[House Hearing, 116 Congress]
[From the U.S. Government Publishing Office]
PROTECTING EVERY CITIZEN: ASSESSING EMERGENCY PREPAREDNESS FOR
UNDERSERVED POPULATIONS
=======================================================================
FIELD HEARING
BEFORE THE
SUBCOMMITTEE ON
EMERGENCY PREPAREDNESS,
RESPONSE, AND RECOVERY
OF THE
COMMITTEE ON HOMELAND SECURITY
HOUSE OF REPRESENTATIVES
ONE HUNDRED SIXTEENTH CONGRESS
FIRST SESSION
__________
JULY 23, 2019
__________
Serial No. 116-33
__________
Printed for the use of the Committee on Homeland Security
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://www.govinfo.gov
___________
U.S. GOVERNMENT PUBLISHING OFFICE
39-416 PDF WASHINGTON : 2020
COMMITTEE ON HOMELAND SECURITY
Bennie G. Thompson, Mississippi, Chairman
Sheila Jackson Lee, Texas Mike Rogers, Alabama
James R. Langevin, Rhode Island Peter T. King, New York
Cedric L. Richmond, Louisiana Michael T. McCaul, Texas
Donald M. Payne, Jr., New Jersey John Katko, New York
Kathleen M. Rice, New York John Ratcliffe, Texas
J. Luis Correa, California Mark Walker, North Carolina
Xochitl Torres Small, New Mexico Clay Higgins, Louisiana
Max Rose, New York Debbie Lesko, Arizona
Lauren Underwood, Illinois Mark Green, Tennessee
Elissa Slotkin, Michigan Van Taylor, Texas
Emanuel Cleaver, Missouri John Joyce, Pennsylvania
Al Green, Texas Dan Crenshaw, Texas
Yvette D. Clarke, New York Michael Guest, Mississippi
Dina Titus, Nevada
Bonnie Watson Coleman, New Jersey
Nanette Diaz Barragan, California
Val Butler Demings, Florida
Hope Goins, Staff Director
Chris Vieson, Minority Staff Director
------
SUBCOMMITTEE ON EMERGENCY PREPAREDNESS, RESPONSE, AND RECOVERY
Donald M. Payne Jr., New Jersey, Chairman
Cedric Richmond, Louisiana Peter T. King, New York, Ranking
Max Rose, New York Member
Lauren Underwood, Illinois John Joyce, Pennsylvania
Al Green, Texas Dan Crenshaw, Texas
Yvette D. Clarke, New York Michael Guest, Mississippi
Bennie G. Thompson, Mississippi (ex Mike Rogers, Alabama (ex officio)
officio)
Lauren McClain, Subcommittee Staff Director
Diana Bergwin, Minority Subcommittee Staff Director
C O N T E N T S
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Page
STATEMENTS
The Honorable Donald M. Payne Jr., a Representative in Congress
From the State of New Jersey, and Chairman, Subcommittee on
Emergency Preparedness, Response, and Recovery:
Oral Statement................................................. 1
Prepared Statement............................................. 2
The Honorable Bennie G. Thompson, a Representative in Congress
From the State of Mississippi, and Chairman, Committee on
Homeland Security:
Prepared Statement............................................. 4
The Honorable Bill Pascrell, a Representative in Congress From
the State of New Jersey:
Prepared Statement............................................. 3
WITNESSES
Panel I
Major Louis V. Bucchere, Commanding Officer, Emergency Management
Section, New Jersey State Police:
Oral Statement................................................. 5
Prepared Statement............................................. 7
Ms. Kelly Boyd, Access and Functional Needs Planner, Preparedness
Bureau/Emergency Management Section, New Jersey Office of
Emergency Management:
Oral Statement................................................. 15
Ms. Elizabeth H. Curda, Director, Education, Workforce, and
Income Security, Government Accountability Office:
Oral Statement................................................. 16
Prepared Statement............................................. 18
Ms. Marcie Roth, Chief Executive Officer, Partnership for
Inclusive Disaster Strategies:
Oral Statement................................................. 24
Prepared Statement............................................. 26
Panel II
Ms. Luke Koppisch, Deputy Director, Alliance Center for
Independence:
Oral Statement................................................. 39
Prepared Statement............................................. 41
Ms. Laurence Flint, M.D., New Jersey Chapter Representative,
American Academy of Pediatrics (AAP) Disaster Preparedness
Committee:
Oral Statement................................................. 42
Prepared Statement............................................. 44
APPENDIX I
Mr. Dorian Herrell, Emergency Management Coordinator, Newark, New
Jersey:
Prepared Statement............................................. 51
APPENDIX II
Questions From Chairman Donald M. Payne, Jr. for Elizabeth H.
Curda.......................................................... 53
PROTECTING EVERY CITIZEN: ASSESSING EMERGENCY PREPAREDNESS FOR
UNDERSERVED POPULATIONS
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Tuesday, July 23, 2019
U.S. House of Representatives,
Committee on Homeland Security,
Subcommittee on Emergency Preparedness,
Response, and Recovery,
Jersey City, NJ.
The committee met, pursuant to notice, at 10:10 a.m., in
the MacMahon Student Center, Saint Peter's University, 47
Glenwood Avenue, Jersey City, New Jersey, Hon. Donald M. Payne,
Jr. (Chairman of the subcommittee) presiding.
Present: Representative Payne.
Also present: Representative Pascrell.
Mr. Payne. The Subcommittee on Emergency Preparedness,
Response, and Recovery will come to order.
The subcommittee is meeting today to receive testimony on
``Protecting Every Citizen: Assessing Emergency Preparedness
for Underserved Populations.''
Good morning. We are here today to discuss how underserved
populations are treated in emergencies. I am particularly
pleased to be back home for this hearing, and I want to thank
Saint Peter's University for hosting us. I appreciate my friend
and colleague from New Jersey, Congressman Bill Pascrell, for
joining me.
I also want to thank our witnesses for being here today.
Each of you bring a unique and insightful perspective to this
topic based on the great work that you have been doing.
Unfortunately, FEMA chose not to attend this hearing, as it has
subsequent hearings, to directly hear from them--directly from
those who have been working on the ground to make disaster
response more equitable.
Working through a partnership between local, State, and
Federal officials, as well as local community groups, everyone
does what they can to help their fellow citizens recover.
Still, not all citizens have the same needs during or after a
disaster, and a ``one size fits all'' approach does not work.
Certain Americans, such as children, low-income individuals, or
those with access and functional needs, may require special
attention in the planning, response, and recovery phases of
disasters.
For instance, children are more likely to experience mental
health distress, including showing signs of PTSD, after a
disaster than adults. Those with access and functional needs
may need some type of durable medical equipment in the midst of
immediately following a disaster. Low-income individuals may
not have the resources to evacuate before a storm or may not
have the resources or knowledge to navigate the confusing maze
of Federal disaster assistance programs after a disaster.
The response gaps that exist today result in real
consequences for those on the ground. George Washington
University researchers found that of 2,975 people who died in
Puerto Rico as a result of Hurricane Maria, the clear majority
were those living in poverty and senior citizens, many of whom
were likely people with disabilities who faced deadly mobility
barriers to safety.
After Sandy, children living in homes with minor damage
were over 4 times likely to be sad or depressed and over twice
as likely to have problems sleeping since the storm, as were
children from homes with no damage. The impact of children
after Hurricane Sandy is one of the reasons I have introduced
the Homeland Security for Children Act, which would require the
Department of Homeland Security to incorporate the needs of
children into its emergency preparedness, response, recovery,
and mitigation activities.
Unless we do more to address and account for the needs of
the disproportionately-impacted populations in our emergency
planning, people will continue to suffer.
The witnesses gathered here today will discuss the work
that they have done to close the response gaps that lead to
disparate outcomes. Through the discussion today, I am hopeful
we can learn from each other's efforts and identify ways that
coordination with the Federal Government can be improved for
the next disaster.
With that, I yield back the balance of my time.
[The statement of Chairman Payne follows:]
Statement of Chairman Donald M. Payne, Jr.
July 23, 2019
Good morning. We are here today to discuss how underserved
populations are treated in emergencies.
I am particularly pleased to be back home for this hearing, and I
want to thank Saint Peter's University for hosting us. I appreciate my
friend and colleague from New Jersey, Congressman Pascrell, for joining
me.
I also want to thank our witnesses for being here. Each of you
brings a unique and insightful perspective to this topic based on the
great work you have been doing.
Unfortunately, FEMA chose not to attend this hearing to hear
directly from those who have been working on the ground to make
disaster response more equitable. Despite their absence, the
information the subcommittee learns today will assist us as we go back
to Washington and continue our legislative and oversight duties.
When an emergency or disaster strikes, all Americans are at their
most vulnerable. New Jersey is no stranger to the devastation of
disasters, with Hurricanes Irene and Sandy both affecting our community
in recent years. Working through a partnership between local, State,
and Federal officials, as well as local community groups, everyone does
what they can to help their fellow citizens recover. Still, not all
citizens have the same needs during or after a disaster, and a one-
size-fits-all approach does not work.
Certain Americans, such as children, low-income individuals, or
those with access and functional needs may require special attention in
the planning, response, and recovery phases of disasters. For instance,
children are more likely to experience mental health distress,
including showing signs of PTSD, after a disaster, than adults. Those
with access and functional needs may need some type of durable medical
equipment in the midst or immediately following a disaster. Low-income
individuals may not have the resources to evacuate before a storm or
may not have the resources or knowledge to navigate the confusing maze
of Federal disaster assistance programs after a disaster. The response
gaps that exist today result in real consequences for those on the
ground.
George Washington University researchers found that of the 2,975
people who died in Puerto Rico as a result of Hurricane Maria, the
clear majority were those living in poverty and seniors--many of whom
were likely people with disabilities who faced deadly mobility barriers
to safety.
After Sandy, children living in homes with minor damage were over 4
times as likely to be sad or depressed, and over twice as likely to
have problems sleeping since the storm, as were children from homes
with no damage. The impact on children after Hurricane Sandy is one of
the reasons I have introduced the Homeland Security for Children Act,
which would require the Department of Homeland security to incorporate
the needs of children into its emergency preparedness, response,
recovery, and mitigation activities. Unless we do more to address and
account for the needs of disproportionally-impacted populations in our
emergency planning, people will continue to suffer.
The witnesses gathered here today will discuss the work they have
done to close the response gaps that lead to disparate outcomes.
Through the discussion today, I am hopeful we can learn from each
other's efforts, and identify ways that coordination with the Federal
Government can be improved for the next disaster.
With that, I yield back the balance of my time.
Mr. Payne. With that, I now recognize my colleague from New
Jersey, Mr. Pascrell.
Mr. Pascrell. Mr. Chairman, thank you for inviting me to
join you on this important field hearing.
As you know, as a long-time member of the original Homeland
Security Committee when it was formed right after 9/11, it is
an honor to be part of today's hearing. I see that our State
police are well-represented here, as we worked with them back
then. Probably the best or at least one of the best in the
entire country. I don't say that by blowing smoke. I mean it,
having worked with them.
I am very impressed with their central communication. As
you know, that was one of the major problems during 9/11, and
that is people couldn't communicate with one another--many
departments, whether it be police or fire--and that was a
major, major step. I think we have come a long way since then
in terms of communication. Because you can't communicate, you
really are going to not be what you need to be for the general
public.
So it is critical that we ensure everyone, that everyone is
safe before, during, and after an emergency. We usually think
about responding to the public and the community after a
tragedy happens. So we are better planning now, doing better
planning, thanks to the work that you have done on Homeland
Security, Mr. Chairman.
We want to know who the vulnerable populations are, like
the elderly, like children, people with disabilities. Already,
they already receive inequitable treatment in our society many
times. Underserved, low-income populations need our help, too.
Our disaster recovery efforts should not exacerbate this issue.
Transit plans are important prior to an emergency. Many
communities do not have emergency evacuations, whether it is a
man-made or nature-made disaster. They already receive
inequitable treatment, again. But transit plans are important
prior to an emergency. After 9/11, buses and the New York MTA
and the New Jersey Transit shuttled people out and equipment in
to support first responders.
The best-laid plans do not always work, though. A transit
plan could have helped an estimated 100,000, 200,000 vulnerable
people after Hurricane Katrina who lacked access to a private
vehicle, but few transit drivers reported to work, and folks
were affected.
In 2008, the Transportation Research Board finalized a
report, which I authorized at that time in the 2005 Federal
highway bill, analyzing the role of transit in emergency
evacuations. This report notes the importance of having a plan
at all levels of government that includes transit, especially
for our vulnerable populations.
The report also calls for funding critical infrastructure,
which we still have not done when it comes to the Hudson tunnel
and Gateway project. Eisenhower built the--started and built,
started the building anyway of the interstate highway system in
this country. The main reason he did it was because of safety
of the population.
Because we had vulnerable folks, but we also--the country
was vulnerable. Everybody was vulnerable. We cannot leave
anybody behind. We must have a plan. As the saying goes, ``An
ounce of prevention is worth a pound of cure.''
We are good at going after something after it occurs. We
are still practicing on preparing and preventing these things
from happening. So I am honored to be on the panel. I am
anxious to hear the panel, and we will get to their questions,
and I have a couple of questions later on.
Thank you.
Mr. Payne. Thank you, Mr. Pascrell. Other Members are
reminded statements may be submitted for the record.
[The statement of Chairman Thompson follows:]
Statement of Chairman Bennie G. Thompson
July 23, 2019
Good morning. I would like to thank Chairman Payne and Ranking
Member King for holding today's hearing.
It is unfortunate that FEMA has decided not to participate today.
Their absence undermines the subcommittee's ability to conduct
meaningful oversight and sends a chilling message to underserved
populations who are affected by disasters the most and who generally
depend on FEMA the most.
Underserved populations are more susceptible to the risks
associated with disasters and following disasters, and it is
significantly more difficult for them to recover. Having experienced
Hurricane Katrina, I know how strenuous going through the basic
emergency response and recovery activities can be for communities, and
how this is especially so for individuals with access and functional
needs, children, the elderly, and the poor. For example, during
Hurricane Katrina, the average income of those who did not evacuate was
$19,500, and only 54 percent of those who stayed had a car.
In the aftermath of Hurricane Sandy, many low-income, elderly, and
disabled survivors remained in their public housing complexes, despite
having no power or heat, due to a lack of transportation and generally
having no other place to go. These and other issues concerning
vulnerable populations influenced enactment of the Post-Katrina
Emergency Management Reform Act of 2006, which established the director
of the Office of Disability Integration and Coordination to ensure the
unique needs of the disability community are considered and addressed
in FEMA's emergency activities.
I am also proud of the work the Committee on Homeland Security has
done through the years to address the needs of vulnerable and
underserved populations in times of emergency. I commend Chairman Payne
for his bill, the Homeland Security for Children Act, which would
ensure that children's needs are included in Department of Homeland
Security-wide activities and would ensure that there is established a
children's technical expert within FEMA. Senator Elizabeth Warren and I
requested the Government Accountability Office review the impact
Federal disaster programs have on socioeconomic inequality.
The need to elevate emergency preparedness, response, and recovery
efforts for vulnerable and underserved populations is all too clear,
and for that I look forward to engaging with the witnesses to get a
better understanding of how the Federal Government can better serve
them in emergency. With extreme weather events increasing in frequency
and intensity, it is critical that we continue to do what is necessary
to improve emergency preparedness for vulnerable and underserved
populations. Every American deserves that in times of disaster, and I
am pleased the subcommittee is taking time today to figure out how we
can improve.
Mr. Payne. I welcome our first panel of witnesses. Our
first witness is Major Lou Bucchere, who is the commanding
officer of the Emergency Management Section within the New
Jersey State Police. This is Major Bucchere's second time
before this subcommittee, and I thank him for coming.
Next, Ms. Kelly Boyd is the access and functional needs
planner for New Jersey's Office of Emergency Management. We
have Ms. Elizabeth Curda is the director for Government
Accountability Office's Education, Workforce, and Income
Security Division. Last, we have Ms. Marcie Roth is the CEO of
the Partnership for Inclusive Disaster Strategies.
Welcome, all of you.
Without objection, the witnesses' full statements will be
inserted in the record. I now ask each witness to summarize his
or her statement for 5 minutes, beginning with Major Bucchere.
STATEMENT OF MAJOR LOUIS V. BUCCHERE, COMMANDING OFFICER,
EMERGENCY MANAGEMENT SECTION, NEW JERSEY STATE POLICE
Major Bucchere. Good morning, Chairman Payne and
Congressman Pascrell. On behalf of the State Director of
Emergency Management, Colonel Patrick J. Callahan, I would like
to thank you for the opportunity to testify here today.
I am Major Louis Bucchere, commanding officer of the New
Jersey Office of Emergency Management. I am accompanied by Ms.
Kelly Boyd, who serves as NJOEM's access and functional needs
planner. Ms. Boyd and I are honored to be here today to share
some of New Jersey's experiences and lessons learned in
emergency management and to discuss preparedness for vulnerable
populations.
The New Jersey emergency management community is committed
to providing fair and equitable emergency management resources
to our residents and minimizing barriers to obtaining services.
We do this by including individuals with disabilities and
others with access and functional needs, advocacy groups,
organizations, community groups, and faith-based organizations
in our emergency management program, providing them not only
with a voice in emergency management, but a role as well.
That role can extend from personal preparedness to working
as an emergency manager, to volunteering, to participating on
working groups and other collaborative efforts to ensure that
our mutual goals are achievable. In short, we look at each
person not only as someone who may need our services, but also
as a person who can contribute to a more resilient and self-
reliant New Jersey.
New Jersey is no stranger to natural disasters. During the
past 10 years, we faced hurricanes, numerous nor'easters,
winter storms, wildfires, wind events, and floods. Each of
these events involved unique circumstances and required us to
take a hard look at the adequacy of planning and response
efforts, our collaborative networks, and impacts to individuals
and communities. Most importantly, we learned about the
significant challenges faced by some of our vulnerable
residents, but we also learned how to incorporate their
experience into the planning process to provide the services
they need, not the services we think they need.
Although it has been nearly 7 years since Hurricane Sandy,
it remains at the forefront of discussions for continuous
evaluation of response operations, improvements in planning,
and building capabilities. Post Sandy, the emergency management
community recognized that we had to make substantial
improvements with outreach to provide better, more efficient
services to our residents, and to ensure that staff and
volunteers have all the tools required for an effective
response.
Although New Jersey is a resource-rich State, our
experiences in Sandy showed the collaborative networks required
for effective communications and service delivery weren't as
robust as needed and didn't connect us well enough to the
diverse communities we serve. Also, while many plans existed at
the State and local levels, more coordinated training exercises
of those plans was required, especially regarding inclusion and
participation by the DAFN population.
In the aftermath of Sandy and other events that have
impacted New Jersey, our emergency management community at all
levels within the State has engaged in the continuous
collaborative review and evaluation of response, planning,
training, and exercises. We have increased focus on
relationship building across all levels, with the end goal of
inclusive, whole-community engagement.
This includes stakeholders across the State and local
level, advocacy groups, and community- and faith-based
organizations that serve DAFN populations, older adults, and
low-income communities. The concerns voiced by vulnerable
populations go beyond issues identified during Sandy.
Transportation accidents, wildfires, active-shooter responses,
and other events across the Nation may generate unique
preparedness concerns for segments of vulnerable populations
that must also be addressed as a part of our planning.
Collaborative planning at the State level is spearheaded
through the State emergency management program's stakeholders,
also known as SEMPS, which brings together emergency management
staff from key State agencies, nongovernmental organizations,
community groups, Federal partners, and the county offices of
emergency management. This group comes together on a monthly
basis.
In fact, most of these emergency managers are on a first-
name basis with each other, as well as the county emergency
management coordinators. The relationships developed through
this network provide integral support for vulnerable
populations and ensure that the emergency management community
at the local level is able to draw upon and connect with the
necessary resources to support emergency management programs.
Ms. Boyd's testimony will address some of the specifics of
the excellent work being done by the State and local
collaborative planning groups to enhance DAFN preparedness and
inclusion in emergency management. Although New Jersey has come
a long way since Sandy, we know that we have many tasks ahead
of us. We are confident, however, that our emergency managers
and residents are committed to a stronger, more resilient New
Jersey with equal access to services for everyone.
I thank you for this opportunity to testify to this
subcommittee.
[The prepared statement of Major Bucchere follows:]
Prepared Statement of Louis V. Bucchere
July 23, 2019
Good morning Chairman Payne, and other Members of the subcommittee.
On behalf of Colonel Patrick J. Callahan of the New Jersey State
Police, who also serves as the State director of emergency management,
I would like to thank you for the opportunity to testify here today.
I am Major Louis Bucchere, commanding officer of the New Jersey
State Police Emergency Management Section, known as the New Jersey
Office of Emergency Management (NJOEM). I am accompanied today by Ms.
Kelly Boyd, who serves as NJOEM's Access and Functional Needs Planner.
Ms. Boyd and I are honored to be here to share some of New Jersey's
lessons learned from Hurricane Irene, Superstorm Sandy, and other
incidents with regard to planning and preparedness for vulnerable
populations, as well as collaborative State-wide planning initiatives
for vulnerable populations.
The New Jersey emergency management community is committed to
providing fair and equitable emergency management services and
resources to each of our residents, as well as minimizing barriers and
impediments to obtaining services. We do this by actively including
individuals with disabilities and others with access and functional
needs (DAFN), advocacy groups, community groups, and faith-based
organizations in our emergency management program--providing them with
not only a voice in emergency management, but a role as well. That role
can extend from personal preparedness to working as an emergency
manager to participating in any number of volunteer programs, working
groups, advocacy groups, and other collaborative efforts to ensure that
our mutual goals are achievable. In short, we look at each person, not
only as someone who may need our services, but also as a person who can
contribute to a more resilient and self-reliant New Jersey.
Preparedness and inclusion are key to this empowerment.
New Jersey is no stranger to natural disasters. During the prior 10
years, we have had numerous Nor'easters, winter storms, floods, wind
events, and of course Hurricane Irene, Tropical Storm Lee, and
Superstorm Sandy. Each of these incidents involved unique circumstances
and required us to take a hard look at the adequacy of State and local
planning and response efforts, our collaborative networks and access to
resources, and the short- and long-term impacts to individuals and
communities. Most importantly, we learned about the significant
challenges faced by some of our more vulnerable residents--but we also
learned how to incorporate their experience and expertise into the
planning process to provide the services they need, not the services we
think they need.
The term ``vulnerable populations'' encompasses a diverse array of
individuals. Although traditionally low-income families and individuals
have not been identified as a separate planning group, low-income
families may be more likely to require sheltering and evacuation
assistance than families with greater financial resources, and
therefore require emergency management services during both large and
small incidents. Other groups considered vulnerable are individuals
with disabilities and others with access and functional needs, which
encompass those who have mobility impairments, developmental
disabilities, mental health conditions, and critical transportation
needs, and communication barriers. Residents may also develop
disabilities and access and functional needs as they age. Additionally,
veterans and first responders may suffer long-term adverse physical and
behavioral consequences from their service.
Some key statistics for the State are contained in the following
table:
DISABILITY STATISTICS IN NEW JERSEY
From the 2017 American Community Survey, as provided by NJLWD
------------------------------------------------------------------------
Amount
------------------------------------------------------------------------
Total civilian noninstitutionalized population.......... 8,902,432
Total civilian population with a disability............. 914,392
Population with a hearing difficulty.................... 221,680
Population with a vision difficulty..................... 165,293
Population with a cognitive difficulty.................. 334,209
Population with an ambulatory difficulty................ 488,741
Children with a disability (17 and under)............... 70,560
Adults with a disability (18-64)........................ 428,932
Seniors with a disability (65+)......................... 414,900
------------------------------------------------------------------------
superstorm sandy
Although it has been nearly 7 years since Superstorm Sandy wreaked
havoc on New Jersey, it remains at the forefront of discussions for
continuous evaluation of response operations, improvements in planning,
and building capacity and capabilities. Perhaps most importantly, Sandy
shined a light on areas for improvement with respect to emergency
preparedness for vulnerable populations.
During Superstorm Sandy, local emergency managers were overwhelmed
by storm preparations and response efforts. Shelter operations
presented many challenges and frustrations to both residents and
service providers. Many of our residents had never experienced a storm
of that magnitude and were not prepared to evacuate to emergency
shelters or to shelter in place.
Shelters were flooded with large numbers of residents who
required various levels of personal care assistance,
medications, durable medical equipment, and other support
services.
Individuals went to shelters without a full understanding of
the minimal conditions provided in an evacuation shelter. This
was particularly difficult for older adults who evacuated to
shelters from 55+ communities and for families with small
children who found it difficult to adjust to shelter life, as
well as for those with DAFN.
Often, residents did not bring necessary supplies with them
because they assumed these items would be available in the
shelters.
Older adults and others did not have necessary prescription
medications, or did not know the names/dosages of their life-
sustaining medications.
Disruptions to power supplies at the shelters created
problems for individuals with medical devices requiring power,
and power outages in impacted communities impeded access to
prescription drugs, dialysis treatment, and other services.
Many shelter workers and volunteers were not trained to assist
individuals with autism, developmental disabilities, and PTSD, or
address the needs of methadone clients. Some shelter staff were not
familiar with communication boards and other aids available to foster
interactions with individuals who do not speak English. In some
instances, there was confusion regarding rules for service animals and
comfort animals in shelters. Individuals who required medical
monitoring went to overcrowded hospitals when local governments were
not able to provide adequate medical needs sheltering--only to be
returned back to medical needs shelters. Staff at medical needs
shelters, working without the benefit of previously-employed plans and
procedures, faced shortages of equipment, staff, and trained medical
personnel.
We also encountered challenges throughout the State with
communications and communication networks. Language barriers prevented
some residents from having full access to necessary preparedness
messaging. Individuals arriving at reception centers, shelters, and
other locations struggled with the lack of translators, which hampered
service delivery and casework. Ensuring seamless communications with
those who are deaf and hard of hearing and/or blind and visually
impaired was also challenging.
During the recovery phase of Sandy, there were challenges in
disseminating recovery information to non-English speaking
communities, which impeded their access to recovery funds.
Some groups were disenfranchised due to the absence of
political influences or networks and alliances within their
community.
Older adults and others had difficulty navigating websites
to obtain recovery information and file applications.
Sandy disrupted daily life for tens of thousands of residents,
including young children who suffered trauma from being displaced and
the disruption to their daily routines. Some displaced children were
not able to get to school from their shelters until the local boards of
education were able to identify their location and arrange busing. Some
transportation-dependent individuals were sent to shelters distant from
their jobs and communities, which affected their ability to work.
While many individuals worked tirelessly during Sandy to provide
necessary services to our impacted residents, the emergency management
community recognized that we had to make substantial improvements with
outreach to provide better, more efficient services to our vulnerable
residents, and to ensure that our staff and volunteers have all the
tools and resources required for an effective response. It was also
clear that the cadre of emergency management personnel, emergency
workers, and volunteers was not sufficient to respond to the needs of
New Jersey's 9 million residents; ``all hands on deck'' would be
required.
Although New Jersey is a resource-rich State, our experiences in
Sandy showed that the collaborative networks required to leverage our
agencies, partners, NGO's, and community and faith-based organizations
were not as robust as they could have been to enable more efficient and
effective communications and service delivery for vulnerable
populations. Also, while many plans existed at the State and local
levels, more coordinated training and exercising of those plans was
required--especially with respect to the inclusion of enhancements for,
and participation by, the DAFN population.
collaborative and inclusive solutions
In the aftermath of Sandy and other incidents that have impacted
New Jersey, our emergency management community at all levels within the
State has engaged in a continuous collaborative review and evaluation
of responses to incidents, planning, training, and exercising.\1\ More
importantly, we have an increased focus on relationship building across
all levels--with the end goal of inclusive, whole community engagement.
This emanates from the top down and the bottom up, and emphasizes the
inclusion of stakeholders across all realms at the State and local
level, such as Federal, State, and local agencies, advocacy groups, and
community and faith-based organizations that serve DAFN populations,
older adults, and low income communities.
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\1\ The concerns voiced by vulnerable populations go beyond the
issues identified during Sandy. Transportation accidents, wildfires,
active-shooter responses, and other incidents across the Nation may
generate unique preparedness concerns for segments of vulnerable
populations that must also be addressed as part of our planning.
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Collaborative and inclusive planning is the best solution for
serving the diverse needs of our vulnerable populations. State-level
planning groups, working in tandem with local emergency managers,
ensure that best practices and access to resources and training are
available to low income urban and rural areas, as well as the wealthier
communities. NJOEM ensures coordination between State planning efforts
and initiatives with local practices, while respecting ``home rule''
and recognizing that local leaders, groups, and emergency managers
understand their community's needs and capabilities.
Task forces and planning groups have been established at all
levels to foster collaboration, identify gaps and resources,
and develop inclusive plans by harnessing the subject-matter
expertise of the DAFN community and other vulnerable
populations.
These individuals and groups are now integrated in the
emergency management community. Because they are in the best
position to voice their concerns and identify solutions and
resources, they are an integral part of the solution.
Collaborative planning at the State level is spearheaded through
the State Emergency Management Program Stakeholders (SEMPS), which
brings together emergency management staff from key State agencies,
NGO's, community groups, Federal partners, and the county offices of
emergency management. This group meets and/or exercises on a monthly
basis. In fact, most of the key department emergency managers for major
agencies and organizations serving the State are on a first-name basis
with each other and with the County Emergency Management Coordinators.
While the SEMPS group focuses on wide-ranging planning initiatives at
the State level, many of the relationships developed through the SEMPS
meetings and exercises provide integral support for initiatives for
vulnerable populations, and ensure that the emergency management
community at the local level is able to draw upon and connect with
social services, programs, counseling, and access to necessary
resources to support emergency management programs.
Key SEMPS partners, such as the NJ Department of Human Services, NJ
Department of Health, NJ Department of Children and Families, NJ
Department of Education, American Red Cross, NJ 2-1-1, NJ Board of
Public Utilities, NJ Department of the Treasury, NJ Department of
Transportation, NJ Department of Labor and Workforce Development, the
NJ Office of Homeland Security and Preparedness (OHSP), FEMA, and many
other SEMPS agencies serve as subject-matter experts and provide
resources to enhance planning and preparedness initiatives for the
State's most vulnerable populations. They also participate in the task
forces and planning groups established to facilitate preparedness for
the DAFN community and other vulnerable populations. For instance,
outreach programs such as OHSP's safety initiative for faith-based
organizations can serve as an entry point for other preparedness
initiatives in vulnerable communities.
One of our SEMPS partners, the State Library, developed a disaster
preparedness and outreach plan to support and encourage the use of
local libraries for effective disaster preparedness, response and
recovery within local communities. Drawing upon best practices from
Sandy, local libraries can serve as accessible meeting places.
Librarians across the State are encouraged to have disaster plans,
develop relationships with community emergency managers, and be
prepared to disseminate important disaster information and assist
residents with accessible internet access and research. This support
can be extremely valuable for low-income individuals who may not have
access to computers, older adults and others who may not be adept at
using computers or searching for information, or others who need
accessible technology.
Another example of collaborative preparedness for the DAFN
community is the dynamic engagement of SEMPS partners in the promotion
of State's Register Ready program administered by NJOEM:
NJ 2-1-1 provides assistance in multiple languages and
through accessible means for registering vulnerable individuals
in Register Ready.
The Department of Education disseminated Register Ready
information through the local school districts.
The American Red Cross has been distributing flyers for the
Register Ready Program as part of its Home Fires Campaign.
The Board of Public Utilities engaged public utility
companies to disseminate Register Ready information with their
monthly bills, in newsletters and emails, and also on their
websites.
Other agencies, such as the NJ Department of Human Services,
the NJ Department of Labor and Workforce Development, and the
NJ Motor Vehicle Commission also post and disseminate Register
Ready information to their vulnerable clients.
collaborative dafn initiatives--core advisory groups
NJOEM is a strong a proponent of the Core Advisory Group (CAG)
concept developed by FEMA to involve individuals with DAFN in all
aspects of emergency management to foster the whole community approach.
Similar to the SEMPS group, the overarching goal of a CAG is to promote
inclusive emergency management by encouraging collaboration and
partnerships between community disability stakeholders and emergency
managers. Knowledge of the specific needs of this often-overlooked
vulnerable population enables emergency managers to become more
inclusive in their planning efforts, as various disability stakeholders
are able to bring unique resources to the table to assist them in their
planning.
CAGs are encouraged to meet on a regular basis to discuss any
issues, best practices, new legislation, and litigation to bring about
positive changes in how emergency services are provided to the DAFN
community in the event of a disaster.
State Core Advisory Group
A State-level CAG, known as the New Jersey Group for Access and
Integration Needs in Emergencies and Disasters (NJGAINED), chaired by
the New Jersey Department of Human Services and co-chaired by NJOEM,
has been in place for over 12 years. The group includes representation
from many State agencies and offices that service the DAFN community,
such as the Division of Disability Services, the Division of Deaf and
Hard of Hearing, and the Division of Developmental Disabilities.
NJGAINED also includes disability advocacy groups and other
organizations, including Disability Rights New Jersey, Centers for
Independent Living, State-wide Parent Advocacy Network and others, as
well as representation from faith-based organizations and county CAGs.
The FEMA Region 2 Disability Integration Advisor and Disability
Integration Specialist, as well as the FEMA Integration Team assigned
to NJ, also participate in NJGAINED meetings.
During Superstorm Sandy, which occurred during 2012 just as FEMA
was rolling out its Disability Integration Advisors program, NJGAINED
provided critical support to the DAFN community and served as subject-
matter experts to the State and local emergency managers. For example:
NJGAINED members banded together during the Sandy response
and recovery efforts to field requests for assistance.
The NJ Division of Disability Services received many
requests for help through its Information & Referral hotline.
Many of the requests were related to needs for durable medical
equipment, wheelchair ramp repairs, and/or housing.
NJGAINED assisted in sending out emergency alerts and made
calls to individuals to see if help was needed. Members also
shared important updates and provided information on how
individuals with DAFN could obtain assistance after the storm.
NJGAINED members participated in daily briefings to share
concerns.
Through the intervention of NJGAINED, one of the NJ Centers
for Independent Living also partnered with FEMA to set up an
Individual Assistance Center in their office.
One of NJGAINED's current initiatives includes establishing a
State-wide Functional Assessment and Service Team (FAST). A FAST serves
as a strike team to conduct assessments of individuals with DAFN at
mass care shelters or other areas of refuge. A FAST also conducts
aggregate assessments of individuals with functional needs for the
purposes of supplying disaster intelligence and damage assessments,
enhancing resource management, and improving disaster recovery
planning. A concept of operations was recently drafted and the group is
in the process of identifying State members to be a part of the team.
In addition, NJGAINED is working on DAFN emergency preparedness
brochures and promoting mass care trainings. The group also continues
to evaluate current events in emergency management and promote best
practices for DAFN populations.
County Core Advisory Groups
During the last few years, with the support of FEMA and NJOEM,
several New Jersey counties have formed CAGs, and many other counties
have been in discussions with local disability advocacy groups to
develop CAGs in their counties. Because NJOEM believes that CAGs
represent an ideal solution to effective and inclusive collaborative
planning for DAFN preparedness, we have tied funding to this
initiative. The State now requires each county to participate in the
CAG process as part of its Emergency Management Agency Assistance
(EMAA) grant work plan. Additionally, FEMA is currently developing a
CAG toolkit and presentation to help guide counties in developing CAGs.
The county CAGs have taken on significant projects and initiatives,
many of which are being replicated in other counties or supported at
the State level, and include:
Developing and conducting a Community Reception Center
Radiation Emergency exercise, focused on serving the DAFN
population.
Hosting the State's first DAFN Overnight Emergency Shelter
Simulation to provide emergency responders with experience in
working with the DAFN community and to familiarize members of
the DAFN community with a shelter experience.
Creating a DAFN Active-Shooter Preparedness video with tips
on how law enforcement and the DAFN community should best
respond to an incident.
The DAFN Active-Shooter Preparedness Working Group is
spearheaded by a County CAG with support from State
agencies and NJOEM.
Currently, the group is organizing an active-shooter
preparedness training and a tabletop exercise for key staff
from all NJ dialysis centers.
Serving on a panel at a summit on school safety hosted by
the New Jersey Council on Developmental Disabilities to address
students with disabilities and active-shooter incidents.
Conducting an outreach event and panel discussion on
Emergency Preparedness and People with Disabilities as part of
Disability Awareness Month in October.
Developing the Pathways to Preparedness Guide for vulnerable
individuals to prepare for all types of emergencies, created at
the request of the State-wide Independent Living Council.
Hosting classes for inclusive Community Emergency Response
Team (CERT) training.
Staffing emergency preparedness booths at expos and
conferences, attended by thousands of vulnerable residents,
their caregivers, and those who work in the field.
As a result of the strong relationships developed with FEMA through
their support of the CAGs and NJGAINED, the NJOEM AFN Planner and
Middlesex County's Deputy Emergency Manager also provided input as
staff from FEMA Region 2 demonstrated use of the Disability Resource
Database, the Region's first database to offer disability-related
resources that can be utilized by emergency managers and other
stakeholders during emergencies.
emergency management integration through the county afn coordinators
To enhance coordination with the county and local emergency
management community, each county in New Jersey is required to appoint
a County AFN Coordinator to oversee local emergency management planning
pertaining to vulnerable populations, provide trainings, assist with
issues in vulnerable communities as they arise, and coordinate with the
NJOEM AFN Planner. The County AFN Coordinator is also expected to
attend the County CAG meetings to ensure consistency and integration.
The County AFN Coordinators meet quarterly along with other stakeholder
groups, including Centers for Independent Living and other advocacy
groups, as well as the many State agencies that plan for the State's
vulnerable populations. These meetings provide a forum for key partners
to provide briefings, best practices, and information on new
legislation, and to discuss areas of concern. Training on various
topics regarding vulnerable populations in emergency management is
provided at each meeting.
Some of the recent preparedness and planning initiatives and
trainings addressed by the County AFN Coordinators include:
Enhancing Register Ready outreach, and upgrading the
system's search capabilities, and GIS and mapping functions.
Discussing new or proposed legislation with DAFN impact.
Evaluating formation of County Functional Assessment Service
Teams and Core Advisory Groups.
Working with suppliers and entering into MOUs for medical
equipment and supplements that might be needed during
emergencies.
Receiving trainings on a variety of topics, including
service animals; renal dialysis preparedness and response;
utilizing Register Ready; and accommodating vulnerable
populations at shelters and Community Reception Centers.
Partnering with FEMA to keep current on regional and
National projects, such as the Region's new Disability Resource
Database and the NJ Mapping Project, which looks at where
vulnerable populations reside in New Jersey.
Working with partners to host a number of trainings,
including Emergency Preparedness: Access and Functional Needs
in the Disability Community; Autism Shield; Care Assistant
Fundamentals; Responding to the Disabilities and Access and
Functional Needs Community (a CERT workshop); and Emergency
Preparedness Tips for Families of Individuals Who Have Autism,
among others.
Participating in exercises, such as the Central East
Regional Coalition Emerging Infectious Disease/Ebola exercise
and discussion.
new jersey state sheltering task force and subcommittees
The New Jersey State Sheltering Task Force (STF) is a multi-agency
planning team formed in 2014 with a view toward understanding the
capabilities and gaps in sheltering throughout the State, and to
identify areas for improvement, including those experienced by
vulnerable populations during Superstorm Sandy. The STF has visited
with and assessed sheltering gaps and best practices in each of the 21
counties, as well as several larger urban areas across the State. To
address the most common problems/gaps identified among the counties and
urban areas, the STF established 3 subcommittees: DAFN; Staffing; and
Facilities. These subcommittees have issued guidance and
recommendations for whole-community shelter training curriculum,
shelter facility supply lists and ADA guidelines, and DAFN preparedness
information for sheltering and evacuation.
register ready
Register Ready is a secure and voluntary database, administered by
NJOEM, and designed for residents to enter their personal and DAFN-
specific information so that emergency response agencies can better
plan to serve them in a disaster or other emergency. Currently, the
Office of the Public Guardian requires that vulnerable children be
registered in Register Ready based on Court Orders.
Register Ready serves as a planning tool for emergency managers to
gain a better understanding of the needs of individuals living in their
communities to help facilitate planning for sheltering, evacuation and
other emergencies. At present, approximately 22,000 New Jersey
residents and over 300 facilities are registered in the Register Ready
database. The system also offers GIS mapping capabilities to allow
emergency managers to hone in on individuals who may need assistance if
a disaster strikes a particular area.
Register Ready has been used by emergency managers for localized
incidents as well as large incidents, such as Superstorm Sandy. County
and local staff with administrative rights can access information for
residents in their jurisdiction, and receive periodic trainings on how
to use the system. Information in Register Ready can be used to
generate reverse 9-1-1 calls, support wellness checks, and identify
special needs before, during, or after an incident. Information
obtained from Register Ready can help emergency managers plan for
specific needs in their community, such as preparing for oxygen needs,
durable medical equipment and other supplies in shelters; facilitating
accessible transportation to shelters; and arranging for interpreters
and translation tools.
training and guidance
Working through the NJOEM AFN Planner, stakeholders at the Federal,
State, and local levels have developed and offered training and
guidance for individuals, families, emergency management personnel,
first responders, disability advocacy groups, volunteers, and other
partners.
NJOEM, with the support of the Progressive Center for
Independent Living (PCIL), developed a module for the CERT
curriculum entitled Responding to the Disabilities and Access
and Functional Needs Community.
NJOEM and the Department of Human Services partner to offer
Emergency Preparedness: Access and Functional Needs in the
Disability Community to enhance emergency planning involving
the disability community.
The State's Medical Reserve Corps (MRC), PCIL, and the
American Red Cross developed a program to train MRC and CERT
members to serve as personal care assistants in shelters.
Emergency Preparedness Tips for Families of Individuals Who
Have Autism, a workshop developed by The Alliance Center for
Independence and NJOEM, provides essential tips to help
caregivers prepare to withstand various types of emergencies.
There is also another version of the presentation that provides
autism-specific tips for emergency managers and first
responders.
The State periodically offers Autism Shield, a workshop
provided by Parents of Autistic Children, to law enforcement,
public health workers, and emergency management officials from
around New Jersey. This workshop provides participants with
information to enhance recognition of a person with autism and
identify appropriate response methods for first responders
working in field situations.
exercises
The State is a strong proponent of inclusive exercises at the State
and local level, with input and participation by the NJOEM AFN Planner,
CAGs, and disability advocacy groups. The State plans for all hazards,
including natural disasters, incidents at the State's nuclear power
plants, rail/air/other transportation incidents, active-shooter
situations, and other incidents. Recent exercises included:
the Newark Airport 2018 Full-Scale Exercise, for which the
NJOEM AFN Planner served as an evaluator
the annual LIFT exercise at Trenton-Mercer Airport to help
staff learn to interact with the autism community
the annual State-level functional emergency management
exercises addressing radiological incidents, transportation
incidents, and hurricane responses, which also tested DAFN
components of sheltering and evacuation
the County DAFN overnight shelter simulations that provided
training to DAFN individuals as well as emergency management
staff and volunteers
the NJ Transit annual rail drills involving CAG
participation and evaluation.
summary--lessons learned
In addition to the foregoing, some of the specific lessons learned
by our emergency management community from the responses to Sandy and
other incidents with respect to vulnerable populations are:
It is necessary to clarify expectations of both the
emergency management community and vulnerable populations to
minimize misunderstandings.
Emergency managers and community leaders must gain a
better understanding of their constituents.
Registries, such as the State's Register Ready program and
other local registries, can help emergency managers and first
responders plan for the needs of vulnerable populations.
Vulnerable populations should understand the limitations
of local emergency plans and resources and take steps to
increase individual preparedness.
Emergency managers should be cognizant of the needs of
their local vulnerable populations, as well as the
resources that they bring to the table.
Federal funding to support community outreach and
preparedness efforts at the local level would enhance
preparedness efforts and improve response and recovery.
Effective and efficient emergency management requires
personal preparedness on the part of all individuals, and
vulnerable populations will require tailored preparedness
materials.
Individuals need specific information regarding what to
expect in sheltering, what to pack for evacuation and
sheltering, how to obtain information about evacuation and
sheltering, and how to make an emergency plan.
Individuals should understand when and how to shelter in
place, and what the practical consequences are for
registering with State or local special needs registries,
with the utility companies, etc.
Websites that convey emergency management information
should be compatible with accessible screen reader programs
and provide options for alternate languages, if possible.
Local governments and agencies should collaborate with VOAD
members and non-profits, such as NJ 2-1-1, to enhance and
amplify emergency messaging, and provide vulnerable residents
with information on where they can find assistance and
information for recovery programs, warming, and cooling
shelters.
NJOEM social media platforms (e.g. Facebook and Twitter),
ready.nj.gov and Register Ready are compatible with accessible
screen reader programs and have multi-language translation
capability.
Alerts and warnings, and preparedness information should be
disseminated in multiple formats to ensure receipt by those
with visual or hearing impairments.
Communication boards and other aids should be available in
shelters and other locations.
Community and faith-based organizations should be tapped
to provide translation services and amplify messaging to
assist non-English speaking populations.
Emergency managers should explore new communication
technologies and develop relationships with individuals
within the community or through volunteer agencies who can
serve as translators, ASL interpreters, etc. in shelters
and other service locations.
Federal funding should be available to assist with
acquiring adaptive technologies and enhanced 9-1-1
services.
Older adults and others may need assistance navigating
computer technology to access preparedness information,
recovery benefits, etc.
Local emergency managers should work with Federal, State,
and local partners and volunteer groups to ensure that
individuals are able to use the technology required, or to
have alternate systems in place.
Education departments and local school boards must be
included in the planning processes to facilitate use of schools
as shelters, ensure minimal disruption of education for
children displaced by the incident, provide counseling as
necessary for impacted students, and ensure school safety.
Assistance centers where disaster and social services are
offered, must be accessible by those with transportation needs
and offer flexible hours.
Local emergency managers and social service departments
should ensure that transportation is being provided to and
from the assistance centers and that the centers have
flexible operating hours to accommodate the needs of the
local residents.
Disaster relief funding should consider additional needs for
vulnerable populations.
Additional funding may be needed to ensure that those who
have physical disabilities receiving funds to elevate their
homes also receive funds to install stair chairs,
elevators, or proper ramping, etc., so that they have
access into the home.
Rental assistance funding should be supplemented with
further funding for food, clothing, etc.
Vulnerable populations are disproportionately burdened by
delays in the funding process because they do not have the
financial means to sustain their needs.
Funding for training and more staff to speed up the
application review process would be beneficial.
Although New Jersey has come a long way since Sandy, we know that
we have many tasks ahead of us. We are confident, however, that our
emergency managers and our residents are committed to a stronger, more
resilient New Jersey with equal access to services for everyone. We
thank you for this opportunity to testify to this subcommittee.
Mr. Payne. Thank you, sir.
Next we have Ms. Boyd.
STATEMENT OF KELLY BOYD, ACCESS AND FUNCTIONAL NEEDS PLANNER,
PREPAREDNESS BUREAU/EMERGENCY MANAGEMENT SECTION, NEW JERSEY
OFFICE OF EMERGENCY MANAGEMENT
Ms. Boyd. Good morning, Chairman Payne and committee
Members. My name is Kelly Boyd.
For several years, I have had the privilege of serving as
the access and functional needs planner for NJOEM. As a person
with a disability and as an emergency manager, I am honored to
testify today about the exciting work we are doing to enhance
preparedness for the disabilities and access and functional
needs, DAFN, community in New Jersey.
I work with Government agencies, advocacy groups, faith-
and community-based organizations, and NGO's. Through strong
alliances with many organizations, including the Centers for
Independent Living and the State-wide Parent Advocacy Network,
we strive to ensure the personal preparedness of the DAFN
community and provide emergency managers with a pool of DAFN
subject-matter experts and resources.
My testimony will cover the State's Register Ready program
and give an overview of our inclusive planning initiatives.
This includes State and county core advisory groups, the county
AFN coordinators group, and special DAFN-related working
groups. As noted, one planning tool NJOEM administers and
encourages emergency managers to use is Register Ready. It is a
secure database where residents and facilities can voluntarily
enter DAFN-specific information so emergency managers can
better plan for their needs.
Its GIS mapping capabilities also allow emergency managers
to identify individuals within an impacted area. Emergency
managers have used the data to make reverse 9-1-1 calls,
conduct wellness checks, assist with evacuations, and
anticipate DAFN supplies and staffing needs for shelters.
Additionally, we follow FEMA's core advisory group, CAG,
concept for inclusive collaboration between disability
stakeholders and emergency managers. We have State and county
CAGs. The State CAG, known as the New Jersey Group for Access
and Integration Needs in Emergencies and Disasters, NJ GAINED,
was established in 2006.
Members from relevant State agencies and disability
advocacy groups share best practices, offer training, engage in
planning, and provide resources and subject-matter expertise.
In fact, during Sandy, members provided critical information
and resources to the DAFN community, including durable medical
equipment and supplies.
We help counties establish CAGs led by disability advocacy
groups, which is now required for county EMAA funding. One
third of our counties already have CAGs that have carried out
significant projects with wide-ranging impact.
For example, CAGs have developed and conducted a
radiological reception center exercise and DAFN overnight
emergency shelter simulations for emergency managers and
individuals who have DAFN. We avoid role playing by engaging
members of the DAFN community.
Another unique CAG initiative is the DAFN Active-Shooter
Preparedness Working Group, which recently produced a video
with tips for law enforcement and the DAFN community. Members
also participated in a school safety summit on active-shooter
response planning for students with disabilities and are
currently working on a tabletop exercise for dialysis centers.
Several CAGs also work with the Community Emergency
Response Team, CERT program, to host CERT classes that have
recruited individuals with DAFN. CAGs also developed a
comprehensive preparedness guide for vulnerable individuals and
provide preparedness information to thousands of vulnerable
residents and service providers at public events.
I also oversee the county AFN coordinators group, comprised
of an AFN coordinator from each county Office of Emergency
Management. The group has addressed matters such as Register
Ready capabilities, proposed legislation, MOUs for medical
equipment and supplies, and DAFN-related training. We also
partner with FEMA on special projects such as the region's
disability resource database and the New Jersey mapping project
for vulnerable populations.
The CAGs and county AFN coordinators group identify gaps in
training and then develop and deliver training to members of
the emergency management and DAFN communities. Examples include
a new CERT module focused on responding to DAFN community
needs, personal care assistance training for shelter workers,
autism awareness training for responders and preparedness tips
for family members, and emergency preparedness training for
those who are visually impaired.
Additionally, we ensure exercises at all levels include
DAFN consideration and involvement. Recent exercises and drills
included air and rail incidents, hurricanes, and nuclear and
radiological incidents. Finally, we established working groups
to address specific gaps. One example is the State Sheltering
Task Force, a multi-agency planning team that examined
capabilities and gaps in sheltering, including issues
experienced by vulnerable populations. The task force develops
training to address those issues, as well as guidance.
Thank you for permitting me to testify here today.
Mr. Payne. Thank you, Ms. Boyd.
Next we will hear from--I now recognize Ms. Curda to
summarize her statement for 5 minutes.
STATEMENT OF ELIZABETH H. CURDA, DIRECTOR, EDUCATION,
WORKFORCE, AND INCOME SECURITY, GOVERNMENT ACCOUNTABILITY
OFFICE
Ms. Curda. Chairman Payne and Representative Pascrell,
thank you for inviting me to New Jersey to discuss disaster
assistance for people with disabilities. I am sure many people
in this room experienced the devastation of Hurricane Sandy in
2012 and its impact on people with disabilities.
As you are keenly aware, in 2017, 3 hurricanes--Harvey,
Irma, and Maria--hit Texas, Florida, Puerto Rico, and the U.S.
Virgin Islands in rapid succession, causing widespread damage.
As a result, obtaining food, water, medicine, and
transportation was challenging for those affected by the
hurricanes and particularly for those with disabilities.
Today, I will discuss aspects of our May 2019 report on the
challenges people with disabilities faced in accessing disaster
assistance following the 2017 hurricanes. I will also discuss
how effectively FEMA has implemented changes in how it supports
people with disabilities.
Regarding the challenges, substantial damage from the
hurricanes made it more difficult for some people with
disabilities to access life-sustaining provisions, such as
oxygen. This was particularly true in Puerto Rico and the U.S.
Virgins Islands, where supplies in central locations could not
be delivered to remote areas of the islands. In addition,
shelters did not always have appropriate food or accessible
restrooms for people with disabilities.
Aspects of FEMA's application process for assistance also
created challenges. For example, in addition to long wait times
of up to an hour-and-a-half on FEMA's helpline, FEMA's
registration process did not give people a clear opportunity to
state that they have a disability or to request an
accommodation. FEMA needs this information so it can offer
appropriate accommodations or other assistance to survivors. As
a result, it may have been more difficult or even impossible
for some people with disabilities to get the help that they
needed.
In addition, even for those who disclosed their disability-
related needs, FEMA did not have a systematic way to highlight
and share that information with staff tasked with providing
assistance across its various programs. In our May report, we
recommended that FEMA develop new registration questions to
better identify survivors' disability-related needs.
FEMA agreed and has already agreed to change--has already
changed the registration questions. Since the change, FEMA told
us that more people have been reporting their disability-
related needs following recent disasters.
We also recommended that FEMA develop a way to
systematically alert FEMA staff working with survivors who have
reported a disability-related need. FEMA disagreed with this
recommendation because it said it lacked the funding to change
its information systems in the near term and will not be able
to do so until it completes a long-term system modernization in
2024.
However, we believe that in the interim, FEMA could
identify workarounds, such as encouraging staff working
directly with survivors to review case file notes. Following
the 2017 hurricanes, FEMA launched a new approach to how it
responds to and assists people with disabilities, but FEMA's
implementation of this new approach had limitations.
For example, FEMA significantly reduced the number of
disability integration staff deployed to disasters and changed
their role from directly assisting people with disabilities to
advising joint field office managers on how to do this. Instead
of deploying staff specialists to provide assistance, all
generalist staff deployed to help respond to and recover from a
disaster were to receive training on disability issues and
provide hands-on assistance where needed.
However, FEMA has not yet provided comprehensive training
to all deployable staff on how to help people with
disabilities. We recommended that FEMA develop a plan for
delivering training to FEMA staff that promotes competency and
disability awareness. FEMA agreed but is pursuing a somewhat
different approach. We will monitor FEMA's efforts to ensure
that it has clear plans in place for developing this training.
Finally, in 2017, FEMA stopped offering comprehensive
training to non-Federal partners on how to incorporate the
needs of people with disabilities in emergency planning. FEMA
stated it planned to improve the course but had no time line
for doing so. We recommended FEMA develop time lines for
developing the new course, and FEMA agreed. FEMA has stated
that the new course will be ready for the 2020 hurricane
season.
In conclusion, FEMA has taken a number of steps to improve
how FEMA supports individuals with disabilities following a
disaster. However, we continue to believe that changing its
approach to disability integration before staff have been fully
trained may leave FEMA staff ill-prepared to identify and
address the challenges that individuals with disabilities face
while recovering from a disaster.
We will continue to monitor FEMA's actions, as it makes
additional progress toward addressing our recommendations.
This concludes my prepared statement, and I would be happy
to answer the committee's questions.
[The prepared statement of Ms. Curda follows:]
Prepared Statement of Elizabeth H. Curda
july 23, 2019
gao highlights
Highlights of GAO-19-652T, a testimony before the Subcommittee on
Emergency Preparedness, Response, and Recovery, Committee on Homeland
Security, House of Representatives.
Why GAO Did This Study
Three sequential hurricanes--Harvey, Irma, and Maria--affected more
than 28 million people in 2017, according to FEMA. Hurricane survivors
aged 65 and older and those with disabilities faced particular
challenges evacuating to safe shelter, accessing medicine, and
obtaining recovery assistance. In June 2018, FEMA began implementing a
new approach to assist individuals with disabilities.
This statement describes: (1) Reported challenges faced by these
individuals in accessing disaster assistance from FEMA and its non-
Federal partners following the 2017 hurricanes; and (2) the extent to
which FEMA has implemented changes in how it supports these
individuals. This statement is based on a May 2019 GAO report and
selected updates. For the report, GAO analyzed FEMA documents and data
from FEMA call centers and also visited 2017 hurricane locations to
interview State, territorial, and local officials. GAO also interviewed
FEMA officials from headquarters and deployed to each disaster
location. To update FEMA's progress toward addressing its
recommendations, GAO interviewed FEMA officials and analyzed agency
documents.
What GAO Recommends
In the May 2019 report, GAO made 7 recommendations to FEMA; FEMA
concurred with 6. FEMA has established new registration questions and a
time line to offer training to its partners. GAO continues to believe
its recommendations to develop a plan to train its staff on disability
awareness, among other actions, are valid.
disaster assistance.--fema has taken steps toward better supporting
individuals who are older or have disabilities
What GAO Found
GAO's May 2019 report found that some individuals who are older or
have disabilities may have faced challenges registering for and
receiving assistance from the Federal Emergency Management Agency
(FEMA) and its non-Federal partners (such as State, territorial, and
local emergency managers).
FEMA's registration did not include an initial question that
directly asks individuals if they have a disability or if they
would like to request an accommodation. GAO recommended that
FEMA use new registration-intake questions to improve the
agency's ability to identify and address individuals'
disability-related needs. FEMA concurred and, in May 2019,
updated the questions to directly ask individuals if they have
a disability.
GAO found that the substantial damage caused by the 2017
hurricanes prevented or slowed some individuals with
disabilities from obtaining food, water, and other critical
goods and services from States, territories, and localities.
Officials from one State reported that few public
transportation services, including paratransit, were functional
following the 2017 hurricane affecting the State. The officials
said this may have prevented people with disabilities from
maintaining their health and wellness--such as by shopping for
groceries or going to medical appointments--after the storm.
GAO's May 2019 report also found that FEMA had taken limited steps
to implement the agency's new approach to assist individuals with
disabilities.
GAO recommended the agency establish and disseminate
objectives for implementing its new approach. FEMA concurred,
and developed a draft strategic plan that includes strategic
goals and objectives for the new approach, which the agency
plans to finalize and disseminate in 2019.
GAO recommended that FEMA, as part of its new approach,
develop a plan for delivering training to all FEMA staff
deployed during disasters that promotes competency in
disability awareness. In concurring with this recommendation,
FEMA described its plan to incorporate a disability awareness
competency into the job requirements for all deployable staff,
but has not yet developed a plan for training.
GAO's May 2019 report also recommended that FEMA develop a
time line for completing the development of training on
incorporating the needs of individuals with disabilities into
emergency planning, which it planned to offer to its non-
Federal partners. FEMA concurred with GAO's recommendation and,
in June 2019, officials began procuring external consulting
services to develop a replacement course. According to
officials, the course will take about 1 year to develop and
will be ready to field by August 2020.
Chairman Payne, Ranking Member King, and Members of the
subcommittee: Thank you for the opportunity to discuss our recent work
on disaster assistance for individuals who are older or have
disabilities.\1\ For instance, individuals with disabilities that
affect their ability to evacuate, shelter, or recover from hurricanes
and other large-scale disasters can face particular challenges
obtaining disaster assistance. Some of these individuals, who otherwise
function independently in their day-to-day lives, may rely on supports
that disasters can interrupt. For example, after Hurricane Maria made
landfall on Puerto Rico as a category 4 hurricane, the two suppliers of
oxygen on the island of Puerto Rico lost production capabilities due to
a lack of power.\2\ According to a disability rights organization's
report, this lack of production capabilities threatened the health of
approximately 50,000 Puerto Ricans who depended on oxygen.\3\
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\1\ GAO, Disaster Assistance: FEMA Action Needed to Better Support
Individuals Who Are Older or Have Disabilities, GAO-19-318 (Washington,
DC: May 14, 2019). Under Federal civil rights laws, an individual with
a disability is generally defined as an individual who has a physical
or mental impairment that substantially limits one or more major life
activities. The Federal Emergency Management Agency (FEMA) provides
specialized services to those with ``access and functional needs,''
which includes, among others, individuals with disabilities, older
adults, and individuals with limited English proficiency, limited
access to transportation, and/or limited access to financial resources
to prepare for, respond to, and recover from a disaster. For the
purposes of this statement, ``individuals with disabilities'' refers to
individual disaster survivors, including those who are 65 or older, who
have a disability that affects their ability to evacuate, shelter, or
recover from a disaster. In addition, ``individuals who are older''
refers to individuals who are age 65 or older, regardless of whether
they have a disability. For presentation purposes, we use ``individuals
with disabilities'' to refer to both.
\2\ As we reported in September 2018, Hurricane Maria caused wide-
spread infrastructural damages that left 3.7 million of the island's
residents without electricity and 95 percent of cell towers out of
service. GAO, 2017 Hurricanes and Wildfires: Initial Observations on
the Federal Response and Key Recovery Challenges, GAO-18-472
(Washington, DC: Sept. 4, 2018).
\3\ The Partnership for Inclusive Disaster Strategies, Getting It
Wrong: An Indictment with a Blueprint for Getting It Right. Disability
Rights, Obligations and Responsibilities Before, During and After
Disasters (May 2018).
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The sequential Hurricanes Harvey, Irma, and Maria caused wide-
spread damage to critical infrastructure, livelihoods, and property in
2017. As a result, obtaining food, water, medicine, and transportation
was challenging for those affected by the hurricanes, and was
particularly challenging for some individuals with disabilities. State,
territorial, and local emergency management and private organization
partners turned to the Federal Emergency Management Agency (FEMA) for
help, including from FEMA disability integration staff who were
responsible for providing assistance to individuals with
disabilities.\4\ In June 2018, near the start of the 2018 hurricane
season, FEMA announced plans to reorganize its workforce to more
thoroughly incorporate disability integration principles into all
preparedness, response, and recovery activities Nation-wide and reduce
reliance on disability integration staff in FEMA's Office of Disability
Integration and Coordination (ODIC).
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\4\ Disability integration staff are responsible for focusing on
inclusive practices in emergency management, and include those deployed
to areas affected by disasters and those working permanently in FEMA's
regional offices. Inclusive practices are intended to ensure people
with disabilities have equal opportunities to participate in, and
receive the benefits of, emergency management programs and services.
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My statement today discusses information from our May 2019 report
on disaster assistance for individuals who are older or have
disabilities. Specifically, this statement addresses: (1) Reported
challenges these individuals faced in accessing disaster assistance
from FEMA and its non-Federal partners following the 2017 hurricanes;
and (2) the extent to which FEMA has implemented changes in how it
supports these individuals.
This statement is primarily based on the May 2019 report as well as
selected updates. For that report we analyzed FEMA policies,
procedures, guidance, and memoranda and assessed these documents
against goals and objectives in FEMA's 2018-2022 Strategic Plan,
Department of Homeland Security (DHS) policy for ensuring
nondiscrimination for individuals with disabilities, and Federal
standards for internal control.\5\ We obtained and analyzed data from
FEMA call centers that operate FEMA's helpline. We also visited
Florida, Puerto Rico, Texas, and the U.S. Virgin Islands in June and
July 2018 to interview State or territorial emergency managers, public
health and human services officials, and representatives of nonprofit
disability organizations, among others.\6\ We also interviewed FEMA
officials from headquarters and staff deployed to each disaster
location, including staff focused on assisting individuals with
disabilities. More detailed information on the scope and methodology
for that work can be found in Appendix I of the issued report. To
update progress FEMA has made toward addressing our recommendations
from the May 2019 report, we interviewed FEMA officials and analyzed
documents they provided.
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\5\ See FEMA, 2018-2022 Strategic Plan, March 15, 2018; DHS
Directive 065-01, Nondiscrimination for Individuals with Disabilities
in DHS-Conducted Programs and Activities (Non-Employment), Sept. 25,
2013; and GAO, Standards for Internal Control in the Federal
Government, GAO-14-704G (Washington, DC: September 2014). We did not
independently assess whether any programs or activities conducted by
FEMA or its partners during the period covered by our review complied
with applicable non-discrimination or civil rights laws.
\6\ Hurricane Harvey primarily affected the Gulf Coast of Texas;
Hurricane Irma primarily affected the U.S. Virgin Islands, Puerto Rico,
and Florida; and Hurricane Maria primarily affected the U.S. Virgin
Islands and Puerto Rico. We supplemented the information we obtained
from the site visit interviews with summaries of 8 public listening
sessions across the 4 disaster locations. The summaries were published
by DHS's Office for Civil Rights and Civil Liberties and co-hosted with
FEMA between February 2018 and May 2018.
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We conducted the work on which this statement is based in
accordance with generally-accepted Government auditing standards. Those
standards require that we plan and perform the audit to obtain
sufficient, appropriate evidence to provide a reasonable basis for our
findings and conclusions based on our audit objectives. We believe that
the evidence obtained provides a reasonable basis for our findings and
conclusions based on our audit objectives.
registering for and receiving assistance from fema and its partners
posed challenges for individuals with disabilities following the 2017
disasters
Aspects of FEMA's Application Process for Assistance Created Challenges
for Individuals with Disabilities
To receive FEMA assistance under FEMA's Individuals and Households
Program, through which disaster survivors can receive help with housing
and other needs, individuals must register by answering a standard
series of intake questions.\7\ In our May 2019 report, we found that
some individuals with disabilities may have faced long wait times and
unclear registration questions, and that FEMA's internal communication
across its programs about survivors' disability-related needs was
ineffective.
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\7\ Individuals can register by phone using a toll-free helpline,
via the internet, or in person at FEMA-staffed Disaster Recovery
Centers.
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Long wait times.--Individuals who tried to apply for
assistance using the helpline confronted long wait times, which
may have posed greater challenges for those with disabilities.
In the days after Hurricane Maria affected Puerto Rico and the
U.S. Virgin Islands--when survivors from Harvey and Irma were
concurrently contacting the helpline--up to 69 percent of calls
went unanswered and the daily average wait time for answered
calls peaked at almost an hour and a half, according to our
analysis of FEMA data. While long wait times could be
burdensome for all individuals, State officials and disability
advocates we interviewed said long wait times were especially
burdensome for people with certain disabilities, such as those
with attention disorders or whose assistive technology prevents
multi-tasking when waiting on hold.
Unclear registration questions.--FEMA's registration process
did not give individuals a clear opportunity to State they have
a disability or request an accommodation because the
registration did not directly ask registrants to provide this
information.\8\ According to FEMA officials at the time,
information about disability-related needs can help FEMA staff
match individuals with disabilities with appropriate resources
in a timely and efficient manner and target additional
assistance, such as help with the application process. However,
individuals with disabilities may not have requested
accomodations or reported their disability and related needs
during FEMA's registration-intake due to the unclear questions.
As a result, the registration process may have under-identified
people with disabilities. For example, in Puerto Rico, an
estimated 21.6 percent of people have disabilities, according
to 2017 census data. However, less than 3 percent of all
registrants in the territory answered ``yes'' to the
disability-related question in response to Hurricanes Irma and
Maria.\9\
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\8\ According to a FEMA policy document, FEMA makes reasonable
accommodations to policies, practices, and procedures to ensure
physical, programmatic, and effective communication access to FEMA
disaster assistance. We did not assess whether any accommodations or
other services provided by FEMA or its partners complied with any
applicable non-discrimination or civil rights laws.
\9\ The data are from the 2017 Puerto Rico Community Survey, a
survey administered annually by the United States Census Bureau. The
Puerto Rico Community Survey produces 1-year estimates for the total
civilian noninstitutionalized population and is the equivalent of the
American Community Survey for the 50 States and District of Columbia.
Data results from both surveys are released together as a unified
American Community Survey dataset. The estimate for Puerto Rico has a
margin of error at the 90 percent confidence interval of plus or minus
0.5 percentage points.
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Ineffective communication across FEMA programs.--Individuals
may have faced challenges receiving necessary assistance
because FEMA did not effectively track and communicate
information about individuals' disability-related needs across
its assistance programs after such needs were identified. FEMA
officials we interviewed for the May 2019 report explained that
accommodation requests and disability-related information
identified after registration-intake are recorded in a general
``notes'' section of a registrant's case file, which can be
easily overlooked as a case file is passed along to subsequent
FEMA officials.
In our May 2019 report we recommended that FEMA implement new
registration-intake questions to improve FEMA's ability to identify and
address survivors' disability-related needs. FEMA concurred with this
recommendation, and officials reported that in May 2019 the agency
updated the questions to directly ask individuals if they have a
disability. According to FEMA's analysis of applications for assistance
following recent disasters, which used the updated questions, the
percentage of registrants who reported having a disability increased.
FEMA officials stated this increase gives them confidence the change
has improved FEMA's ability to identify and address disability-related
needs of individuals affected by disasters.
We also recommended that FEMA improve its communication of
registrants' disability-related information across FEMA programs, such
as by developing an alert within survivor files that indicates an
accommodation request. FEMA did not concur with this recommendation,
explaining that the agency lacks specific funding to augment the legacy
data systems that capture and communicate registration information. In
its comments on our May 2019 report, FEMA stated that it began a long-
term initiative in April 2017 to improve data management and exchange,
and improve overall data quality and standardization.\10\ After FEMA
completes this initiative, which officials said will be in 2024, FEMA
expects that efforts to share and flag specific disability-related data
will be much easier. We believe that in the interim, FEMA could explore
other cost-effective ways to improve communication, such as through
agency guidance that encourages program officials to review
registrants' case file notes. As FEMA moves ahead with its initiatives
to improve data, we encourage it to consider and ultimately implement
technology changes, such as developing an alert within files that
indicates an accommodation request, to help improve communication
across FEMA programs.
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\10\ The letter said that FEMA expects the initiative to include
the development of a modern, cloud-based data storage system with a
data analytics platform that will allow analysts, decision makers, and
stakeholders more ready access to FEMA data.
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Officials Reported that Individuals with Disabilities Faced Challenges
Obtaining Critical Goods and Services
State, territorial, and local governments are primarily responsible
for response and recovery activities in their jurisdictions, including
those involving health and safety. In our May 2019 report, we found
that the substantial damage caused by the 2017 hurricanes prevented or
slowed some individuals with disabilities from obtaining food and
water. According to territorial and nonprofit officials in Puerto Rico
and the U.S. Virgin Islands, as well as survivors we interviewed in the
U.S. Virgin Islands, this was due to centralized distribution models,
in which the majority of food and water was distributed to centralized
locations around the islands. Officials from one governmental agency in
Puerto Rico said this posed a major barrier to people with mobility
challenges or without caregivers receiving food and water because they
had to rely on home delivery, which took time and in some cases, did
not happen. We also found that Hurricane Maria survivors faced
challenges obtaining needed medication and oxygen in Puerto Rico and
the U.S. Virgin Islands, according to territorial and nonprofit
officials.
State, territorial, and local agencies are also primarily
responsible for administering shelters, when necessary, for those
affected by a disaster. We found in our May 2019 report that
individuals with disabilities affected by the 2017 hurricanes may have
faced challenges accessing basic services from local shelters,
including restrooms and food, according to State, territorial, local,
and nonprofit officials in Florida, Puerto Rico, Texas, and the U.S.
Virgin Islands. For example, nonprofit officials in Florida and Puerto
Rico described instances of shelter residents with impairments that
prevented them from accessing shelter restrooms.
We also found that transportation was especially challenging for
those who relied on public transportation or were unable to walk long
distances, such as people with disabilities, according to State,
territorial, local, and nonprofit officials we interviewed. For
example, Florida State officials reported that few public
transportation services, including paratransit, were functional
following Hurricane Irma. This may have prevented some people with
disabilities from maintaining their health and wellness--such as by
shopping for groceries or going to medical appointments--after the
storm, according to State officials.
Officials we interviewed from Texas, Florida, and Puerto Rico for
our May 2019 report said they had difficulty obtaining FEMA data that
could help them deliver assistance to individuals, including those with
disabilities. The officials explained that data--including names and
addresses--showing who has registered for and received assistance from
FEMA can help local governments and nonprofits identify who in their
community needs assistance.\11\ To better facilitate authorized non-
Federal partners obtaining these needed data, we recommended that FEMA
develop and publicize guidance for partners who assist individuals with
disabilities on how to request and work with FEMA staff to obtain the
data, as appropriate. FEMA concurred with this recommendation and
officials told us in July 2019 that the agency plans to publish data-
sharing guidelines on its website, among other actions.
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\11\ According to FEMA officials, the agency has broad authority to
share its data on registrations, and follows the framework established
under the Privacy Act of 1974 on the collection, use, maintenance, and
dissemination of personally identifiable information. FEMA has
published a number of routine uses under which FEMA may disclose such
information to State, Tribal, and local government agencies and
emergency managers, including the type of information it can share and
under what circumstances. See 78 Fed. Reg. 25,282 (Apr. 30, 2013).
Generally, FEMA uses agreements with State and other partners to
establish the terms and conditions of how it will share data; however,
according to State and nonprofit officials, obtaining FEMA data has
sometimes been challenging and time-consuming.
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fema had taken limited steps to effectively implement its new
disability integration approach
FEMA Began Implementing Changes Without Communicating Objectives to
Regional Staff
Before initiating its new approach to disability integration, ODIC
distributed an explanatory memorandum and other documentation to FEMA
staff. For example, an April 2018 memorandum to FEMA Regional
Administrators outlined a proposal to add new disability integration
staff in each FEMA region to foster day-to-day relationships with
State, territorial, and local emergency managers and disability
partners. Also, ODIC distributed a document that described FEMA's new
approach to deployments. Under the new approach, fewer disability
integration staff are to be deployed to disasters and all deployable
staff and staff in programmatic offices are to receive training on
disability issues during response and recovery deployments.
However, in our May 2019 report, we found that these documents did
not articulate objectives that could help the agency define success for
the new approach. We concluded that without a set of common objectives
for FEMA's new disability integration approach, FEMA risks inconsistent
application across its regions. In our report, we recommended that FEMA
establish and disseminate a set of objectives for the new approach.
FEMA concurred with this recommendation, and in July 2019 officials
provided us with the draft of ODIC's strategic plan for 2019-2022,
which includes strategic goals and objectives that the new disability
integration approach can help achieve. ODIC officials told us they will
be working throughout 2019 with FEMA's Office of External Affairs to
disseminate the plan agency-wide and to nonFederal partners. We will
continue to monitor FEMA's progress toward sharing the objectives of
its new approach to disability integration with critical stakeholders.
FEMA Had Not Documented Plans for Training All Deployed Staff on
Disability Competencies, but Has Taken Steps to Offer Training
to Non-Federal Partners
To implement FEMA's new deployment model, which will shift the
responsibility of directly assisting individuals with disabilities from
disability integration staff to all FEMA staff, FEMA planned to train
all deployable staff and staff in programmatic offices on disability
issues. We reported in May 2019 that FEMA officials emphasized the need
to integrate disability competencies throughout FEMA's programmatic
offices and deployable staff. However, we found that the agency did not
have written plans--including milestones, performance measures, or a
plan for monitoring performance--for developing new comprehensive
training for all staff. Starting in the 2018 hurricane season, FEMA had
taken initial steps toward training some deployed staff on disability
issues. For example, FEMA required all staff to complete a 30-minute
training on basic disability integration principles and offered
targeted ``just-in-time'' training to deployed staff. We concluded that
developing a training plan would better position FEMA to provide
training to all staff to help achieve FEMA's intended goals.
In our May 2019 report, we recommended that FEMA develop a plan for
delivering training to FEMA staff that promotes competency in
disability awareness. In its letter commenting on our May 2019 report,
FEMA stated that ODIC is developing a plan to introduce the disability
competency in FEMA's position task books for all deployable staff.\12\
The letter explained further that ODIC's plan will describe how FEMA
will communicate the disability integration competency throughout the
agency, establish milestones for measuring how effectively the
competency is integrated across the agency, and outline how ODIC will
monitor and measure integration of the competency across the deployable
workforce.
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\12\ Position task books outline the required activities, tasks,
and behaviors for each job, and serve as a record for task completion.
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In July 2019, FEMA officials told us ODIC plans to hire new staff
to focus on integrating the disability competency FEMA-wide. According
to the officials, after the position task books are updated, ODIC will
work with FEMA's training components to ensure that disability-related
training is consistent with the content of the position task books.
FEMA officials also noted that the Field Operations Division, and not
ODIC, is responsible for measuring how effectively the disability
competency is integrated across FEMA. We will continue to monitor
FEMA's progress toward developing a plan for delivering training to
promote competency in disability awareness among its staff. As noted in
our May 2019 report, the plan for delivering such training should
include milestones, performance measures, and how performance will be
monitored.
In our May 2019 report, we found that deploying a smaller number of
disability integration staff and shifting them away from providing
direct assistance to individuals with disabilities may result in non-
Federal partners (such as State, territorial, and local emergency
managers) providing more direct assistance to individuals with
disabilities than they did previously. In February 2017, we reported
that the comprehensive introductory training course on disability
integration that FEMA offered to its non-Federal partners included
substantial information on how to incorporate the needs of people with
disabilities in emergency planning.\13\ However, according to
officials, FEMA stopped offering this 2-day course in September 2017.
ODIC officials told us during our 2019 review they had determined that
the course, as designed, did not provide actionable training to
emergency management partners to meet the needs of individuals with
disabilities and planned to replace it.
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\13\ Federal Disaster Assistance: FEMA's Progress in Aiding
Individuals with Disabilities Could Be Further Enhanced. GAO-17-200,
(Washington, DC: Feb. 7, 2017).
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However, we found in May 2019 that although officials had plans to
replace the course with new training, they had not provided a time
line, which would help ensure that partners are provided with timely
information on inclusive emergency management practices. We recommended
that FEMA develop a time line for completing the replacement course
and, in June 2019, FEMA officials said they had begun procuring
external consulting services to redevelop it. According to the
officials, ODIC had evaluated alternatives to the suspended course and
determined that an in-person, exercise-based course with remote
participation capabilities would be an appropriate replacement. FEMA
officials said the course will take about 1 year to develop and will be
ready to field by August 2020.
In conclusion, FEMA has taken a number of steps toward addressing
our recommendations related to how it supports individuals with
disabilities in obtaining disaster assistance. ODIC's draft strategic
plan for 2019-2022, which articulates objectives for the new approach
to disability integration, is likely to help facilitate consistent
implementation agency-wide. In addition, we are hopeful that FEMA's
revised registration-intake questions, as well as data-sharing guidance
for non-Federal partners, will help FEMA and its partners better
identify and assist registrants with disabilities. However, we continue
to believe that implementing changes to disability integration before
staff have been fully trained may leave FEMA staff ill-prepared to
identify and address the challenges that individuals with disabilities
face while recovering from disasters. We will continue to monitor
FEMA's actions as it makes additional progress toward addressing our
recommendations.
Chairman Payne, Ranking Member King, and Members of the
subcommittee, this completes my prepared statement. I would be pleased
to respond to any questions that you may have at this time.
Mr. Payne. Thank you, Ms. Curda.
Now I recognize Ms. Roth to summarize her statement for 5
minutes.
STATEMENT OF MARCIE ROTH, CHIEF EXECUTIVE OFFICER, PARTNERSHIP
FOR INCLUSIVE DISASTER STRATEGIES
Ms. Roth. Good morning, Chairman Payne, Congressman
Pascrell, my fellow panelists. I am honored to appear before
you today.
My name is Marcie Roth, and I am the CEO of the Partnership
for Inclusive Disaster Strategies, a national and global
coalition of disability rights, emergency management, public
health, and community leaders committed to equal access and
whole community inclusion before, during, and after disasters.
I was appointed by President Obama and served as senior
adviser to FEMA Administrator Fugate for almost 8 years. My
role included serving as the Congressionally-mandated
disability coordinator responsible for ensuring FEMA meets all
of its disability-related obligations established in the Post-
Katrina Emergency Management Reform Act of 2006. I was also
charged with establishing and directing FEMA's Office of
Disability Integration and Coordination from 2010 until my
departure in 2017.
I am here today to report that despite an investment of
over $34 billion in emergency preparedness funding in the past
15 years, our communities remain unprepared for disasters, and
the people most disproportionately impacted are people with
disabilities, older adults, and others with access and
functional needs. Many of these members of every community in
the country have legal protection in disasters, but these
protections are not monitored and enforced, placing these
individuals and their communities in harm's way every time
there is a disaster.
It is important to note that there have been over 120 major
disasters in the past 3 years. The disproportionate impact of
disasters on people with disabilities, older adults, and others
who also have access and functional needs is not insignificant.
In fact, people with disabilities and older adults are 2 to
4 times more likely to die or be injured in a disaster. This is
due to a lack of planning, accessibility, and accommodation.
According the Centers for Disaster Control, 1 in 4 adults,
26 percent of the population, has one or more disabilities.
Fifteen percent of the population is over age 65 and growing.
Interruption of medical care and disability services were
the primary cause of almost 3,000 deaths following Hurricane
Maria, 71 percent of deaths in Hurricane Katrina were people
over the age of 60, 50 percent of the deaths in Superstorm
Sandy, and 77 percent of people who died in the California
wildfires this past year were over the age of 65, and many had
disabilities.
Equal access to disaster services has been promised to
children and adults with disabilities since passage of the
Rehabilitation Act of 1973 46 years ago. There are no waivers
to civil rights protections during a disaster.
In addition to the obligations that come with the
expenditure of every Federal dollar before, during, and after
disasters, the Americans with Disabilities Act of 1990
prohibits recipients from discriminating on the basis of
disability in the operation of public entities, transportation
systems, public accommodations, and the 1999 Olmstead Supreme
Court decision assured that people with disabilities would be
served in the most integrated setting appropriate to their
needs, including in disasters.
Despite this, there has been no action taken to address the
partnership's formal and informal requests to the Federal
agencies responsible for enforcement to prevent civil rights
violations in disasters, and as recently as last week, a waiver
of civil rights was issued by the Department of Health and
Human Services to Louisiana, allowing nursing home placement of
disaster-impacted people.
Key to compliance is FEMA's Congressionally-mandated
disability coordinator, implementing responsibilities as
defined in the Post-Katrina Emergency Management Reform Act.
These responsibilities include ensuring that the needs of
individuals with disabilities are being properly addressed in
emergency preparedness and disaster relief; consulting with
organizations that represent the interests and rights of
individuals with disabilities; ensuring the development of
training materials and a curriculum for training emergency
response providers, State, local, and Tribal government
officials, and others; and ensuring the availability of
accessible transportation options in evacuation.
The partnership and our member organization have
continually attempted to consult with the FEMA disability
coordinator without success. We are the Nation's organizations
that represent the interests and rights of individuals with
disabilities before, during, and after disasters. The
disability coordinator has also prevented the FEMA Individual
Assistance Directorate from collaborating with us, and it
wasn't until Senator Casey reached out to FEMA that we were
granted an invitation to meet with FEMA senior leadership. This
meeting, requested by one of our community leaders, has not yet
been scheduled.
It must be noted that the DHS Office for Civil Rights and
Civil Liberties meets with us regularly, but even they have
been unable to get FEMA's disability coordinator to the table
with us.
Since 2018, disaster-impacted communities report a lack of
FEMA-qualified disability integration representatives. Most of
the trained and qualified disability experts have left the
agency. Over a year ago, we were told by the disability
coordinator that FEMA would be hiring disability integration
specialists and training the entire agency to ensure qualified
disability integration experts would be ensuring the rights of
disaster-impacted people with disabilities and their
protection.
However, it appears that only 1 has been hired. Existing
training has been discontinued, and at least 1 key position
remains unfilled after an 18-month----
Mr. Payne. Please wrap it up. Please wrap, please.
Ms. Roth [continuing]. Vacancy. After the GAO report that
was recently discussed, two bipartisan bills were introduced,
led by Senators Casey and Collins, Congressmen and -women
Langevin, Smith, Shalala, and Gonzalez-Colon, to address the
urgent needs to protect every citizen, meeting the Federal
Government's obligations.
The Real Emergency Access for Aging and Disability
Inclusion for Disasters Act and the Disaster Relief Medicaid
Act will work together to provide solutions for the whole
community. We call on Congress and the President to quickly
pass and enact these bills into law before the next disaster
strikes.
Mr. Payne. Thank you. Thank you very much.
Ms. Roth. Thank you very much.
[The prepared statement of Ms. Roth follows:]
Prepared Statement of Marcie Roth
Tuesday, July 23, 2019
Good morning Chairman Payne and distinguished committee Members. I
am honored to appear before you today.
My name is Marcie Roth and I am the CEO of the Partnership for
Inclusive Disaster Strategies, a membership organization founded by
Portlight Inclusive Disaster Strategies in 2016.
I am here today to report that, despite an investment of over $34
billion in emergency preparedness funding in the past 15 years, our
communities remain unprepared for disasters, and the people most
disproportionately impacted are people with disabilities, older adults
and others with access and functional needs. I am able to report this
with authority, because this has been my entire focus for the past 19
years, both inside FEMA for almost 8 of those years.
In 2009, I was appointed by President Obama as senior advisor to
the FEMA administrator for disability issues. I was also named as the
Congressionally-mandated disability coordinator, responsible for
ensuring FEMA meets all of its disability-related obligations
established in the Post-Katrina Emergency Management Act of 2006. And,
I was also charged with establishing and directing FEMA's Office of
Disability Integration and Coordination from 2010 until my departure in
2017.
My disaster policy and operations responsibilities included:
Advising Senior Leadership by leading agency and interagency
development and implementation of disability inclusive
emergency management policy and procedures throughout
preparedness, response, recovery, and mitigation, to ensure the
Federal Government was meeting its obligations to provide equal
access, nondiscrimination and reasonable accommodations and
modifications for disaster impacted people with disabilities
before, during and after disasters.
Leading development and delivery of training and technical
assistance tools provided by FEMA to first responders,
emergency managers, and a wide array of stakeholders in States
and communities across the country.
Building a Disability Integration Cadre, one of FEMA's 23
Disaster Response and Recovery Cadres.
In developing the Cadre, I was charged by the administrator with
hiring 285 disability experts, developing, implementing, and serving as
a qualification system official to ensure the level of expertise of
Cadre members in the field.
Between 2013 and 2017, the Cadre had over 400 disaster deployments,
and I was personally deployed to catastrophic disasters as a Qualified
Lead for over 500 days. Deployment teams included as many as 65
qualified specialists and trainees in larger disasters, with some
serving as direct advisors to the Federal Coordinating Officer, and
others working in the field alongside other FEMA employees to support
implementation of FEMA's obligations to disaster impacted people with
disabilities in Federally-declared disasters.
I assumed the position of CEO for the Partnership for Inclusive
Disaster Strategies (the Partnership) in 2017. The Partnership is a
coalition of local, national and global disability rights, emergency
management, public health, and community leaders committed to equal
access and whole community inclusion before, during, and after
disasters. We are the only membership organization in the United States
with a sole focus on the needs and rights of disaster-impacted people
with disabilities, older adults, and people with access and functional
needs. Our coalition focuses on the access and functional needs of
countless people who are disproportionately impacted in disasters due
to inadequate planning, preparedness, and accessibility. This includes
people who may require assistance, accommodation, or modification due
to any situation (temporary or permanent) that limits their ability to
take action in an emergency.
In addition to people with disabilities, this includes people who
are marginalized, stigmatized, or excluded, older adults, individuals
with limited language proficiency, low literacy, temporary and chronic
health conditions, pregnant women, and people experiencing
homelessness, limited access to transportation, or the financial
resources to prepare for, respond to, and recover from a disaster.
Our U.S. members lead disability rights initiatives in every
Congressional district and virtually every community across the
country. Globally, we bring our expertise and leadership to disaster
risk reduction, climate change adaptation, human rights, humanitarian
action, strategic development, and resilient community initiatives.
The disproportionate impact of disasters on people with
disabilities, older adults, and others who also have access and
functional needs is not insignificant. In fact, people with
disabilities and older adults are 2 to 4 times more likely to die or be
injured in a disaster. Due to a lack of planning, accessibility, and
accommodation, most are not due to diagnostic labels or medical
conditions.
According to the Centers for Disease Control, 1 in 4 adults, 26
percent of the population has 1 or more disabilities. There are at
least 7 million children with disabilities, 14 percent of all school-
age children as well, and 15 percent of the population is over age 65,
and will grow to 1 in 5 people in the United States over the next 10
years.
Interruption of medical care and disability services were the
primary cause of almost 3,000 deaths following Hurricane Maria. Almost
15 percent were attributed to an inability to access needed medications
and almost 10 percent were caused by unmet needs for respiratory
equipment requiring electricity. Most of these individuals had
disabilities related to chronic health conditions.
Seventy-one percent of deaths in Hurricane Katrina were people over
the age of 60, 50 percent of the deaths in Super Storm Sandy and 77
percent of people who died in the California wildfires were over 65 and
many had disabilities.
Over 2.5 million people use medical equipment and devices that
require electricity.
About 46 percent of the U.S. population used 1 or more prescription
drugs in the past 30 days, according to a survey from the National
Center for Health Statistics. Without uninterrupted access in a
disaster, many of these people will require a higher level of health
care at the very time when access to health care will be at its most
limited.
There are laws in place to ensure equal access, without exception,
in a disaster. The Rehabilitation Act of 1973 protects the civil rights
of persons with disabilities. It prohibits discrimination on the basis
of disability by the Federal Government, Federal contractors, and by
recipients of Federal financial assistance.
Any recipient or sub-recipient of Federal funds is required
to make their programs accessible to individuals with
disabilities. Its protections apply to ALL programs and
businesses that receive ANY Federal funds.
This applies to all elements of physical/architectural,
programmatic and effective communication accessibility in all
services and activities conducted by or funded by the Federal
Government.
Under the Rehabilitation Act, ``entities selected to receive a
grant, cooperative agreement, or other award of Federal financial
assistance from the U.S. Department of Homeland Security (DHS) or one
of its components, including State Administering Agencies must comply
with civil rights obligations. Sub recipients have the same obligations
as their primary recipient to comply with applicable civil rights
requirements and should follow their primary recipient's procedures
regarding compliance with civil rights obligations.''\1\ \2\
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\1\ Department of Homeland Security. ``Civil Rights Evaluation
Tool, OMB Control No. 1601-0024.'' https://www.dhs.gov/sites/default/
files/publications/dhs-civil-rights-evaluation-tool.pdf.
\2\ U.S. Department of Justice, ``ADA Best Practices Tool Kit for
State and Local Governments,'' https://www.ada.gov/pcatoolkit/
chap7emergencymgmt.htm.
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Equal access to disaster services has been promised to children and
adults with disabilities since passage of the Rehabilitation Act of
1973, 46 years ago. However, the promise remains unfulfilled. This is
despite extensive legal protection; despite countless ``lessons
learned'' documents, produced over 14 years since the Nation's failed
response to Hurricane Katrina; and, despite claims that actionable
emergency plans exist, children and adults with disabilities were
consistently denied equal access to disaster-related programs and
services throughout the catastrophic disasters of 2017 and 2018 and are
still being denied in 2019. These equal access failures extend to all
aspects of disaster response and recovery including:
Alerts, warnings, and notification
Actionable information and instructions
Evacuation
Sheltering in the most integrated setting
Health maintenance and acute medical care
Life-saving and life-sustaining goods and services
Food and potable water
Registering for disaster services including FEMA and State/
territory emergency programs
Temporary and permanent housing
Return to home, school, work and community life
Disaster recovery and mitigation investments.
In addition to the obligations that come with the expenditure of
every Federal dollar, before, during and after disasters, the Americans
with Disabilities Act of 1990 prohibits recipients from discriminating
on the basis of disability in the operation of public entities, public
and private transportation systems, places of public accommodation, and
certain testing entities.
In order to ensure compliance, recipients must provide program
access, ensure effective communication, and provide physical access for
persons with disabilities in developing budgets and in conducting
programs and activities.
The U.S. Supreme Court decided in its 1999 Olmstead decision that
the Americans with Disabilities Act requires provision of services to
individuals with disabilities in the ``most integrated setting
appropriate to the needs of the individual''.
In 2007, the U.S. Department of Justice instructed State and local
governments in their ADA Best Practices Tool Kit for State and Local
Governments, Chapter 7 that ``The ADA requires people with disabilities
to be accommodated in the most integrated setting appropriate to their
needs, and the disability-related needs of people who are not medically
fragile can typically be met in a mass care shelter. For this reason,
people with disabilities should generally be housed with their
families, friends, and neighbors in mass care shelters and not be
diverted to special needs or medical shelters.'' . . . ``Special needs
and medical shelters are intended to house people who require the type
and level of medical care that would ordinarily be provided by trained
medical personnel in a nursing home or hospital.''
``The ADA requires emergency managers and shelter operators to
accommodate people with disabilities in the most integrated setting
appropriate to their needs, which is typically a mass care shelter'' .
. . ``Local governments and shelter operators may not make eligibility
for mass care shelters dependent on a person's ability to bring his or
her own personal care attendant.''
Despite this, the use of ``medical special needs shelters'',
``medical friendly shelters'', ``special needs shelters'', ``Federal
Medical Stations'' and other terms describe the only type of emergency
sheltering provided for many individuals with disabilities living in
the community and not appropriately served in a nursing home or
hospital. The use of these facilities has been prevalent in many of the
recent disasters requiring evacuation of disaster-impacted communities.
These shelters have operated in Florida, Louisiana, South Carolina,
North Carolina, Virginia, and other States with Federal disaster
declarations over the past 3 years with people being sheltered in what
is frequently described as circumstances that are ``less than
optimal''.
The use of any of these facilities to meet the disaster-related
sheltering needs of individuals with disabilities who ``don't require
the type and level of medical care that would ordinarily be provided by
trained medical personnel in a nursing home or hospital''\3\ must be
halted. Each of these facilities is a place of public accommodation and
most receive some Federal funds. Thus, these facilities must comply
with Title II of the ADA and Section 504 of the Rehabilitation Act.
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\3\ https://www.ada.gov/pcatoolkit/chap7shelterprog.htm.
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We have also seen the use of ``evacuation centers'', including
those funded with FEMA P-361 grant funds,\4\ which, despite the grant
instructions, are repeatedly described by local and State government as
``different than shelters'' and ``not required to provide disability
accommodations'' such as accessible bathrooms, personal assistance,
interpreters, cots, and other reasonable accommodations.
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\4\ https://www.fema.gov/fema-p-361-safe-rooms-tornadoes-and-
hurricanes-guidance-community-and-residential-safe-rooms.
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Stakeholders report civil rights violations that were due to
failure to provide necessary guidance, training and technical
assistance to State and local government; failure to monitor
compliance; and failure to enforce civil rights laws that apply before,
during, and after disasters.
Contributing to these failures is contradictory information about
the requirements for sheltering people with disabilities in emergencies
and disasters. Further confounding the problem with inconsistent civil
rights guidance and lack of enforcement from the responsible Federal
agencies is a lack of clarity about which agency has ultimate
responsibility for and ownership of the obligation for enforcing the
requirement to provide sheltering to people with disabilities in the
most integrated setting throughout emergencies and disasters.
hhs office for civil rights (ocr)
``Being mindful of all segments of the community and taking
reasonable steps to provide an equal opportunity to benefit from
emergency response efforts will help ensure that responsible officials
are in compliance with Federal civil rights laws and that the disaster
management in the affected areas by Hurricane Florence is
successful.''\5\
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\5\ https://www.hhs.gov/about/news/2018/09/13/ocr-issues-guidance-
to-help-ensure-equal-access-to-emergency-services-medical-information-
during-hurricane-florence.html.
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hhs centers for disease control and prevention (cdc)
``Somewhere between a temporary shelter and temporary hospital, a
Federal Medical Station is a non-emergency medical center set up during
a natural disaster to care for displaced persons with special health
needs--including those with chronic health conditions, limited
mobility, or common mental health issues--that cannot be met in a
shelter for the general population during an incident.''\6\
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\6\ https://www.cdc.gov/phpr/stockpile/fedmedstation.htm.
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hhs office of the assistant secretary for preparedness and response
(aspr)
Federal Medical Stations ``sustain from 50 to 250 stable primary or
chronic care patients who require medical and nursing services.''
Federal Medical Stations provide ``low acuity care for patients with
chronic illnesses whose access to care is impeded due to the
disaster.''\7\
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\7\ https://www.phe.gov/Preparedness/support/medicalassistance/
Pages/default.aspx.
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doj
``Shelters are usually divided into two categories: (1) ``Mass
care'' shelters, which serve the general population, and (2) ``special
needs'' or ``medical'' shelters, which provide a heightened level of
medical care for people who are medically fragile. Special needs and
medical shelters are intended to house people who require the type and
level of medical care that would ordinarily be provided by trained
medical personnel in a nursing home or hospital.''\8\
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\8\ https://www.ada.gov/pcatoolkit/chap7shelterprog.htm.
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dhs office for civil rights and civil liberties (crcl)
``Under Federal civil rights laws, sheltering services and
facilities must be accessible to children and adults with disabilities.
Sheltering and temporary housing of persons with disabilities must take
place in the most integrated setting appropriate to the needs of the
person, which in most cases is the same setting people without
disabilities enjoy. See, Guidance on Planning for Integration of
Functional Needs Support Services in General Population. The intent of
this Federal guidance is to ensure that individuals are provided
appropriate accommodations and are not turned away or moved from
general population shelters and temporary housing or inappropriately
placed in other, more restrictive, environments (e.g., ``special
needs'' shelters, institutions, nursing homes, and hotels and motels
disconnected from other support services).''\9\
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\9\ https://www.dhs.gov/sites/default/files/publications/notice-
nondiscrimination-during-disasters.pdf.
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fema
1. ``Segregating children and adults with and without disabilities
who have access or functional needs and those with whom they
are associated from general population shelters to ``special
needs'' shelters is ineffective in achieving equitable program
access and violates Federal law. People with disabilities are
entitled by law to equal opportunity to participate in
programs, services, and activities in the most integrated
setting appropriate to the needs of the individual.
Additionally, children and adults with and without disabilities
who have access and functional needs should not be sheltered
separately from their families, friends, and/or caregivers
because services they require are not available to them in
general population shelters.''\10\
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\10\ https://www.fema.gov/media-library-data/20130726-1831-25045-
7316/fnss_guidance.pdf.
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2. ``Providers must be aware that they may fall into more than one
category of provider. For example, a State agency that receives
Federal financial assistance must comply with laws that apply
to Federal financial assistance recipients as well as to laws
that apply to State and local governments. Non-profit
organizations that receive Federal financial assistance to
provide food, clothing, shelter, or transportation in
connection with an emergency must comply with obligations
applicable to recipients of such assistance as well as
requirements generally applicable to nonprofit organizations
that provide services to the public.''\11\
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\11\ https://www.fema.gov/media-library-data/20130726-1617-20490-
6430/section689refer- enceguide.pdf.
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Despite this, the U.S. Department of Health and Human Services
Centers for Medicare and Medicaid repeatedly issue waivers to States in
``Public Health Emergency Declarations'' which allow States to place
individuals with disabilities directly into nursing homes from their
own home or from hospital beds to make room for others who may need
that bed, regardless of the needs of the individual for nursing home
level care. This is in direct violation of the Americans with
Disabilities Act and the Rehabilitation Act.
These waivers typically allow:
waiver of the 3-day hospitalization requirement before
eligibility for nursing home admission, because of ``shelter
needs'' not the needs of the individual.
permission to move acute care hospital patients to nursing
homes based on the needs of other patients, not their own level
of care needs
placement of individuals who ``need skilled nursing care as
a result of the emergency'', without any defining criteria to
protect the civil rights of eligible disaster-impacted
individuals with disabilities.
The Partnership filed a complaint with the Department of Justice,
Department of Homeland Security, Department of Health and Human
Services, and FEMA in September 2018. We were granted a ``listening
session'' in November 2018. There has been no further action taken to
address this conflicting guidance to States, and as recently as last
week, another waiver was issued to Louisiana allowing nursing home
placement of disaster-impacted people.\12\
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\12\ https://www.hhs.gov/about/news/2019/07/12/azar-declares-
public-health-emergency-louisiana-tropical-storm-barry.html.
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Regardless of the Federal agency ultimately responsible for
ensuring the rights of people with disabilities in disasters, at the
heart of these violations of the rights of people with disabilities is
a total failure on the part of FEMA to have its Congressionally-
mandated Disability Coordinator implementing her responsibilities as
defined in the Post-Katrina Emergency Management Reform Act of 2006.
These responsibilities include:
ensuring that the needs of individuals with disabilities are
being properly addressed in emergency preparedness and disaster
relief;
consulting with organizations that represent the interests
and rights of individuals with disabilities about the needs of
individuals with disabilities in emergency planning
requirements and relief efforts in the event of a natural
disaster, act of terrorism, or other man-made disaster;
ensuring the development of training materials and a
curriculum for training of emergency response providers, State,
local, and Tribal government officials, and others on the needs
of individuals with disabilities;
ensuring the availability of accessible transportation
options for individuals with disabilities in the event of an
evacuation;
ensure that the rights and wishes of individuals with
disabilities regarding post-evacuation residency and relocation
are respected.
The Partnership and our member organizations have continually
attempted, since she first assumed her position in 2017 to consult with
and collaborate with the FEMA Disability Coordinator, without success.
We are the Nation's organizations that represent the interests and
rights of individuals with disabilities about the needs of individuals
with disabilities in emergency planning requirements and relief efforts
in the event of a natural disaster, act of terrorism, or other man-made
disaster. The Disability Coordinator has also stopped the FEMA
Individual Assistance Directorate from collaborating with us, and it
wasn't until Senator Casey reached out to FEMA that we were granted an
invitation to meet with FEMA senior leadership. This meeting requested
by one of our community leaders 3 months ago has not yet been
scheduled.
We have heard from many of the FEMA Disability Integration staff
that they have been directed not to speak with us, and disability
leaders in disaster-impacted communities report a continual lack of
local presence of FEMA-qualified disability integration cadre
representatives. We have also been told that the Cadre has been
discontinued and most of the trained and qualified disability experts
have left the agency. Over a year ago, we were told by the Disability
Coordinator that FEMA would be hiring Disability Integration
Specialists in every State and training the entire agency to ensure
qualified disability integration experts would be ensuring the rights
of disaster-impacted people with disabilities would be protected by
FEMA. However, it appears that only one Disability Coordinator has been
hired in TX, existing training has been discontinued, and a contract to
develop new training has not yet been awarded. Further, at least one of
the Regional Disability Specialist positions, Region IV, remains
unfilled after an 18-month vacancy--a region that has sustained
repeated disasters over the past 2 years.
In its May 24, 2019 report to President Trump, Preserving Our
Freedom: Ending Institutionalization of People with Disabilities During
and After Disasters the National Council on Disability made the
following recommendations:
The Department of Justice (DOJ), the Department of Health
and Human Services (HHS), the Department of Homeland Security
(DHS), and the Department of Housing and Urban Development
(HUD) monitor and enforce the Americans with Disabilities Act
(ADA) Olmstead integration mandate and the Rehabilitation Act
obligation to use Federal funds in such a way that people are
served in the most integrated setting appropriate to their
needs.
All relevant Federal agencies engage with National, State,
and local coalitions of disability-led organizations and
stakeholders.
DOJ assesses the equal access and non-discrimination civil
rights compliance performance of the American Red Cross and
other shelter and mass-care providers in relation to actions
resulting in institutionalization of disaster survivors with
disabilities.
The Federal Emergency Management Agency (FEMA) explore ways
to expeditiously modify its Individual Assistance registration
process to curtail the incidence of institutionalization of
individuals with disabilities.
DHS/FEMA and HHS/Administration for Community Living (ACL)
provide grant funds to support Independent Living Centers in
supporting disaster-impacted people with disabilities in their
community. (This funding should incorporate all 5 core services
of Independent Living Centers, including their obligation to
prevent and divert institutionalization of disaster-impacted
people throughout disaster response and recovery.)
Relevant Federal agencies integrate disaster-related
services for veterans with disabilities with all other
emergency and disaster services in order to address the current
gap in coordination.
Legislation be introduced and swiftly enacted to address all
gaps in meeting the civil rights obligations to people with
disabilities impacted by disasters.
In June 2019, the Government Accountability Office (GAO) released a
report entitled, FEMA Action Needed to Better Support Individuals Who
are Older or Have Disabilities.
The GAO report was requested by a bipartisan and bicameral group of
17 Congressional committee leaders to evaluate FEMA's disaster
assistance for older Americans and individuals with disabilities.
The findings detail what the Partnership has attempted to address
with FEMA since Hurricane Harvey made landfall in August 2017. Among
these are FEMA's system-wide failure to ensure disaster-impacted people
with disabilities and older adults are provided with equal access to
FEMA assistance programs and critical needs services, such as food,
water, and health care in the 2017 hurricanes.
The GAO findings also evaluate the 2018 restructuring of the FEMA
Office of Disability Integration and Coordination (ODIC), which further
dismantled critical supports to disaster-impacted people with access
and functional needs, and the communities and responders serving them,
without developing, implementing, or communicating a replacement plan.
The GAO report provides recommended actions and an agreed time
line, stretching over a year into 2020, for FEMA to implement.
However, these plans are hollow due to the continued silence toward
disability community leaders and key stakeholders from FEMA's Office of
Disability Integration and Coordination, the Individual Assistance
Division, and FEMA's Administrator.
Immediately after the GAO report was released, two bipartisan,
bicameral bills were introduced by Senator Robert Casey, Senator Susan
Collins, Congressman James Langevin, Congressman Chris Smith,
Congresswoman Donna Shalala, and Congresswoman Jenniffer Gonzalez-Colon
to address the urgent need to protect every citizen by meeting the
Federal Government's obligations to underserved and multiply
marginalized people with disabilities, older adults, and people who
also have access and functional needs.
The Real Emergency Access for Aging and Disability Inclusion for
Disasters Act (REAADI) S-1755 and HR-3208 and the Disaster Relief
Medicaid Act (DRMA) S-1754 and HR-3215 will work together to provide
solutions that help individuals maintain their health, safety, and
independence before, during, and after disasters by:
Funding research;
Developing and delivering technical assistance and training;
Creating a National commission with people with
disabilities, older adults, experts on disability inclusive
emergency management and Government and community stakeholders
to provide guidance on disability and aging issues before,
during, and after disasters;
Providing uninterrupted access to Medicaid services when
recipients must evacuate across State lines;
Department of Justice review of ADA non-compliance
settlement agreements in preparedness, response, and recovery
efforts;
Government Accountability review of Federal funds expended
in disasters to ensure compliance with Rehabilitation Act
requirements.
We call on Congress to quickly enact these bills into law before
the next disaster strikes.
Despite years of planning, people with disabilities and older
adults continue to pay the price for our collective emergency planning
shortfalls. Many are still without the basic necessities to meet their
independence, safety, and health maintenance needs. Many more have been
denied their basic right to equal access to Federally-funded emergency
programs and services.
The people most knowledgeable about the needs of the people in
their own community are expected to volunteer their time, while
Government and the disaster business giants get grants, donations, and
tax-payer dollars to perpetuate strategies long proven to be bad for
individuals and just as bad for communities.
The time to monitor and enforce the laws is overdue and effective
practices for whole community inclusion must be led by experts in
disability and aging inclusive emergency management.
It's time to stop admiring the problems. It's just not an option to
fail again. The Partnership for Inclusive Disaster Strategies remains
fully committed to working collaboratively with FEMA, DHS, HHS, and our
Government to ensure that the rights and disaster-related needs of the
61 million Americans with disabilities, over 50 million older adults,
and countless others who also have access and functional needs are no
longer denied. Until we all join forces and work together--led by those
of us with lived experience--our families, neighbors, and communities
remain in harm's way as soon as the next flood, fire, tornado,
hurricane, earthquake, terrorist attack, or other disaster strikes.
The Partnership and our allies from across the country are looking
to Congress for your leadership and appreciate the opportunity to speak
with you today.
Mr. Payne. The Chair now, in the interest of time, the
gentleman from New Jersey--the Chair will defer and recognize
the gentleman from New Jersey, Mr. Pascrell, for questions.
Mr. Pascrell. Thank you, Mr. Chairman, for that courtesy.
Just good to be at Saint Peter's, a Jesuit institution.
Having gone to Fordham myself, across the river, this is a good
place to learn, and this is a good place to a hearing like
this. They go together very nicely.
I am very, very concerned and have been particularly the
last few years, Ms. Curda, of FEMA. On the Ways and Means
Committee, we look at these budgets very, very carefully and
what they ask for. You are the spokesman for FEMA today. I am
not here to beat up on FEMA.
But the GAO did a report very specific to what you talk
about, what you did talk about in a very, very reasonable way,
I thought. But my concern is we see a pattern here, I see a
pattern, and I want to ask you a very simple question at the
beginning. Does FEMA have the resources that can address the
very problems we are talking about today?
Of course, the GAO has some questions about that.
Ms. Curda. Yes, we did not analyze whether they have an
appropriate amount of resources. However, they do have a large
deployable staff of people that could be sent out following
hurricanes and disasters. They have this sort of new vision,
which involves training all the staff to have disability
competency and to be able to help people following disasters.
However, they haven't established training for those people
yet, and so it is a little unclear to us how those deployed
resources are going to be put to effective use.
Mr. Pascrell. Well, we need people to do the very thing we
are talking about here today. You don't have the people, you
don't have the resources. There are so many vacancies that have
not been filled. It reminds me of the rest of the
administration.
So I know in a dictatorship, you have very few people to
worry about in the administration because there is only one
person making all the decisions. We are a democracy. So we need
input.
You have heard from each of the people here today--in fact,
I go to Major Bucchere in his statement, which says it all.
Most importantly, he wrote and presented to us, we learned
about the significant challenges faced by some of our more
vulnerable residents, but we also learned how to incorporate
their experience, their expertise into the planning process.
I think that is a profound statement. After my many years
in the Congress, I didn't see too many profound statements. So
in other words, you are going to the very people who have the
problems maybe, which we all do, by the way. But we are talking
about particular problems here. We are asking them in our
planning to protect them and provide safety. What do you think?
What should be done? What didn't you have?
I don't see that in FEMA. Maybe I could be enlightened, or
maybe we should be listening to these people there and be
enlightened, hopefully. Because that GAO report is not a good
one. You know which one I am talking about?
You don't accept that as the end product, then in other
words, we have got--we can rest on whatever laurels we have.
You don't believe that, do you?
Ms. Curda. I am sorry. What is the question?
Mr. Pascrell. You don't rest on the laurels of what has
happened. You see the problem just as the GAO made a report
about FEMA.
Ms. Curda. Yes.
Mr. Pascrell. We have had more hurricanes. We have had more
natural disasters. It seems to me I see very little improvement
in FEMA, to be very honest with you. I fought for every dollar
for FEMA because I think it is necessary. But if the
administration, whatever that administration may be and
whenever it does exist, if they are not cooperating with us, if
they are not cooperating with you and the folks that are here,
what the heck--you know, what are we doing, you know? We are
massaging each other.
We are talking about serious business here, Mr. Chairman,
and this hearing today----
Mr. Payne. I recognize the gentleman for another 3 minutes.
Mr. Pascrell. This problem today that we see is not going--
you know, is not going to go away. So the Disability
Integration and Coordination Office, can you recount how are
special needs populations informed about transportation and
shelter resources in an emergency evacuation?
Ms. Curda. Those--the responsibility for the first response
following a disaster rests primarily with State and local
responders, such as the folks at the table.
Mr. Pascrell. I am sorry?
Ms. Curda. The responsibility for initial response
following a hurricane rests primarily with the State and local
providers, such as those here at the table.
Mr. Pascrell. Then I will ask the Major then. Because you
do have some responsibility according to the mission of FEMA.
Let me ask the Major that same question.
Major Bucchere. So one of the main ways that we connect
with the DAFN population is through technology, and we have NJ
Transit has a link right to our Register Ready platform, and we
can help provide, you know, access points, transportation, et
cetera, for the vulnerable populations in an evacuation.
Mr. Pascrell. Do you communicate with FEMA?
Major Bucchere. Yes.
Mr. Pascrell. Are they cooperative?
Major Bucchere. Yes.
Mr. Pascrell. Let me ask the next question. What would you
suggest to help what we are talking about today, facilitate
what we want to do, what the Chairman is anxious to do and has
been working on day-in and day-out because he is an official
Member of Homeland Security?
I am not there anymore. What would you suggest?
Major Bucchere. Certainly any resources by way of financial
help that we can get would be beneficial. When you talk about
FEMA staff being trained in a wide variety of areas, as opposed
to subject-matter expertise in dealing with these vulnerable
populations, you are asking a lot of that staff person in a
disaster.
In addition to that, you know, FEMA has historically been
very good at sending surge staff in after a disaster and
staying on-board for a period of time. But what we see is that
FEMA is very transient, and they come, they help for a while,
and then they move on to the next disaster. With that movement
causes an interpretation--you know, various interpretations in
rules, policy. It creates hurdles at the State, county, and
local levels.
So we would like not only additional training for FEMA
staff on subject-matter expertise to help these populations,
but embedded personnel to stay with the States and territories
through a disaster to have consistency in interpretation of
policy.
Mr. Pascrell. We have had under Republican and Democratic
administrations very excellent Directors for the most part. We
had some problems back at Katrina, but that is yesterday. This
is today.
I have asked on my own, Mr. Chairman, and I will conclude
with this, 20 Congressman at random--Democrats, Republicans--
only one was able to even tell me who the head of FEMA is now.
I yield. Thank you, Mr. Chairman.
Ms. Payne. Thank you, Mr. Pascrell. That is a tough
question. I might have to think about that myself who the head
of FEMA is these days.
But I would like to thank the gentleman for his questions.
I will now move on to questions myself. I recognize myself.
Ms. Curda, in the 2017 storms, FEMA sent an average of 55
disability integration advisers to help with the response and
recovery after the disaster. Now they start with an average of
5 whose leadership--who advise the leadership rather than go
out into the field. Can you describe FEMA's rationale for this
change, this drastic, dramatic change?
Ms. Curda. All I can say is that what they have articulated
to us is their view that rather than having specialized people
in the field, they believe that they can serve more people if
they have trained everybody, all deployable staff and all
program staff in disability competency. That is what they have
told us is their vision for this change.
Mr. Payne. But I mean going from 55 to 5 seems dramatic at
best, drastic. Such a change, I mean, how are you able to
sustain the same type of support with that dramatic a change in
staffing?
Ms. Curda. It is still unclear to us how that will--how
effective that will be. We looked at the 2017 hurricanes and
the response, and we did identify a lot of problems with the
response and made 7 recommendations to FEMA to improve how they
do this. But, so we have not yet evaluated how this new model
is working.
Mr. Payne. I would urge you to definitely try to focus on
that and come up with some type of response to that, please.
Ms. Roth, any comment you would like to make with respect
to this?
Ms. Roth. One of FEMA's biggest challenges began to be
addressed a number of years ago by developing a qualification
system to ensure that the folks who were being deployed by the
Federal Government have the qualifications necessary to meet
certain responsibilities. One of the Federal Government's
primary responsibilities is to make sure that every Federal
dollar that is either spent by the Federal Government or given
to others to spend complies with civil rights obligations.
The responsibility that FEMA has is to make sure that
qualified people are doing what's necessary to make sure that
the protections of people with disabilities are assured
throughout disasters. It is very difficult to understand how a
generalized work force who doesn't have qualifications in the
very things that FEMA set out to develop qualifications for
could possibly meet those obligations.
We are talking about investments of billions of dollars
that every dollar must comply with those obligations, and yet
unqualified people are now dealing with life and death, life-
saving, life-sustaining, and the futures of 26 percent of the
population, people with disabilities.
Mr. Payne. And every dollar, well, good luck with that.
Major Bucchere, we have heard reports that the process to
apply for FEMA aid is confusing and cumbersome and creates
unnecessary hurdles for low-income individuals. Many simply
give up before making it through the entire process.
After Sandy, did you hear from survivors that the process
to apply for housing assistance was too onerous, and how would
you recommend simplifying that process?
Major Bucchere. Yes, Mr. Chairman. I certainly would say it
is onerous. It is cumbersome. In dealing with it at the State
level, as an example, we are dealing with IT issues right now
and FEMA rolling out new IT programs that aren't compatible
with our own. So we are doing twice the work.
So now imagine you are in a disaster. You have lost
everything, and now you are trying to navigate a system, and
you are a low-income individual. So it is very tough.
One of the things that we would like to see FEMA take a
look at in general is the individual assistance award amount.
When you are talking about an individual assistance award of
$34,900 with no cost-of-living adjustment, it is tough. Here in
the Northeast, it is clearly more expensive to live here than
it is in other areas of the country.
We would also like FEMA to take a look at separating out
renters, you know, the cost of rent from this award. Because
you have individuals that are spending every last dollar of an
award on rent and don't have the necessities that they need,
like simple things like food and clothing.
You know, some of the other things that we would like to
see, we would like FEMA to move ideally to a one-stop shopping
experience. When you have multiple Federal programs, you have
low-income individuals, it is tough to navigate the process. We
would like to see us come to a day when an individual can come,
log on, enter their personal information, and have that system
tell them exactly what they are eligible for.
We understand there are challenges. These people have to be
able to get to a computer. They have to be able to navigate the
process. We have taken steps at our level, at the State level.
We have a State library initiative where we are pushing out
information, working with the State library on personal
preparedness, educating them on the programs that are available
to our most vulnerable residents. They, in turn, are working
with the county and local libraries to be a resource for that
population where those individuals can come in, work with the
library staff and navigate that tough, onerous system.
We also think that there should be an agreement and
deadlines for these programs. Quite often, you have the SBA
come in early on to offer loans and then are gone. You have
people that are waiting to see what aid is available to them.
Do they, do they not have insurance? Are they getting an
insurance award? Then SBA has come and gone.
We would also like to see the SBA move to offer micro loans
to low-income individuals to just help them rapidly get back on
their feet.
Mr. Payne. You know, that is interesting you mention the
availability of a one-stop type situation, and so you are
saying that you work with the libraries in order to provide a
portal for these individuals to come, or maybe even that would
be a good idea for maybe in these circumstances to have FEMA
set up a place where people can go to access the computer for
that service?
Major Bucchere. Yes. This is a multi-pronged initiative.
Certainly in the recovery phase, we would leverage that
relationship with the State library who, again, then connects
with the county and local libraries. We work with them on
everything from individual preparedness to recovery on the back
end.
What we are hoping is that, you know, those who may not
have a computer--maybe they only have a cell phone. You can
imagine navigating an application through a cell phone is not
that easy. We would hope that they would make that trip to the
library, right to the public library, and that connection that
we are making--State, county, local--you know, that
relationship building would ultimately benefit our residents.
Mr. Payne. Thank you.
Does the gentleman have another question he would like to
pose before----
Mr. Pascrell. No, I am good. Thank you.
Mr. Payne. You are good. OK. Let me ask Ms. Boyd, after
Sandy, can you discuss the benefits in New Jersey of having
FEMA's disability integration advisers on the ground-assisting
disaster survivors?
Ms. Boyd. Sure. When Sandy hit in October 2012, my
recollection is that the disability integration adviser program
was fairly new at that time, and I was in the role then as
chair of NJ GAINED, and I was able to interact with a small
group of disability integration advisers and specialists who
assisted New Jersey by working in the field, securing durable
medical equipment, and sharing information and resources.
They also, for example, aided individuals and groups at
senior living facilities when power was out and supplies were
needed in other high-rise buildings and ultimately went on to
work with the long-term recovery groups.
One of the individuals at that time who worked with me was
already familiar with a lot of the projects we had and our
partners because he attended the NJ GAINED meetings and kept in
contact with me as different projects arose and still does to
this day.
We continue to partner on various projects with both the
disability integration specialists and adviser from FEMA Region
2. They have been helpful in pulling in other staff from FEMA,
including the VAL, members of FEMA FIT, and others when we have
needs or questions.
The one concern I had at the time was that some of the
folks that were deployed were unfamiliar with the resources. So
that is why I have worked very hard to maintain a close
relationship with the staff that is currently working within
the region, and they have partnered with me and other
stakeholders to providing trainings to NJ GAINED members and
other groups, especially the core advisory groups and the
county AFN coordinators, and are currently working on a
presentation and a toolkit to help the counties that are
currently working on setting up CAGs better understand what
that process is.
Then they will work with me to provide briefings to those
who are spearheading the CAGs to get them off the ground and
really brainstorm about the issues that need to be addressed. I
also support the hiring of--for more funding so that folks can
be hired at the local level to support emergency management,
especially the vulnerable populations who might be affected by
local emergencies and rely on the staff that is there before
FEMA can get out to assist.
Mr. Payne. Let us see, Ms. Roth, as a former head of the
Office of Disability Integration and Coordination, what are
your thoughts on FEMA's outreach to advocacy groups such as
yours in the wake of a disaster, and are they effectively
leveraging the help of nonprofits to improve their response?
Ms. Roth. The Partnership for Inclusive Disaster Strategies
is a coalition of virtually all of the disability organizations
across the country who focus on these issues. The partnership
itself is an organization that focuses exclusively on
disability and disasters before, during, and after disasters.
We have been trying since 2017 to continue working with
FEMA's Office of Disability Integration and Coordination, and
unfortunately, we have not been successful in that. We have had
a couple of invitations. We have had a couple of opportunities
for the disability coordinator to speak to groups, but we have
had no opportunities for collaboration.
In fact, on a regular basis, I hear from FEMA employees
that they have been specifically told not to work with the
disability organizations. This is a tremendous missed
opportunity. Our members have a footprint in virtually every
community in the country. We have the ability to support local
organizations immediately after disasters.
When disability integration advisers have worked with us
until they have been told not to continue to work with us,
together we have been very successful in meeting urgent and
immediate needs of people who are counting on us the most to
get this right.
Mr. Payne. Thank you. That is very troubling to hear.
Ms. Roth. Yes.
Mr. Payne. For there to be some type of discouragement in
working with organizations that are on the ground, doing the
work, and have the information and can be a vital resource in
moving these efforts forward, it just baffles me. But what is
new with this organization? Just troubling.
But let me thank the witnesses for their valuable testimony
and the Members for their questions. The Members of the
subcommittee may have additional questions for the witnesses,
and we ask that you respond expeditiously in writing to those
questions.
Pursuant to Committee Rule VII(D), the hearing record will
be open for 10 days. Without objection.
Hearing no further business, this subcommittee is in
recess.
[Recess.]
Mr. Payne. I welcome our second panel of witnesses.
Unfortunately, Mr. Dorian Herrell, who is the director of the
Emergency Management and Homeland Security for the city of
Newark, cannot be with us today. There was extensive flooding
in the city of Newark last night, and he is attending to that
emergency.
So I think this hearing is very timely. Next we have Mr.
Luke Koppisch, who is the deputy director for the Alliance
Center for Independence. Last, we have Dr. Laurence Flint, who
is a representative of the New Jersey Chapter of the American
Academy of Pediatrics and serves on the disaster preparedness
committee for the organization.
Without objection, the witnesses' full statements will be
inserted in the record. I now ask each of the witnesses to
summarize his or her statement for 5 minutes, beginning with
Mr. Koppisch.
STATEMENT OF LUKE KOPPISCH, DEPUTY DIRECTOR, ALLIANCE CENTER
FOR INDEPENDENCE
Mr. Koppisch. Hello, and thank you for inviting me to
testify at this important hearing.
Thank you to Chairman Payne and Congressman Pascrell for
bringing attention to this important topic.
My name is Luke Koppisch. I am the deputy director of the
Alliance Center for Independence. We are located in Edison, New
Jersey, and we are a center for independent living. We are a
503(c) nonprofit organization, and we serve Union, Middlesex,
and Somerset Counties in New Jersey.
The Alliance Center for Independence believes that
emergency preparedness for people with disabilities is a civil
rights issue. But we began working on emergency preparedness
since 2011 during Hurricane Irene. Since then, we have trained
over 700 people with disabilities on emergency preparedness and
disaster, organized 2 mock shelter exercises with people with
disabilities as well as emergency planners. We have presented
at many conferences and conducted many trainings to emergency
planners, people with disabilities, parents, and other people
involved with disasters and disability.
ACI first formed the core advisory group along with FEMA
and has been working with emergency managers as well as FEMA,
as well as New Jersey VOAD, and the American Red Cross.
ACI really encourages people to take responsibility for
their own emergency planning. We teach individuals with
disabilities how to prepare, how to communicate with emergency
managers, as well as how to put emergency preparedness plans
into place before a disaster hits. We also train people on
preparing go bags and really to shelter in place, if that is
something that is an option for people.
During Superstorm Sandy, we were called into action to
provide assistance to people with disabilities, survivors of
the storm in our catchment area. Our staff worked and called
3,000 consumers of ours and offered assistance, and the
assistance ranged from financial assistance to where they go
for help with FEMA, to who to call to get durable medical
equipment.
We also volunteered our time to help with Portlight
Inclusive Disaster Strategies to operate a hotline for
survivors of Hurricane Harvey 2 years ago. So we have a lot of
experience.
This work that we do is extremely important because 54
million people in the United States have a disability,
including 3 million children. Sixty-one percent of people with
disabilities have not made a plan to quickly and safely
evacuate their homes. Only 24 percent of people with
disabilities have made emergency plan preparations specific to
their disability.
Two-point-four million people with a disability have
medical equipment that require electricity. My power was out
last night. So I can see--you know, it is still out. So I can
see why this is such a huge need to get people prepared.
Currently, people with disabilities are 2 to 4 times more
likely than nondisabled people to be critically or fatally
injured during a disaster. These are all the reasons why our
communities need to be prepared.
Emergency preparation and response and recovery fall under
Title II and Title III of the Americans with Disabilities Act,
as well as the Rehab Act of 1973. To quote Paul Timmons,
president of Portlight Inclusive Disaster Strategies, ``Right
now, most planning occurs for people with disabilities and
older adults, not with us. Moving forward, we need to ensure
that there is substantial leadership and participation of
people with disabilities during emergency planning.''
That is really what our focus has been, our work has been.
So I just want to go through some of the recommendations that
we have through our work in our office. Some of the things that
emergency planners need to consider is evacuation and training
procedures that include people with physical, sensory, or
intellectual disabilities, or who are autistic or experience
anxiety or other mental health concerns.
Accessible transportation to evacuate older persons and
people with disabilities. We have met with New Jersey Transit
and suggested that their Access Link service, their main ADA
transportation service for people with disabilities, that that
service be available during a disaster. We have general
population shelters are ready to accommodate people with
disabilities and provide those services for people with
disabilities that allow them to get those services in their
shelter rather than going into a segregated, more costly
shelter. Special needs shelter is not something that we would
advocate for.
The other thing that we recommend is that planners utilize
independent living centers like ours. We provide lots of
different services. We are in touch with our constituents. We
could provide counseling services. We can help alleviate social
isolation. We could help fill out paperwork FEMA requires. We
could set up hotlines. So we could be a resource.
We also want to increase the number of accessible emergency
shelters, accessible meaning accessible bathrooms staffed by
trained personnel, staffed by personal assistants. Accessible
meals. A lot of MREs are not accessible for people with
disabilities. Accessible communications. The list goes on.
Mr. Payne. Please finalize.
Mr. Koppisch. Really, we have other recommendations that
are in my testimony, but I think there needs to be a close
working relationship with American Red Cross and FEMA and other
organizations involved with disaster preparation.
Mr. Payne. Thank you very much.
Mr. Koppisch. Thank you.
[The prepared statement of Mr. Koppisch follows:]
Prepared Statement of Luke Koppisch
July 23, 2019
Hello and thank you for inviting me to testify at this important
hearing. Thank you to Congressman Payne for bringing attention to this
important topic. My name is Luke Koppisch, I am the deputy director of
the Alliance Center for Independence, a 501(C)3 organization located in
Edison, NJ. ACI is one of 11 Centers for Independent Living in NJ and
over 400 throughout the United States. ACI extends an open invitation
to visit our Center.
The Alliance Center for Independence (ACI) began working on
preparedness efforts during Hurricane Irene in 2011. Since then we have
trained over 700 people with disabilities on disaster/emergency
preparedness, organized 2 overnight emergency shelter simulations with
people with disabilities and emergency managers and have presented at
many conferences and webinars including 2 FEMA webinars. We also
trained 100's of emergency managers and first responders on disability
etiquette and assisting people with disabilities during a disaster. ACI
formed the first Core Advisory Group (CAG) in NJ and have worked
closely with emergency managers, FEMA, VOAD and the Red Cross. ACI
encourages people to take personal responsibility during an emergency.
We teach individuals with disabilities how to prepare, work with
emergency managers in their communities, how to put a communication
plan in place, create a Go Bag and to be ready to shelter in place.
During Super Storm Sandy we were called to action providing
guidance and assistance to survivors with disabilities in our catchment
area of Middlesex, Somerset, and Union counties in New Jersey. Our
staff contacted 3,000 of our consumers and offer assistance. ACI staff
volunteered their time to assist in operating a hotline set up by
Portlight Inclusive Disaster Strategies, Inc. to assist survivors of
Hurricane Harvey 2 years ago.
Our work is important because:
54 million people in the United States have a disability,
including 3 million children with a disability.
61 percent of people with disabilities have not made plans
to quickly and safely evacuate their homes.
Only 24 percent of people with disabilities made emergency
plan preparations specific to their disability.
2.4 million people with a disability have medical equipment
that require electricity.
Currently, people with disabilities are 2 to 4 times more
likely than non-disabled people to be critically or fatally
injured in a disaster. Our communities need to be ready in a
disaster.
Emergency Preparedness Response and Recovery fall under Title II
and Title III of the Americans with Disabilities Act as well the
Rehabilitation Act of 1973.
According to Paul Timmons, President of Portlight Inclusive
Disaster Strategies (PIDS), ``Right now, most planning occurs `FOR'
people with disabilities and older adults, not `WITH' us. Moving
forward we need to ensure there is substantial leadership and
participation during emergency planning.''
To truly include Americans with disabilities, we recommend that
emergency planners and others involved in disaster preparedness,
implement the following:
Current practices for communicating and broadcasting
emergency warnings to the public are understood by persons with
hearing challenges;
Accessibility of all emergency response communications,
including 9-1-1 and 2-1-1;
Current evacuation and training procedures need to include
people who require mobility support, sensory disabilities,
intellectual disabilities, autism, anxiety and other mental
health concerns;
Trained personnel to implement plans that include people
with disabilities;
Current transportation is accessible to evacuate older
persons and those with disabilities (We have met with NJ
Transit and suggested that Access Link's NJ Transit ADA
Required Transportation Service be deployed during a disaster);
Transit personnel are trained to operate the vehicles and
their accessibility features during emergencies;
Access to food, water, medicine, and power;
Information is available in accessible formats, including
video with captioning, audio, and plain language formats;
General population shelters are ready to accommodate and
provide services to those with disabilities instead of sending
them unnecessarily to segregated and more costly ``special
needs'' or medical shelters;
Utilize Centers for Independent Living to provide various
services before during and after a natural disaster (these
could include counseling services, to alleviate social
isolation, filling out paperwork, setting up hotlines etc.);
Shelters are accessible and have trained personal
assistants, accessible showers and toilets, flexibility in
meals (MREs are not accessible for many people with
disabilities), and equal access to communication;
Equal access to emergency registries operated by State,
Federal, and nonprofit emergency programs;
Improve current response time from the Red Cross, Office of
Emergency Management and FEMA for critical and immediate needs
from public
Service animals are admitted to shelters under the ADA are
shall not be separated from their owners;
Health maintenance items/assistive technology stay with
those who use mobility and communication devices, sign language
interpreters, and personal assistants;
During Super Storm Sandy, there were 285 fatalities. According to
EPA nearly 50 percent of the deaths were elderly or had disabilities.
If implemented our recommendations will no doubt save lives in
future disasters. We hope that the pending REAADI for Disasters ACT
legislation will address our concerns.
Mr. Payne. I now recognize Dr. Flint to summarize his
statement for 5 minutes.
STATEMENT OF LAURENCE FLINT, M.D., NEW JERSEY CHAPTER
REPRESENTATIVE, AMERICAN ACADEMY OF PEDIATRICS (AAP) DISASTER
PREPAREDNESS COMMITTEE
Dr. Flint. Chairman Payne, it is an honor to appear before
you today at this important meeting to speak about the impact
of disasters on children.
As noted, Laurence Flint. I am certified, a board-certified
pediatrician working in hospital in New Jersey, both in general
pediatrics and disaster medicine, and have served as the State
representative to the American Academy of Pediatrics Disaster
Preparedness committee since 2016.
Children make up 25 percent of the U.S. population and have
unique medical and psychological needs. Although they fall
under the umbrella category of ``vulnerable'' populations, they
deserve attention that is customized to meet their specific
needs. By considering which groups are at increased risk in a
specific disaster, including those with disabilities, chronic
illnesses, or who are economically or socially disadvantaged,
advanced planning benefits all children.
Children differ from adults in their physiology, behavior,
emotional and developmental capacities, in their responses to
traumatic events, and they are dependent on others for their
basic physical and emotional needs. They are more susceptible
to physical, biological, chemical hazards and are at an
increased risk of developmental problems as well.
Children often lack the cognitive ability to flee from
disaster or to comprehend risk. Infants and young children
cannot care for themselves and require access to age-
appropriate foods, including human milk or infant formula, as
well as assistance in feeding, hygiene, and dressing.
Security is a high priority, as children are much more
susceptible to physical, emotional, and sexual abuse in the
wake of disasters, particularly when they are separated from
their families. Disasters not only put more stress on
individuals caring for their children, but they also bring out
criminal opportunists who use the cover of a disaster to prey
on the most vulnerable, including our children.
After a disaster, children and their families are likely to
experience a host of negative mental reactions, including
stress, depression, anxiety, PTSD, behavioral regression,
physical symptoms, and the worsening of preexisting conditions.
Children are among those most at risk for psychological trauma
and behavioral difficulties after a disaster.
Research has repeatedly confirmed that psychologically
traumatic events in childhood can have significant life-long
effects, such as increases in chronic disease and poor coping
abilities. Children's limited ability to understand the nature
of the disaster can also lead to stress, fear, anxiety, and an
inability to cope, as well as an exaggerated response to media
exposure. This is far worse in the age of social media.
It is important then to have established, trusted sources
of information for families and communities. Pediatricians and
other health professionals can help fill those roles.
Partnering in advance of disasters is essential to optimizing
community mental health. Psychological recovery is a multi-
tiered process that begins with providing for the basic
physical needs and the provision of psychological first aid
and, later, more comprehensive counseling and mental health
resources to support children in their communities.
Attention to the needs of children in disasters encompasses
a continuum of pre-disaster preparation, delivery of care and
services during a disaster, and follow-up services in the
disaster recovery period. Appropriate medical equipment,
supplies, and medication specific to children of various ages
and sizes should be readily available, as should medical and
mental health providers with some degree of training in
disaster-related concepts.
Disaster preparation extends to all places that work with
children, including schools, shelters, day cares, camps,
hospitals, and medical offices. In the daytime, children are
often separated from their caregivers, and processes for prompt
family reunification are a critical component as children
clearly do best when with their families.
Post-disaster care and assistance is necessary to the
effective resilience of children and their communities. The
American Academy of Pediatrics has been at the forefront of
addressing the needs of children in disasters through
partnering with and advising State, local, and Federal agencies
and by providing numerous resources to inform and educate
professionals, parents, children, and administrators on topics
including natural disasters, pandemics, economic emergencies,
and terror events.
The Disaster Preparedness Advisory Council has more than 80
contacts, including myself, in all AAP State chapters. Some of
the many collaborative efforts with Federal agencies include
the HHS Office of Assistant Secretary for Preparedness
Response, which is requiring pediatric annexes and is offering
funding for pediatric centers of excellence, and the CDC, which
has established its children's preparedness unit.
We believe that continuing to build pediatric capacity
within all areas of government and public health is crucial and
could be facilitated by connecting with the American Academy of
Pediatrics nationally and/or through its local chapters.
Increased inclusion of pediatric practitioners and groups
involved in disaster field care, such as disaster medical
assistance teams on the Federal level or State/urban search and
rescue teams, would enable directly meeting the needs of
children.
Finally, working toward centralized coordination and
implementation of programs can help maximize delivery of care
and standardizing of protocols and procedures on State and
Federal levels.
Thank you for the opportunity to testify on this critical
topic, and thank you for your leadership on this issue.
[The prepared statement of Dr. Flint follows:]
Prepared Statement of Laurence E. Flint, MD, FAAP
July 23, 2019
Chairman Payne, Ranking Member King, and Members of the
subcommittee, it is an honor to appear before you today at this
important hearing on the issue of emergency preparedness for
underserved populations and to speak to you about the impact of
disasters on children. I am Laurence Flint a practicing hospital-based
pediatrician here in NJ with board certification in both General
Pediatrics and Disaster Medicine and I have served as a State
representative to the American Academy of Pediatrics Disaster
Preparedness committee since 2016.
Children make up 25 percent of the U.S. population. They have
unique medical and psychological needs.\1\ Although they fall under the
umbrella category of ``at-risk'' or ``vulnerable'' populations,
children deserve attention that is customized to meet their specific
needs and these needs must be anticipated in the disaster planning
process. By carefully considering which groups of children may be at an
increased, or even highest, risk in a specific disaster, including
those with specialized or chronic health care needs or children who are
economically or socially disadvantaged, advanced planning will benefit
all children and the population at large.\2\ Children differ from
adults in their physiology, behavior, emotional, and developmental
capacities, in their responses to traumatic events and they are
dependent on others for their basic physical and emotional needs. They
are more susceptible to environmental dangers associated with disasters
including physical, biological, and chemical hazards. These put them at
increased risk of developmental problems as well. Children often lack
the cognitive ability to flee from hazards and have a very poor
comprehension of risk. Infants and young children cannot care for
themselves and require access to age-appropriate foods including human
milk/infant formula as well as assistance in feeding, personal hygiene,
and clothing themselves.\3\ Security is a high priority as children are
much more susceptible to physical, emotional, and sexual abuse in the
wake of disasters and particularly in the case of separation from their
families. Disasters not only put more stress on individuals tasked with
the care of their children, but they also bring out criminal
opportunists who use the cover of a disaster to prey on the most
vulnerable including our children.
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\1\ National Commission on Children and Disasters. 2010 Report to
the President and Congress. AHRQ Publication No. 10-M037. Rockville,
MD: Agency for Healthcare Research and Quality. October 2010.
\2\ American Academy of Pediatrics. The Youngest Victims: Disaster
Preparedness to Meet Children's Needs. Elk Grove Village, IL: American
Academy of Pediatrics; 2002.
\3\ Ensuring the Health of Children in Disasters, Disaster
Preparedness Advisory Council and Committee on Pediatric Emergency
Medicine, Pediatrics 2015;136;e1407.
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After a disaster, children and their families are likely to
experience a host of negative mental reactions including stress,
depression, anxiety, PTSD, behavioral regression, physical symptoms,
and worsening of preexisting conditions. Disasters also have the
potential to cause short-term and long-term effects on children's
psychological functioning, emotional adjustment, health, and
developmental trajectory of children, which even may have implications
for their health and psychological functioning in adulthood. As a
group, children are among those most at risk for psychological trauma
and behavioral difficulties after a disaster.\4\ Adverse childhood
experiences, or ACEs, have been a subject of intense study in the past
few years and the research in this area has repeated confirmed that
psychologically traumatic events experienced during childhood,
particularly sustained ones, have significant life-long effects such as
increases in chronic disease and poor coping abilities. Children's
limited ability to understand the nature of the disaster can also lead
to stress, fear, anxiety, inability to cope, and exaggerated response
to media exposure. This is worsened in the age of social media which
can convey gross misinformation and sensationalist hype. It is
important, therefore, that there be established trusted sources of
information for families and communities. Pediatricians and other
health professionals can help to fill those roles. Awareness of and
partnership between pediatricians and other sources of mental health
support are essential to optimizing community mental health. Ideally,
these partnerships should be established in advance of a disaster.
Psychological recovery is a multi-tiered process that begins with
providing for the basic needs of individuals affected by a disaster
including food, shelter, safety, supervision, communication, and
reunification with loved ones. With that should come the provision of
psychological first aid in the short-term and this includes providing
timely and accurate information, offering appropriate reassurance about
the future, giving practical strategies to facilitate coping with
distress, and helping people identify supports in their family and
useful resources in their communities. Later, more comprehensive
counseling and mental-health resources should be in place to support
children and their communities. It is important to note that children's
adjustment should not be expected before the restoration and
stabilization of the home, school, and community environments and
supports for children.\5\
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\4\ Providing Psychosocial Support to Children and Families in the
Aftermath of Disasters and Crises. DJ. Schonfeld, T. Demaria and the
Disaster Preparedness Advisory Council and Committee on Psychosocial
Aspects of Child and Family Health. Pediatrics 2015;136;e1120.
\5\ Ibid.
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Attention to the needs of children in disasters encompasses a
continuum of pre-disaster preparation, delivery of care and services
during a disaster and follow-up services to children and their families
in the disaster recovery period. It is necessary to have access to
appropriate medical equipment, supplies, and medications specific to
children of various ages and sizes and we need to ensure that medical
and mental health providers are available and have some degree of
training in disaster-related concepts. This extends to any facility and
their employees who work with children including schools, day cares,
camps, hospitals, and medical offices. Security needs are a major
concern in these locations and in any area that children may go to in a
disaster such as a shelter or hospital. In the daytime, children are
often separated from their caregivers while being at school and day
care, and it is critical to keep these children safe and accounted
while they are not in the care of their families. Processes for prompt
family reunification are a critical component as children clearly do
best when with their families. Post-disaster care and assistance is
necessary to the effective resilience and thriving of the children
individually and to their communities as a whole.
The American Academy of Pediatrics (AAP) has been at the forefront
of addressing the health and emotional needs of children in disasters
through partnering with and advising State, local, and Federal agencies
and by providing numerous resources to inform and educate
professionals, parents, children, and administrators across a broad
spectrum of topics including natural disasters, pandemics, economic
emergencies and terror events. The Disaster Preparedness Advisory
Council (DPAC) has more than 80 contacts including myself in all AAP
State chapters. Some of the other many collaborative efforts with
Federal agencies include the Department of Health and Human Services
(HHS) Office of Assistant Secretary for Preparedness & Response (ASPR)
which is requiring Pediatric Annexes and is offering funding for
Pediatric Centers of Excellence, and the Federal Emergency Management
Agency (FEMA) which has a National Children's Advisor. Additionally,
the AAP was very pleased that the Pandemic and All-Hazards Preparedness
and Advancing Innovation Act (PAHPAI) was signed into law last month.
This law focuses on the Nation's medical and public health preparedness
to respond to disasters and strengthens readiness and recovery efforts
including provisions to ensure children and adolescents are prioritized
before, during, and after disasters, reauthorize and expand the HHS
National Advisory Committee on Children and Disasters, and establish
the Children's Preparedness Unit (CPU) at the Centers for Disease
Control and Prevention (CDC) which serves as the agency's leading
source for children's needs in public health emergencies. The AAP
Children and Disasters website provides links to its partnership
efforts, the Academy's on-going disaster-related projects and many
resources to assist practitioners, parents and others.\6\
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\6\ https://www.aap.org/en-us/advocacy-and-policy/aap-health-
initiatives/Children-and-Disasters/Pages/default.aspx.
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The AAP believes that continuing to build pediatric capacity within
all areas of Government and within public health agencies is key to
better disaster preparedness for children. This can be facilitated by
connecting with the AAP nationally and/or its local chapters. Also a
greater engagement with, and inclusion of, pediatric practitioners in
groups involved in direct on-the-ground disaster relief such as Federal
Disaster Medical Assistance Teams (DMATs), Medical Reserve Corps (MRC),
or Urban Search and Rescue (USAR) teams would be useful in better
directly meeting the needs of children. Finally, working toward
centralized coordination and implementation of programs is also an
important step in maximizing delivery of care and standardizing
protocols and procedures on State and Federal levels. For example, here
in New Jersey we have over 600 school districts, all of which operate
independently by municipality which makes it more challenging to
implement programs on a State-wide basis.
Thank you for the opportunity to testify on this critical topic and
thank you for your leadership on this issue.
Mr. Payne. Thank you for your testimony.
Now I recognize myself for questioning.
Mr. Koppisch, can you discuss your collaboration and
relationship with the State and FEMA, and do you see room for
improvement? Or do you believe this is a model for other
States?
Mr. Koppisch. Yes. We have collaborated with FEMA over the
last several years. We work with the FEMA office, Jim Flemming,
who is the integration specialist there. He helped--we worked
with him to set up the first CAG, core advisory group, which is
really an effort of emergency planners and people that are
supposed to come together to really work on planning for the
next disaster. The idea is that is to include people with
disabilities in the planning process.
So FEMA, we work closely with FEMA on this effort. We have
worked with the Red Cross. We have worked with the Office on
Emergency Preparedness. I mentioned in my testimony about two
shelter simulations that we did, and those could not have been
done without the work of the Office of Emergency Management in
the counties that we had those mock exercises in.
So could we do more? There was a lot of work that we could
be doing to educate especially OEM about the accommodation and
the needs of people with disabilities in a shelter and in a
disaster in general. But the work is still going on, and we are
happy that we formed partnerships with these organizations. But
there is always work that needs to be done as far as
information sharing, as far as learning about, you know,
people's disabilities and what accommodations they need during
these disasters and even before disasters.
Mr. Payne. Thank you.
Dr. Flint, we are increasingly seeing children exhibiting
signs of mental health distress after disasters. In Florida
after Hurricane Michael, Puerto Rico after Hurricane Maria, and
elsewhere, children continue to suffer long after the storm
passes. Researchers also found that after Sandy, children with
damage to their homes were over 4 times as likely to be sad or
depressed and over twice as likely to have problems sleeping
compared to children from homes with no damage.
What do you think the Federal Government can do better to
alleviate this distress?
Dr. Flint. Thank you.
Clearly, the mental health component in children and
disasters is a big one, and it is one of the long-term issues
that needs to be addressed to be able to have these kids get
back into doing their normal routines.
As with anything in disaster planning, it is the idea of
that multi-tiered process of both planning and preparedness,
disaster response, and then post-disaster recovery. So the
mental health aspects would go across that spectrum as well.
So in terms of the planning process where we could use help
is identifying the people in the areas that would have
particular special needs, whether that be non-English speaking
or communities with different cultural. So those identification
of needs. Identification of providers and training of those
providers.
Also one of the things that personally I think is great is
bringing in training on disaster preparedness to kids
themselves. So things like the Teen CERT Program where children
are actually brought into--are trained in disaster response. I
think that is not only enriching the communities, but also
empowering those kids as well. Ultimately, you know, having
that ability is going to make them more resilient.
Then in terms of the disaster response itself, as I
mentioned in my testimony, the first part is providing the
basic needs. No amount of counseling or mental health care is
going to replace the security that is brought about by
providing families with safety, shelter, food, and other basic
physical needs that they need.
Secondary to that is to have providers that are trained in
psychological first aid, and that is the idea that these are
the first people that are going to be addressing mental health
concerns in a disaster situation. So those folks are going to
give people access to resources. They are going to give them
some reassurance. They are going to give them information on
the disaster itself so that they have a little more to work
with.
Then, finally, in the post-disaster phase is going to be
where the long-term counseling. So providing mental health
services across the spectrum, which can, as noted, go on for a
long ways. So I think that is where the help can be. Any of
those areas where you could be of assistance is going to impact
that.
Mr. Payne. So it would appear that--and I could be wrong--
that it would be very difficult to be prepared for the
psychological or the mental aspects of the trauma. Until trauma
happens, there is no real way to, you know, prepare young
people like, you know, ``There is a storm coming.''
Dr. Flint. I think that is a fair statement. But I also
think that the idea of getting more--and as disasters are
seeming to become more--happen more and more, bringing the
education of kids just so at least that way, they have an
understanding, an idea, and like I said, even disaster
preparedness training. I think the idea of personal
responsibility and training in disasters is a really good one.
Like I said, I think bringing that into the community is a
very empowering thing. I think that certainly helps with mental
resilience.
Mr. Payne. But making sure that once the disaster does
happen that, you know, in those first responders there are
people that can talk to the mental health aspect----
Dr. Flint. Absolutely.
Mr. Payne [continuing]. As opposed to, you know, a week
into it, but be on the scene and the initial response to it
would be helpful.
Dr. Flint. Certainly those with pediatric training as well.
Just one more point. You know, I think with kids, especially,
the most important thing is that return to structure. So
getting basic services, including schools, up and running
again.
Even though it is not going to be the old normal, at least
it is a new normal, and it is going to put them back in that
structure. That goes a long way to mental resiliency.
Mr. Payne. Thank you.
Let us see, this is to both of you. You have, you know,
shared so much with the subcommittee today, and I really
appreciate you being here. Are there ways that Congress can be
more helpful to you and your organizations?
Mr. Koppisch.
Mr. Koppisch. Sure. I think we talked a lot about funding
and money and how I think it is the same for independent living
centers. When I say we are nonprofit, we are very nonprofit. So
we struggle with--we are asked to do more for little dollars.
So we would love to do more with emergency preparedness if
there is funding attached to it.
We see a lot with talk about mental health services. We see
it during Superstorm Sandy. It is hard for me to say, but we
saw a lot of people with--adults with mental health really--
really being affected by the storm, not knowing where to go,
not trusting who to go to, really are in need of counseling.
Organizations that were set up to provide counseling, we
were told were only there for people affected by the storm and
were not set up to help people who had mental health concerns
before the storm. So that is just one area where our center at
least has been working more on, and we could use more training.
We could use more funding. We could use more resources to help
those individuals.
A lot of the people that we work with with mental health
concerns have their primary concern may be a physical
disability or a cognitive disability, and so we are working
with them on that, but also the mental health may be a
secondary. But we work with all disabilities. When you say how
can Congress help, we could use more money.
Mr. Payne. OK. Thank you.
Dr. Flint.
Dr. Flint. I would echo many of the sentiments that Mr.
Koppisch had said, just substitute ``children'' in there. You
know, I think just the idea of partnering with pediatric
services, pediatric organizations. We have done a lot, you
know, collectively to do that.
Certainly any legislation that is disaster-related, just to
keep in mind the pediatric component and to bring in those that
can speak to that to help with that legislation I think goes a
long way.
Mr. Payne. Thank you.
We are seeing climate change increase the frequency and
severity of these natural disasters. You know, we are having
100-year climate issues every 5 years now, and the vulnerable
and underserved often suffer those effects disproportionately.
What steps need to be taken so underserved populations aren't
disproportionately affected?
Mr. Koppisch.
Mr. Koppisch. I think some of the recommendations that I
went through briefly in my testimony would help alleviate the
vulnerable populations being affected disproportionately. But I
think the key is any emergency planning should include people
with disabilities. That is a must. It has to be done.
What better resource in organizing emergency preparedness
for people with disabilities than people with disabilities
themselves? I want to address something that was said prior
about registering for FEMA services or other services on-line.
A lot of the people that we work with don't have access to the
internet, cannot afford it. There is a great digital divide.
So there needs to be a way to get information to those
individuals who are not connected. We need to not forget about
the old school of communicating with people. So that is
something that is important.
Other ways, accessible formats for people who are hearing
impaired or visually impaired. A lot of people just are not
getting information, and it is because it is not in an
accessible format. I have a statistic here about the number of
fatalities during Superstorm Sandy, 285 fatalities. According
to the EPA, 50 percent of those were people who were elderly or
people with disabilities.
Now I don't know how many of that included people who just
did not know where to go for resources or go for help, but I
can probably guess that there is a lot of people who just
weren't aware, and maybe the information was not accessible to
them. So that is really important.
Equal access to emergency registrations operated by State,
Federal, and nonprofit emergency providers. Again, alternate
format. So different ways rather than the printed way, rather
than the digital way.
So health maintenance items and accessible technology, that
is important for people, especially those who use mobility, who
have mobility concerns. They need to stay with them during a
disaster. A lot of times we have heard about wheelchairs being
separated from people or communication boards being separated
from people during a disaster.
Or deploying personal assistants to help individuals during
a disaster. So I know the State has done that in the past, but
there needs to be a better effort. People rely on others for
assistance--walking, bathing, eating, getting around. That is
really important to have those available during a disaster and
especially in a shelter.
Mr. Payne. Thank you. Dr. Flint.
Dr. Flint. Yes, unfortunately, vulnerable populations,
including underserved, do bear the brunt of a lot of these
disasters just simply because the resources aren't there for
them to be able to recover with that.
I would say for me three things would be important to
increasing the services there. I think, first, it is
identifying the barriers to access within those communities and
addressing them. I would also say that prioritizing them in
disaster response simply because they are going to have long-
term effects that are going to go beyond other communities who
may have greater capacity for resilience.
Then, third, I would say that when we have new disaster
planning procedures, I would prioritize them in terms of
rolling them out in those communities. Certainly the responses
are going to be more difficult in those communities, and I
think overall we are going to gain a lot more information and
education about rolling out different processes and procedures
by going to those communities first and identifying the major
problems that are there.
Mr. Payne. Well, thank you very much. I really appreciate
you being here and providing testimony, which on this
subcommittee and in Homeland Security, we really use this
testimony in order to formulate better practices by FEMA and
different organizations and also creating legislation that
would be helpful in these areas.
So thank you. I want to thank you for your valuable
testimony, and the Members for their questions, which was me.
[Laughter.]
Mr. Payne. The Members of the subcommittee may have
additional questions for the witnesses, and we ask that you
respond expeditiously in writing to those questions.
Pursuant to Committee Rule VII(D), the hearing record will
be open for 10 days. Without objection.
Hearing no further business, this subcommittee stands
adjourned.
Thank you.
[Whereupon, at 11:44 a.m., the subcommittee was adjourned.]
A P P E N D I X I
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Statement of Dorian Herrell, Emergency Management Coordinator, Newark,
New Jersey
introduction
Thank you Chairman Thompson, Ranking Member King, and Members of
this subcommittee for holding this hearing today. I am Dorian Herrell,
the coordinator of the Office of Emergency Management Homeland Security
and Preparedness for the city of Newark, New Jersey. I am honored to be
here to address the concerns of emergency preparedness for the needs of
the underserved populations in an emergency.
As we examine the concerns surrounding the underserved population
during an emergency I want to first commend the responders of my
jurisdiction for their dedication and due diligence in collaborating
with partners, training, and exercises for greater enhanced
capabilities. I will direct my attention to the concerns of emergency
preparedness and the civilians that fall within the underserved
population, the children, low-income individuals, and those with access
and functional needs. I feel the following actions are critical to
managing the responsibility of planning for our vulnerable groups.
First; Outreach.--The populations at risk must be involved within
the planning process so that they can be aware of the threats that are
under way and become more knowledgeable about what is expected of them
under these conditions. The community needs to know what is likely to
happen in a disaster and what emergency organizations that may have
available and/or immediate resources in assisting. The Community
Emergency Response Team (CERT) training is a free program designed to
educate citizens about how to prepare for emergencies that might impact
their area and trains them in basic disaster preparedness skills, such
as fire safety, light search and rescue and disaster medical
operations. CERT members are vital to a community in time of crisis,
especially when professional responders are not immediately available.
Also, in creating a better-informed and prepared community, by
providing information through social media, as well as schedule
speakers to discuss Emergency Preparedness will help citizens in being
better prepared. Seminars and/or presentations are free of charge and
are conducted year round during day and evening hours.
Training.--Emergency drills and exercises provide a setting in
which the adequacy of the Emergency Operations Plan. Multifunctional
exercises also produce publicity for the broader emergency management
process, which informs community leaders and the public that disaster
planning is under way and preparedness is being enhanced.
Resources.--FEMA--Get Ready Now--is a guide on how to plan and
prepare to protect your family in the event of any emergency. It
instructs you how to build an emergency survival kit. This guide also
speaks on Disabled and Special Needs Citizens, Senior Citizens, and
Hurricane survival guidelines. With an Emergency Alert System in place
to notify the community of emergencies is essential.
The support received from the State and Federal Government is vital
and greatly appreciated. However, by increasing funding into these
much-needed communities, will help expand awareness throughout the city
and State and with having an adequate stock-pile of supplies readily to
serve the community in the event of a major, natural, man-made disaster
or terrorist incident is paramount.
I would like to thank you for your attention and time and look
forward to answering any questions you may have.
A P P E N D I X I I
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Questions From Chairman Donald M. Payne, Jr. for Elizabeth H. Curda
Question 1. In its May 2019 report, GAO found that FEMA implemented
changes to disability integration before it had offered its staff
minimal training on its new approach to disability integration. Can you
describe what the lack of more complete and comprehensive training
might do to FEMA's ability to respond to underserved populations after
a disaster?
Answer. As noted in our May 2019 report, FEMA had no written
plans--including milestones, performance measures, or a plan for
monitoring performance--for developing new comprehensive disability
integration training for all FEMA staff beyond the basic and just-in-
time training available when FEMA was implementing its new deployment
model. We reported that, according to FEMA officials, more training is
necessary for FEMA to accomplish its goals related to inclusive
emergency management. We also reported that officials and others we
interviewed in Florida, Puerto Rico, Texas, and the U.S. Virgin Islands
said that FEMA staff did not always effectively communicate with and
assist individuals who are older or have disabilities in completing the
on-line registration-intake form. We continue to believe that such
comprehensive training will better equip all deployed staff to identify
and assist these individuals after a disaster.
Question 2. GAO's May 2019 report documents how FEMA's new approach
to disability integration lacked clear objectives or outcomes to
measure success. Please explain to the subcommittee why having
objectives and measureable goals is important when changing a program
structure so substantially.
Answer. As we reported in May 2019, FEMA began implementing changes
to its disability integration approach without articulating objectives
or desired outcomes for the approach. Each of FEMA's 10 regions
operates relatively independently and may be affected by different
circumstances, such as the type of disaster they are likely to face. To
address these differences, Regional Administrators across the regions
may determine a unique staffing structure, so a lack of common
objectives for FEMA's new disability integration approach, which
involves new positions, roles, and responsibilities, could result in
inconsistent implementation across its regions. Without defining and
communicating objectives in measurable terms, FEMA risks not meeting
those objectives as an agency.
Question 3. In GAO's May 2019 report, GAO found that nonprofits
working with people with disabilities could not get information from
FEMA about disaster survivors. Please explain why such information
would be important, especially in the face of worsening storms and a
FEMA that has been stretched thin in recent years.
Answer. Our May 2019 report explained that information that FEMA
collects from registrants, such as names and addresses, can be helpful
to FEMA's non-Federal partners because it can help the partners,
including nonprofits working with people with disabilities, identify
disaster survivors who remain in need of assistance. For example, in
Puerto Rico, representatives of a disability nonprofit explained that
they had donated goods available, but could not effectively distribute
them because they did not know who had already requested similar items
from FEMA. In addition, data showing who has registered for and
received Individual Assistance can facilitate non-Federal entities in
identifying individuals in the community, including those who are older
or who have disabilities, who have not applied for FEMA assistance.
These entities can use this information to target individuals who may
need help with FEMA's registration process. This may be especially
important for parts of the registration process that are confusing or
complicated, such as the disability-related questions we highlighted in
the report. FEMA has acknowledged this by establishing a strategic goal
of reducing the complexity of the agency, which it describes in its
2018-2022 Strategic Plan as delivering ``assistance and support in as
simple a manner as possible.''
Question 4. What do you believe is the No. 1 issue FEMA needs to
address immediately to better meet the needs of older Americans and
people with disabilities during a disaster?
Answer. We made 7 recommendations based on findings in our May
report, addressing such disparate issues as data sharing, communicating
disability-related information across FEMA programs, and delivering
training to FEMA staff to better equip them to work with survivors with
disabilities. We are encouraged that FEMA has already made progress
addressing some of these recommendations. However, FEMA's current
approach to communicating registrants' disability-related information
across FEMA programs stands out as being the most important issue for
FEMA to address to ensure individuals with disabilities receive the
assistance they need, since this can have a direct impact on services.
Our recommendation to improve this communication was the only one the
Department of Homeland Security did not concur with, stating that FEMA
lacks specific funding to augment the legacy data systems that capture
and communicate registration information in registrant files. However,
as we noted in our report, the recommendation was not solely focused on
system changes, and there are other cost-effective ways that are likely
to improve communication. For example, FEMA could revise its guidance
to remind program officials to review case file notes to identify
registrants' disability-related needs.
Another area that stands out as being critical to FEMA's success in
meeting the needs of disaster survivors who are older or have
disabilities is the agency's plan for delivering training to FEMA staff
that promotes competency in disability awareness. While the Department
of Homeland Security agreed with our recommendation on this issue, we
do not believe FEMA's proposed solution is sufficient to address the
lack of comprehensive disability integration training available to
deployed FEMA staff. FEMA's plan is to include a disability integration
competency in the position task books for all deployable staff and to
hire new staff to focus on disability integration before implementing
training. We continue to believe that a plan for delivering training
that includes milestones, performance measures, and how performance is
monitored will better position FEMA to provide training to all staff
that achieves its intended goals.
[all]