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

An Assessment of Seniors An Assessment of Seniors and Public Health and Public Health

Preparedness in Idaho’s Preparedness in Idaho’s North Central DistrictNorth Central District

Kristin Ungos, RNKristin Ungos, RN

April 3, 2008April 3, 2008

Why the emphasis on Special Why the emphasis on Special Needs Populations?Needs Populations?

In emergencies, they need special In emergencies, they need special planning and considerationsplanning and considerations

It is part of federal contractual It is part of federal contractual requirementsrequirements

The QuestionsThe Questions

Where are the seniors in our District?Where are the seniors in our District? In a public health emergency, how In a public health emergency, how

can we reach them…can we reach them… With health messages?With health messages? With services like immunizations?With services like immunizations?

Seniors in District 2Seniors in District 2

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

Population over the age of Population over the age of 65 65

(2005/2006 census estimates)(2005/2006 census estimates)

CountyCounty NumberNumber PercentagePercentage

ClearwaterClearwater 1,5651,565 19%19%

IdahoIdaho 2,8212,821 18%18%

LatahLatah 3,4333,433 9%9%

LewisLewis 789789 21%21%

Nez PerceNez Perce 6,5156,515 17%17%

Seniors in District 2Seniors in District 2 Where are they?Where are they?

Overall, 40% of the District population lives rurally, but Overall, 40% of the District population lives rurally, but there are wide variationsthere are wide variations

Percent of Population Classified as Rural

40%

56%

80%

38%

100%

17%

District 2 Clearwater Idaho Latah Lew is Nez Perce

Seniors in District 2Seniors in District 2 What are they like?What are they like?

8% live in residential facilities (1,200 total)8% live in residential facilities (1,200 total) 28% live alone (3,800 total)28% live alone (3,800 total) Over 5,600 have at least one disabilityOver 5,600 have at least one disability

PhysicalPhysical SensorySensory Going outside the homeGoing outside the home MentalMental Self-careSelf-care

Nationally, 92% use at least one Nationally, 92% use at least one prescription medicationprescription medication

Potential ResourcesPotential Resources

Health Department Public Health Health Department Public Health Preparedness PlanPreparedness Plan Mobile treatment centersMobile treatment centers Ability for families to pick up multiple Ability for families to pick up multiple

treatment regimens for home-bound treatment regimens for home-bound membersmembers

Potential ResourcesPotential Resources

Reverse 911Reverse 911 Available (or coming soon) in Nez Perce and Available (or coming soon) in Nez Perce and

Clearwater CountiesClearwater Counties Not available in Idaho, Latah, or Lewis CountiesNot available in Idaho, Latah, or Lewis Counties

Prison call system in Idaho CountyPrison call system in Idaho County Lewiston Police Department Lewiston Police Department

““Are You OK?”Are You OK?” Serves Nez Perce and Asotin CountiesServes Nez Perce and Asotin Counties

Potential ResourcesPotential Resources

Home Care and Residential CareHome Care and Residential Care Over 35 agencies provide care for Over 35 agencies provide care for

almost 2,500 seniors (16%)almost 2,500 seniors (16%) These are only Idaho agencies; some These are only Idaho agencies; some

may receive care from Washington may receive care from Washington agenciesagencies

Senior Care AgenciesSenior Care Agencies

Type of Type of AgencyAgency

Number of Number of AgenciesAgencies

Number of Number of People People ServedServed

Home HealthHome Health 1010 11231123

Independent Independent or Assisted or Assisted LivingLiving

1010 622622

Skilled Skilled NursingNursing 99 549549

HospiceHospice 44 2525

Other (not Other (not AAA)AAA)* * Lifeline; adult day Lifeline; adult day healthhealth

22 140140

Potential ResourcesPotential Resources

Community DirectoryCommunity Directory TransportationTransportation NutritionNutrition

Caution in planning with these resourcesCaution in planning with these resources

Area Agency on AgingArea Agency on Aging

Future PossibilitiesFuture Possibilities

Geographic Information Systems Geographic Information Systems (GIS)(GIS) Used for mapping physical structures, Used for mapping physical structures,

potential vulnerabilities, etc.potential vulnerabilities, etc. Examples: Red Zone, BullberryExamples: Red Zone, Bullberry

Recent increase in mapping peopleRecent increase in mapping people Free software is availableFree software is available

Future Possibilities: GISFuture Possibilities: GIS

Two types of population mapping Two types of population mapping General demographicsGeneral demographics

Based on census dataBased on census data Identifies areas that have the highest Identifies areas that have the highest

concentration of vulnerable groupsconcentration of vulnerable groups Specific peopleSpecific people

Using a voluntary registry or other method to Using a voluntary registry or other method to pinpoint location of person with special-needspinpoint location of person with special-needs

Issues: voluntary or not; confidentialityIssues: voluntary or not; confidentiality

Future PossibilitiesFuture Possibilities Special-needs RegistrySpecial-needs Registry

Voluntary registration via internet or paper Voluntary registration via internet or paper applicationapplication

Generally limited to fragile elderly or those Generally limited to fragile elderly or those with medical needswith medical needs

Unable to evacuate independentlyUnable to evacuate independently Unable to stay home alone for up to three Unable to stay home alone for up to three

daysdays Need special notification due to disability Need special notification due to disability

(vision, hearing)(vision, hearing) Gaining popularity all over the U.S.Gaining popularity all over the U.S.

Florida requires each county to have oneFlorida requires each county to have one

Uses of RegistriesUses of Registries

To conduct pre-emergency outreachTo conduct pre-emergency outreach To notify participants of impending To notify participants of impending

disastersdisasters To assist in evacuations To assist in evacuations To plan for special-needs shelters To plan for special-needs shelters

Future Possibilities: RegistryFuture Possibilities: Registry

Issues with special-needs registriesIssues with special-needs registries Funding and StaffingFunding and Staffing MaintenanceMaintenance Deciding eligibilityDeciding eligibility Confidentiality and security of informationConfidentiality and security of information False sense of safety (for registrants)False sense of safety (for registrants) Limited resources for responding = Limited resources for responding =

no guarantee that help will comeno guarantee that help will come

Location of RegistriesLocation of Registries

Emergency Managers or County Emergency Managers or County SheriffSheriff Occasionally with City Police or EMS Occasionally with City Police or EMS

AgencyAgency Occasionally two counties will shareOccasionally two counties will share

Area Agency on AgingArea Agency on Aging

Example of DisclaimerExample of DisclaimerI agree to release the information contained in this I agree to release the information contained in this

application to agencies involved in Emergency application to agencies involved in Emergency Response and Planning.Response and Planning.

I understand that registering does not guarantee I understand that registering does not guarantee that I will be evacuated or receive emergency that I will be evacuated or receive emergency services in a disaster, and that I should still call services in a disaster, and that I should still call 911 if I am in a life threatening situation.911 if I am in a life threatening situation.

NOTE: Every effort will be made to keep your NOTE: Every effort will be made to keep your information confidential. In a declared state of information confidential. In a declared state of emergency, it maybe necessary to release this emergency, it maybe necessary to release this information to State and Federal agencies information to State and Federal agencies coordinating disaster response.coordinating disaster response.

Another DisclaimerAnother Disclaimer

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

Confidentiality IssuesConfidentiality Issues

HIPAAHIPAA Applies only to “covered entities” Applies only to “covered entities” Covered entities can share information with Covered entities can share information with

official disaster relief organizationsofficial disaster relief organizations The American Red Cross is The American Red Cross is notnot under HIPAA under HIPAA Emergency Managers and law enforcement are Emergency Managers and law enforcement are

not under HIPAAnot under HIPAA Other solutionsOther solutions

San Francisco requires hard-copy with signatureSan Francisco requires hard-copy with signature

ResourcesResources

San Francisco Registry WebsiteSan Francisco Registry Website http://www.sanfranciscoems.org/index.php?cat=no&http://www.sanfranciscoems.org/index.php?cat=no&

name=drpForms&exten=htmlname=drpForms&exten=html

Josephine County, Oregon – Registry Josephine County, Oregon – Registry WebsiteWebsite http://http://

josephine.or.networkofcare.org/aging/ver/frm_ver.cfjosephine.or.networkofcare.org/aging/ver/frm_ver.cfmm

National Organization on Disability – National Organization on Disability – Emergency Preparedness GuideEmergency Preparedness Guide http://www.nod.org/resources/PDFs/epiguide2005.pdhttp://www.nod.org/resources/PDFs/epiguide2005.pd

ff

Key to successKey to success

Key to successful management of the Key to successful management of the elderly population’s needs in a elderly population’s needs in a disaster:disaster:

Communication!Communication!