WELCOME TO THE FEMA
REGION VII WEBINAR ON
FUNCTIONAL NEEDS
SUPPORT SERVICES FNSS
May 2, 2012
Administrative Details
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Greetings
Jono Anzalone
Kam Kennedy
Regional Voluntary Agency Liaison
American Red Cross
for
Special Representative
FEMA Region VII
to
816.283.7078
FEMA Region VII
jono.anzalone@fema.dhs.gov
816.283.7250
kam.kennedy@associates..fema.dhs.gov
Gay Jones
Regional Disability Integration Specialist
for
FEMA Region VII
816.283.7535
Gay.Jones@fema.dhs.gov
Cory Fast
Mass Care Specialist
for
FEMA Region VII
816.283.7579
cory.fast@fema.dhs.gov
Purpose and Outcomes

Purpose:
 To
provide an overview of issues pertaining to
Functional Needs Support Services (FNSS) in general
population shelters.

Outcome:
 To
understand the benefits of integrating FNSS
principles in emergency planning, be familiar with
initiatives underway and aware of resources available
as you move forward.
Defining FNSS

Services that enable children and adults to maintain
their usual level of independence in general
population shelters. These services include:
 Reasonable
modifications to policies, practices and
procedures
 Provisions for Durable Medical Equipment (DME)
 Provisions for Consumable Medical Supplies (CMS)
 Provision for Personal Assistance Services (PAS)
 Other goods and services as needed
History of FNSS Guidance: What have we
done and where are we going?
November 1, 2010 FNSS Guidance document released.
 Contract awarded and signed to develop Guidance on Planning
for Integration of Functional Needs Support Services in General
Population Shelters and training to build state capacity for
FNSS.
 Disability Integration Specialists in each of the 10 FEMA
Regions hired.
 Procedural guide for Personal Assistance Services (PAS) in
development for the States.
 Readiness contract executed making Durable Medical
Equipment (DME) available on nationally declared disasters.
 Each Region recognized the need to assign an FNSS POC to
help information flow to and from the States.
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Regional Disability Integration Specialists
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Preparing individuals and families and
strengthening communities before, during and after
a disaster by providing guidance, tools, methods
and strategies to integrate and coordinate
emergency management efforts to meet the access
and functional needs of all citizens, including
children and adults with disabilities.
Subject matter expertise
Disability Demographics
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56.4 million Americans (20% of the population)
12% are children birth - 18 years old
10% are 18 – 64 years old
38% are over 65 years old
11 million people over age 6 need personal
assistance with everyday activities
Globally, there are 650 million people with
disabilities
Disability Facts
1.8 million unable to see printed words (10 million total)
 1 million are unable to hear conversations (30 million total
with hearing loss to some degree from mild to profound)
 2.5 million have difficulty having their speech understood
(431,000 are unable to have their speech understood)
 16.1 million have a cognitive, intellectual or mental health
disability (over 7% of the population)
 3.3 million people over the age of 14 use a wheelchair and
another 10 million have used a cane, crutches, or a walker
to get around for 6 months or longer.
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How Can we Help?

RDIS’s can provide resources and identify key
disability organizations in your area to help in
integrating people with or without disabilities who
have access and functional needs in emergency
planning. There is a difference in talking about
what we think someone needs and actually having
people at the table helping emergency managers
to prepare and plan for those with access and
functional needs.
What are we doing?
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We are working with our Assistive Technology Programs to
increase access to assistive technology devices and services
(DME, sign language interpreters, limited language proficiency,
etc)
Working to include assistive technology devices and services in
Disaster Recovery Centers.
Working with a Kansas City FNSS group and we have people
with disabilities on the committee who are assisting in
identifying needs and resources.
Regional Disability Integration Specialists
Region
States
RDIS
Email
I
CT, ME, MA, MH, RI, VT
Kate McCarthy-Barnett
Kate.mccarthybarnett@fema.dhs.gov
II
NY, NJ, Puerto Rico, USVI
James Flemming
James.flemming@fema.dhs.gov
III
DE, MD, PA, VA, WV, Washington D.C.
LesleyAnne Ezelle
Lesleyanne.Ezelle@fema.dhs.gov
IV
AL, FL, GA. KY, MS, NC, SC, TN
Mike Houston
Michael.Houston@fema.dhs.gov
V
IL, IN, MI, MN, OH, WI
Jessica Mitchell
Jessica.I.mitchell@fema.dhs.gov
VI
AR, LA, NM, OK, TX
Linda Landers
Linda.Landers@fema.dhs.gov
VII
IA, KS, MO, NE
Gay Jones
Gay.Jones@fema.dhs.gov
VIII
CO, MT, ND, SD, UT, WY
Dave Schaad
David.schaad@fema.dhs.gov
IX
AZ, CA, HI, NV, American Samoa,
Commonwealth of the Northern
Marina Islands, Republic of the
Marshall Islands, Federated States of
Micronesia, Guam
David Ball
David.ball3@fema.dhs.gov
X
AK, ID, OR, WA
Holly Finan (temporary)
Holly.Finan@fema.dhs.gov
Whole Community - Partnerships
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National Council on Independent Living
 July
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2010 MOA
National Disability Rights Network
 March
2011 MOA
Supporting People with Functional Needs—
Key Principles ( Same as 7 Principles of the ADA)
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Equal Access – People with functional needs must be able to
access and benefit from the same emergency programs and
services as the general population (access may require
modification of programs, policies, and procedures related to
building(s), equipment, services, supplies, communication
methods, etc.).
Physical Access – Emergency programs, services and activities
must be provided at locations all people can access.
Access to Effective Communication – People with
functional needs must be given information that is
comparable in content and detail to that given to
the general public using methods that are accessible,
understandable and timely.
Supporting People with Functional Needs—
Key Principles (cont.)
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Inclusion – People with functional needs have the right to
participate in and receive the benefits of emergency
programs, services, and activities provided by governments,
private businesses, and nonprofit organizations.
Integration - Emergency programs, services, and activities
typically must be provided in settings accommodating to all
people whether they have functional needs or not.
Program Modifications - People with functional needs must
have equal access to emergency programs and services,
which may entail modifications to rules, policies, practices,
and procedures.
No Charge - People with functional needs may not
be charged to cover the costs of measures
necessary to ensure equal access and
nondiscriminatory treatment.
Legal Foundation for FNSS
The law mandates integration and equal
opportunity for people with disabilities

 Stafford
Act
 Post-Katrina Emergency Management Reform Act
(PKEMRA)
 Federal civil rights laws
PKEMRA:
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Sec. 689. Individuals with Disabilities
This section required the Administrator to:
 Develop
standards to accommodate individuals with
disabilities
 Add individuals with disabilities to section 308 of the
Stafford Act, which describes nondiscrimination policies in
disaster assistance
 Add durable medical equipment to section 403(a)(3)(B)
as an essential service to saving lives
FNSS Legal Authority & References
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Law, regulations and agency guidance define the
scope of FNSS
 Americans
with Disabilities Act of 1990 (ADA)
 Rehabilitation Act of 1973 (RA)
 Title VIII of the Civil Rights Act of 1968 (Fair Housing Act),
as amended
Shelter Selection
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When a shelter that has inaccessible features is
selected, a plan must be in place to make the shelter
accessible before use
A shelter must comply with state and local codes and
standards related to accessibility
Prior to an Emergency or Disaster
Include in State and Local plans a process for
locating, purchasing, and storing as much of the
supplies and equipment (DME and CMS) as possible
and practical to meet the needs of children and
adults with and without disabilities who have access
and functional needs
 Emphasis is not on stockpiling supplies pre-disaster
 Develop agreements with area contractors to
maintain equipment (e.g., generators, oxygen
concentrators, etc.)
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Prior to (cont’)
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Develop provider agreements with the private
sector to ensure that necessary equipment and
supplies, that have not been purchased and/or
stored, will be available during an emergency or
disaster
Key Points
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While planning and resource identification take
time, FNSS Guidance does not require large outlay
of capital:
 FNSS
is not another unfunded mandate
 Plan…Plan…Plan
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Homeland Security Grant Program
 As
new dollars are made available, purchase access
and functional needs equipment (ex. universal cots)
 Mass Care Planners to help with access and
functional needs integration
The Role of Public Health
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Release of Public Health Preparedness Capabilities:
National Standards for State and Local Planning
March 2011
 Section
on Mass Care and Volunteer Management
http://www.cdc.gov/phpr/capabilities/Capabilities_Ma
rch_2011.pdf
Recent Court Cases Concerning FNSS
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Unified Government of Wyandotte County
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City and County of Los Angeles
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http://www.justice.gov/opa/pr/2010/April/10-crt-382.html
http://www.ada.gov/briefs/calif_interest_br.pdf
US Court of Appeals – County of Dakota
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http://www.ca8.uscourts.gov/opndir/10/11/093277P.pdf
Sheltering Philosophy
1.
Shelters must be, first and foremost, places of comfort and
safety
2. Shelters must be readily accessible to those affected
3. Shelter workers and managers must be strong advocates
for their clients
4. Clients must remain proactive participants in recovery
5. Shelters must provide a safe and secure environment
that accommodates the broadest range of needs in
our communities
Red Cross—Vision for Accommodation
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Safely accommodate individuals with access and
functional needs in our congregate shelters by
working with partners and increasing and
sustaining capacity within the Red Cross.
Provide appropriate referrals to partners when
reasonable accommodation is not possible.
Red Cross—Vision for Accommodation
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Exceptions
 Individuals
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who need:
Continuous medical supervision
Acute, life-sustaining medical care
 Individuals
who are a danger to themselves or others
Americans with Disabilities Act (ADA)
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Under the ADA, the Red Cross must:
 Make reasonable modifications to its policies, practices
and procedures when necessary to deliver shelter services
to clients with access or functional needs
 Provide auxiliary aids and services to ensure effective
communication
 Welcome people with service animals
 Ensure that shelter facilities are physically accessible for
people who use wheelchairs or other mobility devices.
Recommendations
29
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Shelter Inventory
Community Planning
Response
Shelter Inventory
30
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Over 56,000 Shelters in inventory
Agreements updated annually
Facilities physically surveyed every three years
Shelter Selection
31
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Use the Shelter Facility Survey Form when selecting
shelter locations
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Determine what physical access modifications will be
needed for each facility
When a shelter that has inaccessible features is
selected, a community plan must be in place to
make the shelter accessible before use.
Integrated Community Planning
32
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Review current plans
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Identify all stakeholders
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Conduct community gap analysis
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Identify resources
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Establish relationships
Current Plans
33
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Determine what FNSS planning is currently occurring
in the community
Join or convene FNSS planning activities
Integrate existing special needs plan into general
population sheltering plan
Response
34
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Ensure Health Services/Disaster Mental Health
(HS/DMH) staff are present in shelters
Identify and address individual client needs
 Use
Initial Intake and Assessment Tool during
registration
 Consult with HS/DMH to address needs
 HS and DMH will work directly with client to determine
resources and next steps
Response
35
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Shelter Layout
 Accessible
routes in dormitories
 20 sq. ft. per person in short-term or evacuation
shelters
 40-60 sq. ft. per person for sheltering longer than 72
hours
 Individuals who use wheelchairs, lift equipment, service
animals, and other personal assistance services can
require up to 100 sq. ft.
Response Examples
36
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Modify kitchen access policies
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Modify sleeping arrangements
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Assist with cutting food
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Provide way-finding assistance to visually-impaired
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Provide extra space for cots when necessary
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Provide communication tools for individuals with visual, hearing
or speech needs, and those with language/cultural
requirements
Response
37
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Embrace self-determination
 People
with access and functional needs are the most
knowledgeable of their own needs and assistance
requirements
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Assist individuals in maintaining their usual level of
independence
Summary of Red Cross Guidance
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Ongoing shelter surveying
Selection of ADA compliant facilities in disaster
when possible
 Modification
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plan for non-compliant facilities
Work with partners to plan for FNSS
Red Cross Health Services
New Concept of Operations
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American Red Cross Disaster Health Services is
moving away from a “Protocol-based” concept of
operations to a “Scope of Practice” concept of
operations
Protocols
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Red Cross Disaster Health Services have used
protocols for the past 30 years to guide health
services provided in shelters
Protocols:
 Extremely
restrictive
 Restricted nursing practices to first aid procedures
 Hampered the ability of Red Cross nurses to provide
adequate assistance to individuals with access and
functional needs
Scope of Practice
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Allows RNs, LPNs, EMTs and others with certifications
to function within the scope of their licensure or
certification
Allows RNs to delegate health care activities (as
appropriate)
Will increase Red Cross’ ability to respond to access
and functional needs in a shelter environment
Next Steps
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State and Local Communities
 Review of FNSS Guidance
 Review Public Health Preparedness Capabilities
 Plan review and resource identification
 Outreach to stakeholders
FEMA and Red Cross
 Continued communication regarding FNSS Guidance
 Continued Stakeholder Outreach
Future Webinars
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Tuesday, May 15, 2012 – 10am – 11am (Central)
Friday, June 22, 2012 - 2pm – 3pm (Central)
Call-in Number: 1-800-320-4330, PIN 746583
Webinar: https://connect.hsin.gov/regionvii/
Resources
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FNSS Guidance (posted on HSIN Connect)
Red Cross Guidance (Crossnet for Red Cross
audience)
Office of Disability Integration and Coordination
(ODIC)
 http://www.fema.gov/about/odic/

Development of Assessment Teams
 Ex.
California Functional Assessment and Service Teams
(FAST)
 http://www.dss.cahwnet.gov/dis/res/pdf/AppendixB.pdf
Remember: PLAN

Pull together stakeholders, providers, agencies and
organizations to identify, assess and determine
what FNSS the community requires.
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Locate, purchase or contract for all necessary
FNSS supplies, equipment and staff.
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Act quickly to implement FNSS when an emergency
or disaster occurs.
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Negotiate to ensure all residents are returned to
the most appropriate, least restrictive environment
when the shelter closes.
Questions
“Disasters are always inclusive. Response and recovery
are not, unless we plan for it.”
—June Isaacson Kailes—
Contact Information
Jono Anzalone
Kam Kennedy
Regional Voluntary Agency Liaison
American Red Cross
for
Special Representative
FEMA Region VII
to
816.283.7078
FEMA Region VII
jono.anzalone@fema.dhs.gov
816.283.7250
kam.kennedy@associates.fema.dhs.gov
Gay Jones
Regional Disability Integration Specialist
for
FEMA Region VII
816.283.7535
Gay.Jones@fema.dhs.gov
Cory Fast
Mass Care Specialist
for
FEMA Region VII
816.283.7579
cory.fast@fema.dhs.gov