Whole Community Assessment & Its Impact on Emergency Preparedness
Most emergency managers maintain detailed inventories of critical infrastructure, their vulnerabilities, state of repair, and hotspots around town that are more easily impacted (i.e. the roads that always flood or ice over), so why is there not the same amount of information available about the residents of a community? As it approached and ultimately made landfall in the northeastern United States in late October, Hurricane Sandy demonstrated the importance of emergency management officials’ awareness of who resides and works in their communities, where they are located, and what kind of assistance they will require should a disaster strike. Some of this information is available; however, it is typically collected by various entities, managed in different systems, and not rapidly accessible when it matters most.
There is much concern in certain populations, and rightfully so, about participating in a special needs or disability registry. Many individuals who are differently-abled, for example those who are deaf or hard of hearing, do not feel inclined to participate in such a system that labels them or singles them out. Two weeks ago, I had the opportunity to take a full-day course offered by the Boston Public Health Commission called Emergency Planning for the Diverse Needs of Communities. This outstanding program was designed to familiarize participants with FEMA’s concept of Whole Community Preparedness, in particular, understanding the needs of and preparing for vulnerable populations. One of the main objectives of the course was to broaden everyone’s thinking about what exactly it means for a member of the community to be “vulnerable” and in need of special consideration by emergency managers. We went around the room rattling off different characteristics that we felt would put someone into that category. The activity began with the more traditional definitions – those with mobility limitations and developmental disabilities – and quickly progressed to others not traditionally considered. By the end, the list included the following:
- Those with limited proficiency in speaking, reading, or understanding the English language
- The elderly
- Deaf or Hard of Hearing
- Visual impairments
- Individuals with medical conditions (particularly those requiring home healthcare, regular outpatient treatment, such as dialysis, or electrically-powered medical devices)
- Institutionalized individuals (assisted living, nursing homes, the incarcerated)
- Caregivers (single parents, medical professionals, social workers, first responders)
- Economically disadvantaged
- Those without access to transportation
- Pet owners
There were other segments of the population mentioned, but even just the above list demonstrates that our at-risk populations include far more than we once planned for. In fact, in Boston, City officials have estimated that anywhere between 39.7% and 46.9% fall into the categories of vulnerable or requiring assistance. Perhaps complicating preparedness efforts even further is the fact that many individuals are vulnerable for multiple reasons – the elderly woman who is the primary caregiver for a grandchild, the child with a significant medical condition (and his parents), etc. The complexity surrounding the makeup and needs of our communities, as well as the shortcomings in recent disasters of responding to those with certain needs, have been large drivers behind FEMA’s focus on the concept of Whole Community Preparedness. That is, the effort to develop emergency operations plans around all of the needs of the community, rather than the relatively small portion of the population that is self-sufficient.
In speaking with emergency management and public health officials, as well as advocacy groups and ADA coordinators, since joining Rave, I have an appreciation for why there is hesitation for being singled out in a government-maintained registry. However, when you consider the breadth of individual and community issues that emergency managers must be prepared to respond to, it strikes me that if properly deployed and marketed, local or state government could capture this information in such a way that it would not be construed as a registry.
More specifically, if the goal is to maintain up-to-date and detailed information about the residents and commuters of a jurisdiction who could be considered vulnerable (i.e. upwards of 50% in some places), then you are no longer targeting two or three specific populations. In fact, this is why we have had such broad support from advocacy groups and ADA coordinators alike for how we market and collect information in Smart911 and SmartPrepare. Smart911 and SmartPrepare partner jurisdictions target every segment of their population for participation in the programs. Of course they will reach out to the Deaf and Hard of Hearing and Autism communities, but they will also message parents, pet owners, and even the young and healthy. Because everyone can at some point benefit from maintaining an updated Safety Profile in our system, no group is singled out. This is the distinction that allows all members of the community to feel comfortable with sharing their information and, ultimately, providing 9-1-1 call takers, first responders, and emergency managers with the vital information needed to enhance response.
When upwards of 50% of some communities fall into the “vulnerable” category, you are no longer talking about special needs. These are normal needs, not just outliers to be addressed in annex to an emergency operations plan. It is for this reason that we need to shift our thinking from maintaining information in a registry to that of a whole community assessment that helps us understand the composition of those we are responsible for serving and protecting.