Polk County Special Needs Registry
Policy and Procedures
Updated 110706
Purpose
The purpose of the Polk County Special Needs Registry (PCSNR) is to provide
emergency responders in Polk County with important health and medical information of
special needs individuals that may require assistance during an emergency, such as a
tornado, flood, blizzard, power outage or disease outbreak. The Special Needs
Registry is a voluntary program and in no way ensures that the individual enrolling in the
program will receive immediate or preferential treatment in an emergency. This
program will merely provide the emergency response community with information that is
pertinent to developing an effective response. The Special Needs Registry in no way
replaces the responsibility of individuals to have their own emergency plan.
History
The Special Needs planning process began as a pilot program for the Western Region
Partnership for Public Health Preparedness as a means of identifying special
populations within a geographical location including mechanisms to contact these
individuals during an emergency that requires evacuation or sheltering in place. The
Special Needs Registry is the result of a Special Needs Planning process that occurred
from February through September of 2006. Over 100 community members, including
emergency responders, chief elected officials, government departments, tribal
representatives and special population individuals identified the need to develop a
database of the most critical special needs populations.
Special Needs Registry Review Team.
The purpose of the Review Team is to review all registry applications and determine the
applicant’s level of enrollment into the program. This system will allow emergency
responders to identify and respond to individuals with the most urgent needs first.
Levels of Enrollment:
1. Level 1: Requires urgent attention. Individual’s medical information indicates
immediate emergency response assistance is necessary for survival.
2. Level 2: Requires moderate attention. Individual’s medical information indicates
an eventual emergency response is necessary but is not considered immediate
or life-threatening.
3. Level 3: Requires little attention. Individual’s medical information indicates
there is no immediate attention required. However, if time and resources
permit, the individual should be contacted by emergency responders.
4. Not eligible for the program.
The Review Team shall:
1. Meet quarterly, or as needed, to review applications.
Polk County Special Needs Registry Policy
Page 1 of 25
2. Consist of a representative from Public Health, Human Services, Emergency
Management, Aging, Home Care, Veterans Affairs and a local healthcare
provider.
3. Make recommendations and determine policy to enhance and maintain the
Special Needs Registry.
4. Determine the enrollment eligibility of an individual into the program.
5. Assign necessary follow-up on registration applications that need additional
information before enrollment eligibility can be determined.
Roles and Responsibilities
The PCSNR has not received any funding for planning, maintenance and/or operations.
The success and longevity of the program will rely heavily on the Departments listed
below to share program functions and costs incurred. To ensure that the program is
operating effectively as possible, it is important that the agencies involved with the
Special Needs Registry have identified core responsibilities along with specific
department responsibilities.
Core Responsibilities
 Promote the program with special populations through existing
communication channels.
 Assess and update the program protocol annually or as needed.
 Provide a Department representative to participate on the Review Team.
 Develop materials to be used by the program including Welcome Letters,
Renewal Letters, Brochures, FAQ’s, etc.
Department Responsibilities:
1. Public Health
 Lead agency in coordinating activities of the Special Needs Registry.
 Coordinate with Emergency Management to determine convening the Review
Team.
2. Human Services
 See Core Responsibilities
3. Aging Department
 Print and send materials to program participants.
4. Veterans Affairs
 Responsible for all marketing activities involved with the registry including
public information.
5. Information Technology
 Develop, maintain and update web registration form.
 Develop and implement a registration database. This system should notify
Emergency Management when a new registration has been submitted.
 Provide technical assistance with software.
6. Land Information
 Using GIS or a similar application process, map out program participants and
County Shelters.
Polk County Special Needs Registry Policy
Page 2 of 25
7. Emergency Management
 Receive all registry applications, On-line and paper, ensuring data entry into
the registry database.
 Maintain the program database.
 Coordinate with Public Health to determine convening the Review Team.
 Notification of Emergency Responders of the Special Needs Registry preincident and dissemination during incident.
Funding Support
To the extent possible, the agencies listed in this plan will share the costs incurred with
maintenance of the program. Emergency Management will be the fiscal agent for the
program and will budget program costs within its annual budget. In turn, Emergency
Management will invoice costs incurred by the program equally among Public Health,
Human Services, Veterans Affairs, and Aging.
Proposed annual operating budget (based on 500 registrations):
 Postage: $200.00
 Marketing (posters, media, etc): $150.00
 Paper: $10.00
 Envelopes: $10.00
 Copies: $75.00
 In-kind resources include personnel time, phone calls, etc.
 Total: $445.00
Information Sharing
The data and information collected from the PCSNR shall be used only during an
emergency. The information will be provided to local Emergency Responders only as
deemed appropriate by Polk County Emergency Management. The database shall not
be re-distributed to any individual or organization without the consent of Emergency
Management. Following a disaster or emergency, all paper forms of the program roster
shall be returned to Emergency Management for destruction. Distributed electronic
versions shall be deleted.
Notification
Notification to individuals enrolling or renewing their application with the PCSNR will
occur several ways:
 If applicants use the on-line registration process, individuals will be notified
instantly via automatic email verification that their application has been
received and is in the process of being reviewed.
 New or renewal applicants will be notified by Emergency Management via a
hardcopy letter whether the individual has been approved or denied into the
program along with an explanation of the circumstances. Emergency
Management will also send out individual emergency planning resources as
appropriate.
 Applicants may be contacted via phone from a member of the Review Team
requesting additional application information to determine eligibility.
Polk County Special Needs Registry Policy
Page 3 of 25

The renewal process will begin no later than March 15th annually. Individuals
in the PCSNR database will be sent a renewal notice via mail with directions
to update and renew their application.
Policy Approval:
The undersigned have hereby reviewed and approved the Polk County Special Needs
Registry. This policy accompanies the Polk County Special Needs Populations Plan for
Disasters and Emergencies which will be incorporated into the Polk County Emergency
Operating Plan.
__________________________________________ __________________________
Pubic Health
Date
__________________________________________ __________________________
Human Services
Date
__________________________________________ __________________________
Emergency Management
Date
__________________________________________ __________________________
Veterans Affairs
Date
__________________________________________ __________________________
Aging Department
Date
__________________________________________ __________________________
Information Technology
Date
__________________________________________ __________________________
Land Information
Date
Polk County Special Needs Registry Policy
Page 4 of 25
Appendix A: Registry Operations Flow
Special Needs Registry
Application
Completed On-Line –
Applicant information
downloaded into
Special Needs
Registry database
Email Notification Sent
to Emergency
Management
Instance Email
Verification Receipt
sent to Applicant
Completed Paper and
mailed in
Emergency
Management Receives
EM sends applicant
letter confirming receipt
of letter
EM and PH convene
Review Team
Application
Denied
Application
Approved – Level
assigned
EM updates
registry
Additional
Information Needed
Review Team
member contacts
applicant for
additional info
EM sends out letters
and other resources
Polk County Special Needs Registry Policy
Page 5 of 25
Appendix B: Application
Polk County Special Needs Registry Application
Disclaimer
The purpose of the Polk County Special Needs Registry is to provide emergency responders in Polk County with important
information from individuals that may require assistance during an emergency, such as tornado, flood, blizzard, power outage or
disease outbreak. This program is voluntary and in no way ensures that the individual completing this form will receive immediate or
preferential treatment in an emergency. This program will merely provide the emergency response community with information that
is pertinent to developing an effective response. The Polk County Special Needs Registry in no way replaces the responsibility of
individuals to have their own emergency plan.
Personal Information
Last Name
□ New Application
□ Update of Previous Application
First Name
MI
Street Address:
City:
Zip:
Primary Phone #:
Mailing Address (If different):
City:
Zip:
Alternate Phone #:
Date of Application:
Name of Subdivision, Mobile Home Park, Apartment Building, etc.:
Date of Birth:
Sex:
Primary Language:
Living Situation (check one): □ Live Alone □ With Spouse □ With Children □ With Parents □ Other (Explain)
Medical Information (Check and complete those that apply to your medical condition.)
□ Wheelchair Bound
□ Mental Health Condition
□ Walker
□ Special Dietary Needs
□ Bedridden
□ Required or Life-Sustaining Equipment
□ Hearing Impaired
□ Portable Oxygen Machine
□ Sign Language
□ Suction Machine
□ Visually Impaired
□ Oxygen Concentrator or Ventilator
□ Seizures
□ Continuous
□ Speech Impaired
□ Intermittent
□ Memory Impaired (Explain)
□ Life Sustaining Medications
□ Ostomy Care
□ Physically Disabled
□ G-tube Feeders
□ Other (Explain)
□ Developmentally Disabled:
Explain any that have been checked above including listing any types of diagnosis, medication, etc.:
Emergency Contact Information
Primary Emergency Contact
Last Name
First Name
Polk County Special Needs Registry Policy
Relationship
Phone
Page 6 of 25
Alternate Emergency Contact
Last Name
First Name
Relationship
Phone
Medical Provider Information (Fill in all that apply)
Physician Name:
Phone:
Pharmacy Name:
Phone:
Home Health Care Agency Name:
Phone:
Shelter Information
Pet Information
Can you, a family member or friend provide you with
transportation to a shelter in an emergency?
□ Yes □ No
Do you have pets that would require special attention if you
were asked to evacuate your home? If so, indicate the
number of:
If you need assistance with transportation, check one of the
following:
□ Automobile
□ Van with wheelchair lift
□ Bus
□ Medical transport required
_____Cat
_____Dog
_____Service Dog
_____Other (Explain)
Applicant Additional Comments
Authorization Information
By signing / submitting this form, I / legal guardian agree that my name be added to the Polk County Special Needs Registry. I give
the Polk County Emergency Management authorization to share this information with other community emergency responders in the
event of an emergency in order to facilitate an effective response. I grant emergency responders permission to enter my home
following an emergency event or disaster situation, if necessary, to assure my safety and welfare.
Applicant Signature
Date
X
Authorized Guardian Signature
Date
X
Mail Completed Form to:
Polk County Emergency Management
1005 West Main, Ste 900,
Balsam Lake, WI 54810
For questions regarding this form or this program, contact the Polk County Emergency Management Office at 715-485-9280 or by
email at kathyp@co.polk.wi.us. This form can be filled out and submitted on-line at www.co.polk.wi.us/emgt
Polk County Special Needs Registry Policy
Page 7 of 25
Appendix C: Registry Letters
1. Denial Letter
Polk County Special Needs Registry
1005 West Main, Ste 900
Balsam Lake, WI 54810
Phone Number: 715-485-9280
Fax Number: 715-485-8315
http://www.co.polk.wi.us/emgt/special_needs
DATE
Dear NAME:
Your Special Needs Application has been reviewed by the Special Populations Program
Review Team and you have been found to be ineligible for the program at this time.
If you feel there is information that was not considered in this review, please contact me
to discuss or fill out a new application with more detailed information and submit it for
reconsideration. If you have significant changes in your situation, please feel free to reapply at anytime.
Enclosed is information to help you plan for your own safety and welfare.
If you have any questions or concerns, please do not hesitate to contact me.
Sincerely,
EMERGENCY MANAGEMENT OFFICE
Kathy A. Poirier, Coordinator
The Polk County Special Populations Registry is sponsored by a partnership between the Departments of Emergency
Management, Public Health, Human Services, Aging and Veterans Affair
Polk County Special Needs Registry Policy
Page 8 of 25
2. Registry Received Letter
Polk County Special Needs Registry
1005 West Main, Ste 900
Balsam Lake, WI 54810
Phone Number: 715-485-9280
Fax Number: 715-485-8315
http://www.co.polk.wi.us/emgt/special_needs
DATE
Dear NAME:
Your Special Needs Application has been received and will be reviewed by the Special
Populations Program Review Team. You will be notified by mail concerning the status of
your application.
If you have any questions or concerns, please do not hesitate to contact me.
Sincerely,
EMERGENCY MANAGEMENT OFFICE
Kathy A. Poirier, Coordinator
The Polk County Special Populations Registry is sponsored by a partnership between the Departments of Emergency
Management, Public Health, Human Services, Aging and Veterans Affair
Polk County Special Needs Registry Policy
Page 9 of 25
3. Update Letter
Polk County Special Needs Registry
1005 West Main, Ste 900
Balsam Lake, WI 54810
Phone Number: 715-485-9280
Fax Number: 715-485-8315
http://www.co.polk.wi.us/emgt/special_needs
DATE
Re: Update of Special Needs Registration
Dear Name:
Polk County Emergency Management would like to assure that all of our Special Needs
Registrants are prepared in the event of a disaster or emergency. In order to properly
update our database of special needs citizens, we are asking that you or your caregiver
fill out the attached application.
Please be sure this form is filled out completely and signed or it will need to be returned
to you for completion. Once received, we will place the updated information you provide
into our database.
We are asking that you return your registration no later than April 30. If you no longer
need our services, please mark the form as such and return it to us.
If you have any questions or concerns, please do not hesitate to contact me.
Sincerely,
EMERGENCY MANAGEMENT OFFICE
The Polk County Special Populations Registry is sponsored by a partnership between the Departments of Emergency
Management, Public Health, Human Services, Aging and Veterans Affair
Polk County Special Needs Registry Policy
Page 10 of 25
4. Welcome Letter
Polk County Special Needs Registry
1005 West Main, Ste 900
Balsam Lake, WI 54810
Phone Number: 715-485-9280
Fax Number: 715-485-8315
http://www.co.polk.wi.us/emgt/special_needs
DATE
Dear NAME:
Your Special Needs Application has been reviewed by the Special Populations Program
Review Team and approved for enrollment into the County database of special needs
individuals.
Each year you will be required to update your application. This update will be done
beginning no later than March 15. You will be sent a reminder to complete a renewal
application. Renewal applications can be completed on-line or a new application can be
sent to you to be filled out and returned to our office. This process will verify continued
eligibility for the Special Needs Registry.
If you have any questions or concerns, please do not hesitate to contact me.
Sincerely,
EMERGENCY MANAGEMENT OFFICE
Kathy A. Poirier, Coordinator
The Polk County Special Populations Registry is sponsored by a partnership between the Departments of Emergency
Management, Public Health, Human Services, Aging and Veterans Affair
Polk County Special Needs Registry Policy
Page 11 of 25
Appendix D: Marketing Plan
I.
Develop Press Release/Public Service Announcement
a. Short, concise, to the point (What/Why, Who, How…)
b. Suitable for Newspaper/Radio/Poster
c. Follow State release guidelines….
II.
Distribute
a. Newspapers (AFP, Ledger, Leader, Osceola Sun)
b. Radio (WXCE, WLMX)
c. Aging Newsletter (Monthly)
d. Senior Citizen Meal Centers (5)
e. Medical Facilities (Social Workers/Clinic Nurse Managers) (Amery,
Osceola, St Croix Falls, etc.)
f. Public Health Nurses/Home Care/Birth to Three
g. Human Services (Case workers, etc.)
h. Emergency Services (Ambulances, Fire, Police/Sheriff)
i. Radio shows/interviews
j. Nursing Home Discharge Planners
III.
PowerPoint Presentation
a. For use at town meetings, public briefings, etc.
b. With or without “formal” presenter…
c. Church presentations
d. County Board Presentation
Notes: Develop release/PSA and poster with concurrence of committee. Provide
copies with attached hardcopy applications for general distribution. Ensure that website
and phone contacts prominent for assistance and additional detail. Keep as simple and
direct as possible for elderly… Ensure that potential applicants know that assistance in
filling out form is easily obtainable.
Polk County Special Needs Registry Policy
Page 12 of 25
Appendix E: Marketing Tools
1. Press Release
Polk County Special Needs Registry
1005 West Main, Ste 900
Balsam Lake, WI 54810
Phone Number: 715-485-9280
Fax Number: 715-485-8315
http://www.co.polk.wi.us/emgt/special_needs
October 30, 2006
For Immediate Release
Rick Gates, Polk County Communications, (715) 485-9243
POLK COUNTY SPECIAL NEEDS REGISTRY PROGRAM
BALSAM LAKE- A new program, the “Special Needs Registry,” is being started in Polk County.
The purpose of this program is to provide local emergency responders (Fire, Police,
Ambulances, etc.) with important information from individuals who reside in Polk County who
might have special needs or need special assistance in the event of an emergency situation,
such as a tornado, flood, blizzard, extended power outage, or disease outbreak. The program
is strictly voluntary, and its intent is to provide the emergency response network with information
pertinent to developing an effective response to emergency situations. Up until now, there has
been no registry or listing of people who would need special assistance in the event of an
emergency.
The people for whom the program is intended are those who have medical conditions or special
needs which would require assistance above and beyond the “normal” level during an
emergency. It is designed to address the needs of those who live independently, and is not for
those people living in institutional settings. Examples would include: elderly people living in
isolated areas, those unable to ambulate (i.e. wheelchair bound, bedridden, etc.), and those on
oxygen or the visually impaired; people on life sustaining medication, the developmentally
disabled, hearing impaired, and those requiring life sustaining equipment. Knowing the status
and location of people in our county with special needs would be critical in, for example, a
severe ice storm or snow condition. If power was lost to an area and would be out for an
extended period of time, it could be life threatening for those unable to leave or who require
electricity to maintain life support equipment.
Participation in this program is strictly voluntary and the information maintained in the registry
will be protected. Only in emergency situations will this information be accessed. Participation
in this registry in no way ensures that the individual will receive immediate or preferential
treatment during an emergency. All residents are encouraged to have their own emergency
plan. Those wishing to register can do so on line at www.co.polk.wi.us/emgt or via paper
application. Please contact Polk County Emergency Management Office (715) 485-9280 or via
email at kathyp@co.polk.wi.us for additional information or assistance in obtaining a paper
application.
Polk County Special Needs Registry Policy
Page 13 of 25
What will you do during an emergency or
Posterscall?
disaster? Do you have a plan? Who will2.you
Are you prepared to be on your own for 3 days?
These are important questions that
every resident of Polk County should
have answers for, but unfortunately
many do not.
Although individual preparedness
begins with you, Polk County
understands that there are residents
with severe health and medical conditions who will require
special help in an emergency. That’s why Polk County
has developed the Polk County Special Needs Registry.
The Registry is:
 Completely voluntary.
 Provides emergency responders
with information to develop an
effective response.
 Secure and confidential.
 Free to register.
For more information about the
Polk County Special Needs Registry
Visit the Polk County Emergency Management Website at www.co.polk.wi.us/emgt or call the
Emergency
Polk County Special Needs Registry
Policy Management Office at (715)485-9280
Page 14 of 25
3. Information Sheet
The Polk County Special Needs Registry is a program developed and sponsored by the Polk
County Departments of Public Health, Emergency Management, Aging, Veterans Affair and
Human Services.
The Registry allows individuals with critical health and medical conditions that may require
assistance during an emergency or disaster, such as a power outage, tornado, flood or
infectious disease outbreak, an opportunity to voluntarily register with the program and get their
name into the PCVSNP database. Then during an emergency or disaster, the Registry will
provide emergency responders in the effected area with important information about your health
and medical needs. This is important so that emergency responders know about you and can
develop a more effective response.
The Registry is a voluntary program and in no way ensures that the individual enrolling in the
program will receive immediate or preferential treatment in an emergency. This program will
merely provide the emergency response community with information that is pertinent to
developing an effective response, whether sheltering-in-place or evacuation. The Registry in
no way replaces the responsibility of individuals to have their own emergency plan.
The Registry is not for everyone though. The Registry should be considered by individuals who
have NO alternative or have no family or friend support structure in their community.
Emergency Management recommends using this program only as a last resort and individuals
with special needs should consider sheltering or evacuating with relatives or friends first.
Program Eligibility
The Registry is for those individuals who are not in a care facility, such as a hospital, nursing
home or congregate living facility. These facilities are required to have an evacuation plan in
place for their residents and patients to be transported to another healthcare facility. The
Registry is for individuals who are not part of a group facility and have no other alternative but to
seek assistance from the County.
1. Individuals require assistance with ostomy and indwelling catheter management.
2. Activities of daily living are so restricted by immobility that others provide assistance to
meet their basic needs and those people may be unavailable during and emergency or
disaster.
3. They have a respiratory condition requiring special equipment such as monitors or
oxygen.
4. There may be other conditions which would render an individual eligible for special
needs emergency sheltering and these will be considered by a Review Team.
Frequently Asked Questions
1. What is the process for determining whether someone meets the program eligibility?
Once an individual submits their application, they are automatically placed in Special Needs
Registry database. A Review Team consisting of emergency response and health and
medical partners will meet regularly to review the applications and make a determination.
Polk County Special Needs Registry Policy
Page 15 of 25
2. How do I register?
Individuals can submit applications to the program by printing, completing and submitting
the Special Needs Registry Application Form to Polk County Emergency Management or by
completing the Special Needs Registry On-line Application Form at www.co.polk.wi.us/emgt
3. How will I be notified if I am enrolled in the program?
After the Review Team looks at the application, they will either accept the application, deny
the application or will contact the individual for more information before making a decision.
Individuals will be notified via letter of the status of their application.
4. Can I register a family member or friend?
Yes. The application provides a section acknowledging that a person other than the
applicants name is completing the form.
5. Will the database be sold or given to non-emergency responders?
No. The database will only be distributed to emergency responders within the geographical
area at the time that emergency or disaster is occurring. Polk County Emergency
Management will house the database and will determine who will receive database
information. All records will be protected by Security Software.
6. What is the process for updating individual’s information?
It is critical that participant’s information stay current including addresses, contact
information, and health status. Individuals enrolled in the Registry will be sent a renewal
notice in March of each year asking the individual to complete the re-application via paper or
through the on-line registration process.
7. The application form indicates that emergency responders can enter my home during
an emergency or disaster. Is this true?
Yes. Depending the nature of the incident, and as a last resort, if you are not responding to
multiple attempts to contact you whether via phone calls or visits to your home or we can not
reach your emergency contact listed on your application, emergency responders may enter
your home to check on you.
8. What does it cost for me to be enrolled in the program?
Nothing. Polk County values our residents and we understand the importance of taking care
of our own. Therefore, the costs incurred for developing, operating and maintaining this
program come from a partnership of government agencies.
9. What can I expect if I am asked to evacuate my home and I have no place to go?
If no other alternatives are available, individuals apart of the Special Needs Registry may be
transported to a Special Needs Emergency Shelter. This shelter will be staffed by
individuals from the American Red Cross, Human Services, Public Health and others.
10. What if I am asked to shelter-in-place?
The nature of the Special Needs Registry allows emergency responders to check in on
those individuals who have serious health and medical needs especially those that rely on
medical equipment and medication for survival.
For additional questions, please contact the Polk County Emergency Management office at
(715) 485-9280.
Polk County Special Needs Registry Policy
Page 16 of 25
Appendix F: Tips for Emergency Responders
The following information was developed by the University of Mexico Center for Development and
Disability (http://cdd.unm.edu/products). Covered in this section are tips for emergency responders in
dealing with:
1. Seniors
2. People With Service Animals
3. People With Mobility Impairments
4. People Who Are Mentally Ill
5. People Who Are Blind Or Visually Impaired
6. People Who Are Deaf Or Hard Of Hearing
7. People With Cognitive Disabilities
Dear First Responder:
Whether you are responding to an emergency caused by natural forces such as a fire, flood or tornado, or
one caused by a terrorist attack, you may encounter persons with some type of disability who will require
assistance. Some disabilities, such as those involving physical impairments may be obvious. Other
disabilities, such as mental illness, are more difficult to detect. In many cases, you can’t tell just by looking
at the person whether they have a disability.
Many first responders have requested quick, easy-to-use procedures for assisting persons with
disabilities. These tip sheets provide information about many types of disabilities you can use during
emergencies as well as during routine encounters. They are not meant to be comprehensive, but contain
specific information that you can read quickly either before or while you are actually responding to an
incident.
If you would like more information about how to best assist persons with disabilities or have suggestions
for future editions of this guide, please contact us.
Seniors
Always ask the person how you can best assist them.
 Some elderly persons may respond more slowly to a crisis and may not fully understand the
extent of the emergency. Repeat questions and answers if necessary. Be patient! Taking time to
listen carefully or to explain again may take less time than dealing with a confused person who
may be less willing to cooperate.
 Reassure the person that they will receive medical assistance without fear of being placed in a
nursing home.
 Older people may fear being removed from their homes – be sympathetic and understanding and
explain that this is temporary.
 Before moving an elderly person, assess their ability to see and hear; adapt rescue techniques
for sensory impairments.
 Persons with a hearing loss may appear disoriented and confused when all that is really “wrong”
is that they can’t hear you. Determine if the person has a hearing aid. If they do, is it available and
working? If it isn’t, can you get a new battery to make it work?
 If the person has a vision loss, identify yourself and explain why you are there. Let the person
hold your arm and then guide them to safety.
 If possible, gather all medications before evacuating. Ask the person what medications they are
taking and where their medications are stored. Most people keep all their medications in one
location in their homes.
 If the person has dementia, turn off emergency lights and sirens if possible. Identify yourself and
explain why you are there. Speak slowly, using short words in a calming voice. Ask yes or no
questions: repeat them if necessary. Maintain eye contact.
Polk County Special Needs Registry Policy
Page 17 of 25
People with Service Animals
Traditionally, the term “service animal” referred to seeing-eye dogs. However, today there are many other
types of service animals.
 Remember – a service animal is not a pet.
 Do not touch or give the animal food or treats without the permission of the owner.
 When a dog is wearing its harness, it is on duty. In the event you are asked to take the dog while
assisting the individual, hold the leash and not the harness.
 Plan to evacuate the animal with the owner. Do not separate them!
 Service animals are not registered and there is no proof that the animal is a service animal. If the
person tells you it is a service animal, treat it as such. However, if the animal is out of control or
presents a threat to the individual or others, remove it from the site.
 A person is not required to give you proof of a disability that requires a service animal. You must
accept that he/she has a disability. If you have doubts, wait until you arrive at your destination
and address the issue with the supervisors in charge.
 The animal need not be specially trained as a service animal. People with psychiatric and
emotional disabilities may have a companion animal. These are just as important to them as a
service animal is to a person with a physical disability – please be understanding and treat the
animal as a service animal.
 A service animal must be in a harness or on a leash, but need not be muzzled.
People with Mobility Impairments









Always ask the person how you can help before attempting any assistance. Every person and
every disability is unique – even though it may be important to evacuate the location where the
person is, respect their independence to the extent possible. Don’t make assumptions about the
person’s abilities.
Ask if they have limitations or problems that may affect their safety.
Some people may need assistance getting out of bed or out of a chair, but CAN then proceed
without assistance. Ask!
Here are some other questions you may find helpful.
“Are you able to stand or walk without the help of a mobility device like a cane, walker or a
wheelchair?”
“You might have to [stand] [walk] for quite awhile on your own. Will this be ok? Please be sure
and tell someone if you think you need assistance.”
“Do you have full use of your arms?”
When carrying the person, avoid putting pressure on his or her arms, legs or chest. This may
result in spasms, pain, and may even interfere with their ability to breathe.
Avoid the “fireman’s carry.” Use the one or two person carry techniques.
Crutches, Canes or Other Mobility Devices
 A person using a mobility device may 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. Do not interfere with the
person’s movement unless asked to do so, or the nature of the emergency is such that absolute
speed is the primary concern. If this is the case, tell the person what you’ll need to do and why.
 Ask if you can help by offering to carry the extra crutch.
 If the stairs are crowded, act as a buffer and run interference for the person.
Evacuating Wheelchair Users
 If the conversation will take more than a few minutes, sit down to speak at eye level.
 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.
 Ask before you assume you need to help, or what that help should be.
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Carrying Techniques for Non-Motorized Wheelchairs
 The In-chair carry is the most desirable technique if possible.
 One-person assist
 Grasp the pushing grips, if available.
 Stand one step above and behind the wheelchair.
 Tilt the wheelchair backward until a balance (fulcrum) is achieved.
 Keep your center of gravity low.
 Descend frontward.
 Let the back wheels gradually lower to the next step.
 Two-person assist
 Positioning of second rescuer:
 Stand in front of the wheelchair.
 Face the wheelchair.
 Stand one, two, or three steps down (depending on the height of the other rescuer).
 Grasp the frame of the wheelchair.
 Push into the wheelchair.
 Descend the stairs backward.
Motorized Wheelchairs
 Motorized wheelchairs may weigh up to 100 pounds unoccupied, and may be longer than manual
wheelchairs. Lifting a motorized wheelchair and user up or down stairs requires two to four
people.
 People in motorized wheelchairs probably know their equipment much better than you do! Before
lifting, ask about heavy chair parts that can be temporarily detached, how you should position
yourselves, where you should grab hold, and what, if any, angle to tip the chair backward.
 Turn the wheelchair’s power off before lifting it.
 Most people who use motorized wheelchairs have limited arm and hand motion. Ask if they have
any special requirements for being transported down the stairs.
People Who Are Mentally Ill
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You may not be able to tell if a person is mentally ill until you have begun the evacuation
procedure.
If a person begins to exhibit unusual behavior, ask if they have any mental health issues you
need to be aware of. However, be aware that they may or may not tell you. If you suspect
someone has a mental health issue, use the following tips to help you through the situation.
In an emergency, the person may become confused. Speak slowly and in a normal speaking
tone.
If the person becomes agitated, help them find a quiet corner away from the confusion.
Keep your communication simple, clear and brief.
If they are confused, don’t give multiple commands – ask or state one thing at a time.
Be empathetic – show that you have heard them and care about what they have told you. Be
reassuring.
If the person is delusional, don’t argue with them or try to “talk them out of it”. Just let them know
you are there to help them.
Ask if there is any medication they should take with them.
Try to avoid interrupting a person who might be disoriented or rambling – just let them know that
you have to go quickly.
Don’t talk down to them, yell or shout.
Have a forward leaning body position – this shows interest and concern.
People who are Visually Impaired
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There is a difference between visual impairment and blindness. Some people who are “legally
blind” have some sight, while others are totally blind.
Announce your presence, speak out, and then enter the area.
Speak naturally and directly to the individual.
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Do not shout.
Don’t be afraid to use words like “see,” “look,” or “blind.”
State the nature of the emergency and offer them your arm. As you walk, advise them of any
obstacles.
Offer assistance but let the person explain what help is needed.
Do not grab or attempt to guide them without first asking them.
Let the person grasp your arm or shoulder lightly for guidance.
They may choose to walk slightly behind you to gauge your body’s reactions to obstacles.
Be sure to mention stairs, doorways, narrow passages, ramps, etc.
When guiding someone to a seat, place the person’s hand on the back of the chair.
If leading several individuals with visual impairments, ask them to guide the person behind them.
Remember that you’ll need to communicate any written information orally.
When you have reached safety, orient the person to the location and ask if any further assistance
is needed.
If the person has a service animal, don’t pet it unless the person says it is ok to do so. Service
animals must be evacuated with the person.
Refer to the section on People with Service Animals.
People Who are Deaf or Hard of Hearing
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There is a difference between hard of hearing and deaf. People who are hearing impaired vary in
the extent of hearing loss they experience. Some are completely deaf, while others can hear
almost normally with hearing aids on.
Hearing aids do not guarantee that the person can hear and understand speech. They increase
volume, not increase clarity.
If possible, flick the lights when entering an area or room to get their attention.
Establish eye contact with the individual, not with the interpreter, if one is present.
Use facial expressions and hand gestures as visual cues.
Check to see if you have been understood and repeat if necessary.
Offer pencil and paper. Write slowly and let the individual read as you write.
Written communication may be especially important if you are unable to understand the person’s
speech.
Do not allow others to interrupt you while conveying the emergency information.
Be patient – the person may have difficulty understanding the urgency of your message.
Provide the person with a flashlight to signal their location in the event they are separated from
the rescue team. This will facilitate lip-reading or signing in the dark.
While written communication should work for many people, others may not understand English
well enough in English to understand written instructions. Keep instructions simple, in the present
tense and use basic vocabulary.
People with Cognitive Disabilities
Say:
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Show:
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Give:
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My name is…. I’m here to help you, not hurt you.
I am a … (name your job)
I am here because … (explain the situation)
I look different than my picture on my badge because … (for example, if you are wearing
protective equipment)
Your picture identification badge (as you say the above).
That you are calm and competent.
Extra time for the person to process what you are saying and to respond.
Respect for the dignity of the person as an equal and as an adult (example: speak directly to
the person).
An arm to the person to hold as they walk. If needed, offer your elbow for balance.
If possible, quiet time to rest (as possible, to lower stress/fatigue).
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Use:
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Short sentences.
Simple, concrete words.
Accurate, honest information.
Pictures and objects to illustrate your words. Point to your ID picture as you say who you are,
point to any protective equipment as you speak about it.
Predict:
 What will happen (simply and concretely)?
 When events will happen (tie to common events in addition to numbers and time, for
example, “By lunch time…” “By the time the sun goes down…”).
 How long this will last – when things will return to normal (if you know).
 When the person can contact/rejoin loved ones (for example: calls to family, re-uniting pets)
Ask for/Look for:
 An identification bracelet with special health information.
 Essential equipment and supplies (for example: wheelchair, walker, oxygen, batteries,
communication devices [head pointers, alphabet boards, speech synthesizers, etc.])
 Medication
 Mobility aids (for example, assistance or service animal)
 Special health instructions (for example: allergies).
 Special communication information (for example, is the person using sign language)?
 Contact information.
 Signs of stress and/or confusion (for example, the person might say [s] he is stressed, look
confused, withdraw, start rubbing their hands together).
 Conditions that people might misinterpret (for example, someone might mistake Cerebral
Palsy for drunkenness).
Repeat:
 Reassurances (for example, “You may feel afraid. That’s ok. We’re safe now.”)
 Encouragement (for example, “Thanks for moving fast. You are doing great. Other people
can look at you and know what to do”).
 Frequent updates on what’s happening and what will happen next. Refer to what you
predicted will happen, for example: “Just like I said before, we’re getting into my car now.
We’ll go to… now”.
Reduce:
 Distractions. For example: lower volume of radio, use flashing lights on vehicle only when
necessary.
Explain:
 Any written material (including signs) in everyday words.
 Public address system announcements in simple words.
Share:
 The information you’ve learned about the person with other workers who’ll be assisting the
person.
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Appendix G: HIPPA References
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