SOS: Disaster Plans for People with Disabilities

ATLANTA—Who can forget the wrenching stories in the
aftermath of Hurricane Katrina? Nursing home residents who drowned,
oxygen patients whose tanks exploded on an evacuation bus, hundreds
of rooftop rescues. Yet four years after the 2005 storm, which
exposed gaping holes in the nation’s response preparedness, a
report from the National Council on Disability says the
country’s disabled citizens are still not given enough
consideration in most government emergency plans.
 
The report, released Aug. 12, urges not only the government but
private companies to consider the needs of people with
disabilities—among the most vulnerable in
disasters—when creating both preparation and response
plans.
 
The NCD’s first evaluation of federal government work in
emergency preparedness and disaster management was published in
April 2005 in a report called “Saving Lives: Including People with
Disabilities in Emergency Planning.” That report laid out a
scenario of a major hurricane striking the Gulf Coast and outlined
steps that the federal government should take to include people
with disabilities in emergency preparedness, disaster relief and
homeland security. Hurricane Katrina struck four months
later.
 
As a result of the organization’s work, the Post-Katrina
Emergency Management Reform Act required FEMA to consult with the
NCD. Its latest report—“Effective Emergency Management: Making
Improvements for Communities and People with
Disabilities”—is the result.
 
Detailing the challenges faced by people with disabilities in
disaster situations, the 500-page report found many emergency
managers and people with disabilities remain unprepared for a
disaster. Despite mandates to do so, most disaster planning occurs
without consulting people with disabilities or disability
organizations, the report said.
 
Under CMS’ accreditation standards, HME providers must have
emergency plans in place to lay out how their companies will
function and how all patients will be serviced. (To continue doing
business with Medicare, DMEPOS providers must be accredited by Oct.
1, 2009.)
 
According to Rhonda Pearce, director of accreditation services with
HQAA, the Waterloo, Iowa-based accreditor breaks emergency planning
into two policies because of the different focus—one
proactive, the other reactive—given to each.
 
“What is most important is that the organization and the
staff are aware of what to do in the event of disaster and/or
emergency,” Pearce said.  
 
“Emergency preparedness outlines the organization’s plan
defining staff’s individual roles in the event of an emergency. Who
is the safety officer, what should staff do, where should they
meet, who should they contact, etc., are a few of the questions
that are answered in the preparedness policy,” Pearce
continued.
 
“The disaster plan defines how an organization reacts once a
disaster has occurred. Who calls staff to let them know if the
office is open or closed, how will patients be serviced, should
service transfer to another company that has not been affected by a
the same disaster, what is the prioritization of the patient care
schema, etc., are some of the questions that are answered in the
disaster plan.”  
 
While providers can’t “make” patients get
prepared, added Mary Ellen Conway, president of Capital Healthcare
Group, Bethesda, Md., they can tell patients about emergency
procedures.
 
She likens the accreditation requirement to a hotel informing
guests of what to do in a fire. “The hotel gives the guest a
list of what to do in case of a fire. This is similar to HME
because you need to tell your patient what to be aware of and what
to doin an event.
 
”It’s along the lines of asking, ‘Do you have a
plan?’” she said.
 
CMS has recently updated its Medicare Fee-for-Service Emergency
Preparedness Questions and Answers. The Q&As are posted here in a
document that also contains a section on the H1N1 flu
virus.