Hilo opening session

 Hilo opening session – delayed from 9 a.m. start (9:18 a.m.) 

Welcome – Francine Wai

Introduce self, Debbie Jackson – planner for DCAB, Danny Tengun and Ina Chan from Civil Defense (planning, sheltering), Robin Brandt taking notes and posting it on a blog site

Howard Marks, Developmental Disability Council, introduced Francine Wai, Executive Director of DCAB

• Asking you to work, update this plan.  Make it a better plan, specific to your needs. Want open discussion about what you [general citizens] want in this plan.
• This is not a training workshop, a workshop because we are asking you to work.
• Turn the 2007 plan into a 2008 plan.  Every year we update this and share it with legislators, policy makers, people who provide funding so that it is responsive to persons with disabilities and special health needs.
• Really need grassroots examination of the plan and improve it, specific to local conditions.
• We will accept and take all your comments.  Tell us if something is junk.  Give us your input.
• Appreciate you taking your time to spend it with us and provide your opinions.
• If you need to take a break to feed your meter, please do that whenever you need to do that.

  

Introduce the people who will help facilitate the plan.

• Debbie Jackson
• Francine Wai
• Danny Tengun
• Robin Brandt

All the agencies that are collaborating to make these meeting possible.

• Paid for by the Center for Disease Control and Prevention.

Debbie will discuss agenda and ground rules.

Debbie:

• Hope everyone has an agenda – there is an Internet address to allow you to get into a blog.  There should be comments on the blog from each visit to each island.
• Everyone get handouts
• Everyone knows where the bathrooms, refreshments are in the back
• Agenda and general timelines – to complete by 3 p.m.
• Copy of PowerPoint handout
• Notice the blog address – comments from your workshop and around the state will be posted
• Some people have not used the blog – it’s pretty intuitive to use
• The PowerPoint to review this morning
• Evaluation form
• Interagency Action Plan handout
• Directions about which facilitator will direct each group and the goals to review.  Everyone will participate in every group.
• Lunch will be provided
• Francine and Debbie will provide a handout specific to their sessions

Logistics:

• Restroom locations provided
• Pick up handouts from outside table – telling what we will do and how we will do it

  

Brief ground rules

1. Respect each other.  Please put cell phones and pages on vibrate
2. Speak one at a time.  We have recorders and sign language interpreters. 
3. Don’t shoot the messenger. Critique ideas but not the person expressing it.
4. Respect the process – let’s follow the agenda and times, start and end the meeting on time.
5. Be open and honest with your feedback
6. Feel free to express ideas others might not agree with.
7. Speak one at a time – we are recording notes and if more than one person speaks it make it difficult.
8. Ask about the assumptions – ask why.  We want your comments, we want your ideas.

PowerPoint to go over what the plan includes

Francine – Ask by show of hands, how many people have seen, heard or read this plan?  We’d like to have a whole room of hands of people who have read the plan.

Review of the agencies that worked on the plan.

  

This plan was developed by a working group that consisted of a number of state agencies:

• Department of Education  - concerned with students
• Department of Health agencies
• Department of Human Services
• All Offices on Aging
• State Civil Defense
• State Council on Developmental Disabilities
• Civil Defense agency in each county
• American Red Cross
• Health Care Association of Hawaii (all hospitals that must respond)
• The Mayor’s committee on Persons with Disabilities in all counties (by various names, none in Honolulu)
• Association of the Blind
• Hawaii Services on Deafness

What we didn’t have is all of you.

Debbie

The workshop here and statewide has included monies for two representatives from each meeting to attend a meeting on O‘ahu on Monday, October 22nd.  Is anyone here interested in attending that meeting on Monday and express your interests from Hawai‘i?  Make sure to give me your name if you are interested.

Why is this issue so important?

• Look at the results of Hurricanes Katrina, Wilma, and Rita.  It taught us that when we are not ready, it costs lives.  Be prepared.  You have your kit ready, you get your kit, know where the shelter is and go.  People who are vulnerable and unable to evacuate: people with disabilities, the elderly, those with special health needs.  We want to include more of these people in the planning.

Who are we talking about when we talk about people with disabilities?

• Physical or mobility disabilities – use canes or crutches
• People with mental illness or has mental retardation or other cognitive disabilities, people with traumatic brain injuries
• People who are blind or partially sighted  (Some people on O‘ahu noted that someone could wave down a bus during an emergency, unless you can’t identify a bus)
• People with speech or hearing disability (sirens cannot be heard by people who are Hard-of-Hearing or Deaf) or people who have difficulty speaking
• Chronic health conditions or frail elderly
• Frail children and youth
• Difficulty in making notification accessible.
• Additional people to add to the list:

  

Who are people with disabilities and special health needs?

Harris Poll for National Organization with Disabilities found:

• In doing the plan, if you look at the ADA – it says there are approximately 20% of our population has a disability – about one in five.  That’s kind of high – not everyone needs special assistance.  If you function by yourself or with a care giver, you could go to a general shelter.
• For this report we are looking at a smaller percent – But the National Organization on Disability did a study and we think about 10 -13% (120,000 to 160,000 people) who may need assistance at evacuation centers.)  Concerned about how many would need a Level II shelter.

Other findings in this poll:

• 58% of people with disabilities do not know who to contact in an emergency.  Individuals who have case managers in a number of services are working to educate about where to go for a shelter.
• 61% have no plans to quickly and safely evacuate their home (identify people in licensed care homes – see last page of the plan – only 12,000 of the 126,000 needing assistance)
• 50% of those employed do not have an evacuation plan (a large portion of the population).  Working on that at your work site – that should be planned in your business too.  And you need to practice.  Know where to meet.
• Where are people located? See last page on the plan to show were 12,000 are – but not most.  People with disabilities live where they choose – so we don’t know where they live.  Some service agencies know where they live – others live independently.  Live in regulated or licensed care homes.  Look at last page of your plan and it shows the 12,000 people.  Listed by county – so you can see how many people have been identified.  Need better idea of where the others who are not shown there, and don’t receive services for providers.  There are a lot of people who live independent who have a disability.

As a public agency we know that transportation is an issue.

We know it involves recovery – but that is not in this plan.  We need to build infrastructure and then include recovery later.

All objectives have one or two agencies asterisked in this plan so there is an agency that is held responsible to take action o the specific objective.

  

Danny

My job as the hurricane planner for the state, and shelter person, is to be responsible for general population shelters, special need shelters, pet friendly shelters and equipment that go in the Level II shelters.

Ina Chan will be writing the appendix.

Special needs are one part of the entire plan.  Ina will use all this input and other meeting to write that annex report. Early part of the next year we will have a draft.  In 3-4 years we will not have this plan.  When objectives are completed, they go away. We want everyone to know what was in the plan.

  

What level of care is needed for an “incident” – all hazards?

Level I is staffed by Red Cross, general population shelter.  Anyone who can function by themselves or a little help.  There are 200 level I shelters in the state of Hawaii and 21 on the Big Island.  Most are in schools.  Look in the white pages of the phone book – it’s right there.

Out of the 29, we want all to be Level II shelters.  Level II will serve those with enhanced health needs: diabetes and needs refrigeration for the insulin, someone who needs changing and feeding.  You need to bring your caregiver.  If you go to a Level II shelter, you must bring your caregiver.  There may not be any assistance.  You cannot expect anyone to care for them.  We are working on staffing the shelters.  If you have any questions, write it on your paper and discuss in the work groups. There will be equipment – we will discuss in the workshop.

  

Level III – examples: someone who is 9 months pregnant and ready to give birth; someone who just had major surgery should call the doctor and get directions about what to do.  If you are under the care of a physician, you should check with a physician to see what the doctor suggests. May tell them to go to Level I or Level II shelter.  Do not go to the hospital.  The hospitals are needed for those in need of acute care. 

How many of you have an emergency care kit?  If not, shame on you.  If you cannot care for yourself, you cannot care for others.

Francine:

Will go through all seven goals rather quickly.  You will have more opportunities to make comment on each.

When we use the words “people with disabilities and special health needs” – in an emergency everyone has a special need.  It might be that you are single parent and your children are half way across the island.  Special health needs means insulin, cots, electricity for breathing, etc.  Not having English as a first language is not a special health need.

Basic principals

The first basic principal is that emergency readiness is first and foremost a personal responsibility.  Emergency readiness is foremost a personal responsibility. Emergency preparedness is a government responsibility.

1. Government is not coming to get you.  We are not going to be able to pick up and transport you, have blankets, batteries or other personal items for you.  .

1. PWD or special health needs should remain as a unit with their families, not be separated.  We want to keep people together as a family unit – it means you will care and support for each other and less for the shelter staff and provide emotional assurance. 

1. As we begin to increase the number of shelters for everybody and improve overall notification system, it will be a better plan for people with disabilities.  This is only an action plan to coordinate with all other plans for emergencies.

1. We are not interested in a registry for people with disabilities.  Some people will wait if they are on a registry and think someone will come and get them.  Registries go out of date. People get a false sense of security.  Surveys show that people think that if there is a tsunami, someone will come to my house.  Although a registry would show that you live at a certain address, you may not be there.  We don’t know where people will be there when the emergency hits.

1. Will only list people who live on the island at the time of the registration but that person may not necessarily be on island at time of disaster.  Or, you may have a more severe need at time of the emergency.  Will be using any registrations that exist after emergency.

Basic goals:

Goal 1: All shelters become ADA compliant

Currently – Upgrade the existing shelters.  Will tell you about the shelters we are already working on.  The training of the shelter workers themselves.

Goal 2: Increase the capacity to shelter in place, if you have a strong enough structure.  Not a single frame wooden home. 

Goal 3: increase the number of Level II shelters.  All shelters are Level II shelters.

Equip with equipment and medical support.

Debbie –

Goal 4:  An accessible public and professional emergency readiness campaign.  Go out and promote readiness.  Last month was National Emergency Preparedness month.

Accessibility means physical access. It also means accessible format to get the message out so everyone knows the message.

• Outreach program using existing programs and information.  DCAB, Red Cross do this already.  Purchase starter disaster kits.  We have one to show you and basic components are in it.
• Conduct emergency planning with State case managers (know where the shelter is and how to make a disaster kit).  For those who were at risk and cannot afford a kit, kits were purchased for them.  The grant bought agencies a bag to show people what minimally needs to be stocked.

Goal 5: Healthcare providers must have evacuation plan in place.  Nursing homes, adult mental health homes, adult residential care home – will have plans for all people living with them.  It did not work at recent emergencies to take all these people and drop them off at a hospital.  Many of these people do not need acute care.  Overwhelmingly what is seen is that care providers are dropping clients off at hospital.  If you care for people, don’t they become members of your family?  Would you drop a family member off at a hospital?

  

Francine, Goals 6 and 7

Danny is discussing shelter.

Debbie says what you are doing to prepare for emergency. 

Then you need to take action.

Goal 6: Notification. Why is that?  People who have may have deaf or hard of hearing may not hear siren, persons with visible disability may not see across the bottom of the television screen, and people with cognitive disabilities may not understand what it means.

• The need for captioning and crawl messages.
• TTYs at emergency information lines
• Accessible websites
• Reversible 911

Goal 7: Transportation.  We may have some unique needs but may have difficulty getting from point A to point B.  What can we do in these situations?

[read the plan goal and objectives]  Will see everyone’s eyes roll – we don’t even have good transportation when we don’t have an emergency.  We’ve heard that neighbor islands need to take a different approach.

Are there any really general concerns about the plan that we can address:

Comment: Fantastic!  Really wonderful.

Response: This is still in the evolution phase and we have a long way to go.  When I first started learning abut this two years ago, I was quite depressed.  But we have come a long way putting these goals in place.  We need to have the goals and objectives; we won’t get money from the Legislature or Homeland Security funds.

  

Danny will discuss the shelters and where they are located.  Don’t shoot the messenger.

I inherited this problem.  It will be with us forever.  There is not enough money to give every one hope that there is enough shelter space for everybody.

Overview of the shelters.  1.4 million population and there are 27 shelters on the Big Island.  Other county facilities are used for brush fires, etc.  There is a shortage of 26,000 spaces.  (Reading from the Power Point presentation.)  This is based on 35% of the population evacuating – it could be more or less.  What will happen if 50% or 60% or 70% of the population needs to evacuate?  Based on 35% for planning purposes – short 26,000 spaces on the Big Island. Bleak picture.

No funds for Level II shelters.  The President and Governor said do something but gave no money?  We came up with this solution: use classrooms for SPED students are being used as special needs shelters unofficially because they are accessible.  If the restroom is not in the room, it will be nearby.  Have shelters, refrigerators for the medicine, and shower in the room.  We created Level II special need spaces.  Only physical [space].  No equipment yet – we are hoping next year.  [Examples of spaces to be used.]  Did neighbor islands first – fewer and this made it easier?  Showed some of the possible spaces – these are not official.  The Red Cross bought into this and responsible for overall sheltering.  They are responsible for staffing Level I.  Pet friendly will be staffed by people by the Humane Society.  No one responsible for Level II shelters yet.

We have done simulations to check the situation out – we include persons with disabilities to develop action plan – and now you will be part of it. For the last year and a half we have had people with special needs in the meetings, the simulations.  Feedback from managers in Katrina was that meetings were held but not inclusive of persons with special needs.

Question: The question was not repeated by the facilitator and the recorder could not hear it.

Answer: One of the things that we learned – the ARC of Hawaii brought a bus load of people. They said that there was a high level of anxiety in the simulation.  The home manager said that it will be much worse in the real thing.  That’s why we plan and practice.  For the pet friendly and the general population.

Level I – independent

Level II – enhanced health needs and caregiver

Level III – call your doctor for instruction, don’t go to the hospital, it may be overwhelmed.

  

Discussion of HUB shelter concept and model.  Put money in a few shelters at first.  As we get funds then others will become a HUB center, until all shelters are HUB shelters and Level II shelters.  Otherwise equipment will be inconsistent.  In any bad disasters, we must accept people with disabilities and special health needs at all shelters regardless of readiness and equipment.

  

Oxygen s the first priority.  Need transfer switch for use of generators for electricity.  Hook up cooking kitchen with the generators.  Just for cooking kitchen.  Post disaster – to feed the population.  If more money will turn on lights and air conditioning.  Now Kauai has generators – left by FEMA but are rusting out.  Cost is $60,000 to$70,000 to maintain.

Need communication equipment and secure storage.  Want these to stay in the inventory, and secure storage must be hardened so it won’t “walk away.”

People must bring own oxygen but there may be some oxygen at Level II shelters.  How many pounds does a hospital bed weigh?  Say 400-500 pounds.  Let’s say someone is told that they must sleep on hospital bed.  We found hospital bed to the shelter – we have some from PVC pipe and filled with polyfoam.

Question: Do you know much oxygen tank weighs and how long they last?  They don’t last very long. 

Answer: Plan now rather than two days before the disaster.  Government will not give you anything.  Red Cross will be there seven days.

Comment: With the cost of these tanks funding may not be available

Question: With such small amounts of support, what good is the shelter?  What is the shelter for?

Answer: Let’s discuss in small groups.

Other initiatives:

Hurricane shelter location brochure

Private sheltering program – churches, theatres, parking structures, condominiums association (no one living in a condo?), nursing home. 

If you have a group, County Civil Defense will go out and give presentations to groups.

Loss Mitigation grant program to retrofit your current home now.  Roof to wall, all to foundation connections, safe rooms. Up to 35% of the cost, up to $2,100 of costs.  Have paper copies to ask for information – and phone number to call for information.  Call 586-0899.  Brought applications.  Download only the part of the application you need to avoid wasting paper.

Products that can be used for retrofitting: film for windows (tinted, clear and good for up to 200 mile and hour wind), screens used on schools, aluminum screens, roll down shutters.  Film will hold shattered window pane in place and not fly.  Black shade cloth made of Kevlar for over 200 mph resistance.  You can see out but not see in.  You strap it into the roof /ceiling and floor.  Can only see holes when it is close up.  Shelters are slide down, fold up.  Hurricane retrofits Google on the internet or “shutters.”

Safe room for $5,000 to $7,000 to $10,000. Use in the corner of your house or in the garage.  You can put these outside as well or add on to your home.  Can get these on the internet.  You and your family with your dog.  You don’t need to retrofit your whole house. About 4 foot by 6 foot.  Danny would never bring his family to the shelter.  He’s seen cots with people guarding them.  People steal things from each other.  With a safe room, people can bring pets into it.

Showing a typical shelter– it has nothing in it.  One gallon of water per person for eacj day – that’s a lot of water.  No flush toilets.  You must do your own planning. 

People are leaving to put money in the meters.

Photos of things that he has in his kit for an emergency.  Hand can opener.  Shampoos, first aid kits. Miscellaneous things like duct tape, FRS radios, no landline.  FRS can talk to family up to 10 miles.  Meals – Meals ready to eat (MRE) or freeze dried.  Date on canned goods.  Water.  Water purifier.  Water treatment tablets.  You’ve got to start planning.

Here is a shot of a piece of plywood that went through a coconut tree.

Picture showing what happens.  The wind comes in, blows the roof off and that’s it – this is the end.

If you live in a single wall home, you must get out.

Everyone will count off.  1, 2, 3.

   

Short break – then move to groups at 10:35 a.m.