Polk County Voluntary Special Needs Program



Polk County Special Needs Registry

Policy and Procedures

Updated 110706

Purpose

The purpose of the Polk County Special Needs Registry (PCSNR) is to provide emergency responders in Polk County with important health and medical information of special needs individuals that may require assistance during an emergency, such as a tornado, flood, blizzard, power outage or disease outbreak. The Special Needs Registry is a voluntary program and in no way ensures that the individual enrolling in the program will receive immediate or preferential treatment in an emergency. This program will merely provide the emergency response community with information that is pertinent to developing an effective response. The Special Needs Registry in no way replaces the responsibility of individuals to have their own emergency plan.

History

The Special Needs planning process began as a pilot program for the Western Region Partnership for Public Health Preparedness as a means of identifying special populations within a geographical location including mechanisms to contact these individuals during an emergency that requires evacuation or sheltering in place. The Special Needs Registry is the result of a Special Needs Planning process that occurred from February through September of 2006. Over 100 community members, including emergency responders, chief elected officials, government departments, tribal representatives and special population individuals identified the need to develop a database of the most critical special needs populations.

Special Needs Registry Review Team.

The purpose of the Review Team is to review all registry applications and determine the applicant’s level of enrollment into the program. This system will allow emergency responders to identify and respond to individuals with the most urgent needs first.

Levels of Enrollment:

1. Level 1: Requires urgent attention. Individual’s medical information indicates immediate emergency response assistance is necessary for survival.

2. Level 2: Requires moderate attention. Individual’s medical information indicates an eventual emergency response is necessary but is not considered immediate or life-threatening.

3. Level 3: Requires little attention. Individual’s medical information indicates there is no immediate attention required. However, if time and resources permit, the individual should be contacted by emergency responders.

4. Not eligible for the program.

The Review Team shall:

1. Meet quarterly, or as needed, to review applications.

2. Consist of a representative from Public Health, Human Services, Emergency Management, Aging, Home Care, Veterans Affairs and a local healthcare provider.

3. Make recommendations and determine policy to enhance and maintain the Special Needs Registry.

4. Determine the enrollment eligibility of an individual into the program.

5. Assign necessary follow-up on registration applications that need additional information before enrollment eligibility can be determined.

Roles and Responsibilities

The PCSNR has not received any funding for planning, maintenance and/or operations. The success and longevity of the program will rely heavily on the Departments listed below to share program functions and costs incurred. To ensure that the program is operating effectively as possible, it is important that the agencies involved with the Special Needs Registry have identified core responsibilities along with specific department responsibilities.

Core Responsibilities

▪ Promote the program with special populations through existing communication channels.

▪ Assess and update the program protocol annually or as needed.

▪ Provide a Department representative to participate on the Review Team.

▪ Develop materials to be used by the program including Welcome Letters, Renewal Letters, Brochures, FAQ’s, etc.

Department Responsibilities:

1. Public Health

▪ Lead agency in coordinating activities of the Special Needs Registry.

▪ Coordinate with Emergency Management to determine convening the Review Team.

2. Human Services

▪ See Core Responsibilities

3. Aging Department

▪ Print and send materials to program participants.

4. Veterans Affairs

▪ Responsible for all marketing activities involved with the registry including public information.

5. Information Technology

▪ Develop, maintain and update web registration form.

▪ Develop and implement a registration database. This system should notify Emergency Management when a new registration has been submitted.

▪ Provide technical assistance with software.

6. Land Information

▪ Using GIS or a similar application process, map out program participants and County Shelters.

7. Emergency Management

▪ Receive all registry applications, On-line and paper, ensuring data entry into the registry database.

▪ Maintain the program database.

▪ Coordinate with Public Health to determine convening the Review Team.

▪ Notification of Emergency Responders of the Special Needs Registry pre-incident and dissemination during incident.

Funding Support

To the extent possible, the agencies listed in this plan will share the costs incurred with maintenance of the program. Emergency Management will be the fiscal agent for the program and will budget program costs within its annual budget. In turn, Emergency Management will invoice costs incurred by the program equally among Public Health, Human Services, Veterans Affairs, and Aging.

Proposed annual operating budget (based on 500 registrations):

▪ Postage: $200.00

▪ Marketing (posters, media, etc): $150.00

▪ Paper: $10.00

▪ Envelopes: $10.00

▪ Copies: $75.00

▪ In-kind resources include personnel time, phone calls, etc.

▪ Total: $445.00

Information Sharing

The data and information collected from the PCSNR shall be used only during an emergency. The information will be provided to local Emergency Responders only as deemed appropriate by Polk County Emergency Management. The database shall not be re-distributed to any individual or organization without the consent of Emergency Management. Following a disaster or emergency, all paper forms of the program roster shall be returned to Emergency Management for destruction. Distributed electronic versions shall be deleted.

Notification

Notification to individuals enrolling or renewing their application with the PCSNR will occur several ways:

▪ If applicants use the on-line registration process, individuals will be notified instantly via automatic email verification that their application has been received and is in the process of being reviewed.

▪ New or renewal applicants will be notified by Emergency Management via a hardcopy letter whether the individual has been approved or denied into the program along with an explanation of the circumstances. Emergency Management will also send out individual emergency planning resources as appropriate.

▪ Applicants may be contacted via phone from a member of the Review Team requesting additional application information to determine eligibility.

▪ The renewal process will begin no later than March 15th annually. Individuals in the PCSNR database will be sent a renewal notice via mail with directions to update and renew their application.

Policy Approval:

The undersigned have hereby reviewed and approved the Polk County Special Needs Registry. This policy accompanies the Polk County Special Needs Populations Plan for Disasters and Emergencies which will be incorporated into the Polk County Emergency Operating Plan.

|__________________________________________ |__________________________ |

|Pubic Health |Date |

|__________________________________________ |__________________________ |

|Human Services |Date |

|__________________________________________ |__________________________ |

|Emergency Management |Date |

|__________________________________________ |__________________________ |

|Veterans Affairs |Date |

|__________________________________________ |__________________________ |

|Aging Department |Date |

|__________________________________________ |__________________________ |

|Information Technology |Date |

|__________________________________________ |__________________________ |

|Land Information |Date |

Appendix A: Registry Operations Flow

Appendix B: Application

|Polk County Special Needs Registry Application |

|Disclaimer |

|The purpose of the Polk County Special Needs Registry is to provide emergency responders in Polk County with important information from individuals that may |

|require assistance during an emergency, such as tornado, flood, blizzard, power outage or disease outbreak. This program is voluntary and in no way ensures |

|that the individual completing this form will receive immediate or preferential treatment in an emergency. This program will merely provide the emergency |

|response community with information that is pertinent to developing an effective response. The Polk County Special Needs Registry in no way replaces the |

|responsibility of individuals to have their own emergency plan. |

|Personal Information |

|Date of Application: |□ New Application |

| |□ Update of Previous Application |

|Last Name |First Name |MI |Date of Birth: |Sex: |

| | | | | |

|Street Address: |City: |Zip: |Primary Phone #: |

| | | | |

| | | | |

| | | |Alternate Phone #: |

|Mailing Address (If different): |City: |Zip: | |

| | | | |

|Name of Subdivision, Mobile Home Park, Apartment Building, etc.: |Primary Language: |

| | |

|Living Situation (check one): □ Live Alone □ With Spouse □ With Children □ With Parents □ Other (Explain) |

| |

|Medical Information (Check and complete those that apply to your medical condition.) |

|□ Wheelchair Bound |□ Mental Health Condition |

|□ Walker |□ Special Dietary Needs |

|□ Bedridden |□ Required or Life-Sustaining Equipment |

|□ Hearing Impaired |□ Portable Oxygen Machine |

|□ Sign Language |□ Suction Machine |

|□ Visually Impaired |□ Oxygen Concentrator or Ventilator |

|□ Seizures |□ Continuous |

|□ Speech Impaired |□ Intermittent |

|□ Memory Impaired (Explain) |□ Life Sustaining Medications |

|□ Ostomy Care |□ Physically Disabled |

|□ G-tube Feeders |□ Other (Explain) |

|□ Developmentally Disabled: | |

|Explain any that have been checked above including listing any types of diagnosis, medication, etc.: |

| |

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|Emergency Contact Information |

|Primary Emergency Contact |

|Last Name |First Name |Relationship |Phone |

| | | | |

|Alternate Emergency Contact |

|Last Name |First Name |Relationship |Phone |

| | | | |

|Medical Provider Information (Fill in all that apply) |

|Physician Name: |Phone: |

| | |

|Pharmacy Name: |Phone: |

| | |

|Home Health Care Agency Name: |Phone: |

| | |

|Shelter Information |Pet Information |

|Can you, a family member or friend provide you with transportation to a shelter |Do you have pets that would require special attention if you were asked to |

|in an emergency? |evacuate your home? If so, indicate the number of: |

|□ Yes □ No | |

| |_____Cat _____Dog |

|If you need assistance with transportation, check one of the following: | |

|□ Automobile □ Van with wheelchair lift |_____Service Dog _____Other (Explain) |

|□ Bus □ Medical transport required | |

|Applicant Additional Comments |

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|Authorization Information |

|By signing / submitting this form, I / legal guardian agree that my name be added to the Polk County Special Needs Registry. I give the Polk County Emergency |

|Management authorization to share this information with other community emergency responders in the event of an emergency in order to facilitate an effective |

|response. I grant emergency responders permission to enter my home following an emergency event or disaster situation, if necessary, to assure my safety and |

|welfare. |

|Applicant Signature |Date |

| | |

|X | |

|Authorized Guardian Signature |Date |

| | |

|X | |

|Mail Completed Form to: |

| |

|Polk County Emergency Management |

|1005 West Main, Ste 900, |

|Balsam Lake, WI  54810 |

| |

|For questions regarding this form or this program, contact the Polk County Emergency Management Office at 715-485-9280 or by email at kathyp@co.polk.wi.us. |

|This form can be filled out and submitted on-line at co.polk.wi.us/emgt |

Appendix C: Registry Letters

1. Denial Letter

DATE

Dear NAME:

Your Special Needs Application has been reviewed by the Special Populations Program Review Team and you have been found to be ineligible for the program at this time.

If you feel there is information that was not considered in this review, please contact me to discuss or fill out a new application with more detailed information and submit it for reconsideration. If you have significant changes in your situation, please feel free to re-apply at anytime.

Enclosed is information to help you plan for your own safety and welfare.

If you have any questions or concerns, please do not hesitate to contact me.

Sincerely,

EMERGENCY MANAGEMENT OFFICE

Kathy A. Poirier, Coordinator

The Polk County Special Populations Registry is sponsored by a partnership between the Departments of Emergency Management, Public Health, Human Services, Aging and Veterans Affair

2. Registry Received Letter

DATE

Dear NAME:

Your Special Needs Application has been received and will be reviewed by the Special Populations Program Review Team. You will be notified by mail concerning the status of your application.

If you have any questions or concerns, please do not hesitate to contact me.

Sincerely,

EMERGENCY MANAGEMENT OFFICE

Kathy A. Poirier, Coordinator

The Polk County Special Populations Registry is sponsored by a partnership between the Departments of Emergency Management, Public Health, Human Services, Aging and Veterans Affair

3. Update Letter

DATE

Re: Update of Special Needs Registration

Dear Name:

Polk County Emergency Management would like to assure that all of our Special Needs Registrants are prepared in the event of a disaster or emergency. In order to properly update our database of special needs citizens, we are asking that you or your caregiver fill out the attached application.

Please be sure this form is filled out completely and signed or it will need to be returned to you for completion. Once received, we will place the updated information you provide into our database.

We are asking that you return your registration no later than April 30. If you no longer need our services, please mark the form as such and return it to us.

If you have any questions or concerns, please do not hesitate to contact me.

Sincerely,

EMERGENCY MANAGEMENT OFFICE

The Polk County Special Populations Registry is sponsored by a partnership between the Departments of Emergency Management, Public Health, Human Services, Aging and Veterans Affair

4. Welcome Letter

DATE

Dear NAME:

Your Special Needs Application has been reviewed by the Special Populations Program Review Team and approved for enrollment into the County database of special needs individuals.

Each year you will be required to update your application. This update will be done beginning no later than March 15. You will be sent a reminder to complete a renewal application. Renewal applications can be completed on-line or a new application can be sent to you to be filled out and returned to our office. This process will verify continued eligibility for the Special Needs Registry.

If you have any questions or concerns, please do not hesitate to contact me.

Sincerely,

EMERGENCY MANAGEMENT OFFICE

Kathy A. Poirier, Coordinator

The Polk County Special Populations Registry is sponsored by a partnership between the Departments of Emergency Management, Public Health, Human Services, Aging and Veterans Affair

Appendix D: Marketing Plan

I. Develop Press Release/Public Service Announcement

a. Short, concise, to the point (What/Why, Who, How…)

b. Suitable for Newspaper/Radio/Poster

c. Follow State release guidelines….

II. Distribute

a. Newspapers (AFP, Ledger, Leader, Osceola Sun)

b. Radio (WXCE, WLMX)

c. Aging Newsletter (Monthly)

d. Senior Citizen Meal Centers (5)

e. Medical Facilities (Social Workers/Clinic Nurse Managers) (Amery, Osceola, St Croix Falls, etc.)

f. Public Health Nurses/Home Care/Birth to Three

g. Human Services (Case workers, etc.)

h. Emergency Services (Ambulances, Fire, Police/Sheriff)

i. Radio shows/interviews

j. Nursing Home Discharge Planners

III. PowerPoint Presentation

a. For use at town meetings, public briefings, etc.

b. With or without “formal” presenter…

c. Church presentations

d. County Board Presentation

Notes: Develop release/PSA and poster with concurrence of committee. Provide copies with attached hardcopy applications for general distribution. Ensure that website and phone contacts prominent for assistance and additional detail. Keep as simple and direct as possible for elderly… Ensure that potential applicants know that assistance in filling out form is easily obtainable.

Appendix E: Marketing Tools

1. Press Release

October 30, 2006

For Immediate Release

Rick Gates, Polk County Communications, (715) 485-9243

POLK COUNTY SPECIAL NEEDS REGISTRY PROGRAM

BALSAM LAKE- A new program, the “Special Needs Registry,” is being started in Polk County. The purpose of this program is to provide local emergency responders (Fire, Police, Ambulances, etc.) with important information from individuals who reside in Polk County who might have special needs or need special assistance in the event of an emergency situation, such as a tornado, flood, blizzard, extended power outage, or disease outbreak. The program is strictly voluntary, and its intent is to provide the emergency response network with information pertinent to developing an effective response to emergency situations. Up until now, there has been no registry or listing of people who would need special assistance in the event of an emergency.

The people for whom the program is intended are those who have medical conditions or special needs which would require assistance above and beyond the “normal” level during an emergency. It is designed to address the needs of those who live independently, and is not for those people living in institutional settings. Examples would include: elderly people living in isolated areas, those unable to ambulate (i.e. wheelchair bound, bedridden, etc.), and those on oxygen or the visually impaired; people on life sustaining medication, the developmentally disabled, hearing impaired, and those requiring life sustaining equipment. Knowing the status and location of people in our county with special needs would be critical in, for example, a severe ice storm or snow condition. If power was lost to an area and would be out for an extended period of time, it could be life threatening for those unable to leave or who require electricity to maintain life support equipment.

Participation in this program is strictly voluntary and the information maintained in the registry will be protected. Only in emergency situations will this information be accessed. Participation in this registry in no way ensures that the individual will receive immediate or preferential treatment during an emergency. All residents are encouraged to have their own emergency plan. Those wishing to register can do so on line at co.polk.wi.us/emgt or via paper application. Please contact Polk County Emergency Management Office (715) 485-9280 or via email at kathyp@co.polk.wi.us for additional information or assistance in obtaining a paper application.

2. Posters

These are important questions that every resident of Polk County should have answers for, but unfortunately many do not.

Although individual preparedness begins with you, Polk County understands that there are residents with severe health and medical conditions who will require special help in an emergency. That’s why Polk County has developed the Polk County Special Needs Registry. The Registry is:

▪ Completely voluntary.

▪ Provides emergency responders with information to develop an effective response.

▪ Secure and confidential.

▪ Free to register.

3. Information Sheet

The Polk County Special Needs Registry is a program developed and sponsored by the Polk County Departments of Public Health, Emergency Management, Aging, Veterans Affair and Human Services.

The Registry allows individuals with critical health and medical conditions that may require assistance during an emergency or disaster, such as a power outage, tornado, flood or infectious disease outbreak, an opportunity to voluntarily register with the program and get their name into the PCVSNP database.  Then during an emergency or disaster, the Registry will provide emergency responders in the effected area with important information about your health and medical needs.  This is important so that emergency responders know about you and can develop a more effective response. 

The Registry is a voluntary program and in no way ensures that the individual enrolling in the program will receive immediate or preferential treatment in an emergency.  This program will merely provide the emergency response community with information that is pertinent to developing an effective response, whether sheltering-in-place or evacuation.   The Registry in no way replaces the responsibility of individuals to have their own emergency plan.   

The Registry is not for everyone though. The Registry should be considered by individuals who have NO alternative or have no family or friend support structure in their community.   Emergency Management recommends using this program only as a last resort and individuals with special needs should consider sheltering or evacuating with relatives or friends first.

Program Eligibility

The Registry is for those individuals who are not in a care facility, such as a hospital, nursing home or congregate living facility. These facilities are required to have an evacuation plan in place for their residents and patients to be transported to another healthcare facility. The Registry is for individuals who are not part of a group facility and have no other alternative but to seek assistance from the County. 

1. Individuals require assistance with ostomy and indwelling catheter management.

2. Activities of daily living are so restricted by immobility that others provide assistance to meet their basic needs and those people may be unavailable during and emergency or disaster.

3. They have a respiratory condition requiring special equipment such as monitors or oxygen.

4. There may be other conditions which would render an individual eligible for special needs emergency sheltering and these will be considered by a Review Team.

Frequently Asked Questions

1. What is the process for determining whether someone meets the program eligibility? 

Once an individual submits their application, they are automatically placed in Special Needs Registry database.  A Review Team consisting of emergency response and health and medical partners will meet regularly to review the applications and make a determination. 

2. How do I register?

Individuals can submit applications to the program by printing, completing and submitting the Special Needs Registry Application Form to Polk County Emergency Management or by completing the Special Needs Registry On-line Application Form at co.polk.wi.us/emgt

3. How will I be notified if I am enrolled in the program?

After the Review Team looks at the application, they will either accept the application, deny the application or will contact the individual for more information before making a decision.  Individuals will be notified via letter of the status of their application. 

4. Can I register a family member or friend?

Yes.  The application provides a section acknowledging that a person other than the applicants name is completing the form.

5. Will the database be sold or given to non-emergency responders?

No.  The database will only be distributed to emergency responders within the geographical area at the time that emergency or disaster is occurring.  Polk County Emergency Management will house the database and will determine who will receive database information.  All records will be protected by Security Software. 

6. What is the process for updating individual’s information?

It is critical that participant’s information stay current including addresses, contact information, and health status.  Individuals enrolled in the Registry will be sent a renewal notice in March of each year asking the individual to complete the re-application via paper or through the on-line registration process. 

7. The application form indicates that emergency responders can enter my home during an emergency or disaster.  Is this true?

Yes.  Depending the nature of the incident, and as a last resort, if you are not responding to multiple attempts to contact you whether via phone calls or visits to your home or we can not reach your emergency contact listed on your application, emergency responders may enter your home to check on you. 

8. What does it cost for me to be enrolled in the program?

Nothing.  Polk County values our residents and we understand the importance of taking care of our own.  Therefore, the costs incurred for developing, operating and maintaining this program come from a partnership of government agencies.

9. What can I expect if I am asked to evacuate my home and I have no place to go?

If no other alternatives are available, individuals apart of the Special Needs Registry may be transported to a Special Needs Emergency Shelter.  This shelter will be staffed by individuals from the American Red Cross, Human Services, Public Health and others. 

10. What if I am asked to shelter-in-place?

The nature of the Special Needs Registry allows emergency responders to check in on those individuals who have serious health and medical needs especially those that rely on medical equipment and medication for survival. 

For additional questions, please contact the Polk County Emergency Management office at (715) 485-9280.

Appendix F: Tips for Emergency Responders

The following information was developed by the University of Mexico Center for Development and Disability (). Covered in this section are tips for emergency responders in dealing with:

1. Seniors

2. People With Service Animals

3. People With Mobility Impairments

4. People Who Are Mentally Ill

5. People Who Are Blind Or Visually Impaired

6. People Who Are Deaf Or Hard Of Hearing

7. People With Cognitive Disabilities

Dear First Responder:

Whether you are responding to an emergency caused by natural forces such as a fire, flood or tornado, or one caused by a terrorist attack, you may encounter persons with some type of disability who will require assistance. Some disabilities, such as those involving physical impairments may be obvious. Other disabilities, such as mental illness, are more difficult to detect. In many cases, you can’t tell just by looking at the person whether they have a disability.

Many first responders have requested quick, easy-to-use procedures for assisting persons with disabilities. These tip sheets provide information about many types of disabilities you can use during emergencies as well as during routine encounters. They are not meant to be comprehensive, but contain specific information that you can read quickly either before or while you are actually responding to an incident.

If you would like more information about how to best assist persons with disabilities or have suggestions for future editions of this guide, please contact us.

Seniors

Always ask the person how you can best assist them.

▪ Some elderly persons may respond more slowly to a crisis and may not fully understand the extent of the emergency. Repeat questions and answers if necessary. Be patient! Taking time to listen carefully or to explain again may take less time than dealing with a confused person who may be less willing to cooperate.

▪ Reassure the person that they will receive medical assistance without fear of being placed in a nursing home.

▪ Older people may fear being removed from their homes – be sympathetic and understanding and explain that this is temporary.

▪ Before moving an elderly person, assess their ability to see and hear; adapt rescue techniques for sensory impairments.

▪ Persons with a hearing loss may appear disoriented and confused when all that is really “wrong” is that they can’t hear you. Determine if the person has a hearing aid. If they do, is it available and working? If it isn’t, can you get a new battery to make it work?

▪ If the person has a vision loss, identify yourself and explain why you are there. Let the person hold your arm and then guide them to safety.

▪ If possible, gather all medications before evacuating. Ask the person what medications they are taking and where their medications are stored. Most people keep all their medications in one location in their homes.

▪ If the person has dementia, turn off emergency lights and sirens if possible. Identify yourself and explain why you are there. Speak slowly, using short words in a calming voice. Ask yes or no questions: repeat them if necessary. Maintain eye contact.

People with Service Animals

Traditionally, the term “service animal” referred to seeing-eye dogs. However, today there are many other types of service animals.

▪ Remember – a service animal is not a pet.

▪ Do not touch or give the animal food or treats without the permission of the owner.

▪ When a dog is wearing its harness, it is on duty. In the event you are asked to take the dog while assisting the individual, hold the leash and not the harness.

▪ Plan to evacuate the animal with the owner. Do not separate them!

▪ Service animals are not registered and there is no proof that the animal is a service animal. If the person tells you it is a service animal, treat it as such. However, if the animal is out of control or presents a threat to the individual or others, remove it from the site.

▪ A person is not required to give you proof of a disability that requires a service animal. You must accept that he/she has a disability. If you have doubts, wait until you arrive at your destination and address the issue with the supervisors in charge.

▪ The animal need not be specially trained as a service animal. People with psychiatric and emotional disabilities may have a companion animal. These are just as important to them as a service animal is to a person with a physical disability – please be understanding and treat the animal as a service animal.

▪ A service animal must be in a harness or on a leash, but need not be muzzled.

People with Mobility Impairments

▪ Always ask the person how you can help before attempting any assistance. Every person and every disability is unique – even though it may be important to evacuate the location where the person is, respect their independence to the extent possible. Don’t make assumptions about the person’s abilities.

▪ Ask if they have limitations or problems that may affect their safety.

▪ Some people may need assistance getting out of bed or out of a chair, but CAN then proceed without assistance. Ask!

▪ Here are some other questions you may find helpful.

▪ “Are you able to stand or walk without the help of a mobility device like a cane, walker or a wheelchair?”

▪ “You might have to [stand] [walk] for quite awhile on your own. Will this be ok? Please be sure and tell someone if you think you need assistance.”

▪ “Do you have full use of your arms?”

▪ When carrying the person, avoid putting pressure on his or her arms, legs or chest. This may result in spasms, pain, and may even interfere with their ability to breathe.

▪ Avoid the “fireman’s carry.” Use the one or two person carry techniques.

Crutches, Canes or Other Mobility Devices

▪ A person using a mobility device may be able to negotiate stairs independently. One hand is used to grasp the handrail while the other hand is used for the crutch or cane. Do not interfere with the person’s movement unless asked to do so, or the nature of the emergency is such that absolute speed is the primary concern. If this is the case, tell the person what you’ll need to do and why.

▪ Ask if you can help by offering to carry the extra crutch.

▪ If the stairs are crowded, act as a buffer and run interference for the person.

Evacuating Wheelchair Users

▪ If the conversation will take more than a few minutes, sit down to speak at eye level.

▪ Wheelchair users are trained in special techniques to transfer from one chair to another. Depending on their upper body strength, they may be able to do much of the work themselves.

▪ Ask before you assume you need to help, or what that help should be.

Carrying Techniques for Non-Motorized Wheelchairs

▪ The In-chair carry is the most desirable technique if possible.

▪ One-person assist

▪ Grasp the pushing grips, if available.

▪ Stand one step above and behind the wheelchair.

▪ Tilt the wheelchair backward until a balance (fulcrum) is achieved.

▪ Keep your center of gravity low.

▪ Descend frontward.

▪ Let the back wheels gradually lower to the next step.

▪ Two-person assist

▪ Positioning of second rescuer:

▪ Stand in front of the wheelchair.

▪ Face the wheelchair.

▪ Stand one, two, or three steps down (depending on the height of the other rescuer).

▪ Grasp the frame of the wheelchair.

▪ Push into the wheelchair.

▪ Descend the stairs backward.

Motorized Wheelchairs

▪ Motorized wheelchairs may weigh up to 100 pounds unoccupied, and may be longer than manual wheelchairs. Lifting a motorized wheelchair and user up or down stairs requires two to four people.

▪ People in motorized wheelchairs probably know their equipment much better than you do! Before lifting, ask about heavy chair parts that can be temporarily detached, how you should position yourselves, where you should grab hold, and what, if any, angle to tip the chair backward.

▪ Turn the wheelchair’s power off before lifting it.

▪ Most people who use motorized wheelchairs have limited arm and hand motion. Ask if they have any special requirements for being transported down the stairs.

People Who Are Mentally Ill

▪ You may not be able to tell if a person is mentally ill until you have begun the evacuation procedure.

▪ If a person begins to exhibit unusual behavior, ask if they have any mental health issues you need to be aware of. However, be aware that they may or may not tell you. If you suspect someone has a mental health issue, use the following tips to help you through the situation.

▪ In an emergency, the person may become confused. Speak slowly and in a normal speaking tone.

▪ If the person becomes agitated, help them find a quiet corner away from the confusion.

▪ Keep your communication simple, clear and brief.

▪ If they are confused, don’t give multiple commands – ask or state one thing at a time.

▪ Be empathetic – show that you have heard them and care about what they have told you. Be reassuring.

▪ If the person is delusional, don’t argue with them or try to “talk them out of it”. Just let them know you are there to help them.

▪ Ask if there is any medication they should take with them.

▪ Try to avoid interrupting a person who might be disoriented or rambling – just let them know that you have to go quickly.

▪ Don’t talk down to them, yell or shout.

▪ Have a forward leaning body position – this shows interest and concern.

People who are Visually Impaired

▪ There is a difference between visual impairment and blindness. Some people who are “legally blind” have some sight, while others are totally blind.

▪ Announce your presence, speak out, and then enter the area.

▪ Speak naturally and directly to the individual.

▪ Do not shout.

▪ Don’t be afraid to use words like “see,” “look,” or “blind.”

▪ State the nature of the emergency and offer them your arm. As you walk, advise them of any obstacles.

▪ Offer assistance but let the person explain what help is needed.

▪ Do not grab or attempt to guide them without first asking them.

▪ Let the person grasp your arm or shoulder lightly for guidance.

▪ They may choose to walk slightly behind you to gauge your body’s reactions to obstacles.

▪ Be sure to mention stairs, doorways, narrow passages, ramps, etc.

▪ When guiding someone to a seat, place the person’s hand on the back of the chair.

▪ If leading several individuals with visual impairments, ask them to guide the person behind them.

▪ Remember that you’ll need to communicate any written information orally.

▪ When you have reached safety, orient the person to the location and ask if any further assistance is needed.

▪ If the person has a service animal, don’t pet it unless the person says it is ok to do so. Service animals must be evacuated with the person.

▪ Refer to the section on People with Service Animals.

People Who are Deaf or Hard of Hearing

▪ There is a difference between hard of hearing and deaf. People who are hearing impaired vary in the extent of hearing loss they experience. Some are completely deaf, while others can hear almost normally with hearing aids on.

▪ Hearing aids do not guarantee that the person can hear and understand speech. They increase volume, not increase clarity.

▪ If possible, flick the lights when entering an area or room to get their attention.

▪ Establish eye contact with the individual, not with the interpreter, if one is present.

▪ Use facial expressions and hand gestures as visual cues.

▪ Check to see if you have been understood and repeat if necessary.

▪ Offer pencil and paper. Write slowly and let the individual read as you write.

▪ Written communication may be especially important if you are unable to understand the person’s speech.

▪ Do not allow others to interrupt you while conveying the emergency information.

▪ Be patient – the person may have difficulty understanding the urgency of your message.

▪ Provide the person with a flashlight to signal their location in the event they are separated from the rescue team. This will facilitate lip-reading or signing in the dark.

▪ While written communication should work for many people, others may not understand English well enough in English to understand written instructions. Keep instructions simple, in the present tense and use basic vocabulary.

People with Cognitive Disabilities

Say:

▪ My name is…. I’m here to help you, not hurt you.

▪ I am a … (name your job)

▪ I am here because … (explain the situation)

▪ I look different than my picture on my badge because … (for example, if you are wearing protective equipment)

Show:

▪ Your picture identification badge (as you say the above).

▪ That you are calm and competent.

Give:

▪ Extra time for the person to process what you are saying and to respond.

▪ Respect for the dignity of the person as an equal and as an adult (example: speak directly to the person).

▪ An arm to the person to hold as they walk. If needed, offer your elbow for balance.

▪ If possible, quiet time to rest (as possible, to lower stress/fatigue).

Use:

▪ Short sentences.

▪ Simple, concrete words.

▪ Accurate, honest information.

▪ Pictures and objects to illustrate your words. Point to your ID picture as you say who you are, point to any protective equipment as you speak about it.

Predict:

▪ What will happen (simply and concretely)?

▪ When events will happen (tie to common events in addition to numbers and time, for example, “By lunch time…” “By the time the sun goes down…”).

▪ How long this will last – when things will return to normal (if you know).

▪ When the person can contact/rejoin loved ones (for example: calls to family, re-uniting pets)

Ask for/Look for:

▪ An identification bracelet with special health information.

▪ Essential equipment and supplies (for example: wheelchair, walker, oxygen, batteries, communication devices [head pointers, alphabet boards, speech synthesizers, etc.])

▪ Medication

▪ Mobility aids (for example, assistance or service animal)

▪ Special health instructions (for example: allergies).

▪ Special communication information (for example, is the person using sign language)?

▪ Contact information.

▪ Signs of stress and/or confusion (for example, the person might say [s] he is stressed, look confused, withdraw, start rubbing their hands together).

▪ Conditions that people might misinterpret (for example, someone might mistake Cerebral Palsy for drunkenness).

Repeat:

▪ Reassurances (for example, “You may feel afraid. That’s ok. We’re safe now.”)

▪ Encouragement (for example, “Thanks for moving fast. You are doing great. Other people can look at you and know what to do”).

▪ Frequent updates on what’s happening and what will happen next. Refer to what you predicted will happen, for example: “Just like I said before, we’re getting into my car now. We’ll go to… now”.

Reduce:

▪ Distractions. For example: lower volume of radio, use flashing lights on vehicle only when necessary.

Explain:

▪ Any written material (including signs) in everyday words.

▪ Public address system announcements in simple words.

Share:

▪ The information you’ve learned about the person with other workers who’ll be assisting the person.

Appendix G: HIPPA References

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Completed On-Line – Applicant information downloaded into Special Needs Registry database

Completed Paper and mailed in

Special Needs Registry Application

Email Notification Sent to Emergency Management

Emergency Management Receives

Instance Email Verification Receipt sent to Applicant

EM sends applicant letter confirming receipt of letter

EM and PH convene Review Team

Application Denied

Additional Information Needed

EM sends out letters and other resources

Application Approved – Level assigned

EM updates registry

Review Team member contacts applicant for additional info

[pic]

Polk County Special Needs Registry

1005 West Main, Ste 900

Balsam Lake, WI  54810

Phone Number: 715-485-9280

Fax Number: 715-485-8315



Sponsored by the Polk County Departments of Emergency Management, Public Health, Human Services, Aging, and Veterans Affair

[pic]

Polk County Special Needs Registry

1005 West Main, Ste 900

Balsam Lake, WI  54810

Phone Number: 715-485-9280

Fax Number: 715-485-8315



[pic]

[pic]

Polk County Special Needs Registry

1005 West Main, Ste 900

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Balsam Lake, WI  54810

Phone Number: 715-485-9280

Fax Number: 715-485-8315



[pic]

Polk County Special Needs Registry

1005 West Main, Ste 900

Balsam Lake, WI  54810

Phone Number: 715-485-9280

Fax Number: 715-485-8315



Sponsored by the Polk County Departments of Emergency Management, Public Health, Human Services, Aging, and Veterans Affair

What will you do during an emergency or disaster? Do you have a plan? Who will you call? Are you prepared to be on your own for 3 days?

Polk County Special Needs Registry

1005 West Main, Ste 900

Balsam Lake, WI  54810

Phone Number: 715-485-9280

Fax Number: 715-485-8315



Sponsored by the Polk County Departments of Emergency Management, Public Health, Human Services, Aging, and Veterans Affair

Sponsored by the Polk County Departments of Emergency Management, Public Health, Human Services, Aging, and Veterans Affair

For more information about the

Polk County Special Needs Registry

Visit the Polk County Emergency Management Website at co.polk.wi.us/emgt or call the

Emergency Management Office at (715)485-9280

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