Emergency-Planning-and-Preparedness-for-Special-Needs-Vulnerable-Populations by liuqingyan

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									Emergency Planning & Preparedness
  for Special Needs/Vulnerable
           Populations
            Amelia Muccio
          Director of Disaster Planning
       NEW JERSEY PRIMARY CARE
             ASSOCIATION
        Learning Objectives

• Discuss the definition of special
  needs/vulnerable populations
• Explain what is currently being done to
  assist this population
• Discuss emergency planning techniques for
  people with diabetes and asthma
• Identify next steps for Community Health
  Centers
 Disaster Exercise: ‗Be the Disaster’
          Anticipate Crises
• According to Webster's Dictionary, knowledge is
  ―the fact or condition of knowing something with
  familiarity gained through experience or
  association.‖
• Therefore, one woman‘s hindsight (experience)
  can be someone else‘s knowledge.
• We must incorporate emergency planning into our
  everyday routine without eliciting
  fear/panic/anxiety.
      Your Mission: Create a Dog Tag
             ―Aurora‘s Tag‖

• ID tag on collar reads:
  –   Aurora
  –   954.975.7550
      (home/land line)
Is That Sufficient?
ID Needs More Information & Redundancy

  • Aurora Ferrigno-
    Muccio
  • Full Address
  • Mobile Number
  • Vet‘s Number

  • While initial tag was
    adequate, it would not
    be helpful during a
    disaster.
Definition of Special Needs/Vulnerable

• In disaster preparedness and response, the terms
  "vulnerable" or "special needs" populations are often used
  to characterize groups whose needs are not fully addressed
  by traditional service providers.
• People who feel they cannot comfortably or safely access
  and use the standard resources offered in disaster
  preparedness, relief and recovery.
• They include but are not limited to those who are
  physically or mentally disabled (blind, Deaf, hard-of-
  hearing, cognitive disorders, mobility limitations), limited
  or non-English speaking, geographically or culturally
  isolated, medically or chemically dependent, homeless,
  frail/elderly and children.
      Who Are We Protecting?

–   Elderly
–   Disabled
–   High Dx Prevalence
–   Pregnant Women
–   Homeless
–   Children
–   Low SES
–   Minorities
–   Low Education Level
–   Non-English Speaking
            First Problem:
            The Definition
• No ‗one size fits all‘ definition
• Diversity within Special Needs/Vulnerable
• Too narrow of a definition includes a
  chance of exclusion
• Too broad of a definition will include
  everyone
• Need definition that is balanced but will
  NOT leave anyone behind
Do We Know What ‗They‘ Need?
Second Problem:
 The Diversity
            Third Problem:
           Self-Classification
• What if I do not
  consider myself
  ―disabled,‖
  ―vulnerable‖ or
  ―special needs?‖
      Rule of Thumb on Definition

• During a disaster, who
  enters American Red
  Cross shelter population?
• Hint: it is not you and I...
• Common threads:
   – lack of social and fiscal
     safety net
   – Lack of freedom/mobility
• Dependency!!!
 The Special Needs/Vulnerable Community
 Example: Langa Settlement, South Africa

• Similar populations
• Patient demographic:
   • Underinsured &
     Uninsured
   • Stigmatized Poor
   • Socially Stressed
   • Migrant
   • High Disease
     Prevalence
   • Low Education
     Levels
Rebuilding Part of Langa Settlement after
         Massive Fire (1000+)
    Langa Rebuilt in 1 Day But
Our Communities Need Much Longer
  • Lack of fiscal
    resources (savings)
  • Lack of safety nets
    (Renter’s Insurance)
  • Voiceless
  • The population
    FQHC’s serve will
    have difficulties
    recovering from a
    disaster.
  • Therefore, we must
    focus on prevention
    and preparedness.
         What is Needed?
       Special Needs Registry
1. Advanced registration
•  State or County driven
•  Register online or by phone
•  Central database linked to Police, OEM,
   EMS, Etc.
2. ‗Just in Time‘ registration
• Assist those who did not pre-register
Transportation Needed!!!!
          Broward County, Florida
          Registration or Roundup
• Elderly population
• Advanced Special Needs
  Registry
• EMS transports registered
  disabled to Hurricane Shelters
• Police transport homeless and
  high-risk areas (mobile homes)
• Some accuse County of
  dumping them (homeless
  cannot bring personal
  belongings and disabled
  transported with records)
New Jersey Special Needs Advisory Panel
              (NJSNAP)
 • NJSNAP identifies issues affecting members of
   New Jersey‘s special needs population in their
   emergency preparedness, and issues affecting
   emergency management personnel as they prepare
   to assist individuals with special needs.
 • NJSNAP is also tasked with making
   recommendations, developing solutions, drafting
   proposed legislation, formulating memos of
   understanding, and devising programs to address
   identified issues as directed by NJOEM.
       The Value of Partnerships

• Diverse population
  requires diverse
  solutions
• Must be a joint effort
  to take care of special
  needs/vulnerable
  populations
• Multiple stakeholders
  across disaster
  continuum
Emergency Planning for Diabetes & Asthma
Real Life Implications: Hurricane Katrina

 • Of the more than 1,300+ people who died because
   of Hurricane Katrina, more than 70% were over
   age 60.
 • New Orleans has one of the largest diabetic
   populations in South
    – People fled without shoes
    – Medicare allows only one pair per year
    – Many patients with diabetes developed wounds
      (skin ulcers to limb amputations)
Special Needs/Vulnerable Populations

• High risk of
  mortality/morbidity
  during disaster due to
  mobility,
  transportation, social
  network, and illness
  (O2 dependent)
  issues.
    Hurricane Wilma, October 2005
             Example #1
• No electricity
• No working phone
• No automobile
• No generator
• You are geographically
  isolated
• Your family member
  enters into diabetic stupor
• What do you do?
     Hurricane Wilma, October 2005
              Example #2
• No electricity
• No working phone
• No generator
• No automobile
• Pharmacies have been
  closed for 3 days
• Family member runs out
  of asthma medication and
  is experiencing breathing
  distress
• What do you do?
         Diabetics & Asthmatics

• Diabetics:                  • Asthmatics:
   – Disaster is major          – Disaster affects
     stressor and affects         respiratory system
     insulin levels             – Sensitive population,
   – Mobility issues              canaries in a coal mine
   – Difficulty evacuating      – Lack of medication
   – Lack of medication         – Difficulty evacuating
   – No storage for insulin     – Environmental
   – Wound care issues            pollutants post-disaster
     arise
Diabetics: Evacuation & Wound Care
Asthmatics: Environmental Exposure Post-
                Disaster
 Know What Your CHC Can Offer

• Assist hospitals with patient surge
• Dispatch mobile vans into community
• Function as Alternate Care Site for treatment of non-
  acute patients (walking wounded)
• Serve as POD (Point of Distribution) for prophylaxis
• Function as screening Center and provide disease
  surveillance
• Serve existing patient population (vulnerable
  population) during event (stay open later)
          Basic Emergency Planning:
     Disaster Needs Mimic Everyday Needs

•   Organizational agility
•   Plans, drills, and evaluations
•   Training and education
•   Staff protection and support
•   Communications and reporting
•   Supplies and equipment
•   Security
•   JCAHO and HRSA PIN*
               M+P>R+R
Successful Disaster Planning Equation
 • CHC‘s are planning for events (pandemic,
   hurricane, power outage, outbreak,
   terrorism) that require high levels of pre-
   disaster preparedness (prevention, and
   mitigation activities).
 • Disaster is reasonably expected and
   preparedness initiatives have been
   undertaken.
 • Examples of low levels of pre-disaster
   preparedness, economic depression and
   long-term civil war
Recommendation #1. Diabetics/Asthmatics Obtain
 Emergency Health Information Card/MedicTag

  • An emergency health information card &
    MedicTag communicates to rescuers what they
    need to know about patient if they find him/her
    unconscious or incoherent, or if they need to
    quickly help evacuate them.
  • An emergency health information card should
    contain information about medications,
    equipment, allergies and sensitivities,
    communication difficulties , preferred treatment,
    treatment-medical providers, and important
    contact people.
Recommendation #2: Diabetics/Asthmatics Obtain
           Additional Medication

  • Medication: It is best if your patients are
    able to maintain at least a 7 to 14 day
    supply of essential medications
    (insulin/inhalers) and keep this supply with
    them at all times.
  • If this is not possible, even maintaining a
    three day supply would be extremely
    helpful.
Recommendation #3: Diabetics/Asthmatics Establish a Personal
       Support Network—―Be a Good Neighbor‖

    • Check on your elderly/disabled neighbors
      especially if they lack local family members
    • Know their family contact info
    • Keep in mind their limitations
    • Power failures in high rises have killed many
      elderly/disabled
    • They die of dehydration in their own homes b/c
      they could not walk down the stairs (phones were
      out)
    Recommendation #4: FEMA Independent Study: IS-197.SP
Special Needs Planning Considerations for Service/Support Providers

       • Course Objectives
          – Describe the impact of different types of hazards on
            special needs populations.
          – Describe challenges during the different phases of an
            emergency.
          – Explain how to develop emergency plans and work
            with emergency management and other local officials
            during the planning process for your local community.
       • CEUs: 0.4
       • Course Length: 4.5 hours
Recommendation #5: Utilize CHC‘s Waiting Room as Disaster
                    Education Tool

   • Next to Cosmo and GQ, add disaster
     preparedness resources
   • Plenty of free/nominally priced brochures
     on emergency disaster planning, family
     disaster plans, go bags, emergency supplies
     kits, communication plans, special needs
     planning, shelter-in-place, and disaster
     coloring books for children
                 In Summary

• Diversity prevents one single definition from being all
  inclusive
• Advanced Special Needs Registries are needed
• CHC‘s populations need additional emergency planning
  considerations
• Assist patients in incorporating emergency preparedness
  into their daily routine
• Diabetics and Asthmatics need to have emergency
  supplies kits with medical documentation, extra
  medication, and medical supplies
Successful Emergency Preparedness:
        Plan. Drill. Revise.

								
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