EIIP Virtual Forum Presentation — October 25, 2006

Outcomes of the Working Conference
on Emergency Management and
Individuals with Disabilities and the Elderly

Patricia A. Morrissey, Ph.D.
Commissioner, Administration on Developmental Disabilities
Administration on Children & Families
U.S. Department of Health & Human Services

Avagene Moore
EIIP Moderator

The following version of the transcript has been edited for easier reading and comprehension. A raw, unedited transcript is available from our archives. See our home page at http://www.emforum.org

[Welcome / Introduction]

Avagene Moore: Welcome to the EIIP Virtual Forum! We are pleased you could join us today! Today's topic is the "Working Conference on Emergency Management Related to Individuals with Disabilities and the Elderly."

It is a pleasure to introduce our guest speaker today. Dr. Patricia Morrissey is the Commissioner of the Administration on Developmental Disabilities (ADD), housed in the Administration for Children and Families in the Department of Health and Human Services (HHS).

Prior to being appointed by President George W. Bush in August 2001, Dr. Morrissey was a senior associate at Booz Allen Hamilton where she provided consulting services to federal agencies. Dr. Morrissey is a very accomplished lady and has played a central role in the drafting of major disability legislation. She has also published four books and assisted in the production of six training videos on disability issues. If you have not read the background page, I urge you to do so after our session today to learn more about our speaker's respective expertise and experience.

We welcome you to the EIIP Virtual Forum, Pat.


Patricia Morrissey: Hello, it is a pleasure to be in the EIIP Virtual Forum today.

I was privileged to be one of the conference coordinators of the Working Conference on Emergency Management Related to Individuals with Disabilities and the Elderly. Daniel W. Sutherland, the Officer for Civil Rights and Civil Liberties, Department of Homeland Security (DHS), shared this responsibility with me. The conference was held this past summer, June 28 - 30, in Washington, D.C. I will share with you an overview of the purpose, expectations and some of the outcomes or findings of this successful conference.

As background to my remarks, one of the key lessons of Hurricanes Katrina and Rita is that all levels of government, working closely with the private sector, must ensure that the emergency management process fully integrates the needs and talents of the communities of individuals with the full range of disabilities and the elderly.

As the 2006 hurricane season approached and much of the national priority was on preparation for a flu pandemic, we deemed it time to gather State experts in disability, aging, and emergency management to learn about what works, formulate State teams, take a critical look at State emergency planning processes and identify how they could be strengthened with regard to individuals with disabilities and the elderly.

The purpose of this working conference was to bring together Governor-appointed State teams and to connect State health and emergency management officials with key disability and aging experts to:

• work toward integration of efforts within their jurisdiction’s emergency management framework;

• facilitate cooperative planning with senior officials of the Federal Emergency Management Agency regions;

• identify and institute measurable outcomes and systems for tracking results.

The conference was the first of its kind with presentations by key national leaders on the complex issues facing the disability and aging populations in the face of natural or man-made disasters. Senior officials from the Department of Health and Human Services (HHS) and the Department of Homeland Security (DHS) made keynote presentations along with colleagues from other federal agencies. The top experts from State and local governments and the private sector also addressed the conference.

Attendance was by invitation only. Each Governor was asked to appoint State officials to be part of the delegation seats for his/her State. Specifically the following State agencies/entities were requested:

1. State Emergency Management Agency,

2. State Department of Public Health,

3. State Office on Aging,

4. State/Governor’s Special Needs Task Force/Office representative,

5. Governor’s Homeland Security Advisor (if different from #1).

Appointed delegates from each of these fields were required to have authority, knowledge, and expertise in their subject area and also the responsibility for or direct oversight of emergency planning and special needs issues within their purview. Alternatively, a delegate could also be the person tasked with such a role within the State to commence post-conference.

Should a State-level Special Needs Task Force or Office not exist, the Governor could use his/her discretion to select an appropriate alternative representative. In some States, the Governor’s Homeland Security Advisor is the same as the State Emergency Management Agency representative.

In addition, individuals with expertise in disabilities, drawn from the grantees funded by the Administration on Developmental Disabilities, were invited to participate as members of State delegations.

As stated earlier, this was truly a 3-day working conference and certain expectations were explained to the participants prior to their arrival:

• May be asked to complete on-line surveys before the conference to help shape the conference;

• Come prepared to the conference by reading materials assigned and provided ahead of time, so that time is maximized at the conference;

• May be asked to complete assignments each night of the conference to realize gains toward the next day’s objectives;

• Develop the next steps for when they return home to continue progress on strengthening their State emergency management process as it relates to people with disabilities and the elderly; and

• Have quarterly ‘homework’ assignments following the working conference to share progress they have made in establishing and putting into action recommendations they developed over the three days.

There were 408 conference attendees not including speakers, facilitators, and administrative staff. All States were represented with the exception of Arizona, Colorado, Montana, Nebraska, Rhode Island and Wyoming.

Key findings of the conference are issues that were repeatedly identified by State delegates, discussants and speakers during plenary and breakout sessions. The findings have implications for all levels of government as we seriously take steps to integrate disability and elderly issues in our emergency planning.

The 2006 Conference findings may be broken down into three major areas:

1. Guidance and Policy

• Develop a federal term, definition or model to signify "special needs populations" that can be used as a guide for state and local authorities in planning. The definition should be based on a functional model rather than a medical model, and be flexible and adaptable to accommodate state/local planning.

• Increase planning support to the local level with tool kits, planning templates, best practices, and models, for special needs planning, for local emergency planners.

• National standards and reimbursement policy for special needs shelters (i.e., medical needs shelters) should be developed as guidance for state and local authorities.

• Clear guidance and best practices are needed for developing registries. Included should be issues such as: how to set parameters, public awareness, how to maintain and update, funding sources, false expectations, privacy/safety, purpose, etc.

• Ensure that Medicaid waivers that allow for state-to-state services are part of emergency plans. Restriction in the Medicaid program for community-based services prevents proper referral and care for people with disabilities.

• Medicaid reimbursement funds should follow the person. In some States there are Medicaid protocols that allow the funds to follow the person across agencies in-State, but no such provisions which provide reimbursement coverage across States.

2. Planning and Preparedness

• Integrate disability and senior organizations and agencies into emergency management programs. Reach out to non-traditional disaster agencies, organizations and individuals from within these networks.

• Communication and coordination must be improved among federal, region, state, tribal, and local agencies in the emergency management, disability and aging fields.

• Planning for people with disabilities and the elderly needs to be a priority in emergency management.

• Communication plans and public information campaigns must include people with disabilities, the elderly and caregivers.

• Disability and elderly communities should be involved in exercises and drills.

• Work with public and private insurance programs about access to prescription drugs and limits on the supply of these drugs.

3. Research and Development

• Further research is needed in the area of emergency planning for people with disabilities and the elderly. For example, this would help identify models for issues such as registries, sheltering, evacuation, etc.

• The conference Website is a successful outcome of the conference and several requests have been made to keep it maintained and available both for conference attendees and those who did not attend.

• Funding specifically for planning around disability and elderly issues should be increased or there should be increased flexibility in current funding streams to cover these issues.

• Utilizing existing systems for sharing resources, such as the Emergency Management Assistance Compact (EMAC), and incorporating this into planning for people with disabilities and the elderly to allow states to share focused resources during emergencies/disasters.

• More funding is needed to develop accessible temporary and long-term housing post-disasters.

In closing, I would like to share a quote from a keynote speaker during the 2006 Working Conference on Emergency Management and People with Disabilities and the Elderly.

David Paulison, DHS Under Secretary of Federal Emergency Management and Director of the Federal Emergency Management Agency, told attendees, "We have got to work together; we have got to go into this as a partnership. We can’t go into it as a State doing it by themselves or the local government doing it by themselves, or the federal government coming in and taking over, because that is not what we are going to do. But if we go into it as partners, if we go into it hand in hand, there are a lot of these issues we can resolve and we can make sure that people’s lives will be much better off when we finish at the end of the day."

Outcomes and findings of the conference will continue to evolve for the next year through quarterly reports and other monitoring coordinated by ADD. The true success will be seen in how the State delegates and other attendees take what they learned and address issues at home and across the country.

I highly recommend you read the Conference Report to understand the methodology of the conference and to get into the details of these three vital days of discussion. See http://www.add-em-conf.com/confreport.htm. I also encourage each of you to get involved to help resolve the disability and elderly issues in your community.

Thank you for this opportunity. I now turn you back to our Moderator.

Avagene Moore: Thanks for being here today, Pat. We will now turn to questions from our audience.

[Audience Questions & Answers]

Deborah Matherly: Is this conference related to "Emergency Preparedness and Response Conference for People with Disabilities, the Elderly, Pediatrics and Animals" scheduled for Dec 13 -14?

Patricia Morrissey: No, but the key person, Hilary Styron, was one of our facilitators. I will speak there.

Tina Field: Pat: What about those states that didn't participate in this initial workshop? I'm in Emergency Preparedness in Arizona and this greatly concerns me. Will AZ be able to join in the efforts at a later date? Are they intending to go it alone?

Patricia Morrissey: I am willing to talk to AZ people. We are working on next steps, but nothing is formalized.

Larry Mundy: How can we acquire a plan developed by a local government that is already in place and working that addresses the needs of the disabled and elderly during a time of crisis?

Patricia Morrissey: Good question. I do not have the answer. Quarterly reports may help. All plans are works in progress on this topic.

Deborah Matherly: I am interested in the follow up assignments to participants you mentioned- how is that going? And what has been requested?

Patricia Morrissey: All we asked is that they report quarterly. Here are some answers we got from first batch of reports. All delegations have expanded. Most are working with locally useful initiatives. Emergency management or human services agencies submitted most reports. Most delegations have been integrated with larger state groups. Most reported specific planning initiatives. There is a lot of training going on. About 12 states have had summits based on our conference.

Burt Wallrich: I get uneasy when the feds decide to "initiate" something that is already being done in some communities. On-going, effective local efforts are overlooked and redundant programs are started. I would like to see an item near the top of #2, Planning and Preparedness, that says, "research and build on what is already being done."

Patricia Morrissey: I agree.

Barbara Fay: Does anyone have an existing template/guidance for special needs shelters? I am at [email protected] .

In response to Larry's question, in Maryland we are initiating "local jurisdictional planning groups" that start with a preliminary meeting with Emergency Management and Commissions on Disabilities and then expand to an open meeting with individuals with disabilities, government agencies and service providers and more to form an ongoing collaboration. Some are two years old. The intent is to have input into local planning and exercises.

Patricia Morrissey: We are working on an MOU and Shelter Assessment tool with the Red Cross.

Renee Rupple: To what degree has business been involved in these conferences, etc, given the disabled population in the workforce?

Patricia Morrissey: Not at all as part of the conference, but a few states indicated working with communities/businesses in quarterly reports.

Amy Sebring: Pat, as you know we had many deaths associated with the Hurricane Rita evacuation among the frail elderly. These included not only those on the bus that caught on fire, but also many others associated with the trauma of relocation up to 3 months later. The evacuation itself was a disaster. We have no good total numbers and the actual statistics may never be available. Have you identified a research item to investigate the impacts of evacuation on the frail elderly? Did anyone at the conference bring this up?

Patricia Morrissey: We are a very small office that took on a big task. I will follow up with the Administration on Aging. The topic came up.

Ray Pena: Up until late 2004 Dane County Emergency Management in Madison WI had a Special Populations Emergency Planning group, built around the idea that agencies that serve people with special needs all the time should be involved in emergency preparedness activities. The agencies developed agency plans and worked together on an appendix to the Human Services Annex. The group formed in 1991 and did good work. Don't know the current status. It may be worth contacting them for some info.

Patricia Morrissey: Thank you. I will.

Deborah Matherly: Did the conference include reps from CDC to discuss the "Public Health Workbook to Define, Locate and Reach Special, Vulnerable and At Risk Populations in an Emergency"? I have found that draft to be very helpful and informative.

Patricia Morrissey: Yes. We had Vince Campbell speak and delegates had the report you refer to as a pre-conference reading assignment.

Amy Sebring: We now have a mandate for pet planning thanks to recent legislation. While I am all for pet planning, my concern is that unresolved issues in special needs planning, especially for the non-institutionalized home bound will take a back seat. Did you hear anything similar at the conference?

Patricia Morrissey: No. Pets came up in the context of guide/assist dogs -- which should accompany their owners if possible so they can maintain independence when they are sheltered.

Robie Lovinger: Which U.S. State, or which country, has the "best" overall plan in place, currently?

Patricia Morrissey: I am not a reader of state plans. We tried to get them for the conference but they are protected. The NY quarterly report is great.

Barbara Fay: Is the public health workbook still a draft?

Patricia Morrissey: I think so. I will check.

Teresa Brightly: Representing the business sector, where can I find a good list of requirements to ensure that all needs of the disabled or handicapped are met during an emergency evacuation or declared disaster event?

Patricia Morrissey: I would ask Elizabeth Davis in NY. She made our conference a success!

Elizabeth Davis: Thanks Pat! As a follow up to Teresa I would direct you to the Department of Labor as they did pull together many materials, reports, etc as a result of a forum in December 2003 that focused specifically on workplace. There are additional resources and I would be happy to direct you off line.

We have also posted some materials under resources on our site at www.eadassociates.com if that is of any help. Another point of reference for business is the National Oraganization on Disability Emergency Preparedness Initiative resurvey (found at www.nod.org/emergency) and you will see that the most significant improvements in planning for people with disabilities between the two years was actually in the workplace as evidenced by the number of employees with disabilities indicating an improved awareness and planning on site.

Also a great work site example (albeit a government agency) is USDA Target Center. Again, I can offer to connect you with a few folks if you want to email me offline at [email protected].

Renee Rupple: Is anyone collating information from the quarterly reports and determining best practices? What information is being shared with business? What businesses are developing plans for the workplace and their disabled populations?

Patricia Morrissey: We are doing simple compilations across states for internal use related to possible next steps. The reports are not long, 3-7 pages. If you use the search function and input business you could do a quick scan.

John Dolan: Does anyone participating today have experience utilizing volunteers in the area of special needs disaster preparedness? What type of projects were they used on or perhaps grassroots activities that engage the community on an immediate level integrating preparedness? My e-mail is [email protected].

Patricia Morrissey: I would like to share information about NDRN [National Disability Rights Network], which we can do off line.

Amy Sebring: Pat, do you plan to make the Working Conference an annual event, or at least a follow up next year? I would also suggest that you publish a list of State Point of Contacts on your Website for those local planners who would like to follow up in their own regions.

Patricia Morrissey: State delegation info is on the web site and in each report. I wish we could make it annual event. No plans or funding right now.

Eddie Aguero: In what ways can our efforts focus on valuing People with Disabilities as a resource to address emergency/disaster challenges? There is much activity on addressing needs, but not much on incorporating people with disabilities as part of the solution. California has been addressing this via its national service/disability/emergency partners.

Patricia Morrissey: Good question. Simple answer -- invite them to the planning table, encourage them to be or help responders, and give them a direct role in recovery.

Elizabeth Davis: I can offer a thought on that if you wish. 1) look to Citizen Corp which for 4 past annual meetings has made just that plug 2) look to EPI's Partners in Preparedness campaign 2 years in a row now plus with the focus of their original guide 3) Dr. Morrissey's conference focused on this too and 4) many local CERTS and VOADS specifically recruit and incorporate people w/ disabilities as a resource (ex: Nassau County in NY and many others too).

Robie Lovinger FEMA NY: One Private Sector Resource: Hilton Hotels Corporation has some excellent resources; in particular, Doubletree Hotels; check their website

Barbara Fay: Volunteers: No experience here to date but we are talking to our volunteer centers/volunteer mobilization centers about inserting "disability literate volunteers" into their vocabulary and potential resource list. To Eddie's question, we are involving people with disabilities in exercises and the question has been put to the HSEEP design team. It also comes up in volunteer mobilization center training.

Patricia Morrissey: All good examples.

Avagene Moore: Pat, several folks in our audience would like to contact you later. Would you please input your contact info, especially your email address? Phone number too if you wish to provide.

Patricia Morrissey: [email protected], 202.690.6590.


Avagene Moore: Thank you, Pat! We greatly appreciate your effort and time on our behalf and wish you well as you continue your work. And thanks to Elizabeth Davis for being here today. We appreciate your comments too. Elizabeth heads up EAD & Associates, LLC - Emergency Management & Special Needs Consultants.

Please stand by a moment while we make some quick announcements. If you are not currently on our mailing list, and would like to get program announcements and notices of transcript availability, please see the Subscribe link on our home page.

We are proud to announce two new EIIP Partners today. The first is Johnson County (KS) Emergency Management and Homeland Security http://www.jocoem.org. The Point of Contact to the EIIP is Dan Robeson, CEM, Homeland Security Planner for Johnson County. Dan was our Virtual Forum speaker two weeks ago. The second Partner is the Western Pennsylvania Search and Rescue Development Center (WPSARDC) http://www.wpsardc.org. Cynthia A. Garfold is the POC. Welcome to both new Partners!

If you are interested in becoming an EIIP Partner, please see the "Partnership for You" link on the EIIP Virtual Forum homepage http://www.emforum.org .

Again, the transcript of today's session will be posted later today and you will be able to access it from our home page. An announcement will also be sent to our Mail Lists when the transcript is available.

Thanks to everyone for participating today. We appreciate you, the audience! Before you go, please help me show our appreciation to Pat for a fine job. The EIIP Virtual Forum is adjourned!