6

Broadening Stakeholders Invested in Children

Highlights of Points Made by Individual Speakers

  • Availability of child care is a critical component of recovery; it allows parents to attend to their business, such as applying for aid and other recovery activities.
  • The spiritual and religious needs of faith communities are generally lacking in mass care and mass fatality planning, which can have detrimental effects on children. Including spiritual and religious groups in planning can also build a better communication network to families.
  • Greater religious literacy and competency is needed in emergency management and public health; specific consideration should be placed on the needs of children in disasters and the effects of emotional and spiritual trauma.
  • Youth who are trained in preparedness become more resilient and are highly effective messengers, engaging their peers, parents, and other adults.

Typically, in planning stages, public health and emergency planners will include partners within their sectors or other leaders of government who are involved or directly related to formulating a successful response. However, with certain sections of the population, children especially, including nontraditional community partners can allow for better and more comprehensive planning and response. In this chapter, some examples of nontraditional partners are explored, from child care providers to those who serve special populations of children such as individuals with disabilities, faith communities, and engaged youth. A theme mentioned in earlier chapters—bringing together a diverse set of stake-



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6 Broadening Stakeholders Invested in Children Highlights of Points Made by Individual Speakers  Availability of child care is a critical component of recovery; it allows parents to attend to their business, such as applying for aid and other recovery activities.  The spiritual and religious needs of faith communities are generally lacking in mass care and mass fatality planning, which can have detrimental effects on children. Including spiritual and religious groups in planning can also build a better communication network to families.  Greater religious literacy and competency is needed in emergency management and public health; specific consideration should be placed on the needs of children in disasters and the effects of emotional and spiritual trauma.  Youth who are trained in preparedness become more resilient and are highly effective messengers, engaging their peers, parents, and other adults. Typically, in planning stages, public health and emergency planners will include partners within their sectors or other leaders of government who are involved or directly related to formulating a successful response. However, with certain sections of the population, children especially, including nontraditional community partners can allow for better and more comprehensive planning and response. In this chapter, some ex- amples of nontraditional partners are explored, from child care providers to those who serve special populations of children such as individuals with disabilities, faith communities, and engaged youth. A theme mentioned in earlier chapters—bringing together a diverse set of stake- 59

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60 CONSIDERATIONS FOR CHILDREN AND FAMILIES holders when adding children and family needs to emergency plans—can assist in making the outcomes more realistic and the tactics more viable. PREPAREDNESS ISSUES FOR CHILD CARE Linda Smith, Deputy Assistant Secretary and Inter-Departmental Liaison for Early Childhood Development at the Administration for Children and Families (ACF), provided an overview of child care in the United States and highlighted some of the preparedness issues for child care at the federal, local, and provider levels. Painting a picture of child care providers across the country, Smith explained that there are about 2.1 million child care workers in the United States, with an annual turnover rate of about 30 percent. Average salary for a child care worker is $21,000 per year, which Smith pointed out is poverty level for a family of three. Child care workers are 98 percent female, many have only a high school education or less, and half are eligible for public assistance. Roughly 12 million children in the United States aged 5 years old and younger are in child care. One million children are in centers, about 250,000 are in family home-based child care, and the rest are in some form of in-home or relative care. Child care takes place in neighbor- hoods, strip malls, and churches. It is for-profit and nonprofit. Child care is not a universal system, Smith stressed. Smith described several examples of child care–related activities at the federal level. For example, the Federal Emergency Management Agency (FEMA) released a recovery fact sheet on public assistance for child care services to help the public to understand what FEMA can and cannot do with regard to child care in the aftermath of a disaster.1 FEMA and ACF also sent a joint letter to state governors asking them to include child care in their state emergency plans.2 When child care is not included in the plans, the providers are not eligible for FEMA reimbursement, making recovery even more difficult. At the local level, it is important for first responders to know where child care is taking place in their communities. To help with this, the federal government has funded some projects to map child care in communities, Smith noted. It is also important to back up the local data 1 See http://www.acf.hhs.gov/sites/default/files/occ/fema_public_assistance_for_child_ care_services.pdf (accessed October 28, 2013). 2 The FEMA and ACF letter can be found at http://www.acf.hhs.gov/programs/occ/resource/ acf-and-fema-joint-letter-to-state-governors (accessed October 28, 2013).

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BROADENING STAKEHOLDERS INVESTED IN CHILDREN 61 regarding children in child care. A child care provider may have parents in their database, and a city may have child care providers in a database, but this needs to be backed up and remotely available so that it is accessible when needed. Finally, at the provider level, Smith reiterated, preparedness is “more than a fire drill.” Providers need assistance in developing plans and Smith noted several specific needs, listed below:  A call-in system: Child care providers can contact a central location to report their status during a disaster.  Age-specific materials: These are currently lacking and could be useful for providers when working with young children who have been traumatized.  Up-to-date information from parents (e.g., how to reach them in an emergency, medications the child may need to have if evacuated).  Funding for preparedness activities: Given the limited income of a child care provider, this is especially needed. Although needs and gaps exist, child care remains a critical component of response and recovery. Parents need to clean up, pick up, move or rebuild, stand in lines for assistance, and return to work. At the same time, child care providers are also trying to rebuild their home or business. Providers themselves are part of the impacted community and are also traumatized. Providers are not automatically trained to deal with traumatized children. Facilities may be damaged and closed, and if a facility is closed for 2 or 3 months, it may go out of business. In closing, Smith referred participants to emergency standards for child care developed by Save the Children and the National Association of Child Care Resource and Referral Agencies (now Child Care Aware).3 COMMUNITY ENGAGEMENT Among many other organizations, FEMA has recently embraced and encouraged a “whole community” approach when it comes to emergency planning and response and recovery. Parallel with that concept, a continuous theme throughout the workshop was that the involved 3 Available at http://www.naccrra.org/sites/default/files/publications/naccrra_publications/ 2012/protectingchildreninchildcareemergencies.pdf (accessed September 9, 2013).

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62 CONSIDERATIONS FOR CHILDREN AND FAMILIES stakeholders in planning discussions need to be broadened past that of just pediatricians and child-focused hospital coalitions. Stakeholders should include organizations and representatives across all sectors that work or interact with children, including schools, youth groups, religious organizations, and others. This section brings together nontraditional partners who represent community groups that can be leveraged for better community engagement and buy-in and improved risk com- munication and message dissemination. Planning for the Needs of People with Disabilities Easter Seals is a social service organization focused on providing services and support to people with disabilities. Patricia Wright, national director of autism services at Easter Seals, said that in 2012, the organization provided direct service to 1.6 million people with disabilities in the United States, more than half of whom were children. Wright listed 13 categories of disability: specific learning disabilities, speech or language impairments, intellectual disability, emotional disturbance, hearing impairments, orthopedic impairments, other health impairments, visual impairments, multiple disabilities, deaf- blindness, autism, traumatic brain injury, and developmental delay. Wright noted that the needs of those with physical disabilities or orthopedic impairments are often raised in preparedness planning discussions, but learning, intellectual, emotional, and speech and language disabilities are also prominent in society. People with disabilities have unique needs; for example, children with autism are subject to wandering. Many children with intellectual disabilities also have parents with intellectual disabilities who will need services and support. Wright listed several resources available specifically for people with disabilities. The Rehabilitation Engineering Research Center (RERC) has developed specific tools for use with individuals who have complex communication needs, including, for example, a universal comm- unication access board that uses pictograms and pictures for communication.4 The universal design of such devices makes them useful not only for communication with people who are nonverbal or have low literacy rates, but also with people who speak other languages. 4 RERC resources available at http://aac-rerc.psu.edu/index.php/pages/show/id/4 (ac- cessed September 9, 2013).

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BROADENING STAKEHOLDERS INVESTED IN CHILDREN 63 Another tool is a “go bag” filled with the unique items a person with a disability might need to take with them in an emergency (e.g., a communication board, medicines and supplies, food, clothing). Relaxation techniques are also useful for people with disabilities. The Oregon Health Science University (OHSU) and the Green Mountain Emergency Preparedness Project at the University of Vermont also have emergency preparedness toolkits for people with disabilities.5 Wright urged state and local planners to include people with disabilities or their representatives in planning groups. Organizations with disability expertise to share include, for example, the University Centers for Excellence in Developmental Disabilities, Family Voices, Community Council on Developmental Disabilities, and Centers for Independent Living. Engaging Faith Communities The American religious landscape is a mosaic, as diverse as the population, said Peter Gudaitis, chief response officer for New York Disaster Interfaith Services and president of the National Disaster Interfaiths Network. About 90 percent of Americans say they are religious or spiritual, and 43 percent of Americans say that they attend worship services regularly at approximately 345,000 U.S. houses of worship. The United States is the most Christian country in the world. Eighty percent of Americans self-identify as Christian, although the percentage is decreasing due to demographic shifts in the population. Today, for example, there are more Muslims in the United States than there are Episcopalians and Presbyterians. Americans are connecting with their religious institutions as places of learning and communication, and Gudaitis added that activities such as religious education, Bible study, and youth groups probably account for the most significant percentage of institutional relationships outside of schools. Faith communities have historically responded to disasters and human suffering. There is growing interest from government for greater faith community engagement, and a growing interest from and need for faith communities to work with government on disasters. There are 5 The OHSU toolkit is available at http://www.ohsu.edu/xd/research/centers- institutes/institute-on-development-and-disability/public-health-programs/oodh-emergency- preparedness.cfm; University of Vermont toolkit available at http://www. uvm.edu/~cdci/gmep (accessed September 9, 2013).

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64 CONSIDERATIONS FOR CHILDREN AND FAMILIES significant gaps between these two entities, compounded by what Gudaitis described as an “extraordinary lack of religious literacy and competency.” Religious competency, Gudaitis explained, is knowing how to navigate and engage each faith community (and individual adherents) competently and respectfully, as a trusted, knowledgeable, and effective partner. Religious literacy is having a basic understand- ing of the history, sacred texts, beliefs, and rituals (including diet, clothing) of multiple faith traditions, and the ability to understand the intersection of religions and social, political, and cultural life. The spiritual and religious needs of the faith communities are generally lacking in mass care and mass fatality planning, Gudaitis said. If a Muslim family entered a shelter, for example, would the staff know that the men and women may want to shelter separately, what Halal food is, and whether or not Kosher food would be acceptable instead? Even if the sleeping areas of the shelter were separated by gender, it may still be unacceptable for the women and men to have to walk past each other to the bathrooms. Helping to Improve Planning Gudaitis drew from the objectives and recommendations of a project on faith communities and disasters that he has worked on with the Center for Religion and Civic Culture at the University of Southern California (funded by the California Emergency Management Agency). To improve disaster planning for children, he said, we need greater religious literacy and competency in emergency management and public health; competent government outreach to congregations, faith-based organizations, and religious families; and education for religious leaders on the needs of children in disasters and the effects of emotional and spiritual trauma. Disaster planning for children should include faith-based risk communication and public service announcements oriented to the full range of children’s ages and/or their caregivers, Gudaitis continued. Religious leaders need information on how to care effectively for children and their congregation, and how to educate parents and their caregivers to care for children in disasters, particularly in minority, immigrant, or non-English-speaking communities. All disaster mental health planning should include the spiritual needs of children and mass care, and mass fatality plans should provide specific direction for the care and disposition of children from religious families.

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BROADENING STAKEHOLDERS INVESTED IN CHILDREN 65 Gudaitis referred participants to a series of tip sheets developed by the National Disaster Interfaith Network for religious leaders to help them address needs of religious children and families.6 The back page of each “Be a Ready Congregation” tip sheet also includes information on training resources or education resources. Examples shown were tip sheets addressing children in a disaster and an active shooter in a house of worship. There are also a series of tip sheets for faith community partners which are competency guidelines on issues such as sheltering and mass care of different faith communities with unique dress, diet, or sheltering requirements (e.g., Buddhist, Hindu, Jewish, Muslim, Sikh). Information on how to support children of those faith traditions is included as well. In closing, Gudaitis recommended a text by Stephen Prothero, Religious Literacy, to those interested in learning more about religious literacy and competency. Engaging Youth Ashley Houston, a high school student and member of FEMA’s Youth Preparedness Council, shared her personal experience and perspective on engaging youth in preparedness. Houston became involved in the youth council through a school club called Health Occupations Students of America. Children can play an important role during emergencies and should be a part of all disaster planning, preparedness, response, and recovery efforts, she said. Communities and towns should target teens through schools and community programs because youth who are trained in preparedness become more resilient in actual disasters. Youth are also highly effective messengers who can be used to reach their parents as well as other adults. In addition, engaging youth today will ensure future generations of prepared adults. The FEMA Youth Preparedness Council gives teenagers an opportunity to voice their opinions, share their experiences, and offer ideas and solutions to help strengthen the nation’s resiliency for all types of disasters. The council is comprised of 13 diverse leaders from across the country, ranging in age from 13 to 17, who have demonstrated a willingness to represent the youth perspective on emergency prepared- ness and to take information back to their communities. Members of the Youth Preparedness Council work on yearlong projects, help to set up 6 More information on the tip sheets for congregations and community partners is avail- able at http://www.n-din.org (accessed September 9, 2013).

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66 CONSIDERATIONS FOR CHILDREN AND FAMILIES regional youth councils, serve as ambassadors of youth preparedness, and provide feedback. Houston described some of her activities, including coordinating and participating in teen Community Emergency Response Team (CERT) demonstrations at local events in her community, and completing the necessary training to become a CERT instructor as well as organizing a course for teens at her school. Because youth play such an important role in outreach to other audiences, Houston recommended reaching out to them through their school programs. School drills, for example, help prepare children for real emergencies, and they share this information at home with their parents. Most schools also have student resource officers who are law- related counselors and educators in the school who can share information. School clubs are a big part of student’s lives and are also a good way to reach students. Houston also offered suggestion on ways to connect with youth outside of schools through youth organizations (e.g., Boy Scouts of America, Girl Scouts of America), church groups, and emergency response programs (e.g., CERT and Teen CERT). Finally, Houston said that Twitter and social media are tools that can be used to connect with and involve youth in preparedness. She added that members of the Youth Preparedness Council have been teaching their advisors how youth use social media tools and how social media can better be used for outreach. Engaging different parts of the community for their input on planning and assistance in outreach can be a great tool for jurisdictions as they try to promote more awareness and identify gaps in the response and recovery frameworks.