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Things that are going on that you might want to know. 

 

61

 

September 24, 2005
Evaluating a What-If Case: New York City's Evacuation
Since Hurricane Katrina, New York City officials have assured residents that the city is prepared to handle the kind of evacuation that a major hurricane would require. The city has plans to move people from areas that are likely to flood, plans to open shelters and reception centers, and plans to use public transportation to carry them there.

Most experts say the city's plans, if imperfect, are better thought out than those in other cities. They also say the city's mass transit network makes the plans for evacuating in advance of flooding or in the aftermath of isolated biological attacks more realistic than would be the case elsewhere.

These experts say there is no question that city officials have spent considerable time and money envisioning situations and developing strategies for dealing with them. But Katrina and the scenes that unfolded as Hurricane Rita howled toward Texas raised a question: Would it be possible to carry out a complete evacuation of New York City?

City officials do not pretend that it would be easy, or even doable. They say that very few situations would trigger such a necessity. Those situations are not hurricanes, but things like a nuclear event.

But even the "area evacuations" they envision for hurricanes-evacuations of zones they have already designated as likely to be flooded-could involve huge traffic jams. Given how many bridges and tunnels the city has, the jams in Houston could seem mild. And they say that moving hospital or nursing home patients completely out of the city would be an epic challenge.

Thus, after watching the disastrous, and in at least one instance deadly, backups in Houston, they have already tried to adjust their thinking about how to assist drivers who run out of gas. Yesterday, one official said, they worked out a plan to assign police escorts to gasoline trucks.

Officials are acutely aware that talking about an all-out evacuation is talking about something unprecedented in scope.

"If New York City had to be evacuated, that would become a national event," said Joseph F. Bruno, the city's emergency management commissioner. "The event would have to be so major, we'd call on federal assets almost immediately."

Officials like Mr. Bruno and experts who have studied emergency preparedness say New York is unique among cities for the potential usefulness of its transportation system. Its subways, buses and commuter trains carry eight million commuters a day as is, and people could get to neighboring states more easily by New Jersey Transit and PATH trains than by driving.

But Assemblyman Richard L. Brodsky and others have raised questions about the city's evacuation planning. Mr. Brodsky, a Westchester Democrat, takes issue with the city's estimates of how many evacuees it could handle in a hurricane.

He said that the city was prepared to handle a million evacuees and to provide shelter for 224,000 after a Category 4 hurricane. But he said that a 1993 Army Corps of Engineers study found that a less powerful Category 3 storm would create 2.5 million evacuees and the need to shelter as many as a million.

Mr. Bruno, who did not comment on Mr. Brodsky's characterization of the city's plans, said yesterday that, based on Houston's experience with Rita, he believes that both estimates are low. "We think more people will go" in an evacuation, he said.

"We do think that the earlier assumptions, a blasé New York approach, won't be there in light of Katrina and Rita," Mr. Bruno said. "People are going to act a little more frightened or be a little quicker to get out rather than say, 'I'm going to tough this out.' We saw too many images of that from New Orleans. The difference is New Orleans is below sea level and most of New York is not. We saw in Mississippi, which is not, that the land dried out quickly and people could get back. We'll be able to get people back."

Other experts question whether hurricane evacuations could be as limited in scope as the city envisions.

"We can't rest on a limited scenario, which is the sort of hurricane plan we have, where you just evacuate parts of the city from one portion of the city to other portions of the city," said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at the Mailman School of Public Health at Columbia University.

He also questioned how hospitals would evacuate patients. "To my knowledge, there are no plans that I would be comfortable with for evacuating major medical centers and nursing homes from the city," he said. "No hospital with 500 patients, including people on ventilators, people in intensive care, can get all those people out of the city on its own, without major help from outside."

Mr. Bruno said that the city's plan called for firefighters to go to hospitals and see what was needed. "We have them all mapped," he said. "If we see the possibility of an evacuation having to occur, the Fire Department will go out and communicate with each of them and say, 'What are your plans, how are you going to do it?"'

Mr. Brodsky based his study on parts of the city's plan. He said he had repeatedly asked for a complete copy of the plan but that the city had refused to release all of it at once, saying it was always "in flux."

Officials have said that a Category 3 hurricane could bring a 25-foot storm surge in the financial district, southern Brooklyn and eastern Staten Island and at Kennedy Airport. The city's plan calls for opening 23 "reception centers" and hundreds of shelters, mainly in schools. Evacuees would go to a reception center and be assigned to a shelter.

But city officials acknowledge that elements of an evacuation would have to be improvised.

The city's emergency operations center has room for representatives of more than 90 federal, state and city agencies. City officials say they have invited officials from surrounding counties and New Jersey.

In fact, Police Commissioner Raymond W. Kelly says that the city has two general evacuation plans, one for hurricanes and another to be put into effect in the event of a terrorist attack or other catastrophe.

The Police Department's role is a component of the overall plans, which have been prepared by Mr. Bruno's agency, the Office of Emergency Management.

Commissioner Kelly, in an interview yesterday, said that the hurricane plan had different contingencies for different hurricane levels. Under the hurricane plan, he said, the emergency management agency coordinates the response and the Police Department has its "core competencies": assisting in the evacuation, overseeing security in evacuated areas, and attending to traffic control and search and rescue operations.

The hurricane plan divides the city into three zones. Under the plan for an attack or other catastrophic event, the city would be divided into 151 sectors, each roughly equivalent in population and with some variation based on terrain and other particularities of individual neighborhoods.

In coordination with other agencies, the city would use trains, boats and city buses to move people out of the city along preset routes.

Mr. Kelly acknowledged that traffic, which sometimes seems to calcify during a normal commuter rush, would present a significant challenge.

But he declined to characterize the plan as unthinkable, saying he believed the size of the problem the Police Department could field would prevent the kind of paralysis that seemed to strike Houston.

Hanging over all this is the issue of how and when to inform the public, for no plan can succeed if residents are unaware of it. The city says it is prepared to spread the word , and that its efforts to do so include having Mr. Bruno appear on a Russian-language radio program (with a translator) to reach listeners in Brighton Beach, Brooklyn..

But others, Mr. Brodsky included, say that most residents have no idea of where to go or what to do in an evacuation, which is exactly what crippled New Orleans.

Al Baker, Richard Pérez-Peña and William K. Rashbaum contributed reporting for this article.

 

 

 

62

 

Medicare Q&A Weekly Column
September 22, 2005

Q: This summer I received a letter from Social Security that says I might qualify for extra help to pay for the annual premiums, deductible, and co-payments related to the new Medicare prescription drug plan. What does this mean? —T

Dear T

The Social Security Administration is mailing letters to people on Medicare who may qualify for additional financial help when the Medicare drug benefit starts in January. This extra help — targeted to people on Medicare with limited incomes and modest resources — could provide significant savings to those who sign up for a new Medicare prescription drug plan.

Beginning in 2006, all people on Medicare will be able to receive coverage under new prescription drug plans, but most will have to pay a new monthly premium, a deductible, and a copayment for each prescription.

If you expect to sign up for a Medicare drug plan for 2006 and your annual income is less than about $14,400 (or $19,250 per couple) and you have less than $11,500 in assets ($23,000 per couple), not including your home or car, you can qualify for extra help. You may not have to pay the full premium or deductible and you will only pay a couple of dollars for each covered prescription. You can apply for this additional assistance through Social Security or through your state Medicaid (Medical Assistance) program.

One last reminder: Don’t forget to enroll in a Medicare prescription drug plan — in addition to applying for extra help provided to those with modest means. It would be a good idea to compare Medicare drug plans in your area and consider which plan is best for you. You can find out about the drug plans in your area starting in mid-October by visiting www.Medicare.gov or calling 1-800-MEDICARE. Deciding how to choose the right plan will be a topic in future columns.

 

 

63

 

Transportation Bill Enhances Travel Opportunities for People Who Are Visually Disabled

 

SAN FRANCISCO, /PRNewswire/ -- By signing the Transportation Equity Act - A Legacy for Users, (TEA-LU), the President authorized the funding of a major project evaluating remote infrared audible signage (RIAS). This project is another important step in the efforts to make the built environment accessible to people with disabilities originally launched by the signing of the Americans with Disabilities Act in 1990.

The technology operates by the installation of infrared light transmitters that broadcast repeating, human voice messages, providing directional, wayfinding information that can be heard by visually, cognitively, or learning disabled users through small, hand-held receivers. RIAS systems have proven effective for navigation in transit stations, bus shelters (providing the user the destination and time of arrival of the next bus), and at street crossings. They enable a user to tell what bus is coming when it is up to one hundred feet away and to locate its entrance. In addition to transit applications, the system has been installed in libraries, city halls, convention centers, museums, and parks; primarily in the U.S. and Japan.

 

The project, entitled the Remote Infrared Audible Signage Model Accessibility Project (RIAS MAP) authorized in the new act, will provide funding for a regional, multi-modal/intra-modal evaluation of the technology. The impact of RIAS on education, work, personal economics and quality of life will be studied. Its use for emergency egress will also be evaluated. The Transportation Equity Act - A Legacy for Users (TEA-LU), authorizes the Secretary of Transportation to spend a minimum of $500,000 annually on the RIAS program from 2006-2009.

 

Congressman Richard Baker, 6 District, Louisiana along with Representatives Eleanor Holmes-Norton of Washington, D.C. and Stephen LaTourette, District 14, Cleveland, Ohio, championed the inclusion of the RIAS MAP.

 

Invented in 1981 at the Smith-Kettlewell Rehabilitation Engineering Research Center in San Francisco, the technology was researched, developed and evaluated through the next two decades.

 

Today, Henry Metz, Director of the Smith-Kettlewell Eye Research Institute said:

 

"RIAS has already demonstrated a new freedom to individuals whose independence has been limited by lack of access to signs on buses and in other public transit environments. The technology is as useful to people with visual disabilities as curb cuts and ramps are to people who use wheel chairs. This new Congressional action to create RIAS MAP will provide portal-to- portal, seamless orientation access to wayfinding signage and hopefully will add significantly to its present national and international deployment."

 

RIAS is currently being installed in the US and Canada by Talking Signs, Inc. of Baton Rouge, LA and in Japan and Norway by Mitsubishi Precision Co., Ltd. of Tokyo.

 

Contact: Bill Crandall, Ph.D., Smith-Kettlewell Eye Research Institute - 415-608-4242

 

 

 

 

64

 

MEDICARE TO COVER ADULT DAY CARE

 

            Under a three-year Medicare demonstration project scheduled to start next year, Medicare will cover adult day care services for 15,000 people who would otherwise require a nurse home visit.

            Medicare wants to see if treating more patients at fewer locations is more efficient.

            Todd Lyles, head of administration for a home health agency, made the analogy that: “The [visiting nurse] model is very similar to the physical model that disappeared years ago. Doctors used to make a lot of house calls. But doctors don’t make house calls today because it’s not an efficient use of their time.” Lyles pointed out that visiting nurses only see up to five or six patients a day, leaving room for improvements in efficiency.

            However, Visiting Nurse Associations of America are skeptical. Bob Wardwell, vice president of regulatory and public affairs, suggests that seeing more patients at one place may not save money and that it may increase the home health companies’ liability.

            There are currently some 3,400 adult day-care facilities in the United States, and more than 60 percent provide some health care services, according to a Wake Forest University study.

           

 

 

 

65

 

 

 ADAPT to President, Congress:

Don't Target Poor People with Disabilities with Cuts, Caps

Washington, D.C. --- Reeling from massive planned cuts to the
nation's Medicaid program, ADAPT is going to the nation's
capitol September 17-22 to tell Congress and the President,
"Don't target poor people with disabilities!" If enacted, the
already planned cuts and proposed legislation will force even
more older and disabled Americans out of their own homes and
into nursing homes.

"I feel like I've got a target painted on my back, said Randy
Alexander, ADAPT Organizer in Tennessee, and one of the leaders
of the 3 month old Citizens to Save TennCare protest at the
Tennessee state capitol.

"We are getting hit by draconian cuts in our own state, and by
frightening cuts and legislation planned by the federal
government. And all this is happening at a time when our
brothers and sisters with and without disabilities in Louisiana
and Mississippi and Alabama who survived hurricane Katrina need
a solid, comprehensive Medicaid program more than ever."

When George W. Bush assumed the Presidency in 2001, one of his
first acts was to issue his New Freedom Initiative, focused on
removing the barriers that keep people with disabilities and
older Americans from full participation in their communities,
and from fully accessing all government services and programs.
Despite this presidential directive, Congress has yet to pass
legislation, including Money Follows the Person (S 528; HR 3063)
and MiCASSA (S 401; HR 901), that would remove the Medicaid
institutional bias and give people choice to receive long term
services in the community.

"People with disabilities need long term services and supports,
as will many of the survivors of Hurricane Katrina who have lost
their homes, and life as they knew it. Now is not the time for
Congress to pit the needs of the survivors against the ongoing
needs of poor people with disabilities,said Bob Liston, ADAPT
Organizer from Montana who has over 20 family members displaced
by Hurricane Katrina. "Congress shouldn't be trying to put
bandaids on our dysfunctional support system, but should be
enacting legislation like Money Follows the Person to provide
needed reform that will improve our community support
infrastructure for everyone."

Currently, nursing homes in a number of states don't provide
care for people who use ventilators. If individual states don't
provide community-based care for those ventilator users, they
are shipped off to nursing homes in other states. Such is the
case for over 15 ventilator users from West Virginia who have
been sent away from their families and communities to nursing
homes in Ohio.  Tennessee is similarly poised to send ventilator
users to nursing homes in other states as Gov. Bredesen has cut
from the budget the services that kept them living in their own
homes. Legislation like Money Follows the Person and MiCASSA
would remedy this situation by allowing people to stay in or
return to their own homes

Another mounting national crisis is the profound lack of
affordable, accessible housing across the country. Such housing
is critical for people wanting to move out of, or avoid, nursing
homes and other institutions. In the wake of Hurricane Katrina
there is an exponentially increased demand for affordable
housing to accommodate survivors with and without disabilities
who are now homeless.

"There aren't enough resources to meet the current demand," said
Beto Berrera, ADAPT organizer and housing specialist from
Chicago. "And with the drastically increased need caused by
Katrina, people with disabilities will likely be pushed off the
housing waiting lists by survivors of the hurricane. This should
not be a Sophie's choice. In a country that can send people to
the moon, there should be enough for everyone."

For More Information:
Bob Kafka 512-431-4085
Marsha Katz 406-544-9504


 

 

 

 

 

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Last updated on 07/19/2008