GAO Report, Congress, Urge Better Disaster Response to Seniors and Disabled

Published in the Woonsocket Call on June 23, 2019

Following a newly released 75-page report on the nation’s disaster response from the nonpartisan Government Accountability Office (GAO), and after an outbreak of destructive tornadoes in the Midwest and the start of the 2019 hurricane season, U.S. Senators Bob Casey (D-PA) and Susan Collins (R-ME), Ranking Member and Chairman of the Special Committee on Aging, throw a bill into the legislative hopper to assist seniors and disabled persons before, during and after natural disasters strike.

The Casey-Collins legislation, S. 1755, titled the “Real Emergency Access for Aging and Disability Inclusion (REAADI) for Disasters Act” would support the development of preparedness, response, recovery and mitigation plans that are inclusive of seniors and people with disabilities. The legislation would also ensure that these individuals would have a voice in creating emergency plans that directly affect them. Senators cosponsoring the bill include Doug Jones (D-AL), Richard Blumenthal (D-CT), Tammy Duckworth (D-IL), Kamala Harris (D-CA), Maggie Hassan (D-NH) and Kirsten Gillibrand (D-NY).

Another bill, S.1754, titled the “Disaster Relief Medicaid Act” (DRMA), sponsored by Cassey, would ensure Medicaid services are consistently available for individuals forced to relocate to another state due to disaster or emergency. It would protect those residing in an area covered under a presidential disaster declaration as a “Relief-Eligible Survivor,” and grant them the support needed to easily access or apply for Medicaid services in their host state. Senators Sherrod Brown (D-OH), Kamala Harris (D-CA), Richard Blumenthal (D-CT) and Kirsten Gillibrand (D-NY) are cosponsoring this bill.

Congressman Jim Langevin (D-RI) and Chris Smith (R-NJ) plan to introduce the House companion measure of REAADI Act. Congresswoman Donna Shalala (D-FL) will introduce DRMA in the House chamber.

Inadequate Disaster Planning Can Result in Death

“Inadequate planning for disasters can mean life or death, so it is critically important that every
community is prepared to meet the needs of all citizens—including older adults and people with disabilities—before, during and after a disaster strikes,” says Casey in a June 11 statement announcing the introduction of REAADI, calling for seniors and people with disabilities to be actively involved in developing emergency preparedness plans that will keep them safe.

In this statement, Collins adds, “As we have learned from natural disasters such as Hurricanes Irma and Harvey, some of our neighbors – especially seniors and individuals with disabilities – face many obstacles during a crisis. We must focus on the attention they may need. The bipartisan legislation improves training and coordination to help ensure that local, state, and federal officials are adequately equipped to care for the most vulnerable in their communities during a natural disaster.”

“As someone who lives with a disability, I take this issue to heart. The REAADI for Disasters Act will help eliminate barriers faced by people with disabilities and older adults during disasters by providing them a greater role in the policymaking process,” says Langevin, co-chair of the Bipartisan Disabilities Caucus, stressing the importance of passing the DRMA to continue Medicaid support services to America’s disabled and seniors.

GAO Report Gives Roadmap to Integrating Assistance During Natural Disasters

Released June 5, GAO’s Report, titled FEMA Action Needed to Better Support Individuals to Better Support Individuals Who Are Older or Have Disabilities, examines the Federal Emergency Management Agency’s (FEMA) disaster response to three sequential hurricanes – Harvey, Irma and Maria – that affected more than 28 million people in 2017. According to FEMA, seniors and persons with disabilities faced challenges in these natural disasters when evacuated to safe shelter, accessing medicine and obtaining recovery assistance. In June 2018, FEMA began implementing a new approach to assist individuals with disabilities.

GAO’s report addressed the challenges FEMA partners reported in providing assistance to seniors and the disabled and took a look at the challenges such individuals faced accessing assistance from the federal agency and the actions FEMA took to address these challenges. The federal study also examined the FAMA’s new strategy to assist persons with disability.

Here are GAO’s seven recommendations to FEMA:

The federal agency, charged with providing auditing, evaluation and investigated services to Congress, called on the FEMA Administrator to develop and publicize guidance for partners, during the data sharing process, who are requesting individual assistance data from seniors and persons with disabilities during natural disasters.

The GAO report also called on the FEMA Administrator to implement new registration-intake questions to improve FEMA’s ability to identify and address survivors’ disability-related needs, by directly soliciting survivors’ accommodation requests.

GAO also suggested that the FEMA Administrator improve communication of registrants’ disability-related information across FEMA programs, by developing an alert within survivor files that indicates an accommodation request.

As to the federal agency’s new strategy to specifically assist persons with disability, GAO urged the FEMA Administrator to establish and disseminate a set of objectives for the federal agency’s new disability integration approach.

The GAO report also recommended that the FEMA Administrator provide a written plan for implementing its new disability integration staffing approach to Regional Administrators and Regional Disability Integration Specialists. The plan would be consistent with the new objectives established for disability integration. It would also include an implementation timeline and details on staff responsibilities, which regions could use to evaluate staff performance.

Additionally, the GAO report recommends that the FEMA Administrator should develop a plan for delivering training to FEMA staff that promotes their competency in disability awareness. The plan should include milestones and performance measures, and outline how performance will be monitored.

Finally, the GAO report suggests that the FEMA Administrator develop a timeline for completing the development of new disability-related training that the federal agency can offer to its partners that incorporates the needs of individuals with disabilities into disaster preparedness, response and recovery operations.

For a copy of the GAO report, go to http://www.aging.senate.gov/imo/media/doc/GAO%2019-318%206-3-19.pdf.

Senate Aging Panel Calls for Improved Emergency Preparation and Response

Published in the Woonsocket call on October 8, 2017

“Those who cannot remember the past are condemned to repeat it” — George Santayana, a philosopher, essayist, poet, and novelist

In the wake of Hurricanes Irma and Harvey, after the death of at least nine nursing facility residents due to heat-related illness due to sweltering heat at a Hollywood, Florida-based facility that had lost power to run its air conditioner, the Senate Special Committee on Aging put the spotlight on the challenges facing seniors during natural disasters at a hearing on Sept. 20, 2017.

News coverage of Hurricanes Irma and Harvey provided heartbreaking reminders that seniors and persons with disabilities are particularly vulnerable during a natural disaster. On Florida’s Gulf Coast, an assisted care facility for dementia patients lost electrical power for three days, causing 20 seniors to suffer from high indoor temperatures. Meanwhile, in Dickinson, Texas, a widely-shared photo showed elderly residents of an assisted-living center awaiting rescue as flood waters rose waist deep inside the facility.

Heeding the Lessons from Past Disasters

When Hurricane Katrina slammed into the Gulf Coast 12 years ago, more than half of those who died were seniors, according to a report from the National Institutes of Health. Since that devastating storm, disaster response officials have placed much emphasis at the national, state, and local level to better protect older Americans during an emergency.

“As we have learned from Hurricanes Irma and Harvey as well as past catastrophes such as Hurricane Katrina, some of our neighbors – especially seniors – face many obstacles during a crisis, and we must focus on the attention older adults may need,” said Senators Susan Collins (R-ME) and Bob Casey (D-PA), Chairman and Ranking Member of the Senate Aging Committee in a statement announcing the Senate panel hearing held in 562 Dirksen Senate Office Building.

In her testimony, Dr. Karen B. DeSalvo the former health commissioner for New Orleans after Hurricane Katrina hit the city in 2005, noted that medical records for most patients at the time of Katrina were kept only on paper and were destroyed, “turning to useless bricks,” or lost because of the disaster. For clinicians, treating patients who lost their medicines became a major challenge, she said.

Creating Registries to Protect the Vulnerable

Since Katrina, the New Orleans Health Department has been “working aggressively, to create a medical special needs digitized registry to maintain a list of high-risk individuals, those most in need of medical assistance for evacuation during preparations or in response operations, says Dr. DeSalvo

Dr. DeSalvo called for “leveraging data and technology” as a way of creating more efficient and effective strategies of identifying the most vulnerable in a community. All communities could create such registries by using state Medicaid data to locate where residents who are electricity-dependent live. The electronic system, called emPOWER, is available for use nationally, and she recommended Congress fund training exercises to respond to disasters. response.

A witness, Jay Delaney, fire chief and management coordinator for the City of Wilkes-Barre, Pennsylvania, suggests that Congress continue to fully fund the National Weather Service and the Federal Emergency Management Agency (FEMA). Investing in surveillance tools can enhance decision making by making crucial weather data available before, during, and after a disaster.

For nursing homes and assisted living facilities, it is “critical” they have detailed shelter-in-place emergency plans, says Delaney, but for those who stubbornly choose to not leave their homes during a disaster, preparedness for those is a “tough nut to crack.”

“When you have to evacuate 15,000 people in 10 hours, you don’t have time to say, ‘Mam or sir, here’s why you have to go,’” Delaney said.

In his testimony, Paul Timmons Jr., CEO and president of Portlight Inclusive Disaster Strategies, proposed the establishment of a National Center for Excellence inclusive Disability and Aging Emergency Management to improve emergency management responses to disasters to reduce injuries and save lives. “The initial focus of the center should include community engagement, leadership, training and exercise development, evacuation, sheltering, housing and universal accessibility,” he said, suggesting a five-year, $1 billion budget.

Finally, Witness Kathryn Hyer, a professor in the School of Aging Studies at the University of South Florida in Tampa, provided eight tips for the Senate Aging panel to protect seniors during disasters. She called for emergency plan for nursing homes and assisted living; required generators to support generators in the event of a power failure, more research on what types of patients will benefit from evacuation or sheltering in place; construction of facilities in places that minimize flooding risk; identification of and prioritization for nursing homes and assisted living communities by state and local management organizations for restoration of services; litigation protection for facilities that abide by regulations and provide care during disaster scenarios; and continued commitment to geriatric education programs.

Prioritizing Senior’s Needs in Disasters

On Sept. 26, one week after the Senate Special Committee on Aging hearing on disaster preparedness and seniors, Senators Collins and Casey called for a swift federal response to the growing humanitarian crisis in Puerto Rico and the U.S. Virgin Islands. In correspondence to three federal agencies, they urged the Administration to take all available steps to act swiftly and prioritize seniors in the response to Hurricane Maria The senators also urged the federal agencies to prioritize not only patients in acute health care facilities, but individuals in nursing homes and assisted living facilities, as well as seniors living at home.

“We urge the Administration to heed the lessons of the recent hurricane response efforts in Florida and Texas and take all available steps to prioritize seniors in the response to this devastating storm,” the senators wrote. “Seniors must be quickly identified and resources deployed to ensure that no older American is left in unbearable heat without air conditioning or without water and food as response efforts continue… During this recovery period, it is even more important to multiply our efforts and deploy sufficient resources to support and rescue seniors.

It has been reported that the intensity of North Atlantic hurricanes and the number of Category 4 and 5 hurricanes are increasing. With a high concentration of people and properties in coastal areas were hurricanes strike, it become crucial to learn emergency management lessons gleaned from past hurricanes and disasters, from Hurricane Katrina to Hurricane Irma. The Senate Select Committee on Aging is on the right track in seeking ways to put disaster emergency preparedness on the nation’s policy agenda. Now, it’s time for Congressional standing committees to adequate fund FEMA and the National Weather Service and strengthen emergency preparedness laws.