REPORT TO THE NEW MEXICO DEPARTMENT OF HEALTH
BEST PRACTICES MODEL
INCLUDING THE NEEDS OF PEOPLE WITH DISABILITIES,
SENIORS, AND INDIVIDUALS WITH
CHRONIC MENTAL ILLNESS IN
EMERGENCY PREPAREDNESS AND PLANNING
PREPARED BY
ANN MCCAMPBELL, MD
Research By
Dee Martinez
FOR THE
THE GOVERNOR’S COMMITTEE ON CONCERNS
OF THE HANDICAPPED (GCCH)
(Has been renamed to Governor’s Commission on Disability in 2006)
April 7, 2003
TABLE OF CONTENTS
I.
II.
III.
IV.
V.
VI.
INTRODUCTION
SUMMARY OF KEY BEST PRACTICE RECOMMENDATIONS
WHO ARE PEOPLE WITH DISABILITIES, INDIVIDUALS WITH CHRONIC
MENTAL ILLNESS, AND SENIORS?
A.
People with Disabilities
B.
Children with Disabilities
C.
Individuals with Chronic Mental Illness
D.
Seniors
BARRIERS ENCOUNTERED AND LESSONS LEARNED IN PREVIOUS
DISASTERS
A.
World Trade Center Disaster (9/11)
B.
World Trade Center (1993 Bombing)
C.
Northridge Earthquake (1994)
D.
Florida Hurricane
E.
Grand Forks Flood (North Dakota, 1997)
F.
Ice Storm in Southeastern Canada (1998)
PRINCIPLES THAT SHOULD GUIDE DISASTER RELIEF
MAJOR ISSUES
A
Communication
B.
Emergency Health Information
C.
Registries
D.
Evacuation
E.
Transportation
F.
Public Health Service Sites
G.
Assistance Animals
H.
Shelters
I.
Isolation and Quarantine
J.
Training for First Responders and other Rescue Workers
K.
Recovery Phase and Points of Service
2
VII.
VIII.
CONCLUSION
APPENDICES
A.
Process and List of Contributors
B.
Bibliography / Background Materials
C.
Accessible Checklists for Public Health Service Sites and Shelters
D.
Tips on Assisting People with Disabilities, Individuals with
Chronic Mental Illness and Seniors
1. Specific Assistance Techniques for those with:
a. Vision Impairments
b. Animal Guides
c. Hearing Impairments
d. Learning Disabilities
e. Mobility Impairments
f. Chemical Sensitivities
G.. Electromagnetic Sensitivities
h. Other Limitations
2. Carry Techniques
3. Evacuating Wheelchair Users
3
I. INTRODUCTION.
There is growing concern over the threat of terrorism using weapons of mass destruction
(such as biological, chemical, radiological and other agents) by terrorist groups, foreign
governments, or individuals. The use of such agents could have a devastating impact on
public health. People with disabilities, individuals with chronic mental illness, and
seniors are vulnerable populations who may be particularly impacted by a terrorist attack.
The needs of these populations need to be identified and included, along with methods of
meeting them, in the New Mexico emergency response plan.
In addition to terrorist events, people with disabilities, individuals with chronic mental
illness, and seniors are at increased risk following other disasters, such as explosions,
toxic spills, transportation catastrophes, nuclear power plant accidents, fires, floods,
earthquakes, mud slides, hurricanes, tornadoes, volcano eruptions, winter storms, very
cold or very hot weather, power outages, and/or loss of phone or water service.
Disasters vary in their severity. Some cause only minor disruptions in everyday life
whereas others can cause massive loss of infrastructure, including loss of roads, phones,
electricity, and water that can last for days to weeks. In addition, the impact of a terrorist
strike on New Mexico would depend on whether a biological, chemical, or radiological
agent was released directly in the state or whether it was released elsewhere in the U.S.
In the latter case, it could still impact New Mexico by interfering with the flow of goods
and services here and instilling possible fear and panic in residents.
In some ways, people with disabilities may have an advantage over people without
disabilities during disasters because they deal with altered and frequently difficult
physical and environmental limitations on a daily basis (Disaster Strikes). In particular,
people with chemical sensitivities have vast experience managing their air and water,
segregating and decontaminating their belongings, wearing protective masks, using air
filters, sealing windows and doors to keep out smoke and other noxious fumes, being in a
constant state of preparedness for potential assaults, e.g., from neighbor pesticide
sprayings or someone walking by wearing perfume, as well as having lots of practice
with evacuations.
In general, however, people with disabilities, individuals with chronic mental illness, and
seniors have a more difficult time during disasters than the general population. When the
support system of a person with a disability or senior is disrupted, the person’s ability to
live independently changes dramatically. According to June Isaacson Kailes in her
Emergency Evacuation Preparedness Guide, “For people with disabilities, barrier-free, as
well as barrier-ridden environments, can become a great deal more hostile and difficult to
4
deal with during and after an emergency. For example, people with physical disabilities
may have reduced ability to get to accessible exits, as well as reduced access to their
personal items and emergency supplies. People with vision and hearing loss and people
with speech related disabilities often encounter many more communication barriers,
especially when regular communication channels are down or overloaded. These barriers
appear at a time when rapid communication may be crucial to survival and safety.”
As a result, people with disabilities who were self-sufficient prior to a disaster may have
to rely on help of others following one. And people who were previously able-bodied
may become disabled, temporarily or permanently, after a disaster occurs. Other people
may perform well in a drill, but experience problems during an actual disaster. On the
other hand, some people with obvious disabilities or conditions may not need additional
assistance in an emergency.
Whether an individual with a disability requires electricity to power a respirator, lifesustaining medication, mobility assistance, or post-disaster recovery services, relief
organizations and rescue personnel increasingly must be prepared to address the needs of
these individuals in the hours and days following a disaster (Blanck, Ctr. Access).
But in the aftermath of earthquakes, hurricanes, or other disasters, many people with
disabilities have criticized disaster-relief organizations such as the Red Cross and the
Federal Emergency Management Agency (FEMA) for being ill-equipped to deal with
their unique concerns. When forced from their homes, people with disabilities may
encounter evacuation centers that are wholly or partially inaccessible. Distribution of
food, water, and other supplies may be conducted from inaccessible locations, with no
means of getting supplies to people who cannot reach the centers. Frequently, the
procedures of agencies do not take people with disabilities into account, or if they do,
staff members are not aware of them. (Disaster Strikes)
II. SUMMARY OF KEY BEST PRACTICE RECOMMENDATIONS

People with disabilities, individuals with chronic mental illness, and seniors need to
be included in an ongoing and meaningful manner in disaster preparedness planning,
and not just in the development of initial plans.

It is important to include individuals in disaster planning who represent a broad range
of physical and mental disabilities and seniors, and to include community members as
well as government employees in the process; this should include as many people as
possible who have a disability or are seniors.

Strategies should be identified that will better enable state, local, and federal
agencies, non-profit organizations, and community groups to work together to
enhance emergency preparedness, especially in the areas of communication,
transportation, and accessibility.
5

Public Health Service Sites (PHSS) and emergency shelters should at least comply
with the minimum accessibility requirements of the Americans with Disabilities Act
(ADA) and the New Mexico Building Code (NMBC) 1997, as determined by a
certified access specialist. (See Appendix C – Checklists for PHSS and shelters.)

People with disabilities, individuals with chronic mental illness, and seniors need to
be included in all emergency drills and practices.

First responders and emergency personnel need additional training on how to help
seniors and people with a broad range of mental and physical disabilities, including
how to interact with assistance animals. Having patience and respect are key.

Special attention should be paid to identifying developing technologies that can be
used to improve communication with seniors and people who have disabilities.

The best way to prepare for caring for people with disabilities during an emergency is
to increase awareness of disability issues and improve access for people with
disabilities during non-disaster times.

A state ADA coordinator should be established.
III. WHO ARE PEOPLE WITH DISABILITIES, INDIVIDUALS WITH CHRONIC
MENTAL ILLNESS, AND SENIORS?
A.
PEOPLE WITH DISABILITIES. Fifty-four million people in the United States
are living with a disability. Approximately 220,000 people with disabilities live in New
Mexico. The Americans with Disabilities Act (ADA) defines a disability as a physical or
mental impairment that causes substantial limitations in a major life activity, such as
hearing, seeing, speaking, thinking, walking, breathing, or performing manual tasks.
People with disabilities are a diverse group that includes people of all ages with a variety
of physical and mental disabilities that manifest in different ways and to different
degrees. Many have more than one disability, such as those who are deaf-blind. Some
people’s disability will be obvious whereas others have less noticeable or invisible
disabilities.
In addition, people with disabilities may have health problems for which they are
dependent on daily medication, oxygen, dialysis treatments, or other medical equipment
or procedures. Some people with disabilities live in residential care facilities or group
homes, but the majority lives and work independently and are thus dispersed among the
population. Some may rarely, if ever, leave their homes. Approximately 800,000 people
live in assisted living facilities nationwide.
6
People with disabilities include, but are not limited to, those with:
Communication and Speech impairments
Hearing impairments
Visual impairments
Cognitive impairments
Mobility impairments,
Psychiatric impairments
Chemical and electromagnetic sensitivities
As well as:
Users of life support equipment
Users of assistance animals
Individuals who are immunocompromised
Barriers that people with disabilities may encounter during an emergency include lack of
wheelchair access, inaccessible restrooms, and shelters full of perfume or pesticide, lack
of needed medications, and/or emergency notices that are inaccessible for people with
vision and/or hearing impairments. After a disaster, people with disabilities may also
have a hard time reaching or getting help from personal assistants and other home health
providers (Red Cross). And they may not be able to wait in lines for long periods to
receive water, food, and other disaster relief assistance.
According to the National Organization on Disability’s Emergency Preparedness
Initiative:
 61% of people with disabilities have not made plans to quickly and safely
evacuate their homes.
 58% of people with disabilities do not know whom to contact about emergency
plans for their community in the event of a disaster.
 50% of people with disabilities who are employed full or part time say no plans
have been made for a safe evacuation at their workplace.
People with disabilities are not a homogeneous group. They have different capabilities,
opinions, needs, and circumstances. No one individual or organization speaks for all
people with disabilities. Therefore, it is important to include representatives from a
diverse range of disability advocacy groups in disaster planning efforts, such as
representatives from independent living centers, local groups serving disabled
populations (e.g., people who are blind, deaf, have limited mobility or cognitive
disabilities or chemical sensitivities), and individuals with disabilities who, though not
affiliated with a group, are interested in participating. (N.O.D.)
.
7
It is also important to treat all people with disabilities as individuals. One should not
‘lump’ all people with disabilities into one category. For example, there are some
emergency plans where all people with disabilities were directed to go to the area of
rescue assistance to await members of the emergency team to escort them to safety. As a
general rule, there is no reason that individuals with hearing or vision loss cannot use the
stairs to make an independent escape as long as they are effectively notified of the need
to evacuate.” (Kailes)
In New Mexico, Americans with Disabilities Act (ADA) issues are handled by the
Governor’s Committee on Concerns of the Handicapped (GCCH) and other state
agencies, but there is currently no single person designated as the state ADA coordinator.
B.
CHILDREN WITH DISABILITIES. Children may be medically fragile and/or
have other disabilities like those of adults. However, the needs of these children differ
from those of adults with disabilities because (Amer. Academy of Peds):
Children are particularly vulnerable to aerosolized biological or chemical agents
because they breathe more rapidly than adults and because some terrorist agents,
like sarin and chlorine, are heavier than air and accumulate close to the ground in
the breathing zone of children.
Children are more vulnerable to agents that act on or through the skin because
their skin is thinner and they have a larger surface-to-mass ratio than adults do.
Children are more vulnerable to effects of agents that induce vomiting or diarrhea
because they become dehydrated more easily than adults do.
Children have smaller circulating blood volumes than adults, so loss of relatively
small amounts of blood can more rapidly lead to shock.
Other factors increasing children’s risk of shock is their increased sensitivity to
changes in body temperature and faster metabolisms.
Children require different dosages and/or different medications than adults.
Skin decontamination showers that are safe for adults may result in hypothermia
in children unless heating lamps or other warming equipment is provided.
Children have greater susceptibility to the effect of radiation exposure than adults
(Montefiore).
Children’s motor skills and cognitive levels, which can include the inability to
follow directions from others, may impede their ability to escape from danger.
8
Children may struggle against the efforts of health care workers because they do
not understand what is going on or may be frightened by the appearance of
workers in protective gear.
Providing quality mental health care to children following a disaster requires ageappropriate intervention.
Many children with special health care needs require technologies to keep them out of a
health care crisis. When a power outage or other disaster occurs, the lives of the
following children are threatened (Family Voices):
Children dependent on life-sustaining technology, such as oxygen, ventilators,
IVs, apnea monitors, and total parenteral nutrition (TPN) lines.
Children who cannot be easily moved because of physical fragility.
Children affected by extremes of temperature.
Children in large casts or other equipment that impedes movement and carrying.
Children who have conditions such as autism, brain injury, developmental
disability, head injury, or visual impairment that makes it hard for them to adjust
to sudden environmental changes.
Children with cancer who are hooked up to IVs and other equipment.
Premature babies.
C.
INDIVIDUALS WITH CHRONIC MENTAL ILLNESS. Approximately 115,000
people in New Mexico report having a mental disability. People who have a chronic
mental illness include, but are not limited to, those with bipolar disorder, panic and
anxiety disorders, post-traumatic stress disorder (PTSD), depression, schizophrenia,
autism, and Alzheimer’s disease, as well as alcoholism, drug and other addictions.
Some people with these disorders may be medicated or receiving other treatment which
reduces or eliminates their symptoms. Others may be anxious, panicky, delusional, or
paranoid, especially in the midst of a crisis. In addition, the presence of a thought
disorder, hallucinations and/or delusional beliefs can make it difficult to comprehend an
emergency. In fact, some people with chronic mental illness may seem oblivious to a
disaster.
People with chronic mental illnesses comprise a significant portion of the homeless
population. Others may live in private residential housing, group homes, motels, the state
psychiatric facility, or stay with friends or family members. Some people with chronic
mental illness are competent to make their own decisions. Others may have a guardian,
conservator, or treatment guardian to make certain decisions for them.
9
There are differing opinions on the degree to which people with chronic mental illness
are negatively impacted by disasters. While stressful events are known to trigger relapses
-- such as paranoia, hallucinations, or mania -- a surprising number of people with
chronic mental illness have coped well during previous disasters, as long as mental health
services continue to be available. On the other hand, studies have shown that people with
chronic mental illness are more likely than others to develop post traumatic stress
disorder (PTSD) following a disaster. This is in addition to the estimated 30-40% of
people with chronic mental illness who currently have PTSD. (Nat’l Ctr. for PTSD)
While there are already acknowledged gaps in the availability of required services and
medications for people with chronic mental illness during normal times, access to these
services is often further jeopardized during a disaster.
D.
SENIORS. Seniors are people over 65 years of age. The numbers of seniors are
growing throughout the United States. They comprise 11.7% of the population in New
Mexico. Many are perfectly healthy, while others may have a mental or physical illness
or disability. It is not unusual for seniors to have increasing trouble with seeing, hearing,
walking, balance, concentration, and memory. In New Mexico, ten to twelve thousand
seniors are blind or visually impaired. Seniors may also lose their sense of direction and
tend to get lost easily. In addition, their diminished immune and detoxification systems
make them more vulnerable to biological and chemical agents. As with people with
mental and physical disabilities, some seniors may be homeless, while others may live in
residential care facility and/or rarely, if ever, leave their homes. Some seniors are
competent to make their own decisions, while others have a guardian or conservator to
help them.
The majority of older New Yorkers are reported to have held up extremely well in the
chaos of September 11th and its aftermath. This is consistent with studies that have found
that older adults who have survived previous disasters are more psychologically able to
cope with subsequent disasters than less experienced people. On the other hand, for some
seniors who have already suffered multiple losses, such as loss of health, ability to work,
and loss of loved ones, the occurrence of a disaster can be the final straw that overcomes
their ability to cope.
The frail elderly, many of whom require institutional care, are also likely to suffer
adverse impacts during a disaster situation. Over 90% of nursing home residents carry at
least one psychiatric diagnosis and/or one behavioral problem. The additional stress of a
disaster will likely tax the already limited psychological and cognitive capacities of this
population. Even in facilities with exemplary preparedness, “transfer trauma” is common
when institutionalized elderly are evacuated from familiar surroundings. This trauma can
be minimized if routines and ties with caregivers, relatives, and friends, are quickly reestablished. Even seniors who are living independently may be extremely reluctant to
leave their homes, especially if they are not allowed to take their pets with them. (Psych
Times)
10
IV. BARRIERS ENCOUNTERED AND LESSONS LEARNED IN PREVIOUS
DISASTERS
A.
WORLD TRADE CENTER DISASTER (9/11):
A wheelchair user who worked on the 68th floor of the World Trade Center (WTC) was
safely carried from the building thanks to a specialized chair purchased after the 1993
bombing.
Two wheelchair users escaped from the WTC using evacuation chairs with inexperienced
helpers because they broke the rules and left before being found by rescue workers. Most
who did what they were expected to do, that is, waited to be rescued, died. (Kailes)
People who were deaf and hard of hearing could not receive instructions on the stairwell
after the power and lights went out (Kailes), however those with text pagers did receive
disaster and evacuation information (Davis).
Some people with respiratory problems acknowledged that prior to the emergency they
had not considered themselves as having a disability that would qualify them for
inclusion in the emergency evacuation plans for those requiring specific assistance.
(Kailes)
Equipment installed in the Pentagon to help blind people evacuate in emergency
situations also helped others evacuate the smoke-filled corridors.
The entire staff of the Associated Blind safely evacuated their building’s 9th floor which
they attributed to their advance planning and evacuation drills.
Because emergency workers believed that buildings had been evacuated, some seniors
and people with disabilities who were unable to leave their apartments were left behind
with no electricity (and therefore no television, lights, elevators, refrigerators, etc.), no
running water, and no information about what was happening and what they should do.
(O’Brien)
Within 24 hours following the 9/11 terrorist attacks, animal advocates were on the scene
rescuing pets, yet some seniors and people with disabilities waited for up to seven days
for an ad hoc medical team to rescue them. (O’Brien)
It is reported that one quadriplegic person was alone for three days until the Red Cross
team of medical professionals searched the building and found the critically ill resident.
(O’Brien)
It was difficult or impossible for home health aides to check on whether or not their
clients had been rescued.
11
There are reports that younger able-bodied individuals commandeered evacuation buses
leaving some seniors and people with disabilities behind. (Lewis)
There were problems for some people with hearing impairments who were evacuated
without their hearing aids.
Some people with disabilities assumed the emergency shelters would be inaccessible and
paid to stay in hotels instead.
Some agencies had hotlines that did not show TTY/TTD (teletext typewriter /
telecommunications device for the deaf) numbers.
Even when a hotline was TTY/TTD accessible, the media frequently did not publicize
this information.
Closed news captioning disappeared for a period of time on the few televisions that were
still working.
In the days to weeks following the attacks:
Paratransit service in the Ground Zero area was suspended and placed under stricter
limits citywide [Note: Paratransit is specialized curb-to-curb service, usually in vans or
sedans, for people with disabilities who are unable to ride fixed-route public
transportation, such as buses and trains, and/or cannot get to boarding locations.]
Some people who previously had used paratransit services or had received mobility
training for a certain route, or used accessible train stations couldn’t get to work or home.
Some people were not able to get necessary prescriptions filled.
Wheelchair and other equipment repairs were delayed or unfinished because repair shops
were closed.
Many people were not making it to critical health care appointments, either because they
could not find transportation or were afraid to leave their homes.
People who are blind or have low vision had to spend hundreds of hours learning how to
navigate the rearranged city, on foot and by re-routed public transportation.
People with disabilities who were displaced from their homes had a very difficult time
finding other accessible apartments, which constitute only small percentage of the already
scarce apartments in New York City. (CIDNY)
Y2K preparedness plans were useful in providing already established plans to convert
from computer to paper-based operations, such as issuing emergency paper vouchers for
food stamps when the food stamp cards ceased to work.
12
Elizabeth Davis, who was the Special Needs Adviser to the New York City Office of
Emergency Management at the time of the WTC attacks, adds the following
observations:
Information and Notification – A media antenna was lost when the WTC collapsed which
initially wiped out television transmission to the tri-state area (New York, New Jersey,
and Connecticut); power went out, cell phones did not work, computers went down, and
mail and newspaper delivery was halted in the disaster area.
Evacuation – Elevators did not work in surrounding buildings; some isolated elderly
individuals were frozen in shock and had to be found via door-to-door searches and urged
and helped to evacuate.
Transportation – Was a big problem and slow to restore; bridges, tunnels, and airports
were closed; subway service was down for a year in the disaster zone; paratransit had
difficulties because streets were not cleared; certain bus routes were either unavailable or
altered; some people with disabilities were unable to read the signs announcing route
changes and/or were unable to reach other boarding locations.
Geography – Some streets and buildings were gone; blind individuals had to retrain to
find new landmarks, which were constantly changing during cleanup.
Shelters – Were minimally used; most people sought refuge with family and friends; even
though emergency shelters were advertised as “evacuation centers,” some people may
have avoided them because they sounded like homeless shelters, which they found
unappealing; all the shelters/evacuation centers met minimum accessibility criteria for
people with disabilities.
Prescriptions – The inability to refill their prescriptions was a critical problem for seniors
and others dependent on medications; people had trouble getting their medications
refilled because their usual pharmacy was closed, Medicaid or Medicare cases were
pending but the federal building was closed, people could not physically get to open
pharmacies, and/or some pharmacies would not honor “emergency” Medicaid as the
vouchers were paper (old system) and not plastic swipe cards (new electronic system);
however, major pharmacy chains agreed to provide a small supply of non-controlled
substance medications to people who had an empty bottle that indicated they were
entitled to a refill.
Services – There was a disruption in many services, including food stamps, meals on
wheels, home health, attendant and other services that many seniors and people with
disabilities rely on. Some caregivers were hesitant to enter what was possibly a
contaminated area.
Examples of transportation impacts on people with disabilities due to enhanced air travel
security following the World Trade Center attacks:
13
People with visual impairments were forbidden to bring their canes on board a plane
because they could be used as weapons.
Some people with a service animal were suspected of having a vicious attack dog.
A traveler's Braille 'n' speak computer device was taken from him and not returned until
he got off the plane.
Hearing aids were inspected in case they were secret transmitters.
People's power wheelchairs were dismantled and scrutinized.
One man was bodily lifted out of his wheelchair so guards could check under the
seat cushion for weapons.
Insulin syringes were seized as weapons.
Medicine bags were taken away as excess carry-on-luggage.
B.
WORLD TRADE CENTER (1993 Bombing) – Another of the lessons learned
from the World Trade Center incident involved the complaints of blind tenants who, after
being escorted down and out of the building, were left in unfamiliar surroundings in the
midst of a winter ice storm, where they had to negotiate ice covered sidewalks and falling
glass from overhead.
C.
NORTHRIDGE EARTHQUAKE (1994) (Earthquake):
Following the Northridge earthquake, complaints received by the Independent Living
Center of Southern California included complaints of inaccessible shelters, unreachable
supply distribution points, and poorly trained volunteers, among other problems. In a
number of cases, disabled people were turned away from shelters and told to go to
hospitals by staff members who assumed that they were sick or injured. (Disaster Strikes)
Initially there was no power, television, or telephone. Loss of electrical power had
serious and possibly dangerous repercussions for those dependent on motorized
wheelchairs, respirators, and other pieces of equipment (Disaster Strikes).
A woman who uses a wheelchair was forced to leave her fifth-floor apartment because of
damage to the elevator. She applied to the Federal Emergency Management Agency
(FEMA) for emergency housing assistance, but was turned down because the building
had been “green-tagged” (inspected and judged to be safe for occupation even though the
elevator was not working). (Disaster Strikes).
14
There were problems with the Red Cross shelter. A man with a hearing impairment was
denied shelter because its personnel could not understand sign language. People with
cerebral palsy conditions were not served because shelter volunteers thought they were
on drugs or alcohol. A quadriplegic man could not take a shower for a week because the
shelter was not equipped with an accessible shower stall. A man was not permitted to
bring his seeing-eye dog into a shelter. He was angry at the ignorance and lacks of
compassion that he felt were displayed by organizations supposedly set up to help people
in times of crisis. He felt everyone should be given equal treatment and that he wasn’t.
In an attempt to improve or resolve such problems, members of a disability advocacy
center led on-site awareness sessions at shelters during the first week after the
earthquake. (Disaster Strikes).
In another report, it was noted that trash and glass were everywhere after the quake. It
was hard to get around, especially for wheelchair users and the visually impaired.
Elevators went out, and that combined with the minimal transportation availability (most
of it non-accessible) made it nearly impossible for most people with disabilities to make
it to shelters. Once in shelters, people with disabilities had access problems, especially
with restrooms and showers. No guide dogs or assistance animals were allowed in any
emergency shelter. Many people with disabilities were unable to stand in line for up to 7
hours for post-disaster services. (Berkeley)
After the quake, many services normally available to people with disabilities were no
longer available or were stretched beyond demand. For example, people could not get
extra attendant hours allotted for clean-up or in-home support help. Finding accessible
replacement housing was very difficult. The Red Cross and other local emergency
preparedness plans either did not include people with disabilities at all or their plans were
inadequate.
D.
FLORIDA HURRICANE – One major problem was that people with hearing
impairments could not keep up with storm warnings on radio and television. In response,
television stations now close-caption their hurricane coverage and several deaf
organizations have set up TTY/TDD hotlines to keep those with hearing-impairments upto-date on storm warnings and evacuation orders. (Disaster Strikes).
In another Florida storm that caused severe flooding, a chemically sensitive man tried to
use an emergency shelter, but was made so sick by the perfume, laundry detergent fumes,
scented hair products, and tobacco smoke residue on other people that he had to leave.
When he asked the shelter director what he was supposed to, he was told to go back home
(even though residents had been instructed to leave the area) because the shelter was only
set up to deal with the majority of people and could not worry about problems like his.
The man ended up spending the night in his car. He was very angry because he felt he
was entitled to shelter services like everyone else.
15
E.
GRAND FORKS FLOOD (North Dakota, 1997) – A man who used a wheelchair
and lived independently was flooded out of his accessible home. The man was offered
temporary accessible housing, but it was 250 miles away and would have removed him
from his support network. Local emergency planners arranged for accelerated repairs
and cleanup of his home and he was able to return to it without a prolonged disruption.
(N.O.D.)
F.
ICE STORM IN SOUTHEASTERN CANADA (1998) – People with chronic
mental illness coped well because they continued to have access to medications and other
mental health services. Some individuals even reported that they enjoyed the 2-week
period of the ice storm, since they had uncharacteristically easy access to food, shelter,
and company. (Canada)
IV. PRINCIPLES THAT SHOULD GUIDE DISASTER RELIEF (7 Principles Blanck,
adapted)
A.
1. Accessible Communications and Assistance:
Communication is vital for people with disabilities during a disaster in order to help
assess damage, collect information, and deploy supplies. People with hearing
impairments require interpreters, TTY/TDD communications, and signaling devices. In
addition, written materials must be produced on cassette tape, on CD-ROM, or in large
print for people with visual impairments. People with cognitive impairments, such as
those with developmental disabilities, Alzheimer’s disease, or brain injury, require
assistance to cope with new surroundings and minimize confusion. The media, in
partnership with disability and governmental organizations, should provide emergency
information in formats accessible to people with disabilities.
2. Accessible Disaster Facilities and Services:
Access to appropriate facilities, including housing, beds, toilets, and other necessities,
must be monitored and made available to individuals with disabilities before, during, and
after a disaster. This access also must be ensured for those who incur a disability as a
result of a disaster. Appropriate planning and management of information related to
architectural accessibility improves the provision of disaster services for people with
disabilities. Disaster relief plans should embrace the concept of universal access and
design. Universal design is the design of products and environments to be usable by all
people, to the greatest extent possible, without the need for adaptation or specialized
design (Universal Design Center).
3. Disaster Preparation, Education, and Training:
Relief and rescue operations must have the appropriate medical equipment, supplies, and
training to address the immediate needs of people with disabilities. They may require
oxygen, bladder bags, insulin pumps, walkers, or wheelchairs. Relief personnel must be
equipped and trained in the use of such equipment. In addition, relief personnel should
provide training, particularly for personnel and volunteers in the field, on how to support
the independence and dignity of people with disabilities in the aftermath of a disaster.
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4. Cooperative Partnerships:
Leaders and experts within the disability and seniors communities should establish a
cooperative relationship and ongoing dialogue with members of relief organizations
(including the Red Cross), media professionals, and local, state, and federal officials in
order to include people from these communities in disaster preparedness plans.(Blanck,
Annenberg)
B. MORE PRINCIPLES TO GUIDE DISASTER PREPAREDNESS (N.O.D. adapted,
Emergency Preparedness Initiative and N.O.D. web information)
The best way to prepare for taking care of people with disabilities in an emergency is to
improve their access and others’ awareness of disability issues during non-disaster times.
Provide first responders and other emergency personnel with training, information, and
practice in taking care of people with a variety of disabilities, including individuals with
chronic mental illness, and seniors.
Make sure that the needs of people with disabilities are adequately addressed prior to an
emergency.
Make the needs of people with disabilities, individuals with chronic mental illness, and
seniors, as well as other vulnerable populations, a priority in emergency planning rather
than the current focus on the healthy able-bodied majority.
People with disabilities must be included in preparedness planning for all emergencies,
and all plans must take people with disabilities into account.
Ensure that people with disabilities are included in the emergency planning process for
all four phases of emergency management – mitigation, preparedness, response, and
recovery.
Hold public hearings and solicit public input on emergency preparedness plans for people
with disabilities and seniors.
People with all types of disabilities must be included in emergency plans and planning,
including those who are deaf/hard of hearing, blind, or have a mental illness, chemical
sensitivities, or a physical, cognitive, or invisible disability.
Ensure that people with a variety of different disabilities are included in drills and
practice emergencies.
Informational materials and emergency notification communications must be provided in
alternate formats including closed-captioning, audio alerts, and interpreter services.
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All notices of meetings and interactions relevant to disaster preparedness must mention
the needs of people with disabilities and such meetings shall be held in accessible
locations (including speakerphone access) with all information pertaining to them
available in accessible formats.
Identify where concentrations of people with disabilities and/or seniors live or work in
the community, such as senior housing developments, residential care facilities, schools
with large populations of students with disabilities, and apartment complexes that may
house large numbers of residents with disabilities.
Make allowances at blockades, shelters, and other impacted areas for access by
attendants, home health aides, visiting nurses, assistance animals, and other individuals
crucial to the immediate health care needs of people with disabilities.
Identify the impact on the disability community of an interruption in utility services and
make plans for providing alternative energy sources and/or restoring utility services as
quickly as possible.
Plan for accessible shelters and appropriate temporary housing needs.
Address how people with disabilities who are employed by businesses that are able to
open soon after a disaster will get to work.
Involve representatives of the disability community in “after action reviews” in order to
assess the true impact of the disaster and to improve plans for the future.
Prior to an emergency, train volunteers on the basics of serving and caring for seniors and
people with disabilities.
Address questions of whether nursing homes are required to have an onsite source of
redundant power and what level of emergency plans home care agencies are required to
have in place for their clients with disabilities.
Make maximum use of universal design standards. Compliance with such standards
often provides the best opportunity to escape from buildings and homes.
Ensure that the medical community is prepared to advise and treat people with disabilities
who may have severe medical problems during emergencies.
Have plans to deliver services from alternate locations and in alternate methods if needed
during an emergency.
People with disabilities must be given priority during a disaster’s recovery phase to avoid
further trauma or interruption of established services.
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Ensure plans identify appropriate exceptions to standard plans such as allowing access to
restricted zones for people with disabilities using paratransit and other accessible vehicles
and permitting access to restricted zones to personal care attendants who need to reach
their clients who are seniors and/or have disabilities.
Rely on appropriate members of the disability community to help research emergency
equipment for use by people with disabilities during a disaster, such as evacuation chairs,
transfer-height cots, communication boards, and masks and air filters.
Identify and take appropriate steps to minimize the unintended disability-related effects
of security measures, including transportation barriers, limited access to buildings and
facilities, restrictions on electronic information technology, exposure to environmentally
unsafe environments, and reduced opportunities for employment.
Ensure that necessary research relating to preparedness and people with disabilities,
including surveys of specific needs, and research and development of low-tech and hightech solutions for response, evacuation and relief issues is undertaken and utilized.
Ensure that all personnel of the Office of Emergency Services and Security in the NM
Department of Public Safety are properly trained and regularly exercised in procedures
relating to seniors and people with disabilities and include seniors and people with
disabilities in developing training materials and procedures.
Ensure that all state-produced emergency preparedness information for the general
public, from training materials to warnings of imminent emergencies, is available in
accessible formats, including closed-captioning television broadcasts.
Ensure that a variety of people within the broad spectrum of disabilities are included and
appropriately represented in all preparedness materials, publicity and plans.
Ensure that shelters and facilities used are accessible to people with disabilities and
seniors and that there is the capacity for reaching out to people who are unable to leave
their homes.
Promote the creation of a bank of mechanical and electronic equipment to meet the needs
of people with disabilities and seniors, such as eyeglasses, hearing aids, oxygen tanks,
humidifiers, canes, crutches, walkers, wheelchairs, and others.
Promote the establishment of support networks for people with disabilities and seniors.
Identify and offer training to volunteers and organizations interested in helping people
with physical and mental disabilities and frail seniors who live alone and/or lack a
primary person responsible for their care.
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Identify strategies that will better enable state, local, and federal agencies to work
together to enhance emergency preparedness in areas of communication, transportation,
food and water distribution, vaccinations, evacuations, and appropriateness of shelter
sites, among other things.
Disaster plans should include specific protocols for management of children, including
children with disabilities, in such as areas as prevention, communication, community
preparedness, countermeasures, therapeutics, and emergency response (Amer Academy
of Peds).
Local disaster teams should include pediatricians and other personnel skilled at
evaluating and treating children.
Schools and child care and after-school care facilities must be prepared to evacuate
children (including those who are too young to walk and/or follow directions and those
with disabilities and/or special health care needs), take them to a safe place, notify their
parents, reunite children with their families, provide or arrange care for children whose
parents are incapacitated or cannot be reached, and render first aid.
Government agencies should work to ensure that adequate supplies of antibiotics,
antidotes, and vaccines are available to children.
Y2K plans should be reviewed to determine their relevance to general emergency
preparedness.
Compile rules, regulations, laws, and legislation that pertain to people with disabilities,
individuals with chronic mental illness, and seniors in New Mexico (such as the
Americans with Disabilities Act) and ensure that emergency plans are in compliance with
them.
Use information obtained from oxygen providers to determine the number of individuals
dependent on oxygen service in order to estimate the number of people who might need
oxygen at a shelter following a disaster.
Consider the creation of a statewide 2-1-1 phone system to provide information and
referrals to community services, which can be especially helpful for seniors and people
with disabilities following a disaster.
Use a flexible, outreach-oriented approach to mental health service delivery following
disasters.
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VI.
MAJOR ISSUES
The following describes issues and best practices with regard to communication,
identifying and locating individuals needing help, transportation, evacuation, and access
to public health service sites, shelters, and post-disaster services for people with
disabilities, individuals with a chronic mental illness, and seniors.
A. COMMUNICATION
Communication is crucial in an emergency to provide initial warnings, specific directions
on how to shelter or evacuate, and what personal items (like medicines and life supports)
to take. Emergency communication includes preparedness outreach, emergency warning
or notification, emergency information and instruction, and recovery information.
It is also important for members of the public, including people with disabilities, to be
able to communicate effectively with first responders, other emergency personnel, and
health care providers. Most disability-targeted communication can be implemented as an
adjunct to more general strategies.
Communication Recommendations:
Use as many varied media as possible to spread information.
Television stations should not run a text message “crawl” across a television screen in
any area reserved for closed-captioning.
All television emergency messages should be captioned, including live updates.
Camera operators and editors need to include the sign language interpreter in the picture
if he or she is interpreting next to an emergency spokesperson.
Emergency hotlines should include TTY/TDD numbers or the instruction “TTY/TDD
callers use relay”. Make sure the same information is provided by emergency
spokespersons and is used on television and radio.
Frequently repeat the most essential emergency information in a simple message format
that those with cognitive disabilities can follow.
When posting information on a web site, make sure the web site is accessible, i.e., meets
World Wide Web Consortium’s Bobby standards or the Federal Government’s Section
508 standards.
Provide information in alternate formats whenever possible, such as Braille,
audiocassettes, large font text, and color contrasts.
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Check with large theme parks, e.g., Disneyworld and Busch Gardens, to see how they
communicate information to visitors who are deaf, hard of hearing, or have other
disabilities, and to obtain information on their emergency plans for evacuations and
sheltering.
Reunification plans should be established to facilitate people finding each other after a
disaster, especially caregivers finding seniors and people with disabilities.
Soon after a disaster, locations of shelters need to be well publicized so that family,
friends, and caregivers can search more effectively for people with disabilities, and vice
versa.
More Communication Recommendations (DP2 adapted):
The state should either establish an Internet web site or add web pages to an existing web
site that will communicate response and recovery information of interest to people with
disabilities after a disaster. The state should publicize the existence of this information
resource to the disability community in advance of a disaster and to the entire community
immediately after a disaster. The GGCH should recommend information to appear on the
Internet site, encourage disability service organizations to submit pertinent information,
and periodically update information prepared in anticipation of a future disaster.
Information should also be broadcast on Newsline for the Blind.
There should be captioned video preparedness information before a disaster and closed
captioning and signing available after a disaster (Berkeley).
If online services and power are available after the emergency, computers could be a
great resource for those in the deaf community.
Attention should be paid to identifying developing technologies that can be used to
improve communication with seniors and people with disabilities.
Television stations should:
Understand that excessive broadcast of disaster damage has an adverse impact on some
people with disabilities; that footage of disaster damage always needs a geographic
context; and that viewers who have disabilities (both inside and outside the disaster area)
need more specific information about what they should do.
Comply with the FCC rule that requires that broadcasted disaster information contain
open captions.
Voice all broadcast displays of telephone numbers, the names of streets and geographical
areas affected, and other displayed information for those with visual or cognitive
disabilities.
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Radio and television stations should:
Provide information specifically related to people with disabilities in general, as well as
information pertinent to particular disability groups.
Clarify whether warnings about not drinking contaminated water also apply to assistance
animals used by people with disabilities.
Inquire, before broadcasting announcements about disaster services for senior citizens, if
people with disabilities are also eligible for the services.
Produce public service announcements pertinent to people with disabilities in advance of
a disaster and periodically review them for continued validity.
If blimps with message boards are available, consider using them to publicize disabilityrelated information and resources.
Emergency announcements should include brief notices about major sources of
disability-related information, as well as TTY/TDD telephone numbers that can be passed
on to hearing-impaired people.
Disaster information centers (phone lines) should provide information on disabilityrelated disaster resources.
Guides published on food distribution sites should include information on their
accessibility for people with disabilities and, if necessary, alternative means by which
they can obtain food.
Telephone companies should consult with the GCCH in order to add information about
disaster resources, preparedness, and response pertinent to people with disabilities to the
white pages of telephone books.
Telephone companies should establish an 800-number voice information system for those
with visual and cognitive impairments in order to hear the white pages disaster
information. The system should have an option for listening to response and recovery
information following a disaster.
Agencies with video information on disaster preparation and response should add
captioning for hearing-impaired people and audio description for visually-impaired
people.
The state should urge major distributors of such videos to only market videos with
captioning and audio description.
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B. EMERGENCY HEALTH INFORMATION
The state should encourage seniors, people with disabilities, and other citizens to carry
emergency health information with them at all times. This information should include
critical health information and emergency contacts, as well as local emergency response
numbers. Emergency health information tells emergency and rescue personnel what they
need to know about you if they find you unconscious, confused, in shock, or just unable
to provide the information. People are encouraged to make multiple copies of this
information to keep in emergency supply kits, car, work, wallet (behind driver’s license
or official identification card), wheelchair pack, etc. (Kailes) In storage areas where
there is room, it is also advisable to put the information sheet in a plastic ziplock bag in
order to protect it from water damage.
Emergency health information should at least include a person’s name, home and work
address and phone numbers, birth date, blood type (if known), social security number,
health plan and account number, person to contact in an emergency, how to contact one’s
primary care provider, disability/health conditions, medications, allergies and
sensitivities, immunizations, and information on how one communicates and what
devices or other assistive equipment one uses. (Kailes)
C. REGISTRIES – While there is understandably concern about reaching vulnerable
people in an emergency, many people with disabilities, seniors, and individuals with
chronic mental illness have mixed feelings about being listed on a registry for people
requiring special assistance. These special needs registries are typically used for preemergency outreach, alerting citizens about an emergency, assisting with evacuations,
and providing emergency services such as transportation and health care during a
disaster. But many people with disabilities do not want to have their privacy violated by
registering with a government agency for this purpose. In addition, some people may not
wish to identify themselves as having a disability. Others may not view their disability as
one that causes them to need more help than other people.
It is a recommended best practice in New Mexico that a voluntary locally-based registry
be offered to people with disabilities, individuals with chronic mental illness, seniors, and
other vulnerable populations. The availability of this registry should be broadly
advertised, including notices going to members or clients of organizations representing or
serving people with disabilities, such as independent living centers and Commission for
the Blind, for example. In lieu of, or in addition to, a voluntary registry, individuals
should be advised to contact their local fire departments and emergency medical service
personnel to let them know who they are, where they are, what problems they have, and
the help they may need in an emergency.
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In Berkeley, California, for example, a plan was drafted for creating a voluntary registry
of people who were likely to need help within 72 hours of an emergency due to a
disability and/or need for oxygen, ventilators, and batteries, among other things. Those
wishing to join the registry would have made themselves, their locations and specific
needs known to emergency personnel. No other information was required to be
disclosed. It would have allowed emergency personnel to locate and offer help to people
on the registry in the case of a major disaster.
If a special needs registry is created in New Mexico, several issues need to be addressed:
Are funding, equipment, and staff available to maintain the registry?
Are there resources to continually update it once it is created?
What will the criteria for inclusion in the registry be?
Who will review applications for inclusion and make eligibility determinations?
What expectations will be placed on individuals with disabilities or chronic?
mental illness, or seniors, once they are listed?
What allowances and accommodations will be made for people who are
temporarily disabled, like those in long-term rehabilitation, recovering
from a serious illness, or in the hospital?
What safeguards will be put in place to protect registrants’ privacy and the
confidential information they provide? When, how and with whom can
this information be shared?
D. EVACUATION
Not all disasters require residents to flee their homes or place of work. In fact, many
times the safest place to be in is one’s home. However, the need for escape or rapid exit
is common enough that it should be addressed in emergency planning efforts.
Unfortunately, the needs of people with disabilities have often been overlooked or
inadequately addressed in the past. Several disability advocates have noted that after the
years of work it has taken to get people with disabilities into buildings, the current
challenge is to do a better job of getting them out.
All workplaces, schools, apartment buildings, and other residential facilities should have
an evacuation plan and conduct regular drills to familiarize residents and employees with
the escape plans. These plans should include the needs of all people with disabilities,
which can range from those who use wheelchairs or have other mobility impairments to
people with visual, hearing, or mental impairments, or chemical sensitivities.
In places of employment, evacuation plans should address the following questions (JAN):
Do all people with disabilities have “buddies” to alert and assist them in an
emergency?
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Have employees been encouraged to make a list of medications, allergies,
sensitivities, and special equipment, as well as the names, addresses, and
telephone numbers of doctors, pharmacies, family members, friends, and any
other important information?
Are storage areas provided for necessary evacuation aids, such as evacuation
chairs?
Are storage areas provided in several accessible areas for emergency supplies,
such as packs or backpacks that attach to walkers, wheelchairs, or scooters?
Are there numerous barrier-free passageways and exits from the building?
Are manual pull stations mounted at a height between 48 to 54 inches?
Is the building in compliance with all federal, state, and local building codes?
Are lighted strobes and other visual or vibrating alerting devices used to
supplement audible alarms (taking into account that lighted strobes should not
exceed five flashes per second due to the risk of triggering seizures in some
individuals).
Have areas of rescue, locations that are relatively safe from immediate danger,
been established? If these areas do not have escape routes, they should have 1) an
operating phone, cell-phone, or two-way radio so that emergency services can be
contacted, 2) a closing door, 3) supplies that enable individuals to block smoke
from entering the room from under the door, 4) a window and something to write
with (crayon, marker) or a “help” sign to alert rescuers that people are in this
location, and 5) respirator masks.
Have accessible signs been placed, such as Braille or audible directional signage?
Are heavy gloves, which are used to protect individuals’ hands from debris when
pushing their manual wheelchairs, a patch kit to repair flat tires, and extra
batteries for those who use motorized wheelchairs or scooters, available in a
supply kit?
Have emergency procedures been distributed in Braille, large print, and
audiocassette formats?
Have employees received training on understanding and interacting with people
who have disabilities?
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Have employees been trained in how to carry or assist individuals who use
mobility aids, basic sign language to communicate with individuals who are deaf
or hard of hearing, and instructions for helping individuals who use assistance
animals?
In large facilities, such as stadiums, arenas, and museums, full-scale evacuation drills are
usually not feasible (with certain exceptions like schools). Nevertheless, it is critical that
managers of these facilities have effective evacuation procedures in place for people with
disabilities and that staff members are trained in dealing with people with all types of
disabilities. For example, they must be able to communicate disaster instructions to
people with disabilities during a crisis and/or under unfavorable circumstances, such as
the loss of power.
Community evacuation plans should be designed to allow the necessary time and
assistance for people with disabilities to be adequately notified of evacuation plans. They
also must be able to bring with them special equipment or supplies, e.g., wheelchairs,
crutches, dialysis machines, ventilators, respirators, oxygen tanks, air filters, tolerated
food and water, and guide animals. It is recommended that large care facilities be among
those first notified of the need for an evacuation to allow more lead time to move its
residents. Communities may need to provide accessible transportation and other
resources if people with disabilities are among those ordered to evacuate an area.
E. TRANSPORTATION
It is vital to make accessible transportation available during and after a disaster. Because
transport fleets with wheelchair lifts or ramps may not be available or might be called
into service in other areas, it is helpful to include non-emergency vehicles in disaster
plans. Door-to-door pick-ups have been employed in some localities and should be
incorporated into emergency plans if applicable. Use of senior vans should be
considered. Few people with chemical sensitivities can use public transportation and
would probably need to rely on their own vehicles or other more chemically-inert
vehicles owned by other chemically sensitive people.
With regards to the heightened airport security since the World Trade Center attacks, the
U.S. Department of Transportation says that travelers with disabilities must realize that it
is as legitimate to suspect people with disabilities of bad intentions as it is to suspect
people who do not have disabilities. Therefore, some of their equipment is worthy of
suspicion and careful inspection, whatever that takes. However, the Department also
acknowledges that violations of civil rights and the Air Carrier Access Act are not
acceptable and that steps will be taken to ensure that the new security requirements
preserve and respect the civil rights of people with disabilities.
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F. PUBLIC HEALTH SERVICE SITES
Public Health Service Sites (PHSS) should be as accessible as possible for as many
people as possible. In addition, there should be outreach capabilities to provide services
to individuals who are unable to leave their homes or do not have transportation to get to
sites.
Public Health Service Sites (PHSS), including triage and medical evaluation areas
(separate areas for identifying and evaluating people who are ill), must comply with the
minimum accessibility requirements of the ADA and the NM Building Code (NMBC)
1997 as determined by a certified access specialist. (See Appendix C, Accessible
Checklists for Public Health Service Sites and Shelters.)
Public Health Service Sites (PHSS) should have adequate disabled parking, be
wheelchair accessible, have accessible entrances/exits and restrooms (including at least
one non-chemical toilet), TTY/TDD phone capabilities, a sign language interpreter if
needed (use deaf or hard of hearing person whenever possible and appropriate language),
provide assistive listening devices, have ability to separate people with animal allergies
from assistance animals, a separate fragrance-free room for people with chemical
sensitivities, asthma, and others who are particularly impacted by poor air quality, and
public rest facilities.
Note that trailers used for triage or medical evaluation areas are unlikely to be accessible
to mobility-impaired individuals and trailers and tents are unlikely to be accessible for
some people with chemical sensitivities. In cases where the PHSS is inaccessible for
people with chemical or electromagnetic sensitivities or people with other disabilities,
there should be an option of receiving services outdoors.
In addition, public health service sites (PHSS) should be able to provide oxygen, insulin,
sugar snacks, N-100 viral protection masks, and seizure, asthma, psychiatric and other
common vital medications to individuals who need them. Smoking should be prohibited
inside the building and within 50 yards surrounding it. Vehicle engines should not be
permitted to idle within 50 yards of the site (except when necessary to start engines).
People with disabilities, individuals with chronic mental illness, and seniors who are
unable to stand in line for long periods or in excessively hot or cold or otherwise
intolerable areas should be allowed to go to the head of lines.
ASSISTANCE ANIMALS
The Americans with Disabilities Act (ADA) defines an assistance animal as any guide
dog, signal dog, or other animal that is individually trained to provide assistance to an
individual with a disability. Assistance animals are also known as service animals.
Assistance animals are not pets or “comfort” animals. Some assistance animals are
professionally trained while others are trained by their owners. Some, but not all,
assistance animals wear special collars or harnesses.
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Service animals perform some of the functions and tasks that the individual with a
disability cannot perform for himself or herself. People are most familiar with “seeing
eye dogs”, but other animals such as monkeys and even miniature horses can be used as
assistance animals. Assistance animals can provide an array of services for people with
disabilities (Guidehorse), including:
 Guiding people with visual impairments when walking
 Helping people with mobility impairments with balance and walking
 Pulling wheelchairs or picking up or carrying things for people with mobility
impairments
 Alerting people with hearing impairments to sound
 Detecting impending seizures in people with epilepsy
 Detecting low blood sugar in people with diabetes
Some people who use an assistance animal have obvious disabilities, while others may
have a less noticeable or invisible disabling condition, such as epilepsy, heart or lung
disease, or a mental illness. Therefore, people who are accompanied by an assistance
animal may or may not “look” like they have a disability.
By federal (ADA) and state law (NMSA, annotated, 28-11-2 et seq., Service Animal
Act), people with disabilities have the right to be accompanied by their assistance animals
in all places of public accommodations, including emergency shelters, public health
service sites, and motels, among other places. (San Antonio) In addition, individuals who
are accompanied by assistance animals are not to be routinely segregated from other
people who are occupying or using the facility.
A person who is accompanied by an assistance animal is not required to show proof that
the animal is an assistance animal. Neither is the person with a disability required to
provide verbal or written confirmation to establish his or her disability. (NYC Bar)
Although some states (not New Mexico) offer certification of assistance animals, the
ADA does not require states to establish licensing or certification programs for assistance
animals. And even in states where certification is offered, animals are not required to be
certified to meet the ADA definition of assistance animals. Therefore, if a person
declares that he or she has a disability and that his or her animal is an assistance animal,
then that animal should be treated as an assistance animal.
Some people with disabilities or seniors, especially those who may be hard of hearing or
frail, rely on their animals to alert them to people approaching their homes or to unusual
noises or circumstances. While these “alert” animals, usually dogs, are not trained as
“assistance” animals, they may still provide an important service to their owners.
Whenever possible, these “alert” animals should be allowed to accompany the people
with disabilities and seniors who use them. This would include allowing “alert” animals
to accompany their owners if they are isolated or quarantined in a location other than
their homes.
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G. SHELTERS
Shelters should meet the minimum accessibility requirements of the Americans with
Disabilities Act (ADA) and the NM Building Code (NMBC) 1997 as determined by a
certified access specialist. See requirements under Public Health Service Sites and
Appendix C, Accessible Checklists for PHSS and Shelters. It is also recommended that
individuals with chemical sensitivities be consulted regarding the accessibility of
potential shelter sites.
The level of medical oversight to be provided in shelters must be determined well in
advance of an emergency. Whether or not there will be different classes of shelters (e.g.,
medically managed or designated for special needs) must also be established in the
planning phase. In general, shelters should strive to be as inclusive as possible for people
with disabilities, individuals with chronic mental illness, and seniors. It is not acceptable,
for example, to send all people with disabilities to one shelter that may be far removed
from their home or workplace, when suitable closer ones are available. While “special
needs” shelters that offer more extensive accommodations and/or medical services are
valuable, individuals with disabilities and seniors should not be forced to use them if they
can otherwise safely sustain themselves at a general population shelter.
Recommendations on making emergency shelters more accessible:
Adequate numbers of cots should be available that are high enough for seniors and
mobility-impaired people to use comfortably and safely.
Be prepared to provide extra food and water to people with disabilities who are
accompanied by assistance animals.
In neighborhoods where familiar landmarks are altered or missing due to a disaster, some
visually-impaired people may need assistance to travel about.
Some people are non-vocal but still capable of thinking and making their needs known.
Shelter staff needs to be aware, patient, and creative when interacting with them.
Avoid using outdoor areas that are muddy, sandy, or covered by thick grass (although
areas may be preferred by chemically sensitive people if the air is cleanest there).
Shelter personnel should know how to use the deaf relay service -- Relay NM, 1-800659-1779 (voice), 1-800-659-8331 (TTY/TDD) -- to make and receive phone calls with
hearing and speech-impaired individuals.
Permit people with mobility impairments or other disabilities (which may or may not be
visible) the option of going to the head of long lines.
Train staff to realize that some people have the physical ability to ride buses, but do not
have the cognitive ability to learn new routes established because of a disaster.
30
Train staff to know how to contact disability agencies, such as sign interpreter agencies
and agencies that help families with at-risk infants with disabilities.
Train staff on the difference between the medical model and the independence model of
disability.
Train staff not to automatically assume that a person with a disability needs medical
services.
Shelters should have information about transportation resources and disability service
agencies.
Out-of-area emergency volunteers should not be given hotel accommodations that are
needed by local people with disabilities and seniors.
Portable telephones should be provided that have volume controls.
Public phone stations need power sockets nearby to supply power to portable TTY/TDDs
used by deaf, hearing-impaired, and speech-impaired people.
Train staff to know that even normal amounts of background noise may prevent a person
with a hearing impairment from understanding spoken directions and instructions.
Train staff to know that some disabilities may give a person the appearance of being
intoxicated.
Train staff to know that some disabilities in certain circumstances lead to disruptive
behaviors and how to respond appropriately when such behaviors occur.
Stock writing tablets and pencils for hearing-impaired people to use, but do not assume
they read English. Use pictures when necessary.
Shelter managers should provide or know how to obtain a folding white cane, regular
cane, crutches, walker, manual wheelchair, portable ramp, shower chair, transfer board,
portable accessible commode, disposable briefs (e.g., “Depends”), large-handled eating
utensils, flexible straws, two-handled drinking mugs, leash and collar for service animals,
pet bowl, and portable TTY/TDD.
At the accessible entrance to a shelter, have signage providing information about features
of the shelter that is less than fully accessible.
Insure that the shelter’s address is clearly visible from the street.
Insure the approach to outdoor toilets is free of stones, rubble, steps, tree roots, mud, and
loose sand, and provide at least one non-chemical toilet.
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Stock simple tools and patch kits for repairing flat tires on wheelchairs.
Establish contact with local agencies that supply personal care attendants for people with
disabilities, such as independent living centers.
Train staff to realize the large number of hard of hearing people and their needs.
Train staff to be aware of the numerous chemical barriers presented by typical shelters for
people with chemical sensitivities, such as perfume, cleaning products, new carpets or
paint, newly built or remodeled buildings, pesticides, disinfectants, etc.
Use unscented cleaning products in the shelter.
Prohibit the use of perfume and cologne by staff and shelter residents and/or provide a
fragrance-free room.
Discourage the use of other scented personal care products by shelter occupants.
Prohibit smoking inside the shelter and within 50 yards of it outside.
Prohibit idling of vehicle engines within 50 yards of the shelter (except when necessary
to start engines).
Train staff to be aware of barriers for electromagnetically sensitive individuals, such as
electronic fluorescent lights, cell phones, computers, and other electrical equipment.
Allow individuals to stay in cars or other vehicles in parking lots or other areas near the
shelter if the shelter is inaccessible to them, and provide services in these areas if
necessary.
All shelters need information boards with notices about announcements that people with
disabilities may not hear or were not present for when the announcements were made.
H. ISOLATION AND QUARANTINE
If a person with a disability, individual with chronic mental illness, or a senior is required
to be isolated or quarantined, the facility needs to be accessible and tolerated by that
individual as well as provide adequate and appropriate medical care. In keeping with
New Mexico law, this should be by the least restrictive means possible and should
preferentially isolate or quarantine an individual with a disability, mental illness or a
senior in his or her home whenever possible.
32
I. TRAINING FOR FIRST RESPONDERS AND OTHER RESCUE WORKERS (DP2,
adapted)
Train personnel to regard a person with a disability as the best expert in his or her
disability and to ask the person for advice before lifting or moving him or her.
Train personnel to recognize that the parents or caregiver of a child with a disability are
the best experts in knowing how to assist the child.
Train personnel to take extra time when communicating with people who are deaf,
hearing or speech-impaired, mentally ill, or emotionally upset.
Train personnel in basic sign language to effectively communicate with individuals who
are deaf.
Train personnel to never separate a person with a disability from his or her assistive aids,
such as wheelchairs, canes, hearing aids, medications, special diet food, urinary supplies,
masks, respirators, or assistance animal.
Train personnel to know that assistance animals are allowed to stay in emergency shelters
with their owners.
Train personnel to realize that the equipment of a person with a disability may not be
working after a disaster occurs, or it may be insufficient for emergency circumstances.
Train personnel to realize that a disaster may temporarily confuse assistance animals
during which time they may not be able to help their owners as effectively as before the
disaster.
Train rescue workers to know that some individuals with emotional and developmental
disabilities may be too unsettled to respond appropriately to instructions and directions,
such as a public address announcement to evacuate a building. Some individuals may act
confused or angry or may even try to hide from rescue workers. These individuals may
need to be in a quiet place for a while to regain their composure
Train personnel to realize that some individuals with significant mental or learning
disabilities may not understand the significance of “Keep Out” signs and barricade tape.
Train personnel on how to carry or assist individuals who use mobility aids, since the
traditional “fire fighter’s carry” may be harmful to some individuals.
Train personnel to know that removing some individuals from wheelchairs may
disconnect them from life-sustaining equipment, such as a ventilator.
Train personnel to know that children with disabilities may need different sizes of
equipment than adults, such as needles, oxygen masks, wheelchairs, and ventilators.
33
Train personnel to know that children are highly influenced by the emotional state of
their caregivers.
Train personnel that decontamination showers that are safe for adults may result in
hypothermia in children unless heating lamps or other warming equipment is provided.
Train personnel that children may struggle against the efforts of health care workers or
emergency responders because they do not understand what is going on or may be
frightened by the appearance of workers in protective gear.
Also train personnel that (FEMA):
Individuals with disabilities, seniors, and those who have a chronic mental illness should
be treated as fully competent to make their own decisions (unless the person is a child or
has a legal guardian or conservator).
People with disabilities generally know the best way to be assisted. A minute or so spent
talking with the individual will provide crucial information. People providing assistance
should be trained on how to help without causing injury to themselves or others. This is
especially relevant if someone needs to be lifted or carried. (Easterseals)
People with disabilities often need more time than others to make necessary preparations
and take action in an emergency.
The needs of many seniors are often similar to those of people with disabilities.
People who are deaf or hard of hearing may not receive early disaster warnings and
emergency instructions because they are often given by audible means such as sirens and
radio announcements. Be their source of emergency information as it comes over the
radio or television. Prepare written information in clear language that can be handed out.
Some people who are blind or visually-impaired, especially older people, may be
extremely reluctant to leave familiar surroundings when the request for evacuation comes
from a stranger.
People with impaired mobility are often concerned about being dropped when being
lifted or carried. Find out the proper way to transfer or move someone in a wheelchair
and what exit routes from buildings are best.
Some people with mental retardation may be unable to understand the emergency and
may become disoriented, frightened, or confused about the proper way to react.
Many respiratory illnesses can be aggravated by stress and air pollution. In an
emergency, oxygen and respiratory equipment may not be readily available.
34
People with epilepsy, Parkinson’s disease, diabetes, thyroid disease, and psychiatric or
other acute or chronic medical conditions often have medication regimens that cannot be
interrupted without serious consequences. Some people may be unable to communicate
this information in an emergency.
People with chronic illnesses may need to be reminded to take their medication after a
disaster.
People with disabilities may need transportation to a shelter. This may require a
specialized vehicle designed to carry a wheelchair or other mobility equipment and/or be
free of cigarette smoke and fragrance residues, pesticide, diesel fumes, and new
upholstery.
Also, see Tips on Assisting People with Disabilities, Individuals Who Have a Mental
Illness, and Seniors, Appendix C.
J. RECOVERY PHASE AND POINTS OF SERVICE
The recovery phase of a disaster can be especially traumatic for people with disabilities,
individuals with chronic mental illness and seniors. In addition to coping with personal
losses or injuries they may have suffered as a result of the disaster, they may be deprived
of vital connections to attendants, home health aides, assistance animals, home-delivered
meals, neighbors, local businesses, and even family members. Often they are no longer
able to follow their accustomed routines.
Addressing the needs of people with disabilities should be given a high priority during a
disaster’s recovery phase to minimize the interruption of critical services, such as
attendant care; access to medications, oxygen, dialysis, diabetic supplies, physical
therapy, or other ongoing medical or psychological care; and re-establishing electricity
for those dependent on electrical equipment, among other things.
Recommendations on how to make services accessible after a disaster:
All service locations must be accessible for people with disabilities and seniors, including
having accessible parking nearby with a clear loading area, and being near accessible
transit.
People with mobility impairments and many visually impaired people will likely need
assistance to transport food and 5-gallon water containers from distribution points to their
residences.
Some people with disabilities may need assistance to travel to and from points of
emergency and recovery services.
Some people with disabilities may need assistance to wait in line at points of service or
need to be allowed to go the front of the line.
35
Avoid using outdoor areas that are muddy, sandy, or covered by thick grass (except for
serving chemically sensitive people who may prefer those areas if the air is the cleanest
there).
Permit people with mobility and other impairments, which may or may not be visible, the
option of going to the head of long lines.
Train staff to realize that some people have the physical ability to ride buses, but do not
have the cognitive ability to learn new routes established because of a disaster.
Train staff to realize that some people with emotional or developmental disabilities may
be too unsettled by the disaster to return to their safe residence unless accompanied by a
counselor familiar with the particular disability. Train staff to know how to locate
resources for these counselors.
Some people with mental retardation may need assistance understanding and filling out
emergency paperwork.
Train staff to know that even normal amounts of background noise may prevent a person
with a hearing impairment from understanding spoken instruction and directions.
Forms and explanations for FEMA and other assistance should be available in Braille,
large print, and on audiotape.
Stock bicycle tire patch kits for use on wheelchairs and scooters with flat tires.
Train staff to know essential sign language signs.
Realize that a food stamp application question such as “Do you buy and prepare your
own food?” yields a misleading answer when asked of people with disabilities who use
attendants.
FEMA disaster centers need to have TTY/TDDs.
Have the ability to make emergency allocations of Temporary Assistance for Needy
Families (TANF) and food stamps, as well as emergency Medicaid authorizations.
VII. CONCLUSION: The New Mexico emergency preparedness plan for people with
disabilities, individuals with chronic mental illness, and seniors should be considered a
work in progress. There needs to be ongoing involvement of people in these
communities as plans evolve and new information, technology, and resources become
available. For example, a FEMA disaster preparedness guide for people with disabilities
is soon to be released and likely will contain useful information to incorporate into the
emergency preparedness plan.
36
APPENDICES
APPENDIX A -- PROCESS AND LIST OF CONTRIBUTORS:
The Governor’s Committee on Concerns of the Handicapped (GCCH) began meeting
with the disability community regarding bioterrorism and emergency preparedness in
June, 2002. This workgroup expanded and has continued to meet, discuss relevant
issues, and recommend best practices and tips sheets, which has helped shape this report.
Members of the workgroup include:
Judy Myers
Dee Martinez
Hope Reed
Kim Banales
Karen Courtney
Greg Trapp
James Salas
Debbie Armstrong
Shirley Washburn
Romelia Rodriguez
Ann McCampbell, MD
Director, Gov’s Committee on Concerns of Handicapped
Researcher, Governor’s Committee on Concerns of the
Handicapped
Governor’s Committee on Concerns of the Handicapped
NM Commission for the Deaf and Hard of Hearing
NM Commission for the Deaf and Hard of Hearing
Executive Director, NM Commission for the Blind
NM Commission for the Blind
State Agency on Aging
National Alliance for the Mentally Ill (NAMI)
American Lung Association (ALA)
Multiple Chemical Sensitivities Task Force of NM
In addition to meeting with workgroup members, we met (by phone) with emergency
management/special needs consultant Elizabeth Davis (718-330-0034,
edavis@eadassociates.org) who had been the Special Needs Adviser to the New York
City Office of Emergency Management during the 9/11 World Trade Center disaster.
She now heads up the National Organization on Disability’s Emergency Preparedness
Initiative. GCCH staff and/or the consultant also spoke with Red Cross representatives
Bert Blumenfeld (505-424-1611) and Morris Huling (505-265-8514), Scott Boman at the
Santa Fe County 911 center (955-5080) and county emergency manager James Leach
(992-3086), and Carl Cameron of the National Center on Emergency Planning for People
with Disabilities (202-546-4464, ext. 201), and met with Department of Health staff and
its emergency preparedness advisory committee for people with disabilities, seniors, and
the chronically mentally ill.
37
APPENDIX B -- BIBLIOGRAPHY / BACKGROUND MATERIALS: GCCH staff
and the consultant reviewed the following web sites, videos, and documents in preparing
these best practice recommendations. It was found that there was an abundance of
available information on how people with disabilities can help themselves, but much less
on best practices for emergency preparedness and advice for emergency personnel on
how to help them.
INFORMATION ON EMERGENCIES AND PEOPLE WITH DISABILITIES,
INDIVIDUALS WITH CHRONIC MENTAL ILLNESS, AND SENIORS
(Includes problems encountered in past events, advice on assisting people with
disabilities and seniors, and making plans for assisting them, and/or advice on individual
preparedness.)
EMERGENCY PREPAREDNESS INITIATIVE, Guide on the Special Needs of
People with Disabilities for Emergency Managers, Planners & Responders,
National Organization on Disability (NOD), www.nod.org/content.cfm?id=1267
DISASTER PREPAREDNESS FOR PEOPLE WITH DISABILITIES –
RESOURCE, National Organization on Disability (NOD)
www.nod.org/cont/dsp_cont_item_view.cfm?viewType=itemView&contentId=787
DISASTER MOBILIZATION INITIATIVE: RESPONSE TO SEPTEMBER 11TH
National Organization on Disability (NOD),
www.nod.org/cont/dsp_cont_item_view.cfm?viewType=itemView&contentId=622&lc
EMERGENCY EVACUATION PREPAREDNESS, Taking Responsibility for Your
Safety, A Guide for People with Disabilities and Other Activity Limitations, by June
Isaacson Kailes, 2002, www.cdihp.org/ppdf/finalv4brochure.pdf
EARTHQUAKE, Coping with the aftermath can be a disaster, too, for people with
disabilities; Jim Hammitt, When Disaster Strikes, Mainstream Magazine, May 1994,
www.mainstream-mag.com/quake.htm
DISASTER, If you have a disability, the forces of nature can be meaner to you than
anyone else, but you can fight back, be prepared, Douglas Lathrop, Special Report: When
Disaster Strikes, Mainstream Magazine, November 1994,
www.mainstream-mag.com/disaster%20prep.htm
DISASTER PLANNING INFORMATION & SUGGESTIONS FOR PERSONS
WITH DISABILITIES AND THOSE ASSISTING THEM, Draft of an Appendix to
the City of Berkeley’s Earthquake Preparation Handbook, published as the “CERT
Handbook” in 1998. Prepared by Matthew Wangeman and Jane Nandi, December, 1996.
www.members.aol.com/jeannandi/HOMEPAGE/dis_plan.html
38
DISASTER MITIGATION FOR PERSONS WITH DISABILITIES, The Center for
an Accessible Society, From a report by The Annenberg Washington Program written in
collaboration with the President’s Committee on the Employment of People with
Disabilities by Dr. Peter David Blanck, Annenberg Senior Fellow,
www.accessiblesociety.org/topics/independentliving/disasterprep.htm
DISABLED PEOPLE AND DISASTER PLANNING (DP2), Recommendations for
reducing problems with accessibility that many disabled people experienced after the
1994 Northridge earthquake, www.citycent.com/dp2
Prepare for What Will Happen, http://citycent.com/dp2/prepare.htm
Shelter Managers Should Know, http://citycent.com/dp2/shelmngr.htm
Training Rescue Workers, http://citycent.co/dp2/rescue.htm
Evacuating Wheelchair Users, http://citycent.com/dp2/wheelchair.htm
Communications after a Disaster, http://citycent.com/dp2/communications.htm
Managing Shelters, http://citycent.com/dp2/shelters.htm
Points of Service (Food, Water, Financial Aid), http://citycent.com/dp2/service.htm
Related Websites, http://citycent.com/dp2/links.htm
DISABILITY ETIQUETTE HANDBOOK, City of San Antonio Disability Access
Office (Texas), includes information on service animals,
www.sanantonio.gov/planning/disability_handbook/disability_handbook.asp
TIPS FOR PEOPLE WITH DISABILITIES, American Red Cross, Information
prepared, developed, and distributed by Independent Living Resource Center, San
Francisco, California, in cooperation with June Kailes,
www.redcross.org/disaster/safety/eqtips.html
Has links to additional tip sheets on Health Cards, Emergency Documents, People with
Visual Disabilities, Deaf or Hard of Hearing, Communication and Speech Related
Disabilities, Psychiatric Disabilities, Developmental or Cognitive Disabilities, Mobility
Disabilities, Multiple Chemical Sensitivities, People Who Use Life Support Systems, and
Service Animals.
DISASTER PREPAREDNESS FOR PEOPLE WITH DISABILITIES, American
Red Cross, www.redcross.org/services/disaster/beprepared/disability.html
DISASTER PREPAREDNESS FOR PEOPLE WITH DISABILITIES, Federal
Emergency Management Agency (FEMA), www.fema.gov/library/disprepf.shtm
ASSISTING PEOPLE WITH DISABILITIES IN A DISASTER, FEMA,
www.fema.gov/rrr/assistf.shtm
S.A.F.E.T.Y.FIRST, Working Together for Safer Communities, Easter Seals,
www.easter-seals.org/site/PageServer?pagename=ntl_safety_first
What It is, Program Provides Evacuation Planning Support, s.a.f.e.t.y.first Tips, Key
Considerations for Someone with Special Needs, Accessibility Resources, Are Your
Tenants Safe?
39
NATIONAL CENTER ON EMERGENCY PLANNING FOR PEOPLE WITH
DISABILITIES (NCEPPD), www.disabilitypreparedness.org,
This organization offers training kits to assist in developing comprehensive emergency
plans that take into account the needs of people with disabilities.
EMERGENCY PLANNING FOR PEOPLE WITH DISABILITIES AND OTHER
SPECIAL NEEDS, Carl T. Cameron, Ph.D., Inclusion Incorporated, Founder of the
National Center on Emergency Preparedness for People with Disabilities.
THE CENTER FOR INDEPENDENCE OF THE DISABLED IN New York, INC.
(CIDNY) Has your independence been disrupted by the events of September 11?
www.cidny.org
RECOMMENDATIONS FOR THE CARE OF MENTALLY OR PHYSICALLY
CHALLENGED PERSONS AND THE ELDERLY IN EMERGENCIES
Pan American Health Organization,
www.paho.org/english/ped/te_snreto.htm
NEW YORK CITY’S GUIDE TO EMERGENCY PREPAREDNESS for Seniors and
People with Disabilities by New York City Mayor Michael R. Bloomberg, Mayor’s
Office for People with Disabilities (MOPD), Office of Emergency Management (OEM),
and Department for the Aging (DFTA),
http://home.nyc.gov/html/oem/pdf/emergency_prep_guide_2002.pdf
EMERGENCY PREPAREDNESS FOR OLDER PEOPLE, Nora O’Brien, Issue
Brief, January-February 2003, International Longevity Center-USA,
www.ilcusa.org/_lib/pdf/epopib.pdf
THE FRAIL AND THE HARDY SENIORS OF 9/11: THE NEEDS AND
CONTRIBUTIONS OF OLDER AMERICANS, Myrna Lewis, The Public as an
Asset, Not a Problem, A summit on leadership during bioterrorism, Johns Hopkins
University Center for Civilian Biodefense Strategies,
www.hopkins-biodefense.org/pages/events/peoplesrole/lewis/lewis_trans.html
THE ELDERLY MAY HAVE ADVANTAGE IN NATURAL DISASTERS,
Elizabeth Fried Ellen, LICSW, Psychiatric Times, January 2001,
www.psychiatrictimes.com/p010133.html
THE EFFECTS OF DISASTER ON PEOPLE WITH SEVERE MENTAL
ILLNESS, Kay Jankowski, Ph.D. and Jessica Hamblen, Ph.D., A National Center for
PTSD Fact Sheet, National Center for Post-Traumatic Stress Disorder (PTSD),
www.ncptsd.org/facts/disasters/fs_smi_disaster.html
COPING WITH DISASTER, Anand Pandya, MD, NAMI-NYC Metro, Affiliate of the
National Alliance for the Mentally Ill, http://nyc.nami.org/askthedoctor/ask10.htm
40
COPING WITH DISASTER – AFTERMATH OF SEPTEMBER 11, Evelyn
Roberts, Ph.D. and Susan Saler, MSW, NAMI-NYC Metro, Affiliate of the National
Alliance for the Mentally Ill, http://nyc.nami.org/meeting_sept11.htm
NATURAL DISASTERS AND SERVICE DELIVERY TO INDIVIDUALS WITH
SEVERE MENTAL ILLNESS – ICE STORM 1998, Lisa McMurray, MD and Warren
Steiner, MD, Canadian Journal of Psychiatry, May 2000, Canadian Psychiatric
Association, www.cpa-apc.org/Publications/Archives/CJP/2000/May/Brief.asp
POWER OUTAGES AND MAJOR DISASTERS: HOW THEY AFFECT
CHILDREN WITH SPECIAL HEALTH CARE NEEDS, Family Voices,
www.familyvoices.org/fs/power-outages.html
COPING WITH DISASTER: SUGGESTIONS FOR HELPING CHILDREN
WITH COGNITIVE DISABILITIES, Anne Farrell, Ph.D. and Daniel Crimmins,
Ph.D., Administration for Children & Families, U.S. Department of Health & Human
Services,
www.acf.dhhs.gov/programs/add/Sept11/addcoping.html
FOR THE SAFETY OF YOUR PET, New York City Emergency Management,
www.nyc.gov/html/oem/html/preparedness/tips_for_pets.html
COMMONLY ASKED QUESTIONS ABOUT SERVICE ANIMALS IN PLACES
OF BUSINESS, U.S. Department of Justice, Civil Rights Division, Disability Rights
Section, on The Guide Horse Foundation website, www.guidehorse.org/DOJ.htm
ACCESS RIGHTS OF PEOPLE WITH DISABILITIES AND THEIR SERVICE
ANIMALS, The Association of the Bar of the City of New York,
www.abcny.org/servanim.htm
PRINTABLE EMERGENCY GUIDE FOR CITIZENS WITH DISABILITIES,
City of New Orleans Office of Emergency Preparedness,
www.new-orleans.la.us/home/departmentsAndAgencies/nooep/printable_disabilities.php
ADA DESIGN REQUIREMENTS FOR ACCESSIBLE EGRESS, Resources on
Emergency Evacuation and Disaster Preparedness, Architectural and Transportation
Barriers Compliance Board, www.access-board.gov/evac.htm
EMERGENCY EVACUATION PROCEDURES FOR EMPLOYEES WITH
DISABILITIES, Job Accommodation Network (JAN), a service of the Office of
Disability Employment Policy of the U.S. Department of Labor, Linda Carter Batiste and
Beth Loy, www.jan.wvu.edu/media/emergency.html
EVAC+CHAIR CORPORATION, www.evac-chair.com
41
DISABILITY RESOURCES ON THE INTERNET, The Disability Resources
Monthly (DRM) Guide, DisabilityResources.org,
http://www.disabilityresources.org
FEMA EMERGENCY PROCEDURES: SPECIAL EQUIPMENT AND DEVICES,
2001, www.ican.com/news/fullpage.cfm?articleid=E778C428-9D78-46879B0777B461E3A4EF
FEMA EMERGENCY PROCEDURES: PROVIDING ASSISTANCE, 2001,
www.ican.com/news/fullpage.cfm?articleid=0F9E8D43-25E2-46B898787F369AABD5C6
10 WAYS TO MAKE YOURSELF SAFE AT WORK, Nicole Bondi, iCan!,
www.ican.com/news/fullpage.cfm/articleid/B0547F84-4752-42B781592B326706E119/cx/employment.succeed_at_work/article.cfm
EMERGENCY MEDICAL I.D. CARD (EMID)
http://www.spec.net/emid.htm
INTERACTING WITH PEOPLE WITH DISABILITIES, Independent Living,
Community Resources for Independence, www.crinet.org/interact.php
WHAT IS UNIVERSAL DESIGN?, The Center for Universal Design,
www.design.ncsu.edu/cud/univ_design/ud.htm
WHERE TO FIND INFORMATION ON ILLNESS OR DISABILITY, Community
Health Non-Profits of New Mexico, Family Caregiver Project, University of New
Mexico Health Sciences Center,
http://hsc.unm.edu/consg/family_caregivers/illness_info.shtml
7-1-1 PHONE SERVICE TO HELP HEARING/SPEECH IMPAIRED CONNECT,
Jay Wrolstad, ITS America (Intelligent Transportation Society of America), Oct. 1, 2001,
www.itsa.org/ITSNEWS.NSF/4e0650bef6193b3e852562350056a3a7/c9df6c080b91023d
85256ad8003f0329?OpenDocument
2-1-1 INFOLINE, United Way of Connecticut, A single source for information about
community services, referrals to human services, and crisis intervention,
www.infoline.org/AboutUs/2002Default.asp
INFORMATION ON EMERGENCY PREPAREDNESS FOR THE GENERAL
PUBLIC
ARE YOU READY? A Guide to Citizen Preparedness, FEMA,
www.fema.gov/areyouready/
42
UNITED FOR A STRONGER AMERICA: CITIZENS’ PREPAREDNESS GUIDE,
Prepared by the USA Freedom Corps, National Crime Prevention Council (NCPC), and
U.S. Department of Justice (DOJ)
www.ojp.usdoj.gov/ojpcorp/cpg.pdf
GET READY NOW, Preparing Makes Sense, U.S. Office of Homeland Security,
www.ready.gov
DISASTER LINKS ON THE WEB, Emergency Network Los Angles, Inc. (ENLA)
http://www.enla.org/ENLABookMark.htm
CALIFORNIA GOVERNOR’S OFFICE OF EMERGENCY SERVICES
www.oes.ca.gov/Operational/OESHome.nsf/1?OpenForm
NEW MEXICO EMERGENCY INFORMATION PORTAL,
sponsored by the New Mexico Internet Professionals Association
http://www.fire.nmipa.org
COUNTY LINES, CELL PHONES CAN DELAY 911 RESPONSES,
Bo Petersen, The Post and Courier, 8/20/01,
http://www.kernodlelaw.com/082001.htm
THE YOUNGEST VICTIMS: DISASTER PREPAREDNESS TO MEET
CHILDREN’S NEEDS, Children, Terrorism & Disasters Toolkit, American Academy
of Pediatrics, www.aap.org/terrorism/topics/PhysiciansSheet.pdf
MODEL TERRORISM AND DISASTER PROGRAM ANNOUNCED TO TREAT
YOUNG VICTIMS, Montefiore Medical Center,
www.childrenshealthfund.org/pedpreprelease.html
INFORMATION ON RESPONDER PREPAREDNESS FOR TERRORISM
INTRODUCTION TO NBC (Nuclear, Biological, Chemical) TERRORISM,
An Awareness Primer and Preparedness Guide for Emergency Responders,
Robert J. Heyer, D.Sc.; Disaster Preparedness and Emergency Response Association
(DERA), www.disasters.org/dera/library/Heyer%20WMD.pdf
FEMA’s EMERGENCY RESPONSE TO TERRORISM SELF-STUDY COURSE
www.usfa.fema.gov/dhtml/fire-service/nfa-off3ss2.cfm
A 1999 self-study course designed to provide basic awareness training to prepare first
responders to respond safely and effectively to incidents of terrorism. Five modules Terrorism in Perspective, Incidents and Indicators, Self-Protection, Scene Control,
Notification and Coordination.
43
EMERGENCY RESPONDER GUIDELINES
By the Office for Domestic Preparedness (ODP), U.S. Department of Justice, 2002,
Provides information on training for first responders on awareness, performance level
guidelines, and planning and management level guidelines.
www.ojp.usdoj.gov/odp/docs/coursecatalog.pdf
ANTHRAX INFORMATION RESOURCES FOR FIRST RESPONDERS, CounterTerrorism, U.S. Fire Administration, Federal Emergency Management Agency (FEMA),
www.usfa.fea.gov/dhtml/fire-service/bioagents.cfm
WEAPONS OF MASS DESTRUCTION TRAINING PROGRAM, Enhancing State
and Local Capabilities to Respond to Incidents of Terrorism, U.S. Department of Justice,
Office of Justice Programs, Office for Domestic Preparedness; catalog of training courses
and materials on WMD for a broad spectrum of emergency responders, including fire,
hazardous materials (HazMat), law enforcement, emergency medical services (EMS),
public health, emergency management, and public works agencies,
www.ojp.usdoj.gov/odp/docs/coursecatalog.pdf
METROPOLITAN MEDICAL RESPONSE SYSTEM FIELD OPERATIONS
GUIDE, Counterterrorism Program, Office of Emergency Preparedness, U.S.
Department of Health & Human Services, November 1998; A field guide designed for
first responders to assist in preparing for a medical response to a weapons of mass
destruction (WMD) incident,
www.ndms.dhhs.gov/CT_Program/Response_Planning/response_planning.html
RESPONDING FIRST TO BIOTERRORISM, Web resources for “First Responders”
on bioterrorism and public safety, The National Academies, www.nap.edu/firstresponders
Includes sections on training programs and procedures for first responders on how to do
their jobs effectively in a bioterrorism incident.
LOCAL LAW ENFORCEMENT RESPONDS TO TERRORISM, Lessons in
Prevention and Preparedness, COPS Innovations – A Closer Look, U.S. Department of
Justice, Office of Community Oriented Policing Services (COPS),
www.cops.usdoj.gov/default.asp?Open=True&Item=296
STATE AND LOCAL DOMESTIC PREPAREDNESS SUPPORT HELPINE,
1-800-368-6498, Office for Domestic Preparedness (ODP), Office of Justice Programs
(OJP), U.S. Department of Justice (DOJ), www.ojp.usdoj.gov/odp/docs/helpline.htm,
The Helpline is a non-emergency resource available for use by emergency responders.
ELEMENTS OF EFFECTIVE BIOTERRORISM PREPAREDNESS: A Planning
Primer for Local Public Health Agencies, National Association of County and City
Health Officials (NACCHO), January, 2001,
www.naccho.org/files/documents/Final_Effective_Bioterrism.pdf
44
LOCAL EMERGENCY PREPAREDNESS AND RESPONSE INVENTORY, A
Tool for Rapid Assessment of Local Capacity to Respond to Bioterrorism, Outbreaks of
Infectious Disease, and Other Public Health Threats and Emergencies, Public Health
Practice Program Office, Centers for Disease Control and Prevention (Draft 2002, in
process of being updated), www.phppo.cdc.gov/documents/localinventory.pdf
COMMUNITY RESPONSE TO THE THREAT OF TERRORISM, Issues and Ideas
Papers Presented During a Public Entity Risk Institute (PERI) Internet Symposium,
November 2001,
www.riskinstitute.org/ptrdocs/CommunityResponse-Terrorism.pdf
RESOURCE LIST – DISASTERS, Emergency Medical Services for Children,
www.ems-c.org/cfusion/resourcegroup.cfm?cat=/disasters
PEDIATRIC DISASTER LIFE SUPPORT – PDLS, Caring for Children during
Disaster is a two day training course for medical, EMS, and disaster professionals. It
provides information on disaster planning, response, and mitigation and addresses the
unique needs of children during disasters, University of Massachusetts Medical School,
information on the Emergency Medical Services for Children website,
www.ems-c.org/cfusion/ResourceDetailNew.cfm?id=259768130
EMERGENCY RESPONDERS … IN AN ONGOING STATE OF
PREPAREDNESS, Jennifer Grow and James Parker,
National Safety Council Home & Community,
www.nsc.org/issues/emerg/strikes.htm
INTEROPERABLE COMMUNICATIONS FOR FIRST RESPONDERS FACES
CHALLENGES, National Governor’s Association Center for Best Practices,
Notes that one of the biggest challenges for emergency responders is the need for a
communication system that permits responders from various agencies to communicate
with each other.
www.nga.org/center/frontAndCenter/1,1188,C_FRONT_CENTER^D_3635,00.html
EMERGENCY COMMUNICATIONS: THE QUEST FOR INTEROPERABILITY
IN THE UNITED STATES AND EUROPE, Viktor Mayer-Schonberger, Belfer Center
for Science and International Affairs (BCSIA) Discussion Paper 2002-7, Executive
Session on Domestic Preparedness (ESDP) Discussion Paper ESDP-2002-03, John F.
Kennedy School of Government, Harvard University, March 2002,
http://bcsia.ksg.harvard.edu/BCSIA_content/documents/Emergency_Communications__The_Quest_for_Interoperability_in_the_United_States_and_Europe.pdf
ONALERT RADIO RECEIVERS, Emergency Notification system to alert, inform, and
instruct, Warning Systems, Inc. (WSI), www.warningsystems.com
45
VIDEOS – U.S. Department of Justice, Office of Justice Programs, Office for Domestic
Preparedness:
Managing Terrorism Incidents: Using Unified Command in WMD Incidents
(Parts 1 and 2)
Weapons of Mass Destruction and the First Responder
Surviving Weapons of Mass Destruction
Weapons of Mass Destruction and the First Responder
Surviving the Secondary Device, the Rules Have Changed
DISASTER PSYCHIATRY OUTREACH (DPO), A non-profit volunteer organization
of psychiatrists providing on –site psychotherapeutic and psychopharmacologic disaster
services, www.disasterpsych.org
PUBLIC HEALTH EMERGENCY PREPAREDNESS & RESPONSE, Selected
Agents and Threats, Centers for Disease Control and Prevention (CDC), www.bt.cdc.gov
SMALLPOX, Public Health Emergency Preparedness & Response, CDC,
www.bt.cdc.gov/agent/smallpox/index.asp
SMALLPOX RESPONSE PLAN AND GUIDELINES (Version 3.0), Public Health
Emergency Preparedness & Response, CDC,
www.bt.cdc.gov/agent/smallpox/response-plan/index.asp
SMALLPOX BASICS: INFORMATION FOR THE GENERAL PUBLIC, Public
Health Emergency Preparedness & Response, CDC,
www.bt.cdc.gov/agent/smallpox/basics/index.asp
PUBLIC HEALTH ASSESSMENT OF POTENTIAL BIOLOGICAL
TERRORISM AGENTS, Report Summary, Lisa Rotz, et.al, Emerging Infectious
Diseases, CDC, www.cdc.gov/ncidod/EID/vol8no2/01-0164.htm
ANNEX 3 – SMALLPOX VACCINATION CLINIC GUIDE, Logistical
Considerations and Guidance for State and Local Planning for Emergency, Large-Scale,
Voluntary Administration of Smallpox Vaccine in Response to a Smallpox Outbreak,
www.bt.cdc.gov/agent/smallpox/response-plan/files/annex-3.pdf
NEW MEXICO HOMELAND SECURITY STRATEGIC PLAN, “Readiness for
today, Enhanced Capability for Tomorrow,” August 2002
PUBLIC HEALTH SERVICE SITE (PHSS) PACKET, Section 2, Information for
people who are working in a PHSS, New Mexico Department of Health, Final Draft
1/31/03
46
MEDICAL MANAGEMENT OF BIOLOGICAL CASUALTIES HANDBOOK,
Third Edition, U.S. Army Medical Research, Institute of Infectious Disease, July 1998,
www.nbc-med.org/SiteContent/medRef/OnlineRef/FieldManuals/medman/Cover.htm
[Fourth Edition, February 2001, www.usamriid.army.mil/education/bluebook.html]
MEDICAL TREATMENT AND RESPONSE TO SUSPECTED SMALLPOX:
Information for Health Care Providers during Biologic Emergencies, New York City
Department of Health, Bureau of Communicable Disease
www.nyc.gov/html/doh/html/cd/smallmd.html
RECOGNITION OF ILLNESS ASSOCIATED WITH THE INTENTIONAL
RELEASE OF A BIOLOGIC AGENT, National Center for Infectious Diseases,
Epidemiology Program Office, Public Health Practice Program Office, Office of the
Director, Centers for Disease Control and Prevention (CDC), Morbidity and Mortality
Weekly Report (MMWR), October 19, 2001,
www.cdc.gov/mmwr/preview/mmwrhtml/mm50541a2.htm
FOCUS ON BIOTERRORISM, Web resources, American Academy of Physician
Assistants, www.aapa.org/clinissues/Bioterrorism.htm
THE DEMON IN THE FREEZER, How smallpox, a disease officially eradicated
twenty years ago, became the biggest bioterrorist threat we now face, Richard Preston,
The New Yorker, July 12, 1999, http://cryptome.org/smallpox-wmd.htm
THE BIOWEAPONEERS, in the last few years, Russian scientists have invented the
world’s deadliest plagues. Have we learned about this too late to stop it?, Richard
Preston, The New Yorker, March 9, 1998, http://cryptome.org/bioweap.htm
APPENDIX C – ACCESSIBLE CHECKLISTS FOR PUBLIC HEALTH SERVICE
SITES AND SHELTERS, Governor’s Committee on Concerns of the Handicapped (See
attached)
APPENDIX D -- TIPS ON ASSISTING PEOPLE WITH DISABILITIES,
INDIVIDUALS WITH CHRONIC MENTAL ILLNESS, AND SENIORS
1. SPECIFIC ASSISTANCE TECHNIQUES (FEMA Assistance/iCan!)
a) When assisting people with VISION IMPAIRMENTS: (+Berkeley)
Announce your presence; speak out then enter the area.
Identify yourself and offer help, but let the person explain what help is needed.
Let the person use his or her cane if desired.
Speak directly to the individual and NOT through a third party.
Describe the action to be taken in advance, that is, give clear directions as to what they
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are to do or where they are to go; do not shout.
Don’t be afraid to use words like “see,” “look,” or “blind”.
To guide a blind person:
Let the individual grasp your arm or shoulder lightly and follow the motion of
your body.
Walk about one-half step ahead and identify steps, curbs, doorways, narrow
passages, ramps, or other obstacles as you approach them.
Pause briefly at steps or curbs.
Go up or down stairs one step ahead of the person being guided.
In areas too narrow for walking two abreast, tell the person about the situation and
Indicate that he or she should get behind you by bending your arm backward so
that your hand is partly behind your back. This position, when held, extends your
elbow behind you and automatically puts the person being guided more directly
behind you. If circumstances make such a position impractical, improvise by
having the blind person hold on to your shoulder.
When helping a blind person to a chair, guide his or her hand to the chair arm or
back.
When a blind person is to enter a car, guide his or her hand to the leading object,
e.g., door handle or edge of a door, and let the person you are guiding do the rest.
Keep doors closed or wide open. A partially closed door is one of the most
dangerous obstacles a blind person can encounter. Avoid walking where there are
overhanging obstacles.
If leading several individuals with visual impairment at the same time, ask them
to hold each other’s hands.
You should ensure that after exiting the building that individuals with impaired vision are
not abandoned, but are led to a place of safety, where a colleague(s) should remain with
them until the emergency is over.
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Suggested bullets for tip sheets for first responders on assisting people with visual
disabilities:



Ask the blind person what he or she needs, and how he or she may be assisted. Do
not grab or attempt to guide a blind or visually-impaired person without first gaining
permission to do so.
Communicate written information orally, including information on signs, posters, and
instructions.
Respect the person and his or her use of an assistance animal or white cane. Do not
pet the animal and do not grab the cane.
b) Suggestions for assisting owners of ANIMAL GUIDES:
Do not pet or offer the animal food without permission of the owner.
Ask the person how to deal with his or her assistance animal.
When the animal is wearing its harness, it is on duty; if you want the animal not to guide
its owner, have the person remove the animal’s harness.
Plan for the animal to be evacuated with the owner.
In the event you are asked to take the animal while assisting the individual, it is
recommended that you hold the leash and not the animal’s harness.
c). when assisting people with HEARING IMPAIRMENTS: (+Berkeley)
Flick the lights when entering the room or area to get the person’s attention.
The hearing impaired need to communicate face-to-face.
Face the person directly and get as close as you comfortably can.
Establish and maintain eye contact with the individual, even if an interpreter is present.
If you look away, the individual will think the conversation is over.
Face the light, do not cover or turn your face away.
Use facial expressions and hand gestures as visual cues.
Keep yours hands away from your face when talking. Eating, smoking, chewing gum, or
adjusting your eyeglasses obscures your mouth and makes your speech difficult to
understand.
Offer pencil and paper, bearing in mind that not all deaf or hearing-impaired people can
read. If the person can read, write slowly and let the individual read as you write.
Written communication may be especially important if you are unable to understand the
individual's speech.
Keep your language simple and draw pictures as necessary. When the deaf person
responds in writing, be aware that he or she may use unusual sentence structure and
syntax.
Also be aware that some deaf people may be wary of non-deaf people.
Check to see if you have been understood and repeat if necessary.
Do not allow others to interrupt or joke with you while conveying the emergency
information.
Be patient, the individual may have difficulty comprehending the urgency of your
message.
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Provide the individual with a flashlight for signaling their location in the event that they
are separated from the rescuing team and to facilitate lip-reading in the dark.
d) When assisting people with LEARNING DISABILITIES keep in mind that:
You need to be patient when assisting people with learning disabilities.
Their visual perception of written instructions or signs may be confused.
They may need someone to accompany them because their sense of direction may be
limited.
Directions or information may need to be broken down into simple steps.
Simple signals and/or symbols should be used.
A person’s ability to understand speech is often more developed than his or her own
vocabulary.
Do not talk about a person to others in front of him or her.
People should be treated as adults who happen to have a cognitive or learning disability;
do not talk down to them or treat them like children.
e) When assisting people with MOBILITY IMPAIRMENTS: (+Berkeley)
Someone using a crutch or cane might be able to negotiate stairs independently. One
hand is used to grasp the handrail while the other hand is used for the crutch or cane.
Here, it is best NOT to interfere with this person’s movement. You might be of
assistance by offering to carry the extra crutch. Also, if the stairs are crowded, you can
act as a buffer and “run interference”.
In other words, if you see someone with mobility impairment, offer your services but do
not presume that they are needed. If the person needs assistance, he or she will
appreciate your offer and tell you exactly what actions would be helpful. Be sure to
listen to these instructions carefully.
Wheelchair users are trained in special techniques to transfer from one chair to another.
Depending on their upper body strength, they may be able to do much of the work
themselves. If you assist a wheelchair user, avoid putting pressure on the person’s
extremities and chest. Such pressure might cause spasms, pain and even restrict
breathing. Carrying someone slung over your shoulders (something like the so-called
“fireman’s carry”) is like sitting on their chest and poses danger for some people with
certain neurologic and/or orthopedic disabilities.
If a conversation with someone using a wheelchair will take more than a few minutes, sit
down to speak at eye level. It is very uncomfortable for a seated person to look up for a
long period of time. A person in a wheelchair may be paralyzed in one or more parts of
his or her body, which can be accompanied by lost pain perception in those areas. Thus
he or she may be unaware of serious injury there. Try to minimize the amount of time a
person is separated from his or her chair and avoid abandoning the wheelchair whenever
possible.
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f) When assisting people with CHEMICAL SENSITIVITIES:
Provide non-smoking personnel who are not wearing perfume, cologne, aftershave or
other strongly scented products.
Ask if the person needs to be moved to a less-toxic area, possibly outdoors.
Do not use latex gloves, disinfectants or other volatile chemicals without asking first.
Be aware that chemically sensitive individuals can react adversely to a wide variety of
chemicals at very low levels, which you may not be able to detect. These reactions can
include headache, nausea, vomiting, diarrhea, fatigue, muscle and joint pain, wheezing,
confusion, irregular heartbeat, and seizures.
Be aware that when some chemically sensitive individuals are in a reaction, they may be
too confused to follow evacuation or other instructions and may need help to comply.
Be aware that when some chemically sensitive individuals are in a reaction, they may
temporarily lose their ability to think or speak. They should be removed to an area with
cleaner air in order to communicate with them.
If a person is wearing a mask or respirator, speak directly to the individual and not
through a third party; there is no need to shout since the mask does not affect the person’s
ability to hear.
Go to a quieter location if you are having trouble hearing a person who is speaking with a
mask or respirator on.
Suggested bullets for tips for first responders in assisting people with chemical and/or
electromagnetic sensitivities:



Respect what the person says about what exposures will or are making the person sick
and help the person minimize or avoid them.
Provide non-smoking personnel who are not wearing perfume, cologne aftershave or
other strongly scented products and turn off cell phone.
Ask the person if he or she needs to move to a less-toxic area, possibly outdoors.
g) When assisting people with ELECTROMAGNETIC SENSITIVITIES:
Turn off cell phone.
Ask if the person needs to be moved or served away from computers, fluorescent lights,
high tension electrical lines, and other electronic equipment.
If a person is unconscious or otherwise unable to communicate, move the person to an
area with reduced electromagnetic fields (which can be measured with a handheld Gauss
meter).
h) When assisting people with OTHER LIMITATIONS:
Pregnancy can result in reduced stamina or impaired mobility, especially in negotiating
chairs. In these cases, offer to walk with the woman and be of support both emotionally
and physically. Remain with her until you have reached safety and she has a safe, warm
place to sit.
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Asthma, emphysema, and other respiratory disorders can be triggered or worsened by
stress, exertion, or exposure to small amounts of dust or smoke. Make sure these
individuals have access to needed medication, appropriate masks, and areas with good air
quality.
People with heart and other medical conditions may have reduced stamina and require
frequent rest periods. Offer them assistance in walking and make sure they have access
to needed medications.
2. CARRY TECHNIQUES
One-person carry technique: The cradle lift is the preferred method when the person to
be carried has little or no arm strength. It is safer if the person being carried weighs less
than the carrier’s weight.
Two-person carry technique – the swing or chair carry. To use this technique:
Carriers stand on opposite sides of the individual.
Take the arm on your side and wrap it around your shoulder.
Grasp your carry partner’s forearm behind the person in the small of the back.
Reach under the person’s knees to grasp the wrist of your carry partner’s other hand.
Both carry partners should then lean in, close to the person, and lift on the count of three.
Continue pressing into the person being carried for additional support in the carry.
The advantage of this carry is that partners can support (with practice and coordination) a
person whose weight is the same or greater than their own weight. The disadvantage is
the increased awkwardness in vertical travel (e.g., stair descent) due to the increased
complexity of the two-person carry. Three persons abreast may exceed the effective
width of the stairway.
To assist in moving a wheelchair downstairs: When descending stairs, stand behind the
chair grasping the pushing grips. Tilt the chair backwards until a balance is achieved.
Descend frontward. Stand one step above the chair, keeping your center of gravity low
and let the back wheels gradually lower to the next step. Be careful to keep the chair
tilted back. If possible, have another person assist by holding the frame of the wheelchair
and pushing in from the front. But do not lift the chair, as this places more weight on the
individual who is behind.
3. EVACUATING WHEELCHAIR USERS
a) All Wheelchair Users
Discuss with the user of the wheelchair how to lift the user and the wheelchair either
together or separately. When circumstances necessitate separating the user and the
wheelchair, keep the period of separation to a minimum.
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Some parts of a wheelchair are safe to lift from, others will come off when lifted.
Always ask the user to confirm where it is safe to lift. Also, ask the user what else about
his or her wheelchair you should know in order to lift it safely.
Wheelchairs with four wheels (not three-wheeled scooters) usually have handbrakes on
each side of the chair. When the wheelchair is to remain stationary, set both brakes.
When more than one flight of stairs is traversed, helpers may need to switch position
since one person may be doing most of the lifting. Switch positions only on a level
landing.
When the lifting is complete, follow the instruction of the chair’s user and restore the
manual or motorized wheelchair to full operation; then direct the user to a safe area.
b) Manual (non-motorized) Wheelchairs
Manual chairs weight between 20 and 60 pounds. Two people are required to lift a
manual wheelchair when occupied by the user.
Generally, the best way to lift the chair and user together is to position one helper behind
the chair and the other helper in front. The helper behind the wheelchair tips it
backwards to a balance angle that is tolerable to the user. The other helper grasps the
front of the wheelchair and guides its movement. The two helpers lower or raise the
wheelchair one step at a time making sure both rear tires hit step edges evenly.
c) Motorized Wheelchairs
Motorized wheelchairs can weigh up to 100 pounds (unoccupied), and may be longer and
heavier to push than manual wheelchairs. Some motorized chairs have additional
electrical equipment such as a respirator or a communications device.
Lifting a motorized chair and user up or down stairs requires two to four helpers. Before
lifting, discuss with the user if some heavy parts of the chair can be detached temporarily,
how to position the helpers, where they should grab hold, and at what if any angle to tip
the chair backward. Turn the chair’s power off before lifting the chair.
If the chair’s power drive is temporarily detached, the chair becomes “free wheeling”.
Helpers must realize they are entirely responsible for the safety of the user since the user
of a motorized wheelchair generally lacks the arm function to control the chair’s
movement.
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