Introduce 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.
• 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.
• Appreciate you taking your time to spend it with us and provide your opinions.

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 CDC.

Debbie will discuss agenda and ground rules.

Debbie:
• Handouts are on the blog
• Hope everyone 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 around the state will be posted
• 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:
• Location of the restrooms was provided.

Brief ground rules
1. Respect each other. Silence your cell phones and put your pagers 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 communication.
6. Listen to be understood. Don’t “kill the messenger.”
7. Feel free to express ideas others might not agree with
8. Speak one at a time – we are recording notes and if more than one person speaks it make it difficult. This helps the sign language interpreter and the recorder.
9. Ask about the assumptions – ask why. We want your comments, we want your ideas.

Francine – Asked how many people have seen, heard or read this plan? About a third of the group. That’s good.

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 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 some counties
• Association of the Blind
• Hawaii Services on Deafness

The plan needs input by the public and particularly people with disabilities

Introduction of representatives from neighbor island meetings.
Introduction of representatives from other nations: Guam, and American Samoa

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’re your kit, know where the shelter is and go. People who are vulnerable and unable to evacuate: people with disabilities, the elderly, the aged. 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 who have mental illness or has mental retardation or other cognitive disabilities, people with traumatic brain injuries;
• People who are blind or partially sighted (Some people noted that someone could wave down a bus, 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; and
• Other meeting sites suggested inclusion of various groups: single parent families, persons who use English as a second language.

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 Council on Disability did a study and we think about 10 -13% (120,000 to 160,000 people) who may need our 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 casemanagers 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 our 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 – other 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.

Debbie

What level of care are needed for an “incident” for the Plan the working group looked at what functional levels people were at and developed shelters that would be staffed to meet that level of care.

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. Most are in schools. Look in the white pages of the phone book – it’s right there.

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 assistance with changing clothes 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 limited equipment available at Level II shelters – 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.

Question: Are transportation bus drivers on theBus first responders?
Answer: Transportation has had the most diverse input from participants on each island.

Any other general questions on the plan? None.

Francine:

We will go through all seven goals rather quickly. You will have more opportunities to make comment on each in the smaller group sessions.

When we use the words “people with disabilities and special health need” – 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 coming to get you. We are not going to be able to pick up and transport, have blankets, batteries. Each individual is responsible to bring his or her own food, medication and equipment to the emergency shelter.

2. People with disabilities 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.

3. 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.

4. 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 it they put themselves on a registry. Surveys show that people think that if there is a tsunami, someone will come to my house to help me. 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.

5. Will only list people who live on the island at the time of the registration, but the individual may not necessarily 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. The ultimate goal is that all shelters will shelters be Level II shelters that have a limited supply of equipment and medical support.

Debbie –

Goal 4 An accessible public and professional emergency readiness campaign. Go out and promote readiness. Last month, September, was national emergency preparedness month.
Accessibility means physical access. It also means accessible format to get the message out so everyone understands 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 –Healthcareproviders 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 discussed shelters.
Debbie talked about what you are doing to prepare for emergency.
Then you need to take action.

Goal 6 [read goal] 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; and
• Reverse 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.

Danny will discuss the shelters and where they are located.  Don’t shoot the messenger. He inherited this problem. It will be with us forever. There is not enough money to give everyone hope there is enough shelter space for everybody.

Danny

Overview of the shelters. 1.4 million people live in Hawaii. There are a large number of beds that are short. (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?

No funds for Level II shelters. We came up with this solution: use classrooms for special education students 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 is responsible for overall sheltering. They are responsible for staffing Level I shelters. Pet friendly shelters will be staffed by people by the Humane Society. No one responsible for Level II shelter staffing 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.

Discussion about simulations that happened earlier this year. Some participants from the Association of Retarded Citizens (Arc) participated in the simulation. They said that there was a high level of anxiety in the simulation. Danny 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 HUBshelter, 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 availability.

This is an action plan. It includes items to be accomplished. The retrofit plan has no funding so the HUB shelter approach model was adopted. Schools are about 98% of the shelters. Need to put generators and transfer switches (takes 990 not a 110 which is what houses use), to power the communication equipment and cooking kitchens for the campus and possibly other equipment. There will need to be secure storage for this equipment and funding to maintain it.

Oxygen is 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 is available, 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.

Other initiatives:
Hurricane shelter location brochure; and
Private sheltering program – churches, theatres, parking structures, condominiumassociations (no one living in a condo?), nursing home.

If you have a group, City or 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 with him. 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 “retrofit” – you can google it 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. He 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 will bring your pets into it.

Showing a typical shelter– it has nothing in it. One gallon of water per person for 10 days – that’s a lot of water. No flush toilets. You must do your own planning. Photos of things that he has in his kit for an emergency. Hand-operatedcan opener. Shampoos, first aid kits. Miscellaneous things like duct tape, FRS radios, no landline. FRS can talk to family up to 10 miles. Meals – MRE or freeze dried. Date on canned goods. Water. Water purifier. Water treatment tablets. You’ve got to start planning.

Comment: You point to this and that, but a person who is blind cannot see it.

Presenter continued and described the items that are part of a more complete set of equipment and supplies for an emergency. Items that were mentioned included: cot, crank or shake flashlight, glow sticks, duct tape, sterno, hand-operated can opener, plates, cups and utensils. Personal hygiene items, first aid kit with personal medications, hand-held walkie talkies that are good for line-of-sight communication.

Comment: Remember – not everyone has a computer to access lists.

Question: Are there any walkie talkies that have a text or captioning screen on it?
Answer: No, haven’t seen any locally.

Comment: Bring extra hearing aid or other batteries for communication devices.

Comment: I have seen the radios (the walkie talkies) but they are not at the stores, which have captioning.

Question: Communication radios?
Answer: No, just walkie talkies.

Comment: Caption radios are available in Europe but not in the United States.

Question: You are saying all this is what I need to bring to a shelter – right? I can see where I am going and I use a walker. How can I transport all this stuff to a shelter by myself?
Answer: You need to break it into parts and use a wheeled carrier. You will need to work with other people, buddies who are neighbors, friends or family members to help you.

Question: A participant asked a question about the difference between the type of film put on car windows and the film that is used for hardening windows against projectiles.

Question: Could the Civil Defense partner with companies that sell these supplies for hardening a home?
Answer: FEMA has trailers with disaster equipment around the state.

Question: You are talking about this being a personal responsibility. Why not work with KMART, Wal-Mart and various other retail stores that could collaborate and provide supplies needed. Or at the City and County stores, for example – to help consumers.
Answer: Home Depot and Wal-Mart have preparedness fairs. They have kits available.

Comment: I would like to see permanent displays as a constant reminder to be ready for emergencies with the suggested partners.
Answer: Add this to goal 4 or 5 when you attend that group discussion.

Question: Tsunami, hurricanes – how many days or hours advance notice do we have for each of these?
Answer: If a tsunami is a locally generated off Kona, probably about 20 minutes. A tsunami generated in Alaska would allow about 2 days notice. For a hurricane, like Flossie, start on the east coast of Mexico and moves west in the Pacific Ocean. You can get an update in the media when it’s about 5 days out. First they start as a tropical storm and could have high winds and rain – there may need to be a need to evacuate the low-lying coasts even if it is a tropical storm. But people wait until the last minute to prepare and get their emergency supplies.

Comment: In the kits, some supplies need to be replaced. For example, the glow sticks need to be replaced after about a year.
Answer: Yes, that’s right. Can goods should be rotated every three to six months. A book from HECO shows how to prepare for emergencies

Question: What about people in the hotels, apartment buildings? If they get the film, what do they do?
Answer: There are 159,000 tourists a day. They would need to shelter in place. Police have an evacuation plan for Waikiki. No cars will be allowed to drive out of Waikiki. It would be better to walk out.

Question: In some apartment buildings some hallways are on the inside and some are in the exterior or outdoors. Are the interior hallways safer?
Answer: Hallways in the interior are safer. Some people with disabilities or people with special health needs live in building with exterior and that won’t work.

Comment: Emergency kit – even if you have it, you can shelter in place. You can keep water in your bathtub. Leeward residents must shelter in place. Emphasize the need to have personal emergency kits.

Comment: Hospitals are not shelters for persons with disabilities just because they have disabilities. This was a problem in Hurricane Katrina – people with disabilities living in paid care facilities were dropped off at hospitals. They should shelter in place or go to a Level I or II shelter. Hospitals need to be able to provide space and care to people who need medical care.
Answer: Yes, we stress that if there are questions, the doctor should be contacted to determine where the individual should go for shelter.

Question: Return to the slide on preventing the roof from blowing away and discuss it more completely.
Answer: Board the windows with plywood. (Another member of the audience described a situation in which a new house lost its roof because the house was boarded on one side of the house but the other. Board all windows.) Yes, all side of the house windows or openings must be boarded up.

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 check your name badge to see which group you should join.

Short break – then move to small group sessions.

Thank you to people who created the forum and invited people. The community decided who to invite.

Also thank Debbie Jackson from DCAB who is coordinating the meetings.

Robin Brandt will free float and check all the sessions – to aggregate comments and come up with all the plans. Take comments and synthesize them.

Two people (Danny and Ina) from State Civil Defense.

People from different agencies introduce selves in small groups, then ask for representatives to Oahu October 22nd meeting.
•Debbie provides flow of today’s meeting.
How we will move forth:
• Overview in powerpont
• Break into three groups (count off by three)
• Remember numbers – direct to group area
• Handouts: agenda, plan and evaluation sheet
• Timelines on agenda are guidelines – zip through this to bring ideas to us
• Each group will select recorder and share information from group with larger group
• Ground rules:
   o Silence your phones
   o Respect each other
   o Be open andhonest with the group
   o Give feedback on ideas
   o Don’t hurt the messenger – feel safe
   o Listen to understand
   o Raise your hand to be acknowledged
   o Speak one at a time
   o Respect the process (start and end on time)
   o Ask why questions to assumptions
   o Express your ideas here – to help us.
•Set up blog – so you can log in and express ideas later on
•Money provided for the workshop includes two round trip tickets to Honolulu so people from the county of Kauai can participate. If agreeable with the group,leave with Mayor’s committee on equal access to select the candidates. Let Larry or Kristina know if you would like to come.

On with the show – Francine will start the powerpoint

• How many people know about this document on line? (very few hands go up)
• Discussion of impact of Hurricane Kristina and need to address emergency situations to be inclusive of persons with disabilities
• Focus on state agencies that were included in a discussin here in Hawaii:
   o Department of Educaiton
   o Dept of Health
   o DCAB
   o Executive Office on Aging (aging population)
   o Emergency response – Civil Defense at state and county levels
   o American Red Cross
   o Healthcare Association of Hawaii – coordinate response from hospitals
   o Advocacy agencies: Mayor’s Cmmittes on Persons with Disabilities and Hawaii Association of the Blind and Hawaii Services on Deafness
   o Lacked input from the community

Developed plan and went to the Legislature for a number of initatives
How to improve and tweek the plan
This is a planning meeting – not to teach you about emergency preparedness
When develop 2008 and 2009 plan, can see the objectives and move objectives off as they are accomplished.
Every year see what needs to be improved
Please speak up and tell us – even if you object to just one work (derogatory, incorrect, expanded, etc.)

Debbie will discuss how we got to this stage of the plan
     Why is the issue important – recent experiences with Hurricanes Rita, Katrina and other disasters include the entire population, so the most vulnerable people should be included.
     One of the biggestdiscussions was “who are people with disabilities”?
     Can’t just use ADA because some people can function independently with a care giver. Level 2 – may not need those

Give list of who is included in the plan:

As we all age, it includes all of us.

Generally think that about 20% of the people might need assistance, but 10-13% might need assistance in this state. Harris Poll for National Organization on Disability

General statistics
58% of the do not know who to contact in emergency
61% have no plans to safely and quickly evacuate
50% have no plans to safely evacuate from the workplace

Where are the people located – see on last page of the plan – they are registered in care facility. There are others who are not living in care facilities and identified in other ways.

End of October will send out a survey to know where the pockets of people with disabilities are to recommend to State Civil Defense where to locate next phase of Level 2 shelters

Focus of plan
Includes in 2007 – transportation, communities without mass transit, people without own cars have no way to get to and from a shelter

Planning for people by level of care needed (not disability) Staff different shelters with different kinds of people needed

Danny discuss levels of care and shelters
Hurricane planner for State of Hawaii is the planner for shelters – lack of shelters, types of shelters. Are behind, hope to be on track in 2007

Level 1 is regular (220 statewide) staffed by Red Cross – need 600 – 700 statewide Staffed by Red Cross. If have person with arthritis, artificial limbs, insulin pumps, etc. Shelters are segregated. Single males and females are in different corners. Families in different corner. People with special needs in another corner. Regular self care.

Level 2 – more stringent – need care for feeding, changing clothes, going to the bathroom, taking medications. Must have caregiver come with you. Heard horror stories from Katrina. Only one medical person – not care at level 2 shelters. If people need care, they must bring the caregiver.

Level 3 – ready to give birth, had a major operation – acute medical care required and under the care of a physician.

Francine
Assumptions or Basic Principles
First – emergency readiness is foremost a personal responsibility You must be ready and prepared – it is a personal responsibility. The government will not be coming to get you.

People with special needs should be kept with their families and not separated from them. Remain as a unit. Will try to keep units together because the more a unit is together, the more they can provide care and attention to each other.

Second –
Plan for pwd and special needs must be part of the overall planning for the entire community.
Although want to know where people are located and the Dept of Health and Human Services with databases on their clients, not supporting registeration of all people with disabilities.

Danny
Must have own personal disaster kit – must have individual and family disaster kit to help self.

Goal 1 – all pre-designated communit emergency management shelters Objectives:
• Upgrade existing shelters
• Locate new accessible spaces and hard to increase capacity
• Train shelter workers to response appropriately to pwd

Goal 2 the capacity to “shelter in place” shall be increased – alleviate the demand on level 1 shelters and allow individuals to remain in place
• Establish tax credits or other incentives for “shelter in place” renovations
• Assist in long term care facialites to upgrade
• Retrofit homes to allow people to stay in place

Goal 3 Increase number of level 2 shelters Long term goal all
Objectives:
• Id and designate – Level I
• Level 2
• Level 3

Goal 4 accessible public and emergency readiness campaign developed and implemented Objectives:
• Develop and conduct statewide public and professional outreach programs
• Conduct emergency planning with State case managers
• Purchase emergency kits – sold by Red Cross with basic items in kit (clothing, medication to be added)

Goal 5 Health care providers shall have appropriate emergency guidelines in place
• Develop appropriate county evacuation guidelines – what do different agencies do?
• Strengthen licensing and oversight of health care facilities to include emergency evacuation

Goal 6 (notification) Individuals with disabilities or special health needs shall receive equivalent notification of evacuation in accessible formats
• Media broadcast
• TTYs
• Accessible websites
• Reverse 911 system

Goal 7 Each county shall have a plan for providing transportation for pwd or people with special health needs who have no transporation to get to and from shelters
• Develop operational transit service plans for pwd in each county
• Inform pwd of transporation options available in the county if an emergency occurs.

Yes, transit system or service may need to be activated but not available in regular times.

Questions?

Instead of giving registered names – you are looking at where people live – discussed with Debbie –
Plot out where people live so know where to place shelters.

Question – what about the homeless people?
Answer – that’s a good questions. Maybe include agencies that provide access to people who are homeless. In Katrina – got a lot of people who were homeless. The hardest people to work with were people who are homeless because now had a place to go (shelter), so the problem is getting them to leave the shelter after the disaster is over.

Question – Gene Ota, DOE, everybody on break. Asked to attend yesterday at last minute. On State Task force for the Schools. Medicaid Fragile students – may be tied in – these are the students with oxygen or other things. Are we going to be prepared at the schools? When Medicaid fragile students are at school, their needs during a disaster needs to be addressed.
Answer – There is database of all the children served – but not all the children existing. Public health nurses know all those in their delivery system and creating an individualized plan for these families. People don’t get all services in one place. Sometimes they get no service – may not be on anyone’s case services. Maybe just Meals on Wheels and a child checking in. It doesn’t hurt to have all agencies helping pwd be prepared.

Question – Personal attendant caregivers – is there a guarantee that the caregiver will stay with the child at the school. Have tough time finding caregivers or will they go home and care for own famlies. That is a real concern.
Answer – No guarantee – gut reactions when an emergency occurs. Worry about own family first – then hope that personal care attendant will return. But we do not know if personal care attendant will do that.
 

Question – Will AmericanRed Cross train people to be able to provide this care?
Answer – not specifically in the plan
Danail – RedCross does not have enough staff to man all the shelters. Will be asking – if something were to happen next week and do have the shelters open (all 200) even if we don’t have a MOU but have guidelines established, we will open Level 2 Shelter. Maybe won’t have all the caregivers. But will find the volunteers that we can use to help the people who need it. Whatever the role – babysit, registration, security, take out of the garbage – whoever goes to the shelter will be asked to do their part, and asked about their skills. People tend to pull together in an emergency. It will happen. We have a plan and working toward the completion of the plan. Don’t have people trained to provide all the care needed right now. We may need to change the objectives, make the wording stronger. Asked for $8 million dollars (153,000 spaces short) last year to retrofit more DOE schools. No money was appropriated.  Need your help with the legislators.

We can finish this plan before the legislative session and talk with the key legislators to provide the funds to help in all the areas. Need infusion of money and human capital to come up to a standard we would all like to see before a tragedy occurs.

Instructions:

Think as big a system as possible but knowing you will respond as an individual.

For example, I live in a condo and we have a buddy system. That’s fine for evacuating in a fire and at the time of a fire if we are both there.

At the same time I have an elderly father in single wall constructed home . I have a sister with severe disabilities and visual disability. Also have responsibility for acting in the disaster response. We must all make very quick decisions, when the emergency hits.  What will the streets will look like? Just run through as many scenarios as possible and make good decisions as possible.

Break into groups.

Introduce Francine Wai, Executive Director of DCAB
• Ask by show of hands, how many people have seen, heard or read 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.

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 Centers for Disease Control, U.S. Department of Health and Human Services through the Public Health Emergency Preparedness Cooperative Agreement
Thank Howard for arranging the logistics here.

Debbie will discuss agenda and ground rules.

Debbie:
• Did everyone get handouts
• Agenda and general timelines – to complete by 3 p.m.
• 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
• Francine and Debbie will provide a handout specific to their sessions

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

Brief ground rules
1.  Resepect each other – so all cell phones and beepers silenced
2.  Be open and honest with your feedback
3.  Critique ideas but not the person expressing it
4.  Feel free to express ideas others might not agree with
5.  Speak one at a time – we are recording notes and if more than one person speaks it makes it difficult
6.  Respect the process – let’s follow the agenda and times, start and end the meeting on time
7.  Ask about the assumptions – work on dialogue
8.  Express ideas here at the meeting. If you have an idea that comes up later, and see how things work out – you can access the blog. You can type in your comment. You can put it up later on. The blog will have the meeting notes from all meetings.

Invitation for two participants to attend a meeting next Monday, October 22nd on O’ahu

PowerPoint to go over what the plan includes

Francine – from the time that you checked in to now, how many read the current report?

The plan is on the DCAB website.

How many have seen or read the report – good, a few more than on Kauai Focuses on the needs of persons with disabilities and other special health needs We will finish this and take to the Legislators in January.

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
• Executive Office on Aging
• State Civil Defense
• State Council on Developmental Disabilities
• Civil Defense in each county
• Health Care Association of Hawaii (all hospitals that must respond)
• The Mayor’s committee in all counties (by various names, none in Honolulu)
• Association of the Blind
• Association of the Deaf

Why is this issue so important?
• Look at the results of hurricane Katrina, Wilma, and Rita. When there are no preparations then people lose their lives. Particularly those who are vulnerable and unable to evacuate: people with disabilities, the elderly, and 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
• PW mental illness or has mental retardation or other cognitive disabilities, people with traumatic brain injuries
• PW are blind or partially sighted (Some people noted that someone could wave down a bus, unless you can’t identify a bus)
• PW speech or hearing disability (sirens cannot be heard by people who are HOH or Deaf) or people who have difficulty speaking
• Chronic health conditions or frail elderly
• Frail children and youth
• Pregnant women and infants [noted, in Kona]

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.
• For this report we are looking at a smaller percent – But the National Organization on Disabilities did a study and we think about 10 -13% (120,000 to 160,000 people) who may need assistance at evacuation centers.)

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)
• 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 – other live independently.
Focus of this plan is:
• Emergency preparedness

Question:  I’m one of the independent people. But if you put me somewhere else, put me in a shelter, I will no longer be independent. I won’t know where the grab bars are. I made my home so I am independent. In a shelter I am reduced to a different level. By reducing the number who you serve, you say they won’t need help. You should be looking at the statistics so that more need help, not less.
Answer: Danny will discuss shelters and these statistics. We are not forcing anyone to move to a shelter. No one will force you to go to a shelter. We will make space available for folks who want to go to a shelter. We are pushing “shelter in place”. For example nursing facility with 40 people with medical equipment and medication available.

Level II – Who knows what a level II shelter is?

Level I shelters are for persons with disabilities who can care for themselves. There are about 200 of these in the state. It is a segregated shelter. Single males cannot sleep with single females. This is because it requires order. “General shelter” Joke: people with two year old babies are sleeping outside. Segregated shelters are not bad. They are segregated to create control. If you can take care of yourself, you will be in a Level I shelter. The shelters are safer than wooden shelters.

Level II – portions of the general population. Envision everyone seeking shelter on the same campus. People with different needs and desire to have pets with them will have their pets in a different part of the campus. Level II shelter is for people needing medical assistance or self care help. People with chronic illness or requiring heightened need. For example, someone who needs help changing clothes, feeding, medication, have life-sustaining equipment. Must bring your caregiver.

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. This area needs more discussion. This is simply a concept now. Acute medical care.

Question:  What if there is no phone service.
Answer:  You need to talk with your doctor.

Question:  What if I come with heightened level of need – will you turn me away?
Answer:  No. No one will be turned away. It’s a personal responsibility.
We are not only talking about our residents but also our visitors. And realize that some people will become ill or injured or disabled as a result of this emergency. There will not be badges to label people. Everyone will be advised where they should go, based upon their capacity.

Question:  Have you considered putting this in phone books?
Answer:  Give that suggestion in Debbie’s group.
 

Comment:  County Civil Defense pushes reading your phone book.

Comment:  National Caregiver’s Association is going to have a conference next month would be a good place to advertise this information.

Francine:

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

Basic principals

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

1. Emergency sheltering is a personal responsibility – whether we have a responsibility or not.

2. PWD or special health needs should remain with their families, not be separated. We want to keep people together as a family unit – it means you will care for each other and less for the shelter staff or health staff to care for. People with disabilities or special health needs will be kept with their caregiver.

3. This action plan must be done in the community – not in isolation – with other emergencies (pandemic flu, terrorist response, emergency or natural disaster).

4. 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. (Discussion of the problem with a registry – may create a false sense of security, thinking that the person will be “saved” because on the registry.)

Basic goals:

Goal 1: Meet all ADA requirements for all shelters
Upgrade the existing shelters. Will tell you about the shelters we are already working on. The training of the shelter workers themselves.

Goal 2: Shelter in place as much as possible. Not enough money to make shelters for everyone.
• We will never have enough money to shelter everyone who needs a shelter – everyone should try as much as possible by sheltering in place
• Tax credits and care facility – loss mitigation program give money from DCCA for mitigation of personal homes

Goal 3: Increase the number of Level II shelters. Have 220 shelters goal to have Level II space to the same campus.

Debbie –

Goal 4: Started with Department of Health and Department of Human Services.

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.

Question:  Will this be a requirement?
Answer:  This is being made into a requirement. Need to look at sheltering in place for care home and nursing home residents.

Question:  When Katrina hit – there was a lot of lawlessness, people who died who had no where to go. Is this part of the plan?
Answer:  No, not in this plan. This plan must be part of a larger picture. Shelters must deal with food preparation, the homeless people who don’t want to leave after the emergency is over because there is no where to go. We tried to stay out of these issues, unless there is a unique disability concern.

Question:  People with disabilities are targeted more for murder and rape.
Answer:  The types of emergencies vary greatly. Red Cross has a SOP for volunteers. I did go to Katrina and Astrodome. Yes, it is a concern. But we need to focus on this plan. Bring up anything you feel should be brought up – it can and should be part of a bigger plan.

Question: I learned a year ago how important it is to plan ahead. Even though my home is served by three elevators, all were out. One came back in three days. All three were fixed six months later. I was lucky it occurred at 7 a.m. Three hours later I would have been out and I could not have gone back home in three days. Are there temporary plans – so that I could get shelter in the period where I couldn’t get home?
Answer:  If you raise the flag that planning – we don’t have a Red Cross staff person here. But if you have a special situation, talk to the County, talk to Red Cross.  If you have ten people who need to be evacuated to a shelter, reserve a spot now. If you have an agreement ahead of time, I may have a problem ahead of time. We can work on it.

If the County opens up a temporary shelter, they may need to accommodate a person with a disability. You may need two to three other people where you can go if you cannot go to your home. Have a mental plan of options other than your own home. Exchanges of home sharing in the case of an emergency.

Francine, Goals 6 and 7

Goal 6:  Notification.

Question:  Would like to see people with limited English proficiency on this list as well.
Answer:  When this goal started out, with have a difficult time notifying people. But people with disabilities or special health needs may take longer to get ready.  It’s more difficult.

Question:  I’ve been bringing this up for several years. Puna area is unwired. Not even radio service for the police. There are AWS and coconut wireless. How will we get the information out when nothing else works?
Answer:  Let’s discuss in goal 6.  We recognize that there are issues about electricity.

Goal 7:  Transportation. People with disabilities may have difficulty getting somewhere, to a shelter. Looked at developing emergency plans and options in each county if an emergency occurs. Our goals here are very high, and a significant dose of reality has jarred many of us about what is not going to happen in an emergency. Especially since neighbor island transit is not developed as well as O’ahu in regular times, much less in emergency times.

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

Overview of the shelters. 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 PowerPoint presentation.) This is based on 35% of the population evacuating but it could be more or less. What will happen if 50% or 60% or 70% of the population needs to evacuate?

With the funding left, we will probably create an additional 6,000 spaces in the state.

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.

Question:  One of the schools is right on the edge of tsunami evacuation. If a tsunami hits, it will be disrupted.
Answer:  Yes, all shelters are not automatically open. Wait until the tsunami hits and open shelters afterward. Reads list of shelters – it doesn’t mean they will all be open. Red Cross, County Civil Defense and Department of Education will make determination of which shelters to open. Listen to your radio.

Question:  There were no radio stations or TV during the earthquake. Has that been corrected?
Answer:  Governor’s Communication group has been working on this. That was a big problem that the media did not have backup generators.

Comment:  If it is mass communication, the reverse cell phone would be helpful. A couple of radio towers in Puna would be helpful.

We have done simulations to check the situation out.  We included persons with disabilities to develop action plan, and now you will be part of it.

Pictures of simulations for persons with special needs.

Discussion of HUB shelter concept and model.

Supplies that will be initiatives for focus. May have oxygen available, need other people to step up. Also need secure storage for this equipment. No one will transport hospital bed to the shelter – we have some from PVC pipe and filled with foam. Are planning to have some beds.

Private sheltering program to develop the use of churches, theatres, parking structures, condominiums, nursing home as shelters.
Loss Mitigation grant program to retrofit your home for any high winds. First come first serve. You can do that today. Call 586-0899. Brought applications.

Products that can be used for retrofitting: film for windows, screens used on schools, aluminum screens, roll down shutters. Safe room for $5,000 to $7,000. Use in the corner of your house. 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.

Typical shelter – about 35% of those present have an emergency kit. Everyone needs one. Red Cross says that you must exist 5 to 10 days. FEMA won’t come in for a bout 10 days. You must bring your own stuff. No pets in the shelter. Once DOE signs off MOA with Humane Society, it will be able to use campuses for pet friendly shelters.

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

Question:  What about assistance animals?
Answer:  Any shelter must take an assistance animal.
• Count off – in order to break off. We have group 1 and 2.
• Danny goal 1, 2 and 3  emergency shelters
• Francine goal 6 and 7  notification and transportation
• Debbie goal 4 and 5 public education and working with facilities so that we can have people more prepared in the case of an emergency
• We will look for another room for meeting because the noise from group discussions can be overwhelming.
• Break in the morning after the PowerPoint
• We will provide lunch. After lunch we will meet in groups again.

Everyone will have a chance to comment on every part of the plan.

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

K1          In background statement, second line:
               ● Premise that equivalent notification should be provided may need to be modified for [persons with] cognitive disabilities who need to depend on [social service] agencies and or care givers

K2         Spell [out] acronyms

K3         Emphasize that redundancy of notification is important (in background statement)

K4         No one system works for all and people may not pay attention until they hear the message the third or fourth time

K5          Long term care facilities need same advances, lead time as hospitals – general comment

K6          Would like to have more specifics on contacting populations with developmental disabilities and who are Deaf – general comment

K7          Reword Goal 6 to read: SCD mechanisms will make available information in accessible formats

M1          Shelters – can they charge cell phones, black berries, etc.

M2          Notification based on use of electricity – need alt. power
                ● Radio stations need backup generator
                ● People need battery radio

M3          Stations need updates at 15 minute intervals – many stations not ‘live’ – list which station to turn to

KON1     Project Lifesaver – bracelet triangulation monthly battery check. Only effective on Big Island. May be good for very vulnerable population. (Cost is $30 a year, expense of a battery replacement, the county has this technology.)

KON2     Ensure each agency with client caseload has an “emergency tree [phone] system” [to contact clients in the case of an emergency]

KON3     Sirens [are] nonfunctioning [currently] – some don’t go off. Need multiple level system [of emergency notification]. For [example, in the case of a] local tsunami, there is no enough time to alert [residents].

KON4     [Sirens] Differentiate [among tsunami] near ocean versus others – different sounds mean different action
                ● Need to educate tourists on [the different sounds and type of emergency]

KON5     Ensure all radio, television, utility have back-up generators and stay operational

KON6     Satellite communication systems? Status?

KON7     Develop a symbol which means “take action” for [an] emergency
                ● Different for each emergency, adapt from Department of Labor and Natural Resources signs

KON8     “Symbol” [would] pop up on cell phone, Department of Transportation road signs, [and in] laser light shows, [as well as] computers

KON9     Lifeline service – notify people [who use this services as a] “reverse Lifeline”

KON10   All providers – cell and regular phones and pagers

KON11    Loudspeaker for tsunami – trucks in neighborhoods (low tech)

KON12    Networking – CERT teams, caregivers, postal carriers, care-homes, homeowner subdivisions – condo associations, service club

KON13    Cognitive disability – work through caregiver or family

H1            Expand wording to reflect notification of emergency in addition to evacuation.

How to warn people (other than relying on friend) who are deaf or blind?

O1            Draw “X” on person’s back

O2            Buddy system – COBWEB image

O3            Sprint – notify in emergency (have program to subscribe – on trial now for people who are deaf & hard of hearing

O4            SNAP – Video Relay Service (VRS) – relay video

O5            HOVRS

O6            Civil Defense
                 ● Use flag & hoist at various location (store, mall, school – Red Alert)
                 ● System & strobe with own power

O7            Weather service – self subscribe; need to promote – NOAA.gov

O8            Layer from: no-tech, low-tech, hi-tech

O9            Remember notification in middle of night – most systems not in place
                 ● Flares in night – use military

O10          Notification system in condos

O11          S.O.S.

O12          Need to ensure that siren system is working, especially at night

O13          Use neighborhood watch system

O14          HPR used to give out info (statewide)
                 ● Based on geographic area

O15          Neighborhood notification board

O16         Crime stoppers – Emergency Watch

O17          Town crier / block watch – depend on human

O18          Reverse 911 – self subscribe

O19          Encourage use of old (wired, plug into telephone jack) phones

O20         Back up generator for Oceanic Cable vision for phone.
                ● If power goes down, no phone

O21         Satellite phones – will they work?

O22         Manual Siren – tsunami

O23         Sprint notification system when developed will reach all subscribers

Objective 6.1

K1         State Civil Defense (SCD) should monitor TV captioning and crawl as it is aired

K2         Note that purpose of TV alert is only warning to direct person to alternate source for more specific information

K3         Need to differentiate ALERT NOTIFICATION from INFORMATION

M1        Please identify ‘all broadcast media’

H1         Radio in Kona only caught Maui. If emergency on one island, all islands should broadcast.

Objective 6.2

M1        Explain Blog

M2        Teach people to register for emergency notification

O1         Add video relay at SCD

O2         Back up generator for radio station

O3         Video Relay Service (VRS) – if it is faster to get. DSL, then teletypewriter for the deaf (TTY) not best choice

O4         Notify agencies (residential services) that serve PWD in advance – how long in advance

Objective 6.3

K1          Add universal pictures or pictograms or symbols for emergency on website – some people may not read words but would understand pictures.

K2         Add other sites such as Kauai.gov, Hawaii.gov to list

Objective 6.4

K1        Add cognitive

K2        Check emergency email.org as possible alert paging system

K3        Health insurance company (HMSA, Kaiser, Medicare, Medicaid)

K4        Initiate system with ISP to post notice on website as soon as you log in

K5        Put “Flash” audio warning on Kauai.gov website (check with ISPs) other websites

Objective 6.5

K1        Reverse 911 – problem to keep up list. Therefore system should be self-register or subscribe and unsubscribe

K2        First responders and persons with special needs are target but system can be open to all

K3        Kauai.gov ensure staff 24/7 and link to fire and police

K4        Do not limit objective to reverse 911 (instant messaging or other systems may be as appropriate as reverse 911)

Objective 6.6

M1        Teletypewriters (TTYs) for the deaf – low on list

M2        Look at text messaging

M3        Get text message from cell phone company

M4        Repetition, duplication

M5        Lifeline systems – activate call

M6        Maui County status of Reverse 911?

M7        Different sounds with sirens

M8        Educate public to use phone books

M9        HAM radios – still being used?

M10      Molokai & Lanai – check re: notification

M11       Advanced (before general public) notice
               ● Agencies, senior housing, home care, long term care
               ● How much advance notice depends on type of emergency?
               ● (Legality?) Case managers in state

M12       Town bulletins (Paul Revere)

M13       E-mail good in some situations

M14       Warning signs on roads

M15       Flashing strobe

M16       Individual Service Plans (ISP) – Developmental Disabilities Division (DDD) for notification

M17       Check fire department – people on ventilators
               ● Durable medical equipment – liability?
               ● Public libraries – handouts
               ● Amber Alert – not on Maui

M18       School can give out emergency card to parents (shelter info)

M19       TV commercials

M20       Have a designated radio station – (KMVI) – Maui

M21        List of providers – add to 1st responders

M22        Register with system where people get benefits (social worker, to then go out) – Social Security or welfare

M23        Radio

New Objective

K1            Initiate Statewide public service campaign on siren system, especially to information visitors

K2            Have Hawaiian’s Tel Relay Service initiate calls to all TTY users for notification. Have Oceanic, etc. text messages to subscribers

Other Comments

H1            Plan should take into account what will work in an emergency – especially in earthquake (Radio station no back up power)

H2            Distinguish hurricane from earthquake because amount of notification.

H3            Updated interpreter list – make sure they can go to a TV station

H4            People who are Deaf just don’t get information

H5            Need to plan for no electricity or communication system

H6            Reverse 911 – phone, cell, pager, voice & text
                 ● Who will be contacted?
                 ● Will it be self-registry?

H7            Many DD clients live alone – can’t read or speak

H8            Develop symbols for those who are high visual or can’t read/understand symbols exist but not used in notification (county has new signs for tsunami areas)

H9            Police – can they go out and flash lights?

H10          Big Island word of mouth (rural)

                  ● Text will work longer than voice on phones

H11           Reverse 911 – 1st responders then general public until system shuts down

H12           AM / FM station ok. HAM radios ok

H13           E-net (Hawaiian Paradise Park) – bullhorn within the community – very local level; use CERT or neighborhood (police) watch citizens’ corps.

H14          Community Association President is called during emergency. Include condo association in Kona.

H15          Check with other places – Safe place – Austin, TX

H16          In Flossie – DOH notified DDD and all OHCA facilities of impending disaster.

H17          In reverse 911, priorities to TTY users text msg.

H18          Use informal support (neighbors) through large agencies to notify people

H19          Register database. Use Office on Aging – vans used for evacuation; for notification?

H20         Reverse Life Alert implement (waiver can pay)

H21          Neighborhood notification system

H22          Develop program for HAM radios

H23          Ensure all sirens are functional. *DD priority

H24          DOH says that if you experience earthquake, get out. 20 minutes

H25          Puna – lava outbreaks alert now

H26          Alert PAs and caregivers to tell their clients – top priority for reverse 911

H27          Habitat for Humanity – include safe room in their projects

H28          Pre-taping generic announcements with captioning or interpreting

H29          Neighbors – 1st line of redundancy. Set up notification system at local level -community based phone tree / network

H30          Rebates for purchase of HAM radio and flashlights manual or not dependent on electricity / battery

H31          Alert sticker on home / business

H32          Federal Communication Commission (FCC) regulation limits local stations change regulations?

H33          Green Harvest – drop info / bullhorn

H34          Homeless disabled – care-a-van notification and outreach workers (private non-profit) and police

H35          Establish announcements on road signs

H36          Program street lights – flashing light (code lights)

H37          Link flashers with tsunami warnings (code lights)

H38          Utility company to contact those dependent on electricity – check with medical supply companies.

Goal 7

K1            Comments on evacuation – general
                 ● The amount of time is a factor in providing transportation
                 ● Hurricanes may have days warning notice to allow for transportation and evacuation
                 ● Tsunami generated elsewhere may be a matter of a few hours notice
                 ● Tsunami generated locally may be as little notice as half an hour
                 ● In the case of a tsunami, there can be no evacuation for isolated or hard to reach areas (Ha`ena to Hanalei, as example) due to lack of time. Evacuation with transportation is only realistic with a hurricane due to advanced notice.
                 ● Emphasize that mass transit is the preferred means instead of private automobile to get to shelter
                 ● Resolve liability issue

M1           Maui Economic Opportunity (MEO) and Roberts both in inundation zone. Need to move their assets if tsunami as top priority

M2          Time of day affects where you move people (work to home, home to shelter)

M3          Tsunami vs. hurricane (most severe) affects response

M4          Frail elderly – many cannot use buses

M5          Need central dispatch for Kaunoa

M6          Identify gas stations operable

M7          How soon after evacuate?

M8          Shelters – when full can or should you transport to the shelters?

M9          Maui County Transportation will respond to County Civil Defense (CD) for “unique transport situations. Keep mass transit operating as long as possible. Then revert to on-call to CD. Cannot respond to any individual public request.

M10        Emphasize personal plan

M11        County to take over all buses in disaster

M12        Set up an ohana (neighbor) response to provide transportation to PWD and elderly who are isolated. – CERT is limited to specific emergency.

M13        Use of rental cars, taxi

KON1     Realities showed that trying to move people is more of a risk than people staying in place

KON2     Question whether there is any realistic option in Kona – keep in the plan so that issue is not lost

KON3      All buses must be lift accessible

KON4      Rural Kona – difficulty in getting in and out of client’s home due to isolation and poor [road or travel] conditions [therefore] shelter in place

KON5      Alternate arterial roadway system

H1            MOA to use vehicles – not county has authority to take private vehicles or facilities

H2            County Transportation needs to respond to a voluntary list of people with disabilities to transport. (County Office of Aging will activate for their clients)

H3            Activate the school buses and develop a registry of drivers who are able to drive a bus or van. Create incentive for those with Commercial Drivers License (CDL) to be activated.

H4            Tax incentive to trucking companies whose drivers would be activated in emergency.

O1            TheBus – Oahu – buses will have notice to transport to shelter

O2            Maile Alert System – electricity

O3            Electronic system on highways

O4            TTY is not a good way – because it is becoming obsolete

O5            Transportation depends on amount of advance notice

O6            Handi Van will not transport if emergency announced. Will try to pick up clients, if possible

O7            Roberts, Gomes – bus has capability to transport – van pool? Agencies servicing PWD have vans.

O8            Military – active duty, reserve – limited use for transportation in flood, might evacuate

O9            Agreements to use school buses and tourist buses

O10          Transport to shelter ahead of time? Need to open Level II

O11          Direct service workers – protect families first

New Objective

K1            Tie transportation registries into “neighborhood evacuation” group or CERT teams

K2            The paratransit list is too limited

K3            Coordinate with utility companies to notify people of emergency, include if they have transportation needs. Kauai utility company has a registry already. [Notify the following groups by phone:]

                 ● Special needs
                 ● Medical
                 ● Elderly

K4            Establish County agreements to share use of private vehicles (e.g. with long term facilities) to increase [transportation] capacity

K5            Coordinate with transportation services for medical trips

K1        Document own needs
             •Pre-registration for ALL shelters
             •Prescription
             •Contact number
             •Department of Health form to use (to give to public)

K2        Fire department
             •Volunteer stickers (Symbol for person with a disability, i.e., symbolic representation of person using a wheelchair, pet)

K3        Standardized identification for persons with disabilities/special health needs
             •Item in emergency kit 
             •Part of the county brochure – use that “Hurricane readiness”
             •Wallet-sized

K4        Develop system to fill out form (including foreign language)

K5        Collaboration to include health provider in discussion (especially if [person] speaks foreign language)

K6        Provide information to
             •parents
             •health insurance company (HMSA, Kaiser, Medicare, Medicaid)

K7        What can we learn from Hurricane ‘Iwa and ‘Iniki? Use past experience

K8        Agency listing – include the Americans with Disabilities (ADA) Coordinator, Center for Independent Living (CIL),
Area Agency on Aging (AAA)
             •Need to designate agency to maintain list

K9        Education campaign
             •Use what’s in media now re: disaster [preparation]
             •Community meetings
             •School system, insurance
             •Internet
             •Health fairs
             •Fun runs
             •State fairs/county fair information booths

K10      Use senior companion program for education (and senior centers)

K11      Develop natural supports/buddy system

K12      Staff positions to teach facilities to review and make functional evaluation plans

K13      As shelters are designated (Level II), post information in places to inform the public

K14      People register for shelters
             •Estimate how many people will use shelters (although not everyone will show up)
             •American Red Cross can determine staffing needs for shelter

K15      First responder liability (when not on duty)

K16      Recovery phase – Need to develop short term and long term plans

K17       Visitors
             •Hotels – involve in planning
             •Registration – of persons with severe health needs or physical needs
             •Inform of own responsibilities
             •Provide information card to visitor at hotel registration

K18      Client information
             •Picture ID – address
             •Homeless – physical description of location where they regularly stay
             •Database and paper file

K19      Provider agencies – give services/get information / provide information

K20      Partner with pharmacist when people get their prescription
              •Contact form – gather information and provide education
              •Contact form /provide information (minimum supply /O2 [oxygen])

K21       Release of information /share information forms (agencies to share information with each other)

K22        PSA – educational (residents and visitors)

K23        Shut-ins brochure to provide information on emergency preparedness
               •1-1 staff to educate person /make plan
               •1-1 staff to help execute plan

K24        Develop specialized agency for this purpose
               •Educate community (people with disabilities, persons who are elderly, families and agencies)
               •Set up database
               •Maintain database

K25       Use civic organizations as partner
              •Education
              •Buddy system

K26       Churches – member list

K27       Electric company – has listings (persons with severe health needs, medical, and elderly
              •Bill insert – for educating
              •Software with programmable message (within one year)

K28       Education PSAs – “Help your neighbor” campaign
              •Care providers

K29       Physician’s offices distribute information

K30       Live broadcasting
              •Internet – streaming media
              •Information – in a PDF format
              •Blog
              •Radio

K31       Community Meetings – for public education
              •Neighborhood Watch
              •Have voluntary registry of people who need assistance

K32       DOH annual assessments – check form to identify if education is needed or to request meeting

K33       Ethnic or cultural associations

K34       District meetings
              •Discuss needs
              •To improve communication between parties

K35       Mandate emergency planning and evacuation as part of the “Plan of Care”
              •For people who are Medicaid regulations, Hawaii Administrative Rules (HAR), developmental disability (DD), or have a mental illness (MI)
              •Licensing Hawaii Administrative Rules (HAR) 100 or 89 Adult Residential Care Home (ARCH or Dom Homes)
              •Include emergency planning

K36       Agencies contracting with the State of Hawaii
              •Include emergency evacuation plan
              •Work with Department of Accounting and General Services (DAGS) -  procurement

K37       Goal 4 – make first sentence an objective
              •Make second sentence the goal – “emergency preparedness or evaluation plan in place.”

K38       Use consistent wording
              •“emergency preparation” and “emergency evacuation preparation” as these terms don’t mean the same thing – perhaps use “comprehensive emergency planning”

K40       Definition page – include terminology and abbreviations

K41       Outreach to homeless population
              •Who is responsible to help develop this plan?

K42       Staffing Level II shelters
              •Medical Reserve Corp

K43       Emergency Preparedness Campaign Week (same message – consistency)
              •Electricity bill inserts
              •First responders
              •Television Public Service Announcement (PSA)
              •County Plan
              •Transportation Plan
              •Registration
              •Update individual plans annually

K44       Media Campaign
              •Disaster mascot (like “Sparky”)

K45       Updated Shelter list
              •Publish in newspaper
              •Publish in phone book

M1         Department of Health (DOH) – Developmental Disabilities Division (DDD) – in process of meeting with clients
              •Provide list of supplies
              •Case manager notify clients / parents – meeting with parents / family – Individual Service Plan (ISP)
              •Identify shelters – listen to radio – ensure shelter open
              •Provide special ID for person with developmental disabilities (bracelets)
              •If can’t wait in line at shelter, American Red Cross is looking at “spotters” to see if there is a need to be addressed and can move people out of line

M2        Person with disability – have indicated on State ID card “epilepsy” “diabetes”

M3        Schools – emergency plan

M4        Checklist in phone book

M5        Accurate & update information to disseminate

M6        Public Service Announcement (PSA) – television (elderly prefer)
              •*Budget for State Civil Defense (SCD) to do PSAs (LeslieWilcox – Public Broadcasting Station director – contact)
              •Use current tsunami card to include more information about person

M7        Portable TV – battery operated

M8        Community Organizations –meetings- establish list of PWD

M9        Churches

M10      Mail-deliver 1 page flyer & stuff in mailboxes – use a large postcard

M11       Emergency medication for Medicaid clients

M12       www.mauiready.org
               •Website with emergency info
               •Booklet & wallet card, shelter list & map

M13       Disaster kit include:
               •Air mattress
               •Ziploc bags
               •Paper plates
               •Incontinent supplies
               •Folding shovel
               •Use fishing vest with pockets for person in wheelchair to have easy access to items, instead of looking for it in a bag

M14       Insert -Maui news

M15       Identify isolated clients
               •Education – provide checklist
               •Examples – flashlights
               •“Ready to Go Plan”
               •*Think of preparation

M16       Information desk / booth at community events (whole day)

M17       Postcard advertising at Internet cafes “Are You Ready?”

M18       Short video – air different stations

M19       Radio announcements

M20       Advertising stickers / magnet – where to go for information

M21       Frank Delima for PSA

M22       Senior fair / health fair – information booths

M23       Maui LTC Partnership (MLTCP) – Maui Health Initiative Task Force (MHITF)

M24       Veterans Organizations – resource for information distribution

M25       Aloha Disaster Network (faith-based group)

M26       Mormon Church

M27       Voluntary Organizations Active in Disaster (VOAD)

M28       Local Emergency Planning Council (Maui Electric Company)

M29       Maui Economic Opportunity (MEO)

M30       Vocational Rehabilitation (VR)

M31       Homeless Community – education
               •Anyone working with homeless & emergency preparedness? Are there any existing resources?
               •Information exchange

M32       School curriculum to teach kids about emergency preparedness

KON1     Have radios, flashlights and phone [that] work without batteries

KON2     Weather alert – [over the] Internet
                •Doesn’t work anymore – how do get it again

KON3     [Pacific Disaster Center, managed by the University of Hawai`i and located on] Maui [could it be used?]
                •Inform their staff with respect to people with disabilities

KON4     Shelter in place included in each [personal] evaluation plan?

KON5     Big Island has many different kinds of emergencies
                •How do you deal with [all the] variety?

KON6     Let people know all involved – education about all issues

KON7     [Provide] Drills in schools
                •Tsunami drills

KON8      Humane society and veterinarians – [when an individual or family] adopts a pet provide information on emergency

KON9      Evacuation [When the] statewide survey [is conducted] – include schools – “Safety week” theme include different variety of

KON10    Agencis [emergency in blogs or disaster have evcuation readiness] issues plan and practice (including hotels)

KON11     Schools need to prepare to keep children if disaster occurs

KON12     [Put information about emergency readiness in the] Phone book
                  •Information

KON13     [Put out a public service] message to have battery-powered radio (or a crank radio)

H1             HDRC – ice chest – use as a kit. Preparedness
                  •What would you do? (practice on own and in simulations)
                  •Assessing if plan will work (reality during emergency)

H3             Standardize part of message
                  •PSA – captioning / interpreting message
                  •Posters – for people with mobility impairments; post/mount near water fountain

H4             DOH
                  •PSAs good
                  •Health educators part of team (work with district office)

H5            Work with community colleges / high schools and have students work on project

H6            Living in Paradise – Derek Koresu (local stories)

H7            Provide a statewide message and include PWD in general message – safety and emergency prep is statewide issue

H8            Find a way to get more than 30 days worth of medicine (Quest / Medicare / Medicaid) – look at this on larger scale (have back up for emergency – rotate supplies)

H9            *Legislation for monies for PSA

H10          Beacon lights – mount on homes to indicate “special needs” home

H11           Work with churches to include PWD in plans

H12          Grocery stores – info table for emergency prep checklist
                 •Have price cap for cost of items during emergency
                 •Stay open 24 hours during emergency

H13         *Matson containers
                •Use for community storage and can lock for security
                •Add lights that blink during emergency
                •Can store generators and large supplies

H14         Each family look at own needs – investigate re: being paid back – people with limited income have difficulties

H15         Sprint – text message for people who are Deaf

H16         TV – text and have an American Sign Language interpreter

H17         Community forums

H18        Agencies serving PWD
               •Responsible to educate clients, families, direct service worker (DSW) / personal care attendant (PCA), community based providers
               •Easter Seals does education; has phone tree and will contact families to inform them of disaster and having plan in place
               •Share plans

H19       Keaau Youth Business Center (include in discussion)
              •Has audio visual equipment
              •Cyd Hoffeld (contact person) to create educational video

H20      Have back up plan if no power for cell phones

H21      Emergency prep planning (include all groups – include churches)

H22      Foodbank for planning to gather food for those without food

H23      Employers / airlines – provide education (brochures)

H24      Worry about tourist, homeless

O1         Reword, summarize it
              •Use action word 1st “Develop and Implement a Personal Emergency Readiness / Preparedness Campaign (Larry Littleton to come up with wording)
              •Preparedness includes evacuation
              •Clarify Goal 4 – Develop goal and then disseminate
              •Develop statewide outreach program

Objective 4.1

M1         Message ideas
               •”You are Responsible”
               •”Shelter in Place”
               •”Are You Prepared?”

M2         Get car charger for cell phone

M3         Being prepared means having gas in your car

M4         County Fair / Fundraiser / Walks – information booths – caregivers walk

M5         Department of Human Services (DHS) – Do mail-out with Medicaid / Med Quest

M6         Preparation – have medication ready

KON1    General message about readiness with website listed (on-going messages) – Shelter in place message [broadcast]
               •Film for windows (broadcast where to purchase)

KON2    How to get message out to people with disabilities so that it’s understandable

KON3    [Utilize traffic or transportation] Message boards (digital) [to alert the public of impending emergency]

KON4    One message – yellow flashing light means “turn on [your] radio” [to learn about emergency]

KON5    Include the Department of Health Communications Office, [contact] Janice Okubo

KON6    Put up two FM towers to improve communication system in rural/remote areas (Puna, Oceanview, Ka`u, and H1 Kohala)

H1          Simple statewide slogan. Use a “short and sweet message”
               •”Be Emergency Ready” & pictures
               •”Readiness Alert Information”

H2         PCA / DSW – training for self and client to be ready

H3         Agencies have in place as part of Medicaid Waiver Contracts – annual plan review (have plan outline for provider)

H4         For clients – part of Individual Service Plan (ISP), but not “real”
              •Practice (basic)
              •Families / case managers need to work on developing natural supports and community contracts

H5         Downtown associations / malls / Small Business Association (SBA) – outreach and training – use posters

H6         Bus stops near ocean
              •Stop operations – normal transportation not operational
              •Be aware of action plan and practice

H7         Agencies – post maps and emergency evacuation plan for people to see and use

H8        County Civil Defense – design standardized signage for emergencies (symbols and color)

H9        Community groups in various geographic areas can begin to inform public

H10      Department of Education (DOE) train children every quarter on how to be ready for emergency – when working with “deaf-blind” person write “XX” on back means it is emergency and need to follow them now and it will be explained later

H11       “Making Your Own Connections for Notification of Emergency”
              •For people with communication difficulties
              •Don’t wait – go now (if any questions, go now)
              •”Planning, planning, planning” (with practice)

H12       How can a person send universal “S.O.S” if they are in trouble or need assistance?
              •Personal signaling device ($30/mo)(Lifesaver program)

H13       Include alternative format
              •Simple language or graphics
              •If you know someone who needs alternate format, do this.. . (go to website, radio, etc)

H14       If you are okay, check on your neighbor

H15       Message – send to workers who work with PWD or kids with disabilities to help family to figure out needs – develop, practice, implement plan

O1         Use identifiable personality

O2         Private/public partnership
              •Phone book information (ensure information is accessible and page number, update what’s in phone book) used to provide information in Braille – not now; include phone number to have information provided on tape
              •Use “Katrina” to get information out (“Remember Katrina – Are you prepared?”
              •Cable TV – emergency evacuation information – provide in large print and spoken (accessibility)

O3         County and State Civil Defense
               •Use city bus and cab to advertise/post information

O4          Get to blind consumers – National Federation of the Blind (NFB), American Federation of the Blind (AFB)

O5          Channel – how to reach blind community, wheelchair users and general population

O6           Footnote – add accessibility for people who are blind
                •Medium – Braille, large print, print, electronic (ensure it’s available to deaf-blind people)

O7           Mascot (contest to select one) – age appropriate

O8           Motto “Always be prepared”

O9           Include “gum”, “squeeze ball”, “worry beads” in kits for stress relief

Objective 4.2

K1            Challenge agencies to ensure clients have individual plans

H1            Good to continue to work with all agencies – Hawaii Waiver Providers Association
                 •Working with consumers with disabilities
                 •Do collaboration with them at DOH

H2            Home health care collaborate
                 •Hawaii Health Care Association
                 •Primary Care Association

H3            People with mental health issues – include in education and planning (DOH –Adult Mental Health Division (AMHD), Child & Adolescent Mental Health Division (CAMHD), private organizations) – *information on support services Mental Health (MH) Transformation Grant available

O1             Clarify purpose for listing of agencies (what will be done with list)
                 •Agencies on list – what can do during emergency and after disaster (Hawaii VOAD group)
                 •Add Hawaii Centers for Independent Living (HCIL), Honolulu Police Department (HPD), Honolulu Fire Department (HFD)

O2            Develop one phone number for emergency information (211, 711, etc.)

O3            Provide accessible information form at phone company, electric company, gas company (for cooking purposes)

O4            One-stop-shop for emergency evacuation needs

O5            Assistance for people with cognitive disorders to assemble kits
                 •Sylvia Yuen – Center on the Family (UH). Scatter gram to look at cluster of PWD (census data)

O7            Kupuna Program

O8            Number itself detracts from objective

O9            Delete “form the foundation of”, and replace with “information dissemination” (Keep language simple)
                 •Making list of organization serving persons with special needs

O10         Definition section

O11         Ok way it was

O12         Deaf information hotline / emergency alert (free) – text

O13         Comic book

O14         Be sensitive to Health Insurance Portability and Accounting Act (HIPAA) confidentiality requirements

O15         Include Department of Education (DOE), University of Hawaii (UH) & Community Colleges (CC)

Objective 4.3

K1            Change the wording
                 •“individuals who need level II shelters.”
                 •Use people first language through out the document and label Shelters Level II not Level II individuals

M1           Each agency working with PWD / SHN – have agency emergency preparedness plan

M2           Use agency email lists to send out emergency info (i.e. Special Olympics)

M3           Designate agency to order /assemble / distribute disaster kits
                 •*Use civic organizations (Lions, Rotary, etc.) to fundraise to purchase kits

M4           Educate Foodbank staff – will need to distribute food during emergency

M5           Collect water – catchments

KON1      Check about National Emergency Preparation Month (September – annually)
                 •October 21, 2007 Is the `Ohana Outreach Fair
                 •Outreach and counseling to earthquake victims [from a year ago]

KON2      Include Hawai`i Disability Rights Center in interagency work group

KON3      Communication disconnect at various stages of government
                 •State and County
                 •Agencies: development of materials (example Hawai`i Disability Rights Center [developed] forms in isolation)

KON4      Use plan in other places
                 •Plans [should] have outcomes
                 •This is not a “vision” – it is on-going
                 •Designate lead agencies to work with clients; [this is] occurring

KON5      Who explains 20 shelters but only two are operational?

KON6      Who is the point of contact for involvement in this plan? How can they be involved?

KON7      Communication, even across [this] island about plans can be severe disconnect; often exclude persons with

H1            Evening trainings – families and friends and PWD – Churches who may be responsible for various areas

H2            Need money to purchase kits – grants / money from civic organizations to buy and assemble kits (kits with wheels)

H3            Ace Hardware – at Christmas – asks for money donations and assembled kits for people who are homeless

H4           Offer evening trainings to families and friends

H5           Anxiety and stress levels increase during and after event

H6           Use video for some information – already developed – online version of training – distance learning

H7           Make available on public access channel

H8           Resource -Mental Health Division

H9           Educate state employees with family members with disabilities about emergencies

H10         Hawaii Visitors Bureau
                •Train the trainers on critical stress management
                •Volunteer de-briefing

H11         Include “calming” foods / techniques in disaster kits (teas but no coffee or chocolate)

O1           Multilingual and in accessible format

O2           Broaden into agencies providing services

O3           Include QUEST – Aged, Blind & Disabled (ABD) population

O4           Simplify language
                •Use one term (defined at beginning of plan) for who the target population is and use one term throughout the Plan
                •At beginning – include that we must have the ADA in the forefront of our minds

O5           Maintain multilingual wording (separate objective) (demographic on language – use information from that)

O6           Where is cultural aspect addressed?

O7           Define “agency” “everybody”

O8           Status on work with people who are elderly

O9           Report on status of clients served by state agencies (which populations completed)

Objective 4.4

K1           Challenge agencies to ensure clients have individual plans

H1           Developmental Disabilities Division (DDD) – attached with ISP
                •Done as annual planning process
                •Clients have plans / kits (encourage families to have plans and kits also)

H2           ??Department of Human Services (DHS) Progress on Big Island

H3           ??DOH AMHD and CAMHD – status on Big Island

KON1     Can we get some emergency kits for care home clients?

KON2     Where are the nearest shelters?

KON3     How can we get to the shelters? [For Goal 7]

KON4     Neighborhood readiness: in case of emergency, focus [will be on the provision of] water, sewage [service provision]

KON5     Care facilities dilemma – know what need to do but cannot people who need care get there

KON6     Rural areas – longer wait for service
                •Infrastructure missing (ex., Lack of building inspectors). No registry of building inspectors.
                •Two county building inspectors – need to increase the number. This is a county issue. [However] the county call the state for a solution

KON7      Communication between the government liaison and city and count and state systems – need to identify these breakdowns in responsibility and where to create change.

KON8      Make system more responsive

KON9      Get information out – county training communities – (CERT contact Ralph Yawata) to be self-sufficient. Take care of their own. Needs to be incorporated into this plan. – Take care of self and own, especially in isolated rural areas
                 •Do this with neighborhoods (as they do in Hana)
                 •South Kona, Puna, and Kohala also examples
                 •Sub-divisions off feeder highways with their own community center such as Cove, Oceanview Estates

KON10    [Create] own registry in [these more isolated] communities

KON11     Personal information doesn’t appear to be concern – not overriding concern. Should this be expanded?

KON12     [The federal] Department of Justice suggested a registry for agencies serving people with disabilities

KON13     People at the Mayor’s Committee for Persons with Disabilities discussed [the idea and implementation of a registry] and were unanimously opposed to it.

KON14     How does one create a registry that does not collect dust [and remains in] use?

KON15     [The] DD Council [has been] discussing this [the idea of a registry] for some time

O1             Adult Mental Health Division (AMDH) working in education of clients

O2             Partner with Health Insurance Companies

O3             Have a guide, checklist, clearinghouse of information (211)

O4             Department of Health (DOH), Developmental Disabilities Division – case managers working first with individuals (statewide) – follow up doing now

O5            Delete “clients” use “customers” or “consumers”

O6            By case managers / providers – put in deadline

Objective 4.5

K1             Combine Objectives 4.4 All state clients needs plan and 4.5 All students need plan

M1            More detail

M2            Make emergency ID for children with disabilities and teach student how to put on during emergency – include one

M3            Parents involved with developing evacuation plan

M4            Department of Education (DOE) – parent / teacher meeting

M5            Train DOE staff – for all students (Public Health Nurses to train DOE staff)

M6            Safety fair – annually at each school – *can make interactive for participants

M7            Involve fire/police departments with planning -*have “Emergency Preparedness Week”

M8            Include disability awareness information at safety fairs – pass out standardized information

M9            *Block watch programs – “Help Your Neighbor Campaign”

M10          Include Department of Hawaiian Home Lands (DHHL) in educational efforts

M11          Include all tenants / community / realtor associations – develop “Aloha Kits” to distribute

M12          Red Cross – Information on “How to Find Each Other After a Disaster”

M13          Use churches -meetings – work to educate – Office of Social Ministry – Catholic Church

M14          “Aloha Network” -meeting 1/mo – Education Emergencies
                  •Med Quest -mailing
                  •”This is where your shelter is…”

M15          ”Make sure you have enough medication.”

M16          Include phone book.. . indicate which shelter is Level II

M17          National Oceanic Atmospheric Administration (NOAA) website
                  •Hana
                  •Everyone knows each other
                  •Everyone know who PWD are

M18          Help each other during crisis

M19          Have emergency kit in car – water & food

M20         Have insurance companies hand out emergency information to members to put together evacuation plan

M21          What are plans for beyond DOE? [University of Hawaii (UH) & Maui Community College (MCC)]

O1             Emergency preparedness in schools – Gene Kaneshiro, DOE; Rodney Iwaski, Department of Education (DOE).

O2             Special Education – has bathrooms and possible generator. Include private schools.

Other Comments

H1             Message needs to be multi-language and culturally appropriate

H2             Need registry on Big Island

H3             Many people living in remote areas have equipment they need to take during evacuation

Goal 5

M1            Health care providers – transporting people – keep emergency kit in car

M2            Why aren’t Adult Residential Care Home (ARCH) plans monitored?

M3             ARCH clients have “direct plan” for Power of Attorney for decisions during disaster

M4            Require disaster kits for each consumer with a disability (Make it standard)

M5            Shelter in place needs:
                  •Stove
                  •Water (purification / catchments)
                  •Medication
                  •Refrigeration

KON1       Not sure if civil defense procedures are in place

KON2       Check care homes in operation to ensure if they receive state dollars, [assure that they] are accessible

KON3       Improve monitoring and inspections of ICF/SNF

KON4       Who decides if the person wants to stay in place?

KON5       Who is responsible when decision is made [for person with disability to] stay in place?
                  •Who is liable?
KON6       DDD Case manager doesn’t make decision. Leans toward a person with an informed consent
                  •May need to pursue further
KON7       If [who hears?] allegations of abuse and neglect, contact state ombudsman’s office

O1            Hawaii Health Systems Corp – Tom Driskill

O2            More comfortable – shelter-in-place

O3            Facility inspection / hardening

O4            Shelter-in-place – staffing needs (short and long term planning)

O5            “Evacuation” not appropriate wording – Disaster mitigation

O6            Add definition of” health care providers”

O7            Remove “evacuation” from 5.1 and 5.2

Objective 5.1

M1           Follow up on dissemination of county guidelines

KON1      Agencies [should] work together

KON2      Add the County Civil Defense

KON3      New technology should be integrated into the plan, for example GPS

KON4      Project Lifesaver – bracelet triangulation monthly battery check. Only effective on Big Island. May be good for very vulnerable population. (Cost is $30 a year, expense of a battery replacement, the county has this technology.)

O1            Remove “evacuation”

Objective 5.2

M1           Follow up on dissemination of county guidelines

H1            County Civil Defense works with individual agencies to develop plan

H2            Need to identify the homes (apartments) with PWD (under Housing and Urban Development – HUD) but not licensed by State – have night managers but no one there 24/7

H3             3,600 students with DA identified by DOE in county of Hawaii

O1             Remove “evacuation”

What is the TOPOFF Exercise Series?

The Department of Homeland Security (DHS) Preparedness Directorate’s, National Preparedness Task Force is sponsoring the Top Officials (TOPOFF) exercise series, which is a two-year cycle of seminars, planning events, and exercises designed to strengthen the nation’s capacity to prevent, prepare for, respond to, and recover from terrorist attacks involving Weapons of Mass Destruction (WMD).

What is TOPOFF and what are its goals? How does this vary in relation to earlier TOPOFF exercises?

The Federal Executive Branch will conduct the T4 Full Scale Exercise (F SE) during October 15-24, 2007. The series is designed to engage top officials from Federal, State, territorial, local, and tribal government departments and agencies; the private sector; and international partners.

The goals of TOPOFF 4 are to:

�      Assess the nation’s capability to prevent, respond to, and recover from realistic and threat-based acts of terrorism during a national, biennial exercise series.

�      Examine relationships amongst Federal, State, territorial, local, and tribal jurisdictions and the private sector in response to a realistic and challenging series of integrated geographically dispersed terrorist threats and acts.

�      Use performance based objectives to evaluate the relationships amongst Federal, State, territorial, local, and tribal jurisdictions and the private sector.

TOPOFF 4 will also serve as the vehicle to help introduce a Homeland Security “Campaign Plan”. The “Campaign Plan” will alter the past approach of TOPOFF by adapting it to serve as the framework of an organized campaign targeted at producing specific products and processes across a broad range of programmatic areas (e.g., a revised NRP; a concept plan) and performance-testing them in a full system test (FST).

What are the unique challenges and opportunities of developing the exercises?

T4 provides an opportunity to fully integrate in conformance with Homeland Security Presidential Directive – 8, the National Preparedness Goal and in pursuit of a National Exercise Program. DHS will introduce the five-year National Exercise Program during the TOPOFF 4 exercise cycle. This program combines exercise activities and affords Departments and Agencies the opportunity to reduce the number of separate exercises they must plan and participate in, and more importantly, provides an opportunity to demonstrate that the Government can operate effectively during an elevated continuity posture.

What new features are anticipated for this year’s exercise? In particular what roles will Arizona, Oregon and Guam play, and what is meant by an international component?

The T4 exercise will take a capabilities-based planning approach to address past TOPOFF lessons learned. By adopting this approach, FSL entities will address capabilities suitable for a wide range of hazards during the exercise. The capabilities that will be examined during the exercise include:

·        Protective Actions: Evacuation/Shelter-in-Place

·        Mass Care

·        Mass Prophylaxis

·        Communications

While the exercises will focus on an RDD scenario, many of the capabilities that will be validated are common amongst a variety of scenarios, including hurricanes, improvised nuclear device, improvised explosive device, etc.

Exercise design and development is currently underway, and each TOPOFF partner’s role will become more clearly defined in the upcoming months. The U.S. Department of State is responsible for coordinating TOPOFF’s international partners.

Who can I contact at DHS public affairs for additional information?

Please contact Ms. Vallee Bunting if you have additional questions. Ms. Bunting can be reached at vallee.bunting@dhs.gov or 202-447-3447.

Additional Background Information

What were some of the highlights of previous exercises in 2004 and 2005? And how did the exercises help shape priorities and foster innovations in the federal and state security sectors?

TOPOFF 2000 took place in May of 2000 in Portsmouth, New Hampshire and Denver, Colorado and exercised a chemical and biological attack respectively. In May of 2003, the State of Illinois and State of Washington participated in TOPOFF again exercising a biological attack as well as a radiological attack. The U.S. Department of State coordinated Canada’s, limited but integrated participation. And finally, TOPOFF 3 took place in April 2005 with the numbers of partners and participants growing to more than 15,000. The State of Connecticut exercised a chemical attack and the State of New Jersey exercised a biological attack. The U.S. Department of State again coordinated international partners including involvement from Canada, the United Kingdom, as well as a number of U.S. embassies. Every TOPOFF exercise builds on real-world and exercise experiences and lessons learned to further enhance our national preparedness.

Lessons learned from each TOPOFF exercise provide valuable insights that guide future planning for securing the nation against terrorist attacks. As part of the exercise aft-action reporting process, participants identify necessary improvements and assign them to responsible parties. DHS provides support in tracking progress toward implementation of improvement actions, to ensure that the exercises result in concrete preparedness and response benefits.

What role does the private sector play in T4?

The National Preparedness Task Force works in close coordination with the DHS Private Sector Office and the DHS Office of Infrastructure Protection to involve the private sector in the TOPOFF exercise cycle of events. TOPOFF 3 involved more than 5,000 members of the private sector participating at varying levels. At this point, the level of participation of the private sector has not yet been determined. 

As in a real-world response, agencies and organizations will deploy staff into the field and will face realistic incident –specific challenges, including the allocation of limited response resources and exercise actions needed to effectively manage conditions as they emerge. Planning and preparation for the exercise will also help strengthen working relationships between departments and agencies that are critical to successful prevention and response in real emergencies.

TOPOFF 4 will involve more than 15,000 participants in Guam, Arizona, and Oregon from all levels of government, international partners and the private sector in a full-scale, simulated response to radiological dispersal device attacks. For the first time, a U.S. Territory, Guam, will participate in the TOPOFF series, providing an opportunity to practice coordinated prevention and response activities between the continental U.S. and a U.S. territory. About 1,000 people will be participating in the Guam TOPOFF event. Between 200-250 of those participants are from off-island.

At the Federal level, exercise play will be marked by the coordinated participation of multiple agencies and departments. For example, in addition to response, the U.S. Department of Homeland Security will be exercising prevention through its Terrorism Prevention Exercise Program (TPEP).

In the weeks leading up to the full-scale exercise, law enforcement and intelligence community players will work the information gathering, intelligence analysis, and information-sharing capabilities that help tothwart terrorist activities. In addition, the U.S. Department of Health and Human Services (HHS) will mobilize around emerging public health issues related to a radiological emergency, and the U.S. Department of Defense (DoD) will run concurrent exercises to address global terror threats.

To reach the over-arching goal and objectives to enhance interagency coordinator, planning and preparedness, TOPOFF 4 will focus on five key areas:

1.         Prevention: To test the handling and flow of operational and time-critical intelligence between agencies to prevent a terrorist attack.

2.        Intelligence/Investigation: To test the handling and flow of operational and time-critical intelligence between agencies prior to, and in response to, a linked terrorist incident.

3.        Incident management: To test the full range of existing procedures for domestic incident management of a terrorist weapon of mass destruction event and to improve the top officials’ capabilities to respond consistent with the National Response Plan and the National Incident Management System.

4.        Public Information: To practice the strategic coordination of a terrorist weapon of mass destruction event or incident of national significance.

5.        Evaluation: To identify lessons learned and promote best practices.

TOPOFF 4 is based on National Planning Scenario 11 (NPS-1 1). The scenario begins as terrorist, who have been planning attacks in Oregon, Arizona, and Guam, successfully bring radioactive material into the United States. The first of three coordinated attacks occurs in Guam, with the simulated detonation of a Radiological Dispersal Device (RDD), or “dirty bomb,” causing casualties and wide-spread contamination in a populous area near a power plant. Similar attacks occur in the hours that follow in Portland and Phoenix.

An RDD is not the same as a nuclear attack. It is a conventional explosive that, upon detonation, there are severe rescue, health, and long-term decontamination concerns associated with an RDD. Real weapons will not be used in the scenario, but the response will be mounted as if they had been.

The Island of Guam, because of its geographic location, is under constant threat of natural and manmade disasters that may cause mass casualty and injuries, loss of real property and damage to our environment.

The Government of Guam has created two plans to ensure effective response and recovery from disasters, as well as a solid strategy for mitigation to reduce risks from future events. The Guam Emergency Response Plan outlines the actions necessary to respond to events, while the Guam Hazard Mitigation Plan (HM Plan) demonstrates Guam’s commitment to reduce risks from natural hazards and serves as a guide for Guam’s decision-makers as they commit resources to reducing the effects of natural hazards.

Effective emergency response plans are critical to ensure that public safety, real property and our environment are protected when a natural or other disaster occurs. The Guam Emergency Response Plan is based on older versions of the Plan and has been updated with consultation from emergency management experts and lessons learned during responses to a variety of threats over the years.

The Island of Guam relies on both technical and other assistance from Federal partners during response to and recovery from events, making close coordination between all parties a necessity.

As a condition of receiving Federal disaster mitigation funds, the Guam Hazard Mitigation Plan must meet the requirements of Section 409 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1988 (Stafford Act) and Section 322 of the Disaster Mitigation Act of 2000 (DMA 2000).

The HM Plan has been developed by the Hazard Mitigation Advisory Committee of the Civil Defense Advisory Council and is in place.

The Plan describes Guam’s planning process for identifying hazards, risks and vulnerabilities. It also identifies and prioritizes mitigation actions, encouraging the ongoing development and effective implementation of Guam’s specific mitigation strategies and provides technical support for these efforts.

This plan meets all requirements of the Robert T. Stafford Disaster Relief and Emergency Assistance Act of 1988 (Stafford Act) and Section 322 of the Disaster Mitigation Act of 2000 (DMA 2000). This includes meeting the requirement the Plan be adopted by the Government of Guam and fulfilling all of the requirements of the Crosswalk (specific criteria used [by] the Federal Emergency Management Agency (FEMA) to evaluate the Plan.

The Government of Guam will also comply with all applicable Federal statutes and regulations in effect with respect to the periods for which it receives grant funding, in compliance with 44 CFR 13.1 1( c). Furthermore, the Plan will be updated whenever necessary to reflect changes in Guam or Federal laws and statutes, as required in 44 CFR 13.11 (d).

It is imperative that current emergency plans for effective use of all our island’s resources to save lives and reduce human suffering and property loss be maintained and updated.

This Plan, the Guam Emergency Response Plan, will serve as the basis for the execution of all activities on behalf of the Government of Guam in response to all natural, man-made, and technological disaster/emergencies that effect our island community. 

http://www.guamhs.org/main/?pg=guam_emergency_response

Video clip showing an emergency preparedness exercise that Manuel Cruz was involved with.  He is the Acting Executive Director, Guam DDC. 

http://www.guampdn.com/apps/pbcs.dll/section?Category=VIDEO