What Now? What Next? – May 14th, 2021

Discussion Forum

Please scroll down and submit comments below so we can use this space to continue our conversation on What Now? What Next? and support each other in this work. Ask/answer questions, share successes and challenges, respond to each other, etc.

Lesson 8: Thanks for Visiting Disasterville Again

Aerial view of a small town with several buildings, intersecting streets lined with trees, and a grassy area
Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: Well, Terrye, you’ve done it. Eight visits to Disasterville! We’ve talked about the American emergency management “system of systems” and local emergency planning. You’ve explored the Prepared4ALL process. You’ve seen examples of Prepared4ALL in action. We talked about planning for a COVID-19 testing site and vaccine Emergency Dispensing Site (EDS).

We’ve talked about “whole community” planning and the Americans with Disabilities Act (ADA). Title II of the ADA requires county, city, and town governments to provide equal access, inclusion, and equity in local emergency services, including COVID-19 testing and vaccination. Involving people with disabilities in the planning process and ongoing planning are the best ways to achieve access, equity, and inclusion.

EM, a white bald man in his 50s wears a facemask

EM: We reviewed the “functional and access needs” concept and the “C-MIST” framework which are ways of thinking about the needs of people with disabilities and others during a disaster or pandemic.

We’ve also talked about topics that emergency and public health preparedness planners may not know. For example, they may not understand local disability demographics. They may not know about negative experiences people with disabilities have had during disasters or COVID-19. Planners may not understand program and physical access or effective communication.

PJ, in their 30s wears a facemask and uses a walking cane

PJ: Terrye, you’re ready to return to Tornado Gap. Now you can use the Prepared4ALL process to develop a coalition to engage and collaborate with the local emergency and public health preparedness planners. Job well done! And you know you’re welcome back any time for a review of what you’ve learned here.

Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: Before you go home, Terrye, there are a few things you need to do.

Download the Prepared4ALL Resource List: This is a list of the resources we talked about during your visits here plus other key information.

Download the Prepared4ALL Active Planning Workbook, if you haven’t already.

Download the Prepared4ALL Kick Start Directory tool, if you haven’t already.

Complete Survey: We’re going to ask you questions based on your Disasterville visits. Your input will help improve the experience for the next group of visitors.

Course 8: The Active Planning Process and How to Hold Community Stakeholder Meetings

  • Thank you for completing this course. Please complete the following questions before you go.
  • How satisfied are you with the following aspects of today’s training:
  • Please rate how confident you are that you could do the following activities as of today.

Lesson 8: Join An Active Planning Meeting Now in Progress

📅⌛Six weeks later…

EM stands in front of a community meeting. About 20 people sit in a meeting room, wearing face masks.
It may not look like it, but the people in this room are socially distanced. There is an American Sign Language (ASL) interpreter signing for those who need it.
Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: Hey, Terrye. Glad you could stop by for part of our Community Stakeholder Meeting. You missed my intro, the Action Team’s intro, and the meeting scope. Remember, these parts of the meeting are in the Active Planning Workbook, the guide we use to run Active Planning Meetings? Then we heard a summary of the local emergency plan, that’s the next step of the meeting.

Then we heard a summary of the local emergency plan. We identified strengths and gaps before you came. Now we’re talking about them. EM is leading this part of the meeting.

Next we used the first Workbook tool, the needs assessment/gap analysis checklist to identify strengths and gaps. Now we’re talking about the strengths and gaps we found in our local plan. After that, then we’ll use the Workbook to count the number of gaps. Then we’ll set priorities and decide what gap to close first.

EM is leading this part of the meeting.

What follows are from discussions based on real life Community Stakeholder Meetings.

Scope of the Local Emergency Plan

Rafe, an Afro-Caribbean man in his 40s, wears a facemask and US Marine Corps hat

Rafe: Hmm…about that emergency plan summary we just heard. The scope seems narrow. It only takes residents into account. What about people who work or shop here? What about visitors to Disasterville Amusement Park?

Maryam, Middle Eastern woman in her 60s wears a facemask and a hijab (headscarf). She is a lower arm amputee.

Maryam: You know, people with disabilities aren’t just residents either. They might be working here, shopping at the mall, at the amusement park or visiting the library. Kids with disabilities from outside the county go to Disasterville’s public schools’ inclusive after school programs.

EM, a white bald man in his 50s wears a facemask

EM: Got it. The plan needs to accommodate people besides residents. The plan needs to assume that there will be people with and without disabilities in any place, at any time, who might be impacted when disaster strikes.

Image of an emergency plan cover.

Disability Community Needs

Elisa, a Latino woman, wears a police uniform and facemask

Elisa: Here’s what I want to know. How do we get a better feel for disability community needs? Do we even know how many people with disabilities live here?

Jane in her 60's wearing a skirt and sweater pushes her mom Gwen's wheelchair who has white hair and is in her 80's

Jane: I’m with the local Council on Aging. We keep a list of program participants. And the public housing agency has a list of residents in accessible units. There may be a way to remove names and other private info from these lists and share only the numbers (aggregate data) without names and other personally identifiable information. That would be helpful for planning purposes.

Rachel, a white woman in her 40s, wears a facemask and glucose monitor on her upper arm

Rachel: I’m a researcher from Disasterville University. You know, the U.S. Census (American Community Survey) has data on the functional needs of people with disabilities in counties. You can get it online for free. One of my students could get you the data for Disasterville.

Jane in her 60's wearing a skirt and sweater pushes her mom Gwen's wheelchair who has white hair and is in her 80's

Jane: Just remember that these data on who lives here, or demographics, won’t tell the whole story. But this is a beginning to get some idea of numbers. You also should connect with disability organizations. They can tell you generally about what people with disabilities who participate in their programs often need. They can likely do this without personally identifiable information to keep everyone’s information private and safe.

Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: Great! We can use multiple data sources in addition to connecting with disability provider agencies to learn about the people they serve. This all paints a sharper picture of local needs. We’ll remember that a sharper picture won’t be the whole picture. It’s impossible to know the exact number of people with disabilities in a community, and it wouldn’t even be worth trying to find out.

Image of an emergency plan cover.

Disaster Resources

Barrett, an Asian man in his 30s, wears a facemask and off-duty fire department T-shirt and hat

Barrett: These checklists are intense. Are we REALLY going to have to buy expensive equipment like Hoyer lifts (used by some people with physical disabilities to move off and on toilets or in and out of bathtubs) for our local emergency shelter? What about the budget?

Reuben, a Latino man in his 60s, wears a facemask and uses a walker.

Reuben: I’m the special education administrator at Disasterville High. Why can’t you just borrow our Hoyer lift during an emergency? School’s likely to be closed anyway. We could bring it to you since the shelter is down the road.

César, a Latino man in his 40s, wears a suit and a facemask. He uses a power wheelchair and has a Golden Retriever service dog (Ginger)

César: It’s not about buying all this stuff in advance. It’s about knowing how to get resources fast. You’ll need to know if you will borrow, trade, or purchase needed items. It’s about sharing community resources like expertise, materials, or equipment.

Image of an emergency plan cover.

Disaster Resources

Reuben, a Latino man in his 60s, wears a facemask and uses a walker.

Reuben: As long as we’re talking resources, why can’t we ask the library to borrow the CCTV low vision magnifier so people with low vision could use it to read or complete registration forms at the COVID-19 test center?

Allen, a Black man, wears a facemask and uses a walker.

Allen: Well, that’s great for the magnifier. But what if we need information in Braille?

Jane in her 60's wearing a skirt and sweater pushes her mom Gwen's wheelchair who has white hair and is in her 80's

Jane: The Council on Aging has a resource for you. We’ll be happy to share.

Image of an emergency plan cover.

Disaster Resources

Marco, Franny and their baby Juniper stand together. Wearing facemasks, Franny signs "Hello" in ASL and Marco has Juniper in a front-facing baby carrier

Franny [Signing]: I’m from Disasterville General Hospital. You mentioned needing non-English and sign language interpreters. We can share with the County during an emergency. Let’s develop a Memorandum of Understanding (MOU) to spell things out.

Sondra, a Black woman in her 20s, wears a facemask and eyeglasses

Sondra: Do we have contact with local businesses? Remember last winter when we had that terrible ice storm and everyone lost power? You know Disasterville Fish & Chips on Lowell St. that everyone loves? Freddy, the owner, was about to lose his inventory so he brought it all down to the emergency shelter and we had the biggest, best fish fry ever.

César, a Latino man in his 40s, wears a suit and a facemask. He uses a power wheelchair and has a Golden Retriever service dog (Ginger)

César: I’m on the Disasterville Business Council.  At our next meeting, we can discuss how the business community could partner with the County to address disasters and emergencies, including COVID-19. 

Image of an emergency plan cover.

Inclusive Disaster Drills and Exercises

Lynn, a White teenage woman with Down syndrome, wears a facemask

Lynn: I’m a community member. Can I be in a drill?

Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: Sure you can. I was at a hospital HazMat decontamination drill. People with and without disabilities played “volunteer disaster survivors.”

A “volunteer disaster survivor” with an intellectual disability had trouble understanding the instructions. By having a real person to practice with, the responders and hospital staff realized that they needed to give directions in multiple ways. You don’t get real reactions from the inflatable dummies they used to use for drills.

PJ, in their 30s wears a facemask and uses a walking cane

PJ: Great idea, Lynn! Having volunteer survivors would give responders a better idea of who’s in the community, what their needs are, increase disability awareness, and it might even highlight gaps in the local plan.

EM, a white bald man in his 50s wears a facemask

EM: I’d like to thank you all for the great discussion so far. While our recorder tallies our checkmarks and blank spaces using Tool 2 to set priorities, I’ll recap.

We found a number of areas for improvement:

Broadening the emergency plan scope

– Understanding disability community needs

– Getting resources

– Drills

We thought of some quick fixes and fairly easy next steps to handle these issues.

PJ, in their 30s wears a facemask and uses a walking cane

PJ: Communication always emerges as a big issue. There were lots of blank spaces in the checklist about communication. Please add it to the list.

We talked about:

A need to increase communication between Disasterville emergency management, public health planners, and the disability community

A need for better public education for the disability community

Better, more actionable, and accessible emergency instructions for the public

A need for American Sign Language and other non-English language interpreters. Thanks to Disasterville General Hospital we made some progress on that one.

After discussion and a vote, Mina recorded our Action Plan. Mina, would you please project Priority 1 onto the screen?

Image of table with 4 headings: Priority number, Brief description of the gap, Proposed strategy to close the gap, Responsible person and contact info, Start and end dates. Priority 1. Brief description of the gap: Communication gaps: Limited communication with disability community: (a) public education/preparedness; (b) emergency instructions. Messages not geared towards intended audience. Lack of sign language and other non-English language interpreters.    Proposed strategy to close the gap: (a)  Enhance communication between Disasterville planners and disability provider organizations: Distribute public education materials through organizations; Hold preparedness training at organizations; Co-develop inclusive preparedness trainings; (b) Develop emergency instructions in multiple and accessible modalities; have people with disabilities review content and form of instructions developed in advance (c) Work with disability community and health organizations, local houses of worship to develop lists of qualified American Sign Language (ASL) and non-English language interpreters.     Person responsible and contact info: PJ Smith, Public Health Preparedness Planner (555)-555-5555, pjplanner@Disasterville.us (1) Disasterville Independent Living Center: Co-develop personal preparedness training; Act as liaison to share information. (2)Disasterville Disability Commission: Test emergency instruction messages for accessibility and inclusion. (3) Disasterville County Hospital: Loan sign language interpreters (written agreement needed).(4) Disasterville Latin American Health Center: Develop and test Spanish language messages; provide Spanish language interpretation; Act as liaison to share information.     (5) Disasterville House of Worship will provide space for personal preparedness event.    Start/end dates: 11/30/21-11/30/22
Click the image to see full size
EM, a white bald man in his 50s wears a facemask

EM: The rest of the Action Plan is now complete. Before we close, I want to thank my colleagues from Disasterville County government. I want to thank the Prepared4ALL Action Team and other residents for their hard work today.

We’ll send out the notes from this meeting.

Then we’ll send reminders of action items and timelines. We’ll also keep tabs on progress and report back to the group.

💭Pause a minute, Terrye. Think about the Community Stakeholder Meeting up to this point. What do you notice about the meeting so far? Is anything missing?

PJ, in their 30s wears a facemask and uses a walking cane

PJ: EM, you forgot something. We have to add a COVID-19 Vaccine Annex (attachment) to the Emergency Dispensing Site (EDS) Plan. I’d like to ask the Action Team and others a big question. What are some access and functional needs issues we should be thinking about?

Lynn, a White teenage woman with Down syndrome, wears a facemask

Lynn: I want to know EVERYTHING that will happen when I get the shot.

PJ, in their 30s wears a facemask and uses a walking cane

PJ: That reminds me that we need plain language public information and easy-to-read and understand signage in the EDS.

Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: I’ll remind you about registration and consent formats in accessible formats. Maybe we also need the forms on computers for people who use screen reader software.

Oh, and the aisles in the space need to be wide enough to accommodate people with mobility equipment and service animals.

Maryam, Middle Eastern woman in her 60s wears a facemask and a hijab (headscarf). She is a lower arm amputee.

Maryam: I’m concerned about social distancing and masking at the EDS. People my age may get sick more easily.

PJ, in their 30s wears a facemask and uses a walking cane

PJ: I’ll work with the partners from the Disasterville Community Health Center to set up those protocols or guidelines to keep people safe.

Rafe, an Afro-Caribbean man in his 40s, wears a facemask and US Marine Corps hat

Rafe: Like the young lady, I want to know each step of what’s going to happen. What about a flow chart or diagram with all of the steps in the process? And what if the noise, lights, and people make me anxious? Is there going to be a quiet area?

EM, a white bald man in his 50s wears a facemask

EM: We have someone in the office who knows how to make infographics, PJ. And we need a big enough space so there can be quiet areas. Hmm…maybe we should hold a drive-thru EDS. Or, maybe we should have indoor and outdoor EDS sites. We want to move people through quickly, don’t we PJ?

PJ, in their 30s wears a facemask and uses a walking cane

PJ: I think we’re going to need an indoor and outdoor EDS. I better check on personnel to give the vaccines. We may have to see if Medical Reserve Corps medical professionals and public school nurses are available to help.

Jane in her 60's wearing a skirt and sweater pushes her mom Gwen's wheelchair who has white hair and is in her 80's

Jane: What about vaccine hesitancy? You know, people who are afraid or worried and don’t want the vaccine?

Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: You raise an important issue. Some people are very concerned about the vaccine. People ask: “Is it safe?” “Can I trust the government?” “What aren’t they telling us?” I’d like to see if some experts on vaccine hesitancy could meet with us.

PJ, in their 30s wears a facemask and uses a walking cane

PJ: This is so helpful. Thanks, everyone. There’s so much to talk about with COVID that we should hold a separate COVID-19 vaccine distribution public meeting. As you all know, the vaccines will be coming soon. We’re providing the vaccines in phases. While we use our yearly flu clinics as practice for an EDS, this year we can use the Phase 1 vaccine group, health care workers, and first responders, as a drill as well. I’d like to talk about that at the COVID-19 vaccine meeting.

…And now, this meeting can finally be adjourned. Good night everyone. Thank you all.

Lesson 8: The Active Planning Workbook

Seven community members wearing face masks are seated around a table in a small meeting style room.
It may not look like it, but the people in this room are socially distanced. There is an American Sign Language (ASL) interpreting for anyone who needs it.
EM, a white bald man in his 50s wears a facemask

EM: The Active Planning Workbook guides the Community Stakeholder Meeting. Participants collaborate to complete 3 steps using 3 tools in the Workbook. 

The Active Planning Workbook 

3 Steps to Follow

1. Where are we now?

2. Where do we want to be? 

3. How do we get there?  

 3 Tools to Complete 

1. Needs Assessment/Gap Analysis 

2. Set Priorities 

3. Close the gap with an Action Plan 

Marco, Franny and their baby Juniper stand together. Wearing facemasks, Franny signs "Hello" in ASL and Marco has Juniper in a front-facing baby carrier

Marco [Signing]: As Community Stakeholder Meeting participants collaborate to complete the Active Planning Workbook, group discussion will identify gaps and lead to strategies for closing the gaps. Once the Workbook is complete the community will have a blueprint to make the local emergency plan (and any response practices not in the plan) more inclusive.

If you’d like, take a quick look at the workbook now and then come back to talk some more. [Link to Workbook PDF] You’ll be able to download the entire Workbook as a PDF as you leave Disasterville. 

arrow with three boxes, one is filled in reading "where are we now? needs assessment and gap analysis step 1"

Let’s go over the 3 Steps in more detail.

Step 1: The Meeting Facilitator reads Tool 1, Where are we now? Needs Assessment and Gap Analysis, a checklist of standards, out loud, item by item. Participants decide together whether the community meets each standard described. The Recorder makes a checkmark in the Workbook if standards are met and leaves a blank if standards aren’t met. Some communities choose to give themselves partial credit.

The checklist is meant to start a discussion about people with disabilities and other populations with access and functional needs, local emergency services, resources, and individual responsibility to self-prepare. 

As items are read aloud, participants share ideas, knowledge, expertise, and resources. As the discussion continues, gaps and areas for improvement become clear, and participants begin to think of strategies to address the gaps. 

Checkmarks mean a standard has been met. Unchecked lines mean gaps or areas for improvement. 

If the checklist seems overwhelming, remember it’s a discussion starter. Some items may not apply to every community. 

PJ, in their 30s, wears a facemask and glasses

PJ: Think of your community as you look at examples from the Workbook’s Tool 1 checklist below.

From: Tool 1 – Where are we now? 

Transportation and evacuation 

  • ___Our emergency plan includes a description of the likely evacuation needs of people with disabilities
  • ___Our emergency plan specifies a policy to evacuate families together evacuate caregivers together with those they care for, and evacuate people with disabilities together with vital equipment, assistive technology, and service animals
  • ___This policy is incorporated into our contracts with third-party transportation providers
  • ___Our emergency managers/planners have coordinated with local entities that are required to have evacuation plans
  • ___Our emergency managers/planners have reached out to workplaces and public venues that are not required to have evacuation plans and encouraged those entities to share their evacuation plans with the emergency managers/planners

Mass Care Sheltering

  • __ Our shelter capacity assessment takes into account space issues relating to people with disabilities, such as additional space for caregivers, service animals, mobility and other equipment, or accessible cots
  • __ Our emergency plan includes a process to evaluate potential shelter sites for physical accessibility and to address inaccessibility with remediation or by switching sites
  • __ Our emergency plan identifies sources for supplies likely to be needed by people with disabilities that can be borrowed, traded or used in exchanged for some other item or purchased and accessed quickly
  • ___Our emergency plan identifies sources for supplies likely to be needed by people with disabilities that can be borrowed, bartered, or purchased and accessed quickly
  • ___Shelter policy permits service animals in all parts of the shelter where their owners may go
  • ___ Shelter staff understands that by law they may ask only 2 questions about service animals:
    1.) Is the service animal required because of a disability 2.) What work or task has service animal been trained to perform

Emergency Dispensing Site (EDS)

  • ___The EDS site is in an accessible building with:
  • ___Accessible parking and passenger drop off areas 
  • ___Accessible entryways and pathways 
  •  ___Accessible restrooms 
  • ___Check in areas with chairs and accessible tables
  • ____Registration materials accessible and in different
  • ____People to help with registration 
  •  ___Waiting areas with chairs and accessible tables 
  •   ___Quiet space is available for those who need it 
  • ___Inclusive and accessible signage
  •        ___Clear instructions for the pathway through the stations and at each station
  • ____ The registration information collects information which will aid in contact tracing, if needed
  • ____ Reminder system for second vaccine, if needed
  • ____ There is a protocol for triaging people getting the vaccine
  • ____ There is a protocol if the triage indicates that someone has COVID-19

 

Recovery

  • ___ People with disabilities participate in writing after-action reports
  • __ A priority facility restoration list has been developed and the list includes facilities that serve people with disabilities.

💭 Think about these examples. What parts of the checklist are new to you? Which ones are you already familiar with? Are there certain questions that you may need to emphasize for work in your community?

Allen, a Black man, wears a facemask and uses a walker.

Allen:

Step 2: The Recorder tallies the checkmarks and blank spaces from Tool 1 and announces the results. The meeting participants decide on 5 gaps or areas for improvement with simple, quick, and/or inexpensive solutions. The group then selects 3 gaps that will need more extensive or expensive solutions.

arrow with three boxes, one is filled in reading "where do we want to be setting priorities, step 2"
Rachel, a white woman in her 40s, wears a facemask and glucose monitor on her upper arm

Rachel:

Step 3: The Facilitator leads the group to complete an Action Plan which describes the main gaps identified, proposed strategies to address those gaps, people responsible for implementation, and a timeline. The Action Plan is based on the results of the checklist and discussions at the Community Stakeholder Meeting.

arrow with three boxes, one is filled in reading "how do we get there? closing the gap step 3"

💭 Just for practice, Terrye, think about a potential priority for your community. Consider using the template below from Tool 3 below to think through how to fill this gap. (If you can’t think of a priority, you might use accessible communication for sending out important public information since this is a common gap.)

Action Plan

PriorityDescribe GapProposed SolutionResponsible personsStart and End Dates
1Example: accessible communication to send out important public informationLocal disability organization offered to lead workshop on accessible communication for public health planning office.
 
Local self-advocate group offered to review materials for plain text readability.
Shaniqua Wilson
Blane Smith
 Start: May, 2021
End: Sept, 2021
EM, a white bald man in his 50s wears a facemask

EM: Now you’ll be ready for the Disasterville Community Stakeholder Meeting in a few weeks.

Lesson 8: Planning Community Stakeholder Meetings

Seven community members wearing face masks are seated around a table in a small meeting style room.
It may not look like it, but the people at this meeting are socially distanced. There is an American Sign Language (ASL) interpreting for anyone who needs it
PJ, in their 30s, wears a facemask and glasses

PJ: Terrye, you remember our Prepared4ALL Action Team, right? You met them on an earlier visit. We plan Community Stakeholder Meetings together with the Prepared4ALL Action Team. The goal of a Community Stakeholder Meeting is for community stakeholders to review the local emergency plan(s) with emergency and public health preparedness planners to find and close any gaps.

Folks, we’d better get moving…the Community Stakeholder Meeting is about 6 weeks away. We have the agenda from our last meeting. We kept notes of what went well and what didn’t.

Here’s what we need to do:

Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: Send out the agenda, emergency plan, and Workbook in advance for people to review if they can. Here’s a sample agenda.

Community Stakeholder Meeting Sample Agenda

1. Introductions (including Community Stakeholder Meeting roles: facilitator, timekeeper, recorder, plan expert, other experts)

2. Review meeting goals

3. Briefly review the Workbook and meeting process

4. Summarize the local emergency plan and emergency response practices (sometimes common practices aren’t recorded in the plan)

5. Complete the Workbook

6. Determine next steps and responsibilities. How will meeting notes be shared?

7. Share handouts and resources
Self-preparedness handouts for disability community member participants and other community and organizational representatives
Disability awareness-raising handouts for emergency planners, managers, responders and community officials

Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: Think about this agenda for a minute.

During the meeting, you can use the Prepared4ALL wheel to find strengths and make a plan to close gaps.

Prepared4ALL wheel image

💭Carrie: Think about how you would use one part of the Prepared4ALL wheel to find strengths and make a plan to close gaps during a Community Stakeholder Meeting.

Rachel, a white woman in her 40s, wears a facemask and glucose monitor on her upper arm

Rachel: Pinpoint: Find the local disability inclusion issue. The first issue is finding gaps and areas of strength in the local emergency plan. The emergency management and public health agencies are already pinpointed. Now the planners need to pinpoint the other local government agencies to involve.

Relate: Find local organizations with related goals for collaboration.

Engage: The Prepared4ALL Action Team members and other community representatives can think about which other groups to involve and then engage with them. This is also an opportunity for the local planners to engage with them.

Positive: While reviewing the workbook, be positive and think about the strengths in the local plan, positive emergency response practices, and the local community’s strengths. Think about what you can do.

Advance opportunities: When prioritizing which gaps to close, choose some gaps which can be closed easily. “Fast and easy wins” will move the group forward. Think about collaborator strengths and leverage them to decide on gap closing strategies.

Reflect: At the beginning of the meeting, reflect about what brought the group together. During the meeting, think about how solutions to other challenges might be used to close emergency plan gaps. Before setting priorities, reflect about what needs to be dealt with immediately. Reflect on the number and kinds of gaps and strengths identified. Look for patterns related to strengths, gaps, and solutions. At the end of the Community Stakeholder Meeting, reflect on what the participants accomplished.

Envision: During the discussion, envision more than one way to close a gap. Then envision the best way to close that gap. Who would be the best person or people to implement the gap closing solution? What resources do they already have and what else do they need to be successful?

Deploy: Make an Action Plan to put the gap closing solutions into action. Be ready to review and revise action steps moving forward.

Rachel, a white woman in her 40s, wears a facemask and glucose monitor on her upper arm

Rachel: Remember “4All.” At the meeting ask whether the solutions meet the STATE test. Do the solutions give “Same Time Access To Everyone?” Do all local partners own and share the issue?

EM, a white bald man in his 50s wears a facemask

EM: Let’s move from talking about planning to a closer look at the Active Planning Workbook. The Workbook is a guide to lead you through the Community Stakeholder Meeting.

Lesson 8: Community Stakeholder Meetings

Carrie, PJ and EM sit at a meeting table together, wearing face masks.
It may not look like it, but the people in this room are socially distanced.
EM, a white bald man in his 50s wears a facemask

EM: Terrye, you’ve been here a while. You know how we work, using Prepared4ALL as our guide. We’re going to put it all together for you today and show you our Active Planning Workbook and Community Stakeholder Meeting process.

A Community Stakeholder Meeting is a tool for whole community planning. It brings together for collaboration local people with disabilities, families, support networks, disability organizations, and service providers with emergency planners, responders, and local government officials.

At a Community Stakeholder Meeting, stakeholders:

Find gaps and areas of strength related to people with disabilities

Discuss the local emergency plan and emergency response practices (which may not be written in the plan)

Think of strategies and make an action plan to build on strengths and close the gaps. A Community Stakeholder Meeting takes time, planning, and coordination. But the benefits can be big: sharing information, expertise and resources, legal compliance, and building a stronger community.

💭 Terrye, think about a community’s emergency plan and some gaps that you might find in a local plan. What are some physical access, program access and effective communication gaps you might find?

It’s about having the right people at the same place at the same time.

Here’s an example of something that happened at a Massachusetts Community Stakeholder Meeting a couple of years ago. The people at the meeting felt that the town needed extra wheelchairs for natural disasters. They thought that people might be hurt or might lose their adaptive equipment. They were trying to figure out where they could find the budget for those wheelchairs. The Council on Aging director was at the meeting. She let everyone know her office had extra wheelchairs and offered them for town emergency use. She even offered to store them until needed.

At another real-life Community Stakeholder Meeting the partners identified the need for an accessible local government website. A local government official mentioned a tech company that had asked how they could help the community. The official turned the company away. He didn’t know what to ask the company for! The group urged a return call to the tech company to ask for help making the website accessible.

Problems solved. No extra cost!

The Community Stakeholder Meeting deepens community knowledge and expertise. Community Stakeholder Meetings may encourage community members and organizations to become more active locally. 

PJ, in their 30s, wears a facemask and glasses

PJ: At some point during each Community Stakeholder Meeting meeting, there is an “Aha!” moment that happens to help move the group from identifying gaps to gap-closing strategies.

💡 Community Stakeholder Meeting participants work as a group to ask and answer questions like:

Do we understand local disability community emergency needs? Have we addressed CMIST and functional and access needs in our plan?

– Where are our plan’s areas of strength?

Does our plan or response practice have any gaps or areas for improvement related to the emergency needs of people with disabilities? 

What are the priority gaps we want to address? 

What are strategies for closing the gaps? How should we implement those strategies?

Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: What? You’re wondering where this Community Stakeholder Meeting idea came from? And what about the workbook guide?

The Community Stakeholder Meetings come from a FEMA-funded project that was developed at the E.K. Shriver Center, University of Massachusetts Medical School. When the FEMA funding ended, the project continued. Community Stakeholder Meetings were held in approximately 21 Massachusetts towns, cities and one county. All of the Community Stakeholder Meetings were successful. Participants found at least five gaps in each local emergency plan, and some communities found more. They also found areas of strength in the local emergency plans and response practices. Using the workbook as a guide, all the communities made an action plan to close the gaps they found.

PJ, in their 30s, wears a facemask and glasses

PJ: So, you wonder, how often do we hold Community Stakeholder Meetings? Who do we invite?

We hold Community Stakeholder Meetings one to two times a year. Each meeting lasts about three hours. Like EM said, the best Community Stakeholder Meetings happen when lots of different people contribute. Ideally, a Community Stakeholder Meeting results in sharing resources, information, and expertise. These meetings are focused meetings that require all attendees to work together collaboratively.  Community Stakeholder Meetings address disasters, pandemics, and emergencies—they are not designed to voice other community concerns.

🧑‍🤝‍🧑The people at Disasterville’s Community Stakeholder Meetings include:

EM, the local emergency manager and me, the public health preparedness planner

Carrie, our local ADA coordinator

Several other local government staff like the representatives from the Council on Aging, Human Services Department, and Public Works Department

The Prepared4ALL Action Team who you met on your second visit here. (There may already be a community coalition in your community. If there is one, ask to join it.)

Representatives from disability organizations (including staff, Board Members and/or program participants)

Representatives from community organizations like the local food pantry, houses of worship, social service organizations, volunteer organizations, etc. (including staff, Board Members, and/or program participants).

💭 Terrye, think about your community. What are some organizations to invite to a Community Stakeholder Meeting? Who are some key people to invite?

EM, a white bald man in his 50s wears a facemask

EM: Here are some other organizations to think about inviting, in addition to the Action Team and disability and other community organizations in local emergency planning.  

In addition to being thoughtful about who to invite to a Community Stakeholder Meeting, it’s important to have enough time to follow the workbook guide and talk during the meeting. It’s the discussion that’s the important part of each meeting.

Now we’ve got to get ready for the next Community Stakeholder Meeting. It’s coming up soon…

Lesson 7: Whole Community Promising Practices

Carrie, PJ and EM sit at a meeting table together, wearing face masks.
It may not look like it but the people in this room are socially distanced.
EM, a white bald man in his 50s wears a facemask

EM: Hey, Terrye. We’re going to wrap up today with a list of whole community promising practices. The list comes from a review of about 100 state and local emergency plans, planning guidance, whole community guides, court decisions, and U.S. Department of Justice legal settlements, plus interviews with experts.

Whole community emergency plans should include:

  • A statement of the whole community and/or access and functional need (AFN) philosophy, mission, and/or vision
  • A local whole community planning group
  • AFN population members and/or provider organizations review the local plan or are directly included in the emergency planning process
  • Emergency shelter physical and program accessibility mandated
  • Service animal procedures; a plan to keep service animals with their owners
  • Plan/procedure to include Americans with Disabilities Act (ADA) obligations written into 3rd party contracts (like contracts with the Red Cross or other organizations that provide disaster services)
  • Accessible evacuation and/or transportation
  • Accessible communication modalities and/or content (alerts/warnings that include sign language and Closed Captioning; public education materials; website; auxiliary aids available)
  • Community volunteer responder groups that include people with disabilities and/or others with access and functional needs
  • Multi-hour conference, seminar, or summit about whole community
  • Whole community training (AFN population leaders and participants)
  • Inclusive drills and exercises (AFN population participants and/or inclusive topic)
  • Accessible print or online guide/resource lists
  • Specific public health or emergency management personnel dedicated to AFN populations and/or local government ADA coordinator responsible for AFN population emergency needs
  • Dedicated Emergency Support Function (ESF) position and/or Emergency Operations Center (EOC) position related to access and functional needs (ESF refers to specific response duties. For example, ESF-8 is public health and medical services.)
  • Emergency planning includes AFN population demographic analysis
  • Evaluation of whole community planning and response
  • Inclusive recovery, including post-disaster housing

And maybe the most important thing. Make sure that local governments add whole community planning and access and functional needs issues into the local budget cycle from the beginning. There are knowable and plannable inclusion costs.

Some local planners may not understand their responsibility for whole community planning and so they don’t do it. Then when they learn about this responsibility there may be no funding in the local government budget. Don’t let funding concerns become an excuse.

Click the quiz link below to check your learning and continue.

Lesson 7: Thanks for Visiting Disasterville Again

Aerial view of a small town with several buildings, intersecting streets lined with trees, and a grassy area
Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: We hope today’s visit has been useful. We’re excited to share more information with you that you can take back to Tornado Gap. We look forward to seeing you back here soon.

Your next Disasterville visit can happen now or you can come back when it works for you.

When you’re ready, we’ll talk about Active Planning and Community Stakeholder Meetings. These are whole community meetings where emergency planners collaborate with people with disabilities, disability organizations and other community representatives to review the local emergency plan for strengths and gaps.

We’ll save your progress along the way because we’re rooting for you to get that Prepared4ALL Certificate after your last visit. At your last visit we’ll give you a Resource List so you don’t have to worry about taking notes or writing down links during your visits here.

See ya soon!

Prepared4ALL: Course 7: Whole Community Emergency Planning Pre-Test

  • We want to know more about you. Please answer the questions below.

Lesson 7: The CMIST Framework

Communiity members of different ages, genders, abilities, and races are in downtown Disasterville near a grocery store, all wearing face masks. Some people are walking in groups and some are sitting down at tables talking. Two people have service animals.
It may not look like it but the people in this scene are socially distanced.
Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: We’ve been talking about access needs and function needs. Someone with access needs faces challenges accessing disaster or emergency resources or services. Someone with functional needs faces challenges with everyday functioning, like communication, staying healthy by taking medicine or maintaining their independence by using medical equipment, mobility equipment, assistive devices, service animals, or with support from someone else.

We said that the CMIST framework is useful for describing and planning for access and functional needs. First we’ll talk about this framework. Then we’ll give you some examples to think about.

The CMIST framework breaks access and functional needs into 5 categories. An emergency plan that addresses CMIST needs is likely to be 4ALL.

The CMIST framework assumes that there are 5 broad categories of access and functional needs: communication, maintaining health, independence, support & safety, and transportation. CMIST can be used for temporary and permanent conditions. Someone with a broken leg and someone without a car may benefit from CMIST. It’s not about a label or diagnosis. It’s about needs someone may have during an emergency.

CMIST categories: communication, maintaining health, independence, support & safety, transportation
ASPR, 2021 https://www.phe.gov/Preparedness/planning/a
bc/Pages/at-risk.aspx

Here is how the Office of the Assistant Secretary for Preparedness and Response (ASPR) describes CMIST:

Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: Look at some emergency items and supports to meet CMIST needs. Whole community emergency plans should include information about CMIST resources and where to find them if needed during an emergency.

Overview of emergency items and supports before, during, and after an emergency following the CMIST framework
PJ, in their 30s wears a facemask and uses a walking cane

PJ: You remember these folks, right? They’ve agreed to talk to you about their CMIST needs.

Click the quiz link below to speak to each person about their CMIST needs.

Lesson 7: Access and Functional Needs (AFN)

Seven community members wearing face masks are seated around a table in a small meeting style room.
It may not look like it but the people in this room are socially distanced. There is an American Sign Language (ASL) interpreter to interpret for those who need it.
Marco, Franny and their baby Juniper stand together. Wearing facemasks, Franny signs "Hello" in ASL and Marco has Juniper in a front-facing baby carrier

Marco [Signing]: Now that you know the basics about whole community, we should talk about “access and functional needs” and the “CMIST framework,” which can be useful in thinking about how to meet those needs during emergencies.

PJ, in their 30s wears a facemask and uses a walking cane

PJ: According to the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response (ASPR), about half the people in the U.S. have temporary or permanent conditions that limit their ability to act during a disaster. These people have access and functional needs (AFN).

Rachel, a white woman in her 40s, wears a facemask and glucose monitor on her upper arm

Rachel: ASPR says that regardless of a specific diagnosis or label some people have access or functional needs that may interfere with their ability to access or receive medical or emergency services before, during, or after a disaster or pandemic, like COVID-19.

“Access-based needs: All people must have access to certain resources, such as social services, accommodations, information, transportation, medications to maintain health, and so on. People with access needs face challenges accessing emergency services or resources.

Function-based needs: Function-based needs refer to restrictions or limitations an individual may have that requires assistance before, during, and/or after a disaster or public health emergency.

People with functional needs may need help to function during emergencies, disasters, or pandemics like COVID-19.”

(ASPR, 2021 https://www.phe.gov/Preparedness/planning/abc/Pages/atrisk.aspx)

Due to COVID-19, there are additional people who may have access and functional needs, per the Centers for Disease Control and Prevention (CDC):

Racial and ethnic minorities

People who have intellectual/developmental disabilities

– People living in rural communities

– People in correctional and detention facilities

Newly resettled refugee populations

Rachel, a white woman in her 40s, wears a facemask and glucose monitor on her upper arm

Rachel: Take me, for example. I have Type 1 diabetes. Diabetes is a chronic health condition where I need constant medicine and medical equipment to stay alive and healthy. During a disaster, I need ongoing access to my insulin pump and glucose monitor as well as access to a power outlet if I need to charge my medical devices. These are functional needs related to my diabetes. My personal emergency plan includes extra supplies, but if I run out during a disaster it’s a problem. Having diabetes also makes me more susceptible to COVID-19 complications. I need to know that my community’s emergency plan includes strategies to help me get my medical supplies if I need them.

PJ, in their 30s wears a facemask and uses a walking cane

PJ: Also, think about me. I identify as gender non-conforming. I face bias a lot. I’m concerned about being comfortable if I have to stay in an emergency shelter or if I interact with a responder or clinician who’s biased and not knowledgeable. I also sometimes use a cane when my arthritis acts up. In terms of functional needs, I need my cane (medical equipment) all the time. Because of bias and knowledge gaps, I can have access needs. Whole community planning should include planning for and with people with disabilities and others with access and functional needs.

EM, a white bald man in his 50s wears a facemask

EM: The CMIST framework is useful for describing and planning for access and functional needs. We’ll talk about that next. But I’d like you to take time to reflect first.

Click the quiz link below to check your learning and continue.

Lesson 7:What is “Whole Community”? Why is it important?

Seven community members wearing face masks are seated around a table in a small meeting style room.
It may not look like it but the people in this room are socially distant. There is an American Sign Language (ASL) interpreter in the room to interpret for those who need it.
Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: Welcome! As early as your first visit we started talking about “whole community” planning, which is an attitude and way of doing things. Whole community plans apply to an entire community, strengthen community resilience, and help communities bounce back quickly after disaster strikes.

Good communication is an important part of whole community.

FEMA says the phrase “whole community” means involving people in the development of national preparedness document and ensuring their roles and responsibilities are reflected in the content of the materials.

As you work on whole community planning, you may get to know community members or groups that you didn’t know before. Part of respectful collaboration is checking with community groups about how they prefer to be identified.

One partner that may be new to you is the Partnership for Inclusive Disaster Strategies, a national organization that addresses needs of people with disabilities before, during and after disasters and emergencies.

Communication is also important with partners. The Action Team will communicate with local planners before emergencies at Action Team meetings and other times. Using our Kick Start Directory tool may help you create and sustain stronger community partnerships. But what about when disaster strikes?

Communication between a disability organization and local emergency management and public health during an emergency may be different for each community. For example, some communities may give emergency instructions by radio. Some communities may want to use a communication type besides 9-1-1.

Disability organizations should ask local planners:
· How will you be sharing information with community organization like ours during a disaster, disaster and pandemic?
· How would you like community organizations like ours to communicate with you during an emergency, disaster or pandemic?

Disability organizations should ask local planners: We know that you would like everyone to be ready for an emergency, disaster, or pandemic. But if a person with a disability needs help during an emergency, disaster or pandemic, who should they contact? The answer to this question may be different in each community.

EM, a white bald man in his 50s wears a facemask

EM: Remember when you met César when we were out and about? He told us that he was on vacation in Faraway County when disaster struck. He made it to the emergency shelter, but they didn’t allow his service animal, Ginger, to stay with him. He asked you to imagine the impact of separating him from Ginger.

César said he was usually very independent. He lives alone, rides public transit to and from work and all over the city. He’s used to a lot of independence. Without Ginger, he lost a lot of his independence. He needed a lot more help than usual. César said he was humiliated. He had to get help to go to the bathroom and lunchroom. The shelter workers were so busy they didn’t have time to help him. He had to wait an hour to go to the bathroom. He was right to be angry.

Think about César and Ginger again. Separating people from their service animals in shelters was a Faraway County emergency policy. The policy protects people with animal allergies or fears.

This policy is:

EM, a white bald man in his 50s wears a facemask

EM: A policy that separates disaster survivors from their service animals is not an example of whole community planning.

The whole community means planning by everyone, including the general public, businesses, non-profit organizations, and all levels of government to increase coordination and better working relationships.

PJ, in their 30s wears a facemask and uses a walking cane

PJ: Participation of the whole community means equal access to local, state and national preparedness activities and programs without discrimination. It means meeting the equal access and functional needs of all individuals. And it also means consistent and active participation in all aspects of planning.

Community and individual readiness for emergencies are key.

Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: We said that this policy violates the Americans with Disabilities Act (ADA), the key civil rights law for people with disabilities. Under the ADA, state and local governments must provide physical access, program access, and access to effective communication in their services, including emergency planning. All of these must be included in emergency planning.

💭 Think about the policy again. Which is (are) the strongest ADA argument(s):

Now think about a new situation. Suppose there was smoke in the emergency shelter, but the alarm was broken and didn’t sound. Nobody told César about the smoke and he couldn’t smell it. If Ginger were with him and was trained to alert him to smoke, then in a sense Ginger would be needed for his access to effective communication.

💭 How should Faraway County change the policy that impacted César? The new policy should be:

Allen, a Black man, wears a facemask and uses a walker.

Allen: Some counties, cities, and towns include a statement of whole community philosophy in their emergency plans.

Here are three examples:

💭Think about what the whole community could mean for your community. What are some examples of what that would look like?

Rachel, a white woman in her 40s, wears a facemask and glucose monitor on her upper arm

Rachel: Let’s talk about some real-life situations. See the table below for some issues experienced by people with disabilities in emergency situations and whole community solutions to address the issues.

What happened?Why?Whole community solution
People who are Deaf didn’t understand important safety information.The local emergency plan calls for warnings by radio and bullhorn.Multiple communication modalities for disaster warnings:
• Radio
• Bullhorn
• County website
• Texts
• Qualified American Sign Language (ASL) interpreter
• Closed Captioning (CC
)
People with intellectual disabilities were evacuated to an emergency shelter. Shelter workers took away the people’s money for their own safety.The shelter workers didn’t know that people with intellectual disabilities lead independent lives and could keep their own money. The shelter workers thought the people with intellectual disabilities needed to be protected. Training for shelter workers so they would know to support independence for people with intellectual disabilities.
People were not evacuated with their wheelchairs.The local emergency plan didn’t state the importance of keeping people together with mobility and other vital equipment.Training for planners and first responders. Change the emergency plan to state that people with disabilities should be evacuated with their key equipment.
People who have sensory issues (like social anxiety or Autism Spectrum Disorder, ASD) find the emergency shelter too noisy and crowded. They may feel overwhelmed.The shelter plan does not provide a separate quiet space in the shelter.Planning to have a separate quiet room is an important part of a shelter plan.

Lesson 7: Welcome Back

Street sign that says Welcome to Disasterville
Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: Nice to see you again, Terrye.  Hope you have a good visit today!

We’ll take a closer look at “whole community” or “inclusive” emergency planning. We’ll look at promising practices and talk about access and functional needs again. Let’s meet with the Action Team again.

Let’s meet with the Action Team again.

Lesson 6: Making Your Point

Seven community members wearing face masks are seated around a table in a small meeting style room.
It may not seem like it, but the people in this room are socially distanced. The American Sign Language interpreter is in the room to sign for anyone who needs it.
Allen, a Black man, wears a facemask and uses a walker.

Allen: Local disability organizations can choose a strategy to help local governments understand what they must do under the Americans with Disabilities Act (ADA).

Besides direct persuasion and education by speaking with planners, disability organizations might start an email writing or phone call campaign, contact the media, ask for support from other groups, or think about legal strategies. Action Teams should reflect on which strategies are best and why. They should assess their strategies from time to time to see which ones are most successful.

On the other hand, local governments can’t just say “we have no money, no time and no personnel” and end the conversation. A limited budget is not an excuse to take no action. The Prepared4ALL approach is one way to keep the conversation going.

It’s important that local emergency plans include specific strategies for addressing disability and other access and functional needs. And that local budgets include whole community planning from the beginning.

Local planners may be more receptive if they understand how whole community planning benefits them. In smaller communities, local public health and emergency management offices will have limited funding and personnel. Hearing from Action Teams about the benefits of leveraging community resources might strengthen their interest.

Action Teams that approach local planners with an offer of help and interest in their work, in addition to “an ask,” may be more successful. But this doesn’t mean that the local disability community is responsible for doing the work that emergency and public health preparedness planners are supposed to do.

Americans are frequently active in their communities. Offering information, technical assistance and referral to local planners can be part of an organization’s community commitment. It can also yield positive public opinion and recognition of the organization’s hard work and importance.

PJ, in their 30s wears a facemask and uses a walking cane

PJ: Action Teams may offer informational resources to their local government partners.

Tips for First Responders is a quick reference about appropriate interaction with people with different disability and other functional and access needs. There is a free online version and a low cost printed version.

Screenshot of handout called "Tips for First Responders"

The ADA National Network is a terrific free and confidential ADA resource. It provides information, guidance and training on how to implement the Americans with Disabilities Act (ADA), and information about emergencies, disasters and pandemics.

logo reading "ADA National Network"

The Georgia Tech Center for Inclusive Design and Innovation (CIDI) adapts COVID-19 materials into accessible formats for people with disabilities. There is a webinar series on the microsite and you can request embossed Braille documents, download accessible Word documents and PDFs, and register for the upcoming webinars.

Screenshot of Georgia Tech's Center on COVID-19 Accessible Resources

More information about these free resources and others is in the Resource List that you will get after your last visit to Disasterville. Sharing resources is an important way for your community to be Prepared4ALL.

Click the quiz link below to check your learning and continue.

Lesson 6: Thanks for Visiting Disasterville Again

Aerial view of a small town with several buildings, intersecting streets lined with trees, and a grassy area
Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: We hope today’s visit has been useful. We look forward to seeing you again soon.

Your next Disasterville visit can happen now or you can come back when it works for you. On your next visit we’ll talk more about people with “access and functional needs” and the “CMIST” framework and talk about inclusive emergency plans.

We’ll save your progress along the way because we’re rooting for you to get that Prepared4ALL Certificate after your last visit. You’ll also get a Resource List so you don’t have to worry about taking notes or writing down links during your visits here.

Only 2 more visits to go. See ya soon!

Course 6: Americans with Disabilities Act Rights in Emergencies and Pandemics

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Lesson 6: The ADA and COVID-19

Seven community members wearing face masks are seated around a table in a small meeting style room.
: It may not seem like it, but the people in this room are socially distanced. An American Sign Language (ASL) Interpreter is in the room to sign for anyone who needs it.
EM, a white bald man in his 50s wears a facemask

EM: Let’s turn to COVID-19. So many people have gotten sick. So many have died. On an earlier visit we talked about the vulnerability of people with disabilities, and in particular People of Color or Indigenous Peoples.

There are some Americans with Disabilities Act (ADA) issues with COVID-19.

Allen, a Black man, wears a facemask and uses a walker.

Allen: Under the ADA people with disabilities should have equal access to COVID-19 services, treatments, and effective communication. Spaces for COVID-19 related services and treatments must be physically accessible.

💭 Under the ADA, equal access and effective communication related to COVID-19 would include:

One situation related to the ADA and COVID-19 is allowing companions to be with people with disabilities during medical treatment.

Tariq’s friend Monique wasn’t allowed to bring both parents to a painful medical procedure, even though it took both parents to help her keep her mask on and to keep her calm during the procedure. The doctor knew her and understood her needs, but hospital rules did not allow visitors. Her parents had to fight to be with her during the procedure. Luckily her parents came, the procedure went well, and she was fine.

Many health care organizations and providers have now changed these rules, based on the ADA rights to equal access and effective communication.

Rachel, a white woman in her 40s, wears a facemask and glucose monitor on her upper arm

Rachel: Wearing face masks has been another issue.

The Disability Rights and Defense Fund (DREDF) and Disability Rights California give these examples of people who can’t wear masks at all or can’t wear them for a long time:

“… universal mask requirements present difficulties for some people with disabilities who cannot wear masks either at all or for an extended period of time. Examples include: individuals with developmental or intellectual disabilities, including autistic people, who cannot tolerate masks; people with mobility impairments who cannot independently put on or take off a mask; people with seizure disorders who may be in danger if they experience a seizure while wearing a mask (the mask may obstruct breathing or cause choking); people with lung diseases or breathing difficulties; and people with anxiety disorders who experience panic attacks while wearing masks. Some people use ventilators to support breathing and may not be able to safely wear a face mask.

In addition, some people with disabilities cannot communicate effectively with another person if the other person is wearing a mask. Examples include deaf and people with hearing issues and some people with intellectual, developmental, or processing disabilities.


Further, many people of color and particularly black people are deterred from wearing face masks because of racial profiling and harassment by police
.”

(Disability Rights and Defense Fund (DREDF) and Disability Rights California, July 23, 2020)

💭 So, does this mean that all people with disabilities are exempt from wearing face masks during COVID-19?

According to federal regulations, government programs, services and activities must be “readily accessible to and usable by individuals with disabilities.” What does this mean for COVID-19?

According to the Disability Rights Education and Defense Fund (DREDF) and Disability Rights California:

“Government programs must take affirmative steps to include and protect all disabled people during the pandemic, whether or not they can wear a mask, communicate with other people wearing masks, or be around other people. Such steps include providing:

• Free face masks and hand sanitizer for any employees or members of the public who need to interact in person
• Accessible remote (on-line, video, telephonic, and mail) service, whenever reasonable and equally effective
• Individualized service
• Curbside service
• Waivers or extensions of time for required appointments
• Flexibility, patience, repeating information, writing notes, and using speech-to-text programs
• Auxiliary aids and services including sign language interpreting and real-time captioning
• Use of alternatives to cloth face masks for communication, such as clear masks, face shields, or plexiglass barriers.”

(Disability Rights and Defense Fund (DREDF) and Disability Rights California, July 23, 2020)

PJ, in their 30s wears a facemask and uses a walking cane

PJ: Medical rationing is another really important issue. When there isn’t enough medicine, vaccines, or other medical care for everyone who needs them, then hospitals and health provider organizations may be forced to decide who should receive care and who shouldn’t.

Medical rationing based on disability is not legal under the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act and Section 1557 of the Affordable Care Act. Also, some state laws prohibit medical rationing based on disability.

Health care providers can’t limit or deny care to a person with a disability because of their disability or need for reasonable modifications. They can’t limit or deny care because a person with a disability may require more intensive care or is less likely to survive. Providers should provide the medical care to people with disabilities that they provide to everyone else.

Click the quiz link below to check your learning and continue.

Lesson 6: The ADA: Service Animals

Seven community members wearing face masks are seated around a table in a small meeting style room.
It may not seem like it, but the people in this room are socially distanced. An American Sign Language (ASL) Interpreter is in the room to sign for anyone who needs it.
Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: We get a lot of questions about our service animal policies, Terrye.

Look at this draft policy:

Emergency Shelter Pet Policy

Disasterville’s disaster shelters do not allow pets. Shelters do allow service animals in all areas. However, each shelter will have an “animal free” area so that people with dog allergies or phobias can have as little contact with the animals as possible.

This policy is:

PJ, in their 30s, wears a facemask and glasses

PJ: Terrye, maybe we should back up a minute and discuss service animals. Do you know how the Americans with Disabilities Act (ADA) defines “service animal”?

💭 Can any animal be a service animal under the Americans with Disabilities Act (ADA)?

What are other requirements for service animals under the Americans with Disabilities Act (ADA)?

PJ, in their 30s, wears a facemask and glasses

PJ: People think that service animals need special tags, a special vest, or a certificate but they don’t. They don’t need to be registered. Service animals must be required because of a disability and trained to perform a specific task related to the disability.

For example, César’s dog, Ginger, has been trained to open doors for César.

Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: I use a service animal, Fury, trained for wayfinding. You may be surprised that a miniature horse can be a service animal.

If someone with a dog or miniature horse shows up at an Emergency Dispensing Site (EDS) to get a vaccine, the only questions staff can legally ask about the animal are: (1) Is the animal a service animal required because of a disability; and (2) What work has the animal been trained to perform?

You can’t ask the service animal owner whether they have a disability or what disability they have.

From the Rocky Mountain ADA Center:

“Under the ADA, service animals must be harnessed, leashed, or tethered, unless these devices interfere with the service animal’s work or the individual’s disability prevents using these devices. In that case, the individual must maintain control of the animal through voice, signal, or other effective controls.

“A person with a disability cannot be asked to remove his service animal from the premises unless:

1. The dog is out of control and the handler does not take effective action to control it

2. The dog is not housebroken.

“When there is a legitimate reason to ask that a service animal be removed, staff must offer the person with the disability the opportunity to obtain goods or services without the animal’s presence. Staff are not required to provide care or food for a service animal.”

(Rocky Mountain ADA Center, 2020.)

Lesson 6: The ADA: Effective Communication

Seven community members wearing face masks are seated around a table in a small meeting style room.
It may not seem like it, but the people in this room are socially distanced. An American Sign Language (ASL) Interpreter is in the room to sign for anyone who needs it.
Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: Local emergency management and public health departments must ensure that their communications with people with disabilities are as effective as communications with people without disabilities. Local governments are required to provide auxiliary aids and services, like closed captioning and an American Sign Language (ASL) interpreter, that promote effective communication.

With that in mind, let’s look at this policy:

Auxiliary Communication Aid Policy

When providing public emergency services, Disasterville County will provide auxiliary communication aids and accessibility services, such as American Sign Language (ASL) interpreters, upon request. The person who needs ASL interpretation will be charged a small fee to cover the interpreter’s travel costs, if any.

This policy is:

Other aids and services which may be needed include:

Written materials
-Notetakers
-Exchange of written notes
-Qualified sign language interpreters
-Assistive listening devices
-Audio recordings
-Hearing aid compatible phones
-Text messaging
-Video-based communication and interpreting systems

Plain language materials
Large print materials
Qualified readers
-Braille materials
-Email

And there may be more. For example, a dry erase board may be useful for quick communication with someone who is Deaf or Hard of Hearing under certain circumstances.

PJ, in their 30s, wears a facemask and glasses

PJ: If one auxiliary aid or service is an undue financial or administrative burden, the local government must use another auxiliary aid or service to provide effective communication. Remember, high cost alone usually doesn’t mean an undue burden.

💭 What’s the best auxiliary aid or service to use?

Marco, Franny and their baby Juniper stand together. Wearing facemasks, Franny signs "Hello" in ASL and Marco has Juniper in a front-facing baby carrier

Marco [Signing]: Accessible communication is important in emergencies. It’s important for local governments to use more than one form of communication for emergency alerts, warnings, and public education or instruction. After all, emergency management and public health offices want to make sure everyone can get the same information at the same time and is able to communicate with public health and emergency services.

💭 Think about situations that call for accessible communication in more than one form.

Franny [Signing]: The Action Team gets a lot of questions about sign language interpreters.

Click the quiz link below to check your learning and continue.

Lesson 6: The ADA: Physical and Program Access

Seven community members wearing face masks are seated around a table in a small meeting style room.
It may not seem like it, but the people in this room are socially distanced. An American Sign Language (ASL) Interpreter is in the room to sign for anyone who needs it.
Rachel, a white woman in her 40s, wears a facemask and glucose monitor on her upper arm

Rachel: We’ve had a request to review potential emergency policies, Terrye. If they are in keeping with the Americans with Disabilities Act (ADA), we’ll add them to our local plan. If they are not in keeping with the ADA, they will be kept out of the plan.

On an early visit, we talked about a photo of a Disasterville County emergency shelter. Remember that it looked kind of crowded and seemed like it would be noisy? Remind yourself by looking at the photo below. Then read the modifications list.

An aerial image of a crowded emergency shelter with many people, beds, and supplies
Emergency Shelter during Ice Storm 
Used with permission, L. Jackson, MA Medical Reserve Corps Region 4 A
 

Which modifications do you think would be reasonable under the Americans with Disabilities Act (ADA)?

Rachel, a white woman in her 40s, wears a facemask and glucose monitor on her upper arm

Rachel: Providing extra storage, wayfinding help, and access to a kitchen would be reasonable modifications under the ADA. According to the U.S. Department of Justice, these program access modifications should be provided in an emergency shelter.

Most of these things might seem easy to provide, right? But what about personal care assistance? That seems pricey, doesn’t it? It’s still a reasonable modification, though. Another reason to plan ahead.

Local governments and emergency shelter operators may not require someone to bring their own direct support professional in order to receive shelter services. But local plans could call for publicizing that direct support professionals are welcome in the local emergency shelter.

In engaging with local planners, it’s important to emphasize not just the law, not just that something is the right thing to do, but that there are practical benefits too. For example, publicizing that direct support professionals are welcome might cut down on the number of people who arrive at an emergency shelter without a direct support professional. Fewer people who need direct support help might mean lower costs and less work for shelter staff.

PJ, in their 30s, wears a facemask and glasses

PJ: Take a look at some more policies, Terrye. Below is an emergency transportation policy.

Evacuation Transport Policy

Disasterville County has limited evacuation transportation and has an obligation to protect residents’ safety. Therefore, the County will not evacuate residents together with their mobility equipment (such as wheelchairs) because this kind of equipment takes valuable space in evacuation vehicles which could otherwise be occupied by people.

This policy is:

Here’s another policy:

Disaster Shelter Admission

Any person with a diagnosed mental illness other than depression or anxiety who arrives at a Disasterville emergency shelter will be transferred to a medical facility in order to protect the safety and security of the shelter’s general population.

This policy is:

EM, a white bald man in his 50s wears a facemask

EM: As we get ready to give COVID-19 vaccines, we have to think about Emergency Dispensing Sites (EDS) where many people will go to receive the vaccine. Check out this potential policy.

COVID-19 Emergency Dispensing Site (EDS) Policy

Each year, Disasterville County will assess the physical accessibility of all potential Emergency Dispensing Sites (EDS). All EDS are to be made physically accessible to people with disabilities, unless there are undue financial or administrative burdens, as defined by the Americans with Disabilities Act (ADA). However, at least one emergency dispensing site in this county shall be physically accessible.

This policy is:

Click the quiz link below to check your learning and continue.

Lesson 6: The Americans with Disabilities Act (ADA) and Legal Rights

Seven community members wearing face masks are seated around a table in a small meeting style room.
It may not seem like it, but the people in this room are socially distanced. An American Sign Language (ASL) Interpreter is in the room to sign for anyone who needs it.
EM, a white bald man in his 50s wears a facemask

EM: Nice to see you again, Terrye. You remember Disasterville’s Prepared4ALL Action Team, right?

Marco, Franny and their baby Juniper stand together. Wearing facemasks, Franny signs "Hello" in ASL and Marco has Juniper in a front-facing baby carrier

Marco [Signing]: I speak for all of us when I say we’re so glad to see you again.

We’ve spent a lot of time talking about our community and local government’s role. One of the local government’s main roles is to keep residents and visitors safe from harm, including harm from emergencies, disasters and pandemics.

The Americans with Disabilities Act (ADA) is about expanding access and opportunity to everyone. By following the ADA’s Title II, local governments provide equal access and opportunity to participate in emergency planning and other emergency, disaster and COVID-19 related government programs, services, activities and facilities.

It doesn’t matter if the local government provides these things directly or through third parties, like the American Red Cross or private nonprofit organizations. The ADA, Title II, and other parts of the ADA still apply.

There are different strategies an Action Team could use to discuss legal requirements. The U.S. Department of Justice’s Project Civic Access found that most communities reviewed for ADA compliance knew about their ADA obligations and were making progress towards meeting them. But there may be some communities where planners are unclear about the legal rules. These planners may need more education and explanation than those in other communities. Again, helping planners see ADA compliance as an opportunity to expand access to the whole community, rather than just as a legal checkbox they must complete, can help them see the bigger picture and get onboard with positive change.

There have been Project Civic Access compliance agreements with 206 localities in all 50 states, the District of Columbia, and Puerto Rico to date. To find out if your city, town, county or state was part of a Project Civic Access compliance review, including a review of emergency management policies and procedures, go to Project Civic Access.

Local governments must follow Title II of the ADA in emergency, disaster and pandemic services. The ADA, Title II also applies to related government programs, activities, and facilities. Other parts of the ADA also apply. It doesn’t matter if the local government provides these things directly or through third parties like the American Red Cross or private nonprofit organizations. The ADA still applies.

Local governments generally may not use eligibility criteria that screen out or tend to screen out people with disabilities. This means that, for example, a county can’t make rules like “only people who can walk can come to our emergency shelters during a disaster” or “to be able to ride our emergency evacuation bus you must be able to get on and off the bus by yourself.”

Rachel, a white woman in her 40s, wears a facemask and glucose monitor on her upper arm

Rachel: Equal access may require reasonable modifications to programs, policies, procedures, architecture, equipment, services, supplies, and/or communication.

Reasonable modifications must be made unless they would fundamentally alter the nature of the program, service or activity or impose undue financial or administrative burdens. Local governments can often easily make reasonable modifications.

High cost alone isn’t likely to be an undue financial burden. Reasonable modifications are free for the person who needs them.

Marco, Franny and their baby Juniper stand together. Wearing facemasks, Franny signs "Hello" in ASL and Marco has Juniper in a front-facing baby carrier

Marco [Signing]: There are several key pieces to the ADA in emergencies, disasters and pandemics and they all relate to our Same Time Access To Everyone (STATE) motto.

Physical space is readily accessible and usable
+
👩‍🦽🐕‍🦺🏠 Programs, activities and services are readily accessible and usable
+
💬Communication with people with disabilities is equally as effective as communication with people without disabilities
+
🤔 Reasonable modifications
=
🧑🏽‍🤝‍🧑🏽 Same Time Access To Everyone (STATE)

Marco, Franny and their baby Juniper stand together. Wearing facemasks, Franny signs "Hello" in ASL and Marco has Juniper in a front-facing baby carrier

Marco [Signing]: Services must usually be provided in the most integrated setting appropriate to the person’s needs. This means that most people with disabilities should be sheltered in a general population disaster shelter and not sent to a separate shelter. Most people with disabilities should receive COVID-19 vaccines in the same places that people without disabilities receive them.

Allen, a Black man, wears a facemask and uses a walker.

Allen: By definition, disasters and pandemics are unexpected events. They can overwhelm communities and systems. Because things are happening so fast and are such a surprise, it may seem to make sense to overlook the Americans with Disabilities Act (ADA).

Click the quiz link below to check your learning and continue.

Lesson 6: Welcome Back

Street sign that says Welcome to Disasterville
Carrie, a Black woman in her 30s wears a facemask, has a white cane and a miniature horse that serves as her service animal

Carrie: Nice to see you again, Terrye. This is your 6th visit. Only 2 more to go!!

Today we’ll talk about civil rights, disasters and COVID-19. As you may know, the Americans with Disabilities Act (ADA) prohibits discrimination against people with disabilities, including in all aspects of emergency and pandemic (like COVID-19) services and programs. The means that it is against the law to treat people with disabilities differently from people without disabilities before, during, and after a disaster, emergency or pandemic. Discrimination is prohibited in all emergency phases, including mitigation, planning, response and recovery.

Section 504 of the Rehabilitation Act of 1973 prohibits discrimination on the basis of disability by the federal government, federal contractors, and by entities that receive federal financial assistance. This means that entities which get money from the federal government, like the American Red Cross and many local (city, town, or county) governments, can’t discriminate based on disability.

Other federal laws also apply, like Section 1557 of the Affordable Care Act which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs or activities. The Civil Rights Act of 1964 prohibits discrimination on the basis of race, color, religion, sex, national origin, and later sexual orientation and gender identity.

EM, a white bald man in his 50s wears a facemask

EM: Today our discussion will focus how the ADA relates to disability inclusion and local emergency planning. But planners should also be aware that other federal or state laws and local regulations may also apply. State and local law can generally be more stringent but not less stringent than the ADA.