An Assessment of Seniors and Public Health Preparedness in Idaho’s North Central District

1. An Assessment of Seniors and Public Health Preparedness in Idaho’s North Central District Kristin Ungos, RN April 3, 2008

2. Why the emphasis on Special Needs Populations? • In emergencies, they need special planning and considerations • It is part of federal contractual requirements

3. The Questions • Where are the seniors in our District? • In a public health emergency, how can we reach them… • With health messages? • With services like immunizations?

4. Seniors in District 2 • About 15,000 seniors (15% of population) live in the five counties • Age 65-74 = 51% • Age 75-84 = 36% • Age 85 and over = 14%

5. Population over the age of 65 (2005/2006 census estimates)

6. Seniors in District 2 • Where are they? • Overall, 40% of the District population lives rurally, but there are wide variations

7. Seniors in District 2 • What are they like? • 8% live in residential facilities (1,200 total) • 28% live alone (3,800 total) • Over 5,600 have at least one disability • Physical • Sensory • Going outside the home • Mental • Self-care • Nationally, 92% use at least one prescription medication

8. Potential Resources • Health Department Public Health Preparedness Plan • Mobile treatment centers • Ability for families to pick up multiple treatment regimens for home-bound members

9. Potential Resources • Reverse 911 • Available (or coming soon) in Nez Perce and Clearwater Counties • Not available in Idaho, Latah, or Lewis Counties • Prison call system in Idaho County • Lewiston Police Department • “Are You OK?” • Serves Nez Perce and Asotin Counties

10. Potential Resources • Home Care and Residential Care • Over 35 agencies provide care for almost 2,500 seniors (16%) • These are only Idaho agencies; some may receive care from Washington agencies

11. Senior Care Agencies

12. Potential Resources • Community Directory • Transportation • Nutrition Caution in planning with these resources • Area Agency on Aging

13. Future Possibilities • Geographic Information Systems (GIS) • Used for mapping physical structures, potential vulnerabilities, etc. • Examples: Red Zone, Bullberry • Recent increase in mapping people • Free software is available

14. Future Possibilities: GIS • Two types of population mapping • General demographics • Based on census data • Identifies areas that have the highest concentration of vulnerable groups • Specific people • Using a voluntary registry or other method to pinpoint location of person with special-needs • Issues: voluntary or not; confidentiality

15. Future Possibilities • Special-needs Registry • Voluntary registration via internet or paper application • Generally limited to fragile elderly or those with medical needs • Unable to evacuate independently • Unable to stay home alone for up to three days • Need special notification due to disability (vision, hearing) • Gaining popularity all over the U.S. • Florida requires each county to have one

16. Uses of Registries • To conduct pre-emergency outreach • To notify participants of impending disasters • To assist in evacuations • To plan for special-needs shelters

17. Future Possibilities: Registry • Issues with special-needs registries • Funding and Staffing • Maintenance • Deciding eligibility • Confidentiality and security of information • False sense of safety (for registrants) • Limited resources for responding = no guarantee that help will come

18. Location of Registries • Emergency Managers or County Sheriff • Occasionally with City Police or EMS Agency • Occasionally two counties will share • Area Agency on Aging

19. Example of Disclaimer I agree to release the information contained in this application to agencies involved in Emergency Response and Planning. I understand that registering does not guarantee that I will be evacuated or receive emergency services in a disaster, and that I should still call 911 if I am in a life threatening situation. NOTE: Every effort will be made to keep your information confidential. In a declared state of emergency, it maybe necessary to release this information to State and Federal agencies coordinating disaster response.

20. Another Disclaimer Because the Disaster Registry Program relies on the availability of volunteer responders, the DRP does not provide a guaranteed timely response! Registering with the DRP should be done along with other preparedness activities. All citizens are encouraged to be self sufficient for at least 72 hours including food, water and medications with the assumption that all public utilities will not be available.

21. Confidentiality Issues • HIPAA • Applies only to “covered entities” • Covered entities can share information with official disaster relief organizations • The American Red Cross is not under HIPAA • Emergency Managers and law enforcement are not under HIPAA • Other solutions • San Francisco requires hard-copy with signature

22. Resources • San Francisco Registry Website • http://www.sanfranciscoems.org/index.php?cat=no&name=drpForms&exten=html • Josephine County, Oregon – Registry Website • http://josephine.or.networkofcare.org/aging/ver/frm_ver.cfm • National Organization on Disability – Emergency Preparedness Guide • http://www.nod.org/resources/PDFs/epiguide2005.pdf

23. Key to success • Key to successful management of the elderly population’s needs in a disaster: Communication!