Children and Emergencies Briefing

Mother Nature and Children – A Recipe for DisasterGuidance and Resources for Addressing the Unique Needs of Children

OBJECTIVES

Workshop Objectives

• Share recommendations from the National Commission on Children and Disasters

• Explore successful implementation activities at the child, school and community levels

• Discuss maximizing limited resources

• Present various ways to connect with child-focused stakeholders in the community

• Provide information on best practices and planning tools

Children in Emergencies

Framing the Topic

• In the U.S., children under 18 represent 25% of the total population

• Estimated 27.8% or 7,149,062 children under 18 years old in Texas

• Estimated 24% or 1.5 million of children under 18 are in poverty in Texas

Where are children on a “normal” day?

• School

• Child Care

• Out of school program – Before/after school, camp

• At home

• Informal care

• Foster care

• Juvenile justice facility

Those most vulnerable

• Vulnerable children and families are most likely to end up in mass care shelters

• Few resources and social networks

• Low socioeconomic status (SES) makes children and families more vulnerable to a variety of disaster consequences

Children’s Unique Needs in Emergencies

Children are not just “little adults.” They have unique areas of need that must be addressed to ensure their safety and well-being:

Physical needs for protection vary greatly by age group

At higher risk for long-term mental health consequences

Dependent on guardians for protection, food, clothing, shelter, learning/development

National Progress for Children

Independent: Authorized by Congress in 2007 under Federal law; not tied to any agency

Bipartisan: 10 members appointed by President, Senate and House leaders

Diverse: Expertise drawn from several disciplines: pediatrics, state and local emergency management, non-governmental organizations, and state elected office

National Commission on Children and Disasters (NCCD)

NCCD Final Reportwww.childrenanddisasters.acf.hhs.gov

NCCD: Overarching Findings

Children = 25% of the population, but…

Placed into broad categories: “at-risk” “vulnerable” or “special needs” populations; annexes

Unique needs unaddressed or misunderstood

Homeland Security Grant $$: training, exercising, equipment directed to child-focused projects limited

Recovery $$: rebuilding infrastructure, not lives

NCCD Core Planning Principles

Integrate children across all phases of emergency management

Designate a lead agency and individual for coordinating children’s needs

Build on existing capabilities and requirements

Adopt “whole community” approach: Federal, state, local, non-profit, private sector, parents, children

Encourage relationship building and cooperation prior to incidents

Require accountability: institute goals and monitor progress

monitoring measures

Mass Care - Recommendations

National Standards and Indicators for Children in Mass Care Emergency Shelters Children sheltered with families or caregivers Designate area for families Temporary respite care for children

Shelter Supply List for Infants and Toddlers Identifies basic supplies necessary to sustain and

support 10 infants and children <4 years of age for a 24 hour period

Formula, baby food, diapers, feeding bottles, cribs

Child Physical Health and Trauma - Recommendations

Access to/distribution of pediatric MCM

Build pediatric medical capabilities of response teams through specific training, supplies, personnel

Provide pediatric disaster clinical training for health care professionals who may treat children during an emergency

Ensure hospital Emergency Departments provide effective care for children

Expedite recovery of pediatric health and mental health care delivery systems in disaster-affected areas

NCCD: Mental and Behavioral Health

Integrate mental and behavioral health for children into emergency plans

Enhance pediatric disaster mental and behavioral health training for professionals and paraprofessionals

Support long-term disaster-related mental health treatment for children

• National Commission on Children and Disasters– Publications Includes Appendix E:

“Supplies for Infants and Toddlers in Mass Care Shelters and Emergency Congregate Care Facilities”

– Recommendations to Governors

• Federal Emergency Management Agency (FEMA)– Children’s Working Group– CPG 101 Version 2.0– 2012 HSGP Supplemental Guidance on

Children

National Progress for Children

National Progress for Children and the Child Care Community

• Save the Children 4th Annual Report– Focuses on the ability of schools and child care facilities to protect the

67 million kids in their care on any given day across the nation– Only 17 states meet our four minimal requirements

• Save the Children / NACCRRA– Protecting Children in Child Care During Emergencies: Recommended

State and National Regulatory and Accreditation Standards for Family Child Care Homes and Child Care Centers

• Administration for Children and Families– Guidance to assist Child Care and Development Fund (CCDF) Lead

Agencies in developing, exercising, and maintaining written child care emergency preparedness and response plans pursuant to submission of the CCDF Plan.

• Federal Emergency Management Agency– Public Assistance Fact Sheet 9580.107 identifies child care services

eligible under Category B, Emergency Protective Measures– Emergency Sheltering Costs, Temporary Relocation, Repair, Restoration

or Replacement

National Standards & Indicators for Mass Care

Standards and Indicators for Disaster Shelter Care for Children (ARC) Temporary Respite Care for Children

Shelter Guidance (STC) Low Cost and No Cost Guidance to mitigate risks

Counting Children Family dormitory areas Private breastfeeding area for women

Mega Shelter Planning Guide (IAVM and ARC)

Additional National Change

The Assessment Process:

Strengths, Gaps and Opportunities

State Assessment Example

• Assess the needs of children across all four phases of the emergency management

• Evaluate policies, programs, and regulations• Identify gaps and lessons learned• Compile a comprehensive report for the

governor– Gap analysis – process, findings, critical risks– Low Cost / No-Cost Opportunities

State Assessment Example

Based on NCCD Report and Best Practice Guidance

–Three Working Groups• Pediatric Medical Group• Human Services• Emergency Management

–65 Planning gaps

–Prioritized top 3 and identified cost

Pediatric Medical CareWorking Group Stakeholders

• State Level, Hospital and Pre-hospital

• Leadership group: – Dept. of Public Health– Children’s Hospitals– American Academy of Pediatrics

• Focus group– Local emergency management– University School of Public Health– Emergency Medical Services

Pediatric Medical CareWorking Group Efforts

• State, regional and local plans for pediatric surge (including transport)

• Inventory of pediatric health care specialists• Stockpile with pediatric counter measures• Children included in MA emergency

operations base plans• Mapping and inventory of pediatric resources

in the state. GIS location of children• Critical care Transport: altered standards of

care

PRE-HOSPITAL

• Followed EMSC requirements – most were in place

• Gaps: – off-line medical direction– No pediatric designation– Pediatric education not required– MCI plan to include children– EMS pediatric triage– EMS tracking and reunification

capabilities– Regional pediatric coordinator

HOSPITALS

• Major gap- State capabilities for pediatric medical care for disasters as well as day to day care unknown

• Areas to explore: pediatric ICU/floor beds; hospital pediatric subspecialty capabilities; tracking and reunification

Pediatric Medical Care(4 of 36)

1. Mechanism to request and share medical records for reunification. Cost - No Cost

2. Mandating pediatrics education for pre-hospital providers. Cost – Minimal Cost

3. Conduct analysis of pediatric capabilities for each hospital. Cost - Minimal cost

4. Regional Pediatric Coordinator. Cost - Considerable Cost

Human Services(3 of 11)

1. Basic pediatric disaster mental and behavioral healthtraining required for health care professionals, school personnel, child care, and early education providers.

2. No mechanisms exist currently to share records among federal, state or local partners.

3. Require specific activities for identifying children in the event of a disaster, and to require that foster homes have an emergency plan.

Emergency Management (3 of 19)

1. Identify all local child-serving environments. No Cost

2. Provide training, guidance and Exercise opportunities at the local level, with focus on child-serving environments (including shelters). Moderate cost

3.Hire Child Services Coordinator Considerable Cost

PREPAREDNESS – RESPONSE - RECOVERY: Changing the Way Communities

Protect Children in Disasters

San Antonio: Targeted RRC

Who: San Antonio Office of Emergency Management

What: Children in Emergencies Appendix to Annex C (Mass Care)

How: Created a Children in Emergencies Working Group comprised of partners from the public, private, and non-governmental sectors to strategize and implement best practices during sheltering operations in the San Antonio urban area.

Captain Frank XiquesCaptain Eric Jones

Lt Jim ReidyLt Dean Watson

Engineer Brandon Murray

Pre-planning

Site Acquisition

Shelter Operations

Shelter Branch Team begins with meetings to identify lessons learned and objectives for current season Usually begin this planning in February Here we discuss and develop plans to implement

in our shelters that will allow us to meet the needs of the children entrusted to us

Push-Packs are developed, inventoried and placed at-the-ready in our warehousing space Extensive inventory lists are readied for immediate

ordering Local child-care agencies and stakeholders groups

are consulted or invited to assist us in our planning and preparations

Here you must consider the potential needs of the children that will be in your shelters Ability to provide security in areas that children

will occupy Adequate indoor and outdoor recreation areas

available on site Ability to provide “quiet” areas that will be

needed to help deal with the stresses that accompany an evacuation of one’s home

Easy access for families and children between service areas

Considerations: Separate play and respite areas

Indoor and outdoor Family shower time scheduled Child-friendly entertainment provided Adequate, and easily accessible, restrooms for

children and families to use with an abundance of hand washing stations

Pre-identifying, and early ordering, of anticipated equipment and supplies that will be needed Key here is to forecast and stay ahead of the

curve on what will be needed

Supplies needed for infants, toddlers and children

Assembled into our push-packs our warehouse space

Immediately available upon opening of any shelter

Considerations: Staffing of child-friendly play and respite areas

These areas must be monitored while in use Develop a plan early to address the medical,

psychological, emotional and dental needs of the children Coordinate closely with partnering agencies and

local Health Department to ensure this is provided for

Anticipate and plan for different dietary needs of infants, toddlers and children Again, coordinate closely with partnering

agencies to ensure this

Considerations: Safety and

security Work closely with

partnering agencies and local law enforcement to ensure access control of shelter is in place and monitoring of children-occupied areas is ongoing

Considerations: Professional, certified and credentialed formal

child-care program As the population of the shelter grows, so will

your need for extended and diverse child-care equipment, supplies and services This may exceed your local capabilities

Anticipate the need for this early Utilize ordering process (STAR – State of Texas

Assistance Request) and identify your needs Be very specific as to what it is you want to

accomplish and how many children are under your care

Save the Children Organization www.savethechildren.org

CHILDREN IN DISASTERS GUIDANCE – FEMA www.fema.gov/pdf/government/grant/2012/

fy12_hsgp_children.pdf

Policy Change and PracticeState of Connecticut

Advisory Council and Policy Change

• Moved CT from an “F” to an “A”

Governor of Connecticut Signing Emergency Preparedness Bill(SB 983) Championed by Save the Children

Child Care Preparedness Training

• Trained more than 350 providers (7,000 children)

Translating National Standards and Best Practices to Reality at the Local Level.

Building Community CapacityThe Gulf Coast

Fostering life long partnerships – Beginning, Building, Sustaining.

Community Meeting – New Orleans

• Initiated dialogue and strengthened networks around child-focused issues

TA & Trainings - Coastal Mississippi

• Partnerships with the American Red Cross leverages resources and expands reach

Training and Implementation Houston, Texas

Resilient and Ready Workshop• More than 1,000 children in 2011

Child-Friendly Space Training•Training with Texas State Guard

Impacting Children, Caregivers and Communities through training and implementations.

Response

Child-Friendly Spaces - AmeriCorps NCCC in American Samoa

Journey of Hope – SC New Zealand

What You Can Do

Suggested Child-Focused Checklist

Emergency Planning and Training Include needs of children across emergency

planning, training and exercises

Designate individual as children’s needs coordinator

Provide staff with briefings on children’s unique needs and how they can protect and support children in their role

Steps Forward

Make it a priority to improve emergency planning/response to meet the needs of children

Review and share guiding documents – CIE Resource List

Contact Save the Children to set up briefings or trainings for your organization’s personnel and volunteers

Get Children Involved!

Questions? Comments?

Save the Childrenwww.savethechildren.org

1-800-728-3843

Kate Dischino, C.E.M.Deputy Director of Texas Programs

203-551-0945, kdischino@savechildren.org

Thank you!Thank you!