnot make sense. It isinefficient with regardto budgeting,procurement andresource allocation.Planning is not a twostage processcomprised of "thecritical plan" and then"the special plan."Separate planningoften means planningis never is done.

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inefficiencies will continue. [22]

Recommendation

1. State and local government emergencyplanners should use a “functional needs”framework. Using a more effective,accurate and flexible framework built on anessential functional based orientationaddresses the needs of more people, moreefficiently and effectively in ways that:

• build appropriate levels of capacity fordisaster preparation, emergency responseprocesses, procedures and systems;

• adopt guidelines and protocols forappropriate resource management;

• strengthen service delivery and training;

• prevent health complications and reduceinstitutionalization and the inappropriateuse of scarce, expensive and intensiveemergency medical services;

• allow disaster services to incorporate thevalue that everyone should have thechance to survive;

• translate documented lessons intoknowledge and application; and

• improve overall response successes.

Many underestimate the advanced planning andcoordination time needed to make the transition toa function based approach that is necessary to


effectively integrate and accommodate people withdisabilities and activity limitations. Good practiceinvolves networking, building and strengtheningrelationships that foster ongoing communication,coordination, cooperation and collaborationbetween disability communities and emergencymanagers. Involving qualified representatives fromthese communities helps planners understand andthink through issues from disability, functionalneeds and aging perspectives and can help preventmaking mistakes.

Qualified representatives, include those who, interms of recruiting people for advising, planning,staffing and contracting work:

• Identify as people with disabilities and / oractivity limitations;

• Have a user’s perspective;

• Have personal experience with disability anddisability advocacy;

• Can speak broadly on disability issues asopposed to only addressing their own needs;

• Are knowledgeable about cross-disability accessissues (hearing, vision, mobility, speech, andcognitive limitations);

• Are knowledgeable about a variety of physical,communication, and program access issues.

Qualified people should:

• Be connected to and involved with segments ofnational, state or local constituencies of thedisability community, such as active involvementin broad-based disability organizations (of and


for blind, deaf, hard of hearing, learningdisability, developmental disability, independentliving, multiple chemical sensitivities, etc).

• Have in place and use communication arteries tofacilitate two-way communication with thesegments of the disability community they arerepresenting.

In addition, other types of experience may beneeded. For example, qualified advisors, trainers,contractors and consultants with disabilities mayneed to have:

• Disaster-related technical expertise.

• Advocacy experience, management experience,and training skills. [28]

SB 1451 sponsored by Senator Christine Kehoe(D-San Diego) and developed with input from theCalifornia Council for the Blind, and other disabilitycommunity groups, requires The Governor’s Officeof Emergency Services (OES) to integratemembers of the diverse disability community into allpertinent Standardized Emergency ManagementSystems (SEMS) committees. This enablesqualified individuals with disabilities, through thisstate level planning to address communication,evacuation/transportation, shelter and recoveryissues.

Recommendations

2. As the state emergency planners transitionfrom the SEMS planning committeestructure to a structure that reflects thestate’s revised emergency functions (in the

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soon to be updated State Emergency Plan)the state should continue to ensure inputand integration of diverse qualifieddisability representatives in these newplanning committees.

3. State emergency planners shoulddevelop and offer guidance to localgovernment regarding how to activelyrecruit qualified people with a variety ofdisabilities (i.e., mobility, vision, hearing,cognitive, psychiatric, and otherdisabilities), and how to involveorganizations with expertise on disabilityissues in all phases of emergencymanagement planning.

4.3 Grants and Funding

In 2007, Senator Kehoe introduced SB 426,sponsored by the California Foundation forIndependent Living Centers (CFILC), intended tocreate the position of Deputy Director for Accessand Functional Needs Coordination within the OES.Although the bill did not pass the legislativeprocess, it did emphasize the importance of thisoffice. [22] CFILC’s Access to Readiness Coalitioncontinued its advocacy efforts immediately followingthe wildfires and as a result, in early 2008 the OESDirector established the Office of Access andFunctional Needs.

This office is identifying and addressing barriersto help ensure the safety of all individualsregardless of their functional needs. This office will

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oversee and ensure adequate planning thatincorporates the diverse needs of people withdisabilities and functional limitations in allpreparedness, response, recovery, and mitigationactivities. This includes minimizing adverse impactsby building capacity so that emergency programsand services are accessible to, accommodate andare inclusive of these populations.

Recommendation

4. The state should make the Office ofAccess and Functional Needs permanentand the lead position equivalent to adeputy director / assistant secretary. Thisoffice must have the authority, responsibilityand resources to carry out its criticalobjectives.

Except for the Office of Access and FunctionalNeeds, the state devotes few fiscal resources toidentifying and addressing barriers to help ensurethe safety of all people, regardless of theirfunctional needs.

Recommendations

5. State and local government emergencypolicy makers should allocate a percentageof annual funding for the purpose onstrengthening and improvingpreparedness, response actions andrecovery efforts that include of people

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with disabilities and activity limitations.This AAR provides specificrecommendations for critical projects tofund.

6. State and local government emergencypolicy makers and planners shouldintegrate into emergency grants andcontracts proposal selection criteria(rating score criteria) specific indicatorsfor evaluating proposals that includepeople with disabilities and activitylimitations. For example, as appropriate tothe proposal’s focus, these indicators shouldspecifically detail and show evidence of howapplicants will include function basedservice issues and physical, communication,and program access, such as:

• Meeting the communication, evacuation,transportation, physical access, and healthneeds of diverse functional needspopulations,

• Contracting with and employing qualifiedpeople with disabilities and activitylimitations,

• Forming partnerships among firstresponders, emergency planners andorganizations representing diversefunctional needs populations, to ensureaccurate training information anddevelopment of usable services andresponse,

• Appointing qualified representatives from


diverse functional needs populations toemergency planning efforts as staff,advisors, trainers, contractors, andconsultants,

• Promoting Community EmergencyResponse Teams (CERT) that recruit andaccommodate people with disabilities andactivity limitations.

4.4 Emergency Registries

Emergency registries, as used in this AAR, refer togovernment efforts to collect information aboutpeople with disabilities for use by emergencyand/or health and human service personnel. Thisinformation consists of a database of individualswho voluntarily sign up and meet the eligibilityrequirements for receiving emergency responseservices based on a need. Although some registriesexist in San Diego, they were not used during the2007 fires. There are documented reports fromCalifornia regarding serious problems in keepingregistries current as well as easily and quicklyretrieving the data and responding when needed.[12]

California emergency responders commentingon the use of registries stated:

“The act of creating a registry does not increaseresponse capacity, but focusing on integratingcommunity stakeholders in response does.”

“Lists are only as good as the public being ableto provide information or wanting to provideinformation. The lists are also very time

Many object to theinherent registry biasthat most people withdisabilities are easy tolocate because theyare "homebound."That is, registries do not acknowledgethat this diversepopulation, just likeeveryone else, works,volunteers, plays,prays, shops, eats andtravels.


consuming and require a large amount of stafftime to maintain.”

“There is also a public expectation that being ona “registry” means that the appropriate responsewill occur - during disasters there are usually notenough resources to respond to each registeredperson.” [11]

Some emergency planners mistakenly viewdisability-focused registries as relatively easy andsimple solutions. However, this is not the case,registries have diverse and complex elements thatinclude funding, administration, focus, recruitmentof potential users, enrollment, disclaimers,education efforts, data management (informationcollected, privacy, refreshing-maintenance, storageand retrieval), and response force commitments.

Unfortunately, there is scarce and piecemealresearch on registries and how to operationalizeand sustain them. There is a lack of guidanceregarding accepted good practice when entities arecontemplating creating and maintaining a registry.The research is silent with regard to acknowledgingthe ongoing significant time and labor costs andthere is little documentation regarding successfuloutcomes. [24]

Acceptance of the use of these registries by thepopulations they are intended to assist varies fromappreciation to grave concern and condemnation.Some disability advocates state it is “a lot about uswithout us,” meaning the intended users are notincluded in the planning for or managing the effort.Some question the rigor applied to the critical effortof keeping data current and accurate given the

There is scarce andpiecemeal research onregistries and how tooperationalize andsustain them. There is a lack of guidanceregarding acceptedgood practice when entities arecontemplatingcreating andmaintaining a registry.The research is silentwith regard toacknowledging theongoing significanttime and labor costsand there is littledocumentationregarding successfuloutcomes.


short self-life and perishable nature of registry data.Many object to the inherent registry bias that mostpeople with disabilities are easy to locate becausethey are “homebound.” That is, registries do notacknowledge that this diverse population, just likeeveryone else, works, volunteers, plays, prays,shops, eats and travels.

Some claim registries are inadequateapproaches authorized by emergency managerswho do not comprehend the complexity ofdisability-related emergency services. Some worrythat registries give people a false sense of security,even when they come with educational efforts andvery clear disclaimers. Some complain thatregistries are often undertaken as a “reflexresponse” and a misguided and “easy planning fix”to the disability “problem.” Some question whathappens to the many who do not register. Do onlypeople who register get preferential service andwhat about visitors? [24]

California’s Emergency Services Act promises todevelop model guidelines for local governmentagencies and community-based organizationsplanning to develop a disaster registry, but to datethese guidelines do not exist. [10]

Recommendations

7. State and local government emergencyplanners should proceed cautiously andcarefully with regard to endorsing theuse of emergency registries for peoplewith disabilities and activity limitations.

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8. State emergency planners should reviewexisting registry requirements in theCalifornia Emergency Services Act anddevelop realistic recommendations thatlead to integrating disability-focusedservices and qualified representatives intoemergency planning and managementsystems.


For more information regarding the words andacronyms that are bolded, refer to section 2.Definition and Acronyms.

Reports from the community included:

• People with hearing loss could not hear theevacuation announcements or vehicle sirensfrom patrol cars.

• People with vision loss could not see police andfire-rescue vehicle and helicopter lights.

• TTY numbers were not consistently provided bystate and local government and the media whenproviding information on evacuation centers andlocal assistance centers.

Most people who have limitations that interferewith receiving and effectively responding toinformation are self-sufficient, when they receiveinformation in ways they can understand and use.Limitations of seeing, hearing, speaking,understanding, cognition or intellectual abilities andlimited language proficiency prevent significantnumbers of people from receiving andunderstanding emergency alerts, information,signage, and directions on television and radio.

Access to emergency warnings and informationis important for the general population as well as forpeople with disabilities. There are widespread

5. Communication Access

Individuals whomay need moretime than averageto evacuate andtake other actionfor safety are oftenthe last group ofpeople to receiveemergencyinformation.


concerns about safety due to natural and person-generated disasters. Individuals who may needmore time than average to evacuate and take otheraction for safety are often the last group of peopleto receive emergency information. People withdisabilities need to receive messages at the sametime as the people without disabilities. It is criticalthat people who have limitations of seeing, hearing,understanding, cognition or intellectual abilities andlimited language proficiency receive information thatis functionally equivalent (that is, equal to the sameinformation received by people without disabilities)in order to prepare before, during, and after adisaster.

Clear communication is a cornerstone ofsuccessful planning and response. Access toemergency public warnings, as well aspreparedness and mitigation information andmaterials, must include people who only receivetheir information orally or visually, and people whoneed and use alternative formats (Braille, largeprint, disks, graphics/symbols, and audio) to accessinformation.

5.1 People Who are Deaf, Deaf-Blind,and Hard of Hearing

According to the United States Department ofJustice (DOJ), there are 28 million Americans withsome degree of hearing loss. These individuals areconcerned with their safety due to their limitedaccess to emergency warning announcementsdelivered audibly via TV, radio, and telephones.

Today’s expanding technologies give people

Clear communicationis a cornerstone ofsuccessful planningand response. Accessto emergency publicwarnings, as well aspreparedness andmitigation informationand materials, mustinclude people whoonly receive theirinformation orally orvisually, and peoplewho need and usealternative formats(Braille, large print,disks, graphics/symbols, and audio) to accessinformation.


many options for communication methods. Peoplewho are deaf, deaf-blind, hard of hearing andindividuals with speech disabilities are takingadvantage of these options and rapidly migratingfrom traditional use of land line phones to moreadvanced telecommunications methods, for peer-to-peer communications via wire line and wireless.

`There must be multiple and redundant means ofconveying timely information. A range of optionsmakes it possible for people to choose the methodthat best meets their communication preferences.Once limited to the use of TTYs or amplifiedhandsets, these newer methods include wirelessdevices, videophones/video cams, computers, andmessaging technologies including email, shortmessage service (SMS), and instant messaging(IM). This range of options makes it possible foreach user to choose the equipment mostresponsive to their communication preferences. Byutilizing these devices and connecting with IPRelay, Wireless Relay, IM Relay Service andVideo Relay Service (VRS), individuals canexperience telephone communication morefunctionally equivalent to that enjoyed by peoplewho can hear and speak. [26]

Many members of the deaf and hard of hearingcommunity do not realize that many emergencywarning systems do not have a TTY communicationsystem in place should they need to make contactor be contacted regarding an emergency. Whilesome people who are Deaf and hard of hearing usea TTY at home, others rely on newer technologiessuch as a handheld device for e-mail, Internetprotocol telecommunications relay and videophone

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services. TTYs are large and not as mobile orconvenient. Newer devices provide more freedomto move around and communicate like neverbefore. As a result, wireless text communication isa core communication tool in the deaf community.

Recommendations

9. State and local government emergencyplanners should increase access toemergency information by incorporatingredundant communication methods thatprovide understandable, usable, and timelyinformation to the community.

5.2 Mass Notification Systems forEvacuation

Recommendations

10. State and local government emergencyplanners should train people providingdoor-to-door notification that, in additionto loudspeakers, used in emergencyevacuation announcements they shouldalso include picture/symbol signs(pictograms).

This benefits people with: limited Englishproficiency, hearing loss, limited speech, speechand/or abilities, very young children, and anyoneunder severe stress or with cognitive or intellectual

4


disabilities.

Nongovernmental organization (NGO)preparation should include development ofdistribution lists in advance of events to sendinformation to land line phone, cell, desk, pager,BlackBerry and fax numbers. NGOs can alsoassist with tailoring audience-appropriate messagesto the differing needs of populations, e.g....messages geared to low-level reading ability, withsimple, clear and direct language. [3]

Recommendations

11. State and local government emergencyplanners should create redundancy ofpublic warnings by utilizing NGOs aspartners who have connections tospecific populations to assist in publicwarnings, alerts and notification.

12. State agencies and local governmentsshould consistently provide TTY numbersfor information on evacuation centersand local assistance centers.

5.3 TV Broadcast

Reports from individuals with hearing loss included:

• Lack of captioning, including captioning oninternet videos, prevented people who are deafand hard of hearing from understanding thedanger, resulting in heightened anxiety andconfusion while they watched disturbingtelevision scenes.

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• Scrolling text and crawl messages sometimesblocked captions, making it difficult to readcaptioned information. They also forced thepicture to be smaller which sometimeseliminated the real-time interpreter from view.

• Live interpreters often did not accompany thereporters. [JK1] Press conferences andtelevision interviews did not always includequalified sign language interpreters andcaptioning.

Reports from individuals with vision loss included:

• Flashing news updates on TV often did notinclude voiced reports.

• Emergency scrolling text information includingphone numbers were often not read aloud (“callthe number on your screen”). Logic suggeststhat people could switch to radios for thisinformation. This may not work in some ruralcommunities because some radio stations runautomated broadcasts in the evenings andweekends. In addition, some rural communitiesonly have access to statewide information ratherthan local information.

Just as a combination of captioning and signlanguage interpreting makes communicationaccessible for a broad range of people who aredeaf and hard of hearing, verbal announcements ofphone numbers and other text on TV makeinformation more accessible to low vision and blindindividuals.

Federal Communications Commission (FCC)rules state that for people who are deaf or hard ofhearing, emergency information that is provided in

Sign language interpreterat a televised pressconference. (photo: SanDiego County After ActionReport)


the audio portion of the programming must beprovided using closed captioning or other methodsof visual presentation, such as open captioning,crawls, or scrolls that appear on the screen.Emergency information provided by these meansshould not block any closed captioning, and closedcaptioning should not block any emergencyinformation provided by crawls, scrolls, or othervisual means. This rule regarding access toemergency information for persons with hearingdisabilities became effective on August 29, 2000.[16]

The same information must be accessible topersons who are blind or have low vision.Specifically, emergency information provided in thevideo portion of a regularly scheduled newscast ora newscast that interrupts regular programmingmust be made accessible. This requires the oraldescription of emergency information in the mainaudio, such as open video description. If theemergency information provided in the videoportion of programming is not a regularly schedulednewscast or a newscast that interrupts regularprogramming (e.g., the programmer provides theemergency information through “crawling” or“scrolling” during regular programming), thisinformation must be accompanied by an aural tone.This tone alerts people with vision disabilities thatthe video programming distributor is providingemergency information, and alerts such persons totune to another source, such as a radio, for moreinformation [JK3]. This rule regarding access toemergency information for persons with visiondisabilities became effective February 2, 2001. [16]


Recommendations

13. State and local government emergencyplanners should ensure announcements bygovernment officials on television shouldinclude qualified sign languageinterpreters and have captions to ensurethat people who are deaf and hard ofhearing are able to access the information.

14. State emergency planners should developguidance issued before, and immediatelyin times of disasters, to all broadcasters,reminding them of their obligation tocomply with FCC rules. This guidanceshould be developed in partnership withqualified members of the blind, deaf andhard of hearing communities.

15. Because of a significant shortage ofqualified sign language interpreters, stateand local government emergency plannersshould establish memoranda ofunderstanding and mutual aidagreements with video remoteinterpreting services from diverse in-state and out-of-state areas.

5.4 Emergency Warning Systems

Reports from the community included:

• The San Diego Deaf community reported thatemergency notification systems did not reachthem. Some emergency notification systems donot automatically convert the message to text

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when a TTY machine is detected. Instead, thesystem hangs up on the TTY machine and callsback to deliver the text message. The problem issome TTY machines take a few minutes to resetthemselves. Thus, it may be three to fourminutes before the text message comes through,thereby jeopardizing the safety of the recipient.

• Some complained that there is a limit to thenumber of characters that can be used (e.g., 225to 250 characters) for a TTY message. Thisnumber of characters may be insufficient tocommunicate emergency messages.Specifically, these systems tend to send longervoice messages to traditional land line phoneusers. Thus, people who are deaf or hard-of-hearing often receive more abbreviatedemergency information than the hearingcommunity.

Recommendation

16. State emergency planners should finalizethe system to broadcast messages towireless communication devices inCalifornia communities, and continuedevelopment of other high-technotification systems. This includes TheGovernor’s Office of Emergency Services(OES) charge under AB 2231 to convene aworking group to assess existing and futuretechnologies available in the public andprivate sectors for the expansion oftransmission of emergency alerts to thepublic through a public-private partnership.

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Reverse 9-1-1 proved to be an effective methodof notification, However, many questions remain asto how effectively this reached and worked with thedeaf and hard of hearing communities.

While local government emergency notificationsystems are capable of communicating with non-traditional devices, a large majority of cities andcounties are not utilizing the capabilities oftenbecause they have not collected the necessarydata. For the most part, there has been littleoutreach targeted specifically to the deaf and hardof hearing communities. San Diego jurisdictionsuse two warning system:

1. “21st Technology Universal CommunicationsSystem” (also called Alert San Diego). Thissystem is web based and could reach cell, pagerand BlackBerry numbers if the citizen orbusiness had registered them.

2. The “Reverse 911” system utilizes LAN linephones. [26]

Recommendations

17. State and local government emergencyplanners should provide guidance topublic safety and private sector agenciesthat send emergency alert notificationsto the public. This guidance shouldreinforce that emergency notificationprograms:

• Need to offer functionally equivalentservices to all populations.

• Need to allow the receiver the option to

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have the message repeated.

• Have TTY capabilities, including being able to auto detect TTYs and send theappropriate messages. That is, automaticdialing-announcing devices need thecapacity to call TTYs.

• Need to conduct aggressive outreach andeducation using accessible formats to deafand hard of hearing communities to notifythem of the need to register their TTYnumbers so that they will receive allemergency notifications. The databasesrequire regular updating and shouldinclude wireless numbers (until thesystems “auto detect” capabilities areproven to work effectively).

• Need specific contract language thatdetails the significant penalties for systemsnot compatible with TTYs.

• Need to test TTY compatibility with a mixof TTY and non TTY users to insure theability to accurately auto detect TTYs andsend the appropriate message.

• Involve participation of qualifiedstakeholders to help the State stay abreastof emerging technology and plan for futureadoption and integration into emergencywarning systems.

• Need multiple options with built inredundancy for broad awareness. Thismeans using multiple formats foremergency notification systems, because


emergency e-mail and wireless networkalerts are helpful but information can bespotty and truncated.

In our highly mobile world local governmentneeds to communicate with people where they live,work and play. (See 14. Attachments - 14.2Sample: Emergency Notification: Register Your CellPhone and E-Mail Address)

Recommendations

18. State and local government emergencyplanners should devote significantresources (until they can automaticallyobtain wireless device numbers) toaggressively sustain and maintainoutreach of emergency warningnotification to potential users. They needto urge people to register their wirelessdevices (cell phones, and email addresses)for emergency notifications

19. State and local government emergencyplanners should urge the emergencynotifications vendors to enablecommunication with a variety of devices:

• TTY (text telephone)

• Videophones

• E-mail

• Text pager

• Speech generating devices

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• Text message and Short MessageService (SMS)

• Weather Alert Radio

• Highway electronic variable messageboard

• Fax machines

• Sign Language Interpreter via video e-mail

• American Sign Language version ofcomplex text information on websites

• Other new technologies

5.5 Public Safety Answering Points(PSAPs)

A public safety answering point (PSAP) is aphysical location where 911 emergency telephonecalls are received and then routed to the properemergency services. New wireless and IP-basedcommunications devices are creating challenges forPSAPs. The current 9-1-1 system was neverintended to receive calls and data from these newand emerging technologies. The nation’s 9-1-1systems are in need of overhaul. A Next Generation9-1-1 (NG9-1-1) system must be created to identifythe location of all individuals on wireless systems inorder to provide access to timely and effectiveassistance at all times. Along with a technologicaloverhaul of the system come significant regulatoryand policy issues that must be addressed federally.[18]


PSAPs cannot be contacted by new forms oftelecommunications, such as email, instantmessaging and IP-based forms of relay servicesincluding VRS. The gap between the technologysupported by policy and the technologies currentlyused by people who are deaf or hard of hearingand people with speech disabilities is a seriousproblem that is difficult to solve.

However, the FCC has just issued a rule,effective in 2009, that will result in telephonenumbers being provided to IP relay service users.Many already have telephone numbers associatedwith wireless relay providers. The new rule focuseson 911 access and the ability for 911 to call backeasily. These numbers need to be integrated intotelephone emergency notification systems so thattelephone notification can reach people through therelay services.http://hraunfoss.fcc.gov/edocs_public/attachmatch/FCC-08-151A1.doc

As already mentioned, the use of traditional landline telephones and text telephones among peoplewho are deaf or hard of hearing and people withspeech disabilities has declined. New IP-basedtechnologies that provide mobility, efficientcommunication and accommodation of individualcommunication needs cannot call 9-1-1. Only theanalog technologies, for many a last resort, methodof communications, remain available to thesepopulations. [18]

Cell phones can be used with TTYs for calling 9-1-1, and location information and coverage isequal to that for voice customers. However, theTTY is quite large and bulky compared to wireless


devices and is rarely used with cell phones today.The wireless industry has not built TTY functionalitycompletely into wireless handsets that havekeyboards and screens (such as a BlackBerry™,Sidekick™, and Treo™). This capability wouldpermit such devices to produce TTY calls to 911complete with location information comparable towhat hearing/voice users have. [18]

People who are deaf, deaf-blind, hard ofhearing, blind and low vision, and individuals withspeech disabilities require the same information aseveryone else so they can be more preparedbefore, during and after a disaster. It is critical tohave several options for emergency communicationsystems accessible visually through text, graphics,or other means of communication. These newerwireless and Internet-based telecommunicationdevices are effective for day-to-day relayedtelephone conversations, so people who are deafor hard of hearing want to be able to use them foremergency calling, while maintaining TTY accessas an option. Consequently, there is a need todevelop proven, uniform operational guidelines andrecommendations for:

• Caller to relay service interaction

• Relay service to PSAP interaction

• Caller to relay service to PSAP interaction

A rapidly growing number of consumersincluding people who are deaf, deaf-blind, hard ofhearing, or those who have a speech disabilityhave discontinued land line telephone serviceentirely and rely exclusively on VRS and/or IPRelay services for emergency communications.


Implementing an effective emergencycommunication system must be addressed. Manyof these problems must be dealt with at the federallevel. However, a number of mitigating measurescan be undertaken now in California.

Recommendation

20. State emergency planners will need to staycurrent on the federal standardsdevelopment work in 9-1-1. In addition tothe immediate goal of enabling users ofVRS and IP Relay Services to access theappropriate PSAP, the long-term goal is toprovide a NG9-1-1 environment where theusers of videophones, wireless devices,and/or the internet can access to 9-1-1PSAPs directly without requiring a relayservice as an intermediary.

5.6 Communication Access atShelters and Assistance Centers

Reports from individuals regarding communicationaccess issues included:

• Telephones were not within reach of wheelchairusers (Orange Show).

4Accessible telephone andcommunication equipmentand email access was notavailable in some shelters.Telephones were notwithin reach range ofwheelchair users (OrangeShow).

Accessible telephone andcommunication equipmentand email access wereavailable at some shelters(Del Mar)

Accessibletelephone andcommunicationequipment andemail access wereavailable at someshelters (Del Mar)


• TTYs were not available.

• The availability of qualified sign languageinterpreters was inconsistent and not available atall in shelters. “During the fires there was achronic lack of translators, which hindered theability to evacuate and/or provide otheremergency services. Translation services helpmany people stay informed and in turn remaincalm, seek additional assistance, and feel caredfor.” [14]

• Televisions, available to the public in shelters,often did not have open captioning on.

• Signage (regarding information such as locationsof food, water, first aid and other assistance)was often solely text based English renderingthem unusable for people who have limitationsof seeing, understanding, cognition or intellectualabilities and limited language proficiency.

Recommendations

21. State and local government emergencyplanners should offer guidance regarding

Text based Englishsignage: Medical Needs1A Door 5 (QualCom)

Variety of text basedEnglish signage (OrangeShow)

Television with captions on

Left: Kosher Food at Gate d 9-9:30 PM. Right:Medical Mobile Unit Outside Gate A (left arrow)Free (QualCom)

4


communication access in shelters andassistance centers that includes: turningcaptions on for all televisions used by thepublic, and using understandable signage(using visually dependent, rather thanlanguage dependent signs i.e. symbols inaddition to or in place of text) to assist manypeople who have limitations of seeing,hearing, understanding, cognition orintellectual abilities and limited languageproficiency.

• Qualified sign language interpreters (orvideo remote interpreting) need to beavailable at designated times under pre-established memoranda of understandingand mutual aid agreements.

• When phone service is available andlanguage interpreters are not available,consider using phone-based andTelecommunications Relay Services(TRS) for those with hearing loss or speechdisabilities, and over the phone.

Non-text signage: SIGNLANGUAGEINTERPRETATIONSERVICE 10-11 AM

Non-text sample signage:left to right top - First Aid,Elevator: left to rightbottom - Restrooms, Food

Non-text sample signage:medical assistance

Non-textsamplesignage: top left- Information,bottom left - nosmoking, right -no cell phones

10 - 11 AM


interpretation services for peoplewho do not speak English.

• When emergency telephonetrailers or communicationequipment are made available,telephones need to be accessibleto wheelchair users and TTY users.

• Contents of verbal announcements shouldbe posted in specified shelter areas as wellas in languages used by a significantpercentage of the population.

The 2-1-1 Call Centers, Disaster AssistanceCenters, and Local Assistance Centers do, did andwill continue to play significant roles in providingcritical emergency information, resources andbenefit applications.

Recommendations

22. The 2-1-1 Call Centers, DisasterAssistance Centers, and LocalAssistance Centers should maintainrobust disability-specific serviceinformation. They should insure that theycan communicate with people who havelimitations of seeing, speaking, hearing,understanding, cognition or intellectualabilities and limited language proficiency.

23. State and local government emergencyplanners should ensure equal access byutilizing procedures that allow people to

Non-text sample signage:left to right - accessible -parking, access entrance,accessible restrooms

Combined text and non-text directional signage

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apply in different ways and offerreasonable modifications to applicationprocedures when people with disabilitiesneed them.

Information and application procedures shouldnot limit access by people with disabilities. Forexample, programs that require people to apply bytelephone may exclude people who are deaf orhard of hearing or have difficulty understandingspoken language. Inaccessible web-basedapplication procedures and printed applicationforms may exclude people who are blind or havelow vision or have difficulty reading text. Programsthat require in-person applications may excludepeople who, because of their disabilities, areunable to get there.

Recommendations

24. State and local government emergencyplanners should offer information aboutsocial services and other benefitprograms available in formats peoplewith communication disabilities canunderstand and use.

25. When people are instructed to check awebsite, state and local governmentemergency planners need to insure that (1)the link to website is activated, and (2)the data on the website is compliant withrequirements under Section 508 of theRehabilitation Act of 1973, which can be

4


found at http://www.access-board.gov/508.htm. Additionally, inSeptember 2002, Senate Bill 105 wasenacted to amend Section 11135 ofGovernment Code to read “stategovernmental entities, in developing,procuring, maintaining, or using electronic orinformation technology, either indirectly orthrough the use of state funds by otherentities, shall comply with the accessibilityrequirements of Section 508 of theRehabilitation Act of 1973. The State hasdeveloped recommendations for ensuringwebsites are accessible, found athttp://www.cio.ca.gov/Government/governance/workinggroups/iouca.html.

26. State and local government emergencyplanners need to insure that web sitesused in emergencies can handle theincreased user traffic. This applies toeveryone, but is especially important forpeople who are deaf or hard of hearing.


In contrast to prior disaster-related reports therewere no reports of people with disabilities includingthose using service animals being denied access toshelters. [12] People did report:

• some shelters were fairly accessible, whileothers had significant barriers,

• problems with accessible building entrances,restrooms, and showers,

• lack of directional signage to accessible featuresand elements,

• lack of accessible cots,

• trouble accessing meals, medications, durablemedical equipment (DME) and consumablemedical supplies (CMS) for evacuees inmotels,

• lack of options for specific dietary needs (i.e.people unable to chew, diabetics, etc),

• problems with assistance in refrigeratingmedications,

• difficulty replacing essential medications, (DME)and (CMS),

• lack of shelter personnel responsible forcoordination of services to evacuees withdisabilities, which led to confusion and unmetneeds, and

6. Mass Care and Shelter

Portable restrooms andshowers lacked access


• individuals with experience in addressingessential functional needs of people withdisabilities and activity limitations were notpermitted access to some shelters.

6.1 ADA Requirements

Shelter operators include government, theAmerican Red Cross (ARC) and/ornongovernmental organizations (NGOs).Regardless of who operates a shelter, theAmericans with Disabilities Act of 1990 (ADA)generally requires shelters to conduct operations inways that offer people with disabilities the samebenefits (e.g., safety, comfort, food, medical care,the support of family and friends) provided topeople without disabilities.

Sheltering programs are critical to ensuring thesafety of people with disabilities in emergenciesand disasters. ADA requirements for sheltering aredetailed in two Department of Justice technicalassistance documents for state and localgovernments. These documents provide operatorsguidance in planning to meet the needs of peoplewith disabilities in shelters. [31]

State and local government emergency plannersshould insure that shelters are accessible topeople with disabilities. Making emergencysheltering programs accessible is generallyrequired ADA. Accessible features need to be partof emergency shelters.


Recommendations

27. State and local government emergencypolicy makers need to insert accessstandards in state law definingrequirements for sheltering people withdisabilities and activity limitations.

28. State and local government emergencyplanners should provide guidance to localgovernments to make sure that all shelterfacilities identified for use are accessible.Shelters surveys should identify barriers topeople with disabilities, includingwheelchairs or scooters users or those whohave difficulty walking, people who are deafor hard of hearing and people who are blindor have low vision. This guidance shouldinclude use of the Department of Justice’sQuick-Check Survey and the ADA Checklistfor Emergency Shelters. [32]

These Department of Justice tools assist stateand local officials and operators of emergencyshelters in determining whether a facility beingconsidered for use as an emergency shelter isaccessible and if not, whether modifications areneeded to remove barriers or whether relocation toanother accessible facility is necessary. The Quick-Check Survey provides guidance on whether afacility has certain basic accessible features, andthe detailed ADA Checklist for Emergency Sheltersprovides specific information on barriers toaccessibility.

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Recommendations

29. State and local government emergencyplanners responsible for sheltering mustensure that: where multiple single userportable toilet or bathing units are clusteredat a single location, no more than 5 percentof the toilet units and bathing units at eachcluster shall be accessible; and for singleuser portable toilet or bathing units clusteredat a single location, at least five percent butno less than one toilet unit or bathing unitneeds to be accessible. [2] This access isalso important for children and older people.

30. State and local government emergencyplanners should provide guidance to localgovernments regarding model contractlanguage requiring contractors toprovide accessible portable restroomsand showers. [2]

31. State emergency planners should provideguidance to local governments regardingthe importance of continual vigilancewhen shelters are in use to ensure,walkways and other features are clear ofobstacles such as cords, boxes, trash, etc.For example, advise the media to not stringcables across walkways unless they haveproper materials to prevent them frombecoming barriers for wheelchair or scooterusers as well as tripping hazards for allpeople.

4


Some people with disabilities sheltered in hotels,due to better accessibility, had difficulty obtainingmeals, essential medications, DME and CMS.

Recommendation

32. State emergency planners should provideguidance to local government regardingproviding meals or meal vouchers, essentialmedications, DME and CMS for evacuees inmotels.

6.2 Medications, Durable MedicalEquipment and Consumable MedicalSupplies

Significant numbers of people rely of essentialmedications, CMS and DME. There are manyreasons why they cannot access their own duringan emergency. Planning should incorporate howpeople can quickly replace essential medications(for heart conditions, high blood pressure, seizures,asthma, diabetes, etc.), wheelchairs, walkers,scooters, canes, crutches, oxygen equipment,nebulizer tubing and machines, and catheters,ostomy supplies, etc. This will ensure that morepeople maintain their health, safety andindependence and have fewer unmet needs.

Speed is often critical in obtaining theseessential items. Flexibility regarding purchasingsuch replacement items is important. Therequirement to comply with StandardizedEmergency Management System (SEMS) was a

4


barrier in obtaining necessary resources, forevacuees with disabilities. Requests for theseitems were sometimes, denied, delayed, or ignoredat the Regional Emergency Operation Center(REOC) and the State Operation Center (SOC).

Recommendations

33. State and local government emergencyplanners should ensure a speedymechanism and flexibility of the SEMSprocess to meet the requests formedications, DME and CMS.

34. Training for shelter managers shouldreinforce the importance of quicklycommunicating and following up onrequests for medications, DME and CMSto the local Emergency Operation CenterEOC and REOC.

35. Shelter managers should designate acoordinator for functional needs services.

36. The local EOC should designate acoordinator for functional needs services.

After Katrina, ARC announced that itprepositioned items to improve shelter accessibilityfor individuals with mobility limitations inwarehouses across the country. Items included8,000 cots (designed for easier transfer from awheelchair 32” W x 84” L x 18” H), commodechairs, and shower stools. These items could notbe located during the fires. It turned out the itemswere all warehoused in the Gulf States region. [33]

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Recommendations

37. State emergency planners should stockpileand/ or create effective delivery systems(including establishing memoranda ofunderstanding with suppliers) to sheltersand assistance centers, for accessiblecots and essential medications, DME andCMS.

Initially medical staff would not acceptresponsibility for refrigerating an evacuee’smedications.They later were convinced to do so.

Recommendation

38. State emergency planners should offerguidance to local government and shelteroperators regarding the importance ofincorporating policies regarding therefrigeration and replacement ofessential medications.

Individuals experienced a problem when they triedto replace their prescriptions. They could notreplace their medications if they had already filledtheir prescription within the last 30 days.

Many people are limited to a 30-day supply ofmedication due to payment (Medicare/Medicaid,private insurance) restrictions. This policy makes itdifficult to impossible for people to follow theimportant advice of maintaining seven-day

4

4

Sample of a cot which iseasier to access for peoplewith mobility limitations andhas a higher weightcapacities (450 poundsand above).


emergency supply of essential medications(medication that cannot be interrupted withoutserious consequences) during any disruption in theability to get prescriptions refills. This problematicemergency-related insurance policy, althoughacknowledged for decades, remains unresolved.

Recommendation

39. State health policy makers should worktoward developing a policy that wouldallow people to maintain a seven-dayemergency supply of essentialmedications and, if needed, be prepared toprovide immediately essential medicationrefills during any disruption in the ability toget prescriptions refills.

6.3 Health Advisories

The state should provide stronger and quickerguidance regarding what protective measures thosewith and without respiratory conditions should take.For example sometimes it is contraindicated to useN-95 masks on some individuals who are in long-term care facilities.

Public information and perception aboutfacemasks is inconsistent and confusing. Peoplewearing simple paper or dust masks often believethey are protected from smoke; this is not true.These masks give wearers a false sense ofsecurity, and can put their respiratory health at risk.[6, 15]

4


Recommendation

40. State and local government public healthofficials, in partnership with health-focusedNGOs should compile health informationspecific to the types of disasterscommon in California. These documentscan then easily be revised if necessary, andquickly disseminated as needed.

6.4 Compensate In-Home SupportiveServices Homecare Workers forServices

In order to maintain independence some individualswith disabilities need non-medical personalassistance with feeding, transferring, dressing, andtoileting. These individuals with disabilities ordinarilylive and work in the community and receive theseservices through county sponsored In-HomeSupportive Services (IHSS), pay for the serviceprivately, or receive assistance from neighbors,friends, and family, in their community.

Recommendation

41. State and local government emergencypolicy makers should work with the federal,state and county agencies responsible forthe Medicaid Waiver Program to reviseregulations to allow eligible IHSSrecipients to receive care, and non-IHSSeligible people to receive emergencycare in shelters and hotels/motels.

4

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6.5 Functional Assessment andService Teams (FAST)

Emergency planners and responders need helpwith the very specific and sometimes complexneeds of people with disabilities and activitylimitations. Well-intentioned emergency medicaland public service personnel cannot adequatelyaddress these complex and additional needswithout (1) a deep and thorough understanding ofthe values of independent living and self-determination, (2) service options and resources,and (3) clarity about the human and civil rights ofpeople with disabilities.

During the October 2007 Southern Californiawild fires, the model for Functional Assessmentand Service Teams (FAST), an element of the newdisability specific plan elements from the CaliforniaDepartment of Social Services (CDSS) wasspontaneously tested and proved to be effective.1

[19]

Some individuals with experience in addressingessential functional needs of people with disabilitiesand activity limitations were not permitted access to

1 June Kailes is actually the originator of the FAST and"functional needs" concepts. Originally proposed by Kailesin 2006 these approaches were vetted and accepted byemergency managers and disability advocates involved inthe development of United States Department of HomelandSecurity’s working group on Functional and Medical SupportSheltering Target Capabilities Listhttp://www.disabilitypreparedness.gov/bulletins/oct_06.htmand CDSS’ "People with disabilities and the ElderlySheltering Plan." Developed in coordination with other statedepartments to be used in conjunction with the CDSS MassCare and Shelter Plan.


shelters. When NGO staff volunteered to helpevacuees with disabilities and activity limitationsasked, NGO staff were first told that there were nodisability related needs or issues in a shelter. Thestaff disregarded what they were told and enteredthe shelter. When the staff talked with the shelterresidents, they found unidentified needs.Eventually their assistance was appreciated andthey were permitted to assist evacuees withdisabilities and activity limitations.

During the fires the FAST were able to minimizeadverse impacts, by providing quick assistance withdisability specific service problem-solving, such ashelping people obtain access to communication andinformation in formats they could understand,recruiting personal assistance services, andreplacing essential DME, CMS and medications.FAST members were also instrumental innegotiating quick accessibility fixes such asprocuring accessible showers and toilets.

FAST are government employees and NGO(personnel ready to respond and deploy to disasterareas to work in shelters. Team members have indepth knowledge of the populations they serve,their cultures, and support service systemsincluding housing, benefit programs, disaster aidprograms and a variety of other resources.

FAST skill sets come from years of working withthese diverse communities. FAST members havecombined experience in vision and hearing loss,physical disabilities, mental health disabilities,developmental and other cognitive disabilities,aging, substance abuse, and nursing.

FAST members meetingwith shelter manager(Orange Show)

FAST members planningtheir time and problemsolving (Orange Show)


FAST identify and meet essential needs sopeople can maintain their independence. FASTsupport “at risk individuals” through screening andsupporting independence needs which preventsdeterioration, enabling people to maintain health,and mobility, and successfully manage in massshelters and other temporary housing options.

The City of San Diego’s AAR states, “Specialneeds were identified at Qualcomm outside of theestablished medical facility, such as evacuees withdietary or mobilization restrictions in the parking lotand other areas of the stadium. Theirrecommendation included “volunteers shouldconstantly monitor the care and shelter facility in aneffort to maintain situational awareness of personswith special needs.” [13] Some older evacuees andpeople with disabilities and activity limitations,without friends or family, are unable to advocate forhelp. They may stay on their cots, unnoticed withessential needs going unmet, while volunteers andstaff attend to the needs of people able to ask forwhat they need. FAST use their seasoned andkeenly trained eyes and ears to locate people whomay need help but do not ask for help.

FAST are being operationalized by CDSS’People with Disabilities and Elderly (PWD/E)Shelter Annex to be used with the Mass Care andShelter Plan in large-scale, multi-county,interregional emergencies and disasters. FAST areforce multipliers that can extend the reach ofemergency managers in response and recoverycapacity. The concept is also being developed inten California counties: Alameda, Los Angeles,Sacramento, San Diego, San Joaquin, Santa Clara,

Due to the advocacy ofFAST and a sheltermanager, unionvolunteers built ramps tothe accessible portableshowers and restrooms(Orange Show).


Santa Cruz, San Francisco, Ventura and Yolo andin several other states.

The objectives are to maximize assistance,extend resources as far as possible and preventunnecessary overloading of scarce medicalresources. Traditional government emergencyresponders are not equipped to deal with essentialfunctional needs of many groups. FAST are notfirst responders, but next responders. They can bekey players and force multipliers who extend thereach of emergency managers through responsecapacity. FAST can offer effective, efficient andrapid response to help minimize health problem,injuries and deaths. FAST:

• Conduct assessments and triage (to provideassistance based on severity of need, in place ofa random “first found/first served” approach) todetermine level of functioning, and health, andwhether support can be provided so that anindividual could be safely accommodated bygeneral population shelter services. FASTdistinguish between people who only needassistance in maintaining their health, medicaland psychiatric stability, and mobility, from thosewho need medical help which exceeds thecapacity of the general population shelter. Theseindividuals are connected with appropriateresources, when possible.

• Identify and track needs (including mapping ofshelters in order to locate people needingongoing services and follow up) so people canmaintain their health, safety and functionalindependence by receiving assistance.

Due to the advocacy ofFAST and a sheltermanager, unionvolunteers built ramps tothe accessible portableshowers and restrooms(Orange Show).


• Based on results of functional assessment,assist in providing essential medications, DME,CMS, etc.

• Work side by side with shelter personnel toassist in meeting essential functional needs.

• Prevent inappropriate institutionalization orhospitalizations, FAST interventions can preventthe threat to some individuals with significantdisabilities, who live and work in the community,of being forced unnecessarily into nursing homebecause of lack of other options. In the past,some of these individuals have spent monthstrying to then leave these institutions and regaintheir independent living status.

• Assist shelter and other emergency personnel inmaking quick access fixes such as installingtemporary ramps.

Portable ramps anddirectional signage toaccess features


• Designate specific times of the day and placeswhen interpreters will be available tocommunicate information.

• Assist with transition back to community living bydelivery of services and service coordinationsuch as:

- helping locate and settle into appropriatehousing (temporary and permanent),

- acquiring necessities such as clothing andhousehold supplies,

- securing long-term health and mental healthservices as needed, and

- re-establishing or accessing public benefitsand services.

FAST have unique credible connections andtrust with people they support. For example, someevacuees at shelters would only identify their needsto people they trusted, felt comfortable with andsometimes to people who just looked like them (i.e.a wheelchair user or a person using signlanguage.)

Recommendations

42. State and local government emergencyplanners must be prepared to shelterpeople with disabilities who are able toremain in the general populationshelters, with or without support.

43. State and local government emergencyplanners should move forward in adopting,funding and operationalizing FAST and

Evacuee seekingassistance from FASTmember in obtainingtemporary use of a loanerwheelchair due to difficultynegotiating long distancesin shelters

4

Improving restroomaccess by removing anarrow door and providinga curtain


ensure that FAST become a standardsheltering service.

44. FAST training should includeunderstanding how to follow up onrequests for medications, DME and CMSthrough shelter managers.

Nationally ARC in partnership with theDepartment of Health and Human Services,developed a shelter intake form that includes aseries of questions for shelter workers in generalshelters to ask incoming evacuees . The intent is toenable shelter managers to identify individuals withdisabilities and determine whether the shelter canmeet the individual’s needs.

Although ARC distributed the form to its chaptersalong with guidance, there was no report that theform was used during the fires. ARC officials saidthat procedural changes like this take time to fullyimplement in chapters. Others reported the formwas not used because it takes too long tocomplete. CDSS is in process of adapting this formto make it shorter and thus more usable by FASTand shelter personnel.

Recommendations

45. State and local government emergencyplanners should adopt a uniform andusable functional needs assessmentform.

46. State emergency planners should expedite

4


the process of using California MedicalVolunteers to establish a new consistentprocess of cataloging skills, checkingbackgrounds, registering, and issuingidentification badges that will allow FASTto access places within a controlled area,and verify their emergency respondercredentials. The goal is to insure theadequacy and quality of those who willprovide assistance. These efforts will needto expand to recognize the value of andinclude human service professionals (manyof who have no state license) in addition tolicensed health care providers.


Individuals reported:

• Difficulty getting accessible transportation to andfrom shelters and assistance centers.

• “Everybody left the mountain, all of the childrenand people and elderly were left up in themountain ... and then the evacuation order cameand nobody could go up and get any of thefolks.” [9]

• “I got a phone call from a woman who was usinga power chair who was given literally seconds toget evacuated out of her home. The policemancame with a hand on his gun telling her to getout. There was no way for her to get out, notransportation. They grabbed a neighbor, pickedher up, put her in the back of a car and took herto the high school. When she got to the highschool... she was left in the back seat, nobodywanted to be responsible. That “l” word ofliability came into play and nobody wanted to doanything for her...luckily someone knew aboutthe .... (Independent living center).” [9]

Some people with disabilities need accessibletransportation. Emergency plans must identifymethods and providers of access transportation(i.e., lift-equipped vehicles) available to helpevacuate people with disabilities. Some people withdisabilities and activity limitations will be able to

7. Evacuation and Transportation


reach mass evacuation pick-up locationsindependently, while others may be unable to leavetheir homes without assistance. Evacuation andemergency transportation plans must addressthese evacuation-related needs of people withdisabilities including the need to transport mobilityaids, such as wheelchairs or scooters, oxygentanks or other medical equipment, and serviceanimals. [31]

Significant numbers of people do not haveaccess to evacuation transportation because theycannot drive due to disability, age, poverty,addictions and legal restrictions, or they just do notown a car. When planning incorporates resourcesfor accessible transportation, then more people gettheir evacuation and transportation needs met andthere are fewer unmet needs! Transportation andevacuation planning that includes andaccommodates people with mobility disabilities andlimitations are critical.

Recommendations

47. State emergency planners should providelocal government transportation andevacuation planning guidance thatincludes:

• identifying transportation providers thathave the capacity to move people withdisabilities and activity limitations fromschools, medical facilities, neighborhoods,congregate care facilities, such as but notlimited to:

Memoranda ofunderstanding with theCounty of San Diego andparatransit providers werein process but not yetcomplete. In good faith,these providers showed upanyway to transportcongregate facilityresidents. (Del Mar)

4

Del MarShelter10/07


- Fixed-route buses

- ADA mandated Paratransit Systems

- Dial-a-Rides

- Disability and senior transportation service providers

- NGO transportation providers (i.e. United Cerebral Palsey, regional and developmental centers and their vendors, adult day health care, senior centers, etc)

• Area Agencies on Aging

• Regional Center vendors

- Taxi systems

- Non-medical emergency vans / ambulances

- School district transportation systems

- Airport car rentals, shuttle buses/ vans

- Health care center vendors

• evaluating the type of transportationvehicles needed (taxi, van, bus, medical)and potential destinations

• using databases of vehicles, and drivers,including backup drivers (i.e. the NationalGuard)

• projecting response time (during and afternon-operational hours)

• evacuating people from areas not coveredby public transit


• completing in advance (preferred) as wellas planning for just-in-time (inevitable)memoranda of understanding and mutualaid agreement to facilitate reimbursement(including neighboring jurisdictions)

• treating transit vehicles as emergencyvehicles for purposes of evacuation sothey can access emergency zones whenroads are closed to non-emergencyvehicles

• escorting transit vehicles through dangerareas, when needed

• creating policies and procedures toaddress methods of requesting, prioritizing(when demand for vehicles during a majordisaster will often exceed supply) andscheduling emergency trips, fares waiversetc.

• coordinating to ensure that accessiblevehicles are not over-obligated (double ortriple booked) during an incident (that isaddressing the common issue of multipleentities depending on the same few transitproviders (especially true for long termcare facilities which are a diverse group of:licensed care facilities, congregatefacilities, residential facilities, nursinghomes, assisted living facilities, grouphomes, intermediate care facilities)

• mapping clusters of congregate carefacilities, and community areas where highlevels of paratransit trips occur


• training for drivers certification programs(including an adequate number of backupdrivers)

• including transit providers in drills andemergency exercises

48. State emergency planners should identifyand disseminate model emergencytransportation and evacuation practicesto local government.

49. State and local government emergencypolicy makers should develop standardsfor integrating accessible transportationproviders into local governments’evacuation plans.

50. State and local government emergencypolicy makers should develop contractlanguage that mandates the use ofvehicles purchased with governmentfunds in emergencies. Operators ofaccessible vehicles (equipped with rampsand lifts) must plan, cooperate andcoordinate with emergency managementagencies.

51. Federal, state and local governmentemergency policy makers should requirepublic transit agencies to participate inand be reimbursed for evacuationresponse through memoranda ofunderstanding and mutual aidagreements.


Nongovernmental Organizations (NGO)s, likeother private and public sector organizations needto sustain ongoing and long-term preparednessefforts in order to reduce the disturbing and repeatcycles that often occur after major disasters. Thesecycles consist of the outrage, a short lasting burstof advocacy from the disability community/advocates, followed by the renewed vigilance ofgovernment after an event, all of which melts awayas time passes. Other funding priorities becomemore compelling and the inevitable and pervasivefog of complacency and denial settles back intoplace.

NGOs need to keep all hazard emergencypreparedness on the radar screen for the long-termby continuing to maintain and strengthenemergency preparedness literacy andcompetencies, values, practices, policies andadvocacy.

Recommendations

(See section 10. Training and ExercisePrograms for additional NGO trainingrecommendations)

8. Nongovernmental Organizations:Role of Provider and Advocacy Organizations in Disaster Response

4


52. State and local government emergencypolicy makers should integrate disasterpreparedness funding incentives intoNongovernmental Organizations (NGO)s’government funding contracts, toencourage sustained participation inemergency-related activities, such as, butnot limited to establishing, practicing andupdating their disaster plans, working withthe people they support in preparednessand response activities, and participating instate and local government planning.

53. NGO membership organizations mustadvocate for state emergency planningfunds that would allow them to engage inongoing planning efforts and tostrengthen their significant roles inpreparedness, response and recovery.

54. NGOs should urge and support selectedstaff, including staff with disabilities andactivity limitations, to completeCommunity Emergency Response Team(CERT) training.

55. NGOs need to negotiate mutual aidagreements with local governments inorder to define expectations, provideaccountability, and receive reimbursementfor their services.

56. State emergency planners should offerguidance to local government and NGOsfocused on “how to” instructions andtechnical assistance for negotiating andcompleting mutual aid agreements.


Disability, senior and health care providerservice and advocacy organizations did and canplay a critical role in assisting emergency agenciesin responding to disasters. NGOs working inpartnership with state disaster authorities cancontribute to planning and responding.

NGO personnel along with state employeeswere present (making Functional Assistance andService Teams (FAST) a reality) at shelters andlocal assistance centers. FAST consisted of OrangeCounty, San Diego and San BernadinoIndependent Living Centers, Public Authority of SanBernardino and San Diego County, and FEMA’s -National Disability Coordinator and the CaliforniaDepartmentof Social Services and Department ofRehabilitation.

8.1 Disability Emergency BriefingTeam

An effective, but phone-dependent, tool employed,probably for the first time in the history of Californiadisability-related disaster response, was theestablishment of a Disability Emergency BriefingTeam. This team consisted primarily of staff fromthe:

• California Foundation for Independent LivingCenters Access to Readiness Coalition,

• Alliance for Technology Access AssistiveTechnology Network,

• Disability Rights Advocates,

• Protection & Advocacy Inc.,


• Access to Independence, San Diego,

• Rolling Start Inc. San Bernadino,

• Public Authority of San Bernardino County, InHome Support Services,

• County of San Diego In Home Support ServicesPublic Authority, and

• FEMA’s National Disability Coordinator (who isresponsible for integrating disability issues intofederal emergency planning and preparednessefforts).

The content of these daily calls determinedwhere and what individuals had essential unmetneeds. This group, including some FAST members,who helped to mobilize and facilitate response fromlocal disability service community providers. Thefocus of these calls was problem solving regardingmeeting essential unmet needs that ranged fromreplacing a service animal’s dog harness (stolen ata shelter), to replacing left-behind, lost or damagedconsumable medical supplies (CMS) anddurable medical equipment (DME) wheelchairs,canes, walkers, shower chairs and raised toiletseats.

Recommendations

57. Disability and aging state membershiporganizations and coalitions should continueto strengthen and develop the “DisabilityEmergency Briefing Team”communication network and include broaderrepresentation from senior, developmentaldisability, deaf, hard of hearing, low vision,

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blind, and behavioral health, and mentalhealth provider networks.

58. Disability and aging organizations shouldalso register with The Governor’s Officeof Emergency Services’ (OES) Office forAccess and Functional Needs“Community Network Database” kept atthe California State Warning Center. Thisis a list of state associations and NGOs,who can quickly assist in locatingresources for those individuals withdisabilities and older adults impacted bya disaster.

Many service providers serving older adults andpeople with disabilities and activity limitations lostpower or had to evacuate making it difficult toimpossible to reach them because the statemembership organizations often did not haveemergency contact information. Other serviceorganizations scrambled to prepare response-related web pages. The California AssistiveTechnology Exchange (CATE) would havebenefitted from having ready-to-use web pages.CATE is an assistive technology reutilizationprogram similar to a Craig’s List or eBay model. Itis a database of items available for donation or salebetween two parties. This information can assistpeople in locating usable DME until they canreplace their more customized equipment. Thisservice was promoted during and after the fires, butit could have been more effective if the emergencytemplates had been in place. Other provider


organizations struggled to create fund raising webpages, as well as accounting policies andprocedures, to raise funds to assist survivors withdisabilities who were most in need of recoveryassistance unavailable from other resources.

Recommendation

59. In order to mobilize members quickly,NGO provider organizations need to:

• maintain current emergency contactinformation, which includes home, fax,email, and wireless, contact information;

• create ready-for-use passwordprotected web pages to be ofassistance in mobilization andcommunication of the “DisabilityEmergency Briefing Team” as well asother responder networks;

• create ready-to-use template phonemessages, email and web pages thatcan quickly be customized with responseinformation and resources, and then widelydisseminated, as well as used forfundraising.

8.2 Priority Emergency Client Contact List

NGOs sometimes appear to be at a loss regardingwhat to do first (before, during and after anemergency) and how best to check-in on thepeople they serve.

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Recommendation

60. NGOs should consider developing a“priority emergency consumer/clientcontact list” i.e., a list of people they workwith who are the most vulnerable. Forexample, this may include, those who relyon life sustaining equipment, have a weak ornon-existent support system and/or have noway to evacuate their home without majorsupport.

The NGO could ask people, they are consideringfor their priority emergency client contact list, if theywould consent to being on this list. The NGO wouldhave to explain clearly and carefully that thisprocess does not constitute a promise or aguarantee that the individual would be contactedand assisted after an event. Placement on such alist should also entail the NGO working with theseindividuals to help them strengthen their emergencyplanning including trying to help them strengthentheir support network.

8.3 Timeliness of Hot Washes

A hot wash consists of “after-action” discussionsand evaluations of an organization’s or multipleorganizations performance following an exercise,training session, or major event. The purpose of ahot wash is to identify strengths and weaknesses ofthe response to a given event, which should guidefuture response direction to avoid repeating errorsmade in the past.

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Recommendation

61. NGOs should conduct a hot wash as soonas possible after an event. The lessonsshould be recorded and used to adjustrevise response plans and procedures.

8.4 Mitigation Assistance Programs

Mitigation includes ongoing efforts that can lessenthe impact disasters have on people and property.Mitigation includes long-term activities designed toreduce the effects of unavoidable disaster (forexample, vegetation clearance in high fire dangerareas or building restrictions in potential floodzones).

People with disabilities and activity limitationssometimes do not have the resources or supportsystems to undertake mitigation activities such as:

• strengthening roofs;

• installing fire-resistant shingles;

• installing shatter-resistant window film;

• clearing brush to create a defensible fire-safeperimeter- removing fire-prone dry plant materialfrom gutters and around residences and otherbuildings, or trimming tree limbs that overhangroofs to avoid roof damage during wind storms;

• clearing streams;

• bolting bookshelves to walls;

• installing backflow valves (special valves thatprevent toilet overflows when the household

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sewer is infiltrated with floodwater); and

• placing a fuse box higher on a wall in a flood-prone area.

Recommendation

62. State and local government emergencypolicy makers should insure that mitigationassistance programs are available to lowincome groups throughout the state.

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For purposes of this report long term care facilitiesrefers a diverse group of: licensed care facilities,congregate facilities, residential facilities, nursinghomes, assisted living, group homes, intermediatecare facilities, senior housing, etc. Many of thesefacilities have no or weak emergency plans. [6]

Some facilities reported:

• difficulty with having adequate numbers of staffto accompany and remain with residents whowere evacuated to shelters and to “like”facilities,” and

• difficulty getting adequate transportationresources to evacuate their residents.

Recommendations

63. State and local government emergencypolicy makers should provide guidanceregarding how often plans are reviewedand establish minimum guidelines foremergency plans that include clearperformance measures and benchmarksfor preparedness.

64. State departments responsible forlicensing should carefully audit long termcare facilities for the specificity of their

9. Long Term Care Facilities

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emergency plans related to, but not limitedto:

• evaluating the ability to accept additionalresidents;

• developing and regularly updatingmemoranda of understanding with multiple“like” facilities of variable distances away(within 10 miles, 20 miles, neighboring city,and state) who have the space for (oftenusing unconventional spaces like commonareas and dining rooms) and agree toaccept their residents in times ofemergency;

• assessing realistically the numbers of staffwho will remain and or return to work aftera disaster; and

• completing transportation provideragreements for evacuations.

65. State departments that license long termcare facilities should provide leadershipin identifying discrepancies betweenstate and federal requirements andreconciling them for consistentinterpretations. For example, the federal andstate requirements regarding the numbersand types of drills are different.


With the exception of one “special needs” course,in a cursory review of the training offerings of theCalifornia Office of Homeland Security Training andExercise Division (responsible for the State’sTraining and Exercise Program, including firstresponder and agency training and exercisesrelated to terrorism, weapons of mass destruction,and manmade or natural catastrophes), thereappears to be little integration of functional needscontent.

Tools and techniques are needed to help staffunderstand and apply systematic thought regardingwhat it takes for their programs and services to beaccessible and inclusive of people with disabilitiesand activity limitations. For example:

1. Infusing functional needs specific content into avariety of trainings, so the subject is notconsidered “special.”

2. Integrating disability specific content in new andupdated training modules, courses, andworkshops. [2]

3. In addition to 1 and 2 above, but not in place of,developing additional disability specific contentcourses.

10. Training and Exercise Programs

In emergencyexercises, replacethe use of peoplewearing T-shirtsreading "DeafPerson," "BlindPerson and"Wheelchair User"with people withreal disabilities.


Recommendations

66. State emergency planners should integrateinto and update new and existingtraining/classes to increase the number ofemergency managers and firstresponders with disability and functionalneeds related core competencies, byinfusing disability specific content into avariety of trainings, so the subject is notconsidered “special.”

67. State emergency planners should providedisability and functional needs relatedinformation and technical assistanceservices by:

• offering technical assistance via phone, inperson, and online;

• creating technical expert panels thatmanagers, supervisors, employees,contractors and grantees can contact;

• collecting, disseminating, promoting andsupporting the replication of exemplaryemergency planning, preparedness,response, recovery and mitigation activitiesrelated to people with functional limitations;

• organizing a cadre of trainers who arequalified people with and withoutdisabilities; and

• creating and maintaining web-basedresources to include:

- materials on the legal obligation to

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comply with the Americans with Disabilities Act in planning for, operating and managing shelters and other disaster response services.

Nongovernmental organizations (NGOs) needtraining and guidance materials focused onemergency planning that include clear performancemeasures and benchmarks for preparedness. Forexample, training regarding planning should includehow to:

• provide a quick summary, at-a-glance text orgraphic overview of how to activate plans;

• cross reference emergency policies andprocedures located elsewhere in theorganization’s documentation, that are notintegrated into the core emergency plan;

• provide individual and family preparednesstraining;

• develop testing, drill, revising and trainingprotocols;

• realistically assessing the number of staff whowill be available to work after a disaster duringnontraditional work hours and/or on weekends;

• protect essential records and InformationTechnology;

• develop staff call-back systems;

• provide options for key staff, other than the useof telephones, to communicate following anemergency;


• establish, update and maintain advancedworking relationships and agreements andmemoranda of understanding, beforeemergencies with the nearest police and firedepartments, local government, accessibletransportation providers, health facilities,suppliers and vendors, etc.;

• prepare and analyze lessons learned in afteraction reports and adjust/or revise plans andprocedures as necessary;

• establish and regularly update cooperativeagreements for mutual aid for:

- sharing of resources with “like-serviceorganizations” that include multiple likefacilities of variable distances away (within 10miles, 20 miles, neighboring city, and state)for:

• food, water, sheltering;

• alternative temporary work location;

• accessible transportation; and

• exercise and use the plan in actual operationsand table top exercises.

Recommendation

68. State emergency policy makers should fundthe development of NGO-focusedemergency plan training and guidancematerials (including model processes,policies and procedures) that will endureand are easy to update. Training andtechnical assistance should focus on

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improving and increasing emergencypreparedness literacy and competencies.(Also, see section 8. NongovernmentalOrganizations Role of Provider andAdvocacy Organizations in DisasterResponse)

10.1 Exercises

In emergency exercises replace the common use ofpeople wearing T-shirts reading “Deaf Person,”“Blind Person, and “Wheelchair User,” with peoplewith real functional needs. Integrating disability-specific scenarios and real people with disabilitiesand activity limitations as participants in emergencyexercise appears to be sporadic and haphazard.Seeking and using input from people with a varietyof disabilities and organizations with expertise infunctional needs issues will help emergencyplanners better meet the needs of people withdisabilities in all phases of emergencymanagement.

To include people with disabilities and activitylimitations exercise organizers need to attend toevent details, such as, but not limited to:

• event locations need to be on publictransportation routes;

- coordination with Paratransit or similar servicewhen event is not located on publictransportation route

• reimbursement for transportation expenses whenrequested;


• disseminating event information in accessibleformats (alternative formats (braille, large print,disks, audio);

• avoid scheduling events in the early morninghours and on weekends:

- for those who use public transportation orparatransit, this often requires one to twohours of travel time which may mean leavinghome as early as 5 am

- many bus lines have limited schedules onweekends

- for those who use personal assistants (PA)s,the early start time and weekend schedulemeans scheduling the PA for additional hoursat their own expense, or the PA may not beavailable on weekends or willing to travel atsuch an early hour to assist their client

• provide sign language interpreters for peoplewho are deaf; and

• accommodate people with conditions that affectstamina and endurance or with conditions thatrequire frequent monitoring, medication,treatment etc. [5].

Recommendation

69. State emergency planners should provideguidance regarding integrating intotabletops, training exercises, and drills:disability-specific scenarios, real peoplewith disabilities and activity limitations,attending event access details, disability-

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specific injects and scenarios, anddisability specific elements in after actionexercise evaluations.

10.2 Individual and Family EmergencyPreparedness Training and Materials

People with disabilities and activity limitations needquality emergency preparedness information andadvice that is real, specific and useful. Thesematerials must also recognize the diversity ofdisabilities and activity limitations, and that one sizedoes not fit all. Such customized and relevantmaterials for people with disabilities and activitylimitations are hard to find.

General emergency preparedness information iscritical for everyone including people withdisabilities and activity limitations. However,sometimes these resources have to besupplemented with more specific information forpeople with hearing, vision, mobility, speech, andcognition limitations. Advice for the generalpopulation is not always equally applicable forsome people with disabilities and activity limitations.For example, many wheelchair users cannot takecover under tables and desks. This advice iscommon regarding how to respond immediately toan earthquake.

Attention to the depth and details of the diversityof the disability experience and user perspectiveadds a level of reality and credibility. Attention todetail is a needed survival skill when living withdisability and activity limitations. This attention to


detail can be absent when materials are producedfor and about, instead of with and by, people withdisabilities and activity limitations. When qualifiedusers are not involved in the development of thesematerials the information can sometimes be vague,incomplete, impractical and naïve.

Emergency preparedness information must beeasily available. This means that in addition tousing disability diverse dissemination channelssuch as NGOs serving people with disabilities andactivity limitations, the information must also beobtainable through the same channels as othergeneral preparedness materials are distributed. Thematerial must be specific, useful and available inaccessible and usable formats (e.g., Braille, largeprint, disk, audio) and language (appropriate forNon-English speakers and people who havedifficulty reading).

Many people with disabilities and activitylimitations do not receive information throughdisability specific human services agenciesbecause they have no need to seek support fromthese organizations or they may not know aboutthem and for a variety of reasons, do not identify asa person with a disability or activity limitation.

Recommendations

70. State and local government emergencyplanners, in partnership with qualifiedpeople with disabilities and activitylimitations, should review existingpreparedness training and publicationsoffered and integrate disability and

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functional need content, whereappropriate.

• Integrate new and updated disability-related and functional limitation specifictraining content into general preparednesstraining and materials that include howand where people can access morecustomized disability and functionalneeds specific materials, and

• Ensure these materials are available inunderstandable and usable formats (i.e.,Braille, large print, disks, audio, pictures,accessible web sites, plan language, andother languages in addition to English).

71. State and local government emergencyplanners should establish fellowshipprograms to build disaster expertise amongqualified people with disabilities andactivity limitations who are interested incareers in emergency management.


Disaster means more needs, than resources! Sousing scare resources effectively is important. Themore inclusive the planning for people withfunctional needs, the fewer the unmet needs.Planning involves putting the resources, time anddetail behind the concepts. The following is asummary of all the recommendations in this report.For more information regarding the words andacronyms that are bolded, refer to section 2.Definition and Acronyms.

4. Cross Cutting Issues

4.2 Moving Emergency Planning from “SpecialNeeds” to “Functional Needs”

1. State and local government emergency plannersshould use a “functional needs” framework.Using a more effective, accurate and flexibleframework built on an essential functional basedorientation addresses the needs of more people,more efficiently and effectively in ways that:

• build appropriate levels of capacity fordisaster preparation, emergency responseprocesses, procedures and systems;

• adopt guidelines and protocols for appropriateresource management;

11. Summary of Recommendations

Regarding thelessons documented:the words are easyto write, the stepsare easy to list,doing, making it real,and sustaining it, ishard! The challengeis attending to thedetail!


• strengthen service delivery and training;

• prevent health complications and reduceinstitutionalization and the inappropriate useof scarce, expensive and intensiveemergency medical services;

• allow disaster services to incorporate thevalue that everyone should have the chanceto survive;

• translate documented lessons into knowledgeand application; and

• improve overall response successes.

2. As the state emergency planners transition fromthe SEMS planning committee structure to astructure that reflects the state’s revisedemergency functions (in the soon to be updatedState Emergency Plan) the state should continueto ensure input and integration of diversequalified disability representatives in these newplanning committees.

3. State emergency planners should develop andoffer guidance to local government regardinghow to actively recruit qualified people with avariety of disabilities (i.e., mobility, vision,hearing, cognitive, psychiatric, and otherdisabilities), and how to involve organizationswith expertise on disability issues in all phasesof emergency management planning.

4.3 Grants and Funding

4. The state should make the Office of Access andFunctional Needs permanent and the lead


position equivalent to a deputy director /assistant secretary. This office must have theauthority, responsibility and resources to carryout its critical objectives.

5. State and local government emergency policymakers should allocate a percentage of annualfunding for the purpose on strengthening andimproving preparedness, response actions andrecovery efforts that include of people withdisabilities and activity limitations. This AARprovides specific recommendations for criticalprojects to fund.

6. State and local government emergency policymakers and planners should integrate intoemergency grants and contracts proposalselection criteria (rating score criteria) specificindicators for evaluating proposals that includepeople with disabilities and activity limitations.For example, as appropriate to the proposal’sfocus, these indicators should specifically detailand show evidence of how applicants willinclude function based service issues andphysical, communication, and program access,such as:

• Meeting the communication, evacuation,transportation, physical access, and healthneeds of diverse functional needspopulations,

• Contracting with and employing qualifiedpeople with disabilities and activity limitations,

• Forming partnerships among first responders,emergency planners and organizationsrepresenting diverse functional needs


populations, to ensure accurate traininginformation and development of usableservices and response,

• Appointing qualified representatives fromdiverse functional needs populations toemergency planning efforts as staff, advisors,trainers, contractors, and consultants,

• Promoting Community Emergency ResponseTeams (CERT) that recruit and accommodatepeople with disabilities and activity limitations.

4.4 Emergency Registries

7. State and local government emergency plannersshould proceed cautiously and carefully withregard to endorsing the use of emergencyregistries for people with disabilities and activitylimitations.

8. State emergency planners should reviewexisting registry requirements in the CaliforniaEmergency Services Act and develop realisticrecommendations that lead to integratingdisability-focused services and qualifiedrepresentatives into emergency planning andmanagement systems.

5. Communication Access

5.1 People who are Deaf, Deaf-Blind, and Hardof Hearing

9. State and local government emergency plannersshould increase access to emergencyinformation by incorporating redundant


communication methods that provideunderstandable, usable, and timely informationto the community.

5.2 Mass Notification Systems for Evacuation

10. State and local government emergencyplanners should train people providing door-to-door notification that, in addition toloudspeakers, used in emergency evacuationannouncements they should also includepicture/symbol signs (pictograms).

11. State and local government emergencyplanners should create redundancy of publicwarnings by utilizing NGOs as partners whohave connections to specific populations toassist in public warnings, alerts andnotification.

12. State agencies and local governments shouldconsistently provide TTY numbers forinformation on evacuation centers and localassistance centers.

5.3 TV Broadcast

13. State and local government emergencyplanners should insure announcements bygovernment officials on television shouldinclude qualified sign language interpretersand have captions to ensure that people whoare deaf and hard of hearing are able toaccess the information.

14. State emergency planners should develop


guidance to be issued before, and immediatelyin times of disasters, to all broadcasters,reminding them of their obligation to complywith FCC rules. This guidance should bedeveloped in partnership with qualifiedmembers of the blind, deaf and hard of hearingcommunities.

15. Because of a significant shortage of qualifiedsign language interpreters, state and localgovernment emergency planners shouldestablish memoranda of understanding andmutual aid agreements with video remoteinterpreting services from diverse in-state andout-of-state areas.

5.4 Emergency Warning Systems

16. State emergency planners should finalize thesystem to broadcast messages to wirelesscommunication devices in Californiacommunities, and continue development ofother high-tech notification systems. Thisincludes OES charge under AB 2231 toconvene a working group to assess existingand future technologies available in the publicand private sectors for the expansion oftransmission of emergency alerts to the publicthrough a public-private partnership.

17. State and local government emergencyplanners should provide guidance to publicsafety and private sector agencies that sendemergency alert notifications to the public. Thisguidance should reinforce that emergencynotification programs:


• Need to offer functionally equivalentservices to all populations.

• Need to allow the receiver the option tohave the message repeated.

• Have TTY capabilities, including being ableto auto detect TTYs and send theappropriate messages. That is, automaticdialing-announcing devices need thecapacity to call TTYs.

• Need to conduct aggressive outreach andeducation using accessible formats to deafand hard of hearing communities to notifythem of the need to register their TTYnumbers so that they will receive allemergency notifications. The databasesrequire regular updating and should includewireless numbers (until the systems “autodetect” capabilities are proven to workeffectively).

• Need specific contract language that detailsthe significant penalties for systems notcompatible with TTYs.

• Need to test TTY compatibility with a mix ofTTY and non TTY users to insure the abilityto accurately auto detect TTYs and send theappropriate message.

• Involve participation of qualifiedstakeholders to help the State stay abreastof emerging technology and plan for futureadoption and integration into emergencywarning systems.

• Need multiple options with built in


redundancy for broad awareness. Thismeans using multiple formats for emergencynotification systems, because emergency e-mail and wireless network alerts are helpfulbut information can be spotty and truncated.

18. State and local government emergencyplanners should devote significant resources(until they can automatically obtain wirelessdevice numbers) to aggressively sustain andmaintain outreach of emergency warningnotification to potential users. They need tourge people to register their wireless devices(cell phones, and email addresses) foremergency notifications.

19. State and local government emergencyplanners should urge the emergencynotifications vendors to enable communicationwith a variety of devices:

• TTY (text telephone)

• Videophones

• E-mail

• Text pager

• Speech generating devices

• Text message and Short Message Service(SMS)

• Weather Alert Radio

• Highway electronic variable message board

• Fax machines

• Sign Language Interpreter via video e-mail

• American Sign Language version of


complex text information on websites

• Other new technologies

5.5 Public Safety Answering Points (PSAPs)

20. State emergency planners will need to staycurrent on the federal standards developmentwork in 9-1-1. In addition to the immediate goalof enabling users of VRS and IP RelayServices to access the appropriate PSAP, thelong-term goal is to provide a NG9-1-1environment where the users of videophones,wireless devices, and/or the internet canaccess to 9-1-1 PSAPs directly withoutrequiring a relay service as an intermediary.

5.6 Communication Access at Shelters andAssistance Centers

21. State and local government emergencyplanners should offer guidance regardingcommunication access in shelters andassistance centers that includes: turningcaptions on for all televisions used by thepublic, and using understandable signage(using visually dependent, rather than languagedependent signs i.e. symbols in addition to orin place of text) to assist many people whohave limitations of seeing, hearing,understanding, cognition or intellectual abilitiesand limited language proficiency.

• Qualified sign language interpreters (orvideo remote interpreting) need to beavailable at designated times under pre-


established memoranda of understandingand mutual aid agreements.

• When phone service is available andlanguage interpreters are not available,consider using phone-based andTelecommunications Relay Services(TRS) for those with hearing loss or speechdisabilities, and over the phoneinterpretation services for people who do notspeak English.

• When emergency telephone trailers orcommunication equipment are madeavailable, telephones need to be accessibleto wheelchair users and TTY users.

• Contents of verbal announcements shouldbe posted in specified shelter areas as wellas in languages used by a significantpercentage of the population.

22. The 2-1-1 Call Centers, Disaster AssistanceCenters, and Local Assistance Centers shouldmaintain robust disability-specific serviceinformation. They should insure that they cancommunicate with people who have limitationsof seeing, speaking, hearing, understanding,cognition or intellectual abilities and limitedlanguage proficiency.

23. State and local government emergencyplanners should ensure equal access byutilizing procedures that allow people to applyin different ways and offer reasonablemodifications to application procedures whenpeople with disabilities need them.

24. State and local government emergency


planners should offer information about socialservices and other benefit programs availablein formats people with communicationdisabilities can understand and use.

25. When people are instructed to check a website,state and local government emergencyplanners need to insure that (1) the link towebsite is activated, and (2) the data on thewebsite are compliant with requirements underSection 508 of the Rehabilitation Act of 1973,which can be found at http://www.access-board.gov/508.htm. Additionally, in September2002, Senate Bill 105 was enacted to amendSection 11135 of Government Code to read“state governmental entities, in developing,procuring, maintaining, or using electronic orinformation technology, either indirectly orthrough the use of state funds by other entities,shall comply with the accessibilityrequirements of Section 508 of theRehabilitation Act of 1973. The State hasdeveloped recommendations for ensuringwebsites are accessible, found athttp://www.cio.ca.gov/Government/governance/workinggroups/iouca.html.

26. State and local government emergencyplanners need to insure that web sites used inemergencies can handle the increased usertraffic. This applies to everyone, but isespecially important for people who are deaf orhard of hearing.


6. Mass Care and Shelter

6.1 ADA Requirements

27. State and local government emergency policymakers need to insert access standards instate law defining requirements for shelteringpeople with disabilities and activity limitations.

28. State and local government emergencyplanners should provide guidance to localgovernments to make sure that all shelterfacilities identified for use are accessible.Shelters surveys should identify barriers topeople with disabilities, including wheelchairsor scooters users or those who have difficultywalking, people who are deaf or hard ofhearing and people who are blind or have lowvision. This guidance should include use of theDepartment of Justice’s Quick-Check Surveyand the ADA Checklist for Emergency Shelters.

29. State and local government emergencyplanners responsible for sheltering must ensurethat: where multiple single user portable toiletor bathing units are clustered at a singlelocation, at least 5 percent of the toilet unitsand bathing units at each cluster shall beaccessible; and for single user portable toilet orbathing units clustered at a single location, atleast five percent but no less than one toiletunit or bathing unit needs to be accessible.This access is also important for children andolder people.

30. State and local government emergencyplanners should provide guidance to local


governments regarding model contractlanguage requiring contractors to provideaccessible portable restrooms and showers.

31. State emergency planners should provideguidance to local governments regarding theimportance of continual vigilance when sheltersare in use to ensure, walkways and otherfeatures are clear of obstacles such as cords,boxes, trash, etc. For example, advise themedia to not string cables across walkwaysunless they have proper materials to preventthem from becoming barriers for wheelchair orscooter users as well as tripping hazards for allpeople.

32. State emergency planners should provideguidance to local government regardingproviding meals or meal vouchers, essentialmedications, DME and CMS for evacuees inmotels.

6.2 Medications, Durable Medical Equipment(DME) and Consumable Medical Supplies CMS)

33. State and local government emergencyplanners should ensure a speedy mechanismand flexibility of the SEMS process to meet therequests for medications, DME and CMS.

34. Training for shelter managers should reinforcethe importance of quickly communicating andfollowing up on requests for medications, DMEand CMS to the local Emergency OperationCenter EOC and REOC.

35. Shelter managers should designate a


coordinator for functional needs services.

36. The local EOC should designate a coordinatorfor functional needs services.

37. State emergency planners should stockpileand/ or create effective delivery systems(including establishing memoranda ofunderstanding with suppliers) to shelters andassistance centers, for accessible cots andessential medications, DME and CMS.

38. State emergency planners should offerguidance to local government and shelteroperators regarding the importance ofincorporating policies regarding therefrigeration and replacement of essentialmedications.

39. State health policy makers should work towarddeveloping a policy that would allow people tomaintain a seven-day emergency supply ofessential medications and, if needed, beprepared to provide immediately essentialmedication refills during any disruption in theability to get prescriptions refills.

6.3 Health Advisories

40. State and local government public healthofficials, in partnership with health-focusedNGOs should compile health informationspecific to the types of disasters common inCalifornia. These documents can then easilybe revised if necessary, and quicklydisseminated as needed.


6.4 Compensate In-Home Supportive ServicesHomecare Workers for Services

41. State and local government emergency policymakers should work with the federal, state andcounty agencies responsible for the MedicaidWaiver Program to revise regulations to alloweligible IHSS recipients to receive care, andnon-IHSS eligible people to receiveemergency care in shelters and hotels/motels.

6.5 Functional Assessment and Service Teams(FAST)

42. State and local government emergencyplanners must be prepared to shelter peoplewith disabilities who are able to remain in thegeneral population shelters, with or withoutsupport.

43. State and local government emergencyplanners should move forward in adopting,funding and operationalizing FAST and ensurethat FAST become a standard shelteringservice.

44. FAST training should include understandinghow to follow up on requests for medications,DME and CMS through shelter managers.

45. State and local government emergencyplanners should adopt a uniform and usablefunctional needs assessment form.

46. State emergency planners should expedite theprocess of using California Medical Volunteersto establish a new consistent process ofcataloging skills, checking backgrounds,


registering, and issuing identification badgesthat will allow FAST to access places within acontrolled area, and verify their emergencyresponder credentials. The goal is to insure theadequacy and quality of those who will provideassistance. These efforts will need to expandto recognize the value of and include humanservice professionals (many of who have nostate license) in addition to licensed health careproviders.

7. Evacuation and Transportation

47. State emergency planners should provide localgovernment transportation and evacuationplanning guidance that includes:

• identifying transportation providers thathave the capacity to move people withdisabilities and activity limitations fromschools, medical facilities, neighborhoods,congregate care facilities, such as but notlimited to:

- Fixed-route buses

- ADA mandated Paratransit Systems

- Dial-a-Rides

- Disability and senior transportation service providers

- NGO transportation providers (i.e. United Cerebral Palsey, regional and developmental centers and their vendors, adult day health care, senior centers, etc)

• Area Agencies on Aging


• Regional Center vendors

- Taxi systems

- Non-medical emergency vans / ambulances

- School district transportation systems

- Airport car rentals, shuttle buses/ vans

- Health care center vendors

• evaluating the type of transportation vehiclesneeded (taxi, van, bus, medical) andpotential destinations

• using databases of vehicles, and drivers,including backup drivers (i.e. the NationalGuard)

• projecting response time (during and afternon-operational hours)

• evacuating people from areas not coveredby public transit

• completing in advance (preferred) as well asplanning for just-in-time (inevitable)memoranda of understanding and mutualaid agreement to facilitate reimbursement(including neighboring jurisdictions)

• treating transit vehicles as emergencyvehicles for purposes of evacuation so theycan access emergency zones when roadsare closed to non-emergency vehicles

• escorting transit vehicles through dangerareas, when needed

• creating policies and procedures to addressmethods of requesting, prioritizing (when


demand for vehicles during a major disasterwill often exceed supply) and schedulingemergency trips, fares waivers etc.

• coordinating to ensure that accessiblevehicles are not over-obligated (double ortriple booked) during an incident (that isaddressing the common issue of multipleentities depending on the same few transitproviders (especially true for long term carefacilities which are a diverse group of:licensed care facilities, congregate facilities,residential facilities, nursing homes, assistedliving facilities, group homes, intermediatecare facilities)

• mapping clusters of congregate carefacilities, and community areas where highlevels of paratransit trips occur

• training for drivers certification programs(including an adequate number of backupdrivers)

• including transit providers in drills andemergency exercises

48. State emergency planners should identify anddisseminate model emergency transportationand evacuation practices to local government.

49. State and local government emergency policymakers should develop standards forintegrating accessible transportation providersinto local governments’ evacuation plans.

50. State and local government emergency policymakers should develop contract language thatmandates the use of vehicles purchased with


government funds in emergencies. Operatorsof accessible vehicles (equipped with rampsand lifts) must plan, cooperate and coordinatewith emergency management agencies.

51. Federal, state and local governmentemergency policy makers should require publictransit agencies to participate in and bereimbursed for evacuation response throughmemoranda of understanding and mutual aidagreements.

8. Nongovernmental OrganizationsRole of Provider and AdvocacyOrganizations in Disaster Response

52. State and local government emergency policymakers should integrate disaster preparednessfunding incentives into NongovernmentalOrganizations (NGO)s’ government fundingcontracts, to encourage sustained participationin emergency-related activities, such as, butnot limited to establishing, practicing andupdating their disaster plans, working with thepeople they support in preparedness andresponse activities, and participating in stateand local government planning.

53. NGO membership organizations must advocatefor state emergency planning funds that wouldallow them to engage in ongoing planningefforts and to strengthen their significant rolesin preparedness, response and recovery.

54. NGOs should urge and support selected staff,


including staff with disabilities and activitylimitations, to complete Community EmergencyResponse Team (CERT) training.

55. NGOs need to negotiate mutual aidagreements with local governments in order todefine expectations, provide accountability, andreceive reimbursement for their services.

56. State emergency planners should offerguidance to local government and NGOsfocused on “how to” instructions and technicalassistance for negotiating and completingmutual aid agreements.

8.1 Disability Emergency Briefing Team

57. Disability and aging state membershiporganizations and coalitions should continue tostrengthen and develop the “DisabilityEmergency Briefing Team” communicationnetwork and include broader representationfrom senior, developmental disability, deaf,hard of hearing, low vision, blind, andbehavioral health, and mental health providernetworks.

58. Disability and aging organizations should alsoregister with The Governor’s Office ofEmergency Services’ (OES) Office for Accessand Functional Needs “Community NetworkDatabase” kept at the California State WarningCenter. This is a list of state associations andNGOs, who can quickly assist in locatingresources for those individuals with disabilitiesand older adults impacted by a disaster.


59. In order to mobilize members quickly, NGOprovider organizations need to:

• maintain current emergency contactinformation, which includes home, fax,email, and wireless, contact information;

• create ready-for-use password protectedweb pages to be of assistance inmobilization and communication of the“Disability Emergency Briefing Team” as wellas other responder networks;

• create ready-to-use template phonemessages, email and web pages that canquickly be customized with responseinformation and resources, and then widelydisseminated, as well as used forfundraising.

8.2 Priority Emergency Client Contact List

60. NGOs should consider developing a “priorityemergency consumer/client contact list” i.e., alist of people they work with who are the mostvulnerable. For example, this may include,those who rely on life sustaining equipment,have a weak or non-existent support systemand/or have no way to evacuate their homewithout major support.

8.3 Timeliness of Hot Washes

61. NGOs should conduct a hot wash as soon aspossible after an event. The lessons should berecorded and used to adjust / revise response


plans and procedures.

8.4 Mitigation Assistance Programs

62. State and local government emergency policymakers should insure that mitigation assistanceprograms are available to low income groupsthroughout the state.

9. Long Term Care Facilities

63. State and local government emergency policymakers should provide guidance regarding howoften plans are reviewed and establishminimum guidelines for emergency plans thatinclude clear performance measures andbenchmarks for preparedness.

64. State departments responsible for licensingshould carefully audit long term care facilitiesfor the specificity of their emergency plansrelated to, but not limited to:

• evaluating the ability to accept additionalresidents;

• developing and regularly updatingmemoranda of understanding with multiple“like” facilities of variable distances away(within 10 miles, 20 miles, neighboring city,and state) who have the space for (oftenusing unconventional spaces like commonareas and dining rooms) and agree toaccept their residents in times ofemergency;


• assessing realistically the numbers of staffwho will remain and or return to work after adisaster; and

• completing transportation provideragreements for evacuations.

65. State departments that license long term carefacilities should provide leadership in identifyingdiscrepancies between state and federalrequirements and reconciling them forconsistent interpretations. For example, thefederal and state requirements regarding thenumbers and types of drills are different.

10. Training and Exercise Programs

66. State emergency planners should integrate intoand update new and existing training/classesto increase the number of emergencymanagers and first responders withdisability and functional needs related corecompetencies, by infusing disability specificcontent into a variety of trainings, so thesubject is not considered “special.”

67. State emergency planners should providedisability and functional needs relatedinformation and technical assistance servicesby:

• offering technical assistance via phone, inperson, and online;

• creating technical expert panels thatmanagers, supervisors, employees,


contractors and grantees can contact;

• collecting, disseminating, promoting andsupporting the replication of exemplaryemergency planning, preparedness,response, recovery and mitigation activitiesrelated to people with functional limitations;

• organizing a cadre of trainers who arequalified people with and withoutdisabilities; and

• creating and maintaining web-basedresources to include:

- materials on the legal obligation to complywith the Americans with Disabilities Act in planning for, operating and managing shelters and other disaster response services.

68. State emergency policy makers should fundthe development of NGO-focused emergencyplan training and guidance materials (includingmodel processes, policies and procedures) thatwill endure and are easy to update. Trainingand technical assistance should focus onimproving and increasing emergencypreparedness literacy and competencies. (Also,see section 8. Nongovernmental OrganizationsRole of Provider and Advocacy Organizationsin Disaster Response)

10.1 Exercises

69. State emergency planners should provideguidance regarding integrating into tabletops,training exercises, and drills: disability-specific


scenarios, real people with disabilities andactivity limitations, attending event accessdetails, disability-specific injects and scenarios,and disability specific elements in after-actionexercise evaluations.

10.2 Individual and Family EmergencyPreparedness Training and Materials

70. State and local government emergencyplanners, in partnership with qualified peoplewith disabilities and activity limitations, shouldreview existing preparedness training andpublications offered and integrate disability andfunctional need content, where appropriate.

• Integrate new and update disability-relatedand functional limitation specific trainingcontent into general preparedness trainingand materials that includes how and wherepeople can access more customizeddisability and functional needs specificmaterials, and

• Ensure, these materials are available inunderstandable and usable formats (i.e.braille, large print, disks, audio, pictures,accessible web sites, plan language, andother languages in addition to English).

71. State and local government emergencyplanners should establish fellowship programsto build disaster expertise among qualifiedpeople with disabilities and activitylimitations who are interested in careers inemergency management.


12.1 California Foundation forIndependent Living Centers

California Foundation for Independent LivingCenters (CFILC) is a statewide, non-profit advocacyorganization made up of more than two-dozenIndependent Living Centers. Incorporated in 1982,our mission is to advocate for barrier-free accessand equal opportunity for people with disabilities. Tolearn more about CFILC visit www.cfilc.org.

The Access to Readiness Coalition (A2R),organized and supported by CFILC, is a network ofdisability-focused organizations and allies that arecommitted to strengthening California’s emergencyplanning, response and recovery to meet the needsof people with disabilities and functional limitations.A2R achieves this through public policy advocacy,community education and collaboration on thelocal, state, and national levels. To learn moreabout A2R, visit www.access2readiness.kintera.org.

12.2 Center for Disability Issues andthe Health Professions

The Center for Disability Issues and the HealthProfessions (CDIHP), at Western University ofHealth Sciences in Pomona, California, works toenhance health professions education, and to

12. About the Sponsors and the Author


improve access for people with disabilities tohealth, health education, health care services andemergency services. To learn more about CDIHPvisit www.cdihp.org

12.3 About the Author

June Isaacson Kailes operates a Disability PolicyConsulting practice and is the Associate Director ofthe Center for Disability Issues and the HealthProfessions Western University of Health Sciencesin Pomona, California. June, since the early 1980s,is one of just a handful of people with disabilitieswho focuses a portion of her time on disability andaging related emergency issues. She works onemergency issues nationally and internationally,with community-based organizations and withemergency professionals. Her work as a writer,trainer, researcher, policy analyst and advocate iswidely known and respected.

June is currently working with two Californiadepartments: Social Services on a “People withDisabilities and the Elderly Sheltering Plan” andDevelopmental Disabilities on an EmergencyPreparedness Needs Analysis. She recently co-chaired The United States Department ofHomeland Security’s working group on Functionaland Medical Support Sheltering Target CapabilitiesList.

June has published extensively on emergencyissues related to people with disabilities and activitylimitations. Several of her emergency preparednesspublications include:

• Emergency Preparedness: Taking Responsibility


For Your Safety - Tips for People with ActivityLimitations and Disabilities, written for anddistributed by Los Angeles County, Office ofEmergency Management, Emergency SurvivalProgram,

• Living and Lasting on Shaky Ground: AnEarthquake Preparedness Guide for People withDisabilities, distributed by California Office ofEmergency Safety,

• Creating a Disaster - Resistant Infrastructure forPeople at Risk Including People with Disabilities(published and used in several countries),

• Emergency Evacuation Preparedness: TakingResponsibility for Your Safety: A Guide forPeople with Disabilities and Other ActivityLimitations, available athttp://www.cdihp.org/evacuationpdf.htm.

She has held many offices on the boards of theNational Council of Independent Living and CFILCand served as the Executive Director of theWestside Center for Independent Living in LosAngeles. President Clinton appointed June to theUnited States Access Board where she servedeight years. To learn more about June, visitwww.jik.com.


1. ADA Accessibility Guidelines for Buildings andFacilities, Section 4.1.2 (6), http://www.access-board.gov/ada-aba/final.htm#pgfId-1010419,last accessed 07/14/08

2. ADA and ABA Accessibility Guidelines forBuildings and Facilities, Section 213.2Exception 3, http://www.access-board.gov/ada-aba/final.htm#pgfId-1007285, last accessed07/14/08

3. Association of State and Territorial HealthOfficials. 2008. At-Risk Populations andPandemic Influenza: Planning Guidance forState, Territorial, Tribal, and Local HealthDepartments, June 2008,http://www.astho.org/pubs/ASTHO_ARPP_Guidance_June3008.pdf last accessed 07/27/08

4. Augmentative and Alternative CommunicationRehabilitation Engineering and ResearchCenter. 2008. Disaster Preparedness Tips forEmergency Management Personnel:Communication Access for People with LimitedSpeech, http://www.aac-.rerc.com/index.php?option=com_content&task=view&id=150 , last accessed 07/31/08

5. Bennett, C. 2008. Inclusion of PWD inEmergency Preparedness and EvacuationExercises, Sacramento County Disability

13. References


Compliance Office, e-mail communication7/24/08

6. California Association of Health Facilities. 2007.Report: Lessons Learned from the SouthernCalifornia Fires of October 2007

7. California Department of DevelopmentalServices, Emergency Preparedness Hot Wash.2008. Sacramento, 4/29/07

8. California Department of Rehabilitation. 1997.Disaster Preparedness for Persons withDisabilities Improving California’s Response,http://www.oes.ca.gov/Operational/OESHome.nsf/PrintView/66952778A6D2FA7C88256CEF006A8967, last accessed 07/13/08

9. California Foundation for Independent LivingCenters and Center for Disability Issues andthe Health Professions. 2008. Access toReadiness Coalition Summit, 1/11/08,http://www.kintera.org/site/c.hpIQKWOzFqG/b.2087377/k.D20/Disability_Summit_on_Emergency_Preparedness.htm, last accessed 07/13/08

10. California Governor’s Office of EmergencyServices. 2006. California Emergency ServicesAct, California Disaster Assistance Act &Emergency Compacts, http://www.oes.ca, lastaccessed 03/25/07

11. California Governor’s Office of EmergencyServices, Office for Access and FunctionalNeeds. 2008. Report on California Registries,May 2008

12. California State Independent Living Council.2004. The Impact of 2003 Wildfires on People


with Disabilities, April 1, 2004,http://www.eadassociates.com/resources.html,last accessed 07/9/08

13. City of San Diego. 2008. After Action Report,October 2007 Wildfires, City of San DiegoResponse,http://www.hfncenter.org/cms/SDWildfireAAR ,last accessed 07/13/08

14. County of San Diego. 2007. Firestorms AfterAction Report, http://www.co.san-diego.ca.us/oes/disaster_preparedness/oes_jl_wildland_fire.html , last accessed 07/13/08

15. Emergency Planning and PreparednessForum: Including People with Disabilities. 2008.Sponsored by City of San Diego DisabilityServices Program , Area Board XIII onDevelopmental Disabilities and Access toIndependence , January 23, 2008, Balboa ParkClub

16. Federal Communications Commission. 2004.FCC Reminds Video Programming DistributorsThey Must Make Emergency InformationAccessible To Persons with Hearing or VisionDisabilities, FCC Press Release May 28, 2004

17. Federal Emergency Management Agency andDepartment of Homeland Security, Office forCivil Rights and Civil Liberties. 2008.Comprehensive Preparedness Guide (CPG)30, Interim Emergency Management PlanningGuide for Special Needs Populations

18. Harkin J. & Strauss, K. 2008. Access ToEmergency Number Services, Assistivetechnology, Vol. 20, NO.1, Spring 2008 p.13-25.


19. Kailes, J. 2006. Serving and Protecting All byApplying Lessons Learned - Including Peoplewith Disabilities and Seniors in DisasterServices, Center for Disability Issues and theHealth Professions at Western University ofHealth Sciences, Pomona, California, andCalifornia Foundation for Independent LivingCenters,http://www.cfilc.org/site/c.ghKRI0PDIoE/b.1545243/k.97B8/Disaster_Preparedness_Serving__ProtectingbrPeople_with_Disabilities.htm, lastaccessed 07/13/08

20. Kailes, J. 2007. Access and FunctionalServices Coordinator, California Governor’sOffice of Emergency Service, Proposed DeputyDirector Position, Version 3-04/29/07,www.jik.com/disaster.html, last accessed07/13/08

21. Kailes, J. 2007. Be Real, Specific and Current:Emergency Preparedness Information forPeople with Disabilities and Activity LimitationsVersion 1.4, [email protected] (publication inprocess)

22. Kailes, J. & Enders, A. 2007. A function-basedframework for emergency management andplanning. JDPS, 2007. 17: p. 230-237.www.jik.com/disaster.html, last accessed07/9/08

23. Kailes, J. 2008. Why and How to IncludePeople with Disabilities in Your EmergencyPlanning Process? V2 Kailes-Publications,http://www.jik.com/disaster-new.html, lastaccessed 07/9/08


24. Kailes, J. 2008. Emergency Registries - AnEffective Tool or False Promise for People withDisabilities and Functional Limitations. Version2.0, [email protected] (publication in process)

25. National Council on Disability. 2008. QuarterlyMeeting: People with Disabilities andEmergency Management, Quarterly MeetingReport, January 29, 2008, New Orleans, LA.http://www.ncd.gov/newsroom/publications/2008/Proceedings_Monograph.html last accessed07/12/08

26. National Emergency Number Association(NENA). 2008. Operations AccessibilityCommittee (NENA) Notification Systems for theOID, January 14, 2008 DRAFT

27. National Organization on Disability. 2005.Report on Special Needs Assessment forKatrina Evacuees (SNAKE) Project,http://www.nod.org/Resources/PDFs/katrina_snake_report.pdf , last accessed 07/13/08

28. San Diego Regional Center. 2007. Report OnOctober 2007 Wildfire Emergency, Prepared on11/7/07 (unpublished)

29. U.S. Department of Homeland Security. 2006,National Plan Review Phase 2,https://www.dhs.gov/xlibrary/assets/Prep_NationwidePlanReview.pdf , last accessed 07/13/08

30. U.S. Department of Justice. 2006. An ADAGuide for Local Governments - MakingCommunity Emergency Preparedness andResponse Programs Accessible to People withDisabilities, last update 8/2006,


http://www.usdoj.gov/crt/ada/emergencyprep.htm, last accessed 09/12/07

31. U.S. Department of Justice. 2007. ADA BestPractices Tool Kit for State and LocalGovernments, Chapter 7 Addendum 2: TheADA and Emergency Shelters: Access for All inEmergencies and Disasters, 7/2007,http://www.ada.gov/pcatoolkit/chap7shelterprog.htm, last accessed 09/12/07

32. U.S. Department of Justice. 2007. ADAChecklist for Emergency Shelters, 7/2007,http://www.ada.gov./shleterck.htm, lastaccessed 09/12/07

33. U. S. Government Accountability Office. 2008.NATIONAL DISASTER RESPONSE, FEMAShould Take Action to Improve Capacity andCoordination between Government andVoluntary Sectors, February 2008, GAO-08-369. http://www.gao.gov/new.items/d08369.pdf,last accessed 07/13/08


14.1 Key Informants

Georgianna Armstrong, Office of EmergencyServices Manager, Kern County Fire Department,Bakersfield

Jennifer Weiser Bezoza, Senior Staff Attorney,Disability Rights Advocates, Berkeley

Stephanie Biedermann, Arthur Liman Fellow,Disability Rights Advocates, Berkeley

Marcia Brooks, Project Director,The Carl and RuthShapiro Family National Center for AccessibleMedia at WGBH, Boston, MA

Cindy Daniel, FEMA, National DisabilityCoordinator, Washington, DC

Richard A. Devylder, Special Advisor to the DirectorOffice on Access and Functional Needs Governor’sOffice of Emergency Services, Sacramento

Teresa Favuzzi, Executive Director, CaliforniaFoundation for Independent Living Centers,Sacramento

Louis Frick, Executive Director, Access toIndependence, San Diego

Judy Harkins, Director, Technology AccessProgram, Gallaudet University, Washington, DC

Angela M. Kaufman, Project Coordinator, City of

14. Attachments


Los Angeles Department on Disability

Mary-Lee Kimber , Staff Attorney, Disability RightsAdvocates, Berkeley

Helen Lopez, Executive Director, IHSS PublicAuthority, San Bernardino

Susan Madison, City of San Diego DisabilityServices Coordinator, Mayor’s Office of Ethics andIntegrity

Shannon McCroskey, Outreach/ResourceSpecialist, Rolling Start, Inc. San Bernardino

Jocelyn Montgomery, Director of Clinical Affairs,California Association of Health Facilities,Sacramento

Carolyn Moussa, Cal Volunteers, Sacramento

Andrew Mudryk. Director of Litigation, SouthernCalifornia, Protection & Advocacy, Inc., San Diego

Stasia Place, Emergency Services Coordinator, Cityof San Diego

Richard Ray, Department on Disability, DisabilityAccess and Services Los Angeles

Trevor Riggens, Director, Mass Care, AmericanRed Cross, Washington, DC

Marcie Roth, Executive Director/CEO, NationalSpinal Cord Injury Association, Bethesda, MD

Bernie Smith, Bioterrorism & EmergencyPreparedness Program, Madera

Martin Sweeney, AT Network, Los Angeles

Katherine Weed, Staff Attorney, Disability RightsAdvocates, Berkeley


14.2 Sample: Emergency Notification:Register Your Cell Phone and E-MailAddress

Sent: Monday, October 29, 2007 10:02 AMTo: HHSA-DL, AISSubject: More about Emergency Notification viaCell Phone

EMERGENCY NOTIFICATION: REGISTER YOURCELL PHONE AND E-MAIL ADDRESS

Residents who live in San Diego County , whichincludes all 18 cities and the unincorporated areasof the County, are encouraged to register their cellphones and e-mail addresses for emergencynotifications by visiting http://www.alertsandiego.orgwithin the next few days. Possible moderate tostrong Santa Ana winds are forecast for nextweekend.

Once e-mail addresses and cell phone numbersare registered, it will take up to 24 hours for thatinformation to be updated into AlertSanDiego, theCounty of San Diego mass notification system thatis commonly referred to Reverse 911.

AlertSanDiego will provide emergency alerts toyour cell phone and e-mail address includingevacuation notices. This is in addition to the landline calls received by those who have land linephones.

Residents are able to register multiple cell phonenumbers and e-mail addresses by reopening theWeb page. Residents without computers may


access this Web site from one of the Countylibraries. There is no charge to use the computersat County libraries.

If a City resident has registered a cell phonenumber with the City of San Diego Reverse 9-1-1system that information is automatically shared withthe County cell phone registry. To register an e-mailaddress computer users must register with theCounty system.

Please note that while the County MassNotification System is considered effective andefficient, you should not wait or rely exclusively ona call for evacuation directives. If you think you arein danger, you should evacuate immediately. If youare directed to evacuate by emergency personnel,you should follow their direction.

Denise G. Nelesen, LCSWCommunications Manager, Aging & Independence ServicesCounty of San Diego, (858) 505-6474

14.3 Review of Civil Rights Laws forPeople with Disabilities

From: National Emergency Number Association(NENA) Operations Accessibility Committee(NENA) Notification Systems for the Deaf, Deaf-Blind and Hard of Hearing OID, January 14, 2008DRAFT


The Rehabilitation Act of 1973

A) Section 504 - this law requires for federalgovernment and any agency that receives federalfunding to provide accommodations to people withdisabilities

B) Section 508 of the Rehab Act as Amended in1998: www.section508.gov.

Applies to federal government procurementprocesses. All federal agencies and agencies thatreceive federal funding must procure electronicinformation and information technology productsand services that are accessible to people withdisabilities. This applies to agencies acquiringelectronic devices such as copiers, telephones,web services, they must be accessible.

American with Disabilities Act (ADA)

A) Americans with Disabilities Act (1990) - this lawincludes regulations for five different titles thatinclude requirements for facilities, buildingalterations and construction, airports,transportation, housing, employment, emergencypreparedness. The requirements include alarms,detectable warnings, rescue assistance, emergencyegress and others (U.S. Architectural andTransportation Barriers Compliance Board, 1998).Examples include but are not limited to servicesprovided by emergency management agencies,fire departments, mass care shelters, mallsecurity, private security forces at shoppingmalls, sport arenas, universities and theprovisions of reasonable accommodationsduring planning meetings.


(www.ada.gov/emergencyprep.htm) .

B) Americans with Disabilities Act, Title II (1990)-this states that all state and local governmentshould not discriminate against people withdisabilities in their services, programs and activities.

C) Americans with Disabilities Act, Title III (1990) -this states the private sector should prohibitdiscrimination in their programs, services and otheractivities.

Telecommunication Act of 1996

Section 255 of the Telecom Act of 1996:http://www.fcc.gov/cgb/dro/section255.html

Applies to the telecommunication industry. Telecommanufacturers and service providers must maketheir products and services accessible to peoplewith disabilities where readily achievable. Theymust also have people with disabilities involved inthe planning stages for new products and services.

Federal Communication Commission (FCC)

Accessibility of Emergency Video Programming toPersons with Hearing Disabilities - FederalCommunications Commission (FCC) (2003)requires TV broadcasters to display visualinformation when they provide emergencyinformation to the public. This states that the stationis not required to caption everything on TV, but touse judgment to caption certain information thatwould affect the lives and safety of people.

http://www.fcc.gov/cgb/consumerfacts/emergencyvideo.html.


Executive Order 13347, signed by PresidentGeorge W. Bush on July 26, 2004

http://a257.g.akamaitech.net/7/257/2422/06jun20041800/edocket.access.gpo.gov/2004/pdf/04-17150.pdf This order ensures that the FederalGovernment supports safety and security forindividuals with disabilities in their communities andwork environments. The Interagency CoordinatingCouncil on Emergency

Preparedness and Individuals with Disabilities wascreated by this order to ensure Federaldepartments work together in addressing eightmajor issues;

1) Emergency Communications

2) Emergency Preparedness in the Workplace

3) Emergency Transportation

4) Health

5) Private Sector Coordination

6) Research

7) State, Local and Tribal GovernmentCoordination, and

8) Technical Assistance and Outreach

Disasters are always inclusive; response and recovery are not, unless we plan for it!

- June Isaacson Kailes

Knowing is not enough; we must apply.Willing is not enough; we must do.

- Goethe

Lead On! Lead On!- Justin Dart Jr.

Access to Readiness CoalitionThe Access to Readiness Coalition is a network of disability organizations and allies

that are committed to strengthening California's emergency planning, response,recovery to meet the needs of people with disabilities and functional limitations.

We achieve this through public policy advocacy, community education andcollaboration on the local, state and national levels.

For More Information Contact:c/o CFILC, 1029 J Street Suite 120, Sacramento CA 95814

(916) 325-1690 V (916) 325-1695 TTY (916) 325-1699 Fax

www.access2readiness.org

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