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Welcome to the FEMA Region VII Webinar on Functional needs Support Services FNSS. May 2, 2012. Administrative Details. Your phone is on mute. Please post questions in the “chat room” - PowerPoint PPT Presentation
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WELCOME TO THE FEMA REGION VII WEBINAR ON FUNCTIONAL NEEDS SUPPORT SERVICES FNSS
May 2, 2012
Administrative Details
Your phone is on mute.
Please post questions in the “chat room” A copy of this presentation and
additional resources are available to you in the “file share” section of the website
Click Here
Greetings
Jono Anzalone
Regional Voluntary Agency Liaison
for
FEMA Region VII
816.283.7078
Kam Kennedy
American Red Cross
Special Representative
to
FEMA Region VII
816.283.7250
[email protected] Jones
Regional Disability Integration Specialist
for
FEMA Region VII
Cory FastMass Care Specialist
for
FEMA Region VII
Purpose and Outcomes
Purpose: To provide an overview of issues pertaining
to Functional Needs Support Services (FNSS) in general population shelters.
Outcome: To understand the benefits of integrating
FNSS principles in emergency planning, be familiar with initiatives underway and aware of resources available as you move forward.
Defining FNSS
Services that enable children and adults to maintain their usual level of independence in general population shelters. These services include: Reasonable modifications to policies, practices
and procedures Provisions for Durable Medical Equipment (DME) Provisions for Consumable Medical Supplies
(CMS) Provision for Personal Assistance Services (PAS) Other goods and services as needed
History of FNSS Guidance: What have we done and where are we going? November 1, 2010 FNSS Guidance document released. Contract awarded and signed to develop Guidance on
Planning for Integration of Functional Needs Support Services in General Population Shelters and training to build state capacity for FNSS.
Disability Integration Specialists in each of the 10 FEMA Regions hired.
Procedural guide for Personal Assistance Services (PAS) in development for the States.
Readiness contract executed making Durable Medical Equipment (DME) available on nationally declared disasters.
Each Region recognized the need to assign an FNSS POC to help information flow to and from the States.
Regional Disability Integration Specialists
Preparing individuals and families and strengthening communities before, during and after a disaster by providing guidance, tools, methods and strategies to integrate and coordinate emergency management efforts to meet the access and functional needs of all citizens, including children and adults with disabilities.
Subject matter expertise
Disability Demographics
56.4 million Americans (20% of the population)
12% are children birth - 18 years old 10% are 18 – 64 years old 38% are over 65 years old 11 million people over age 6 need personal
assistance with everyday activities Globally, there are 650 million people with
disabilities
Disability Facts
1.8 million unable to see printed words (10 million total)
1 million are unable to hear conversations (30 million total with hearing loss to some degree from mild to profound)
2.5 million have difficulty having their speech understood (431,000 are unable to have their speech understood)
16.1 million have a cognitive, intellectual or mental health disability (over 7% of the population)
3.3 million people over the age of 14 use a wheelchair and another 10 million have used a cane, crutches, or a walker to get around for 6 months or longer.
How Can we Help?
RDIS’s can provide resources and identify key disability organizations in your area to help in integrating people with or without disabilities who have access and functional needs in emergency planning. There is a difference in talking about what we think someone needs and actually having people at the table helping emergency managers to prepare and plan for those with access and functional needs.
What are we doing?
We are working with our Assistive Technology Programs to increase access to assistive technology devices and services (DME, sign language interpreters, limited language proficiency, etc)
Working to include assistive technology devices and services in Disaster Recovery Centers.
Working with a Kansas City FNSS group and we have people with disabilities on the committee who are assisting in identifying needs and resources.
Regional Disability Integration SpecialistsRegion States RDIS Email
I CT, ME, MA, MH, RI, VT Kate McCarthy-Barnett
II NY, NJ, Puerto Rico, USVI James Flemming [email protected]
III DE, MD, PA, VA, WV, Washington D.C.
LesleyAnne Ezelle [email protected]
IV AL, FL, GA. KY, MS, NC, SC, TN Mike Houston [email protected]
V IL, IN, MI, MN, OH, WI Jessica Mitchell [email protected]
VI AR, LA, NM, OK, TX Linda Landers [email protected]
VII IA, KS, MO, NE Gay Jones [email protected]
VIII CO, MT, ND, SD, UT, WY Dave Schaad [email protected]
IX AZ, CA, HI, NV, American Samoa, Commonwealth of the Northern Marina Islands, Republic of the Marshall Islands, Federated States of Micronesia, Guam
David Ball [email protected]
X AK, ID, OR, WA Holly Finan (temporary)
Whole Community - Partnerships
National Council on Independent Living July 2010 MOA
National Disability Rights Network March 2011 MOA
Supporting People with Functional Needs—Key Principles ( Same as 7 Principles of the ADA)
Equal Access – People with functional needs must be able to access and benefit from the same emergency programs and services as the general population (access may require modification of programs, policies, and procedures related to building(s), equipment, services, supplies, communication methods, etc.).
Physical Access – Emergency programs, services and activities must be provided at locations all people can access.
Access to Effective Communication – People with functional needs must be given information that iscomparable in content and detail to that given to the general public using methods that are accessible, understandable and timely.
Supporting People with Functional Needs—Key Principles (cont.) Inclusion – People with functional needs have the
right to participate in and receive the benefits of emergency programs, services, and activities provided by governments, private businesses, and nonprofit organizations.
Integration - Emergency programs, services, and activities typically must be provided in settings accommodating to all people whether they have functional needs or not.
Program Modifications - People with functional needs must have equal access to emergency programs and services, which may entail modifications to rules, policies, practices, and procedures.
No Charge - People with functional needs may not be charged to cover the costs of measures necessary to ensure equal access and nondiscriminatory treatment.
Legal Foundation for FNSS
The law mandates integration and equal opportunity for people with disabilities
Stafford Act Post-Katrina Emergency Management
Reform Act (PKEMRA) Federal civil rights laws
PKEMRA: Sec. 689. Individuals with Disabilities
This section required the Administrator to: Develop standards to accommodate
individuals with disabilities Add individuals with disabilities to section
308 of the Stafford Act, which describes nondiscrimination policies in disaster assistance
Add durable medical equipment to section 403(a)(3)(B) as an essential service to saving lives
FNSS Legal Authority & References
Law, regulations and agency guidance define the scope of FNSS Americans with Disabilities Act of 1990 (ADA) Rehabilitation Act of 1973 (RA) Title VIII of the Civil Rights Act of 1968 (Fair
Housing Act), as amended
Shelter Selection
When a shelter that has inaccessible features is selected, a plan must be in place to make the shelter accessible before use
A shelter must comply with state and local codes and standards related to accessibility
Prior to an Emergency or Disaster
Include in State and Local plans a process for locating, purchasing, and storing as much of the supplies and equipment (DME and CMS) as possible and practical to meet the needs of children and adults with and without disabilities who have access and functional needs
Emphasis is not on stockpiling supplies pre-disaster
Develop agreements with area contractors to maintain equipment (e.g., generators, oxygen concentrators, etc.)
Prior to (cont’)
Develop provider agreements with the private sector to ensure that necessary equipment and supplies, that have not been purchased and/or stored, will be available during an emergency or disaster
Key Points
While planning and resource identification take time, FNSS Guidance does not require large outlay of capital: FNSS is not another unfunded mandate Plan…Plan…Plan
Homeland Security Grant Program As new dollars are made available, purchase
access and functional needs equipment (ex. universal cots)
Mass Care Planners to help with access andfunctional needs integration
The Role of Public Health
Release of Public Health Preparedness Capabilities: National Standards for State and Local Planning March 2011 Section on Mass Care and Volunteer
Management
http://www.cdc.gov/phpr/capabilities/Capabilities_March_2011.pdf
Recent Court Cases Concerning FNSS
Unified Government of Wyandotte County http://www.justice.gov/opa/pr/2010/April/10-crt-
382.html City and County of Los Angeles
http://www.ada.gov/briefs/calif_interest_br.pdf US Court of Appeals – County of Dakota
http://www.ca8.uscourts.gov/opndir/10/11/093277P.pdf
Sheltering Philosophy
1. Shelters must be, first and foremost, places of comfort and safety
2. Shelters must be readily accessible to those affected
3. Shelter workers and managers must be strong advocates for their clients
4. Clients must remain proactive participants in recovery
5. Shelters must provide a safe and secure environment that accommodates the broadest range of needs in our communities
Red Cross—Vision for Accommodation
Safely accommodate individuals with access and functional needs in our congregate shelters by working with partners and increasing and sustaining capacity within the Red Cross.
Provide appropriate referrals to partners when reasonable accommodation is not possible.
Red Cross—Vision for Accommodation
Exceptions Individuals who need:
Continuous medical supervision Acute, life-sustaining medical care
Individuals who are a danger to themselves or others
Americans with Disabilities Act (ADA)
Under the ADA, the Red Cross must: Make reasonable modifications to its policies,
practices and procedures when necessary to deliver shelter services to clients with access or functional needs
Provide auxiliary aids and services to ensure effective communication
Welcome people with service animals Ensure that shelter facilities are physically
accessible for people who use wheelchairs or other mobility devices.
28
Recommendations
Shelter Inventory Community Planning Response
29
Shelter Inventory
Over 56,000 Shelters in inventory Agreements updated annually Facilities physically surveyed every three
years
30
Shelter Selection
Use the Shelter Facility Survey Form when selecting shelter locations Determine what physical access modifications
will be needed for each facility
When a shelter that has inaccessible features is selected, a community plan must be in place to make the shelter accessible before use.
31
Integrated Community Planning
Review current plans
Identify all stakeholders
Conduct community gap analysis
Identify resources
Establish relationships
32
Current Plans
Determine what FNSS planning is currently occurring in the community
Join or convene FNSS planning activities
Integrate existing special needs plan into general population sheltering plan
33
Response
Ensure Health Services/Disaster Mental Health (HS/DMH) staff are present in shelters
Identify and address individual client needs Use Initial Intake and Assessment Tool
during registration Consult with HS/DMH to address needs HS and DMH will work directly with client to
determine resources and next steps
34
Response
Shelter Layout Accessible routes in dormitories 20 sq. ft. per person in short-term or
evacuation shelters 40-60 sq. ft. per person for sheltering
longer than 72 hours Individuals who use wheelchairs, lift
equipment, service animals, and other personal assistance services can require up to 100 sq. ft.
35
Response Examples
Modify kitchen access policies
Modify sleeping arrangements
Assist with cutting food
Provide way-finding assistance to visually-impaired
Provide extra space for cots when necessary
Provide communication tools for individuals with visual, hearing or speech needs, and those with language/cultural requirements
36
Response
Embrace self-determination
People with access and functional needs are the most knowledgeable of their own needs and assistance requirements
Assist individuals in maintaining their usual level of independence
37
Summary of Red Cross Guidance
Ongoing shelter surveying Selection of ADA compliant facilities in
disaster when possible Modification plan for non-compliant
facilities Work with partners to plan for FNSS
Red Cross Health Services New Concept of Operations
American Red Cross Disaster Health Services is moving away from a “Protocol-based” concept of operations to a “Scope of Practice” concept of operations
Protocols
Red Cross Disaster Health Services have used protocols for the past 30 years to guide health services provided in shelters
Protocols: Extremely restrictive Restricted nursing practices to first aid
procedures Hampered the ability of Red Cross nurses to
provide adequate assistance to individuals with access and functional needs
Scope of Practice
Allows RNs, LPNs, EMTs and others with certifications to function within the scope of their licensure or certification
Allows RNs to delegate health care activities (as appropriate)
Will increase Red Cross’ ability to respond to access and functional needs in a shelter environment
Next Steps
State and Local Communities Review of FNSS Guidance Review Public Health Preparedness Capabilities Plan review and resource identification Outreach to stakeholders
FEMA and Red Cross Continued communication regarding FNSS
Guidance Continued Stakeholder Outreach
Future Webinars
Tuesday, May 15, 2012 – 10am – 11am (Central) Friday, June 22, 2012 - 2pm – 3pm (Central)
Call-in Number: 1-800-320-4330, PIN 746583
Webinar: https://connect.hsin.gov/regionvii/
Resources
FNSS Guidance (posted on HSIN Connect) Red Cross Guidance (Crossnet for Red Cross
audience) Office of Disability Integration and
Coordination (ODIC) http://www.fema.gov/about/odic/
Development of Assessment Teams Ex. California Functional Assessment and Service
Teams (FAST) http://www.dss.cahwnet.gov/dis/res/pdf/
AppendixB.pdf
Remember: PLAN
Pull together stakeholders, providers, agencies and organizations to identify, assess and determine what FNSS the community requires.
Locate, purchase or contract for all necessary FNSS supplies, equipment and staff.
Act quickly to implement FNSS when an emergency or disaster occurs.
Negotiate to ensure all residents are returned to the most appropriate, least restrictive environment when the shelter closes.
Questions
“Disasters are always inclusive. Response and recovery are not, unless we plan for
it.”—June Isaacson Kailes—
Contact Information
Jono Anzalone
Regional Voluntary Agency Liaison
for
FEMA Region VII
816.283.7078
Kam Kennedy
American Red Cross
Special Representative
to
FEMA Region VII
816.283.7250
[email protected] Jones
Regional Disability Integration Specialist
for
FEMA Region VII
Cory FastMass Care Specialist
for
FEMA Region VII
