Hurricane Katrina and People with Disabilities

As you know Hurricane Katrina wrecked enormous havoc on the Gulf Coast area. Much has been reported about the devastation and destruction in both property and human lives. What has been often missing in the reports is the toll the hurricane has had on people with disabilities and the response to their needs.

DAWN doesn't typically report on disability issues in others states, but this is a special circumstance that we thought you would want to know.

The following is an edited email from Justice For All that describes what the relief effort has been by the federal government and by the disability community. It offers suggestions for what you can do to help, as well as useful resources:

From: Justice For All Moderator
Date: 9/8/05 8:39AM
Subject: NCD's 9/7/05 Advisory on Hurricane Katrina

National Council on Disability on Hurricane Katrina Affected Areas September 7, 2005

In the aftermath of Hurricane Katrina, people with disabilities have unique needs that must be surveyed and responded to immediately. In order to evacuate the large number of survivors from the New Orleans area, as well as from other areas of Louisiana, Mississippi and Alabama, people with disabilities were often forced to abandon their wheelchairs, walkers and other medical equipment. People who are blind, who may no longer have a service animal or cane to help them navigate, will require assistance in navigating a new environmental landscape. People who are deaf or hard of hearing will need visual access to emergency information. People in need of personal assistance services may now no longer have access to such services both as the result of separation from attendants during the evacuation process or due to not knowing how to obtain and fund the cost of qualified individuals in the locations where they now find themselves and, consequently, nursing home care in an institutional setting is often seen as the only remaining viable alternative to living in shelters. People with mental health needs, whose access to treatment and medications may have been disrupted, are in critical need of treatment and/or medication. In addition, mental illness symptoms are often exacerbated in times of crisis, and many individuals, even those not directly affected by the hurricane, may need assistance in identifying and accessing available resources.

The Federal Government's Response

The Federal Emergency Management Agency (FEMA) has set up a registration process for people with disabilities and chronic health care needs, and every hurricane survivor with a disability must register to be able to receive the full range of federal disaster relief assistance. See <https://disasterhelp.gov/portal/jhtml/index.jhtml> or call toll-free 1-800-621-3362 or 800-462-9029 or TDD/TTY 800-462-7585.

The Food and Nutrition Service, run by the US Department of Agriculture, has taken several actions to expedite and facilitate the Food Stamp enrollment and receipt for evacuees of Hurricane Katrina in their destination states, as identified on the webpage found at: <http://www.fns.usda.gov/fns/>. This site's "Newsroom" section provides the latest efforts to date.

The US Department of Health and Human Services (HHS) has set up a waiver between all the states housing hurricane survivors who were already receiving Medicaid to have their Medicaid accepted in their current location. HHS has also set up an expedited process for Medicaid eligibility for those who may not be eligible due to their hurricane related situation. The Centers for Medicare and Medicaid Services are also offering the following relief immediately:

• Health care providers that furnish medical services in good faith, but who cannot comply with normal program requirements because of Hurricane Katrina, will be paid for services provided and will be exempt from sanctions for noncompliance, unless it is discovered that fraud or abuse occurred.
• Crisis services provided to Medicare and Medicaid patients who have been transferred to facilities not certified to participate in the programs will be paid.
• Programs will reimburse facilities for providing dialysis to patients with kidney failure in alternative settings.
• Medicare contractors may pay the costs of ambulance transfers of patients being evacuated from one health care facility to another.
• Normal prior authorization and out-of-network requirements will also be waived for enrollees of Medicare, Medicaid or SCHIP managed care plans.
• Normal licensing requirements for doctors, nurses and other health care professionals who cross state lines to provide emergency care in stricken areas will be waived as long as the provider is licensed in their home state.
• Certain HIPAA privacy requirements will be waived so that health care providers can talk to family members about a patient's condition even if that patient is unable to grant that permission to the provider.
• Hospitals and other facilities can be flexible in billing for beds that have been dedicated to other uses, for example, if a psychiatric unit bed is used for an acute care patient admitted during the crisis.
• Hospital emergency rooms will not be held liable under the Emergency Medical Treatment and Labor Act (EMTALA) for transferring patients to other facilities for assessment, if the original facility is in the area where a public health emergency has been declared.

More information about CMS emergency relief activities, including a detailed explanation of billing and payment policy revisions, and phone numbers for the state medical assistance offices can be found at <http://www.cms.hhs.gov/>. Frequently asked questions and their answers on the site will be updated daily by 2 pm. In addition, members of the Interagency Coordinating Council (ICC) on Emergency Preparedness and Individuals with Disabilities, a federal interagency group led by the Department of Homeland Security, participated in a conference call with consumer organizations to identify the most immediate needs of hurricane victims with disabilities, and have fielded comments and inquiries about surfacing problems.

* HHS and HUD have each established toll free hotlines. HUD has established a single toll-free number (1-888-297-8685) to help disaster victims with all housing concerns. Assistance is available from 7 a.m. to 8 p.m., CST, seven days a week. HHS has established a crisis hotline for people in crisis in the aftermath of Hurricane Katrina. By dialing toll-free 1-800-273-8255, callers will be connected to a network of local crisis centers across the country that are committed to crisis counseling. Callers to the hotline will receive counseling from trained staff at the closest certified crisis center in the network.

The Disability Community's Response

The disability community has mobilized to provide its expertise in assisting with the response to the disaster. Among many things, the community has organized several conference calls, directly assisted survivors on the ground, engaged in fundraising efforts, advised governmental entities, developed workgroups for follow up actions, and established informational websites. While the strength and unity of the disability community's response has played a critical role in disaster recovery, the full force of their assistance has been hampered by the lack of relief organizations' coordination with community leaders in the provision of clear and systemic communications, independent funding and resource support and not fully including disability experts in the development and implementation of assistance and recovery plans. Below are a few examples of the actions and information dissemination of the disability community:

• A web site at: <http://www.katrinadisability.info/> has been set up to provide information to people with disabilities and their families who have been affected by Hurricane Katrina. New information and resources will be added as it becomes available, so people should visit often for information and updates.
• California's Independent Living Centers, which are community-based non-profit organizations serving people with disabilities of all ages, have offered to serve as the collection points for new or used items to be delivered to the survivors who are disabled. "We know that many people who receive new replacement equipment, or recover from an injury or illness, keep the older items in case they're ever needed," according to Michael Collins of the State Independent Living Council in Sacramento, "The items gathering dust in garages and storage units around the state could make a real difference to a survivor who cannot move without assistance at a shelter." Since many people who are elderly, and children, need replacement items too, it is hoped that the agencies serving such age groups will join in the California collection drive. For anyone who would prefer to donate money that will assist local disability organizations in the Southeast, the California Foundation for Independent Living Centers is also
  accepting such donations at www.cfilc.org.
  
  Because the deliveries of donated goods need to be coordinated with a local organization capable of temporary storage and effective delivery to the people who really need the equipment and supplies, it is being requested that advance contact be made with a recipient agency near the shelter sites. California's Independent Living Centers have made those contacts, and will coordinate shipment of the needed items. To find the location of the nearest Independent Living Center or community collection drive, call the State Independent Living Council at 1-866-866-7452 or view the address at: <www.calsilc.org>.
• The National Council on Independent Living (NCIL) is organizing a Katrina Disaster Relief Fund. This fund will be used over the long-haul to assist the effected independent living centers in rebuilding and gearing-up to meet the extraordinary demands that they are going to receive from people with disabilities in the their areas. Monetary donations only of whatever amount you can afford will be accepted to NCIL: Katrina Disaster Relief Fund and mail to the NCIL office at 1916 Wilson Blvd., Suite 209, Arlington, VA 22201.
• United Cerebral Palsy Association (UCP) has set up an emergency hotline for UCP of New Orleans. Concerned consumers and their families, employees and volunteers can call toll-free 1-800-872-5827 to receive information, as well as leave messages about their personal status.
  
  Additionally, United Cerebral Palsy has set-up a Hurricane Katrina Disaster Relief Fund to provide services to people with disabilities affected by hurricane Katrina and assist UCP affiliates throughout the region in restoring their operations as quickly as possible. Members of the public, who are able to help, are encouraged to make an online donation at: <www.ucp.org>.
• The National Alliance on Mental Illness (NAMI) is providing a resource guide and a Katrina Hurricane Relief Fund to assist consumers and families affected by the hurricane. Included in this resource: How NAMI is responding to the tragedy as it relates to people with serious mental illness, NAMI's Hurricane Katrina Message Board, NAMI's email alerts, Resources and Links to support and information specific for people living with mental illness and their families at this website or call toll-free 1-800-950-6264.
• The Spina Bifida Association (SBA) has a Hurricane Emergency Life-Support Program including working with industry to secure essential equipment, working with its chapters to distribute supplies when the infrastructure in the region has been restored, and develop an Emergency Preparedness program for future emergency situations. Also links to SBA Chapter and Clinic Lists at: <http://www.sbaa.org/site/PageServer?pagename=campaign_SBA_HELP> or call toll-free 1-800-621-3141.
• TASH (serving persons with severe disabilities) has put together the following information for TASH members and colleagues regarding efforts to assist disability related organizations and individuals with disabilities and their families in the Gulf States and the states receiving refugees from the storm and floods. TASH will be updating this page with additional information as we receive it at: <http://www.tash.org/katrinainfo.htm> or call 410-828-8274.
• The National Spinal Cord Injury Association (NSCIA) has distributed "Ways to Support Disability Related Relief Efforts for Hurricane Katrina." They include links for information, organizations, and assistance on a web site at: <http://www.spinalcord.org/news.php?dep=1&page=0&list=601> or call toll-free 1-800-962-9629.