Emergency preparedness in a sample of persons with disabilities.

OBJECTIVE: The objective of this study was to characterize emergency preparedness in this vulnerable population, and to ascertain the role of the personal assistant (PA) and the potential impact of prior emergency experience on preparedness efforts. DESIGN: Cross-sectional Internet-based survey conducted in 2011. SETTING: Convenience sample. PARTICIPANTS: Two-hundred fifty-three community residents with cognitive and /or physical disabilities, all receiving personal assistance services. MAIN OUTCOME VARIABLES: Emergency preparedness, operationalized as responses to a seven-item scale. RESULTS: The mean score for the emergency preparedness scale was 2.32 (SD = 2.74), range 0-7. Even though 62.8 percent (n = 159) of the participants had previously experienced one or more large-scale emergencies, only 47.4 percent (n = 120) of the entire sample and 55.3 percent (n = 88) of those with actual emergency experience reported preparing an emergency plan. Sixty-three percent (n = 76) of those reporting a plan had involved their PA in its development. Participants who reported such involvement were significantly more likely to have higher scores on the emergency preparedness scale (p < 0.001). Participants who had experienced a prior emergency were also more likely to score higher on the emergency preparedness scale (p < 0.001). In general, participants reported limited attention to other basic preparedness recommendations: only 28 percent (n = 70) had prepared a "go-bag" with necessary supplies, 29 percent (n = 74) had developed a strategy for communicating with their PA during emergencies, and 32 percent (n = 81) had stockpiled emergency supplies. Of particular importance, only 26 percent (n = 66) had made alternative back-up plans for personal assistance. CONCLUSIONS: Involving the PA in the planning process and experiencing an emergency were both significantly associated with higher emergency preparedness scores in this sample of people living with disabilities. However, critical deficiencies in preparedness were noted, such as lack of back-up plans for replacing their PA. Despite a concerted national effort to improve preparedness in the population of people living with disabilities, important preparedness gaps remain. These findings highlight the need for additional study on emergency preparedness barriers in people living with disabilities so that effective strategies to reduce vulnerabilities can be identified.

The ADA in action at health care facilities.

The purpose of the work documented here was to assist defendants in legal actions to comply with settlement agreements, consent decrees, and memoranda of understanding. The work involved surveying medical center facilities and interviewing the staff and, based on the results, developing recommendations for compliance. Recommendations are offered for exam tables and chairs, weight scales, and ancillary aids. Guidance on interior design barriers and communication barriers is also provided. Finally, recommendations regarding facility policies and procedures and staff training are outlined.

Preparing for and responding to pandemic influenza: implications for people with disabilities.

State, local, tribal, and territorial emergency managers and public health officials must address the specific needs of people with disabilities in their pandemic influenza plans. Evidence from Hurricane Katrina indicated that this population was disproportionately affected by the storm and aftermath. People with disabilities, particularly those who require personal assistance and those who reside in congregate care facilities, may be at increased risk during an influenza pandemic because of disrupted care or the introduction of the virus by their caregivers. Emergency and public health planners must ensure that personal assistance agencies and congregate care operators make provisions for backup staffing and that those who provide critical care are given adequate antiviral drugs and vaccines as they become available.