Dynamic Community Partnerships with Disability Stakeholders – Practical Approaches to Engagement with Emergency Management, Public Health, and VOADs EnableUS.

Dynamic Community Partnerships with Disability Stakeholders –

Practical Approaches to Engagement with Emergency Management, Public Health, and VOADs

EnableUS Conference - Philadelphia - September 2009

Maggie Kare-Elestwani, RN ● Lex Frieden

Texas Collaborative for People with Disabilities

Dynamic Community Partnerships with Disability Stakeholders

Over a long distance, you learn about the strength of your horse; over a long time, you learn about the character of your friend.

-Asian Proverb

If we are together nothing is impossible.

-Winston Churchill


Humanitarian Response to Complex Geographic Settings (HRCGS)

Novel Influenza A (H1N1) – the Challenge A (H1N1) and the Disability Connection -

Wellness and Health A (H1N1) At-Risk Disability Overlap A (H1N1) Personal and Community Preparedness and

Response Essential Collaboration – Initiatives and Reports Dynamic Community Partnerships

Outline


Novel A (H1N1) -

Where are we on the HRCGS all hazards map?

Humanitarian Response in Complex Geographic Settings(HRCGS), (Elestwani, 2008)

All Hazards Threat Cascades

Tactical Response Filter

Population Filter-Dynamic Location-Demographics-Dynamic Wellness and Health Status-Logistics/Network

Collaborative Command

& Control –

NRF/NIMS

Complexity/ Human Factors Filter(Deconstruction of Murphy’s Law)

Includes: Emergence – Competition & Cooperation – Pattern Formation including Self-organizing Behavior, Scale of Complexity – Interdependence – Scale of Behavior by individual/group/agency, Complexity Description, Evolution (change over time, i.e., hierarchical, horizontal, strike team, self& immediate group)

Collaborative, Integrated Incident Response

=Temporary partial to complete support of Med CI

with components 1-8

* Pre-existing Unified Command

Medical CI

Expanding Incidents):

Geo/ Time/ Threat/

Response


http://www.cdc.gov/H1N1FLU/

Novel Influenza A (H1N1) – the Challenge


Novel Influenza A (H1N1) – Illness/ Morbidity

Percentage of Visits for Influenza-like Illness (ILI) Reported by the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet), National Summary 2008-2009 and Previous Two Seasons

(Posted August 28, 2009, 6:00 PM ET, for Week Ending August 22, 2009)


Total U.S. 2009 H1N1 Flu Hospitalizations and DeathsPosted September 4, 2009, 11:00 AM ETData reported to CDC by September 3, 2009, 9:00 AM ET

Reporting States and Territories*53

Hospitalized Cases 9,079

Deaths593

*Includes the District of Columbia, American Samoa, Guam, Puerto Rico and the U.S. Virgin Islands.

The number of hospitalized 2009 H1N1 cases and deaths presented in this table are an aggregateof reports received by CDC from U.S. states and territories and will be updated weekly eachFriday at 11am. For state level information, refer to state health departments.

Novel Influenza A (H1N1) – Hospitalizations and Deaths/ Mortality


Healthy People 2010 Objectives for People with Disabilities

http://www.cdc.gov/ncbddd/dh/hp2010.htm

H1N1 Disability Connection - Wellness


Medicare Adult Diagnoses Medicare Pediatric Diagnoses CSHCN Diagnoses

H1N1 Disability Connection – Primary Conditions


A generally understood and clinically applicable definition of secondary conditions is still in development.

Secondary conditions have been defined as "Those physical, medical, cognitive, emotional, or psychosocial consequences to which persons with disabilities are more susceptible by virtue of an underlying condition, including adverse outcomes in health, wellness, participation, and quality of life" (Hough, 1999, p. 186).

“Although some secondary conditions can be prevented or decreased by a combination of health maintenance practices, removal of environmental barriers, and improved access to effective medical care, others are inevitable components of certain types of disabilities and can be managed but not prevented. Some of the more common secondary conditions include depression, hypertension, chronic pain, skin sores, fractures, contractures, urinary tract infections, respiratory infections, unwanted weight gain, excessive fatigue, and social isolation” (Simeonsson & McDevitt, 1999 book).

-M. Nosek, BCM CROWD

H1N1 Disability Connection – Secondary Conditions


A (H1N1) and Disability – Venn Diagram

A (H1N1)

At-Risk

Groups

Disability and DisabiltyHealth

A (H1N1)

At-Risk

Disability Overlap


http://www.flu.gov/

A (H1N1) – Personal Preparedness


Surveillance/ Monitoring for Illness Vaccination Promotion of non-vaccination community

hygiene Promotion of other non-vaccination community

measures like social distancing depending on the Pandemic Severity Index (PSI)

Collaborative Response

A (H1N1) – Community Preparedness and Response


http://www.nod.org/index.cfm?fuseaction=Page.viewPage&pageId=1564

Emergency Preparedness Initiative (NOD)


http://www.ncd.gov/newsroom/publications/2005/saving_lives.htm

Saving Lives (NCD)


Effective Emergency Management: Making Improvements for Communities and

Individuals with Disabilities

http://www.ncd.gov/whatsnew.htm

NCD 2009 - Collaborative Emergency Preparedness Report – a Menu

Dynamic Community Partnerships

with Disability Stakeholders –

One Way Forward


Approach: Practical, Familiar, and Friendly

First Task – Collaborative Collaborative Team Training Build a Strategy of Working Relationships Together Train Together Exercise Together Communicate to the Disability Community How to

Prepare Together Communicate & Celebrate Success!


Scale (Local, county, state, territory, tribal nation, nation)

Geography Community Mosaic Socioeconomics How you work together – the Bottom Line

Every Community is Individual


Come together as a collaborative (emergency management – public health – VOADs – disability stakeholders – other stakeholders)

Identify community issues Identify all hazards issues Look at “the menu” of approaches Set collaborative goals

First Task – Collaborative Goal-setting


What’s after Novel A (H1N1) -

What would your collaborative like to tackle next?

Humanitarian Response in Complex Geographic Settings(HRCGS), (Elestwani, 2008)

All Hazards Threat Cascades

Tactical Response Filter

Population Filter-Dynamic Location-Demographics-Dynamic Wellness and Health Status-Logistics/Network

Collaborative Command

& Control –

NRF/NIMS

Complexity/ Human Factors Filter(Deconstruction of Murphy’s Law)

Includes: Emergence – Competition & Cooperation – Pattern Formation including Self-organizing Behavior, Scale of Complexity – Interdependence – Scale of Behavior by individual/group/agency, Complexity Description, Evolution (change over time, i.e., hierarchical, horizontal, strike team, self& immediate group)

Collaborative, Integrated Incident Response

=Temporary partial to complete support of Med CI

with components 1-8

* Pre-existing Unified Command

Medical CI

Expanding Incidents):

Geo/ Time/ Threat/

Response


Local approaches for local issues Understand the big picture and help shape the approach

– We are all planners! Practical, Familiar, Friendly Leverage your strengths, work to mitigate and build

broad team support for areas of challenge Partnership demands persistence, time, and a team

approach Partnership is a growth process, but with the

understanding that this is a long-term commitment, it is a nurturing and honest friendship also.

Take Homes


If we are together, nothing is impossible.

-Winston Churchill


Thank you!

Maggie Kare-Elestwani, RN

[email protected]

(832) 744-1558

Principal Analyst

Resilient Services Group (RSG)

Agoric Source, LLC

[email protected]

Texas Collaborative for People with Disabilities

ILRU Memorial Hermann TIRR ● Houston CIL ●

BCM CROWD ● Resilient Services Group

Lex FriedenProfessor of Health Informatics, Professor of Rehabilitation, University of Texas at Houstonwww.shis.uth.tmc.eduSenior Vice President, TIRRDirector, ILRU www.ilru.orgProfessor of Rehabilitation, Professor of Community Medicine, Baylor College of Medicine www.bcm.edu (713) 520-0232 x124(713) 520-5785 Faxmailto:[email protected]://www.lexfrieden.com

Dynamic Community Partnerships with Disability Stakeholders – Practical Approaches to Engagement with Emergency Management, Public Health, and VOADs EnableUS.

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