Definitions and Key Concepts
According to the NRP Working Group, before, during and after an incident members of this population may have additional needs in one or more of the following functional areas:
- Transportation
- Communication
- Medical care
- Supervision
- Maintaining Independence
Individuals in need of additional response assistance may include those who:
- Have disabilities
- Live in institutionalized settings
- Are from diverse cultures
- Have limited English proficiency or are non-English speaking
- Are transportation disadvantaged
- Have chronic medical disorders
- Have pharmacological dependency
- Are elderly
- Are children
Individuals within the above mentioned populations are most often classified under the "special needs" umbrella. Members of these populations often have specific disaster-related needs requiring additional assistance or capabilities. This definitional framework is a function based approach to addressing the issues and needs presented by members of the special needs populations. It allows planners to plan for a predictable and specific set of functional support needs and establishes parameters for resource allocation. Notably this definition satisfies a key recommendation from the DHS Nationwide Plan Review calling on the federal government to develop a consistent definition of the term 'special needs'.
This approach establishes a flexible framework that addresses a broad set of common function-based needs irrespective of specific diagnosis, statuses, or labels (e.g., children, the elderly, transportation disadvantaged). For example:
- Transportation – Individuals who cannot drive due to the presence of a disability or who do not have a vehicle will require transportation support for successful evacuation such as the availability accessible vehicles (e.g., lift equipped or vehicle suitable for transporting individuals who uses oxygen) or knowledge of how/where to access mass transportation used to assist in evacuation.
- Communication – Individuals who have limitations that interfere with the receipt of and response to information will need that information provided in methods they can understand and use. They may not be able to hear verbal announcements, see directional signage, or understand how to get assistance all because of hearing, vision, speech, cognitive or intellectual limitations, and limited English proficiency.
- Medical Care – Includes individuals who are not self-sufficient or do not have or have lost adequate support from caregivers, family, or friends and need assistance with: managing unstable, terminal or contagious conditions that require observation and ongoing treatment; managing intravenous (IV) therapy, tube feeding, and vital signs; receiving dialysis, oxygen, and suction administration; managing wounds; and operating power-dependent equipment to sustain life. These individuals require support of trained medical professionals.
- Supervision – Before, during, ands after an emergency or a disaster individuals may lose the support of caregivers, family, or friends or may be unable to cope in a new environment; have conditions such as dementia, Alzheimer's and psychiatric conditions (schizophrenia, intense anxiety); and unaccompanied children will require supervision to make decisions affecting their welfare.
- Maintaining Independence – Individuals in need of support that enables them to be independent in daily activities may lose this support during course of an emergency or a disaster situation. This may include lost or damaged durable medical equipment (wheelchairs, walkers, scooters, and essential supplies –catheters, ostomy supplies, etc.). By supplying needed support/devices individuals will be able to maintain their independence.
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Inclusion and Access: No one should be left behind in emergency and disaster prevention (mitigation), preparedness, response, and recovery, whether an event is natural or manmade. The emergency management framework must be inclusive of all populations regardless of needs.
Effective Communication: At-risk individuals with functional limitations must be given the same information provided to the general population using a method that is understandable and timely.
Equal Access: At-risk individuals with functional limitations must be able to benefit from emergency programs equally with the general population through accessible means.
Equal Opportunity: At-risk individuals with functional limitations must have the same opportunities to benefit from emergency programs, services, and activities as people without functional limitations.
Inclusion: At-risk individuals with functional limitations have the right to participate in all emergency programs, services, and activities provided by governments, private businesses, and nonprofit organizations.
Integration: At-risk individuals with functional limitations must be provided services in the most integrated setting.
No Charge: At-risk individuals with functional limitations may not be charged to cover the costs of measures necessary to ensure nondiscriminatory treatment.
No "One Size Fits All": At-risk individuals with functional limitations do not all require the same assistance and do not all have the same needs.
Physical Access: At-risk individuals with functional limitations must be able to access locations where emergency programs and services are provided.
Program Modifications: At-risk individuals with functional limitations must have equal access to emergency programs and services, which may entail modifications to rules, policies, practices, and procedures.
Self-Determination: At-risk individuals with functional limitations are the most knowledgeable about their own needs.
Service/Assistance Animal: Both service animals and assistance animals should be included.
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