Colorado Community Inclusion Workgroup

8/30/16

12:45 p.m. MST

Captioned By: Nicole, Purple Communications, Inc.

"This text is being provided in a rough draft format.

Communication Access Realtime Translation (CART) is provided in

order to facilitate communication accessibility and may not be a

totally verbatim record of the proceedings."

>> Hi, how are you?

>> Hello, we're not going to start the meeting quite yet but

in case there's somebody on the phone, we want to let you know we

are here, we'll be ready to start in about 5 minutes probably. We're

just in the new space and want to give folks a chance to join us.

Thanks so much.

>> Hello, everyone. Speaking to everybody in the room, as well

as anybody who has joined us on the phone, thank you so much for

joining us for this fourth and actually last of the community

inclusion workgroup meetings for its inaugural year. So I just

wanted to start off by saying thank you so very, very much for being

a part of this group, whether you've been here from the beginning

for all of the meetings, whether you were a part of our -- whether

you were part of our survey that started us off to better understand

what communities would be interested in, in terms of training, in

terms of exercise, in terms of how connected they feel to emergencies,

or whether you're here joining us for the very first time. I feel

like I learn something every single day. I work on this project every

time we host a new meeting, and so as we go around introducing

ourselves, I want to make mention of a running list that we have had

of inclusive meeting practices. I think it's a great thing to learn

every day what makes it more possible for different people to

participate in the way that is most comfortable for them. So as we

go around introducing our names, our preferred pronouns, please also

add any accommodations that we can make in this meeting to make it

easier for you to participate. And then if there has been any

highlights in the last year, in terms of either work that you've seen,

works that you've been a part of, that really speaks to the effort

towards better community inclusion, whether that's specifically in

emergencies or just something you're seeing happening where you live.

Because I think I've said this before probably, but no disaster

happens in a vacuum. So the good foundations that we lay in

day-to-day programs, that we work for in areas outside of emergencies

ultimately help us during emergencies as well. So I'll go first.

My name is Amy. I prefer her, she, and hers. And something that

I've been particularly excited about above and beyond this workgroup

is the opportunity to speak with either each of you individually or

to reach out to you as a group to better understand how we can improve,

especially upcoming opportunities like exercises, and make them more

available for members of our public to participate in. And we have

one of those coming up in the end of June. So I'm really excited

to continue working with this workgroup over the next year, to make

the most of that learning experience the best we way can.

So Jamie, do you mind if I turn to you next?

>> Fine. I'm Jamie pledger. I'm new. My first meeting. I'm

a behavioral health provider Saturday the Colorado coalition for the

homeless, and I guess inclusion at my work, I work at the medical

clinic, integrated care, and just really getting access to care and

removing a lot of barriers has been a wonderful thing sand also

exposure to a lot of barriers and just kind of the reality of it all.

And I'm new.

>> And we're very excited to have Jamie here today as one of

our featured partners doing a quick presentation about some of the

work that she's already encountered in her short time.

>> Good afternoon. My name is Henry Mitchell. I am from mental

health partners in boulder. I'm the emergency manager master

coordinator. I prefer, he, him, his. You can also call me sire or

your highness.

[ Laughter ]

>> Wait a minute.

>> Some inclusion that I've witnessed and have been a part of

as well are the boulder county fire exercises earlier this year and

two months following that, the actual cold springs wildfire that we

had north of Netherlands. And there was really, really good to work

with all of those folks who were helping to respond and just seeing

different active inclusion, not only with our access and punctual

needs group, but with other organizations as well.

>> Henry is also one of our featured partners today and I'm

really excited to hear from him, because he has received kudos from

members of our disabilities advocacy groups and others about how

access and functional needs were well-considered during that

wildfire. So great to have you here.

>> Your highness.

>> Yes. Thank you for coming, your highness.

>> I'm from the Asian Pacific development center which is a

mouthful so we say APDC. I'm an integrated care manager there. Last

fiscal year I was a primary coordinator and I'm transitioning to

backup. We have a new coordinator her name is Ruth. She'll be here

at future meetings. I work at a community mental health center and

we practice integrated care and we primarily serve Asian refugees

and immigrants so what we do every day is work on inclusive practices,

making sure a population with a lot of different functional needs

are able to get the health care they deserve. In terms of what we're

looking forward to, inclusion-wise, I'm looking forward to working

with the red cross to adapt their disaster preparedness training.

That will be cool and really needed. And I know Amy has provided

some guidance and we're excited to participate in full-scale exercise

and see how APDC can participate in ways to make more inclusive that

are around for our population.

>> That's great. I've already learned so much from you about

not just what happened in the immediate moment during disasters but

how do you follow up with community afterwards. Because long after

the so-called disaster is over, the community is feeling the ripple

effects of it for a long time.

I wanted to point out, we're using CART services today, somebody

is providing those services remotely, that's real-time captioning,

I forget what the A stands for.

>> It's called communication access real time translation.

>> So it is a way to have the, all of the spoken word that's

happening right here in the meeting, and actually Candice, I should

let you explain it. It's a way to be captured remotely and sent via

a link to people who are deaf and hard of hearing to read while

everything is happening. And this is a new thing for us, but just

to make sure that everything is audible, we have these nice

microphones up in the ceiling. One of our inclusive practices, speak

with clarity, volume, one at a time. It's good for all of us to keep

the pace of the meeting going well. So thank you.

Great.

>> I'm Peggy Spalding and I work for the state unit on aging

health and human services and I work with caregivers, I work with

the area agencies on aging. I work with respite services, and the

other thing I work with that I would like to see in the inclusion,

the dementia friendly Denver. So the dementia population. And I'm

her, she.

>> I'm Julia beans. I'm with assistant technology partners.

We provide information training about all the assistive devices that

people with disabilities are to receive in all disabilities. So we

know a lot of the different technologies.

>> So I'm guessing I'm impressed with all the increase in

numbers. And they just keep growing in all of the meetings. So I'm

just really impressed that more and more people are getting on the

band wagon, making a huge difference. And the developmental

disabilities council has contacted me and they're interested in doing

a whole lot more. So we'll see what happens.

>> Excellent.

>> I'm Melanie Roth. I work at the state health department in

the health facilities in emergency medical services division. I

always mention dementia as being something we're interested in, but

our goal is to make sure that Colorado and visitors to our state get

safe and quality health care, and that includes during emergencies

and anything that we can do to help people in Colorado to access a

shelter or any kind of emergency environment safely and respectfully.

She and her is fine. The networking and learning about different

programs, learning about planning and the best practices and

challenges of working with individuals that have access and

functional needs and other needs, that's been great. And I have been

thinking about that video that we watched at the last meeting, I

thought it had a lot of real actionable take-aways and thought it

might be something that we could share with our staff. And lastly,

September is preparedness month. So we're planning to do some

individual messaging to our staff. Individual preparedness and also

to help facilities several times during the month. If anybody has

any suggestions.

>> Thank you. I'm Dana Goldsmith I'm with the independent

center in Colorado springs and my title is emergency programs

coordinator. So my job is to bridge the gap between the ADA and

emergency management. Right now I'm a unique breed because I'm the

only one in the state. So I work -- I worked with a consumer

yesterday, all the way up to national people calling me from other

states asking me what we're doing and how they can do it. So city,

county, state, whatever end of the ladder I'm needed right now. Our

overarching goal is to get more people like me around the state, that

I'm not doing it alone. In order to do that, we're building lots

of different preparedness and resiliency programs for people with

access and functional needs in Colorado springs and El Paso county

and kind of test driving some of our ideas to see if they work and

see if they can be implemented across the state. I guess anything

that you want to call me as long as it's nice.

[ Laughter ]

Your highness is fine with me, too. Her Majesty, that's great.

But, yeah. So we have a lot of different programs that we're trying

to get kick started. I'm also putting together a resource list for

people who need durable medical equipment or special transportation

and lots of different things. I could talk for hours about what we're

working on but that's kind of it in a nutshell

>> That's great. And we have so appreciated the leadership that

the independent center has offered from Colorado Springs for a long

time. And it was great to have I think Greg Monk was the person right

before you.

>> And Nick before that.

>> Correct. And it's great to have you all here sharing the

work that you're doing.

>> Hi, my name is Maria and I also work with the Colorado

department of public health and environment. I'm the language

services coordinator. So my work is like really dealing with

inclusion, more people who speak languages other than English and

ASL has always been -- services and points I try to provide to staff

in the department of public health and environment. I'm just trying

to broaden my scope and learn from people like Candice about what

that means that it's not limited to ASL and there are other needs

and other technologies sand I can take what I learn here and try to

further implement it with staff.

>> And Maria has been tremendous in helping our department

better understand how we can expedite services like language services

during a disaster when everything else is in chaos and we're just

trying to figure out how do we move systems that typically move kind

of slowly at a faster pace to meet the needs of our community.

>> My name is Carrie Roberts and I work here at FEMA and my role

is all before the disaster. My role is in emergency preparedness.

And I've had the good pleasure of working with a number of you in

the past. So I'm happy to be here to kind of ultimately mind -- mine

this knowledge base for places where we can practice our preparedness

together.

>> It's hard to understand me. I'm from the independent center.

>> Thank you. We're so happy to have you, and I'm sorry --

>> Thank you.

[ Laughter ]

>> I'm Candice Alder for the Colorado commission for the deaf

and hard of hearing. I'm hard of hearing myself. I work with

Matthew and I used to live in Colorado Springs and I worked for the

rocky mountain center for 12 years so I'm considered an EBA

specialist. I was also involved, myself personally, with the black

forest fire. It hit my neighborhood when I was living in Colorado

Springs and I was stuck in a flash flood also a month later. So I

have some personal experience with disaster as well. I recently went

to the airport air disaster exercise and participated with that and

I found out that being hard of hearing is a death sentence. That's

why Matthew and myself have the jobs that we have. People just don't

understand how to work with us. And a lot of times they're supposed

to be the ones staying calm, but they recognize oh, you have a hearing

loss, you're deaf, you're hard of hearing. I don't know what to do

and they panic. That's why I participate in a lot of these exercises

is to try to educate the emergency responders how to interact with

the deaf and hard of hearing. Right now I'm actually working with

the fire department who is involved with that exercise to provide

them training on how to interact with people who are deaf and hard

of hearing so that we have a real disaster that happens, and you have

someone who is hard-of-hearing or Deaf, they'll know what to do.

Chances are they will have somebody who is hard-of-hearing, because

seniors, as you are already aware, make up the biggest part of that

population. As we age, our hearing declines. So I think it's good

to have us. Thank you for having us.

I also wrote down about getting it right. Funny enough, I was

a part of the production of that at my old job. And I will say -- some

of it is a little bit stereotypical. For example, the mime is a

little bit offensive. So I just wanted to point that out. But if

you would like us to be included in the training on interacting with

people, we'll be happy to come to you to provide training in person

and help.

Also, someone mentioned interpreters. We have an interpreter

list on our website of all certified interpreters. So if you're

having trouble finding one, you can contact us:

>> A huge, huge resource in the room and we're so glad to have

you, Candice. Michael?

>> My name is Michael bean. I work in the same office as Amy,

the office of emergency preparedness and response for the department

of public health. I am the training and exercise coordinator, and

I'm glad that you brought up that you went to the exercise -- I

participated in many exercises across the state every year, and

that's definitely something that I've identified that many times they

struggle and they don't try to even practice it. But I have seen

an increase in the past couple of years of the desire to involve the

community inclusion deaf group more in exercises. For example, back

in May I participated in what's called a C step exercise. Chemical

stock pile emergency preparedness program down in Pueblo where the

chemical stockpile they have there. It's a big army exercise. I

was sent to a boon home to evaluate practices for a home for

developmentally disabled folks and they practiced a fire drill.

Just getting out or sheltering in place. So it was nice to see in

a big exercise, they're still trying to take that into account. And

so part of my job is assisting, for example, what this big exercise

we're doing next year, in helping incorporate those kinds of aspects

into our exercise. Because while it's important to practice putting

out fires and handing out medicine, it's important that we can do

it with everyone. And do it effectively.

>> We're really glad to have Michael here as we continue a

conversation we started at our May meeting about how it is that we

can either make recommendations, get involved in our own local areas,

or come together and come up with other ideas about how to build better

inclusion into the exercises that we have coming up. May I?

Okay, perfect.

>> So this is Cheryl Garcia, and unfortunately there is not

enough time to describe everything she does or who she's with. But

she is an emergency preparedness inclusion extraordinaire all

throughout the state. Everyone knows Cheryl. As far as her

experience with community inclusion she -- oh: Recently she was

involved in a decontamination exercise with the national guard and

involved somewhere around 200 national guard people. And during

this exercise, sorry I come from the emergency management world which

is very male centered. They always say national guardsmen. I'm

trying to say national guards folks. Trying to be more inclusive

myself. So Cheryl decided that during this exercise she would leave

her iPad in the car. And if you know the iPad is very important to

Cheryl. But she had a similar experience that you had at the airport,

that the folks in the national guard struggled. This did not know

what to do, how to communicate and they were very hands-on with her

and kind of this is where you go. All over, touchy-feely, you go

here, this is what you do. They didn't ask her, they didn't try.

And so hopefully in the future exercises can improve. And she

mentions in here she is working with a group that is starting planning

for the annual emergency management conference they put on at the

end of year in February and hopefully community inclusion will be

a part of that as well.

As far as pronouns go, she says she doesn't need your highness,

she just prefers princess. Princess Cheryl.

>> Designated names are also welcome.

Wonderful, also on the speaker committee.

>> Fantastic. I am hoping that folks at integrated conferences

as well as maybe something that this workgroup sets up, possibly not

this year, but in a future year, we could create a conference where

space is made to really turn the training in the other direction from

the community to the systems. And I think that would be an excellent,

excellent opportunity.

>> She wants to tell everyone that I have a little baby. Which

I do. And I love showing pictures. If anyone wants to see baby

pictures. I won't force them on you.

>> It's great.

>> Thank you for telling everyone.

>> It's her way of telling everyone to make you tell everyone.

>> That's wonderful. Has anyone joined us on the phone besides

our CART services folks?

All right. We will endeavor to have conference call capability

at every meeting from here on out. We also have an Adobe connect

right now that is just sharing the agenda currently but it will make

it possible to share some of the content of the meeting with folks

at a distance.

>> Do you mind to make a request when people take turns to say

their names --

>> Absolutely. Great request. This is Amy again. And as we

try to expand the reach of this workgroup, I'm very excited that we

have a connection now in Durango, connections in Pueblo that are with

the Colorado crest disability coalition who have been working with

us for a long time, it's great. So if you have compatriots in other

parts of the state that you think would enjoy being a part of this,

we really welcome that and we will do our best to make opportunities

available, both remotely and especially if we have a conference-type

event, make it possible for travel scholarships to really facilitate

that geographic inclusion as well.

So at this point in the meeting, hearing that there aren't other

folks on the phone, I just wanted to take an opportunity to say thank

you. As I said right at the very beginning, we have been meeting

now for a year, and as a part of this workgroup, we have had over

35 community leaders participate in one way or another, again,

whether that was the initial survey coming to a single meeting or

coming to consistent meetings across the way. And deep gratitude

to Carie and Cheryl who have stepped up to host the meetings. Another

big thank you to the independent center, to Cheryl again and then

today to Jamie and Henry for coming to present. I think it is much

better to hear from one another than to hear from a single voice at

any one time. So I think it's made these workgroup meetings

particularly helpful. I'm going to show you a web page that many

of you may have visited at this point over the course of the year,

especially with this workgroup's involvement. We have had the

opportunity to create a community inclusion workgroup page that sits

within the larger community inclusion in Colorado web page at our

department. It's very rudimentary introduction to some of the

efforts and interests of making community inclusion a wider state

effort. It connects to the maps that are being shared with a lot

of local public health and emergency response partners. And then

we have our page down here for the community inclusion and health

groups and when you click on it, it takes you to our web page where

all of the minutes and documents and shared resources from our past

meetings now show up. This has become a huge resource. We actually

did an analytics of this web page and saw that people are spending

on age 3.5 minutes on the page, which for anybody who does analytics,

that is huge. The click away is a much less often. And for this

community inclusion workgroup page, more than a third of the folks

who visit the first page actually come to visit this page as well.

So we're really excited. Word is getting out about this work group

and we really hope that that helps people reach out to you as community

experts and just continues to build the interest and the

participation in these kinds of efforts.

In addition to the web page, and probably found in the web page,

this group has produced survey results about the interest and needs

and expert tease of training and exercise in our communities. We

have a running inclusive meetings practice list that has been

requested by other folks to think about what they can do to make

meetings more inclusive. You all have shared tremendous partner

ideas that have expanded the reach of this group. We are starting

to solicit those extra participation ideas. We'll continue with

that today. And they're, I think, just as we went around, I'm hearing

so much more, as Julia said, just people and places where this

conversation is taking place. So I come to you today with an

unbelievable amount of gratitude and I've actually got certificates

for everyone to thank you for being a part of this group this year.

Even those of you who are here for the very first time. But if you

are ever interested, I have a list of all 35-plus folks that have

now been a part of this workgroup. And you're just champions in the

state. And I really -- I really many so grateful to have connections

to you professionally, but especially this summer, after the Orlando

shooting happened at Pulse nightclub, I was grateful to reach out

to you personally on that day. Because that is the antithesis of

what we're doing here. Having people that recognize the value and

worth and knowledge and expertise of every person in our community

are people I want to surround myself with. And I have so much

thankfulness to offer you. And no that I've worked myself up, I am

ready to hand this part of the meeting over to our featured partners

for today, starting with Jamie. Is there anything I can hand out

for you or?

>> Jamie: I can do it.

>> Amy:

>> Jamie: And this is Jamie now speaking.

So I'm passing around, it's really like my notes, so it won't

make a ton of sense to you right now but I'll try and go through it.

Just a little about my background, like I said my name is Jamie

pledger, I'm a behavioral health provider at the health center, works

with the Colorado coalition for the homeless. I actually just

graduated with my master's from the international disaster

psychology program.

[ Applause ] yeah for me. It's very exciting.

So actually with Amy, it's my first year is kind of how I got into

this. And last year I interned up in the Colorado refugee center.

I have some experience with refugees as well. I forgot to mention

my pronouns. She and her are great for me. Yeah, that's kind of

my background. So today I just thought I would describe a little

about CCH which is Colorado coalition for the homeless, so if you

hear me saying that, that's what I mean. And bear in mind this is

my fifth week at the organization and I am very much still learning.

But I thought I would start with the mission of CCH which is to work

collaboratively towards the prevention of homelessness towards

lasting solutions for homeless individuals throughout Colorado. So

the clinic I work at is located at park and 22nd downtown and if you've

ever been in that area, we kind of own two blocks downtown, which

is pretty cool for an organization. So we have a lot of great -- I

think the important part of our mission is to create lasting

solutions, so that's why we try and attack the issue from multiple

points, because as you know, homelessness is often chronic and

requires a lot of services, acute management and wrap-around

services.

So some of the services that we provide. Health care. The main way

we provide that is the health clinic and it is integrated and I love

it and we'll go through that more. But we do have some offices

too -- and we have one at St. Frances hospital. We also have a health

outreach program. I actually got to spend the day on it. It hopped

around Denver, that's why they call it that, I don't know. But what's

really neat about that is they have a nurse, a medical provider and

a behavioral health provider and they can line up. One of them is

at a church, I don't know if you know the church. It's the great

church that provides showers and laundry services for the homeless.

They give food out every day and the hops goes and they can get medical

attention as well. The hop is able to provide medication and stuff

that is kind of hard to access.

We also do provide management services which are very overburdened

as you can imagine. But they're trying. And we do have housing

services. Which I'm going to talk about a little later about the

burden placed on the housing program. Upwards of 15 apartment units

which I was shocked about. I didn't realize. So if you ever see

the renaissance brand of housing, it's actually the Colorado

coalition for the homeless housing. So that's pretty cool. And

fort lion, I don't know if any of you know of fort lion, but it's

a residential program down in Pueblo so the homeless can go and stay

for up to two years, so it's a great option for someone looking for

housing. And we send a lot of people who are recovering from

substance abuse down there, because it is a clean, sober environment.

It can be really helpful for people who are struggling in Denver,

especially where downtown where access is readily available.

Sometimes we have trouble sending them back because it's so isolated

down there. And sometimes the housing once they're out in Pueblo.

So that can be difficult.

And then there's housing first, I believe it's mostly for people who

have felony on the record and who have trouble otherwise getting into

housing. And then pack is specifically a program for people who are

chronically homeless.

Resources, I'm pretty sure I'm missing a bunch of others but that's

kind of what I know about.

And then since I work at south street, it's a little easier for me

to talk about that. Like I said, it's integrated care. What we

offer there is primary care, behavioral health, which is what I do,

psychiatry, you can get psychiatric meds, they can see an eye doctor,

go to the dentist, an in-house pharmacy and we do provide substance

abuse treatment. So it's pretty comprehensive care. And what is

nice about our model is they can come in and pretty much do it all

in the same day. It's a very long, frustrating day for them as you

can imagine. It's a lot of paperwork. But when you think about

psychiatry, having a wait list of three months, then the last year

or maybe up to a year it's pretty often they might be able to access

that in a day. So we deal with Medicaid, because of Medicaid

expansion, I think that's really increased the number of people that

we serve, so we're actually having a hard time keeping up, but it's

a great thing. More people are insured.

And then just some like, we do have a rapid response team at our

clinic, if someone is in crisis, either a mental health crisis or

medical crisis, normally that will result sending people to the ER

but what's so great about that is people can come in and, you know,

what they may have experienced on the street previously they're

experiencing in the clinic, at least they're being monitored while

they're going through the crisis. For example, the other day we

actually broke the record for how many ambulances we had in a single

day. Normally we have at least one. Kind of like, I mean, it's the

nature of dealing with the population, there's a lot of serious issues

going on. But one of the best things we actually had an overdose

in the bathroom but because we had medical providers there, they were

able to resuscitate the person and get them to the ER. So very good

thing, it's all put in place to help provide them with the best

services possible.

Okay. Any questions about all of that?

>> This is Peggy. The house scene, what's the wait time?

>> I was going to talk about that.

>> Peggy: Do you have it down here?

>> Jamie: I may not but I'll talk about it now. It's very,

very long. As you can imagine Denver prices are through the roof.

I was doing a presentation the other day which was talking about the

political side of things, which is really getting into the ability

to provide affordable housing, it's a huge issue. So, for example,

path, the wait list is a minimum year and a half. I think section

8 right now is also around that wait list. So it's really hard. It's

so hard to sit in the room can you get into housing yeah but you're

going to need to wait a year and a half and then thinking about a

year and a half in a shelter or just on the street it's hard.

>> Amy: This is Amy. It sounds like emergencies are

definitely intersecting the housing market. We've had a lot of folks

driven down to the metro area from some of our more northern cities

because of recent wildfires or flooding. But at the same time,

sometimes emergencies can be either that crucible space or flexible

space. Do you see a place where there could be either learning in

both directions, something you could recommend during disasters, for

this community either in terms of housing or something else that has

been done during emergencies that you wish could carry over into more

stable systems?

>> A hard one to say right off the bat, this is Jamie speaking

again, sorry. I think I'll have to get back to you on that. In the

bottom section where consideration for the homeless community really

meant during like a homeless disaster so I can speak to that a little

bit. But one of the things that just popped into my head when we

were talking with medication, and I know that in psychological first

aid, that's one of the first things we're trained to ask is do you

have medication that you need, that you're missing, when you're

forced to evacuate. And with the homeless population, I would say

that a very high portion of them are medication. That is very

important for them to have. And so I think that's more readily built

into disaster response than necessarily like a shelter for the

homeless. It's nice that we're here, but I don't know how other

cities are doing with homeless populations in terms of medical access

and medication access and stuff like that. And this is Denver, even

in Colorado it could be worse than other parts of the state. Not

quite sure how it's going in Colorado Springs for example, or Pueblo

or things like that.

>> Amy: This is Amy again. So one thing that happens

especially during a public health disaster that maybe need to get

a new kind of medicine to the public at large, are there ways of

outreaches to the homeless community that you would want emergency

managers or planners to know about, the best way to connect with that

community?

>> Jamie: I don't know if it's what you're referring to, but

last week very convenient timing, from Denver public health come in

to tell us that we're actually a pod for dispensing medication during

a disaster. So that is fantastic. We were kind of joking we were

told we're a closed pod which means we only provide to our population,

but we serve the homeless, but we're not going to tell someone who

comes in you don't look homeless, we're not going to turn anyone away

so we'll probably function as an open pod.

>> I wouldn't tell Denver public health that.

>> Yeah. So that's good. That's a great access point for

homeless. Especially with that open and closed, it's something what

if they're staying at the Samaritan house but they haven't

established health care at the clinic, won't be able to turn them

away.

>> Mike: This is Mike. To build off Amy's question, in an

incident like that where you had to open a pod, would your

organization be in charge of spreading the news going out and telling

the homeless, come here? Or would that be the responsibility of the

city government to go out and direct them to you?

>> Jamie: This is Jamie. Trying to think about what I was told

in the training. There's another guy in the organization I'm

supposed to link up with who does a lot of disaster preparedness.

I'm not exactly sure what that would be, but something that I would

talk about is just communication with the homeless is difficult in

general, just because of access to phones, they're their transient

state. So I think that it would be most likely up to us. But I'll

get back to you on.

>> Do you have a question?

>> My question is kind of similar to his question,

communication. How do you communicate with the population. But

I'll expand on that question a little bit and ask how also do you

communicate with people who are homeless but also have other things

going on? For example, they have other limitations access to

communication?

>> Jamie: Yeah. Part of the deaf or hard of hearing, I haven't

had a personal experience yet. I imagine there's something set in

place, but I think it's a good consideration for me to take back and

ask about that. Do know that we use interpretation phone services,

for example if they don't speak English, so we do have those. But

other than that, I'm not quite sure. So I'll have to ask about that.

>> Just the communication issue, I can just look at what I was

going to say.

So a lot of our population don't actually have phones, or they

lose them or their phone number is changing a lot, so it's a huge

issue. One thing that is word of mouth, one thing I've learned is

that the homeless community is actually pretty tight knit. If you

ask them, they probably know of the other person that you're looking

for. So that population is probably our best resource for reaching

out to people within the population. And it's complicated for sure,

but I have also heard a lot from some of my clients that it's a

supportive community so they do try and help each other out. So part

of me thinks that word of mouth is the most effective way of reaching

out. Because there are people there that we're not aware of that

some of our clients probably do know of. But communication is a huge

issue in general. So definitely open to hearing suggestions for that

or what you would think. Yeah?

>> Amy: This is Amy. I would echo that. I have actually been

trying to learn a little bit more about a while ago what was called

the Colfax hotline, the way that information traveled through the

homeless community via Colfax avenue here in Denver. And more than

anything, I think what then become really apparent is that it is

important to have somebody who is a member of that community part

of conversations wherever possible. Because, yeah. I've heard the

exact same thing about word of mouth in that regard.

>> Jamie: This is Jamie. One thing, the last four weeks you

can imagine and we do have a lot of staff that are either previous

clients or have been previously homeless, so that's a great way for

us to reach out too is they have connections in the community often

and kind of put themselves in the situation more so than some of us

can. I'll go through some of the considerations I wrote down for

the homeless during a disaster.

One thing I thought I would briefly touch on is the homelessness

definition. Because I think it's sometimes we imagine homeless

people on a street. But it can obviously be staying in a shelter,

it can be being evicted from a place and not having a place to stay

within 14 days of that eviction and you would be considered homeless.

Staying in a place that's not meant for humans is also considered

homelessness. And basically existing in a shelter where they stay

up to 90 days. They could have had housing for three months and still

be considered homeless. Also couch surfing, that can be considered

homelessness. Just some things to think about there.

I wrote down survival mode because I was thinking how I would

react if I were homeless and a disaster happen. I think our

population is in survival mode all the time. And that can affect

their future-oriented thinking as far as planning ahead. They might

not really be planning that far ahead, they're just providing day

to day, that might affect how they respond in a disaster situation.

Hyper vigilant, because with respect to the population has a lot of

trauma. And their response to being evacuated or something might

be kind of difficult. So just imaging better interventions with

them, TSA being helpful. Just trust of the system and other people.

They're a population that often gets taken advantage of. I think

in just my short time at the clinic, that's what I've learned. I

wrote down medication, so we already talked about that. Super

important. Also within the population -- thinking about withdrawal

if they don't have access.

>> What is TSA?

>> Psychological first aid. PFA.

>> Do you need to say more about that? You're good. Great.

So I was thinking about withdrawal, for example. If someone

has been using alcohol regularly and for somebody in a disaster it

doesn't allow them to keep using alcohol, it can be super dangerous,

as you all probably know.

If you try to take that back, it's going to be a big issue.

Property. Think about how you can best manage moving them with their

things, if they can evacuate. And health hazard, I've seen a lot

of clients with bed bugs or body lice, so just thinking about if you're

going to have an isolation area for people who do come in with those

type of things.

I just wrote resilience in the end. The population is really

resilient. If they're surviving on the streets, they have to be.

I like to keep that in mind also. And community perceptions, I was

thinking about what would happen if, for example, if there was a

community all needed to go to the shelter and the homeless were held

with the more general population and depending on that reaction, what

kind of complications that could bring up. I don't think there's

any secret about sort of attitude towards the homeless in the general

population can be quite negative. And so just kind of considering

that ahead of time might be helpful. Don't mean to say that's all

people's perceptions or that it's necessarily going to go poorly or

well, but it's just something to think about. This is my ramblings.

I'm sorry, this is all over the place.

>> I love your ramblings. This is Cari and I was at red cross

prior to being here. I wonder if there's opportunities for you to

help red cross, from understanding from what you were just talking

about. When those shelters are opened, those are meant to be for

anyone who is affected by the disaster, but there is certainly a gap

in training for those workers, who we should remember are volunteers,

in knowing with all the different populations we're talking about,

sort of what that looks like. So there may be opportunities there,

I don't know if that would be near or otherwise, but in looking at

offering some training or even some tips. More frequent our

disasters become, we used to plan for about 10% of the population

would need sheltering, and that number is increasing. Because the

sheltering is more frequent. So sisters and neighbors and whoever's

couch we were sleeping on because of the disaster are tired of it.

So more people are come to shelters and staying for longer. I wonder

if that's an opportunity to make those connections if you don't

already have.

>> Jamie. This is Jamie and I think that would be great. I

would love that.

>> Amy: Any other questions?

>> This is Matthew, I want to make a comment. Denver -- so okay.

Part of it. Provide -- but they can't communicate. They could stay

a month to recover. A cycle. I see that all the time. Make

reasonable accommodations -- they get away with it.

>> Sometimes the shelters are run by churches, they're exempt

from being able to provide services. What Matthew and ADA says that

church-run facilities are exempt from ADA requirements. If they're

run by state agencies or if they're receiving federal money or state

money, that's when it becomes responsibility to provide effective

communications. But the problem is they say we don't have the

funding to provide effective communication. So the expectations of

shelters itself is not clear to that person. So it's easy for them

to break the rules, because they're not communicating clearly to that

individual what is required of them. And also, who wants to go to

a place that doesn't want to communicate with you. I mean, that's

another thing. You already feel left out. Being homeless, being

transient, you already feel rejected in a lot of ways, and then you

add a communication barrier on top of that, it becomes a no-win

situation.

>> Even go camping -- I'm good, I'll go camping. We had a TTY.

And then provide video phones or we cannot have it. We have Internet

that provides free video phones in the lobby. We only have one. But

at this point --

>> Amy: Yeah, this is Amy. What I heard in that was it goes

above and beyond what the rules are about what you must accommodate.

There is so much to culture and how we get used to the wide diversity,

how we invite the wide diversity of our state into all spaces so that

in those emergent situations, when people are having just that

increase in anxiety, that increase in just hyper arousal, we don't

fall back on acting scared around one another, and not

problem-solving, even when there are so many different excuses that

people use to not make inclusion a priority during that time. So

I think the effort, not just to enforce and to promote the use of

actual policies and actual rules that are out there, but to really

facilitate relationships is the only way that we're going to get

people to step beyond what the rules are saying to them at this point.

>> This is Candice. I want to piggyback on what Amy just said.

I agree 1000%. The biggest barrier I think a lot of times we face

is just other people's attitudes. Straight up.

>> Yeah, this is Jamie. I think your point about the brutal

cycle is so well-taken. I mean, it's a problem in everyday life,

so it's going to be a huge problem during a disaster. And it's

certainly a huge problem with the homeless population. A brutal

cycle. I think it's a problem with all of our population. Just when

thinking about when I worked with refugees last year and spend them

to specialty referrals who are supposed to provide interpretation

but just wouldn't and our clients would come back and say well, they

didn't have an interpreter so I didn't get to have my MRI, which was

like pretty important.

>> That's what we deal with so much. So what you're saying

resonates. And Amy your point about the relationship to try to get

people to change their attitude and doing more what is required of

them, that's the only way we've had any success in helping address

that particular issue. It's just getting people to know you and your

communities and getting them to care. And that's hard to do. It's

really the only way we've been able to address that.

>> This is Carrie, what I find working with community partners

is the desire to be inclusive, the knowledge of how to do that.

That's why a group like this is helpful to say I'm willing to come

in or give you a list of interpreters. I think more and more it may

be a fear of not doing it correctly, of not providing correctly or

wholly or whatever the thing is, and that sometimes looks like I don't

care, when really it's I don't want to screw it up. I don't know

what I'm doing. So I think it's incumbent upon all of us to help

the folks we work with to know who to call and know how to do that,

be patient and not have any gotcha about the work that you're doing.

Because I think there's a lot of gotcha you didn't do it right, and

I say that sitting in the government, but it shouldn't be that. It

should be here let me show you how to do the things we're asking you

to do. Not because there's a rule about it, but because this person

isn't getting the information they need to live their life. Disaster

or not disaster.

>> This is Maria. I just want to underscore the importance of

communication across any and all languages when you're talking about

languages and there's so many similarities in themes that you could

build upon those so when you're working with folks you don't have

to worry about we're training for specifically ADA or we're training

for refugees. We're training in terms of communication, this is what

you do. And this is the process that you follow. You build on so

much what you said in terms of fear and not feeling appreciated, not

feeling wanted. Again, these are themes that are common across all

racial and ethnic groups, and there's some themes that you can build

on to increase training across.

>> Universal design. And this is Amy. And that's why we've

really been pushing this move that I think public health maybe

especially has been a little bit slow to pick up on, which is a move

away from the language of vulnerable populations to this idea of

accessing functional needs, to this idea of community inclusion.

Because what's become very apparent is that everybody needs to be

able to do certain things during a disaster. And so if you're

planning for communication and inclusive communication, then you're

going to, by certain strategies, not just help one population, but

help many populations all at the same time. And the only way that

we're going to know whether we've hit that mark is if we have those

good relationships where we get the feedback from community members

to say yeah, that worked. Or this is something that we can do better

next time.

>> I just want to increase and build on Amy is it's not only

to have those good relationships -- I don't have to do this because

it's a federal requirement. Moving beyond those you have to -- our

goal is to have preparedness. Our goal is to have good outcomes.

Our goal is to prevent homelessness. Those goals, overarching goals

across agencies that really -- what's the word? Goes beyond the

finger pointing or the tallying.

>> We call them best practices too. A little beyond that, but,

you know, when we talk to people when we're doing training to health

care providers, we say yes, this is the regulation. This is the

minimum that you have to do. You have to do this minimum. But we

try to also talk about best practices, what is the best practice.

This might be what you have to do, but this is the best way to provide

inclusion. To communicate with everyone. This is how best to be

prepared for anybody that comes in.

>> Amy: This is Amy one more time. Jamie, thank you so much

for facilitating such a great conversation.

[ Applause ]

I would like to also make sure that we have time for Henry to do a

quick just informal conversation about some of the experiences that

he has recently had both with recent disasters but also was the access

and functional needs group that he is a part of in Boulder. So I'm

going to sign back up so I can pull up some assessment tools that

their team has been working with to bring attention to access and

functional needs early on during disasters in Boulder but I also have

a few copies, so I'll make sure that there's at least one copy on

each table, but hopefully it will be up here on the computer in just

a second as well.

Very quickly while we're in a quick transition, there is food for

everybody in the room, so please take a moment to grab water or food

or anything like that.

So, this is Henry Mitchell from Boulder mental health partners. And

thank you all very much for your time.

I just want to speak a little about how access and functional needs

team, AFN team as we call them. This team has gone through a number

of different names and forms, but as it stands now, we are the AFN

team of Boulder. And this team is comprised of members from

community services department of Boulder county, public health, and

mental health partners as well.

In the past during exercises and actual emergencies and response to

disasters, we definitely noticed that there were some needs that were

being overlooked. And there was some great opportunities for us to

continue to develop our program so that we develop a system that

identifies the needs as they come up. And really does a practical

job of addressing them. So those needs were mostly communication

issues, medical issues, functional independence issues.

Supervision and behavioral health issues as well. And so in

identifying all those needs, we did find that the three Boulder county

organizations that did the most to affect change in an emergency and

to really address those needs were community services, public health

and mental health as well. I want to say that public health was

instrumental and irreplaceable in really pushing this forward.

Public health is the EFS8 lead which means emergency support function

lead, if you're not familiar with some of the EOC lingo. Basically

that means they lead a deaf and lead the response effort on the public

health side. And because of that position, they really do have great

reach, and the work that's done in shelters and exercises and what

not. So Boulder County Public Health was really important in pushing

this forward in developing this tool.

So we did find that -- so there were certain issues with getting folks

resources that they needed. Actually at the shelters. When people

actually got to the final shelter point. So we really worked through

that, and we're looking to find a way to identify these needs before

people even got to the shelters. And as it stands normally when we

have some sort of evacuation order, folks are moved first to an

evacuation point, and then moved to an evacuation shelter after that,

or the evacuation point is turned into a shelter later.

So we found that that was the best place in which we could insert

ourselves and really go to work and identify some of these needs that

our community members have. So this is at the evacuation point,

pretty much the quickest point or the quickest way to access evacuees,

once they have been moved or once that order has been given.

So once the evacuation point is set up, then we call our team together,

and one of us from either community services, public health, or mental

health will gather our tools and go to the evacuation points and go

ahead and look to identify needs there. And one thing about that

is that it's different than going to the evacuation point and setting

up a table. We really wanted to be, I won't say more aggressive,

but we wanted to make sure there were no missed opportunities. And

so what that meant for us was really putting aside that table model

and actually getting into the evacuation point and interacting with

the evacuees. That means active observation of any possible needs,

actually going in and speaking with evacuees and making contact with

our shelter or evacuation point managers, and those who are leading

that effort, as well as other organizations who are there on scene

as well. And so what that does is we are making contact with them

and telling them why we're here, what we do, and that allowed them

to in turn point to any folks who have needs to us, any folks that

we may have missed.

So it's inclusion, not only of the people that we are trying to serve,

but also including other organizations in our efforts as well,

letting them know what we're doing and how they can help us and we

can help them.

So what you have in front of you are the access and functional needs

assessment tools. And there's one at each table. The first one is

the assessment tool. And that is what is used in the immediate. So

if there are folks who are at the evacuation points and they need

something immediately or there's a big, bright, shiny immediate need

that really sticks out to us, we can use this rapid assessment tool

or RAT.

The actual responder is responsible for filling out this form. So

it's not the person who is in need, but it's the actual responder

from public health community services or mental health. We have this

form and we'll walk around and fill it out as we are speaking to the

people.

>> Can we get copies?

>> Absolutely.

And so with this tool, as we are here today, and as we continue

our partnerships in the future, we are more than welcome to any

suggestions for improvement. I myself personally am welcoming any

suggestions for improvement regarding especially the behavioral

health section. So anything that you all have found really useful

in the past or any great ideas that you may have had that you think

will be using for this tool in the future, absolutely let us know.

And we can see it works. That is the rapid assessment tool for

initial use.

And then after that we have an individual assessment tool or

IAT, if you like acronyms. This is a little more in depth but

basically covers a lot of the same needs that we're trying to

identify, communication needs, medical issues, functional

dependence needs and what not. And these tools are worded in a way

that allows the person who's giving this assessment to not just ask

plain, dry, okay, are you unable to relate current living situations,

blah, blah, blah. It allows us to have more of a conversational

relationship with anyone who hears assessing, which really helps in

an emergency situation in a way. We don't want people think they're

being put through a big bureaucratic system. That's why we're

straying from the home table concept. We want to be approachable,

we want people to be comfortable telling us what their needs are.

So one great thing about this is that because it comes from the

ESS8 desk, which is public health, any of these requests that we get

for resources, those can be considered official resource requests.

So as these assessments are being made in the field, these resource

requests are being communicated up to the emergency operation center,

and verified by the emergency ESF8 slash public health desk, and we

can actual put that into an official resource request form, so we

can say we have a need for X amount of resources here. Or we will

see that we have a need when the shelter is being set up for these

resources. And it really allows us to be official, and have an

official record of requests and also really get these requests and

these needs for resources answered and fulfilled in a timely manner.

So it's all kind of a smaller part of a bigger response machine, if

you will.

I think I mentioned communication with shelter managers and

other response groups. We find that that is probably a step that

is overlooked often and can really be leveraged to provide supports

to our folks who need it. If people, if the shelters managers and

volunteers know why you're there and what your capabilities are, then

they can really lend a helping hand in assisting anyone or pointing

someone towards you if we have missed an opportunity to assess someone

and provide someone with resources that are needed.

So are there any questions? Or suggestions?

>> Michael: This is Michael. One challenge that seems to me

is some of the responses on this may be subjective according to who's

recording. For example, has hearing difficulties a red look

different to one person may look yellow to another person. So what

efforts can you take to train or to practice this to make sure that

everybody is filling it out consistently and making sure that

everybody is receiving consistent service?

>> Yeah, absolutely. And that is an issue that we are seeing.

And that is another reason why I'm glad I'm here is to maybe get some

advice and recommendations on that and really how to differentiate

that and make those differences. We would absolutely love any sort

of recommendations for that.

>> Would I be yellow and he be red?

>> Yellow, green, red.

[ Laughter ]

Which one is purple, right?

Yeah, exactly. With this I think that in our effort to identify and

our effort to assess, those are things that can be worked out

hopefully in that conversational relationship that we're trying to

build. So that's where we're hoping to go with that. And really

speak with the person and get an understanding of what their needs

are. But, as I said, if we have any ideas, as far as identifiers,

that you feel would be useful, let us know.

>> I have a question. What does red, yellow, green, tell you

as far as your response to that?

>> Red, yellow, green, we were going off some of the traditional

triage models where red is an immediate need. Yellow is a high need

but not as immediate, not as of right now. And green is a need, but

it's something that is not needed super fast.

>> Maybe not a severity, maybe not a red or a green, but time.

Needs in the next four hours.

>> It would be red all the time because the need to communicate

is vital.

>> Absolutely. We're also thinking about medications. A red

medication need would be someone who has issues with maybe asthma

and they need it now. So that's what we're looking at. But if you

have an inhaler that's almost out and you know you're probably going

to need it in a couple of days, that would be a yellow. So it's more

like a time thing than severity of any particular.

>> Amy: This is Amy. I think what is so interesting about

these tools is it's an effort to create a bridge between the systems

that the emergency services are already using and help articulate,

be an advocate for the community needs in a language that they

recognize. So here's an opportunity for us to put community needs

on the same level as the other resource request needs that come in

during a disaster. So model-wise, I think it's an advocacy in ways

to make it clear that this should be taken as seriously as any

structural or resource need in another way. But at the same time,

I think the room has brought up good examples of why a triage doesn't

always make sense. Or how we could use a triage system to always

say it's red, to make sure that these needs are considered as rapidly

as we possibly can. Because ultimately, the reason we have -- the

reason we have emergency systems, my philosophy anyway, is that we

want disaster events that happen to have as little impact on the

community that we serve as possible. So you better believe that I

think that these sorts of issues are the reddest red that you can

really take into consideration. Because these are the experiences

of people in disaster.

>> This is Maria. I missed the beginning part but I just want

to get the context of the tool. Can you tell me about when this

is -- is this preparedness, is this response? I apologize.

>> Henry: This is Henry. Absolutely. So this is along the

lines of response.

>> Maria: The event has happened.

>> Henry: Right. The event has happened and we have our access

and functional needs team which is comprised of community service

members, mental health and county and representatives from one of

those groups will go to an evacuation point before a shelter is set

up to start with the assessment. So this is during or post-event.

And when we're really getting into the response.

>> Dana: This is Dana. Do you guys give these triage documents

over to your sheltering partner after you've opened so they can

continue care, or do you manage the care from start to finish if they

come to an evacuation?

>> Henry: So sheltering partners, the organization who is

running the shelter?

>> Yeah. If a shelter is determined to be necessary, do you

send that individual to the shelter with this document saying here

are my needs, or does your organization handle this form and all of

the needs that have been assessed from start to finish?

>> Henry: So our organizations handle this form and the needs

identified by this form. Those needs are communicated to the shelter

managers. But that is not what the expectation that those

organizations are obligated to fulfill those needs.

>> Or able.

>> Henry: Or even able to fulfill those needs. As county

governmental organizations and partners of such, you would have

definitely something that is within our ability and that is something

that we are tasked with doing. We want to communicate. So on the

back end, if we took these assessments at the evacuation point and

a shelter is formed later on, we're going to communicate those needs

that we have a certain amount of people officially who have identified

that they may need -- whatever. And we can communicate that to the

shelter managers just so that they know that we're coming and that

those things are taken care of. And thankfully it seems like that

communication takes place at the EOC level -- EFC level? As well

as in the field. That's what happened during the wildfire.

>> This is Melanie. So you track where these people at the

evacuation point are going to be going? They might not all be going

to the same shelter.

>> Henry: That's a piece that we figure out during the

assessments and that actually means a lot to us in our county, because

generally a lot of folks, we don't see a really big shelter population

all the time. A lot of folks I know in the mountains, they probably

have a close-knit relationship with the neighbors. If it's

something down here in the flat lands, folks either have friends or

other resources that they can go to for sheltering. So when we're

doing this, we definitely try to identify, are you going to the

shelter. If not, then let's find a way to get in contact and get

their contact information.

>> This is Maria again. I'm just curious the responders

responsible as a responder, as you're out in the field, what tools

do you have available to you to help you at that moment? Say you're

filling this out and you do come across that has a language need or

a functional need, what happens at that point? Because when that

person is there and you can't look down and fill out that form without

being able to communicate with them. I'm wondering what rapport you

have as a responder with somebody who has a communication need that

makes it difficult --

>> Henry: Absolutely. So we have some support. Granted it

is limited. We do have some support as it worked out in our wildfire

exercise. We have the Boulder County medical reserve corps who fall

as a support organization under public health and therefore the

access and functional needs team. So if it's needed and activated,

we make sure we have someone needed and do these assessments and also

activate the medical reserve corps. With the medical reserve corps

we have people who can provide medical attention and treatment as

needed. There are limited translation opportunities that we have

there, translation resources. If there is a bigger need that's

identified, we do have those resources available to call. But as

it stands, right then and there getting immediately to that

evacuation point, we don't have the robust translation resources that

maybe we would need or we would have. We do have them but we're in

the works.

>> This is Maria again. Just going to throw a suggestion out

there. I was working with Amy and this is one of those things that

you could really -- I think you're safe to assume there's always going

to be a language barrier. So rather than waiting to have to respond,

to be pro active about it. I work with Amy and her team over the

past few years going off of the flood example and thinking about what

things you can have translated ahead of time or available ahead of

time or making it standard practice that as a responder, if I'm going

to go out in the field, I'm going to go out with a phone with

interpretation support. I don't know if there's anything could have

CART services available, just so you have those tools with you as

a responder on the ground so that's not holding you back. So you're

probably going to need it at some point in time regardless -- just

something to consider as part of what the tool that you need to have

with you.

>> Henry. : Absolutely.

>> That segued into a question I have on the first page where

it says hearing issues with no hearing aids. I don't benefit from

hearing aids. We have degenerative disorders that causes me to be

dizzy when wearing hearing aids. I would suggest saying -- what I'm

assuming this means, that they don't have their technology, right,

they didn't bring it. Or something.

>> Right.

>> So I would suggest staying instead doesn't have their hearing

assistive technology.

>> Henry: That's exactly what we want. That's the kind of

feedback I'm looking for. Thank you so much.

>> Dana: This is Dana, just as another resource similar to what

Maria was talking about, the independent center is putting together

on what we're calling an interpreter strike team. Certified

interpreters who are able to travel around the state who have taken

FEMA1-700 and 800 and are familiar with the emergency response

environment. One of the hurdles is trying to get RID to give them

CEUs. Once we've established that, we have about seven or eight

interested interpreters and I'm traveling to California this week

to find out -- they're already implementing this. They've been

doing it for about four or five years now. I'm going there to find

out what they're doing, how they're doing it, who's funding it, all

of those kinds of things. Whatever I can learn about the program

that's already in place. We're hoping to have something on the

ground within the next year as an ASL option.

>> Henry: Thank you. Definitely a need and you know, once that

group is sort of on the same notification and response level, like

the medical reserve corps are, that would be great.

>> A big piece of it, this is Dana, a big piece of it is looping

them into the resource banks and other lists that are out there so

ASL is included when they go through the list of interpreting

agencies. So we do eventually want to loop into to make sure that

they're included so that if people call they have that resource

immediately. We're not sure if that call would come into the

independent center or we may do it through CCDHH. We're not sure

yet who they would call. We're kind of building the structure around

it. But we're hoping to at least establish that team and start this

relationship.

>> Henry. . Yeah.

So another thing that we are looking to in these assessments,

another addition to this tool, would be a visual assessment tool for

anyone who, if we are not able to communicate with them verbally and

there are no visual impairments, actual picture boards and what not.

Great resources and we're going to continue to make sure that we have

that tool ready that coincides with our access and functional needs.

So if anyone else has any of those kind of visual resources, send

them our way as well.

>> Amy: Low tech and high tech. Having both versions of just

the ones that you can hold out in front of you, like a laminated board

are great. But there are also apps out there for sure that facilitate

picture board transitions as well.

>> Jamie: It's Jamie. I guess I have a question, it's a

learning moment for me. I was thinking about medical issues and

thinking about my population issue, thinking about intoxication. Is

there any criteria in shelters about intoxication and how do you

respond?

>> Henry: Like rules against?

>> Jamie. Yeah, and getting into a shelter and how to deal with.

>> Henry: We haven't had those issues and we do consider that

to be kind of a health issue as well. As far as intoxication in

shelters, I'm not sure if there's a set rule. I would think there

would be. But that's not an issue that we've really run into.

>> Certainly not allowed to have alcohol in the shelter. And

it's definitely part of the shelter training, the managers how to

have those conversations, those are one-on-one conversations about

the behavior more so than about the intoxication. You don't have

to sleep in a parking lot, but keep it out. I would double-check

that again with your red cross contact to make sure what the current

training that being given. It's something that's used as an example

in exercises. We always have somebody sneaking in a bottle as part

of the exercise to see how does the shelter manager have that

conversation.

>> I just wanted to mention another resource for you guys. The

independent center also has a braille translating machine that they

would be willing to use if you needed it to translate any of your

written materials.

>> You have to have somebody to read the braille to make sure

it's translated correctly. Because it's not 100%.

>> We can do it on a limited basis, but in a crunch if we really

needed to, we have the machine and the individuals who can do that.

And we also are big on making sure that forms like this are in a

14-point font or larger for people with low vision.

>> This is Amy. This is a project that we've been looking at

in our office. This is a very clear example of why it is so important

for emergency partners to know what their critical messages are going

to be during a disaster and pre-translate, pre multiformat all of

their resources that need to be accessible by everybody in our

population. And so if there is anybody in this room or if anybody

knows of anyone, just a process by which people could walk through

identifying their critical messages, better understanding who lives

in their community, and where to better understand that a non-English

language, whether it's a different kind of format that is needed for

that particular resource to be available in, that this is our

preparedness is just so huge. Because there is not time once the

disaster hits the fan to get that done, usually. There's a minimal

amount that can be done in a crunch, but most of it has to be done

ahead of time.

>> This is Julia. So we have handouts on alternate formats and

what to do, you said 14 the preferred is 18. You've got to have lots

of paper on hand if you're going to print stuff out. And the picture

boards are the universal language and we have electronic picture

boards that we can certainly share with you.

>> Assistive technology partners at the university of Colorado,

if you haven't made friends with them --

>> I just have one last question. I was curious about the

role -- to the floods, there was lots and lots of coverage. I felt

there was a really missed opportunity in the Spanish media outlets

to facilitate that media kind of communication. So again,

questions, maybe suggestion how to network and work with not only

your mainstream media channels but your Spanish language or perhaps

if there's a similar equivalent within the Asian population. I know

as a population we tend to go to our sources. Radio or television

or another network of communicating back to that population.

Because a lot of people during an event have their devices and what

not.

>> I use Facebook during the flood.

>> Exactly. Social media.

>> That's how I got my information.

>> Which is why it's critical to know the communication loops

that already exist day to day. And sometimes that's not media.

That's community organizations that already have the relationship

with our community members, and bringing them to the table early on

to better understand like do you have a 24-hour person that I could

call if I need to get a message out to this community lickty split

during a disaster. And the other thing is, especially with social

media out there is knowing those informal leaders as well. As you

were saying, Jamie, the fact that the people in the homeless community

get tight-knit quick. Is there a means by which worth of mouth or

the folks that are called thought leaders in social media can be

recognized in your own community, especially as it reaches groups

that don't use mainstream media as much.

>> Amy: This is Amy and I hate to cut a tremendous conversation

off short. I'm just recognizing that we have about 12 minutes and

I want to honor everybody's time. Thank you Henry, so much. I'm

sure there will be many, many people reaching out to you with larger

conversations about how do we structure some of these ways to

recognize the needs in the community so that it's easier to see this

represented across the state.

I wanted to spend the last 10 minutes basically asking a question

of this group about how we make the most of this upcoming year.

Especially embedded as I am, as Michael is, as some of us are on both

a state planning level, with some events that are coming up, just

so deeply want to make use of the expertise in the room to do our

best to make, especially the public health full-scale exercise that's

coming up, as inclusive as possible. And so I just wanted to

highlight a couple of things that are coming down the pike, in terms

of our knowledge of how that exercise is going to shake out. And

Michael stop me if I say something wrong.

So between September, the middle of September and the beginning

of October, our local public health partners and their health care

coalition partners will be letting us know which of them will have

a public-facing component, or more specifically, which of them will

have a point of dispensing component of their full-scale exercise.

When we say full-scale exercise, very easy, I think as folks who don't

always do exercises to think okay, we're going to do, you know, a

disaster from beginning to end full-out, just without the actual

disaster impinging on us. But full-scale, usually means full-scale

of particular components, rather than the whole, whole thing. Just

because usually we can't set aside daily operations for long enough

to do a full-length disaster event in simulation. We have local

partners who will need to do a point of dispensing component, which

is that the point at which the medicine that is rapidly disseminated

during a public health event reaches the local level and then is

either divided out through organizations, we heard this language

earlier, closed pods, closed points of dispensing, that are able to

give it to people that are their staff, that are their staff's

families, that are their clients. Or there are called what are

called open pods which face the public. And that's how we get the

majority of just Colorado families in to distribute that medicine.

That is one of the big points of this exercise is to practice that

distribution from a high federal state level down to that regional

local level, but we don't know yet how many of them will have a

public-facing component. We want to definitely look at those groups

who are doing public-facing components and invite them to have a lot

of community inclusion and consideration. And one of the things that

we have in place already is that local public health partners are

asked to invite two non-traditional community partners to come and

observe the exercise so that there's a little bit of community

education that happens about, this is what an exercise looks like.

This is what happens during a disaster that you should be aware of.

And hopefully that starts a conversation about oh, that's what's

going to happen. You know, this might be a point that's difficult

for folks in my community, unless you have this piece worked into

it as well. So we're hoping that those conversations start that way.

But specifically with the groups who will have a public interface

as part of their full-scale exercise, we're hoping we can get more

representative members of the public to participate in the exercises.

And so one thing that I would like to have more of a conversation

with you all about is how do we facilitate that? Once we know who

that's going to be, how can we both identify who critical populations

are in that jurisdiction, to really be aware of what those access

and functional needs are, and how do we make sure that, again, we're

not playing a gotcha game. We want it to be an opportunity for us

to understand where our systems have gotten to at this point, as a

baseline, and then make recommendations about where we can go from

here in the next five years, in the next ten years. And hopefully

again through the relationships in this room, connect people with

resources that are already out there.

So that's one question I have for you. And I'm afraid I'm only

going to have an opportunity to frame these questions and maybe we

can continue a conversation before our next meeting in November. But

the other thing -- the other strategy that we have is also, and some

of you have been a part of this in years past, is identifying injects

that we can add to the exercise, that confront emergency partners

with the diversity of our communities. So at one point Maria and

I actually simulated a request or an inject in an exercise that there

were members of the Spanish-speaking media who wanted more

information and they had seen a document in English and were wondering

if we could provide them a Spanish-speaking document. So we worked

out the expedited language translation process that our office could

go through to make sure that that came through.

But on the other hand, some sort of inject that we might get

is that we're seeing more people with mobility difficulty showing

up at hospitals, because for some reason they're not able to go to

the places where we're distributing medication. And so an

alternative form of distribution needs to happen. Those are the

kinds of injects that we can at least suggest to our community, to

our local emergency partners, to just like say what would you do if

you got this information in the middle of an exercise. So this is

my proposal to this group, that we spend the November meeting

basically half and half on that. In November, talking about which

communities have identify that they have a public-facing component,

and figuring out how we can identify who would be really great to

go through those pods so that we have an experience of community

members giving us feedback about how is it -- how are they doing and

how they could be better and on the second half, brainstorm

collectively, in this kind of public health emergency, what

situations would you want, if possible, the system to practice to

better understand what's in place to meet the needs of the community.

>> The second half of that, coming up as the injects that we

would all like to see.

>> Maria, and one other person I can't remember right now, helped

us do that during our table talk -- cable talk exercise planning and

it was tremendous. I think we had a lot of people, especially in

the public information side of the house, really stand up and go,

oh, you know what? I'm embedded in the public health system, I might

have one of those translation services, I just never thought about

how I can bring them into an exercise to play with us. Does that

sound like a plan for November, is that all right since we ran out

of time today?

>> This is Dana. I just wanted to let you know that the county

health -- what I discussed with them was rotating a consumer with

a different type of disability at every planning meeting so they could

have some kind of input and influence on what the planning looks like.

So I'm assuming --

>> Makes my heart happy.

>> It's something we just talked about this morning. I don't

know this probably hasn't been passed along to you that I'm working

with Dan and Janel to do exactly that.

>> Glad to hear it.

>> So hopefully we could bring in, as we have more conversations

between now and November, I can bring you guys some of the things

we're talking about doing to kind of get the wheels turning on what

else we could do.

>> Fantastic. We would love to learn from you as you build that

relationship.

I'm hoping that many others of you get tapped. I know some of

you are already in there. It is 3:00 now. Thank you so much for

your time. Cheryl, what can we do?

>> Just as a last-minute note, Cheryl and I are both on the FEMA

conference speaker committee and we are looking for people who are

interested in speaking to access and functional needs at the FEMA

conference this year in the spring. That would be in February, I'm

sorry. This year it's in Colorado Springs again just like it was

last year. So if there's anybody who really wants to come down and

speak to your programs and some of the inclusionary efforts that

aren't necessarily being talked about, we would love to hear from

you to get more information about what maybe topics you would be

interested in presenting and how we can get you a platform in front

of all our emergency managers across the state.

Our central reason AFN group is having a free emergency

preparedness training for folks with disabilities. FEMA has sent

out in the preparedness round-up some information about that. And

Cheryl has the flyers so if anybody else wants them, she said she'll

send them to Amy and Amy can get them out to you guys.

>> Amy: You sent them to me yesterday and I'll make sure it

goes out. It's on September 8th and we do need folks to register

because there is a limited amount of space. There are three

different opportunities coming up? Great. So I know the next one,

there's one in longmont happening on September 8th, but there will

be other dates coming up and we'll definitely keep everybody in the

loop.

Thank you all so much for your time.

[ Applause ]