Chapter 2: Legislative Framework
Used in this Chapter:
Older Americans Act of 1965 (OAA)
As one of the most devastating events to impact the United States in recent times, Hurricane Katrina played a pivotal role in legislatively enforcing the inclusion of special needs populations in all aspects of emergency management, including mitigation, planning, response, and recovery efforts. During the immediate aftermath of Hurricanes Katrina and Rita in 2005, media coverage of people with disabilities and medical conditions stranded on bridges, nursing homes, and rooftops with little hope of rescue left a horrific and indelible mark on the psyche of Americans and those around the world. Statistics documented in Impacts and Contributions of Older Persons in Emergency Situations: A Case Study of Hurricane Katrina in the United States of America  and the US General Accounting Office’s (GAO’s) Disaster Preparedness: Preliminary Observations on the Evacuation of Vulnerable Populations Due to Hurricanes and Other Events  cited that:
- There were approximately 1,464 reported deaths. Of the 910 recovered by the Disaster Mortuary Operational Response Team (DMORT), 64 percent were 65 years of age and older.
- In New Orleans alone, 15 percent of the population was over the age of 60; 74 percent of known victims were in this same age group. During Hurricane Katrina, the National Disaster Medical System (NDMS) assisted in evacuating 2,900 patients from mobilization centers to patient reception areas. It was the first time the NDMS patient evacuation component was activated.
- There are higher numbers of elderly who are transportation disadvantaged because of the overlap between age, disability, low income, and less likelihood of driving.
The 2006 NCD report noted that some people with psychiatric disabilities “had difficulty comprehending the evacuation messages and other essential communications and some were treated roughly because they could not follow the instructions”.
The National Council on Disability (NCD) released a report in 2006 outlining how the government failed to assist people with psychiatric disabilities during Hurricanes Katrina and Rita, and identifying major violations of the law on several accounts including discrimination during evacuations. The findings indicate that the mismanagement of evacuating people with psychiatric disabilities resulted in losing residents, mistreatment, and inappropriate institutionalization. According to the report:
Disaster response plans often did not include protocols to evacuate people with psychiatric disabilities. During evacuations, emergency officials physically lost residents of group homes and psychiatric facilities many of who are still missing. Others have not or cannot return home because essential supports have not been restored or because the cost of living has increased too much. When people with psychiatric disabilities arrived at evacuation locations—ranging from state parks to churches—those locations often were not prepared to meet the medical and mental health needs of the evacuees with psychiatric disabilities. Many people with psychiatric disabilities never made it to evacuation shelters because they were inappropriately and involuntarily institutionalized. Some of these people still have not been discharged, despite evaluations that indicate they should be. 
The catastrophic events of September 11, 2001, and Hurricanes Katrina and Rita in 2005 have led to the integration of special needs issues into emergency management planning at the national level. This section highlights key legislation and federal initiatives associated with special needs populations and emergency management; however, it is not a comprehensive list. There is still debate among key planners at the national level about different components of the planning (for example, the very definition of “special needs populations” is widely contested). Therefore, as local planners use national guidance and become familiar with the latest opinions and views on these issues, solutions will be developed to meet local capabilities.
Disaster Preparedness in Federal Legislation, Regulations, Policy
All levels of government share responsibility for preparing for and responding to disasters, depending on the size and scope of the disaster. The local government level maintains the primary responsibility and authority for disaster preparedness and response, including evacuations. Good practices dictate that local governments work with individuals and families to prepare for disasters and potential evacuations. Local political authorities retain the responsibility for issuing evacuation orders and executing evacuations. When local governments are unable to effectively respond to a disaster, they may request assistance from other local governments and their state, territory, or tribal nation. Likewise, when a state is unable to meet the needs of the local governments requesting assistance, the state may request mutual aid from other states and the federal government. The following sections focus on the aspects of existing laws related to special needs populations. Table 2-1 provides a brief overview of some existing legislation, and Annex 2 provides additional details.
|Title of Legislation||Type of Mandate||Description||How Relates to Special Needs|
|Robert T. Stafford Disaster Relief & Emergency Assistance Act (P.L. 93-288)||Law||Established the Presidential Disaster Declaration system, which triggers federal financial and resource assistance to eligible states and local authorities through FEMA.||Special needs fully integrated into emergency management.|
|Americans with Disabilities Act (ADA) of 1990||Law||Mandates that all public and private sector facilities come into and remain in compliance, provide reasonable accommodations, and be accessible. Access must be both physical (e.g., architectural barriers) and programmatic.||Public facilities should consider the needs of people with disabilities in emergency evacuation planning.|
|Older Americans Act of 1965 (OAA)||Law||An anti-discrimination law that classifies older Americans as a legally protected class.||Can be used to authorize funds to assist older Americans in the recovery process primarily because OAA provides grants to states for community planning and services.|
|2004 Executive Order (13347) and Creation of the Interagency Coordinating Council on Emergency Preparedness and Individuals with Disabilities||Exec Order||Established to ensure that the federal government appropriately supports safety and security for individuals with disabilities in disaster situations.||Consider the unique needs of employees and individuals with disabilities served by state, local, and tribal governments, and private organizations and individuals in emergency preparedness planning.|
|Health Insurance Portability and Accountability Act (HIPAA)||Law||Requires uniform federal privacy protections for individually identifiable health information.||Medical information of people with special needs must be protected.|
|Pet Evacuation Transportation Standards Act of 2006 (PETS Act)||Law||All cities and states must have a pet plan in place to receive FEMA funding.||All emergency evacuation plans must include policies and procedures for evacuating both service animals and household pets.|
|HHS, Pandemic and All-Hazards Preparedness Act||Law||Focuses on public health and medical bioterrorism preparedness as well as all hazard medical surge capacity.||The needs of “at-risk” individuals should be taken into account in managing preparedness initiatives such as the Strategic National Stockpile (SNS) and grants to states.|
 Tokesky & Weston (2006)
 NCD, “The Needs of People with Psychiatric Disabilities During and After Hurricanes Katrina and Rita: Position Paper and Recommendations” (2006)